Quantitative Evaluation of the Clinical Efficacy of Attention Bias Modification Treatment for Anxiety Disorders
Anxiety Disorders; Cognition; Confidence Intervals; Depression; Anxiety; Psychology; Children; Clinical Trials; computer; Anxieties; Anxiety Disorders - therapy; COGNITIVE-BEHAVIORAL THERAPY; PSYCHIATRY; Psychology; THREAT; INDIVIDUALS; Clinical; GENERALIZED SOCIAL PHOBIA; Internet technology; Meta-Analysis; MODIFICATION PROGRAM; RANDOMIZED CONTROLLED-TRIAL; STIMULI; treatment
Attention bias modification treatment (ABMT) is a novel treatment for anxiety disorders. Although a number of other meta-analytic reviews exist, the purpose of the present meta-analysis is to examine issues unaddressed in prior reviews. Specifically, the review estimates the efficacy of ABMT in clinically anxious patients and examines the effect of delivery context (clinic vs. home) on symptom reduction. A literature search using PsychInfo and Web of Science databases was performed. Only randomized controlled trials (RCTs) examining dot-probe-based ABMT in clinically diagnosed anxious patients were included. From 714 articles located through the search, 36 ABMT studies were identified and 11 studies met inclusion criteria (N = 589 patients). ABMT was associated with greater clinician-rated reductions in anxiety symptoms relative to control training: between-groups effect (d = 0.42, P = .001, confidence interval (CI) = 0.18-0.66), contrast of within-group effects (Q = 7.25, P < .01). More patients in the treatment group no longer met formal diagnostic criteria for their anxiety disorder posttreatment relative to patients in the control condition (P < .05). Analyses of patients' self-reported anxiety were nonsignificant for the between-groups contrast (P = .35), and were at a trend level of significance for the contrast between the within-group effects (P = .06). Moderation analysis of the between-groups effect revealed a significant effect for ABMT delivered in the clinic (d = 0.34, P = 0.01, CI = 0.07-0.62), and a nonsignificant effect for ABMT delivered at home (d = -0.10, P = 0.40, CI = -0.33-0.13). The current meta-analysis provides support for ABMT as a novel evidenced-based treatment for anxiety disorders. Overall, ABMT effects are mainly evident when it is delivered in the clinic and when clinical outcome is evaluated by a clinician. More RCTs of ABMT in specific anxiety disorders are warranted.
2015-06
Linetzky M; Pergamin-HL; Pine DS; Bar‐Haim Yair
Depression And Anxiety
2015
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Journal Article
<a href="http://doi.org/10.1002/da.22344" target="_blank" rel="noreferrer">10.1002/da.22344</a>
Research Review: attention bias modification (ABM): a novel treatment for anxiety disorders
Analysis; Anxiety Disorders; Drug Therapy; Child Psychology; Anxiety; Health aspects; Children; Cognitive Therapy; Adolescents; Therapy; Attention; Anxieties; Anxiety Disorders - diagnosis; Anxiety Disorders - psychology; Anxiety Disorders - therapy; Attentional bias; Care and treatment; Cognitive Restructuring; Cognitive Therapy/methods; COGNITIVE-BEHAVIORAL THERAPY; DEVELOPMENTAL; EMOTIONAL FACES; EXPERIMENTAL MANIPULATION; Medical Research; Medical treatment; Outcomes of Treatment; PSYCHIATRY; Psychology; RANDOMIZED CLINICAL-TRIAL; SCHIZOPHRENIA; SOCIAL PHOBIA; THREAT; VISUAL-ATTENTION
Attention bias modification (ABM) is a newly emerging therapy for anxiety disorders that is rooted in current cognitive models of anxiety and in established experimental data on threat-related attentional biases in anxiety. This review describes the evidence indicating that ABM has the potential to become an enhancing tool for current psychological and pharmacological treatments for anxiety or even a novel standalone treatment. The review also outlines the gaps in need of bridging before ABM techniques could be routinely applied and incorporated into standard treatment protocols. [PUBLICATION ABSTRACT]
2010-08
Bar-Haim Y
Journal Of Child Psychology And Psychiatry
2010
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1111/j.1469-7610.2010.02251.x" target="_blank" rel="noreferrer">10.1111/j.1469-7610.2010.02251.x</a>
Attention Bias Modification Treatment for Pediatric Anxiety Disorders: A Randomized Controlled Trial
Depression; Management; Children; Diagnosis; Adolescents; Anxieties; Attentional bias; Care and treatment; PSYCHIATRY; THREAT; Anxiety in children; Child & adolescent psychiatry; childhood; Clinical outcomes; FACIAL EXPRESSIONS; INDIVIDUALS; Influence; MANIPULATION; VULNERABILITY
Objective: While attention bias modification (ABM) is a promising novel treatment for anxiety disorders, clinical trial data remain restricted to adults. The authors examined whether ABM induces greater reductions in pediatric anxiety symptoms and symptom severity than multiple control training interventions. Method: From a target sample of 186 treatment-seeking children at a hospital-based child anxiety clinic, 40 patients with an ongoing anxiety disorder who met all inclusion criteria were enrolled in the study. Children were randomly assigned to one of three conditions: ABM designed to shift attention away from threat; placebo attention training using stimuli identical to those in the ABM condition; and placebo attention training using only neutral stimuli. All participants completed four weekly 480-trial sessions (1,920 total trials). Before and after the attention training sessions, children's clinical status was determined via semi-structured interviews and questionnaires. Reduction in the number of anxiety symptoms and their severity was compared across the three groups. Results: Change in the number of anxiety symptoms and their severity differed across the three conditions. This reflected significant reductions in the number of anxiety symptoms and symptom severity in the ABM condition but not in the placebo attention training or placebo-neutral condition. Conclusions: ABM, compared with two control conditions, reduces pediatric anxiety symptoms and severity. Further study of efficacy and underlying mechanisms is warranted. (Am J Psychiatry 2012; 169:213-220)
Eldar S; Apter A; Lotan D; Perez-Edgar K; Naim R; Fox NA; Pine DS; Bar-Haim Y
American Journal Of Psychiatry
2012
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1176/appi.ajp.2011.11060886" target="_blank" rel="noreferrer">10.1176/appi.ajp.2011.11060886</a>
‘no Second Chance’ – Junior Neonatal Nurses Experiences Of Caring For An Infant At The End-of-life And Their Family
Anxieties; End-of-life; Infants; Junior Nurses; Neonatal Unit (nnu)
Death of an infant is acutely stressful for parents and professionals. Little is known about junior nurses' experiences providing end-of-life care in Neonatal units (NNU). This study aimed to better understand junior nurses' experiences providing end-of-life care in NNU. Neonatal nurses (n = 12) with less than 3 years experience participated in a focus group. Nominal Group Technique (NGT) was used to build consensus around the challenges faced, alongside suggested developments in improving future care provision. Primary analysis involved successive rounds of ranking and decision-making whilst secondary analysis involved thematic analysis. All issues, whether environmental, professional or social appeared driven by an awareness on the part of nurses, that there was no ‘second chance’ which created a huge pressure to ‘get if right’ for the infants and families. Regarding future care 2 areas of improvement identified were ‘Education and Training’ and Support. This paper unpacks these findings making recommendations for practice.
Nurse Sharon; Price Jayne
Journal Of Neonatal Nursing
2017
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10.1016/j.jnn.2016.04.008
Animal-assisted Therapy In Pediatric Palliative Care
Alternative Therapies; Chronic Heart-failure; Psychiatric-patients Pediatrics; Animal-assisted Therapy; Hospitalized Children; Pet-therapy; Evidence-based Practice; Dogs; Complementary; Suffering; Intervention; Nursing; Companion Animals; Anxieties; Palliative Care; Cancer-patients
Animal-assisted Therapy; Pediatrics; Palliative Care; Interventions; Suffering; Evidence-based Practice
Animal-assisted therapy is an emerging complementary strategy with an increasing presence in the literature. Limited studies have been conducted with children, particularly those with life-threatening and life-limiting conditions. Although outcomes show promise in decreasing suffering of children receiving palliative care services, more work is needed to validate evidence to support implementation of animal-assisted therapy with this vulnerable population.
M J Gilmer
Nursing Clinics Of North America
2016
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://dx.doi.org/10.1016/j.cnur.2016.05.007" target="_blank" rel="noreferrer">http://dx.doi.org/10.1016/j.cnur.2016.05.007</a>
Impact Of Early Palliative Care Intervention On Maternal Stress In Mothers Of Infants Prenatally Diagnosed With Single Ventricle Heart Disease: A Randomized Clinical Trial.
Mothers; Communication; Palliative Care; Families & Family Life; Anxieties; Cardiovascular Disease
Background: Children with single ventricle (SV) cardiac defects requiring staged palliation have a high risk of mortality and receive
invasive and complex care, resulting in significant maternal stress. In other complex, life-limiting illnesses among children, pediatric
palliative care (PPC) may mitigate maternal distress. We hypothesized early PPC in the SV population may have the same beneficial effect
upon mothers.
Methods: In this pilot trial of early PPC, mothers of infants with a prenatal diagnosis of SV completed 4 questionnaires measuring anxiety,
depression, coping, and quality of life/family functioning at a prenatal visit (not at initial diagnosis) and again at neonatal discharge. Infants
were randomized to receive early PPC (defined as initial consultation prior to surgery consisting of structured evaluation, psychosocial/
spiritual support, and communication between mothers and care providers) or usual care.
Results: Among 56 eligible subjects, forty mothers enrolled and completed baseline surveys; 38 neonates randomized (18 early PPC, 20
usual care) and 34 postnatal surveys were completed (3 neonates died, 1 mother declined). Baseline Beck Depression Index II and StateTrait
Anxiety Index (STAI) scores exceeded those of a normal pregnant sample (mean 13.76 ± SD 8.46 vs. 7.0 ± 5.0, and 46.34 ± 12.59
vs. 29.8 ± 6.35, respectively; both P=0.0001), but there were no significant differences between study groups. There was a significant
decrease in prenatal to postnatal STAI scores in the early PPC group (-7.6 vs. 0.3 in usual care, P=0.02). Significantly higher postnatal
Brief Cope Inventory scores for positive reframing, an adaptive response, were noted in the early PPC group (P=0.03). The early PPC
group had a positive change in communication and family relationships scores for the Peds QL Family Impact Module (medium effect size
of 0.46 and 0.41, respectively).
Conclusions: In this pilot randomized trial of early PPC, mothers of children with SV heart disease experienced high levels of depression
and anxiety in the prenatal period. Early PPC in the SV population resulted in decreased maternal stress, improved maternal coping, and
improved communication and family relationships.
Hancock H; Pituch K; Uzark K; Bhat P; Fifer C; Silveira M
Journal Of The American College Of Cardiology
2016
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
doi:10.1016/S0735-1097(16)30921-4