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游戏化注意偏差修改培训以增强青少年焦虑障碍的认知行为疗法:随机对照试验
Meghan E Byrne1, Simone Haller1, Julia O Linke2
1National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland.
概括
将注意力偏差修改训练 (ABMT) 添加到认知行为疗法 (CBT) 并没有改善年轻人的焦虑症状. 需要进一步的研究,以找到有效的焦虑治疗注意力偏差修改策略.
科学领域:
- 神经科学
- 精神病学
- 临床心理学
背景情况:
- 认知行为疗法是青少年焦虑症的常见治疗方法.
- 注意偏差修改训练 (ABMT) 针对与焦虑相关的认知过程.
- 通过ABMT增强CBT的神经机制尚不清楚.
研究的目的:
- 调查积极的游戏化注意力偏差修改训练 (ABMT) 是否提高了焦虑障碍的青少年的认知行为治疗 (CBT) 的有效性.
- 检查与治疗结果相关的神经相关性,特别是桃体连接性.
主要方法:
- 一项预先注册的,双盲的,随机对照试验对121名被诊断患有焦虑症的儿科患者 (8 - 17岁) 进行.
- 参与者接受了为期12周的手动CBT,随机分为主动或假游戏ABMT.
- 主要结局包括儿科焦虑评分表 (PARS) 和临床整体印象改善表 (CGI- I). 使用fMRI进行了桃体连接的评估.
主要成果:
- 无论是活跃的ABMT组还是假的ABMT组,都显示了焦虑症状的显著减少 (PARS得分显著下降).
- 对于任何一项主要结局措施,在活跃的ABMT和假药组之间没有发现显著的临床疗效差异.
- 虽然桃体连接得到检查,但在健康对照组中其可靠性是可疑的;然而,较弱的左桃体连接与较低的治疗后焦虑有关.
结论:
- 积极游戏化的ABMT会增加青少年焦虑症的CBT疗效的假设没有得到支持.
- 这些发现表明目前的注意力偏差修改策略可能不是最佳的增强CBT响应在这个人群.
- 未来的研究应该探索其他ABMT方法,并专注于提高基于fMRI的注意力任务的可靠性.
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