(PS3-31) Correlates of Treatment Change: Insights from a Randomized Controlled Trial of Attention Bias Modification Training for Youth with Internalizing Symptomatology

Abstract Text: While attention bias modification training (ABMT) for youth with internalizing psychopathology has shown some promise in augmenting cognitive behavioral therapy (CBT), more reliable and replicable studies are needed both to evaluate its efficacy and identify potential moderators of treatment outcomes. Self-efficacy (SE) reflects an individual's belief in their ability to achieve goals and exert control over their environment, emotions, and actions. These self-referential beliefs have been linked to both psychological wellbeing and treatment response. Given SE’s role in information processing and treatment outcomes, and the limited research on correlates of change in ABMT, this study examined the relationship between SE and treatment response among pediatric patients (N = 111; mean age = 12.83±2.65 years) undergoing a 12-week course of CBT, supplemented with either active or control gamified ABMT. AMBT was administered via computer and consisted of dot-probe and visual search components aimed at training youths’ attention away from negatively valanced social stimuli. SE was assessed using the child-reported Self-Efficacy Questionnaire (SEQ), which evaluates SE across emotional, social, and academic domains. Anxiety and depression were measured through child- and parent-reported Mood and Feelings Questionnaire (MFQ), the Screen for Child Anxiety-Related Disorders (SCARED), and the clinician-reported Pediatric Anxiety Rating Scale (PARS). Measures were collected at the third week of treatment before the start of exposures (CBT 3), at the midpoint (CBT 8), and at the end of exposure treatment (CBT 12). Linear mixed-effects models revealed that among those in the active ABMT condition, but not the control condition, higher SE prior to exposures was associated with greater changes in parent-reported depressive symptoms at CBT 12 (β = 0.16, p = 0.02). No associations emerged for clinician, parent, or child-reported anxiety (p > 0.4). Findings that SE levels prior to engagement in exposures in CBT influence ABMT responsiveness highlights high SE as a potential correlate of change in mood symptoms over the course of ABMT+CBT treatment. Results can help in understanding which patient profiles might benefit most from ABMT+CBT vs CBT alone. Overall, current findings elucidate the complex, yet significant role of SE in mood-related treatment response and the need for further investigation into the relations between SE, attentional biases, and treatment outcomes among multiple reporters.