title: Combined "top-down" and "bottom-up" intervention for anxiety sensitivity: Pilot randomized trial testing the additive effect of interpretation bias modification.
abstract: Anxiety disorders contribute substantially to the overall public health burden. Anxiety sensitivity (AS), a fear of anxiety-related sensations, is one of the few known malleable risk factors for anxiety pathology. Previous AS reduction treatments have primarily utilized "top-down" (e.g., psychoeducation) interventions. The goal of the current study was to evaluate the effect of adding a "bottom-up" (interpretation bias modification; CBM-I) intervention to an AS psychoeducation intervention.
  
  
  
  Single-site randomized controlled trial. Participants completed either a 1) Psychoeducation + active CBM-I or 2) Psychoeducation + control CBM-I intervention. Change in AS was assessed post-intervention and at a one-month follow-up.
  
  
  
  Individuals with elevated levels of AS.
  
  
  
  Single-session computer-delivered intervention for AS.
  
  
  
  Accounting for baseline ASI-3 scores, post-intervention ASI-3 scores were significantly lower in the combined condition than in the psychoeducation + control CBM-I condition (β = 0.24, p < 0.05; d = 0.99). The active CBM-I plus psychoeducation AS intervention was successful in reducing overall AS (59% post-intervention; p < 0.05, Cohen's d = 0.99) and these reductions were maintained through one-month post-intervention (52%; p < 0.05, Cohen's d = 1.18). Participants in the active condition reported significantly lower rates of panic responding to a vital-capacity CO2challenge (OR = 6.34, 95% CI = 1.07-37.66). Lastly, change in interpretation bias significantly mediated the relationship between treatment condition and post-treatment AS reductions.
  
  
  
  The current intervention was efficacious in terms of immediate and one-month AS reductions. Given its brevity, low-cost, low-stigma and portability, this intervention could lead to reducing the burden of anxiety disorders.
authors.affiliation: Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA; Department of Psychology, Florida State University, Tallahassee, FL, USA. Electronic address: daniel.capron@usm.edu.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Capron
authors.affiliation: Department of Psychology, Florida State University, Tallahassee, FL, USA.
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Norr
authors.affiliation: Department of Psychology, Florida State University, Tallahassee, FL, USA.
authors.forename: Nicholas P
authors.initials: NP
authors.lastname: Allan
authors.affiliation: Department of Psychology, Florida State University, Tallahassee, FL, USA.
authors.forename: Norman B
authors.initials: NB
authors.lastname: Schmidt
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000503:physiopathology / Q000628:therapy*; D001008:Anxiety Disorders / Q000628:therapy; D002248:Carbon Monoxide; D015928:Cognitive Behavioral Therapy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010200:Panic / Q000502:physiology; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D057566:Self Report; D013813:Therapy, Computer-Assisted / Q000379:methods; D016896:Treatment Outcome; D014797:Vital Capacity; D055815:Young Adult
chemical_list: D002248:Carbon Monoxide