Generalized Anxiety Disorder (GAD) is characterized by excessive, uncontrollable worry (Barlow, et al., 1986) leading to medical over-utilization, poor perceived health, low ratings of quality of life, and impairment at work that result in a significant economic and public health impact (Ballenger et al., 2001;Hoffman et al., 2008;Wittchen, 2002). Lifetime prevalence of GAD is high (5.7%, Kessler et al., 2005;8.5% in primary care setting, Roy-Byrne &Wager, 2004). Although efficacious psychosocial and pharmacological treatments for GAD exist (for a reviews see Nutt, et al., 2002), the majority of these individuals do not access our most effective treatments (Collins et al., 2004) and treatment-seeking delays are longest for this condition relative to other anxiety and mood disorders (i.e., 14 years from the time of onset;Kessler et al., 1998). The substantial delays in treatment seeking, failure to access evidence-based treatments and overutilization of medical services, result in prolonged personal and economic costs. Thus, there is a significant unmet need for the development of efficient and cost-effective treatments that have the potential to be widely accessible to individuals with GAD. The current proposal directly responds to the NIMH priorities for evaluating user-friendly interventions and non- traditional delivery methods to increase access to evidence-based interventions. We will evaluate the efficacy of a 12-week computer-delivered home-based treatment program for GAD. Treatment will comprise a combination of two interventions shown to be efficacious in the treatment of GAD. The Attention Modification Program (AMP) is a computerized program designed to facilitate attention disengagement from threatening stimuli (Amir et al., 2009). Applied Relaxation (AR) is a behavioral, skills-based intervention where individuals learn ways to reduce the physiological cues associated with anxiety and worry (Vst, 1987;Siev &Chambless, 2007). Following the recommended guidelines of the NIMH Workgroup on Psychosocial Intervention Development (Hollon et al., 2002), we review evidence suggesting that both treatments are ideal candidates for the efficient, economical, and widespread transportation of evidence-based treatments for GAD. This proposal has the potential for a significant public health impact by evaluating a new method for delivering evidence-based interventions for hard-to-reach populations through the use of innovative technologies.

Public Health Relevance

Generalized anxiety disorder (GAD) is a prevalent and debilitating psychiatric condition associated with low rates of accessing evidence-based treatments that result in prolonged personal and economic costs. Thus, there is a significant unmet need for development of efficient and cost-effective treatments that are widely accessible to individuals suffering with this condition. The current proposal aims to address these issues by evaluating the feasibility and effectiveness of a computer-delivered home- based treatment program for GAD that comprises a combination of two interventions shown to be efficacious in the treatment of GAD (i.e., attention training and applied relaxation).

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Project (R01)
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Study Section
Mental Health Services in Non-Specialty Settings (SRNS)
Program Officer
Pearson, Jane L
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San Diego State University
Schools of Arts and Sciences
San Diego
United States
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Kinney, Kerry L; Boffa, Joseph W; Amir, Nader (2017) Gender Difference in Attentional Bias Toward Negative and Positive Stimuli in Generalized Anxiety Disorder. Behav Ther 48:277-284
Nelson, Brady D; Jackson, Felicia; Amir, Nader et al. (2017) Attention bias modification reduces neural correlates of response monitoring. Biol Psychol 129:103-110
Kuckertz, Jennie M; Strege, Marlene V; Amir, Nader (2017) Intolerance for approach of ambiguity in social anxiety disorder. Cogn Emot 31:747-754
Boutelle, Kerri N; Monreal, Teresa; Strong, David R et al. (2016) An open trial evaluating an attention bias modification program for overweight adults who binge eat. J Behav Ther Exp Psychiatry 52:138-146
Amir, Nader; Kuckertz, Jennie M; Strege, Marlene V (2016) A Pilot Study of an Adaptive, Idiographic, and Multi-Component Attention Bias Modification Program for Social Anxiety Disorder. Cognit Ther Res 40:661-671
Taylor, Charles T; Cross, Karalani; Amir, Nader (2016) Attentional control moderates the relationship between social anxiety symptoms and attentional disengagement from threatening information. J Behav Ther Exp Psychiatry 50:68-76
Nelson, Brady D; Jackson, Felicia; Amir, Nader et al. (2015) Single-session attention bias modification and error-related brain activity. Cogn Affect Behav Neurosci 15:776-86
Najmi, Sadia; Amir, Nader; Frosio, Kristen E et al. (2015) The effects of cognitive load on attention control in subclinical anxiety and generalised anxiety disorder. Cogn Emot 29:1210-23
Amir, Nader; Kuckertz, Jennie M; Najmi, Sadia et al. (2015) Preliminary Evidence for the Enhancement of Self-Conducted Exposures for OCD using Cognitive Bias Modification. Cognit Ther Res 39:424-440
Price, Rebecca B; Kuckertz, Jennie M; Siegle, Greg J et al. (2015) Empirical recommendations for improving the stability of the dot-probe task in clinical research. Psychol Assess 27:365-76

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