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      Attentional bias modification in reducing test anxiety vulnerability: a randomized controlled trial

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          Abstract

          Background

          A tendency to selectively process a threat to positive information may be involved in the etiology of anxiety disorders. The aim of this study is to examine whether attentional bias modification (ABM) can be used to modify high test-anxiety individuals’ attention to emotional information and whether this change is related to anxiety vulnerability.

          Methods

          Seventy-seven undergraduates were included: 28 individuals received a 5-day modified dot probe task as ABM training, 29 individuals received a 5-day classic dot probe task as placebo, and 20 individuals did not receive an intervention between the two test sections. In addition to the measure of biased attention, salivary α-amylase (sAA) and the visual analogue scale of anxiety were assessed as emotional reactivity to stress.

          Results

          A repeated measurement of variance analysis and paired sample t-test indicated that the ABM group showed a significant change in attentional bias scores after the 5-day training, whereas there were no changes in the attentional bias scores in the placebo or waiting list groups. Importantly, anxiety vulnerability with attention to threats was significantly decreased in the training group.

          Conclusions

          These results suggest that attentional bias toward threat stimuli may play an important role in anxiety vulnerability. The attentional bias modification away from the threat is effective for the individuals preparing for an exam.

          Trial registration

          This trial was retrospectively registered on June 22, 2017 with the registration number ChiCTR-IOR-17011745 and the title ‘Attentional Bias in high anxiety individuals and its modification’.

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          Most cited references 38

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          The trier social stress test –a tool for investigating psychosocial stress responses in a laboratory setting

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            Attention bias modification treatment: a meta-analysis toward the establishment of novel treatment for anxiety.

            Attention Bias Modification Treatment (ABMT) is a newly emerging, promising treatment for anxiety disorders. Although recent randomized control trials (RCTs) suggest that ABMT reduces anxiety, therapeutic effects have not been summarized quantitatively. Standard meta-analytic procedures were used to summarize the effect of ABMT on anxiety. With MEDLINE, January 1995 to February 2010, we identified RCTs comparing the effects on anxiety of ABMT and quantified effect sizes with Hedge's d. Twelve studies met inclusion criteria, including 467 participants from 10 publications. Attention Bias Modification Treatment produced significantly greater reductions in anxiety than control training, with a medium effect (d = .51 [corrected] (p < .001). Age and gender did not moderate the effect of ABMT on anxiety, whereas several characteristics of the ABMT training did. Attention Bias Modification Treatment shows promise as a novel treatment for anxiety. Additional RCTs are needed to fully evaluate the degree to which these findings replicate and apply to patients. Future work should consider the precise role for ABMT in the broader anxiety-disorder therapeutic armamentarium. Copyright © 2010 Society of Biological Psychiatry. All rights reserved.
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              Stress-induced changes in human salivary alpha-amylase activity -- associations with adrenergic activity.

              The salivary enzyme alpha-amylase has been proposed to indicate stress-reactive bodily changes. A previous study by the authors revealed marked increases in salivary alpha-amylase following psychosocial stress, indicating a stress-dependent activation of salivary alpha-amylase. Salivary alpha-amylase has been suggested to reflect catecholaminergic reactivity. Our aim was to assess/evaluate a possible relationship between salivary alpha-amylase and adrenergic parameters, i.e. catecholamines, as well as other stress markers. Using an intra-individual repeated measures design, 30 healthy young men underwent the Trier Social Stress Test (TSST), which consists of a mental arithmetic task and free speech in front of an audience and a control condition in randomized order. Salivary alpha-amylase and salivary cortisol as well as plasma catecholamines and cardiovascular activity were repeatedly measured before, during, and after both conditions. Significant differences were found between the stress and the rest condition in salivary alpha-amylase, salivary cortisol, plasma catecholamines, and cardiovascular parameters (heart rate, LF, HF, LF/HF). However, general alpha-amylase responses (area under the curve) were not associated with general responses in catecholamines and cortisol in the stress condition (r smaller than 0.25 for all analyses). Analysis of cardiovascular parameters indicates a positive relationship between amylase and sympathetic tone (LF/HF) during stress. Salivary alpha-amylase is sensitive to psychosocial stress. Since it does not seem to be closely related to other biological stress markers such as catecholamines and cortisol, salivary alpha-amylase may be a useful additional parameter for the measurement of stress.
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                Author and article information

                Contributors
                wpcai@smmu.edu.cn
                531828485@qq.com
                yokochyz@163.com
                cuiyi210@163.com
                yanjingk@qq.com
                +86-21-81871452 , sophiedongwei@163.com
                +86-21-81871667 , bfbedu@126.com
                Journal
                BMC Psychiatry
                BMC Psychiatry
                BMC Psychiatry
                BioMed Central (London )
                1471-244X
                5 January 2018
                5 January 2018
                2018
                : 18
                Affiliations
                [1 ]ISNI 0000 0004 0369 1660, GRID grid.73113.37, Faculty of Psychology and Mental Health, , Second Military Medical University, ; Xiangyin Road 800, Shanghai, 200433 China
                [2 ]ISNI 0000 0004 1761 8894, GRID grid.414252.4, Department of Medical Psychology, , General Hospital of PLA, ; Beijing, 100853 China
                [3 ]Department of Engineering and Information, Nanjing City Vocational College, Nanjing, 210038 China
                Article
                1517
                10.1186/s12888-017-1517-6
                5756356
                29304757
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                Funding
                Funded by: Major Program of the “12th Five-Year Plan” for Medical Development of PLA
                Award ID: 14CXZ002
                Award Recipient :
                Funded by: General Program of the “12th Five-Year Plan” for Medical Development of PLA
                Award ID: CWS12J015
                Award Recipient :
                Funded by: Second Military Medical University 2016 Annual PhD Innovative Research Fund
                Award ID: 20152049
                Funded by: FundRef http://dx.doi.org/10.13039/501100004543, China Scholarship Council;
                Award ID: 201603170127
                Funded by: the Military Medical Program of Second Military Medical University
                Award ID: 2014JS20
                Award Recipient :
                Funded by: Shanghai Municipal Commission of Health and Family Planning
                Award ID: 2013Y168
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

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