Category: Adult Anxiety


Combined Top-Down and Bottom-Up Computerized Intervention for Anxiety Sensitivity

Sunday, November 19
10:15 AM - 11:45 AM
Location: Sapphire Ballroom A, Level 4, Sapphire Level

Keywords: Anxiety Sensitivity | Anxiety | Technology / Mobile Health
Presentation Type: Symposium

Objective: Anxiety sensitivity (AS), a fear of anxiety-related sensations, is one of the few known malleable risk factors for anxiety pathology.  Participants in previous AS reduction CBM treatments have shown self-reported reductions in AS; however, they have questioned whether they received an active intervention. Most individuals in the active condition report believing they received a placebo intervention, which may lead to reduced patient engagement in non-laboratory medical settings. Pairing CBM with more traditional psychoeducation may create a computer delivered treatment that is more consistent with patient expectations for anxiety treatment.  The goal of the current study was to evaluate an AS intervention utilizing a combination of “top-down” (psychoeducation) and “bottom-up” (interpretation bias modification; CBM-I) intervention elements.  Design: Single-site randomized controlled trial. Participants completed an intervention appointment and one-month follow-up assessment. The main outcome measure was the Anxiety Sensitivity Index-3 (ASI-3; Taylor et al., 2007). Participants: Individuals with elevated levels of AS. Intervention: Single-session computer-delivered combined intervention (CBM-I plus psychoeducation) for AS.  Results: Results indicate that the combined AS intervention was successful in reducing overall AS (59% post-intervention) and these reductions were maintained through one-month post-intervention (52%).  Accounting for baseline ASI-3 scores, post-intervention ASI-3 scores were significantly lower in the combined condition (β = .24, p < .05). Cohen’s d was .99, indicating a large effect of the combined intervention. In addition, accounting for baseline ASI-3 scores, month 1 ASI-3 scores remained significantly lower in the combined condition (β = .26, p < .05), with an effect size estimate of 1.18.  Individuals in the combined condition reported significantly lower rates of panic responding to a vital-capacity CO2 challenge (OR = 6.34, 95% CI = 1.07 – 37.66, Wald = 4.12, p = .04). Change in interpretation bias significantly mediated the relationship between treatment condition and post-treatment AS reductions (B = - 7.30, SE = 3.91, 95% CI [-16.28, -.70]. 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 be used in a variety of patient settings. 

Dan Capron

Assistant Professor
University of Southern Mississippi


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Combined Top-Down and Bottom-Up Computerized Intervention for Anxiety Sensitivity

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