Anxiety disorders are not occasional bouts of worry or fear, according to the National Institutes of Health. They persist and can worsen over time, potentially interfering with job performance, schoolwork and relationships. NMU psychology professor Josh Carlson received a prestigious $358,000 NIH grant to study the neuroscience of anxiety disorders and the impacts of a treatment called attention bias modification (ABM). 

Carlson and students will embark this fall on the first attempt to link ABM-related changes in brain function to underlying structural changes in the brain’s neuroplasticity. Identifying these biomarkers will be important in understanding why ABM treatment is successful for some who suffer from one of the most common psychological disorders, but not for others.

A cardinal feature of anxiety is an elevated attentional bias to threatening information. For example, if an individual with anxiety disorder is shown side-by-side computer images of two distinct facial expressions—one fearful and one neutral—she will typically fixate on the fearful image. But if a dot flashes behind the neutral image, it may redirect her focus. And if this is done repeatedly over time, there appears to be a decline in anxiety symptoms for some subjects. 

“Research indicates that attentional bias to threat is not only correlated with anxiety, but causes related symptoms,” Carlson said. “Yet the primary treatment options of SSRI medications and cognitive behavioral therapy are not aimed at reducing attentional bias. ABM is promising because it’s easy, practical and can be disseminated to a large number of patients. 

“Other studies have looked at functional MRI changes in brain activity following ABM, but the results haven’t been consistent and activity in the brain is dependent on what a person is doing and feeling at that particular moment. Structural changes aren’t susceptible to those types of influences. They are a more stable measure and may better predict behavioral change. Our research will be the first to assess the underlying mechanism that accompanies successful ABM treatment.”

Part of the grant will cover MRIs for subjects before and after ABM training. Carlson said knowing how the brain’s structure is impacted and why some people are more likely than others to benefit from ABM could be important innovations in treatment. 

Carlson and students in his CABIN (Cognitive and Affective Behavior Integrative Neuroscience Lab) will recruit 100 individuals ages 18-37 for the study. The subjects will be screened for their anxiety levels. Half will complete six weeks of at-home training using the NMU CABIN mobile phone app version of attention-bias modification. The other half will serve as the control group. All will undergo MRI pre- and post-training assessments.

“Generally there aren’t many opportunities for undergraduates to receive training in using MRI as a research tool in cognitive neuroscience, but Northern students are doing that,” Carlson said. “They are helping to move the field forward by identifying where neuroplasticity is taking place. Then we can see if tweaks to the training take advantage of that plasticity more and lead to better treatment. The CABIN lab research objectives align with the National Institute of Mental Health’s strategic plan to establish individualized treatments based on behavioral and neural observations. The funding agency liked the cell phone app aspect of our study because the treatment could be portable for people wherever they are.”

After the three-year NIH funding cycle, Carlson said a follow-up grant application might explore how long structural changes last after ABM treatment is stopped at the six-week point. The research could determine if booster sessions would be sufficient to maintain the positive effect, or whether continual training is required.

CABIN is composed of about 20 undergraduates from various disciplines and five to seven graduate students. They have collected attentional bias data from more than 500 participants over the past few years. They also have assisted in the analysis of functional and structural neuroimaging data presented at national conferences and have coauthored published manuscripts of structural MRI data. 

Collaborators on the NIH grant-supported project include Christine Hartline from NMU Counseling and Consultation Services and Michael Stoolmiller, a psychologist and pediatrics faculty member with Michigan State University College of Human Medicine. 

This article appears in the fall issue of Northern Magazine, which was just mailed and revolves around the theme of research. To see the full issue online, click here.