Brief Mental Training and Internal Attentional Control

NCT ID: NCT05353231

Last Updated: 2022-05-24

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: NA
• Total Enrollment: 90 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2022-05-23
• Study Completion Date: 2022-12-31

Brief Summary

Previous research documented that real-time feedback on attention as well as related forms of mental training (e.g. mindfulness meditation) may be used to train and impact external attentional control. These approaches to mental training are designed to train meta-awareness in order to enable attentional control. It is not yet known, however, whether such training targeting meta-awareness can be similarly used to impact internal attentional control. Thus, the investigators will test whether real-time feedback training and a brief mindfulness meditation training, relative to placebo control, will lead to greater internal attentional control among adults with elevated negative repetitive thinking.

Detailed Description

Participants will complete all assessments and training in a single laboratory session. Participants (N=105) with elevated levels of negative repetitive thinking (Rumination Response Scale -Brooding >=11) will be randomly assigned to one of 3 intervention arms: Attention Feedback Awareness and Control Training (A-FACT; n=35), Mindful Disengagement from Thoughts Training (MDTT; n=35), or placebo control (n=35).

At pre- and post-intervention, the investigators will measure: (1) Subjective emotional reactivity in response to negative vs. neutral self-referential thoughts using the Simulated Thought Paradigm (STP)-Emotional Reactivity task; (2) Interoceptive attention (i.e. sensibility) of the subjective location, intensity and hedonic tone of bodily sensations, using the STP-Body Map task, and (3) internal attentional control (i.e. latency to disengage) using the STP-Digit Categorization Task.

At post-intervention assessment only, the investigators will measure: (1) Meta-awareness of internal attentional dyscontrol using the STP-Digit Categorization Task with Self-Caught Probes; (2) internal attentional control (i.e. selective attention) using the STP-One-Back Dichotic Listening Task as a measure of the generalizability of the expected primary effect on internal attentional control.

The primary aim is to test the effect of 2 active intervention arms, Attention Feedback Awareness and Control Training and Mindful Disengagement from Thoughts Training, relative to one another and placebo control, on internal attentional control from pre-to-post training among adults with elevated negative repetitive thinking. The investigators hypothesise that both active interventions conditions will yield improvement in internal attentional control, as measured by the Digit Categorization Task integrated with the Simulated Thoughts Paradigm, from pre-to-post intervention, relative to the placebo-control.

Secondary aims are to test the effects of the 2 active intervention arms, relative to one another and placebo control, on subjective emotional reactivity to negative self-referential thoughts, selection bias to negative self-referential thoughts, meta-awareness of attentional dyscontrol, as well as interoceptive attention to bodily sensations in response to negative self-referential thoughts. The investigators hypothesize that, relative to the control-placebo group, the active intervention groups will yield (a) reduced emotional reactivity to negative self-referential thoughts as measured in the Emotional Reactivity Task, (b) higher levels of meta-awareness of attentional dyscontrol as measured by the STP-Digit Categorization Task with Self-Caught Probes, and (c) higher levels of selective internal attentional control as measured by the STP-One-Back Dichotic Listening Task.

Additionally, the investigators hypothesize that, relative to the placebo control group and the Attention Feedback Awareness and Control Training group, the Mindful Disengagement from Thoughts Training group will yield enhanced interoceptive attention (i.e. sensibility) to a broader range of locations (e.g. peripheral body areas), intensities (e.g. subtle sensations) and hedonic tones (e.g. neutral and pleasant hedonic tones) of bodily sensations in response to self-referential thoughts, as measured by STP-Body Map task.

Finally, the investigators hypothesized non-inferiority between the active intervention groups with respect to all mentioned measured outcomes, with exception of the noted STP-Body-Map Task.

Conditions

Attention Impaired; Mental Health Issue; Rumination

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: BASIC_SCIENCE
• Blinding Strategy: DOUBLE

Study Groups

Intervention 1 - Attention Feedback Awareness and Control Training

Group Type: EXPERIMENTAL

Attention Feedback Awareness and Control Training (A-FACT)

Intervention Type: BEHAVIORAL

A-FACT is designed to promote meta-awareness of moment-to-moment biased internal attention allocation (e.g. toward negative thoughts) and thereby internal attentional control.

Participants will be instructed that they will complete a task designed to reduce their attentional bias to some thoughts. Following a fixation que, the auditory neutral or negative simulated thought stimulus is delivered, and 500ms prior to termination of the auditory stimulus, a visual stimulus is presented until participants categorize the visual stimulus as greater than or smaller than 5 objects. Latency to disengage attention from each thought stimuli, at the trial-level, is repeatedly measured, and after each negative thought stimulus, trial-level feedback on the latency to disengage is delivered back to participants through a visual scale representing their attentional bias. Participants will complete approximately 100 trials in total wherein randomly 1 or 2 neutral trials follow each negative trial.

Intervention 2 - Mindful Disengagement from Thoughts Training

Group Type: EXPERIMENTAL

Mindful Disengagement from Thoughts Training (MDTT)

Intervention Type: BEHAVIORAL

MDTT is designed to promote meta-awareness of moment-to-moment biased internal attention allocation (e.g. toward negative thoughts) and thereby internal attentional control. Participants will be instructed that they will complete a task designed to reduce their attentional bias to some thoughts. Participants will first learn and practice a focused attention on the breath meditation. Then, participants will practice pressing a button each time they notice an inhalation or exhalation during the focused attention meditation. Next, during the meditation, participants will be presented the auditory neutral or negative simulated thought stimuli and will train internal attentional control by repeatedly disengaging their attention from these stimuli and back to their breath MDTT will thus entail 80 trials (40 negative, 40 neutral, ITI ≈ 10sec) during the focused attention on the breath meditation.

Placebo

Group Type: PLACEBO_COMPARATOR

Placebo-Control

Intervention Type: BEHAVIORAL

The condition is designed as a placebo control for the Attention Feedback Awareness and Control Training (A-FACT) training condition. Participants will be instructed that they will complete a task designed to reduce their attentional bias to some thoughts. Rather than the quantity categorization task with trial-level feedback, participants only engage in the quantity categorization task. The task is identical in all other ways to the A-FACT condition. Participants will complete approximately 100 trials in total wherein randomly 1 or 2 neutral trials follow each negative trial.

Interventions

Attention Feedback Awareness and Control Training (A-FACT)

A-FACT is designed to promote meta-awareness of moment-to-moment biased internal attention allocation (e.g. toward negative thoughts) and thereby internal attentional control.

Participants will be instructed that they will complete a task designed to reduce their attentional bias to some thoughts. Following a fixation que, the auditory neutral or negative simulated thought stimulus is delivered, and 500ms prior to termination of the auditory stimulus, a visual stimulus is presented until participants categorize the visual stimulus as greater than or smaller than 5 objects. Latency to disengage attention from each thought stimuli, at the trial-level, is repeatedly measured, and after each negative thought stimulus, trial-level feedback on the latency to disengage is delivered back to participants through a visual scale representing their attentional bias. Participants will complete approximately 100 trials in total wherein randomly 1 or 2 neutral trials follow each negative trial.

Intervention Type: BEHAVIORAL

Mindful Disengagement from Thoughts Training (MDTT)

MDTT is designed to promote meta-awareness of moment-to-moment biased internal attention allocation (e.g. toward negative thoughts) and thereby internal attentional control. Participants will be instructed that they will complete a task designed to reduce their attentional bias to some thoughts. Participants will first learn and practice a focused attention on the breath meditation. Then, participants will practice pressing a button each time they notice an inhalation or exhalation during the focused attention meditation. Next, during the meditation, participants will be presented the auditory neutral or negative simulated thought stimuli and will train internal attentional control by repeatedly disengaging their attention from these stimuli and back to their breath MDTT will thus entail 80 trials (40 negative, 40 neutral, ITI ≈ 10sec) during the focused attention on the breath meditation.

Intervention Type: BEHAVIORAL

Placebo-Control

The condition is designed as a placebo control for the Attention Feedback Awareness and Control Training (A-FACT) training condition. Participants will be instructed that they will complete a task designed to reduce their attentional bias to some thoughts. Rather than the quantity categorization task with trial-level feedback, participants only engage in the quantity categorization task. The task is identical in all other ways to the A-FACT condition. Participants will complete approximately 100 trials in total wherein randomly 1 or 2 neutral trials follow each negative trial.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• Brooding subscale in the Ruminative Responses Scale (RRS) - with score equal to or greater than 11

Exclusion Criteria

• Endorsement of suicidal ideation ("Yes" answer to Patient Health Questionnaire - 9 Item
• Psychotic Symptoms, specifically auditory hallucinations
• Self-report lack of fluency in speaking or understanding Hebrew-language

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

University of Haifa

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Amit Bernstein, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

University of Haifa

Locations

University of Haifa

Haifa, , Israel

Site Status: RECRUITING

Countries

Israel

Central Contacts

Amit Bernstein, Ph.D.

Role: CONTACT

abernstein@psy.haifa.ac.il

+972-4-828-8871

Facility Contacts

Amit Bernstein, Ph.D.

Role: primary

abernstein@psy.haifa.ac.il

+972-4-828-8871

Other Identifiers

MDTT-AFACT

Identifier Type: -

Identifier Source: org_study_id