LPP INDEXES BASELINE AND TREATMENT-RELATED CHANGES IN ANXIETY SENSITIVITY

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2022

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Abstract

Anxiety sensitivity (AS) refers to an individual’s tendency to be fearful of anxiety-related bodily sensations (the symptoms that accompany feelings of anxiety)(Reiss et al., 1986). These symptoms can be cognitive (i.e., fear of losing control of mental processes), physical (i.e., fear of catastrophic physiological outcomes such as heart attack or stroke), or social (i.e., concern about negative social judgment and subsequent observable symptoms of anxiety). AS is a well-understood risk factor for Internalizing psychopathology (INT). Cognitive Anxiety Sensitivity Treatment (CAST) (Schmidt et al., 2014) is a technology-based intervention shown to be efficacious in reducing AS, as well as INT. CAST is a fully-computerized brief intervention with two core components: psychoeducation and interoceptive exposure (Craske et al., 1997). In recent work by Schmidt, nontreatment seeking participants with elevated AS cognitive concerns participated in one session of CAST, which produced significant reductions in AS at posttreatment, relative to controls (d=0.57). The primary purpose of this study is to assess the late positive potential (LPP) event-related potential (ERP) component as an index of baseline AS, as well as treatment-related change in AS in response to CAST. In this study 263 participants (with complete EEG data at 1-month follow-up) received either an anxiety reduction intervention (Anxiety; CAST + cognitive bias modification interpretation [CBM-I] with an anxiety focus; N = 65), a mood intervention (Mood; mood psychoeducation + CBM-I with a mood focus; N = 66), or combined ANX and MOOD interventions (Combined; N = 68), as well a repeated contact control group (RCC; N= 64). Prior to the intervention, baseline LPP was measured via exposure to unpleasant, and baseline AS recorded using the ASI-3. Increased LPP amplitude was associated with higher baseline AS (r=.184, p <.001). We found that the LPP was sensitive to treatment effects in that at month 1, as across treatment groups, baseline LPP amplitude was associated with change in AS from baseline to month 1, with higher amplitude associating with greater reductions in AS (r = -.247, p < .001). In this study, there were no differences between treatment groups in this relationship between amplitude and treatment change, and there were no significant effects of the decrease task instruction on amplitude. These findings could be indicative of a larger pattern to be assessed in future work, or could be a product of low power. Overall, this work’s findings have potential to demonstrate the efficacy of CAST in reducing AS, and given both CAST’s and AS’s implications in psychopathology measures such as internalizing, we can integrate transdiagnostic approaches and develop novel treatment targets for populations in need.

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