Pursuing a new method to address childhood anxiety over concerns that one in eight children suffer from an anxiety disorder in America are researchers.
Based on a computer program, Prof. Yair Bar-Haim of Tel Aviv University's School of Psychological Sciences and his fellow researchers are pursuing the treatment that uses a technique called Attention Bias Modification (ABM) to reduce anxiety by drawing children away from their tendency to dwell on potential threats, ultimately changing their thought patterns.
In its initial clinical trial, the program was as effective as medication and cognitive therapy for children - with several distinct advantages.
Children are comfortable with computers, explained Prof. Bar-Haim. And because of the potential side effects of medications or the difficulty in obtaining cognitive behavioral therapy, such as the need for highly trained professionals, it is good to have an alternative treatment method.
ABM treatments can be disseminated over the Internet or administered by personnel who don't have to be PhD's.
"This could be a game-changer for providing treatment," he said.
According to Prof. Bar-Haim, anxious individuals have a heightened sensitivity towards threats that the average person would ignore, a sensitivity that creates and maintains anxiety.
One of the ways to measure a patient's threat-related attention patterns is called the dot-probe test.
The patient is presented with two pictures or words, one threatening and one neutral. These words then disappear and a dot appears where one of the pictures or words had been, and the patient is asked to press a button to indicate the dot's location.
A fast response time to a dot that appears in the place of the threatening picture or word indicates a bias towards threat.
To turn this test into a therapy, the location of the dot target is manipulated to appear more frequently beneath the neutral word or picture.
Gradually, the patient begins to focus on that stimulus instead, predicting that this is where the dot will appear - helping to normalize the attention bias pattern and reduce anxiety.
Prof. Bar-Haim and his colleagues enlisted the participation of 40 pediatric patients with ongoing anxiety disorders and divided them into three groups.
The first received the new ABM treatment; the second served as a placebo group where the dot appeared equally behind threatening and neutral images; and the third group was shown only neutral stimuli.
Patients participated in one session a week for four weeks, completing 480 dot probe trials each session.
The children's anxiety levels were measured before and after the training sessions using interviews and questionnaires.
In both the placebo group and neutral images group, researchers found no significant change in the patients' bias towards threatening stimuli.
However, in the ABM group, there were marked differences in the participants' threat bias.
By the end of the trial, approximately 33 percent of the patients in this group no longer met the diagnostic criteria for anxiety disorder.
These indications of the method's success in treating children warrant further investigation, Prof. Bar-Haim said.
The more options that exist for patients, the better that clinicians can tailor treatment for their patient's individual needs, Prof. Bar-Haim observes.
There are always patients for whom medication or cognitive therapy is not a viable option, he explained.
"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," he added.
The results of the trial were reported in the American Journal of Psychiatry.