Amanda Baker, PhD

Pronouns

She/Her/Hers

Rank

Assistant Professor

Institution

MGH

BWH-MGH Title

Clinical Psychologist

Department

Psychiatry

Authors

Amanda W. Baker, Ph.D., Nur Hani Zainal, M.S, Samantha N. Hellberg, M.A., Katherine E. Kabel, B.S., & Claire M. Hotchkin, B.A.

Improving Cognitive Behavioral Therapy for Panic Disorder through Attention Bias Modification

WMSS 2022

My clinical training, emphasizing empirically supported psychosocial treatments, has given me the perspective and position to study research questions that are meaningful to improving direct patient care. As such, I have developed a keen interest in understanding what treatment will work for whom to make our treatments more efficient, increase response rates, and reduce relapse rates. Women in Medicine and Science Symposium would be an ideal setting to present my clinical research and make connections with other women across our system. Building my network of women mentors and mentees is an extremely meaningful part of my career.

Background

There is considerable variability in treatment outcomes in Cognitive Behavioral Therapy (CBT) for panic disorder (PD). Cognitive bias theories propose that reducing threat hypervigilance can augment CBT outcomes. However, no studies have previously tested the augmentation of CBT for PD with brief computerized attention bias modification (ABM).

Method

30 adults with PDreceived CBT according to a published protocol. Prior to five CBT sessions, CBM+ABM and CBT+PBO participants completed 15-minute ABM tasks and sham tasks, respectively. Bayesian structural equation modeling (BSEM) was conducted as it produces more credible estimates for small sample sizes.

Results

ABM augmentation of CBT was associated with lower endpoint panic symptoms when controlling for baseline levels of PD (R2=.37, F(2, 19)=5.68, β=0.42, p=0.03) compared to CBT+PBO. All BSEM models showed good fit, such that all posterior predictive p values (PPP) were above .05, PPP=0.153–0.595. CBT+ABM (vs. CBT+PBO) led to significantly greater pre-post-treatment reduction in anxiety sensitivity: ASI–Physical (d=-1.316) and ASI–Social (d=1.357), but not ASI–Cognitive (d=-0.172). In addition, CBT+ABM led to significant larger pre-post changes in depression severity (d=-1.512), compared to CBT+PBO.

Discussion

This pilot study showed adding brief computerized ABM to CBT protocols may enhance therapeutic change for PD.