Exploring the impact of intervention on children and young peoples' anxiety and information processing

Abstract

The efficacy of cognitive behavioural therapy (CBT) for reducing anxiety in children is well documented, however the mechanisms underlying this reduction in symptoms is unclear. This paper presents a systematic review and empirical paper. The review explores the impact of CBT, Cognitive Bias Modification of Interpretation (CBMI) and Attentional Bias Modification Therapy (ABMT) on children and young people’s anxiety levels, attentional biases and interpretation biases, and the relationships between the variables. The review identifies that CBT efficiently reduces anxiety, the impact of CBMI and ABMT on anxiety is not clear. CBMI and ABMT induced their intended cognitive biases, however the effect of altering cognitive biases on anxiety was unclear. Furthermore, no studies considered the interaction between changes in cognitive biases. The limited available evidence supports the proposal that changes in anxiety result in changes in cognitive biases, however further research is necessary to consider the impact of changing cognitive biases on anxiety and the interaction between changes in cognitive biases. The empirical paper assessed whether reductions in anxiety following CBT are linked to improvements in attention (e.g., the ability to focus and shift attention and to suppress attention to threat). The study utilised a time lagged randomised control trial to explore the effects of CBT (vs. waitlist control) on anxiety and attention in young people reporting elevated anxiety. Participants completed questionnaire measures of anxiety and attentional control and experimental measures of inhibitory control and attentional biases to emotional stimuli at pre-intervention, post-intervention and at 10-12 week follow-up. Significant reductions in anxiety were found over time in the CBT and waitlist control groups. Reductions in anxiety were associated with increased top-down control (i.e. self-reported attentional control) and increased top-down control was associated with less bottom-up processing (i.e. greater vigilance for threat).

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