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首页> 外文期刊>BMC Psychiatry >Efficacy and mechanisms underlying a gamified attention bias modification training in anxious youth: protocol for a randomized controlled trial
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Efficacy and mechanisms underlying a gamified attention bias modification training in anxious youth: protocol for a randomized controlled trial

机译：焦虑症青年游戏化注意偏向修正训练的功效和机制：随机对照试验方案

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Attention bias modification training (ABMT) and cognitive behavioral therapy (CBT) likely target different aspects of aberrant threat responses in anxiety disorders and may be combined to maximize therapeutic benefit. However, studies investigating the effect of ABMT in the context of CBT have yielded mixed results. Here, we propose an enhanced ABMT to target the attentional bias towards threat, in addition to classic CBT for anxiety disorders in youth. This enhanced ABMT integrates the modified dot-probe task used in previous studies, where a target is always presented at the previous location of the neutral and not the simultaneously presented threatening stimulus, with a visual search, where the targets are always presented distally of threatening distractors. These two training elements (modified dot-probe and visual search) are embedded in an engaging game to foster motivation and adherence. Our goal is to determine the efficacy of the enhanced ABMT in the context of CBT. Further, we aim to replicate two previous findings: (a) aberrant amygdala connectivity being the neurobiological correlate of the attentional bias towards threat at baseline; and (b) amygdala connectivity being a mediator of the ABMT effect. We will also explore moderators of treatment response (age, sex, depressive symptoms and irritability) on a behavioral and neuronal level. One hundred and twenty youth (8–17?years old) with a primary anxiety disorder diagnosis all receive CBT and are randomized to nine weeks of either active or control ABMT and symptom improvement will be compared between the two study arms. We will also recruit 60 healthy comparison youth, who along with eligible anxious youth, will be assessed with the dot-probe task during fMRI (anxious youth: before and after training; healthy volunteers: second measurement twelve weeks after initial assessment). The present study will contribute to the literature by (1) potentially replicating that aberrant amygdala connectivity mediates the attentional bias towards threat in anxious youth; (2) determining the efficacy of enhanced ABMT; and (3) advancing our understanding of the mechanisms underlying ABMT.
机译：注意偏差修饰训练（ABMT）和认知行为疗法（CBT）可能针对焦虑症中异常威胁反应的不同方面，并且可以组合使用以最大化治疗益处。但是，研究ABMT在CBT情况下的影响的研究得出了不同的结果。在这里，我们提出了一种增强型ABMT，以针对针对威胁的注意力偏见，以及针对青少年焦虑症的经典CBT之外。这种增强的ABMT将以前研究中使用的修改后的点探针任务与以前的研究相结合，在该研究中，始终将目标显示在中性点的先前位置，而不是同时显示威胁刺激，并通过视觉搜索将目标始终显示在威胁的远端干扰因素。这两个训练元素（改进的点探针和视觉搜索）被嵌入到一个引人入胜的游戏中，以促进动力和坚持。我们的目标是确定在CBT背景下增强型ABMT的功效。此外，我们旨在复制两个先前的发现：（a）杏仁核的异常连通性是基线对威胁的注意力偏向的神经生物学关联; （b）杏仁核连通性是ABMT效应的中介。我们还将探讨行为和神经元水平上的治疗反应（年龄，性别，抑郁症状和易怒）的主持人。诊断为原发性焦虑症的120名青年（8-17岁）均接受CBT治疗，并随机分为9个星期进行主动或对照ABMT治疗，两个研究组将比较症状改善情况。我们还将招募60名健康的比较青年，他们将与合格的焦虑青年一起在fMRI期间接受点探针任务评估（焦虑青年：训练前后;健康志愿者：初次评估后十二周进行第二次测量）。本研究将通过以下方式为文献做出贡献：（1）潜在地复制：杏仁核的异常连通性介导了焦虑青年对威胁的注意力偏向; （2）确定增强的ABMT的功效; （3）增进我们对ABMT潜在机制的理解。

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