1- shahid beheshti university
Abstract: (918 Views)
Background & Objectives: Generalized anxiety disorder (GAD) is one of the most frequent and pervasive anxiety disorders characterized by persistent and excessive worrying or anxiety about some events or activities. Particular difficulties in controlling worry in these people cause many personal and social problems and need to be addressed. There are several psychopathological models of generalized anxiety disorder that have examined various psychological processes involved in initiating, developing, and maintaining anxiety and pathological worry in people with generalized anxiety disorder. GAD’s Information processing models showed how anxious individuals process threatening information as a causal role in developing and preserving worry. Substantial evidence exists in which individuals with GAD and high worry and anxiety levels demonstrated attentional bias to threatening information. Based on the literature, it is possible to rehabilitate attentional biases in these people through potential attention training programs. Training attention may decrease attention biases to threatening information and cause reduced anxiety and worry levels in individuals with GAD, and improve their personal and social functions. Therefore, the present study aimed to evaluate the effectiveness of cognitive rehabilitation of attentional bias to reduce the attentional bias on conscious and unconscious levels in Iraqi adolescents with generalized anxiety disorder.
Methods: The present study was a quasi-experimental study with pre-test, post-test, and a three-month follow-up in a group of Iraqi adolescents with generalized anxiety disorders. The statistical population was all the Iraqi adolescents between the ages of 15 and 18 in Najaf city, suffering from GAD. The sample included 17 adolescents (7 girls and ten boys) with GAD who selected from the statistical population using the targeted sampling method. Instruments used to screen anxiety disorders and assess attention biases in the sample were Screen for Child Anxiety Related Disorders (SCARED) and emotional Dot-probe task, respectively. Dot-probe task used to evaluate both unconscious (stimulus presentation time of 200 milliseconds) and conscious (stimulus presentation time of 500 milliseconds) levels of attention bias for the fearful and neutral facial emotion expressions. After screening participants between the ages of 15 and 18 for GAD with the SCARED and certified psychiatrist, those qualified to attend our study completed the dot-probe task before, after, and three months later than intervention. The intervention was twelve one-hour sessions of a cognitive rehabilitation program called ABR by its creator. To analyze the collected data, repeated measures analysis of variance was done by SPSS software. In repeated measure analyses, time levels (pre-test, post-test, and follow-up) were used as within-subject factors. Differences in reaction times to congruent and incongruent stimuli were assessed for both conscious and unconscious situations.
Results: Repeated measures analyses in our study showed statistically significant differences between pre-test, post-test, and follow-up on congruent, and attention bias index in conscious situation (p< 0/001). But there were no significant differences in reaction times to incongruent stimuli between pre-test, post-test, and follow-up. In unconscious situation, we did not find any significant differences from pre-tests to follow-ups on both reaction times to congruent stimuli and attention bias index, but the mean differences between pre-test, post-test, and follow-up on reaction time to incongruent stimuli were statistically significant (p= 0/018). Post Hoc tests for the conscious situation indicated that the attention to congruent stimuli decreased at post-test compared to pre-test and remained at follow-up. Attention bias indices also reduced at the post-test and follow-up compared to the pre-test. Besides, the post-hoc tests for incongruent stimuli at the unconscious level showed reductions at the post-test compared to the pre-test.
Conclusion: Based on the result obtained in the present study, attention biases to threatening information in adolescents with GAD can decrease using the cognitive rehabilitation (ABR) program. This program can affect both conscious and unconscious levels of attention. Therefore, such cognitive rehabilitation programs can be promising as an effective way to modify the attention bias in adolescents with generalized anxiety disorder and decrease the anxiety and worry levels in these people.
Methods: The present study was a quasi-experimental study with pre-test, post-test, and a three-month follow-up in a group of Iraqi adolescents with generalized anxiety disorders. The statistical population was all the Iraqi adolescents between the ages of 15 and 18 in Najaf city, suffering from GAD. The sample included 17 adolescents (7 girls and ten boys) with GAD who selected from the statistical population using the targeted sampling method. Instruments used to screen anxiety disorders and assess attention biases in the sample were Screen for Child Anxiety Related Disorders (SCARED) and emotional Dot-probe task, respectively. Dot-probe task used to evaluate both unconscious (stimulus presentation time of 200 milliseconds) and conscious (stimulus presentation time of 500 milliseconds) levels of attention bias for the fearful and neutral facial emotion expressions. After screening participants between the ages of 15 and 18 for GAD with the SCARED and certified psychiatrist, those qualified to attend our study completed the dot-probe task before, after, and three months later than intervention. The intervention was twelve one-hour sessions of a cognitive rehabilitation program called ABR by its creator. To analyze the collected data, repeated measures analysis of variance was done by SPSS software. In repeated measure analyses, time levels (pre-test, post-test, and follow-up) were used as within-subject factors. Differences in reaction times to congruent and incongruent stimuli were assessed for both conscious and unconscious situations.
Results: Repeated measures analyses in our study showed statistically significant differences between pre-test, post-test, and follow-up on congruent, and attention bias index in conscious situation (p< 0/001). But there were no significant differences in reaction times to incongruent stimuli between pre-test, post-test, and follow-up. In unconscious situation, we did not find any significant differences from pre-tests to follow-ups on both reaction times to congruent stimuli and attention bias index, but the mean differences between pre-test, post-test, and follow-up on reaction time to incongruent stimuli were statistically significant (p= 0/018). Post Hoc tests for the conscious situation indicated that the attention to congruent stimuli decreased at post-test compared to pre-test and remained at follow-up. Attention bias indices also reduced at the post-test and follow-up compared to the pre-test. Besides, the post-hoc tests for incongruent stimuli at the unconscious level showed reductions at the post-test compared to the pre-test.
Conclusion: Based on the result obtained in the present study, attention biases to threatening information in adolescents with GAD can decrease using the cognitive rehabilitation (ABR) program. This program can affect both conscious and unconscious levels of attention. Therefore, such cognitive rehabilitation programs can be promising as an effective way to modify the attention bias in adolescents with generalized anxiety disorder and decrease the anxiety and worry levels in these people.
Type of Study: Original Research Article |
Subject:
Rehabilitation
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