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Anxiety disorders are highly prevalent and costly to the individual and society. Exposure-based cognitive behavioral therapy (CBT) is the gold-standard intervention for anxiety disorders, although this approach does not fully reduce symptoms for all individuals. Therefore there is a need for innovative intervention approaches. One approach to augment and improve existing therapies would be to enhance the neurocognitive basis of fear extinction processes, which are the model on which treatments are based. Enhancing these processes may be possible through computerized cognitive training techniques which target executive functioning, the cognitive processes that help people manage complex cognitive activities. The proposed project is a proof-of-concept pilot study investigating the potential for training of executive functioning to improve anxiety-related outcomes. Individuals with elevated levels of social anxiety will be randomized to single-session COGnitive Enhancement Training (COGENT) or sham training program (ST). All participants will complete a single speech session where they present three 7-minute impromptu speeches and rate their anxiety at specific intervals. Participants will then complete the COGENT paradigm and affective processing task while undergoing fMRI.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cognitive Training + exposure | Experimental | Participants will complete adaptive computerized cognitive training plus a series of speech tasks |
|
| No training + exposure | Active Comparator | Participants will complete a low-dose computerized cognitive program plus a series of speech tasks |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cognitive Training | Behavioral | Participants are asked to remember a series of items while solving puzzles. |
|
| Measure | Description | Time Frame |
|---|---|---|
| BOLD activation during cognitive task | Working Memory Span task during fMRI | immediately after the intervention |
| BOLD activation during emotional task | Face processing task during fMRI | immediately after the intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Speech anxiety ratings | Subjective units of distress, scaled from 0 to 100, during each of 3, 7-minute speech activities | baseline, ratings during 3 speeches |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UC San Diego | San Diego | California | 92037 | United States |
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| ID | Term |
|---|---|
| D001008 | Anxiety Disorders |
| ID | Term |
|---|---|
| D001523 | Mental Disorders |
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| ID | Term |
|---|---|
| D000091942 | Cognitive Training |
| ID | Term |
|---|---|
| D000066530 | Neurological Rehabilitation |
| D012046 | Rehabilitation |
| D000359 | Aftercare |
| D003266 | Continuity of Patient Care |
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| D005791 |
| Patient Care |
| D013812 | Therapeutics |
| D006296 | Health Services |
| D005159 | Health Care Facilities Workforce and Services |