Threat Interpretation Bias as Cognitive Marker and Treatment Target in Pediatric Anxiety: R33 Phase
Přehled studie
Postavení
Postavení
Podmínky
Podmínky
Intervence / Léčba
Intervence / Léčba
Detailní popis
Typ studie
Typ studie
Zápis (Odhadovaný)
Zápis
Fáze
Fáze
- Nelze použít
Kontakty a umístění
Studijní kontakt
Studijní kontakt
- Jméno: Michelle Rozenman, Ph.D.
- Telefonní číslo: 303-871-6448
- E-mail: bravelab@du.edu
Studijní místa
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Colorado
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Denver, Colorado, Spojené státy, 80210
- Nábor
- University of Denver
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Vrchní vyšetřovatel:
- Michelle Rozenman, Ph.D.
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Kontakt:
- Michelle Rozenman, Ph.D.
- Telefonní číslo: 303-871-6448
- E-mail: bravelab@du.edu
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Kritéria účasti
Kritéria způsobilosti
Kritéria způsobilosti
Věk způsobilý ke studiu
- Dítě
Přijímá zdravé dobrovolníky
Popis
Inclusion Criteria:
- Provision of signed and dated informed consent form by parent/legal guardian and signed youth assent. If youth turns 18 after study entry (i.e., Visit 1), they will need to reconsent as an adult to continue participation. Youth and consenting parent/legal guardian agree to 6-week study participation as part of consent/assent process.
- Youth and parent/legal guardian speak sufficient English to engage in study procedures.
- Youth is aged 10 to 17 inclusive, at time of signing consent/assent and completion of Visit 1 procedures.
- Youth meets full diagnostic criteria for primary Generalized Anxiety Disorder, Separation Anxiety Disorder, or Social Anxiety Disorder as assessed by the Anxiety Disorders Interview Schedule-IV (ADIS-IV) during Visit 1. Note: the ADIS diagnostic criteria are only valid for two weeks. For the purposes of our study, a youth should be randomized, have randomization revealed, and be in treatment (i.e., complete Visit 2) within 14 days of Visit 1 diagnostic/clinical interview. If this timeline is not met, clinical measures may need to be updated with the youth and parent/legal guardian, although consent does not need to be re-obtained. Parent and youth versions of the Screen for Child Anxiety Related Emotional Disorders, as well as the Pediatric Anxiety Rating Scale and Clinician's Global Impressions - Severity/Improvement Scale might also be re-administered. The ADIS will need to be reviewed to assess whether there have been any diagnostic changes during the elapsed time period. If more than one month has elapsed from the time of baseline, all measures within baseline procedures would be readministered, including reconsenting parent/legal guardian and youth. All such cases must be triaged in the next immediate weekly Project Management meeting.
- Youth otherwise meeting study entry criteria, who are receiving treatment for a stable medical or psychiatric condition, may be included providing that medication and dose have been stable for at least six weeks (e.g., stable dose of stimulant medication for Attention-Deficit/Hyperactivity Disorder) prior to study entry and remain stable on that medication and dose throughout their study participation. Changes to medication during study participation following randomization at Visit 2 will be considered non-urgent protocol deviations and will be tracked in the Protocol Deviations Form. Youth would not be removed from the study in this case, but their data may be excluded from sensitivity analyses.
- Youth must have a standard score of at least 85 on the Wechsler Abbreviated Scale of Intelligence, Vocabulary and Matrix Reasoning subtests, as well as the Wide Range Achievement Test-4 Reading subtest (administered during Visit 1) to ensure ability to read and understand stimuli during interpretation bias assessments and CBM-I.
- Youth must have access to a desktop or laptop computer and access to internet at home or can access one at their school or local library for the at-home portion of the computer training program. For youth without access, families can agree to complete all 16 CBM-I trainings (if randomized to CBM-I) at the BRAVE Lab.
Exclusion Criteria:
- Requires treatment other than CBM-I/CR: namely, youths with severe anxiety indicating need for higher level of care (e.g., psychiatric hospitalization), or primary major depressive disorder, bipolar disorder, psychosis, safety concerns due to recent or current acute suicidal ideation with plan, intent, and/or attempt that warrants alternate intervention, Posttraumatic Stress Disorder, substance dependence, current physical or sexual abuse, or intellectual disability. This will be determined during the Visit 1 ADIS interview. Consultation with the PI will occur in all cases where another mental health concern may be primary and/or warrant more immediate treatment.
- At Visit 1, is currently in alternate psychosocial intervention for any reason or has plans to initiate any psychosocial intervention for any reason.
- Has previously received any type of cognitive bias modification (attention or interpretation bias as target) at the BRAVE Lab or elsewhere.
- The family indicates they are no longer interested or able to participate in the study after Visit 1 (in which it is determined that the family is eligible) but before the family is randomized or told of their randomization. The youth will be excluded and not included in ITT analyses, and the randomization will be "thrown back" into the randomization scheme.
- Has significant uncorrected vision impairment (e.g., uncorrected blindness) that precludes participation in the computerized assessment and intervention components of the study.
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Singl
Počet zbraní
Zbraně a zásahy
Skupina účastníků / ArmSkupina účastníků / Arm |
Intervence / LéčbaIntervence / Léčba |
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Experimentální: Modifikace kognitivního zkreslení pro interpretace (CBM-I)
Počítačová intervence o 16 sezeních zaměřená na snížení zkreslení interpretace.
V této studii je CBM-I přizpůsobena symptomům úzkosti mládeže.
Během sezení CBM-I mladí lidé uvádějí, zda spolu páry slovo-věta souvisí, a je jim poskytnuta zpětná vazba zaměřená na snížení zkreslení.
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Computerized intervention in which youth see word-sentence pairs personalized to their anxiety symptoms, and indicate whether these are related.
Youth receive feedback aimed to reduce interpretation b
Ostatní jména:
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Aktivní komparátor: Cognitive Restructuring (CR)
Four session psychosocial intervention aimed at reducing anxiety.
CR is a standard treatment technique (and often full intervention protocol) aimed at modifying anxious cognitions by teaching youth to identify when they make threat attributions, consider alternate non-threatening attributions, and thereby change their anxious thought processes, resultant avoidance, and anxiety symptoms.
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Adapted from well-tested manual, The Coping Cat (child and adolescent versions), administered by trained, supervised therapists.
Duration of CR is matched to CBM-I in regard to total time in intervention across four weeks.
Ostatní jména:
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Co je měření studie?
Primární výstupní opatření
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
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Change in Linguistic Interpretation Bias as Assessed by the Word-sentence Association Paradigm for Youth (WSAP-Y)
Časové okno: 6 weeks following randomization/start of treatment (post-treatment study visit at Week 6)
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The WSAP-Y is a computerized assessment of interpretation bias in which youth indicate whether word-sentence pairings are related.
This measure provides information about the degree to which youth evidence interpretation bias, as well as a behavioral (reaction time) index for bias endorsement.
For the primary outcome of percent threat interpretations endorsed, the possible range is 0 (zero) to 100%.
Higher percentage indicates more threat interpretation bias (i.e., the youth endorsed a higher proportion of threat words as related to ambiguous sentences); lower scores indicate lower threat interpretation bias.
Greater decrease in the percent of threat interpretations endorsed and lower absolute scores indicate "better" outcome (i.e., more reduction in threat interpretation bias; less interpretation bias overall).
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6 weeks following randomization/start of treatment (post-treatment study visit at Week 6)
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Change in Visual Interpretation Bias as Assessed by the Ambiguous Faces Task
Časové okno: 6 weeks following randomization/start of treatment (post-treatment study visit at Week 6)
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Youth view faces portraying neutral expressions or subtle emotional expressions (i.e., morphed faces ranging in intensity of emotional valence).
Youth categorization of faces as neutral or threatening provides their sensitivity and bias for reporting presence of threat.
The criterion mean value in outcomes below reflects a score from -1 to 1, with higher negative numbers reflecting greater bias toward angry faces, and higher positive values approaching one reflecting a bias toward happy faces.
Theoretically, higher positive values indicate "better" outcome such that youth have more positive bias toward facial stimuli.
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6 weeks following randomization/start of treatment (post-treatment study visit at Week 6)
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Change in Self-reported Interpretation Bias as Measured by the Children's Automatic Thoughts Scale (CATS)
Časové okno: 6 weeks following randomization/start of treatment (post-treatment study visit at Week 6)
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The Children's Automatic Thoughts Scale is a youth self-report questionnaire which assesses presence and frequency of a variety of anxious thoughts from domains of: physical threat, social threat, personal failure, and anxious hostility.
Total scores range from 0 to 160, with higher scores indicating more threat interpretation bias.
Higher scores indicate "worse" outcome, or that youth self-report that they have more threatening thoughts and/or threatening thoughts at higher frequency; lower scores indicate "better" outcome or that youth self-report fewer threatening thoughts and/or threatening thoughts at lower frequency.
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6 weeks following randomization/start of treatment (post-treatment study visit at Week 6)
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Sekundární výstupní opatření
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
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Number of CBM-I Trainings Completed of 16 Intended Sessions (CBM-I Arm Only)
Časové okno: 6 weeks following randomization/start of treatment (post-treatment study visit at Week 6)
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This outcome is related to the "feasibility of CBM-I" aim.
The number of CBM-I trainings completed of 16 intended sessions.
Theoretically, completion of more training sessions is better and indicates that youth received a higher "dose" of training.
This outcome only applies to the CBM-I arm.
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6 weeks following randomization/start of treatment (post-treatment study visit at Week 6)
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Participant/Parent Acceptability Questionnaire (PAQ)
Časové okno: 6 weeks following randomization/start of treatment (post-treatment study visit at Week 6)
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The Participant Acceptability Questionnaire is a 8-item youth and parent report questionnaire, accompanied by an exit interview, that assesses burden (travel, boredom), credibility of computerized intervention techniques, and youth comprehension of the intervention.
Parents and youth complete the PAQ separately.
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6 weeks following randomization/start of treatment (post-treatment study visit at Week 6)
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Anxiety symptom severity - PARS
Časové okno: 6 weeks following randomization/start of treatment (post-treatment study visit at Week 6)
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Anxiety symptom severity as measured by clinician-administered Pediatric Anxiety Rating Scale (PARS).
Administered separately to parent and child, and scored by clinician by summing totals for the 7 items.
Scores range from 0-35, with higher scores suggesting higher/worse anxiety symptom severity.
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6 weeks following randomization/start of treatment (post-treatment study visit at Week 6)
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Anxiety symptoms - SCARED
Časové okno: 6 weeks following randomization/start of treatment (post-treatment study visit at Week 6)
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Total anxiety symptoms as measured by the Screen for Anxiety Related Emotional Disorders (SCARED), 41-item version.
Each of 41 items ranges from 0-2, total anxiety symptoms calculated by scoring total across all 41 items.
Total scores range from 0-82, with higher scores suggesting more/worse anxiety symptoms.
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6 weeks following randomization/start of treatment (post-treatment study visit at Week 6)
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Spolupracovníci a vyšetřovatelé
Sponzor
Sponzor
Spolupracovníci
Spolupracovníci
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Začátek studia
Primární dokončení (Odhadovaný)
Primární dokončení
Dokončení studie (Odhadovaný)
Dokončení studie
Termíny zápisu do studia
První předloženo
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
První zveřejněno
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Poslední zveřejněná aktualizace
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
Další identifikační čísla studie
Další identifikační čísla studie
- 5R33MH121552 (Grant/smlouva NIH USA)
Plán pro data jednotlivých účastníků (IPD)
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Časový rámec sdílení IPD
Kritéria přístupu pro sdílení IPD
Typ podpůrných informací pro sdílení IPD
- PROTOKOL STUDY
- MÍZA
- ICF
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