Section on Development and Affective Neuroscience, National Institute of Mental Health, 9000 Rockville Pike, Bldg. 15K, Bethesda, MD, 20892, USA.
School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel.
J Abnorm Child Psychol. 2019 May;47(5):881-894. doi: 10.1007/s10802-018-0494-7.
Attention bias modification treatment (ABMT) aims to reduce anxiety symptoms via practice on computerized attention training tasks. Despite evidence of efficacy, clinical effects appear heterogeneous. More research on ABMT mechanisms and moderators of treatment response is needed. Age is one potentially important moderator, as developmental differences in training effects may impact response. We examined developmental links between ABMT training effects and response in social anxiety disorder (SAD). We pooled data from two randomized controlled trials in treatment-seeking youths and adults with SAD (N = 99) that used identical ABMT methods. We first characterized learning effects associated with the eight-session ABMT training protocol. We then tested whether learning magnitude predicted the clinical (change in SAD symptoms) and cognitive (change in attention bias) responses to treatment. Finally, we tested whether age moderated the association between ABMT learning and treatment response. Results indicate that ABMT was associated with an incremental learning curve during the protocol, and that learning improved with age. Age further moderated the association between learning gains during the ABMT protocol and subsequent reduction in self-reported SAD symptoms, such that this association was stronger with age. These effects were not evident in bias scores or clinician ratings. Finally, pre-treatment SAD symptoms and bias scores predicted ABMT learning gains. This study highlights the links among age, learning processes, and clinical response to ABMT. These insights may inform attempts to increase the clinical efficacy of ABMT for anxiety.
注意偏向修正治疗（ABMT）旨在通过计算机化的注意力训练任务来减轻焦虑症状。尽管有疗效的证据，但临床效果似乎存在异质性。需要更多关于 ABMT 机制和治疗反应的调节剂的研究。年龄是一个潜在的重要调节剂，因为训练效果的发展差异可能会影响反应。我们研究了 ABMT 训练效果与社交焦虑障碍（SAD）反应之间的发展联系。我们汇集了两项针对 SAD 青少年和成年人的随机对照试验的数据（N=99），这些试验采用了相同的 ABMT 方法。我们首先描述了与八节 ABMT 训练方案相关的学习效果。然后，我们测试了学习幅度是否预测了治疗的临床（SAD 症状的变化）和认知（注意力偏向的变化）反应。最后，我们测试了年龄是否调节了 ABMT 学习与治疗反应之间的关系。结果表明，ABMT 与方案期间的增量学习曲线有关，并且随着年龄的增长而提高。年龄进一步调节了 ABMT 方案期间的学习增益与随后的自我报告 SAD 症状减轻之间的关联，即这种关联随着年龄的增长而增强。这些影响在偏差分数或临床医生评分中并不明显。最后，治疗前的 SAD 症状和偏差分数预测了 ABMT 的学习增益。这项研究强调了年龄、学习过程和 ABMT 临床反应之间的联系。这些见解可能为提高 ABMT 治疗焦虑的临床疗效提供信息。
