A case series of attention modification in clinically anxious youths

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Abstract

Research in the last fifteen years suggests that anxious individuals selectively attend towards threatening information. Attention modification interventions for internalizing adults have been developed to target cognition at this basic level; these programs have demonstrated initial efficacy in attention bias and anxiety symptom reduction. To date, there have been no published studies of attention modification in youths with clinical levels of anxiety. The current case series examined the initial efficacy of a four-week (12 sessions) attention modification program (AMP) designed to train attention away from threat in 16 children and adolescents (ages 10 to 17) diagnosed with DSM-IV anxiety disorders. Overall, youths experienced a significant decrease in anxiety and depression symptoms, and 12 of 16 youths no longer met criteria for any anxiety diagnosis at post-treatment. AMP was feasible with youths, and all youths and parents deemed the program acceptable. These findings provide support for further research on the use of cognitive bias modification interventions with clinically anxious youths.

Section snippets

Participants

Participants were 16 clinically anxious youths ages 10–17 (M = 14.00, SD = 2.66) presenting for services at a youth internalizing disorders treatment research center. Youths were included in the case series if they (a) met for a primary diagnosis of either Separation Anxiety Disorder, Social Phobia, or Generalized Anxiety Disorder, (b) were aged 8–17, (c) lived with a legal, consenting guardian for the past six months, (d) spoke proficient English, (e) showed no evidence of suicidal ideation with

Results

Table 1 provides youth clinical characteristics at baseline. All youths were diagnosed with a primary anxiety disorder, with 56% of youths also meeting DSM-IV criteria for a secondary anxiety disorder. Although our inclusion criteria allowed for primary diagnosis of Separation, Social, and Generalized Anxiety Disorders, note that nearly the entire sample met for a primary diagnosis of either Social or Generalized Anxiety, with only one youth meeting for a primary diagnosis of Separation Anxiety

Discussion

This case series examined the value of developing attention modification as a treatment for youth anxiety. Despite the short treatment duration (twelve 15-min training sessions over the course of four weeks), youths in this clinical case series demonstrated significant symptomatic improvement from pre- to post-treatment, and 12 of 16 youths (75%) no longer met criteria for any anxiety disorder diagnosis at post-treatment. In addition, the four youths who still met DSM-IV criteria for an anxiety

Acknowledgements

Data collection for this project was supported, in part, by grants from the William T. Grant Foundation and the San Diego State University Minority Research Infrastructure Support Program (SDSU MRISP) to V. Robin Weersing.

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