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Combined "top-down" and "bottom-up" intervention for anxiety sensitivity: Pilot randomized trial testing the additive effect of interpretation bias modification.

Abstract：

OBJECTIVE:Anxiety disorders contribute substantially to the overall public health burden. Anxiety sensitivity (AS), a fear of anxiety-related sensations, is one of the few known malleable risk factors for anxiety pathology. Previous AS reduction treatments have primarily utilized "top-down" (e.g., psychoeducation) interventions. The goal of the current study was to evaluate the effect of adding a "bottom-up" (interpretation bias modification; CBM-I) intervention to an AS psychoeducation intervention. DESIGN:Single-site randomized controlled trial. Participants completed either a 1) Psychoeducation + active CBM-I or 2) Psychoeducation + control CBM-I intervention. Change in AS was assessed post-intervention and at a one-month follow-up. PARTICIPANTS:Individuals with elevated levels of AS. INTERVENTION:Single-session computer-delivered intervention for AS. RESULTS:Accounting for baseline ASI-3 scores, post-intervention ASI-3 scores were significantly lower in the combined condition than in the psychoeducation + control CBM-I condition (β = 0.24, p < 0.05; d = 0.99). The active CBM-I plus psychoeducation AS intervention was successful in reducing overall AS (59% post-intervention; p < 0.05, Cohen's d = 0.99) and these reductions were maintained through one-month post-intervention (52%; p < 0.05, Cohen's d = 1.18). Participants in the active condition reported significantly lower rates of panic responding to a vital-capacity CO2 challenge (OR = 6.34, 95% CI = 1.07-37.66). Lastly, change in interpretation bias significantly mediated the relationship between treatment condition and post-treatment AS reductions. CONCLUSIONS:The current intervention was efficacious in terms of immediate and one-month AS reductions. Given its brevity, low-cost, low-stigma and portability, this intervention could lead to reducing the burden of anxiety disorders.

journal_name

J Psychiatr Res

journal_title

Journal of psychiatric research

authors

Capron DW,Norr AM,Allan NP,Schmidt NB

doi

10.1016/j.jpsychires.2016.11.003

subject

Has Abstract

pub_date

2017-02-01 00:00:00

pages

75-82

eissn

0022-3956

issn

1879-1379

pii

S0022-3956(16)30610-0

journal_volume

pub_type

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Combined "top-down" and "bottom-up" intervention for anxiety sensitivity: Pilot randomized trial testing the additive effect of interpretation bias modification.