Feasibility and dissemination of a computerized home-based treatment for Generalized Anxiety Disorder: A randomized clinical trial. (September 2019)

• Record Type: Journal Article
• Authors: Amir, Nader; Taboas, William; Montero, Miguel
• Is Part Of: Behaviour research and therapy. Volume 120(2019)
• Publication Date: 2019-09
• Subjects: Generalized-anxiety disorder -- Applied relaxation -- Attention bias modification -- Dissemination -- Feasibility -- At-home; Cognitive therapy -- Periodicals; Psychotherapy -- Periodicals; 616.891
• DOI: 10.1016/j.brat.2019.103446
• Languages: English
• ISSNs: 0005-7967

Abstract

Abstract: Generalized Anxiety Disorder (GAD) is a prevalent, impairing, and undertreated psychiatric disorder. We examined if a home-based computerized treatment program can feasibly be delivered and successfully treat GAD symptoms. Using a randomized control trial, we compared three active groups receiving computerized sequenced Attention Bias Modification (ABM) followed by Applied Relaxation psychoeducation (AR-pe), the reversed sequence of AR-pe and ABM, and a simultaneous ABM and AR-pe group to an assessment only control group. The participants comprised 169 adults with a diagnosis of GAD. We asked participants to complete as many as twenty-four 30-min sessions of an at-home computerized treatment program over 12 weeks. The control group received 24 brief assessment questionnaires as well as assessments of attention bias. Results from intent-to-treat analyses show faster rate of improvement for symptoms of anxiety as measured by the Hamilton Anxiety Rating Scale (HAM-A) over time in groups that received active training in contrast to the clinical monitoring (CM) control group. Follow-up analyses revealed that both sequenced groups improved in anxiety when compared to the control group, while the simultaneous group did not outperform the control group. Results suggest that sequenced delivery of ABM and AR, may be a viable home-based treatment option for individuals with GAD who have limited access to resources or are otherwise unable to seek available treatments that require engagement outside of the home. Trial registration: clinicaltrial. gov Identifier: NCT00602563. Highlights: Adults receiving an active treatment improved on anxiety outcomes. Attention Bias Modification and Applied Relaxation demonstrated lasting effects. Remote computerized treatment was feasible and efficacious for reducing anxiety.