June 12, 2012

Investigating Computer Therapy For Children With Anxiety

Connie K. Ho for redOrbit.com

One in eight. This statistic refers to the number of children who suffer from an anxiety disorder, according to the Anxiety and Depression Association of America. Professor Yair Bar-Haim of  Tel Aviv University's School of Psychological Sciences and his team of researchers studied a new way to address childhood anxiety with Attention Bias Modification (ABM), which was reported in a recent edition of the American Journal of Psychiatry.

To begin, ABM lowers anxiety by having children focus less on potential threats and this method can help improve their thought patterns. The program by Bar-Haim went through an initial clinical trial, demonstrating certain advantages and effectiveness as opposed to other medication and cognitive therapy for children. The ABM therapy focused on measuring a patient´s threat-related attention pattern with a dot-probe test. In the dot-probe test, a patient is given two images or words—one which is neutral and the other which is threatening. The words then disappear and a dot replaces one of the images or words that had previously been present. Following the disappearance, the patient is asked to press a button to show where the dot is located. A  fast response time to the dot´s location signifies that the patient has a certain negative bias. The test was changed to a therapy with the location of the dot target changing to appear more often beneath the neutral image or word. Slowly, the patient would begin to focus on the stimuli instead, figuring out where the dot would appear. This would assist in normalizing an attention bias pattern and reducing anxiety.

In the project, 40 pediatric patients with continuous anxiety disorders participated to help researchers better understand the illness. They were divided into three groups; the first group received the ABM treatment, the second acted as a placebo group where the dot appeared threatening and neutral stimuli, and the third group was only given neutral images. The participants underwent the training session once a week over a four-week period, completing 480 dot probe trials during each time. The researchers also measured the children´s anxiety levels before and after the session with interviews and questionnaires. The results of the study showed that the placebo group and neutral images group had no significant change in bias to the threatening stimuli. On the other hand, in the ABM group, the participants showed significant change. By the end of the trial, around 33 percent of the patients in the ABM group no longer showed diagnostic criteria for the anxiety disorder.

With such findings, Bar-Haim explained that ABM was successful because children tended to be comfortable with computers. These positive results showed that ABM could be a good alternative treatment when cognitive therapy could not be obtained or when there were too many negative side effects to medication. In addition, ABM treatments can be conducted online or by personnel who didn´t obtain doctorates.

"This could be a game-changer for providing treatment," noted Bar-Haim.

In taking the next step with the project, Bar-Haim believes that more research needs to be done in this area. He is working with the National Institute of Mental Health in the U.S. to see that the program is placed in 20 different locations in five other continents. Bar-Haim also believes that, the more options there are, the more opportunities there are for physicians to treat patients. Overall, the success of this research shows that early intervention can influence a patient´s life trajectory.

"Psychological disorders are complex, and not every patient will respond well to every treatment. It's great to have new methods that have a basis in neuroscience and clinical evidence," Bar-Haim concluded in the statement.