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Augmenting one session treatment of children’s specific phobias with attention training towards positive stimuli

Augmenting one session treatment of children’s specific phobias with attention training towards positive stimuli
Augmenting one session treatment of children’s specific phobias with attention training towards positive stimuli
This study examined the efficacy of combining two promising approaches to treating children's specific phobias, namely attention training and one 3-h session of exposure therapy (‘one-session treatment’, OST). Attention training towards positive stimuli (ATP) and OST (ATP+OST) was expected to have more positive effects on implicit and explicit cognitive mechanisms and clinical outcome measures than an attention training control (ATC) condition plus OST (ATC+OST). Thirty-seven children (6–17 years) with a specific phobia were randomly assigned to ATP+OST or ATC+OST. In ATP+OST, children completed 160 trials of attention training responding to a probe that always followed the happy face in happy-angry face pairs. In ATC+OST, the probe appeared equally often after angry and happy faces. In the same session, children completed OST targeting their phobic situation/object. Clinical outcomes included clinician, parent and child report measures. Cognitive outcomes were assessed in terms of change in attention bias to happy and angry faces and in danger and coping expectancies. Assessments were completed before and after treatment and three-months later. Compared to ATC+OST, the ATP+OST condition produced (a) significantly greater reductions in children's danger expectancies about their feared situations/object during the OST and at three-month follow-up, and (b) significantly improved attention bias towards positive stimuli at post-treatment, which in turn, predicted a lower level of clinician-rated phobia diagnostic severity three-months after treatment. There were no significant differences between ATP+OST and ATC+OST conditions in clinician, parent, or child-rated clinical outcomes. Training children with phobias to focus on positive stimuli is effective in increasing attention towards positive stimuli and reducing danger expectancy biases. Studies with larger sample sizes and a stronger ‘dose’ of ATP prior to the OST may reveal promising outcomes on clinical measures for training attention towards positive stimuli.
0005-7967
107-119
Waters, A.M.
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Farrell, L.J.
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Zimmer-Gembeck, M.J.
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Milliner, E.
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Tiralongo, E.
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Donovan, C.
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McConnell, H.
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Bradley, B.P.
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Mogg, K.
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Ollendick, T.H.
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Waters, A.M.
87092f14-7f87-4ae0-adc3-15f63fb50b7b
Farrell, L.J.
0c3666b9-22f3-4c0b-aada-de2bcc34ddf6
Zimmer-Gembeck, M.J.
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Milliner, E.
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Tiralongo, E.
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Donovan, C.
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McConnell, H.
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Bradley, B.P.
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Mogg, K.
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Ollendick, T.H.
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Waters, A.M., Farrell, L.J., Zimmer-Gembeck, M.J., Milliner, E., Tiralongo, E., Donovan, C., McConnell, H., Bradley, B.P., Mogg, K. and Ollendick, T.H. (2014) Augmenting one session treatment of children’s specific phobias with attention training towards positive stimuli. [in special issue: The Neuroscience of Psychological Treatments] Behaviour Research and Therapy, 62, 107-119. (doi:10.1016/j.brat.2014.07.020).

Record type: Article

Abstract

This study examined the efficacy of combining two promising approaches to treating children's specific phobias, namely attention training and one 3-h session of exposure therapy (‘one-session treatment’, OST). Attention training towards positive stimuli (ATP) and OST (ATP+OST) was expected to have more positive effects on implicit and explicit cognitive mechanisms and clinical outcome measures than an attention training control (ATC) condition plus OST (ATC+OST). Thirty-seven children (6–17 years) with a specific phobia were randomly assigned to ATP+OST or ATC+OST. In ATP+OST, children completed 160 trials of attention training responding to a probe that always followed the happy face in happy-angry face pairs. In ATC+OST, the probe appeared equally often after angry and happy faces. In the same session, children completed OST targeting their phobic situation/object. Clinical outcomes included clinician, parent and child report measures. Cognitive outcomes were assessed in terms of change in attention bias to happy and angry faces and in danger and coping expectancies. Assessments were completed before and after treatment and three-months later. Compared to ATC+OST, the ATP+OST condition produced (a) significantly greater reductions in children's danger expectancies about their feared situations/object during the OST and at three-month follow-up, and (b) significantly improved attention bias towards positive stimuli at post-treatment, which in turn, predicted a lower level of clinician-rated phobia diagnostic severity three-months after treatment. There were no significant differences between ATP+OST and ATC+OST conditions in clinician, parent, or child-rated clinical outcomes. Training children with phobias to focus on positive stimuli is effective in increasing attention towards positive stimuli and reducing danger expectancy biases. Studies with larger sample sizes and a stronger ‘dose’ of ATP prior to the OST may reveal promising outcomes on clinical measures for training attention towards positive stimuli.

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Accepted/In Press date: 28 July 2014
e-pub ahead of print date: 8 August 2014
Published date: November 2014
Organisations: Psychology

Identifiers

Local EPrints ID: 399518
URI: https://eprints.soton.ac.uk/id/eprint/399518
ISSN: 0005-7967
PURE UUID: 2c9876bd-7f9c-4474-be07-58c22867dc3b
ORCID for B.P. Bradley: ORCID iD orcid.org/0000-0003-2801-4271

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Date deposited: 19 Aug 2016 07:59
Last modified: 18 May 2019 00:36

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Contributors

Author: A.M. Waters
Author: L.J. Farrell
Author: M.J. Zimmer-Gembeck
Author: E. Milliner
Author: E. Tiralongo
Author: C. Donovan
Author: H. McConnell
Author: B.P. Bradley ORCID iD
Author: K. Mogg
Author: T.H. Ollendick

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