Neuromodulation to Enhance Attention Training in Socially Anxious Adolescents

Anxiety and its disorders are prevalent and impairing in adolescents, often following a chronic course, and are associated with heightened prospective risk of depressive disorders, substance use disorders, and suicidal behaviors. Traditional interventions such as cognitive behavioral therapy (CBT) have yielded response rates that highlight the critical need to examine treatment outcome moderators in underrepresented populations and identify and evaluate innovative and alternative interventions that are brief, efficacious, and grounded in neuroscience. This dissertation project presents findings on moderators of CBT outcomes in Latino youth (Chapter II) and explores novel and alternative treatments for social anxiety by targeting neural processes subserving attention to social threat in socially anxious youth (Chapters III and IV). Findings from Chapter II highlight the implications for selecting treatment targets and delivery format in the treatment of anxiety disorders in Latino youth. Findings from Chapter III support the feasibility and acceptability of attention bias modification (ABM) and transcranial direct current stimulation (tDCS) as novel treatment modalities. Lastly, while findings from Chapter IV did not provide evidence of an enhancement effect of tDCS on state anxiety levels or neural processes subserving attention to social threat, it suggests that later stage attentional processes involved in the regulation and control of attention might be malleable in response to ABM and/or tDCS. This portfolio provides insights into the treatment of youth anxiety, for both traditional approaches (i.e., CBT) and innovative and alternative approaches (i.e., ABM and tDCS). It further highlights the importance of advancing understanding of mechanisms of change in both traditional and novel treatments for youth anxiety.

Major Professor: Dr. Jeremy Pettit