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Cited by 220Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesChild and Adolescent Psychosocial and Emotional DevelopmentPsychotherapy Techniques and Applications

Attention bias modification treatment for pediatric anxiety disorders: A randomized controlled trial

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Eldar, Sharon, Apter, Alan, Lotan, Daniel, Edgar, Koraly Perez, Naim, Reut, Fox, Nathan A., Pine, Daniel S., Bar-Haim, Yair·2012·American Journal of Psychiatry
DOI 10.1176/appi.ajp.2011.11060886PMC PMC3491316
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Abstract

OBJECTIVE: While attention bias modification (ABM) is a promising novel treatment for anxiety disorders, clinical trial data remain restricted to adults. The authors examined whether ABM induces greater reductions in pediatric anxiety symptoms and symptom severity than multiple control training interventions. METHOD: From a target sample of 186 treatment-seeking children at a hospital-based child anxiety clinic, 40 patients with an ongoing anxiety disorder who met all inclusion criteria were enrolled in the study. Children were randomly assigned to one of three conditions: ABM designed to shift attention away from threat; placebo attention training using stimuli identical to those in the ABM condition; and placebo attention training using only neutral stimuli. All participants completed four weekly 480-trial sessions (1,920 total trials). Before and after the attention training sessions, children's clinical status was determined via semistructured interviews and questionnaires. Reduction in the number of anxiety symptoms and their severity was compared across the three groups. RESULTS: Change in the number of anxiety symptoms and their severity differed across the three conditions. This reflected significant reductions in the number of anxiety symptoms and symptom severity in the ABM condition but not in the placebo attention training or placebo-neutral condition. CONCLUSIONS: ABM, compared with two control conditions, reduces pediatric anxiety symptoms and severity. Further study of efficacy and underlying mechanisms is warranted.

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  • In one study, almost half of anxious children recruited for ABM-threat-avoidance training were excluded because they showed no pre-existing bias towards threat.

    “In one study, almost a half of anxious children recruited for ABM-threat-avoidance training were excluded because they showed no pre-existing bias towards threat (Eldar et al., 2012).”

    From Anxiety and attention to threat: cognitive mechanisms and treatment with attention bias modification (2016) · cites this paper as Eldar et al., 2012

  • ABM-threat-avoidance training may be inappropriate for anxious individuals who do not show pre-existing AB in orienting towards threat, whereas ABM-positive-search training seems potentially suitable for all anxious individuals, irrespective of whether they show AB in orienting towards or away from threat, or unstable AB.

    “Fifth, these methods may differ in suitability for anxious individuals; as ABM-threatavoidance training may be inappropriate for anxious individuals who do not show pre-existing AB in orienting towards threat (Eldar et al., 2012;Van Bockstaele et al., 2014), whereas ABM-positivesearch training seems potentially suitable for all anxious individuals, irrespective of whether they show AB in orienting”

    From Anxiety and attention to threat: cognitive mechanisms and treatment with attention bias modification (2016) · cites this paper as Eldar et al., 2012

  • Threat-avoidance is sometimes found in anxiety disorders.

    “and is sometimes found in anxiety disorders (e.g., Eldar et al., 2012;Salum et al., 2013;Waters et al., 2014).”

    From Anxiety and attention to threat: cognitive mechanisms and treatment with attention bias modification (2016) · cites this paper as Eldar et al., 2012

  • Twelve RCTs of ABMT in clinically diagnosed anxiety patients had been published, and eleven of these used variants of the dot-probe task.

    “Twelve RCTs of ABMT in clinically diagnosed anxiety patients were published to date.Eleven of these RCTs used variants of the dot-probe task as means of attention bias modification (cf.Waters et al. [7] ).[12][13][14][15][16][17][18][19][20][21][22]”

    From QUANTITATIVE EVALUATION OF THE CLINICAL EFFICACY OF ATTENTION BIAS MODIFICATION TREATMENT FOR ANXIETY DISORDERS: Review: ABMT for Anxiety Disorders: A Meta-Analysis (2015) · cites this paper as [12]

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Research works printed but not linked: 1

  1. [17]Bar-Haim Y Morag I Glickman S Training to disengage attention from threat reduces vulnerability to stress in anxious children J Child Psychol Psychiatry 2011 52 861 869 21250993

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Authors
Eldar, S., Apter, A., Lotan, D., Edgar, K. P., Naim, R., Fox, N. A., Pine, D. S., & Bar-Haim, Y.
Affiliations
  • Tel Aviv University (IL)
  • From the Adler Center for Research in Child Development and Psychopathology, Departments of Psychology, Tel Aviv University, Tel Aviv, Israel, with cooperation of the Feinberg Child Study Center, Schneider Children's Medical Center of Israel, Petach-Tikva, Israel.
ORCID
Venue
American Journal of Psychiatry
Publisher
American Psychiatric Association Publishing
Published
2012-02
Volume
169
Issue
2
Pages
213-230
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
DOI
10.1176/appi.ajp.2011.11060886
PMC
PMC3491316
OpenAlex
W2167291698
Cited by
220
References
30
Citations by year
2026: 4 · 2025: 3 · 2024: 4 · 2023: 8 · 2022: 8 · 2021: 8 · 2020: 12 · 2019: 15 · 2018: 19 · 2017: 16 · 2016: 27 · 2015: 30 · 2014: 25 · 2013: 31 · 2012: 10
FWCI
27.21
Type
journal article
Language
en
Open access
Locations
  • American Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (ZIA‐MH002781)
  • National Institute of Mental Health (ZIAMH002780, R01MH094633, ZIAMH002782)
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 › Psychotherapy Techniques and Applications
Keywords
attentional bias modification, childhood anxiety disorders, children, anxiety symptoms, symptom severity, threat-related attention, cognitive training
MeSH terms
Adolescent, Anxiety Disorders, Attention, Behavior Therapy, Behavioral Symptoms, Child, Child Behavior, Female, Humans, Interview, Psychological, Male, Psychiatric Status Rating Scales, Treatment Outcome, Diagnostic and Statistical Manual of Mental Disorders

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