2 - (SYM 54) Precision Medicine: Modulating a Biomarker of Anxiety Using Attention Bias Modification, a 2-year Follow up Study

Abstract Body
Anxiety and depression are prevalent in adolescents and associated with impairment in different domains of functioning.  Attentional-bias-modification (ABM) programs show promise and one avenue for curbing the naturalistic increases in anxiety and depression in adolescents.   In an recent multi site (San Diego, Florida) report we showed the impact of two home-delivered ABM programs on a biomarker of anxiety (i.e., the error-related negativity [ERN]). We measured the ERN, anxiety, attention bias, and attention control before and after two versions of ABM training and a waitlist control group in 546 adolescents. For participants at the San Diego site we also assessed the participants' mothers anxiety, depression, and stress. In the current report we report the two year follow up data in participants who completed the study in San Diego where we also had access to mothers' self report of anxiety, depression, and stress. One hundred fifty four adolescents ages 11-14 and their mothers visited our lab. We calculated change scores from baseline to two year follow-up, where a larger score indicated greater anxiety, and used it as the dependent variable in linear regression analyses with AABM group, baseline maternal psychopathology, and ERN as predictors. To this end we created contrast codes comparing the general attentional control (cAABM) group and the disengage attention from negative stimuli (eAABM) group to the waitlist group respectively. These analyses revealed a significant main effect of maternal depression such that higher maternal depression resulted in lower increase in anxiety in the children. The effect of maternal anxiety and maternal stress were not significant.  Moreover there was a main effect of baseline ERN that was modified by an interaction of cAABM group contrast with baseline ERN. Follow up analysis examining the regions of significance showed that for those participants with ERN scores of -9 or lower there was a significant impact of being enrolled in the cAABM group compared to those enrolled in the waitlist group. This suggests that cAABM training protects against increases in adolescent anxiety across two years specifically for those with elevated ERN at baseline. Therefore, precision medicine focusing on a particular type of ABM targeting particular participants may be the next step in delivering preventive strategies for adolescents at risk for anxiety. Maternal psychopathology exhibited an independent effect, emphasizing its impact on adolescent anxiety development.