Disorders - Anxiety Disorders
Lau, J. Y. F., Watkins-Muleba, R., Lee, I., Pile, V., Hirsch, C. R.
Background: Anxiety and depression are common,
disabling and frequently start in youth, underscoring the need for effective, accessible early interventions. Empirical data and consultations with
lived experience youth representatives suggest that maladaptive cognitive patterns contribute to and maintain anxiety and depression in daily life.
Promoting adaptive cognitive patterns could therefore reflect \"active ingredients\" in the treatment and/or prevention of youth anxiety and
depression. Here, we described and compared different therapeutic techniques that equipped young people with a more flexible capacity to use
attention and/or promoted a tendency to positive/benign (over threatening/negative) interpretations of uncertain situations. Method(s): We searched
electronic databases (PubMed, PsycINFO, EMBASE, and PsycARTICLES) for studies containing words relating to: intervention; youth; anxiety and/or
depression and attention and/or interpretation, and selected studies which sought to reduce self-reported anxiety/depression in youth by explicitly
altering attention and/or interpretation patterns. Ten young people with lived experiences of anxiety and depression and from diverse backgrounds
were consulted on the relevance of these strategies in managing emotions in their daily lives and also whether there were additional strategies that
could be targeted to promote adaptive thinking styles. Result(s): Two sets of techniques, each targeting different levels of responding with
different strengths and weaknesses were identified. Cognitive bias modification training (CBM) tasks were largely able to alter attention and
interpretation biases but the effects of training on clinical symptoms was more mixed. In contrast, guided instructions that teach young people to
regulate their attention or to evaluate alternative explanations of personally-salient events, reduced symptoms but there was little experimental
data establishing the intervention mechanism. Lived experience representatives suggested that strategies such as deliberately recalling positive past
experiences or positive aspects of oneself to counteract negative thinking. Discussion(s): CBM techniques target clear hypothesised mechanisms but
require further co-design with young people to make them more engaging and augment their clinical effects. Guided instructions benefit from being
embedded in clinical interventions, but lack empirical data to support their intervention mechanism, underscoring the need for more experimental
work. Feedback from young people suggest that combining complimentary techniques within multi-pronged \"toolboxes\" to develop resilient thinking
patterns in youth is empowering. Copyright © 2021, The Author(s).
BMC Psychiatry, 21(1) (no
pagination) :
- Year: 2021
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder), At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Attention/cognitive bias
modification
Kinney, K. L., Burkhouse, K. L., Chang, F., MacNamara,
A., Klumpp, H., Phan, K. L.
Anxiety disorders (ADs) are common and difficult to treat. While research suggests ADs are
characterized by an imbalance between bottom-up and top-down attention processes and that effective treatments work by correcting this dysfunction,
there is insufficient data to explain how and for whom treatments work. The late positive potential (LPP), an event-related potential reflecting
elaborative processing of motivationally salient stimuli, is sensitive to both bottom-up and top-down processes. The present study examines the LPP
in healthy controls (HC) and patients with ADs under low and high working memory (WM) load to assess its utility as a predictor and index of symptom
reduction in patients who underwent cognitive behavioral therapy (CBT) or selective serotonin reuptake inhibitor (SSRI) treatment. The LPP when
viewing negative and neutral distractor images and WM performance were assessed in 96 participants (40 HC, 32 CBT, 24 SSRI) during a letter recall
task at Week 0 and in a subset of the study sample (23 CBT, 16 SSRI) at Week 12. Patients were randomly assigned to twelve weeks of CBT or SSRI
treatment. Participants completed self-reported symptom measures at each time point. Greater Week 0 LPP to negative images under low WM load
predicted greater symptom reduction in the SSRI, but not the CBT, group. Regression analyses examining the LPP to negative images as an index of
symptom reduction revealed a smaller decrease in the LPP to negative images under low WM load was associated with less anxiety reduction across
treatment modalities. Findings suggest the LPP during low WM load may serve as a cost-effective predictor and index of treatment outcome in ADs.
Clinical Trials Registration: ClinicalTrials.gov (Identifier: NCT01903447) Copyright © 2021 Elsevier Ltd
, 82 (no
pagination) :
- Year: 2021
- Problem: Anxiety Disorders (any), Panic
Disorder, Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Antidepressants
(any), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Kim, S. Y., Suh, H., Oh, W., Daheim, J.
OBJECTIVE: This study examined the differences in first-year college students' daily change trajectories in
subjective happiness, depression, anxiety, stress, and state mindfulness. METHOD(S): A 5-day, online mindfulness-based intervention (MI) condition
and stress management (SM) condition were employed in 247 first-year college students. RESULT(S): Students in both the MI and SM conditions displayed
similar significant linear declines in anxiety and stress, but there were significant differences between the two conditions, including: (1) the MI
condition showing a significant linear increase in subjective happiness compared with no change in the SM condition and (2) the SM condition showed a
significant linear decrease in depression compared to no significant change in the MI condition. CONCLUSION(S): Brief online interventions-whether MI
or SM-can promote better mental health and reduce psychological distress. The results also lend support for MI's differential influence on first-
year college students' happiness and SM's differential influence on their depression. Copyright © 2020 Wiley Periodicals LLC.
Journal of clinical psychology, 77(3) : 496-
515
- Year: 2021
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Universal 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)
Kim, Jiheon, Kim, Hansol, Kim, Do-Hoon, Lee, Sang-Kyu, Roh, Jung Yun, Kim, Chan-Hyung, Chang,
Jhin Goo, Roh,
Daeyoung
Background: Cranial Electrotherapy Stimulation (CES) is a promising non-invasive brain stimulation technique with the
potential to alleviate anxiety. We examined the effectiveness of home-based CES with novel, headphone-like, in-ear electrodes on anxiety-related
symptoms and resting-state brain activity. Methods: This study spanned 3-weeks, with randomized, double blind, and active-controlled design.
Nonclinical volunteers experiencing daily anxiety were randomly assigned to either the active or the sham groups. CES provides an alternating current
(10 Hz frequency, 500 microA intensity), connected to smartphone recording treatment logs. Participants treated themselves with 20 trials of CES at
home. We evaluated the effectiveness using State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), Wisconsin Card Sort Test (WCST),
and resting-state electroencephalography (EEG). Results: The active group showed a significant improvement in state-anxiety compared to sham, while
there was a statistical trend in the WCST-Category Completed (p = .061) and no change in depression. In EEG analysis, the active group showed
significantly increased relative power for theta in the left frontal region compared with the sham, and this significantly correlated with the
changes in state-anxiety. The active group exhibited significantly increased high-beta source activity in cuneus and middle occipital gyrus after
intervention compared with the baseline. Limitations: This study had a relatively short treatment period and small sample size. Conclusions: Our
findings provide the first electrophysiological evidence for CES for novel in-ear electrodes to improve anxiety. The modulatory effects of CES on
resting-state oscillations of EEG imply that CES could beneficially affect functional brain activity. (PsycInfo Database Record (c) 2022 APA, all
rights reserved)
, 295 : 856-864
- Year: 2021
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Biological Interventions
(any), Other biological interventions
Karadag, M., Topal, Z., Ezer, R. N., Gokcen, C.
Self-help treatments are an important intervention tool, with high accessibility and ease of
application. To our knowledge, no research has previously been conducted on any self-help intervention derived from eye movement desensitization and
reprocessing (EMDR) therapy. In this study, we evaluated the mental health status of children not directly affected by the pandemic and investigated
the effects of using an EMDR-derived self-help intervention in children as a low-intensity treatment. The mental health status of 178 children was
evaluated online via the State-Trait Anxiety Inventory for Children (STAIC) and Childhood Posttraumatic Stress Reaction Index (CPTS-RI). Then,
children were randomly assigned to intervention and waitlist. A booklet containing EMDR-derived techniques was sent via the school online portal and
the intervention was conducted. Posttests were administered 4 weeks later. The attrition rate was 45.5%, with 97 children completing the trial
(intervention: 52; waitlist: 45). At baseline, 76.4% of children showed posttraumatic stress symptoms (PTSS) above threshold. Results showed a
statistically significant decrease in the posttest PTSS scores for the intervention group compared to waitlist. The intervention group had
significant pre-post improvement on all but one subscale, while the waitlist group showed a significant increase in state anxiety on the STAIC. In
conclusion, posttraumatic stress was found to be high in children during the COVID-19 outbreak period, and EMDR-derived self-help intervention
appeared to be an effective psychosocial intervention tool. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
Journal of EMDR Practice and Research, 15(2) : 114-
126
- Year: 2021
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Eye movement desensitisation and reprocessing (EMDR), Self-help, Technology, interventions delivered using technology (e.g. online, SMS)
Juul, L., Brorsen, E., Gotzsche, K., Nielsen, B. L., Fjorback, L. O.
Background: In this study, we aimed to investigate the effects of a mindfulness program including
Mindfulness-Based Stress Reduction (MBSR) on the mental health of student teachers when offered at their educational institution in a real-life
context. Methods: A parallel randomized controlled trial (RCT) was conducted among selfselected student teachers at a Danish undergraduate program
for teacher education in the autumns of 2019 and 2020. Participation was not recommended in case of (1) clinical depression or a diagnosis of
psychosis or schizophrenia, (2) abuse of alcohol, drugs, and/or medicine. Randomization was performed by a Statistician who was blinded to the
identity of the students. Data was collected using selfreported questionnaires. The primary outcome was a change in perceived stress 3 months from
baseline. Secondary outcome measures were symptoms of anxiety and depression, well-being, resilience, mindfulness, and thoughts and feelings during
rest. The effects were analyzed according to the intention-to-treat principle using mixed-effect linear regression models. Mediating effects of
mindfulness skills on the mental health outcomes were explored using structural equation modeling. Results: The study group included 67 student
teachers with 34 allocated to the intervention group (median age: 25 years; women: n = 24, 71%); and 33 students (median age: 25 years; women: n =
25, 76%) allocated to a waiting list control group. At baseline, mean Perceived Stress Scale (PSS) scores were 18.88 (SD: 5.75) in the intervention
group and 17.91 (SD: 6.36) in the waiting list control group. A total of 56 students completed the questionnaire at a 3-month follow-up (28 in both
the intervention- and the control group). Statistically significant effects of the intervention were found on perceived stress, symptoms of anxiety
and depression, well-being, and on three of seven resting-state dimensions. No effects were found on resilience or mindfulness. Statistically
significant mediated effects via resting-state dimensions were found.\rConclusion The findings suggested that offering a mindfulness program at an
undergraduate program for teacher education could significantly improve the mental health among self-selected students within 3 months. Results of
mediation analysis supported the hypothesis that some of the effects might be explained by reduced distracting thoughts. Clinical Trial Registration:
[www.ClinicalTrials.gov], identifier [NCT04558099].
, 12 : ArtID 722771
- Year: 2021
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Mindfulness based
therapy
Johnstone, N., Milesi, C., Burn, O., van-den-Bogert, B., Nauta, A., Hart, K., Sowden, P., Burnet, P. W. J., Cohen-Kadosh, K.
Current research implicates
pre- and probiotic supplementation as a potential tool for improving symptomology in physical and mental ailments, which makes it an attractive
concept for clinicians and consumers alike. Here we focus on the transitional period of late adolescence and early adulthood during which effective
interventions, such as nutritional supplementation to influence the gut microbiota, have the potential to offset health-related costs in later life.
We examined multiple indices of mood and well-being in 64 healthy females in a 4-week double blind, placebo controlled galacto-oligosaccharides (GOS)
prebiotic supplement intervention and obtained stool samples at baseline and follow-up for gut microbiota sequencing and analyses. We report effects
of the GOS intervention on self-reported high trait anxiety, attentional bias, and bacterial abundance, suggesting that dietary supplementation with
a GOS prebiotic may improve indices of pre-clinical anxiety. Gut microbiota research has captured the imagination of the scientific and lay community
alike, yet we are now at a stage where this early enthusiasm will need to be met with rigorous research in humans. Our work makes an important
contribution to this effort by combining a psychobiotic intervention in a human sample with comprehensive behavioural and gut microbiota
measures.
Scientific
reports, 11(1) : 8302
- Year: 2021
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Vitamins and supplements
Hudson, J. L., McLellan, L.
F., Eapen, V., Rapee, R. M., Wuthrich, V., Lyneham, H. J.
BACKGROUND:
Anxiety disorders are the most prevalent mental disorder in children and young people. Developing effective therapy for these children is critical to
reduce mental disorders across the lifespan. The study aimed to evaluate the efficacy of combining cognitive behavioural therapy (CBT) and sertraline
(SERT) in the treatment of anxiety in youth, using a double-blind randomised control trial design. METHOD(S): Ninety-nine youth (ages 7-15 years)
with an anxiety disorder were randomly allocated to either individual (CBT) and SERT or individual CBT and pill placebo and assessed again
immediately and 6 months after treatment. RESULT(S): There were no significant differences between conditions in remission of primary anxiety
disorder or all anxiety disorders. Furthermore, there were no significant differences in rates of change in diagnostic severity, parent-reported
anxiety symptoms, child-reported anxiety symptoms or life interference due to anxiety. CONCLUSION(S): The efficacy of CBT for children and
adolescents with anxiety disorders is not significantly enhanced by combination with a short-term course of anti-depressants over and above the
combined effects of pill placebo.
Psychological medicine, : 1-
9
- Year: 2021
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Antidepressants
(any), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Hoagwood, K. E., Acri, M., Morrissey, M., Peth-Pierce, R., Seibel,
L., Seag, D. E., Vincent, A., Guo, F., Hamovitch, E.
K., Horwitz, S.
Between 15% to 20% of youth meet diagnostic criteria for anxiety, yet most do not receive
treatment due to workforce shortages, under-detection, or barriers that dissuade families from seeking services in traditional settings. Equine-
assisted services (EAS) include several promising approaches to reach populations who do not access traditional therapies. Few studies using rigorous
methods have been conducted on EAS for youth. This study examined feasibility and outcomes of a 10-session Cognitive Behavioral Therapy (CBT)-based
adaptive riding intervention (hereafter called Reining in Anxiety) delivered by trained equine professionals. Forty-one youth 6- 16 years of age were
recruited from GallopNYC, an adaptive horseback riding center in the NYC metro area. Youth were randomized to an experimental group (n=22) or
services as usual (n=19), a standard adaptive riding group (services as usual or SAU). Severity of anxiety symptoms, anxiety in close relationships,
and emotional self-efficacy were assessed at baseline and at the end of treatment. Fidelity to the manual was excellent, ranging from 88.9% to 100%.
There was a non-significant trend in the experimental group towards greater improvement with higher number of sessions completed. Youth in the
Reining in Anxiety group displayed significant reductions in anxiety (t=4.426, df=38, p=0.042) and improvement in emotional self-efficacy at posttest
(t=4.132, df=38, p=0.049) in comparison to the SAU group. No significant differences were found between groups for anxiety in close relationships.
This study suggests that a CBT-based adaptive riding intervention delivered by non-mental health equine professionals following a detailed manual can
reduce youth anxiety symptoms and be delivered with fidelity by riding instructors. These findings have implications for families seeking non-
traditional services. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
, 9(3) : 60-
78
- Year: 2021
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Other Psychological Interventions, Other complementary & alternative
interventions
Heimgartner,
N., Meier, S., Grolimund, S., Ponti, S., Arpagaus, S., Kappeler, F., Gaab, J.
Considering the high and
increasing prevalence of stress, approaches to mitigate stress-related biological processes become a matter of public health. Since supportive social
interactions contribute substantially to mental and physical health, we set out to develop a social support stress management intervention and
examined its effects on psychophysiological stress responses as well as self-reported stress in healthy women. In a parallel-group randomized
controlled trial, registered in the DSRK (DRKS00017427), 53 healthy women were randomly assigned to a social support stress management or a waitlist
control condition. All participants underwent a standardized psychosocial stress test where physiological and emotional stress responses were
assessed by repeated measurements of cortisol, heart rate, heart rate variability and state anxiety. Also, all participants completed self-report
questionnaires of perceived stress and social support at pre-intervention, post-intervention and follow-up four weeks later. Participants in the
social support stress management showed a significantly attenuated integrated state anxiety response in comparison to those in the control condition,
but conditions did not differ in any of the assessed physiological stress responses. The intervention significantly reduced perceived stress in
comparison to the control condition, but perceived stress levels returned to baseline at follow-up. Our results indicated that the intervention had
no effect on physiological responses to acute psychosocial stress, even though anxiety responses to stress were attenuated. However, the social
support stress management intervention had a significant, albeit transient impact on perceived stress. Copyright: © 2021 Heimgartner 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 ONE, 16(6
June) :
- Year: 2021
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Skills training, Other Psychological Interventions
Hang, Y., Zhang, G., Wang, C., Zhang, N., Liu, G.
Despite accumulating evidence
suggesting the effectiveness of Attention Bias Modification (ABM) in adults, little is known about its efficacy in children and adolescents. As
anxiety has been the chief target in most studies and research in this area has grown rapidly in recent years, we conducted the first meta-analysis
to establish the effects of ABM alone for anxiety disorders in children and adolescents. Studies were identified through a systematic search in three
main databases: PubMed, EMBASE and PsycInfo, resulting in 17 randomized studies. The quality of these studies, possible publication bias and
moderators were then examined. ABM had small but significant effects on clinician-rated anxiety symptoms and attention bias towards threat, while the
effect on self or parent-reported anxiety measures was non-significant. Evidence quality ranged from moderate to very low. ABM was more effective
when conducted as a stand-alone treatment than as an adjunct to other treatments. In addition, younger age and larger number of training sessions
were associated with a greater reduction in clinician-rated anxiety symptoms. Results indicate that ABM may have significant effects on anxiety and
attention bias in children and adolescents. Overall, the effects of ABM are mainly evident when clinical outcome is assessed by a clinician.
Copyright © 2021
Psychiatry Research, 300 (no
pagination) :
- Year: 2021
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder), At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Attention/cognitive bias
modification
Hang, Y., Xu, L., Wang, C., Zhang, G., Zhang, N.
Attention Bias Modification (ABM) is a novel
computerized therapy for anxiety disorders and is thought to augment the effect of Cognitive Behavior Therapy (CBT) as it may target different
mechanisms. Recently, a growing number of studies have examined the combined effects of ABM and CBT on clinically anxious patients, with mixed
results. This review examined the combined efficacy of ABM and CBT. A literature search was conducted in four main databases: PsycINFO, Embase,
Pubmed and the Cochrane library, resulting in 11 randomized studies. The combination of ABM and CBT had small but significant effects on clinician-
rated anxiety symptoms and attention bias towards threat compared to the control group, while ESs for anxiety (all measures), self-reported or
parent-reported anxiety measures and depression symptoms were non-significant. Studies in which ABM was conducted as an integral part of each CBT
session yielded greater reduction in anxiety symptoms than those conducting ABM and CBT at separate time points. Older participants and patients with
social anxiety disorder tended to benefit less from the combination of ABM and CBT based on bias scores. This study may provide preliminary evidence
that ABM and CBT have the potential to complement each other, especially when they are conducted integrally. Copyright © 2021
Psychiatry Research, 299 (no pagination) :
- Year: 2021
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Attention/cognitive bias
modification