ABMT for Social Anxiety Disorder

Not currently recruiting at 1 trial location

Overseen By Jeremy Pettit, PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Florida International University

Must be taking: Stimulants, Non-stimulants

Disqualifiers: Autism, Bipolar, Psychotic, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 8

Duration: 8 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a computer-based program called Attention Bias Modification Treatment (ABMT) to help children with social anxiety disorder. Half of the participants will try ABMT, which focuses on changing their attention patterns, while the other half will perform a similar task without the attention training. Researchers aim to determine if ABMT reduces signs of social anxiety and alters brain activity related to social threats. Children aged 10 to 14 with social anxiety disorder who are not on other strong medications may be suitable for this study. As an unphased trial, this study offers participants a unique opportunity to contribute to innovative research that could lead to new treatment options for social anxiety.

Do I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but you can continue a stable dose of stimulant or non-stimulant medication for ADHD.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but you can continue a stable dose of medication for ADHD if you have it.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that Attention Bias Modification Treatment (ABMT) is generally easy for people to handle. Studies have found that ABMT can effectively lessen social anxiety symptoms without causing major side effects. This computer program helps shift focus away from anxious thoughts. In several studies, it has shown promise in managing social anxiety. Importantly, no major reports of negative effects have been linked to ABMT, making it a safe option for many people. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about Attention Bias Modification Treatment (ABMT) for social anxiety disorder because it offers a unique approach compared to standard therapies like cognitive-behavioral therapy or medication. Unlike these traditional treatments that often focus on changing thought patterns or altering brain chemistry, ABMT is a computer-based program designed to directly train the brain to divert attention away from anxiety-inducing stimuli. This novel mechanism of action could provide a targeted, non-invasive, and potentially faster way to reduce social anxiety symptoms. Additionally, the Neutral Control Task serves as a comparison to ensure the effectiveness of ABMT by using the same computer format but focusing only on neutral stimuli without training attention.

What evidence suggests that this trial's treatments could be effective for social anxiety disorder?

Research has shown that Attention Bias Modification Treatment (ABMT), one of the treatments studied in this trial, can effectively reduce symptoms of social anxiety. Studies have found that ABMT leads to noticeable decreases in social anxiety, as rated by both doctors and patients. In one study, ABMT helped people pay less attention to social threats and reduced their anxiety symptoms. Another study demonstrated that ABMT significantly lowered social anxiety from the beginning to the end of treatment. These findings suggest that ABMT works by training the brain to focus less on negative social signals, easing anxiety in social situations. Participants in this trial may receive ABMT or the Neutral Control Task, which serves as a comparator and includes only neutral stimuli without training attention. ^{6 7 8 9 10}

Who Is on the Research Team?

Wendy K Silverman, PhD

Principal Investigator

Yale University

Jeremy W Pettit, PhD

Principal Investigator

Florida International University

Are You a Good Fit for This Trial?

This trial is for youths aged 10-14 with Social Anxiety Disorder, without severe other psychiatric conditions or current psychotropic medication (except for stable ADHD treatment). They must not have a history of neurological illness, significant head injury, uncorrected vision or physical disabilities affecting mouse use, nor meet criteria for certain other disorders.

Inclusion Criteria

My social anxiety is more severe than any other mental health issues I have.

I am only taking medication for ADHD and nothing else for mental health.

I am between 10 and 14 years old.

Exclusion Criteria

Be a victim of undisclosed abuse requiring investigation/supervision by the Department of Social Services

I have had a neurological illness, seizures, epilepsy, or a significant head injury.

Have an uncorrected vision or physical disability that interferes with the ability to click a mouse button rapidly and repeatedly

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive 8 sessions of computer administered Attention Bias Modification Treatment (ABMT) or Neutral Control Task (NCT)

8 weeks

8 sessions (in-person or virtual)

Post-treatment Assessment

Posttreatment assessment of social anxiety symptom severity using various measures

1 week

Follow-up

Participants are monitored for safety and effectiveness after treatment, including follow-up assessments six months after the final treatment session

6 months

Follow-up assessments (in-person or virtual)

What Are the Treatments Tested in This Trial?

Interventions

• Attention Bias Modification Treatment
• Neutral Control Task

Trial Overview The study tests Attention Bias Modification Treatment (ABMT) against a Neutral Control Task (NCT) in reducing social anxiety. Participants will be randomly assigned to receive one of the two computer-based treatments over eight sessions. The effectiveness will be measured using EEG and social anxiety severity ratings.

How Is the Trial Designed?

Group I: Attention Bias Modification Treatment Experimental Treatment 1 Intervention

Attention Bias Modification Treatment is a computer-based attention training program.

Group II: Neutral Control Task Placebo Group 1 Intervention

Neutral Control Task uses the same computer-based format as Attention Bias Modification Treatment, but includes only neutral stimuli and does not train attention.

Who Is Running the Clinical Trial?

Florida International University

Lead Sponsor

Trials

114

Recruited

19,400+

Yale University

Collaborator

Trials

1,963

Recruited

3,046,000+

Published Research Related to This Trial

In a randomized controlled trial involving 50 patients with social anxiety disorder, those who received cognitive-behavioral group therapy (CBGT) combined with attention bias modification (ABM) showed greater reductions in clinician-rated symptoms of social anxiety compared to those who received CBGT with a placebo, with effects lasting for 3 months after treatment.

The study suggests that training patients to shift their attention away from perceived threats may enhance the effectiveness of standard CBGT for social anxiety disorder, although changes in attention bias did not directly mediate the improvement in anxiety symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Attention bias modification augments cognitive-behavioral group therapy for social anxiety disorder: a randomized controlled trial. Lazarov, A., Marom, S., Yahalom, N., et al.[2019]

Attention bias modification treatment (ABMT) has been shown to significantly reduce anxiety symptoms in clinically anxious patients, with a moderate effect size (d = 0.42) based on a meta-analysis of 11 randomized controlled trials involving 589 patients.

ABMT is more effective when delivered in a clinical setting compared to at home, as indicated by a significant reduction in clinician-rated anxiety symptoms, while self-reported anxiety changes were not statistically significant.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Quantitative evaluation of the clinical efficacy of attention bias modification treatment for anxiety disorders. Linetzky, M., Pergamin-Hight, L., Pine, DS., et al.[2018]

In a study involving 95 adults with social anxiety disorder, Attention Bias Modification Treatment (ABMT) was found to be more effective than Cognitive Bias Modification of Interpretation (CBM-I) in reducing social anxiety symptoms, with significant improvements noted in both clinician ratings and self-reports.

The combination of ABMT and CBM-I did not show superior efficacy compared to ABMT alone, indicating that ABMT may be the more effective standalone treatment for alleviating symptoms of social anxiety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Attention and interpretation bias modification treatment for social anxiety disorder: A randomized clinical trial of efficacy and synergy. Naim, R., Kivity, Y., Bar-Haim, Y., et al.[2019]

In a study involving anxious youth, adding Attention Bias Modification Treatment (ABMT) to 8 weeks of cognitive-behavioral therapy (CBT) did not enhance clinician-rated outcomes, but it did lead to earlier reductions in self-reported anxiety compared to CBT alone.

The research also showed that neural responses related to attention bias were stable in healthy youth, indicating that understanding these stable patterns could inform future ABMT strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Training-associated changes and stability of attention bias in youth: Implications for Attention Bias Modification Treatment for pediatric anxiety. Britton, JC., Bar-Haim, Y., Clementi, MA., et al.[2021]

Attention Bias Modification Treatment (ABMT) shows promise in reducing anxiety symptoms in children who did not respond to Cognitive-Behavioral Therapy (CBT), as evidenced by significant decreases in self-reported anxiety and depressive symptoms in a case series of six children aged around 11 years.

All participants completed the ABMT protocol without any missed sessions, indicating that it is a feasible treatment option for children with anxiety disorders who continue to experience symptoms after CBT.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Attention Bias Modification Treatment for children with anxiety disorders who do not respond to cognitive behavioral therapy: a case series. Bechor, M., Pettit, JW., Silverman, WK., et al.[2021]

Attention training (ATT) has shown promise as an effective treatment for social anxiety disorder (SOC) in children, as demonstrated by a study involving two boys who completed 10 sessions of ATT and experienced reductions in their anxiety levels.

This study provides preliminary evidence for the utility of ATT in treating childhood SOC, highlighting the need for further research to explore its effectiveness and the underlying mechanisms of change.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Attention training in socially anxious children: a multiple baseline design analysis. Cowart, MJ., Ollendick, TH.[2015]

In a randomized controlled trial with 67 youth diagnosed with social anxiety disorder, both Attention Bias Modification Treatment (ABMT) and attention control training (ACT) significantly reduced anxiety symptoms, but ABMT did not show superior efficacy over ACT.

Older children and those with lower attention control benefited more from ABMT, suggesting that age and individual differences in attention may influence treatment outcomes, highlighting the importance of tailoring interventions to developmental stages.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Attention bias modification for youth with social anxiety disorder. Pergamin-Hight, L., Pine, DS., Fox, NA., et al.[2019]

In a study involving 63 anxious children, both active and placebo attention bias modification treatment (ABMT) combined with cognitive behavioral therapy (CBT) led to greater reductions in clinician-rated anxiety symptoms compared to CBT alone.

Only the active ABMT group showed significant improvements in self- and parent-rated anxiety symptoms, suggesting that the active intervention may enhance the effectiveness of CBT in treating anxiety disorders in youth.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Attention bias modification treatment augmenting effects on cognitive behavioral therapy in children with anxiety: randomized controlled trial. Shechner, T., Rimon-Chakir, A., Britton, JC., et al.[2021]

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/30661553/

Attention Bias Modification Treatment for Adolescents With ... We predicted that ABMT would result in greater changes in both threat biases and social anxiety symptoms.

2. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/27435286/

Attention bias modification for youth with social anxiety ... Results: Both ABMT and ACT induced significant reductions in clinician and self-rated social anxiety (ps < . 001).

3. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0005791617300897

Attention and interpretation bias modification treatment for ... Amir and Taylor (2012) reported significant decreases in clinician-rated social anxiety symptoms relative to a control training following 12 sessions of CBM-I.

4. acamh.onlinelibrary.wiley.com acamh.onlinelibrary.wiley.com/doi/10.1111/jcpp.12599

Attention bias modification for youth with social anxiety disorder This study found that both ABMT and ACT significantly reduced social anxiety from baseline to posttreatment.

5. bmcpsychiatry.biomedcentral.com bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-05938-2

Social anxiety and attentional bias to negative emotional ... The results showed that attentional bias modification training can reduce attentional bias to negative emotional information in college students with social ...

6. clinicaltrials.gov clinicaltrials.gov/study/NCT01979263?term=AREA%5BBasicSearch%5D(AREA%5BConditionSearch%5D(%22Phobia,%20Social%22)%20AND%20AREA%5BBasicSearch%5D(gene%20therapy))&rank=4

Attention Bias Modification Treatment for Anxious Youth | ... The purpose of ABMT is to set in place attentional patterns that do not lead to excessive anxiety. Research has shown that it may be highly effective in ...

7. bmcpsychiatry.biomedcentral.com bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-12-66

Internet-delivered attention bias modification training in ... Computerized cognitive bias modification for social anxiety disorder has in several well conducted trials shown great promise with as many ...

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3296778/

Attention Bias Modification Treatment: A meta-analysis ... ABMT produced significantly greater reductions in anxiety than control training, with a medium effect (d = 0.61, p <.001). Age and gender did not moderate the ...

9. sciencedirect.com sciencedirect.com/science/article/abs/pii/S088761852300138X

Attention bias vs. attention control modification for social ... Attention bias modification effectively reduces social anxiety disorder symptoms. •. Valence-specific and non-emotional training induces comparable clinical ...

10. journals.plos.org journals.plos.org/plosone/article?id=10.1371/journal.pone.0264256

Does attention bias modification reduce anxiety in socially ... In sum, this experimental study of the effects of ABM in social anxiety found no significant improvement in either attention biases or in self- ...