OBJECTIVE: To examine targeted, mechanism-based interventions is the next generation of treatment innovation. Biased threat labeling of ambiguous face emotions (interpretation bias) is a potential behavioral treatment target for anger, aggression, and irritability. Changing biases in face-emotion labeling may improve irritability-related outcomes. Here, we report the first randomized, double-blind, placebo-controlled targeted trial of interpretation bias training (IBT) in youths with chronic, severe irritability. METHOD: Patients with current disruptive mood dysregulation disorder (DMDD; N = 44) were randomly assigned to complete 4 sessions of active (n = 22) or sham (n = 22) computerized IBT training within a 1-week period. The first and last trainings were completed onsite, and 2 trainings were completed at home. We examined the effects of active IBT on labeling bias, primary outcome measures of irritability, and secondary outcome measures of anxiety, depression, and functional impairment. Follow-up assessments were completed immediately after the intervention as well as 1 and 2 weeks later. RESULTS: We found that active IBT engaged the behavioral target in the active relative to the sham condition, as shown by a significant shift toward labeling ambiguous faces as happy. However, there was no consistent clinical improvement in active IBT relative to the sham condition either immediately after or 2 weeks after training in either the primary or secondary outcome measures. CONCLUSION: Although this randomized controlled trial of IBT in youths with DMDD engaged the proposed behavioral target, there was no statistically significant improvement on clinical outcome. Identifying and changing behavioral targets is a first step in novel treatment development; these results have broader implications for target-based intervention development. CLINICAL TRIAL REGISTRATION INFORMATION: Psychological Treatments for Youth With Severe Irritability; https://clinicaltrials.gov/; NCT02531893. Published by Elsevier Inc.
OBJECTIVE: To examine targeted, mechanism-based interventions is the next generation of treatment innovation. Biased threat labeling of ambiguous face emotions (interpretation bias) is a potential behavioral treatment target for anger, aggression, and irritability. Changing biases in face-emotion labeling may improve irritability-related outcomes. Here, we report the first randomized, double-blind, placebo-controlled targeted trial of interpretation bias training (IBT) in youths with chronic, severe irritability. METHOD: Patients with current disruptive mood dysregulation disorder (DMDD; N = 44) were randomly assigned to complete 4 sessions of active (n = 22) or sham (n = 22) computerized IBT training within a 1-week period. The first and last trainings were completed onsite, and 2 trainings were completed at home. We examined the effects of active IBT on labeling bias, primary outcome measures of irritability, and secondary outcome measures of anxiety, depression, and functional impairment. Follow-up assessments were completed immediately after the intervention as well as 1 and 2 weeks later. RESULTS: We found that active IBT engaged the behavioral target in the active relative to the sham condition, as shown by a significant shift toward labeling ambiguous faces as happy. However, there was no consistent clinical improvement in active IBT relative to the sham condition either immediately after or 2 weeks after training in either the primary or secondary outcome measures. CONCLUSION: Although this randomized controlled trial of IBT in youths with DMDD engaged the proposed behavioral target, there was no statistically significant improvement on clinical outcome. Identifying and changing behavioral targets is a first step in novel treatment development; these results have broader implications for target-based intervention development. CLINICAL TRIAL REGISTRATION INFORMATION: Psychological Treatments for Youth With Severe Irritability; https://clinicaltrials.gov/; NCT02531893. Published by Elsevier Inc.
Authors: J Kaufman; B Birmaher; D Brent; U Rao; C Flynn; P Moreci; D Williamson; N Ryan Journal: J Am Acad Child Adolesc Psychiatry Date: 1997-07 Impact factor: 8.829
Authors: Francheska Perepletchikova; Donald Nathanson; Seth R Axelrod; Caitlin Merrill; Amy Walker; Meredith Grossman; James Rebeta; Lawrence Scahill; Joan Kaufman; Barbara Flye; Elizabeth Mauer; John Walkup Journal: J Am Acad Child Adolesc Psychiatry Date: 2017-08-10 Impact factor: 8.829
Authors: Melissa A Brotman; Katharina Kircanski; Argyris Stringaris; Daniel S Pine; Ellen Leibenluft Journal: Am J Psychiatry Date: 2017-01-20 Impact factor: 18.112
Authors: Georgina Krebs; Victoria Pile; Sean Grant; Michelle Degli Esposti; Paul Montgomery; Jennifer Y F Lau Journal: J Child Psychol Psychiatry Date: 2017-10-20 Impact factor: 8.982
Authors: Claudia Menne-Lothmann; Wolfgang Viechtbauer; Petra Höhn; Zuzana Kasanova; Simone P Haller; Marjan Drukker; Jim van Os; Marieke Wichers; Jennifer Y F Lau Journal: PLoS One Date: 2014-06-26 Impact factor: 3.240
Authors: Joel Stoddard; Banafsheh Sharif-Askary; Elizabeth A Harkins; Heather R Frank; Melissa A Brotman; Ian S Penton-Voak; Keren Maoz; Yair Bar-Haim; Marcus Munafò; Daniel S Pine; Ellen Leibenluft Journal: J Child Adolesc Psychopharmacol Date: 2016-01-08 Impact factor: 2.576