The attention training technique causally reduces self-focus following worry provocation and reduces cognitive anxiety among self-focused individuals.

BACKGROUND AND OBJECTIVES: The attention training technique (ATT) is a component of metacognitive therapy developed to interrupt self-focused, threat-based processing underlying anxiety disorders. Whereas extant research supports the benefits of ATT, including in relation to anxiety reduction, study findings lead to equivocal conclusions as to whether ATT causally interrupts self-focused attention (SFA) as intended. An additional gap in the literature relates to investigating if ATT is especially effective for reducing anxiety among individuals experiencing a heightened self-focused state. The present study sought to address those two gaps in the literature.
METHOD: Participants scoring high on a measure of general worry severity completed a worry provocation that increased SFA and then were randomized to ATT (n = 45), a mindfulness task (n = 44), or a distraction task (n = 44).
RESULTS: ATT caused large reductions in SFA, whereas there were no changes in focus of attention following the mindfulness or distraction task. Anxiety reduction was found in relation to all three tasks; however, ATT, relative to distraction, was found to cause greater reduction in cognitive anxiety for individuals highly self-focused before the task. LIMITATIONS: The present study used an analogue sample and the design did not allow for an examination of the long-term benefit of ATT.
CONCLUSIONS: Results support ATT causally interrupting self-focused states and that ATT is particularly effective in reducing cognitive anxiety among individuals who are self-focused.

RCT Entities:   Population Interventions Outcomes