The primary objective of this study is to develop an Attention Training (AT) protocol for adolescents with social anxiety disorder (SAD). Attentional biases to threat have been shown to be associated with the development and maintenance of anxiety disorders, in both adults and youth (Bar-Haim et al., 2007;Cowart &Ollendick, 2010;Perez-Edgar et al., 2010;Schechner et al., 2011). Given these relations, AT paradigms have been developed to modify these attentional biases. Such paradigms have been shown to be promising in the treatment of adult anxiety (Amir et al, 2009;Buckner &Timpano, 2009;Klumpp &Amir, 2010;MacLeod &Bridle, 2006;Richey &Schmidt, 2006). However, to date, only two small studies have examined the use of AT with children, and no ATT protocol has been developed specifically for use with children or adolescents. This is important, given the complications and possible ineffectiveness of applying adult-designed therapies to youth (Ollendick &Vasey, 2001). Given this gap in the literature, the primary aims of the current study are intended to develop a treatment program to address attentional biases and anxiety in adolescents with SAD, to collect preliminary data regarding the program's short-term efficacy and feasibility, and to explore attention biases as a mediator and moderator of initial treatment outcomes. It is hypothesized that the AT protocol developed in the current project, compared to a placebo control comparator condition, will result in reductions in social anxiety among a sample of adolescents with SAD. Further, the AT protocol is expected to reduce attentional biases to threat among those adolescents who possess such biases prior to treatment (not all adolescents are expected to show this bias yet AT has been shown to be potentially effective with these youth;the presence/absence of attention bias will be explored as a moderator of change). The proposed study will be a pivotal step towards assessing the feasibility of an adolescent-focused AT procedure for the treatment of SAD. Results will contribute to an emerging body of research exploring the ameliorating effects of experimental paradigms that target information processing biases in anxious youth. Given emerging evidence regarding the use of AT in adult populations, findings from this study may have implications for improving the current prevention and treatment options available for anxious adolescents.

Public Health Relevance

The proposed study represents one of the first known attempts to treat anxiety in socially anxious adolescents through the modification of attentional processing using attention training. This treatment has the potential to be more acceptable to socially anxious adolescents as compared to traditional treatments because of its brief, computer-based nature. As such, we believe this will significantly advance access to treatment in this population.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Planning Grant (R34)
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Interventions Committee for Disorders Involving Children and Their Families (ITVC)
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Avenevoli, Shelli A
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Virginia Polytechnic Institute and State University
Schools of Arts and Sciences
United States
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Wieckowski, Andrea Trubanova; Capriola-Hall, Nicole N; Elias, Rebecca et al. (2018) Variability of attention bias in socially anxious adolescents: differences in fixation duration toward adult and adolescent face stimuli. Cogn Emot :1-7
Capriola-Hall, Nicole N; Wieckowski, Andrea Trubanova; Ollendick, Thomas H et al. (2018) The Influence of Social Communication Impairments on Gaze in Adolescents with Social Anxiety Disorder. Child Psychiatry Hum Dev 49:672-679
Wieckowski, Andrea Trubanova; Coffman, Marika C; Kim-Spoon, Jungmeen et al. (2016) Impaired fear recognition and social anxiety symptoms in adolescence. J Child Fam Stud 25:3381-3386
Coffman, Marika C; Trubanova, Andrea; Richey, J Anthony et al. (2015) Validation of the NIMH-ChEFS adolescent face stimulus set in an adolescent, parent, and health professional sample. Int J Methods Psychiatr Res 24:275-86
Ollendick, Thomas H (2014) Advances toward evidence-based practice: where to from here? Behav Ther 45:51-5