Effects of a brief Attention Training Technique intervention for sub-clinical anxiety in an adolescent population : a case series

Background and Aims: Anxiety is one of the most frequently occurring psychological disorders in children and adolescents. Interventions for child and adolescent anxiety to date have focused on 'traditional' cognitive-behavioural approaches. Whilst these have been shown to be effective in approximately 56% of cases (e.g. Cartwright-Hatton, Roberts, Chitsabesan, Fothergill and Harrington, 2004) a significant proportion do not benefit. An information processing theory of emotional disorder, the Self-Regulatory Executive Function Model (Wells and Matthews, 1994), suggests that dysfunctional attentional processing, such as heightened self-focus and rumination, maintain emotional disorders. Attention Training Technique (AIT; Wells, 1990; 2000), was developed with the aim of reducing dysfunctional self-focused thinking and allowing the individual to develop conscious attentional control over processing. Preliminary case series have shown the effectiveness of AIT in reducing anxiety in adults. The main aim of the current study was to test the effectiveness of AIT on an analogue-clinical sample of adolescents with high trait anxiety using a case series design. A secondary aim was to investigate correlations between anxiety, self-consciousness and attentional control. This study represents the first attempt to investigate AIT in an adolescent population. Method: A total of 110 participants were involved in the screening stage which involved completing the State-Trait Anxiety Inventory (STAI, Spielberger, 1983); the Attention Control Scale (ACS, Derryberry & Reed, 2002) and the Public and Private Self Consciousness Scale - Revised (SCS-R, Sheier & Carver, 1985). Six participants were involved in the case series investigating the effects of AIT. The case series employed a multiple baseline A-B design with follow up (Barlow & Hersen, 1984). The participants were allocated to baselines ranging from 3-6 weeks, during which they completed weekly questionnaires, prior to the four week AIT phase. AIT was delivered on a once-weekly basis, and daily home practice was set using CD versions of ATT. Standardised measures (STAI, ACS and SCS-R) were administered on a weekly basis. Results: The screening stage found a significant correlation between attentional control and trait anxiety, consistent with previous research with children. In addition, a significant correlation was found between trait anxiety and self-consciousness, consistent with previous research with adult samples. The case series provided little overall support for the positive impact of AIT on the standardised measures. Following AIT, two out of six participants showed reductions in trait anxiety scores; one out of six showed a reduction in state anxiety scores; one out of six participants showed a small increase in attentional control; and finally there was no convincing evidence for a decrease in private self consciousness for any participants. Conclusions: This study did not demonstrate the effectiveness of AIT in the population under investigation. It is not possible to draw any firm conclusions ab.out the effectiveness or otherwise of AIT in this population due to the small sample size. Potential reasons for the findings are discussed with reference to the apphcablhty of this technique to younger populations. The strengths and limitations of the study are outlined, along with the clinical implications and directions for future research.EThOS - Electronic Theses Online ServiceGBUnited Kingdo