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Randomized Controlled Trial
. 2023 Jan;54(1):77-90.
doi: 10.1016/j.beth.2022.07.004. Epub 2022 Jul 16.

Attention Training as a Low-Intensity Treatment for Concerning Anxiety in Clinic-Referred Youth

Jeremy W Pettit  1 , Yasmin Rey  2 , Carla E Marin  3 , Michele Bechor  2 , Eli R Lebowitz  3 , Michael W Vasey  4 , James Jaccard  5 , Rany Abend  6 , Daniel S Pine  6 , Yair Bar-Haim  7 , Wendy K Silverman  3
Affiliations
Randomized Controlled Trial

Attention Training as a Low-Intensity Treatment for Concerning Anxiety in Clinic-Referred Youth

Jeremy W Pettit et al. Behav Ther. 2023 Jan.

Abstract

Although youth anxiety treatment research has focused largely on severe and impairing anxiety levels, even milder anxiety levels, including levels that do not meet full criteria for a diagnosis, can be impairing and cause for concern. There is a need to develop and test viable treatments for these concerning anxiety levels to improve functioning and reduce distress. We present findings from a randomized controlled efficacy trial of attention bias modification treatment (ABMT) and attention control training (ACT) for youths with concerning anxiety levels. Fifty-three clinic-referred youths (29 boys, M age = 9.3 years, SD age = 2.6) were randomized to either ABMT or ACT. ABMT and ACT consisted of attention-training trials in a dot-probe task presenting angry and neutral faces; probes appeared in the location of neutral faces in 100% of ABMT trials and 50% of ACT trials. Independent evaluators provided youth anxiety severity ratings; youths and parents provided youth anxiety severity and global impairment ratings; and youths completed measures of attention bias to threat and attention control at pretreatment, posttreatment, and 2-month follow-up. In both arms, anxiety severity and global impairment were significantly reduced at posttreatment and follow-up. At follow-up, anxiety severity and global impairment were significantly lower in ACT compared with ABMT. Attention control, but not attention bias to threat, was significantly improved at follow-up in both arms. Changes in attention control and attention focusing were significantly associated with changes in anxiety severity. Findings support the viability of attention training as a low-intensity treatment for youths with concerning anxiety levels, including levels that do not meet full criteria for a diagnosis. Superior anxiety reduction effects in ACT highlight the critical need for mechanistic research on attention training in this population.

Keywords: adolescents; anxiety; attention bias modification; children; treatment.

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CONSORT Diagram
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References

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