A randomized experimental analysis of the attention training technique: Effects on worry and relevant processes in individuals with probable generalized anxiety disorder

CONTEXT: The Attention Training Technique (ATT, Wells, 1990) is an intervention guiding individuals to focus, shift, and divide their attention in response to sounds presented in an audiorecording. The ATT has long been recommended for generalized anxiety disorder (GAD); however, there is insufficient research on its effects on excessive worry and related processes. OBJECTIVES: This experiment examined whether the ATT is more efficacious than a control intervention at reducing worry and modifying worry-related processes (e.g., attention control, negative metacognitive beliefs, attention bias, mindfulness). PARTICIPANTS: 78 adults with probable GAD. DESIGN: Participants completed measures of worry and worry-related processes at the lab. They then monitored worry and attention daily for a week. Following this baseline, participants recompleted the lab measures and were randomly assigned to ATT or control. Participants listened to their assigned recording once/day for a week while again monitoring worry and attention daily. Participants then recompleted the lab measures. RESULTS: The ATT did not perform better than the control condition on any measure. A variety of improvements were seen over the intervention period in both conditions. CONCLUSIONS: ATT may not have meaningful effects on excessive worry and worry-related processes. Explanations for null findings are offered. CLINICALTRIALS. GOV REGISTRATION: NCT03216382.