Disorders - Anxiety Disorders
Malik,
K.
Background Psychosocial interventions for adolescent mental health problems are effective, but evidence on their longer-term outcomes is
scarce, especially in low-resource settings. We report on the 12-month sustained effectiveness and costs of scaling up a lay counselor-delivered,
transdiagnostic problem-solving intervention for common adolescent mental health problems in low-income schools in New Delhi, India. Methods and
findings Participants in the original trial were 250 school-going adolescents (mean [M] age = 15.61 years, standard deviation [SD] = 1.68), including
174 (69.6%) who identified as male. Participants were recruited from 6 government schools over a period of 4 months (August 20 to December 14, 2018)
and were selected on the basis of elevated mental health symptoms and distress/functional impairment. A 2-arm, randomized controlled trial design was
used to examine the effectiveness of a lay counselor-delivered, problem-solving intervention (4 to 5 sessions over 3 weeks) with supporting printed
booklets (intervention arm) in comparison with problem solving delivered via printed booklets alone (control arm), at the original endpoints of 6 and
12 weeks. The protocol was modified, as per the recommendation of the Trial Steering Committee, to include a post hoc extension of the follow-up
period to 12 months. Primary outcomes were adolescent-reported psychosocial problems (Youth Top Problems [YTP]) and mental health symptoms (Strengths
and Difficulties Questionnaire [SDQ] Total Difficulties scale). Other self-reported outcomes included SDQ subscales, perceived stress, well-being,
and remission. The sustained effects of the intervention were estimated at the 12-month endpoint and over 12 months (the latter assumed a constant
effect across 3 follow-up points) using a linear mixed model for repeated measures and involving complete case analysis. Sensitivity analyses
examined the effect of missing data using multiple imputations. Costs were estimated for delivering the intervention during the trial and from
modeling a scale-up scenario, using a retrospective ingredients approach. Out of the 250 original trial participants, 176 (70.4%) adolescents
participated in the 12-month followup assessment. One adverse event was identified during follow-up and deemed unrelated to the intervention.
Evidence was found for intervention effects on both SDQ Total Difficulties and YTP at 12 months (YTP: adjusted mean difference [AMD] = -0.75, 95%
confidence interval [CI] = -1.47, -0.03, p = 0.04; SDQ Total Difficulties: AMD = -1.73, 95% CI = -3.47, 0.02, p = 0.05), with stronger effects over
12 months (YTP: AMD = -0.98, 95% CI = -1.51, -0.45, p < 0.001; SDQ Total Difficulties: AMD = -1.23, 95% CI = -2.37, -0.09; p = 0.03). There was also
evidence for intervention effects on internalizing symptoms, impairment, perceived stress, and well-being over 12 months. The intervention effect was
stable for most outcomes on sensitivity analyses adjusting for missing data; however, for SDQ Total Difficulties and impairment, the effect was
slightly attenuated. The per-student cost of delivering the intervention during the trial was $3 United States dollars (USD; or $158 USD per case)
and for scaling up the intervention in the modeled scenario was $4 USD (or $23 USD per case). The scaling up cost accounted for 0.4% of the per-
student school budget in New Delhi. The main limitations of the study's methodology were the lack of sample size calculations powered for 12-month
follow-up and the absence of cost-effectiveness analyses using the primary outcomes. Copyright © 2021 Malik et al. This is an open access article
distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any
medium, provided the original author and source are credited.
PLoS Medicine, 18(9) (no
pagination) :
- Year: 2021
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Problem solving therapy (PST)
Malboeuf-Hurtubise, C., Leger-Goodes, T., Mageau, G. A., Joussemet, M., Herba, C., Chadi, N., Lefrancois, D., Camden, C., Bussieres, E. L., Taylor, G., Ethier, M. A., Gagnon, M.
Background: Preliminary evidence suggests that the COVID-19 pandemic has had a negative impact on children's mental health. Given these
problems can have significant impacts throughout the lifespan, preventing the negative repercussions of COVID-19 on children's mental health is
essential. Philosophy for children (P4C) and mindfulness-based interventions (MBIs) show promise in this regard. Objective(s): The goal of the
present study was to compare the impact of online MBI and P4C interventions on mental health, within the context of the COVID-19 pandemic. We used a
randomized cluster trial to assess and compare the impact of both interventions on elementary school students' (N = 37) anxiety and inattention
symptoms as well as on their basic psychological need satisfaction (BPN). Result(s): ANCOVAs revealed a significant effect of the P4C intervention on
mental health difficulties, controlling for baseline levels. Participants in the P4C group showed lower scores on the measured symptoms at post-test
than participants in the MBI group. Significant effects of the MBI on levels of BPN were also found. Participants in the MBI intervention reported
greater BPN satisfaction at post-test than participants in the P4C intervention. Conclusion(s): Results from this study suggest that, in the current
context of the COVID-19 pandemic, a P4C intervention centered around COVID-19 related themes may be helpful to reduce mental health difficulties,
that a MBI may be useful to satisfy BPN, and that both interventions were easy to offer online to elementary school students. Future work including a
larger sample size and follow-up measures is warranted. Public significance: Practice: Philosophy for children (P4C) and mindfulness-based
interventions (MBIs) can be used to foster mental health in elementary school students, in the current COVID-19 context. Policy: As we do not
anticipate that facilitators will be allowed in schools during the 2020-2021 school year and that children will, most likely, be attending school in
the current COVID-19 context, policymakers who want to implement psychological support measures in elementary schools should consider an online
modality, which has shown in this study to work well, be feasible, and yield positive results on youth mental health. Copyright © 2021 Elsevier
Inc.
Progress in Neuro-Psychopharmacology and
Biological Psychiatry, 107 (no pagination) :
- Year: 2021
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Mindfulness based
therapy, Technology, interventions delivered using technology (e.g. online, SMS)
Malboeuf-Hurtubise, C., DiTomaso, C., Lefrancois, D., Mageau, G. A., Taylor, G., Ethier, M. A., Gagnon, M., Leger-Goodes, T.
Background: Philosophy for children (P4C) was initially developed in the 1970s
and served as an educational program to promote critical thinking, caring, creative reasoning and inquiry in the educational environment. Quasi-
experimental research on P4C, a school-based approach that aims to develop children's capacity to think by and for themselves, has suggested it
could be an interesting intervention to foster greater basic psychological need satisfaction in children in school settings. Objective(s): The goal
of the present study was to evaluate the impact of P4C on basic psychological need satisfaction and mental health in elementary school students.
Method(s): Students from grades one to three (N = 57) took part in this study and completed pre-and post-intervention questionnaires. A randomized
cluster trial with a wait-list control group was implemented to compare the effects of P4C on students' mental health. Result(s): Analyses of
covariance (ANCOVAs) revealed a significant effect of group condition on levels of autonomy and anxiety, after controlling for baseline levels.
Participants in the experimental group showed higher scores in autonomy, when compared to participants in the control group, and participants in the
experimental group showed lower anxiety scores, when compared to participants in the control group. Conclusion(s): Overall, results from this study
show that P4C may be a promising intervention to foster greater autonomy in elementary school children, while also improving mental health. Copyright
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.
International Journal of Environmental Research and Public Health, 18(23) (no
pagination) :
- Year: 2021
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
MacLellan, A., Derakshan, N.
Background: Previous research has indicated a causal relationship between attentional control and anxiety with literature
finding that attentional control training combined with mindfulness meditation may lead to cognitive improvements in high worriers. The current study
investigates whether the practical application of Stoicism, a philosophy originating from the Hellenistic period, will provide similar self-report
and cognitive improvement in a sample of high worriers. Method(s): 45 high worriers were randomly allocated into one of three training groups: an
active control 1-back, a combined adaptive dual n-back and Stoic training and a Stoic training only group. Participants were tested on anxiety and
rumination as well as measures of attentional control and a nascent scale to measure Stoic ideation, pre- and post- an 8-session training period.
Result(s): Results found significant effects of Stoic training on rumination and self-efficacy. Text analyses of the Stoic training found reduced
frequencies of anxious and negatively valenced words questions related to self-assessments and planning. Conclusion(s): The study provides a positive
foundation for the further research and development of Stoic training. The wider implications of these results are discussed. Copyright © 2021,
Springer Science+Business Media, LLC, part of Springer Nature.
Cognitive Therapy and
Research., :
- Year: 2021
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Attention/cognitive bias
modification, Technology, interventions delivered using technology (e.g. online, SMS)
Luo, A., McAloon, J.
Cognitive-behavioral therapy (CBT) is regarded as an effective treatment for anxiety disorders in
childhood. Researchers have begun to investigate potential mechanisms of change that drive these positive outcomes, including shifts in cognitions,
behavior, and affect. However, few studies have established the mediational effects of these factors as a proxy for establishing mechanistic change.
This meta-analysis attempts to synthesize the literature on potential mechanisms of change in CBT for childhood anxiety and investigates the
mediational effects of these factors on treatment outcomes. Seventeen studies met the inclusion criteria. Across studies, five potential mediators
were identified: externalizing difficulties, negative self-talk, coping, fear, and depression. Results indicated that CBT was effective in improving
outcomes on all potential mediators, except for fear. Mediational analyses showed that externalizing difficulties, negative self-talk, coping, and
depression mediated anxiety following treatment. Fear did not mediate the relationship. Implications for future mechanisms of change research are
proposed. Copyright © 2020 Wiley Periodicals LLC
Depression and Anxiety, 38(2) : 220-
232
- Year: 2021
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Lowe, C., Wuthrich, V. M.
Typically students in their final year of
school report high levels of anxiety, depression and stress. This study evaluated Study without Stress, a group cognitive behavioural program to
reduce student stress. Fifty-six final year students (77% female) from four Australian secondary schools were randomly allocated to Study without
Stress delivered by school staff, or to an 8-week usual care condition. Changes in self-reported stress, anxiety, depression, self-efficacy, and
teacher reported emotional problems were assessed pre to post-treatment using intent-to-treat analyses. Maintenance of changes were examined 3-months
later. Compared to usual care, Study without Stress led to significant reductions in self-reported stress and distress, and increases in self-
efficacy that were maintained over time, with no significant changes in anxiety, depression or teacher reported emotional problems. Study without
Stress is beneficial for reducing academic stress and improving self-efficacy in final year students when delivered in a school setting.
Child psychiatry and human
development, 52(2) : 205-216
- Year: 2021
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Liang, L., Feng, L., Zheng, X., Wu, Y., Zhang, C., Li, J.
BACKGROUND: During the epidemic, the mental health of college students was generally poor, especially anxiety and depression, which
should be treated using counseling and intervention. This study aimed to observe the influence of dialectical behavior therapy on the anxiety and
depression of medical students during the normalization of the prevention and control of the COVID-19 epidemic.\rMETHODS: A total of 26 medical
students (experimental group) were treated with dialectical behavior therapy intervention for 4 weeks. Changes in depression, anxiety, and stress
levels were assessed by the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder (GAD-7) scale, the Somatic Self-rating Scale
(SSS), and the Perceived Stress Scale (PSS-10). This group was compared with 26 medical students (control group) without intervention.\rRESULTS: The
value-added scores of the PHQ-9 (t=2.543, P=0.014) and GAD-7 scales (t=3.790, P=0.000) in the experimental group were significantly higher than those
in the control group, while in the SSS scale, the value-added score of the depressive symptoms subscale (t=2.234, P=0.030) in the experimental group
was significantly higher than that of the control group. For the total score of the PSS-10 scale (t=2.435, P=0.018), the value-added score of the
experimental group was significantly higher than that of the control group.\rCONCLUSIONS: The intervention of dialectical behavior therapy can
effectively alleviate the depression and anxiety of medical students during the normalization of epidemic prevention and control.\rTRIAL
REGISTRATION: Chinese Clinical Trial Registry ChiCTR2100048784.
Annals of Palliative
Medicine, 10(10) : 10591-10599
- Year: 2021
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Dialectical behavioural therapy
(DBT)
Li, S., Xu, Q., Zhou, A.
A recent study showed that a brief intervention involving reection on personal
values (T1: 2 February 2020) can buffer the anxiety response one week later (T2: Feb. 9) during the COVID-19 pandemic in China. The present study
reported the results from a follow-up two weeks (T3: Feb. 16) and one-month later (T4: Mar. 1). Two hundred and twenty participants were recruited
via convenience sampling and randomly assigned either to the value-affirmation condition or to a control condition, with 110 participants in each
condition. The results revealed that similar to T2, participants who affirmed their values showed a lower anxiety response than those in the control
group at T3, despite the pandemic continuing to increase rapidly during that time. Meanwhile, anxiety decreased in both groups at T4 as the pandemic
eased. Findings suggest that self-affirmations can help reduce stress in the face of the COVID-19.
Psychology, health & medicine, : 1-
6
- Year: 2021
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Li, J., Gao, J., Zhang, Q., Li, C., Cui, L.
Cognitive bias modification-interpretation (CBM-I) is a promising treatment modality for emotional disorders. But the moderate
effect sizes emphasize the need to explore the potential mechanism of the CBM-I. Recent research has identified intolerance of uncertainty (IU) as a
possible a trans-diagnostic risk and maintaining factor emotional disorders. The current study investigated the impact of a four-session IU-focused
CBM-I on reduction of anxiety and determined whether IU mediated the relationship between IU interpretation bias and anxiety. 40 participants
selected based on a high IU interpretation bias (IU-IB) were randomly assigned to an active (IU CBM-I) condition and a control CBM-I condition. By
longitudinal design, anxiety and uncertainty questionnaires were administered before, after and one month after the intervention. Multilayer linear
model analysis indicated that the active IU CBM-I was significantly associated with changes in anxiety from pre-to-post intervention as well as
reductions in IU at post-intervention and month-one follow-up. The results also found that IU mediated the relationship between IU interpretation
bias and anxiety. Copyright © 2020, Springer Science+Business Media, LLC, part of Springer Nature.
Journal of Psychopathology and Behavioral Assessment, 43(1) : 142-151
- Year: 2021
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Attention/cognitive bias
modification
Li, J., Cai, Z., Li, X., Du, R., Shi, Z., Hua, Q., Zhang, M., Zhu, C., Zhang, L., Zhan,
X.
BACKGROUND:
Mindfulness-based interventions (MBIs) and cognitive behavioral therapy (CBT) have both been shown to be effective treatment approaches for anxiety.
The purpose of this paper was to directly investigate the ability of MBIs and CBT to improve anxiety symptoms (primary outcome), as well as
depression symptoms and sleep quality (second outcome).\rMETHODS: We searched the following electronic databases from 1st December, 2019 to 14th
January 2021: English databases including PubMed, PsycINFO, Web of Science, the Cochrane Library, Elsevier, Springer Link, Wiley Online Library,
ClinicalTrails, and Embase, and Chinese database including CNKI, WANFANG, and CQVIP. The eligibility criteria included the following: (I) patients
with anxiety disorders or symptoms of anxiety; and those with physical or mental disorders with comorbid anxiety symptoms; (II) randomized controlled
trial (RCT) design; (III) the treatment group received MBIs; (IV) the control group received CBT; and (V) the treatment outcomes were anxiety,
depression, and sleep quality.\rRESULTS: In total, 4,095 abstracts were reviewed. Of these, the full-texts of 45 articles were read in detail; and 11
RCTs were finally included in the analysis. Upon completion of MBIs and CBT group sessions, the study outcomes (mean anxiety, depression, and sleep
quality scores) revealed no difference between MBIs and CBT with regards to anxiety, depression, and sleep quality post-intervention. Subgroup
analysis was also performed, and the results indicated that MBIs may provide a small advantage for people with anxiety symptoms compared to CBT
[standard mean difference (SMD): -0.36, 95% confidence interval (CI): -0.66 to -0.06], while the CBT group demonstrated a small comparative advantage
for anxiety in the Liebowitz Social Anxiety Scale (LSAS) and Social Phobia Inventory (SPIN) scales, as well as mindfulness-based stress reduction
(MBSR) in the types of MBIs (LSAS: SMD: 0.35, 95% CI: 0.08 to 0.63; SPIN: SMD: 0.51, 95% CI: 0.11 to 0.92; MBSR: SMD: 0.41, 95% CI: 0.07 to 0.74).
\rDISCUSSION: There was no significant difference between MBIs and CBT in terms of the treatment outcomes of anxiety, depression, and sleep quality.
MBIs could be used as an alternative intervention to CBT for anxiety symptoms.\rTRIAL REGISTRATION: This meta-analysis was conducted in line with the
PRISMA guideline and was registered at PROSPERO https://www.crd.york.ac.uk/PROSPERO/ (CRD42021219822).
Annals
of Palliative Medicine, 10(7) : 7596-7612
- Year: 2021
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Mindfulness based
therapy
Leech, T., Dorstyn, D., Taylor, A., Li, W.
[Correction Notice: An Erratum for this article was
reported in Vol 128[106184] of Children and Youth Services Review (see record 2021-76648-001). The authors regret that select data in Table 1 were
misplaced (incorrect table row) for two studies. The corrected details are presented in an erratum.] Objective: Smartphone applications ('apps')
have the potential to improve the scalability of mental health interventions for young people, however, the effectiveness of stand-alone apps in
mental health management remains unclear. This systematic review, with meta-analysis, provides an up-to-date summary of the available high-quality
evidence. Methods: Eleven randomized controlled trials, involving a pooled sample of 1706 adolescents and young adults (age range 10 to 35 years),
were identified from the Cochrane Library, Embase, Google Scholar, PsycINFO and PubMed databases. The reporting quality of studies was evaluated
using the Cochrane Risk of Bias Tool 2.0 (RoB 2.0). Hedges' g effect sizes with 95% confidence intervals, p values and heterogeneity statistics were
additionally calculated using a random effects model. Results: Study reporting quality was sound, with no trials characterized as 'high' risk. App
interventions produced significant symptom improvement across multiple outcomes, compared to wait-list or attention control conditions (depression gw
= 0.52 [CI: 0.18-0.84], p = .01, k = 8; stress gw = 0.30 [CI: 0.06-0.53], p = .02, k = 2). Longer-term benefits could not be established (k = 4),
although individual studies reported positive trends up to 6 months post. Age was not identified as a significant moderator. Conclusions: Smartphone
apps hold promise as a stand-alone self-management tool in mental health service delivery. Further controlled trials with follow-up data are needed
to confirm these findings as well as determine treatment engagement and effectiveness across diverse groups of participants. (PsycInfo Database
Record (c) 2021 APA, all rights reserved)
Children and
Youth Services Review, 127 : ArtID 106073
- Year: 2021
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Lawrence, P. J., Parkinson,
M., Jasper, B., Creswell, C., Halligan, S. L.
Guidance is scarce on whether and how to involve parents in treatment for anxiety and depressive disorders in children and young people. We
did a scoping review of randomised controlled trials of psychological interventions for anxiety and depressive disorders in children and young
people, in which parents were involved in treatment, to identify how parents and carers have been involved in such treatments, how this relates to
both child and broader outcomes, and where research should focus. We identified 73 trials: 62 focused on anxiety and 11 on depressive disorders. How
parents were involved in treatments varied greatly, with at least 13 different combinations of ways of involving parents in the anxiety trials and
seven different combinations in the depression trials. Including parents in treatment did not impair children's and young people's outcomes, but
the wide variability in how they were involved prevents clarity about why some trials favoured parent involvement and others did not. Studies must
consider the long-term and wider benefits beyond children's and young people's mental health, such as enhanced engagement, family wellbeing, and
economic gains.
The Lancet. Psychiatry, 8(10) : 909-
918
- Year: 2021
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions