title: Augmenting one-session treatment of children's specific phobias with attention training to positive stimuli.
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.
authors.affiliation: School of Applied Psychology, Griffith University, Australia; Griffith Health Institute, Griffith University, Australia. Electronic address: a.waters@griffith.edu.au.
authors.forename: Allison M
authors.initials: AM
authors.lastname: Waters
authors.affiliation: School of Applied Psychology, Griffith University, Australia; Griffith Health Institute, Griffith University, Australia.
authors.forename: Lara J
authors.initials: LJ
authors.lastname: Farrell
authors.affiliation: School of Applied Psychology, Griffith University, Australia; Griffith Health Institute, Griffith University, Australia.
authors.forename: Melanie J
authors.initials: MJ
authors.lastname: Zimmer-Gembeck
authors.affiliation: School of Applied Psychology, Griffith University, Australia; Griffith Health Institute, Griffith University, Australia.
authors.forename: Ella
authors.initials: E
authors.lastname: Milliner
authors.affiliation: School of Pharmacy, Griffith University, Australia; Griffith Health Institute, Griffith University, Australia.
authors.forename: Evelin
authors.initials: E
authors.lastname: Tiralongo
authors.affiliation: School of Applied Psychology, Griffith University, Australia; Griffith Health Institute, Griffith University, Australia.
authors.forename: Caroline L
authors.initials: CL
authors.lastname: Donovan
authors.affiliation: School of Medicine, Griffith University, Australia; Griffith Health Institute, Griffith University, Australia.
authors.forename: Harry
authors.initials: H
authors.lastname: McConnell
authors.affiliation: Psychology, University of Southampton, United Kingdom.
authors.forename: Brendan P
authors.initials: BP
authors.lastname: Bradley
authors.affiliation: Psychology, University of Southampton, United Kingdom.
authors.forename: Karin
authors.initials: K
authors.lastname: Mogg
authors.affiliation: Child Study Centre, Virginia Tech, USA.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Ollendick
mesh_terms: D000293:Adolescent; D001288:Attention / Q000502:physiology*; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D004644:Emotions / Q000502:physiology*; D005260:Female; D006801:Humans; D007171:Implosive Therapy / Q000379:methods*; D008297:Male; D010698:Phobic Disorders / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome
keywords: Attention training; Children; Exposure therapy; Phobias