D-Cycloserine for the augmentation of an attentional training intervention for trait anxiety
University of Illinois at Chicago, Chicago, IL 60607, USA. Journal of anxiety disorders
(Impact Factor: 2.68).
02/2010; 24(4):440-5. DOI: 10.1016/j.janxdis.2010.02.009
The present study investigates the combination of two novel strategies for the treatment of anxiety that resulted from translational research. We examined whether the putative memory enhancer, d-cycloserine (DCS), offered benefit to procedures designed to train attention away from threat. Participants were 44 adults selected on the basis of high trait anxiety. In this randomized study, DCS or placebo was administered 1h prior to attentional training away from threat using the dot probe task. On the following day, the effectiveness of this training was assessed along with emotional reactivity following two stressful tasks. We found that the addition of DCS resulted in significantly stronger reduction in attentional bias toward threat relative to placebo, but found no additive effects for the DCS condition on subsequent emotional reactivity. These results provide initial support for the efficacy of DCS for augmenting attentional training tasks; potential strategies for enhancing these results are discussed.
Available from: Emily Holmes
- "More broadly, other forms of pharmacotherapy may interact positively with cognitive bias training regimes. Indeed, an interesting recent study provides some evidence that D-cycloserine may enhance the basic attentional bias training effect (Behar et al, 2010). "
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ABSTRACT: Selective serotonergic reuptake inhibitors (SSRIs) and cognitive therapies are effective in the treatment of anxiety and depression. Previous research suggests that both forms of treatments may work by altering cognitive biases in the processing of affective information. The current study assessed the effects of combining an SSRI with a cognitive intervention on measures of affective processing bias and resilience to external challenge. A total of 62 healthy participants were randomly assigned to receive either 7 days of citalopram (20 mg) or placebo capsules while also completing either an active or a control version of a computerized cognitive bias training task. After treatment, standard measures of affective processing bias were collected. Participants' resilience to external stress was also tested by measuring the increase in negative symptoms induced by a negative mood induction. Participants who received both citalopram and the active cognitive bias training task showed a smaller alteration in emotional memory and categorization bias than did those who received either active intervention singly. The degree to which memory for negative information was altered by citalopram predicted participants' resistance to the negative mood induction. These results suggest that co-administration of an SSRI and a cognitive training intervention can reduce the effectiveness of either treatment alone in terms of anxiety- and depression-relevant emotional processing. More generally, the findings suggest that pinpointing the cognitive actions of treatments may inform future development of combination strategies in mental health.
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ABSTRACT: The rapid emergence of translational developmental neuroscience as the key driver in understanding the onset of mental illness, the restructuring of academic health science centers on the NIH Roadmap, and dramatic shifts in drug, biological, device, and psychosocial intervention development all have important consequences for pediatric anxiety disorders as a field.
This article, which tracks the final presentation at a day-long symposium on pediatric anxiety disorders at the 2010 annual meeting of the Anxiety Disorders Association of America (ADAA), will try to outline where the field will head over the next decade as these forces combine to shape research and practice.
After 20 years of large comparative treatment trials that have defined the place of current generation treatments, the field is shifting toward interventions that will emerge from the revolution in translational developmental neuroscience and that herald the dawn of stratified and ultimately personalized medicine. With a much more efficient discovery to translational continuum, intervention development and dissemination will benefit from the concurrent transformation of the clinical and clinical research enterprise.
Dramatic advances in science and changes in the structure of medicine will condition the future of clinical research across every therapeutic area in medicine. For the field of pediatric anxiety disorders to thrive it will be important to embrace and actively participate in this revolution so that anxious youth are viewed as a key target population and, consequently, preemptive, preventive, and curative interventions will be developed for children by first intent.
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