1 - (SYM 54) A Randomized Controlled Trial of an Interpretation Bias Modification Smartphone App
for Anxious Parents

The 2024 U.S. Surgeon General's Advisory highlighted the profound effects of parent mental health on families and society at large. Anxiety is extremely prevalent in parents, who often transmit anxiety to their children. Theoretical models highlight the potential role of parental interpretation bias in the intergenerational transmission of anxiety via its effect on parenting behaviors (Ollendick & Benoit, 2012). However, very few studies have examined parent interpretation bias as a treatment target. Addressing this mechanism in anxious parents has the potential to improve outcomes for both parents, as well as their children. In the current study, we present mid-point analyses from an ongoing NIMH-funded randomized controlled trial comparing an interpretation bias intervention to an active comparison symptom tracking arm in anxious parents. In contrast to most prior work in this field which has focused exclusively on mothers, we include all genders.

Anxious parents (current N = 81; 89% women, 13% Latinx, 20% Black, Asian, or mixed race; 13% LGBTQ+) of youth (ages 7 to 12) were randomized to either a smartphone interpretation bias modification app “HabitWorks” or Symptom Tracking. Parents in HabitWorks were asked to complete interpretation modification exercises three times per week and self-assessment of symptoms weekly for one month, whereas parents in Symptom Tracking only completed the self-assessment. We used hierarchical linear models to examine change in interpretation bias scores (measured by the Ambiguous Scenarios Questionnaire) and anxiety symptoms (measured by the GAD-7) from pre-intervention to 1-month follow-up. Given this is a mid-point analysis of a final sample size that will be 300, we focus on effect sizes rather than tests of statistical significance.

On average, participants in HabitWorks exceeded the recommended dosage of 3 interpretation exercises for all four weeks. Compared to symptom tracking, parents in HabitWorks evidenced greater improvement in interpretation bias (between group d= 0.67) and anxiety symptoms (between group d = .31) from pre- to 1-month follow-up.

Adherence to HabitWorks was excellent across all four weeks of the intervention. Parents in HabitWorks showed a near transfer effect to a measure of interpretation bias that was different than the modification task, as well as far transfer effect to self-reported anxiety symptoms. Preliminary data suggests that HabitWorks is a feasible low-intensity parent intervention that may ultimately improve parent mental health.