Project Grant R15MH135419

TESTING THE ROLE OF ATTENTIONAL AND AUDIO VOCAL MECHANISMS IN A NEW INTERNET-BASED INTERVENTION FOR SOCIAL ANXIETY: IEXPOSURE - PROJECT SUMMARY (ABSTRACT) SOCIAL ANXIETY IS A PREVALENT MENTAL HEALTH CONCERN THAT IMPACTS APPROXIMATELY 12% OF THE US POPULATION. YET, THE MAJORITY OF INDIVIDUALS WITH SOCIAL ANXIETY DO NOT RECEIVE TREATMENT IN LARGE PART BECAUSE IT IS DIFFICULT TO ACCESS MENTAL HEALTH RESOURCES. THERE IS A NEED FOR TARGETED MECHANISM-FOCUSED INTERVENTIONS FOR SOCIAL ANXIETY THAT ARE ALSO HIGHLY SCALABLE. THE PI DEVELOPED A NATURALISTIC PARADIGM TO STUDY SOCIAL ANXIETY USING SIMULATED TELECONFERENCING INTERACTIONS AND DEMONSTRATED THEIR UTILITY FOR BOTH ELICITING SOCIAL EVALUATIVE THREAT AND TESTING ATTENTION AND AUDIO VOCAL MECHANISMS. THE PI THEN USED THESE SIMULATED TELECONFERENCING INTERACTIONS AS THE BASIS OF A NEW BRIEF EXPOSURE-FOCUSED SELF-GUIDED INTERNET-BASED INTERVENTION CALLED IEXPOSURE. THE INTERVENTION ONLY REQUIRED FOUR SESSIONS, COMPLETED OVER TWO WEEKS. THE PILOT STUDY ALSO TESTED TWO POTENTIAL ATTENTION MECHANISMS THOUGHT TO MAINTAIN SOCIAL ANXIETY, AVOIDANCE AND ATTENTION CONTROL. RESULTS WERE PROMISING, WITH THE MAJORITY OF PARTICIPANTS COMPLETING THE ENTIRE INTERVENTION AND REPORTING MEDIUM-LARGE DECREASES IN SYMPTOMS OF SOCIAL ANXIETY. ADDITIONALLY, THE ATTENTION AUGMENTATIONS APPEARED TO ENHANCE THE EFFICACY OF THE INTERVENTION. HOWEVER, A LARGER STUDY IS NEEDED TO VALIDATE THESE RESULTS AND TO TEST POTENTIAL MECHANISMS IN SOCIAL ANXIETY. THE OVERARCHING GOAL OF THIS PROPOSAL IS TO TEST SEVERAL MECHANISMS IMPLICATED IN SOCIAL ANXIETY USING THE NEWLY DEVELOPED SELF-GUIDED INTERNET-BASED INTERVENTION CALLED IEXPOSURE. AIM 1 WILL DIRECTLY TEST TWO DIFFERENT ATTENTION MECHANISMS IMPLICATED IN SOCIAL ANXIETY BY AUGMENTING IEXPOSURE WITH ATTENTION GUIDANCE OR ATTENTION CONTROL. AIM 2 WILL TEST THE CAUSAL ROLE OF ATTENTIONAL PROCESSES IN THE INTERVENTION'S EFFICACY FOR REDUCING SOCIAL ANXIETY SYMPTOMS THROUGH MEDIATION AND MODERATION MODELS. AIM 3 WILL TEST THE ROLE OF ENGAGEMENT (PROPORTION OF TIME SPENT SPEAKING) AS A CAUSAL FACTOR IN TREATMENT OUTCOMES AND OTHER AUDIO VOCAL FEATURES (PITCH OR AMPLITUDE) AS POTENTIAL PREDICTORS OF TREATMENT RESPONSE. THIS PROJECT WILL PROVIDE GRADUATE STUDENT MENTEES EXPERIENCE WITH MECHANISM-FOCUSED RESEARCH IN THE CONTEXT OF A CLINICAL TRIAL. ADDITIONALLY, MENTEES WILL LEARN A HIGHLY ADAPTABLE FRAMEWORK FOR CONDUCTING INTERNET-BASED INTERVENTIONS FOR THEIR OWN FUTURE MENTORED RESEARCH. MENTEES WILL ALSO GAIN ADVANCED THEORETICAL, TECHNICAL, AND STATISTICAL KNOWLEDGE CRITICAL FOR CONDUCTING EYE MOVEMENT (I.E., VISUAL ATTENTION) AND AUDIO-VOCAL BASED RESEARCH. THIS PROPOSAL WILL ALSO OFFER MENTEES OPPORTUNITIES TO CONNECT WITH THE SCIENTIFIC COMMUNITY THROUGH CONFERENCE PRESENTATIONS AND JOURNAL PUBLICATIONS, AS WELL AS PROVIDE THEM WITH TRAINING OPPORTUNITIES IN OTHER LABS. FINDINGS WILL TEST POTENTIAL TARGETABLE AND MODIFIABLE MECHANISMS MAINTAINING SOCIAL ANXIETY, IN THE CONTEXT OF A HIGHLY ADAPTABLE AND SCALABLE INTERNET INTERVENTION FRAMEWORK. RESULTS MAY INFORM TAILORED TREATMENTS FOR INDIVIDUALS WITH SOCIAL ANXIETY ADDRESSING PERSON-SPECIFIC MAINTAINING FACTORS. TAKEN TOGETHER, THIS PROJECT OFFERS IMPORTANT ADVANCES IN THE TRAINING OF FUTURE CLINICAL SCIENTISTS AND THE DEVELOPMENT OF TARGETED DIGITAL THERAPEUTICS FOR SOCIAL ANXIETY.