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ViewAttendees 10

Symposia

Child / Adolescent - Anxiety

Session: Technological Advances in Experimental and Behavioral Treatments for Anxiety and OCD in Youth

2 - (SYM 26) Attention Training for Anxiety Disorders in Youth: Strategies for Implementation and Mechanisms of Action

Saturday, November 18, 2023
2:30 PM – 4:00 PM PST
Location: Washougal (408), Level 4

The last decade has seen remarkable progress in clinical trials of computer-administered attention training programs for anxiety disorders in children and adolescents (youth). Overall, support for the efficacy of these programs is growing. In spite of this progress and support, the field lacks empirical guidance on strategies for implementing attention training to best help youth with anxiety disorders. The urgency of developing such guidance is exacerbated by high demand for services and need to efficiently use limited mental health resources. In addition to a lack of guidance on implementation strategies, important questions about the mechanisms of attention training’s anxiety reduction effects remain unanswered. In this talk, we first present data on strategies for implementing attention training to treat anxiety in youth. We then describe an ongoing trial of attention training in youth designed to evaluate mechanisms of anxiety reduction.

 We present data from separate, completed clinical trials showing that attention training produces statistically significant reductions on the Pediatric Anxiety Rating Scale (PARS) among (a) N = 53 youths with subthreshold or mild anxiety disorders (Cohen’s d = 0.51), (b) N = 124 youths with anxiety disorders enrolled in a stepped care protocol (Cohen’s d = 0.53), and (c) N = 64 youths with treatment resistant anxiety disorders (Cohen’s d = 1.21). These data demonstrate the versatility of attention training and provide empirical guidance on strategies for its implementation as a low intensity frontline treatment, a first step in a stepped care protocol, and an augment when youth do not respond adequately to other evidence-based treatment.

 Data from these completed trials also raise intriguing questions about attention training’s mechanisms of anxiety reduction in youth. We are addressing these questions in an ongoing two-site randomized controlled mechanistic trial that includes measurement of attentional processes using electroencephalography (EEG) and eye tracking. We describe the design and protocol of this ongoing trial, present preliminary data from N = 150 participants enrolled in the trial, and discuss lessons learned from the first four years of the trial.