Abstract
Dental anxiety is common and associated with negative outcomes. According to information-processing models, anxiety is maintained by maladaptive patterns of processing threatening information. Furthermore, attention training interventions can reduce anxiety in one session. Fifty-three individuals with high levels of dental anxiety completed a Posner reaction-time task. Participants were randomized to attention training or control using a dot-probe task, and then attentional bias was remeasured using another Posner task. Participants then completed a script-driven imaginal exposure task. Results indicated that individuals high in dental anxiety exhibit threat-relevant attentional bias. There was mixed evidence about the efficacy of attention training. On the one hand, training did not eliminate attentional bias and training condition did not predict distress during the imagery task. On the other hand, cue dependency scores in the control group were higher for dental than neutral cues, but did not differ in the training group. In addition, cue dependency scores for both dental and neutral cues predicted subjective anxiety in anticipation of the imagery task. The mixed results of training are considered in terms of the possibility that it enhanced attentional control, rather than reducing bias.
Highlights
Dental anxiety is experienced by approximately 10–20% of adults, with 2.4–3.7% of the population meeting diagnostic criteria for dental phobia (Stinson et al, 2007; Oosterink et al, 2009)
Participants were recruited through various methods and sources, including (1) advertisements posted at the Departments of Psychology and Schools of Dentistry at Nova Southeastern University and the University of Illinois at Chicago (UIC); (2) advertisements sent to private dental clinics in South Florida and Chicago; and (3) e-mails sent to all university students, faculty, and staff at the UIC
Reaction time data were included in analyses for trials on which responses were (a) accurate, (b) within 2 SD of that participant’s mean response latency (Reese et al, 2010), and (c) between 50 and 1,200 ms (Amir et al, 2003)
Summary
Dental anxiety is experienced by approximately 10–20% of adults, with 2.4–3.7% of the population meeting diagnostic criteria for dental phobia (Stinson et al, 2007; Oosterink et al, 2009). Najmi and Amir (2010) found that after only one session of attention training, anxious individuals were more willing to approach feared stimuli even when they did not experience reduced anxiety while doing so, but the majority of studies do not include behavioral approach tasks in order to examine generalizability of findings to non-cognitive outcomes. In another study of individuals with diagnosed dental phobia, Ries (1997) found that relative to demographically matched non-anxious participants, participants with a dental phobia diagnosis were slower to name both standardized and idiographic words depicting dental threat Such attentional biases indicate an interference of the attentional system such that cognitive resources are allocated to feared stimuli. We examined the efficacy of a single-session attentional bias training procedure for reducing both attentional bias and self-reported distress during a behavioral (imaginal exposure) task, using different paradigms to measure and train attention
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