Combined "Top-Down" and "Bottom-Up" Intervention for Anxiety Sensitivity; Pilot Randomized Trial Testing the Additive Effect of Interpretation Bias Modification

Document Type

Article

Publication Date

2-2017

Department

Psychology

Abstract

Objective

Anxiety disorders contribute substantially to the overall public health burden. Anxiety sensitivity (AS), a fear of anxiety-related sensations, is one of the few known malleable risk factors for anxiety pathology. Previous AS reduction treatments have primarily utilized “top-down” (e.g., psychoeducation) interventions. The goal of the current study was to evaluate the effect of adding a “bottom-up” (interpretation bias modification; CBM-I) intervention to an AS psychoeducation intervention.

Design

Single-site randomized controlled trial. Participants completed either a 1) Psychoeducation + active CBM-I or 2) Psychoeducation + control CBM-I intervention. Change in AS was assessed post-intervention and at a one-month follow-up.

Participants

Individuals with elevated levels of AS.

Intervention

Single-session computer-delivered intervention for AS.

Results

Accounting for baseline ASI-3 scores, post-intervention ASI-3 scores were significantly lower in the combined condition than in the psychoeducation + control CBM-I condition (β = 0.24, p < 0.05; d = 0.99). The active CBM-I plus psychoeducation AS intervention was successful in reducing overall AS (59% post-intervention; p < 0.05, Cohen's d = 0.99) and these reductions were maintained through one-month post-intervention (52%; p < 0.05, Cohen's d = 1.18). Participants in the active condition reported significantly lower rates of panic responding to a vital-capacity CO2 challenge (OR = 6.34, 95% CI = 1.07–37.66). Lastly, change in interpretation bias significantly mediated the relationship between treatment condition and post-treatment AS reductions.

Conclusions

The current intervention was efficacious in terms of immediate and one-month AS reductions. Given its brevity, low-cost, low-stigma and portability, this intervention could lead to reducing the burden of anxiety disorders.

Publication Title

Journal of Psychiatric Research

Volume

85

First Page

75

Last Page

82

Link to Full Text

Find in your library

Share

COinS