Objective

Children with behavioral inhibition, a temperament characterized by biologically based hypervigilance to novelty and social withdrawal, are at high risk for developing anxiety. This study examined the effect of a novel attention training protocol, attention bias modification (ABM), on symptomatic, behavioral, and neural risk markers in children with behavioral inhibition.

Method

Nine- to 12-year-old typically developing children identified as having behavioral inhibition (N = 84) were assigned to a 4-session active ABM training (n = 43) or placebo protocol (n = 41) using a double-blinded, randomized, controlled trial approach. Anxiety symptoms (Diagnostic Interview Schedule for Children–Fourth Edition), attention bias (AB; measured by a dot-probe task; AB = incongruent reaction time − congruent reaction time), and AB-related neural activation (measured by functional magnetic resonance imaging activation for the incongruent > congruent contrast in the dot-probe task) were assessed before and after the training sessions.

Results

Results showed that active ABM (n = 40) significantly alleviated participants’ symptoms of separation anxiety, but not social anxiety, compared with the placebo task (n = 40); ABM did not modify behavioral AB scores in the dot-probe task; and at the neural level, active ABM (n = 15) significantly decreased amygdala and insula activation and increased activation in the ventrolateral prefrontal cortex compared with placebo (n = 19).

Conclusion

These findings provide important evidence for ABM as a potentially effective protective tool for temperamentally at-risk children in a developmental window before the emergence of clinical disorder and open to prevention and intervention.

Clinical trial registration information—Attention and Social Behavior in Children (BRAINS); http://clinicaltrials.gov/; NCT02401282.

中文翻译：

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偏重气质风险中注意偏倚修正的生物行为标志：随机对照试验。

客观的

行为抑制儿童的气质以对新奇和社交退缩的生物学基础上的过度警觉为特征，极有可能患上焦虑症。这项研究检查了一种新的注意力训练方案，注意力偏倚修饰（ABM）对行为抑制儿童的症状，行为和神经风险标记的影响。

方法

识别出具有行为抑制作用（N = 84）的9至12岁通常发育中的儿童被分配到使用双盲，四阶段主动ABM训练（n = 43）或安慰剂方案（n = 41），随机对照试验方法。焦虑症状（儿童诊断面试时间表–第四版），注意力偏倚（AB；通过点探针任务测量； AB =反应时间不一致-反应时间一致）和与AB相关的神经激活（通过功能性磁共振成像测量）在训练之前和之后评估点探针任务中不一致（一致）>一致（一致）对比度的激活。

结果

结果显示，与安慰剂相比，积极的ABM（n = 40）可以显着缓解参与者的分离焦虑症状，但不能缓解社交焦虑症状（n = 40）。ABM并未修改点探针任务中的行为AB分数；在神经水平，活性ABM（n = 15）与安慰剂（n = 19）相比，杏仁核和岛岛激活明显减少，腹侧前额叶皮层激活增加。

结论

这些发现为ABM作为潜在的有效保护工具提供了重要证据，该工具可在临床疾病出现之前向处于发育期的气质高危儿童提供预防和干预措施。

临床试验注册信息-儿童的注意力和社会行为（BRAINS）；http://clinicaltrials.gov/；NCT02401282。