Category: Adult Anxiety - Social

Symposium

Upregulating the Approach System in SAD: Outcomes of a Trial of Computerized Approach/Avoidance Training

Saturday, November 18
2:00 PM - 3:30 PM
Location: Aqua Salon A & B, Level 3, Aqua Level

Keywords: Social Anxiety | Social Relationships | Randomized Controlled Trial
Presentation Type: Symposium

Background: At the core of social anxiety disorder (SAD) is an approach/avoidance conflict – the desire for affiliation (approach) combined with fears of rejection (avoidance). Social anxiety is associated with a diminished automatic predisposition to approach positive social cues, a process that may limit one's capacity to capitalize on positive social emotional opportunities. Experimentally inducing an automatic approach bias for positive social cues has been shown to facilitate positive social connections in socially anxious individuals in the laboratory. Method: The current study builds on this work to examine the therapeutic potential of upregulating the approach system through a multi-session approach/avoidance training program in n=40 individuals diagnosed with SAD. The experimental paradigm comprised a computerized Approach Avoidance Task (AAT) in which participants responded to pictures of faces conveying positive or neutral emotional expressions by pulling a joystick toward themselves (approach) or by moving it to the right (sideways control). Participants were randomly assigned to complete four sessions of an AAT designed to either increase approach tendencies for positive social cues (Approach Positive Training; n=20), or to a condition in which there was an equal balance between approach movements for positive and neutral stimuli (Approach Control Training; n=20). Each AAT training session was immediately followed by exposure to a controlled social interaction task. Participants completed measures of positive social relationship functioning at pre, post, and 1-month following the intervention. Results: Treatment completion rates were high (95%). Preliminary analyses revealed that all participants displayed significant improvements in positive relational functioning (e.g., connectedness, relationship satisfaction) from before to after treatment, persisting through follow-up. Group-level analyses (once the experimental blind is broken) will compare differential trajectories of change in the Approach Positive vs. Control Training conditions. Mediators and moderators of treatment response will be explored. Discussion: Results will be considered in relation to (1) a possible causal role of automatic approach-oriented action tendencies in the persistence of social relationship impairments in SAD, and (2) potential therapeutic extensions of computer-delivered approach/avoidance training procedures intended to improve positive social and emotional functioning.

Charles T. Taylor

Assistant Professor
University of California, San Diego

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