Principal Investigator's (PI) goal is to be a scientist in a research-oriented academic setting with a research program focused on preventing anxiety psychopathology among adolescents. A comprehensive training plan was therefore constructed to systematically advance the PI's: 1) expertise regarding conceptual models of broad-based risk factors pertinent to anxiety psychopathology;2) methodological proficiency related to the sophisticated assessment of anxiety-related vulnerability and pathology;and 3) understanding of the development, evaluation, implementation, analysis, and dissemination of prevention programs targeting youth. Importantly, the proposed study is designed to complement the training program by helping the PI to refine relevant research skills while completing an initial test of an adolescent risk factor reduction program. The proposed sample will consist of 88 adolescents (10 to 14 years) with elevated levels of anxiety sensitivity (AS), a cognitive vulnerability variable reflecting fear of the consequences of anxiety. Adult research supports the effectiveness of targeting AS in terms of preventing panic specifically, and anxiety psychopathology generally. AS is thus a "broad-based" risk factor with the potential to impact multiple disorders. Risk factor research suggests AS modification among youth has implications for panic as well as generalized anxiety disorder. However, very little work has evaluated the impact of AS reduction among youth, which is unfortunate given adolescence is a period of "core risk" in terms of anxiety disorder onset. Further, no work has considered the effect of such a program on GAD-relevant outcomes, nor has any work included family-level intervention factors, despite evidence suggesting parents likely play a critical role in promoting prevention programming. To address these notable gaps in the literature, the primary aim of this project is to experimentally test the effects of an Adolescent Anxiety Sensitivity Amelioration Program (AASAP). High AS youth and a parent will be randomly assigned to either the AASAP, which consists of a single 50min session of psychoeducation and experimenter-led interoceptive exposure, or a general health information control condition. Immediate, two-week, and four-week effects of the AASAP will be evaluated, including effects on self-reported AS, panic attack symptoms, and symptoms of generalized anxiety. Further, the program is expected to impact panic- and GAD-relevant vulnerability indexed using sophisticated challenge procedures. This project aligns with the public health mission of the National Institutes of Health, along with multiple recent calls to train sophisticated prevention scientists. Specifically, given the considerable human suffering and economic costs associated with anxiety psychopathology, it is critically important to construct tailored intervention programs for adolescents at risk for developing such problems. We expect that as a result of this project we will have developed a well-specified psychosocial intervention program for adolescents that targets empirically supported processes with relevance to multiple anxiety-relevant conditions.
The anticipated public health significance of the proposed project is substantial both in the short-term and long-term. In the short term, participants will learn about the nature of anxiety as well as evidence-based approaches for attenuating anxiety-related cognitive vulnerability. This benefit should not be underestimated;anxiety disorders are the most common class of psychopathology during adolescence, which is conceptualized as a period of particularly heightened risk for such problems. Further, only a portion of individuals with anxiety problems receive or benefit from current treatment approaches. While there is some evidence of effective anxiety prevention programs, evidence based protocols are typically resource intensive. The current study aims to address this important gap in the literature by conducting an experimental test, among adolescents, of the impact of a brief intervention to reduce a cognitive vulnerability factor shown to impact the development of panic and other anxiety psychopathology in adult research. To complement this initial laboratory-based test, a comprehensive training program is proposed with the goal of situating the PI to pursue a prevention-oriented research program in an academic setting. Given the profound negative consequences of anxiety psychopathology, it is imperative to invest funds in both the testing of promising intervention programming as well as the training of prevention scientists.