Attention bias modification treatment augmenting effects on cognitive behavioral therapy in children with anxiety: randomized controlled trial
Open accessAbstract
Objective Attention bias modification treatment (ABMT) is a promising novel treatment for anxiety disorders, but clinical trials have focused largely on stand-alone formats among adults. This randomized controlled trial examined the augmenting effects of threat-based ABMT on cognitive behavioral therapy (CBT) in clinically anxious youth.Method Sixty-three treatment-seeking children with anxiety disorder were randomly assigned to 1 of the following 3 treatment groups: ABMT + CBT; ABMT placebo + CBT; and CBT-alone. Participants in the 2 ABMT conditions received repeated training on dot-probe tasks either designed to shift attention away from threats (active) or designed to induce no changes in attention patterns (placebo). Primary outcome measures were frequency and severity of anxiety symptoms as determined by a clinician using a semi-structured interview. Self- and parent-rated anxiety measures and threat-related attention bias scores were also measured before and after treatment.Results Both the active and placebo ABMT groups showed greater reductions in clinician-rated anxiety symptoms than the CBT-alone group. Furthermore, only the active ABMT group showed significant reduction in self- or parent-rated anxiety symptoms. Finally, all groups showed a shift in attention patterns across the study, starting with a bias toward threat at baseline and shifting attention away from threat after treatment.Conclusions Active and placebo ABMT might augment the clinical response to CBT for anxiety. This effect could arise from benefits associated with performing computer-based paradigms such as the dot-probe task. Given the absence of group differences in attention-bias changes during treatment, possible mechanisms and methodological issues underlying the observed findings are discussed. Clinical trial registration information-Augmenting Effects of ABMT on CBT in Anxious Children: A Randomized Clinical Trial; http://clinicaltrials.gov/; NCT01730625.
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There are promising indications that ABMT may be a useful add-on to CBT.
“there are promising indications that ABMT may be a useful add-on to CBT. [23,35]”
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“Whereas both ABM and placebo groups showed significantly greater reductions in clinical ratings relative to the CBT-only group, only the active ABM group had significant reductions in parent- and self-rated anxiety measures [35].”
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- Authors
- Shechner, T., Rimon-Chakir, A., Britton, J. C., Lotan, D., Apter, A., Bliese, P. D., Pine, D. S., & Bar-Haim, Y.
- Affiliations
- University of Haifa (IL)
- University of Miami (US)
- Schneider Children's Medical Center (IL)
- Walter Reed Army Institute of Research (US)
- National Institute of Mental Health (US)
- Corresponding author
- Shechner, Tomer
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2014-01
- Volume
- 53
- Issue
- 1
- Pages
- 61-71
- ISSN
- 0890-8567 (ISSN-L)
- PMC
- PMC4629236
- OpenAlex
- W2169102626
- Cited by
- 118
- References
- 28
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 3 · 2023: 4 · 2022: 5 · 2021: 9 · 2020: 8 · 2019: 12 · 2018: 12 · 2017: 17 · 2016: 18 · 2015: 16 · 2014: 9
- FWCI
- 19.37
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (Z99 MH999999)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- attentional bias modification, cognitive behavioral therapy, childhood anxiety, anxiety disorders, dot-probe task, augmentation therapy, computer-based intervention, placebo effect, anxiety symptoms
- MeSH terms
- Adolescent, Anxiety Disorders, Attention, Behavior Therapy, Child, Female, Humans, Male, Cognitive Behavioral Therapy, Treatment Outcome
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