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