Anxiety disorders are one of the most prevalent mental health problems for adolescents. Cognitive Bias Modification (CBM) training targets information processing biases implicated in the development and maintenance of anxiety in adolescents. The main aim of this thesis is the development and evaluation of methods to boost CBM for anxious adolescents. The thesis first presents findings from a meta-analytic evaluation of eye-tracking studies in anxious children and adolescents; the results demonstrating no difference in vigilance to threat between anxious and non-anxious youth, but a greater overall avoidance of threat in anxious youth. Following this, three experimental studies are presented, evaluating methods to boost CBM in anxious adolescents. The first evaluates a multi-session, combined bias CBM package, targeting biases of attention, interpretation and attribution in socially anxious adolescents. Results demonstrate good acceptability and greater reductions in social anxiety, negative social behaviour, general anxiety and depression following an intervention but not a baseline phase, and a significant correlation between interpretation bias change and social anxiety symptom change. The second experimental study aims to boost attention bias modification by comparing incorporation of an extrinsic motivator, in the form of real-time performance feedback, and the use of real-time performance data to tailor the task to the individuals’ optimal rate of learning. Results show an overall modification of attention bias on one measure of attention bias, which did not generalise to an alternative measure, and an effect of initial direction of attention bias on modification outcome. However, no differential effect of training group was observed. The final experiment evaluated the use of neurofeedback (NF), which aims to boost the practice of adaptive emotion regulation strategies by providing real-time feedback of activity from associated brain regions in adolescents. Results showed that individuals unable to acquire the desired pattern of connectivity through NF training displayed greater subsequent social-avoidant behaviour than those who successfully acquired the desired connectivity pattern, as well as reporting a significant decrease in reappraisal ability. The findings are discussed in the context of the wider literature, providing implications for theory and future directions.
Boosting cognitive training: exploring Cognitive Bias Modification adaptations for adolescent anxiety
Lisk, S. (Author). 1 Aug 2019
Student thesis: Doctoral Thesis › Doctor of Philosophy