Sustained Neural Processing in Affective Regions Predicts Efficacy of a Computer-Based Intervention Targeting Attentional Patterns in Transdiagnostic Clinical Anxiety
2019-02-28T19:44:34Z (GMT) by
Research suggests that individuals with clinical anxiety demonstrate an attention bias toward threatening information in their environment. Attention Bias Modification (ABM) is a computer-based treatment that trains attention towards non-threatening stimuli over threatening stimuli. While alterations in initial processing of threat have been linked to responses to ABM, the impact of sustained processing in the aftermath of neutral and threatening information upon outcomes following this targeted intervention has not been well studied. Our study analyzed how sustained activity in brain regions related to cognitive and affective processing can predict who is a good candidate for ABM. Unmedicated anxious individuals assigned to the ABM condition (n=38) underwent fMRI during performance of a novel task sensitive to sustained emotional information processing.Afterward, they underwent eight ABM treatment sessions. Participants whose sustained reactivity to neutral stimuli was high in the amygdala, the left BNST, the left VLPFC, and the pgACC displayed the least improvement with ABM.These results suggest that certain anxious individuals may have difficulty distinguishing between neutral and threatening information due to an overly threat-oriented appraisal of their environment, and would thus benefit less from ABM. By studying neural predictors of success in ABM treatment and focusing on the individual differences in neural-attentional dimensions within a transdiagnostic sample of anxiety patients, we can help identify which subset of anxious patients would be good candidates for this intervention in the clinical setting.