- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05665491
Role of Parent Interpretation Bias in the Transmission of Anxiety to Children
November 28, 2023 updated by: Courtney Beard, PhD, Mclean Hospital
Parent Interpretation Bias as a Key Mechanism of Intergenerational Transmission of Anxiety
Approximately 30% of children will experience an anxiety disorder, making anxiety the most common mental health problem among children in the United States.
However, few children receive treatment and even our most effective anxiety treatments leave up to half of children in need of additional intervention.
Despite the well-established role of parent anxiety in transmitting and maintaining child anxiety, the lack of data on specific parent mechanisms underlying the intergenerational transmission of anxiety is a critical barrier to informing novel targets of personalized treatments.
Consistent with NIMH's Strategic Plan, Objective 2.2 to understand risk factors and behavioral indicators of mental illness across the lifespan and to identify novel intervention targets based on knowledge of psychological mechanisms, the current study focuses on interpretation bias, the tendency to perceive threat in ambiguous situations.
The overall objective of this project is to empirically test a theoretical model of the intergenerational transmission of anxiety focused on parent interpretation bias as a root cause.
Our specific aims are to test theorized effects of parent interpretation bias on (1) parent behavior and (2) child interpretation bias and (3) evaluate potential moderators to refine theories of intergenerational transmission of anxiety and inform future personalized interventions.
Our central hypothesis is that parent interpretation bias influences child interpretation bias through its effects on maladaptive, anxiety-promoting parenting behaviors, such as accommodation and modeling of avoidant coping.
To test this hypothesis, we will randomize 300 parents of children ages 7-12 to complete four weeks of a smartphone delivered interpretation bias manipulation vs. a self-assessment smartphone app condition.
The interpretation bias intervention teaches parents to interpret ambiguous situations in a non-threatening manner via quick, repeated practice and corrective feedback.
Before and after completing their randomly assigned condition, parent-child dyads will complete self-report and behavioral tasks designed to elicit anxiety-promoting behaviors from parents depending upon their interpretation of the ambiguous situation (speech and puzzle tasks).
Parents will also complete Ecological Momentary Assessment (EMA) of parenting behaviors to capture the time course of effects.
Finally, we will examine downstream effects of the interpretation manipulation on child interpretation bias at pre- and post- visits.
We will test moderators (e.g., parent anxiety and gender) to refine theories of intergenerational transmission of anxiety and inform future personalized interventions.
The long-term goal of this work is to inform personalized, mechanism-focused interventions to improve mental health outcomes for anxious children and their parents.
Future studies will translate knowledge gained from this project into a scalable treatment that can be implemented entirely remotely via smartphone thereby increasing access to care
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Estimated)
300
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Courtney Beard, PhD
- Phone Number: 617-855-3557
- Email: cbeard@mclean.harvard.edu
Study Locations
-
-
Massachusetts
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Belmont, Massachusetts, United States, 02478
- Recruiting
- McLean Hospital
-
Contact:
- IreLee Ferguson, BA
- Phone Number: 617-844-4495
- Email: iferguson1@mgb.org
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
7 years and older (Child, Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion criteria for parent participants are:
- Must have an ability to speak and understand English sufficiently to complete assessments
- At least minimal anxiety severity (GAD-7 score > 5)
- At least a minimal level of interpretation bias (WSAP overall accuracy less than 70%)
- No current psychiatric symptoms that would interfere with the individual's ability to provide consent or complete the research procedures
- If receiving treatment, stable on medications or psychotherapy for 8 weeks
- No severe suicidal ideation (PHQ-9 item 9 > 1)
- Own iOS or Android smartphone
- Shared or full custody of child (for EMA assessment of parenting behaviors)
Inclusion criteria for child participants are:
- Age 7 to 12
- Must have an ability to speak and understand English sufficiently to complete assessments
- No diagnosis of intellectual disability or autism spectrum disorder (per parent or clinician report)
- No current psychiatric symptoms that would prevent informed consent or understanding of research procedures
- Wechsler Abbreviated Scale of Intelligence (WASI) full-scale IQ equal to or greater than 80 to ensure understanding of study procedures
- If receiving treatment, stable on medications or psychotherapy for 8 weeks
- No severe suicidal ideation (PHQ-9 item 9 > 1)
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Basic Science
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Interpretation bias manipulation
The primary component of the interpretation bias manipulation is the Word Sentence Association Paradigm (WSAP) delivered by the HabitWorks smartphone app.
Users complete 50 trials in each exercise (approximately 5 min) and are prompted to complete 3 exercises per week (12 total over 4 weeks).
The WSAP incorporates repetitive and quick practice, increasing individuals' awareness of their cognitive biases and shifting of their automatic responses.
|
Smartphone app-delivered interpretation bias intervention
Self-assessment of parenting behaviors and anxiety symptoms
|
Placebo Comparator: Self-Assessment
Parents will complete the same repeated assessments, including EMA of parent behavior and weekly symptom surveys, but they will not complete the WSAP.
|
Self-assessment of parenting behaviors and anxiety symptoms
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Parent behavior
Time Frame: 6 weeks
|
Coding of parent behaviors during parent-child interaction tasks
|
6 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Child interpretation bias
Time Frame: 6 weeks
|
3 items assessing expectations before and perceived performance after the parent-child interaction task
|
6 weeks
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Courtney Beard, PhD, McLean Hospital
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
July 28, 2023
Primary Completion (Estimated)
November 30, 2027
Study Completion (Estimated)
November 30, 2027
Study Registration Dates
First Submitted
December 19, 2022
First Submitted That Met QC Criteria
December 19, 2022
First Posted (Actual)
December 27, 2022
Study Record Updates
Last Update Posted (Estimated)
December 1, 2023
Last Update Submitted That Met QC Criteria
November 28, 2023
Last Verified
November 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2022p003245
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
YES
IPD Plan Description
All de-identified data will be published by the end of the project period or as papers are published, in repositories such as the Open Science Framework.
Datasets will be managed and distributed in accordance with FAIR Guiding Principles (best practices for Findability, Accessibility, Interoperability, and Reusability) to maximize the potential for reuse of the data by other investigators.
We will ensure study transparency, describing recruitment, enrollment, and randomization in a Consolidated Standards of Reporting Trials (CONSORT) diagram and providing detailed descriptions of experimental arms.
The PI will prepare and submit data to clinicaltrials.gov
and share data via the NDCT.
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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