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Efficacy of the Chinese version interpretation bias modification training in an unselected sample: A randomized trial.

ABSTRACT: Training individuals to interpret ambiguous information in positive ways might be an effective method of reducing social anxiety. However, little research had been carried out in Chinese samples, and the effect of interpretation training on other processes such as attentional bias also remained unclear. This study examined the effect of interpretation bias modification program (IMP) on interpretation bias, social anxiety and attentional bias, and the possible mediation effects. 51 healthy adults were randomly assigned to either a 5-session IMP training that guided them to endorse benign interpretation in ambiguous scenarios or an interpretation control condition (ICC). Self-reported measures of social anxiety symptoms, attentional bias and interpretation bias were evaluated before and after training. Results showed that compared to control group, IMP group generated more positive interpretations and less negative interpretations after training (F(1,49) = 7.65, p<0.01, ηp2 = 0.14; F(1,49) = 14.60, p<0.01, ηp2 = 0.23respectively). IMP yielded greater interpretation bias reduction (F(1,49) = 12.84, p<0.01, ηp2 = 0.21) and social anxiety reduction (F(1,49) = 21.39, p<0.01, ηp2 = 0.30) than ICC, but change in attentional bias was not significant between IMP and the control group. Change in interpretation bias did not show a significant mediation effect in the relationship between training condition and social anxiety reduction. This study provided preliminary evidence for the efficacy of the Chinese version of IMP training. Possible methodological issues and interpretations underlying the findings were discussed. This study was registered in Chinese Clinical Trial Registry (www.chitr.org.cn), a WHO approved registry. The title of registration trial was "A Study on the efficiency of cognitive bias and attentional bias training on fear and phobia" and the registration number was ChiCTR2100045670.

SUBMITTER: Zhang F

PROVIDER: S-EPMC8318276 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BACKGROUND: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. METHODS: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). DISCUSSION: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. TRIAL REGISTRATION:Clinicaltrials.gov: NCT03283930 Trial registration date: September 14th 2017. The trial registration took place retrospectively. Data acquisition started February 1st 2017.

Project description:ObjectiveTo examine targeted, mechanism-based interventions is the next generation of treatment innovation. Biased threat labeling of ambiguous face emotions (interpretation bias) is a potential behavioral treatment target for anger, aggression, and irritability. Changing biases in face-emotion labeling may improve irritability-related outcomes. Here, we report the first randomized, double-blind, placebo-controlled targeted trial of interpretation bias training (IBT) in youths with chronic, severe irritability.MethodPatients with current disruptive mood dysregulation disorder (DMDD; N = 44) were randomly assigned to complete 4 sessions of active (n = 22) or sham (n = 22) computerized IBT training within a 1-week period. The first and last trainings were completed onsite, and 2 trainings were completed at home. We examined the effects of active IBT on labeling bias, primary outcome measures of irritability, and secondary outcome measures of anxiety, depression, and functional impairment. Follow-up assessments were completed immediately after the intervention as well as 1 and 2 weeks later.ResultsWe found that active IBT engaged the behavioral target in the active relative to the sham condition, as shown by a significant shift toward labeling ambiguous faces as happy. However, there was no consistent clinical improvement in active IBT relative to the sham condition either immediately after or 2 weeks after training in either the primary or secondary outcome measures.ConclusionAlthough this randomized controlled trial of IBT in youths with DMDD engaged the proposed behavioral target, there was no statistically significant improvement on clinical outcome. Identifying and changing behavioral targets is a first step in novel treatment development; these results have broader implications for target-based intervention development.Clinical trial registration informationPsychological Treatments for Youth With Severe Irritability; https://clinicaltrials.gov/; NCT02531893.

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Efficacy of the Chinese version interpretation bias modification training in an unselected sample: A randomized trial.

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