Disorders - Anxiety Disorders
Seppala, E. M., Bradley, C., Moeller,
J., Harouni, L., Nandamudi, D., Brackett, M. A.
This study aimed to address the decline in
mental health on U.S. university campuses by examining the effects of three interventions. University students suffer from high levels of anxiety,
depression, and suicide. Counseling centers on university campuses are struggling to meet increased demand. The cost to students and universities
could be buffered by offering preventative, psychoeducational, and skill-building training programs that promote mental health and psychological
thriving. To date, the research literature has not yielded systematically evaluated and recommendable preventative mental health and well-being
programs for university students. In a registered, randomized controlled trial, 131 university students were either placed in a non-intervention
control group (N = 47) or received training in one of three 30-hour, eight-week semester-long well-being programs: SKY Campus Happiness (\"SKY\"; N =
29), Foundations of Emotional Intelligence (\"EI\"; N = 21) or Mindfulness-Based Stress Reduction (\"MBSR\"; N = 34). Compared to the control group
and controlling for variance of baseline measurements and multiple comparisons, SKY Campus Happiness showed the greatest impact, benefiting six
outcomes: depression, stress, mental health, mindfulness, positive affect and social connectedness. EI benefited one outcome: mindfulness. The MBSR
group showed no change. Delivering SKY or EI to university students may be a cost-effective and efficient way to proactively and preventatively
address mental health for university students and reduce the financial strain on universities. (PsycInfo Database Record (c) 2023 APA, all rights
reserved)
Frontiers in Psychiatry Vol 11 2020, ArtID 590, 11 :
- Year: 2020
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Other Psychological Interventions, Mindfulness based
therapy, Mind-body exercises (e.g. yoga, tai chi, qigong)
Robertson, S. M. C., Short, S. D., Sawyer,
L., Sweazy, S.
OBJECTIVE: Meta-analyses assessing the efficacy of expressive writing (EW) interventions have produced mixed results.
The current study aimed to assess the efficacy of an EW intervention in the reduction of anxiety symptoms in first-year college students. In an
effort to understand more about moderating variables that influence EW outcomes, the current study also assessed the role of linguistic features in
symptom reduction. DESIGN AND MEASURES: Ninety participants were assigned to complete either an EW intervention or a non-emotional writing
intervention. Participants completed 3 consecutive days of writing and two follow-up visits. Anxiety was measured at each study visit with the Beck
Anxiety Inventory, and linguistic features were assessed with the LIWC software program. RESULT(S): Results indicated that all participants
demonstrated significant decreases in anxiety over time. Participants in the EW group who demonstrated the greatest decreases in anxiety utilized
more first-person singular pronouns and fewer affect words. CONCLUSION(S): Results are explained in the context of two prominent theories regarding
the therapeutic mechanisms of EW: cognitive processing theory and exposure theory. Exposure theory received more support than cognitive processing
theory.
Psychology & health, : 1-25
- Year: 2020
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Creative expression: music, dance, drama, art
Rapee, R. M., Lyneham, H.
J., Wuthrich, V., Chatterton, M. L., Hudson, J. L., Kangas, M., Mihalopoulos, C.
Methods to deliver empirically validated
treatments for anxious youth that require fewer therapist resources (low intensity) are beginning to emerge. However, the relative efficacy of low-
intensity treatment for youth anxiety against standard face-to-face delivery has not been comprehensively evaluated. Young people aged 6-16 years
with a primary anxiety disorder (N = 281) were randomly allocated to treatment delivered either face-to-face or in a low-intensity format. Face-to-
face treatment comprised ten, 60-min sessions delivered by a qualified therapist. Low intensity comprised information delivered in either printed (to
parents of children under 13) or electronic (to adolescents aged 13 +) format and was supported by up to four telephone sessions with a minimally
qualified therapist. Youth receiving face-to-face treatment were significantly more likely to remit from all anxiety disorders (66%) than youth
receiving low intensity (49%). This difference was reflected in parents' (but not child) reports of child's anxiety symptoms and life interference.
No significant moderators were identified. Low intensity delivery utilised significantly less total therapist time (175 min) than face-to-face
delivery (897 min) and this was reflected in a large mean difference in therapy costs ($A735). Standard, face-to-face treatment for anxious youth is
associated with significantly better outcomes than delivery of similar content using low-intensity methods. However, the size of this difference was
relatively small. In contrast, low-intensity delivery requires markedly less time from therapists and subsequently lower treatment cost. Data provide
valuable information for youth anxiety services. Clinical trial registration information: A randomised controlled trial of standard care versus
stepped care for children and adolescents with anxiety disorders; https://anzctr.org.au/; ACTRN12612000351819. Copyright © 2020, Springer-Verlag GmbH
Germany, part of Springer Nature.
European Child and Adolescent Psychiatry., :
- Year: 2020
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions, Self-help, Technology, interventions delivered using technology (e.g. online, SMS)
Pan, D. N., Hoid, D., Wang, X. B., Jia, Z., Li, X.
BACKGROUND: The effect of working
memory training (WM-T) has been found to transfer to emotional wellbeing, despite some debate on whether an affective component in training is
necessary to achieve specific emotion-related benefits. These novel cognitive trainings have not yet been tested in highly anxious individuals, who
have deficits in implicit and explicit emotional regulation and should be the potential beneficiaries of these trainings. METHOD(S): We designed two
types of mobile phone-based training applications: (1) WMT and (2) an emotional working memory training (EWM-T) that comprised negative face
distraction. Ninety-eight participants (33, WM-T; 35, EWM-T; 30, Control group) with high trait anxiety completed the 21-day intervention or placebo
program and conducted pre- and post-test procedures, including questionnaires, emotional regulation and emotional Stroop tasks alongside
electroencephalogram recording. Late positive potential (LPP) in emotion regulation task and P3 in the emotional Stroop task were adopted as neutral
indicators for the explicit and implicit affective regulation/control processing. RESULT(S): Those who had received training (WM-T and EWM-T) showed
enhanced explicit regulation (indexed by reduced LPP during reappraisal) compared with the control. Besides, individuals in EWM-T showed reduced
behavioral attention bias and a decline of P3 in response to negative faces in an emotional Stroop task. The altered neural indicators were
correlated with corresponding behavior indexes that contributed to the anxiety alleviation. CONCLUSION(S): The general WM-T was effective in
enhancing explicit emotional regulation, while training with emotional add-in further improved implicit emotional control. (E)WM-T shows potential as
a beneficial intervention for the anxiety population.
Psychological medicine, : 1-10
- Year: 2020
- 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, Technology, interventions delivered using technology (e.g. online, SMS)
Pan, D. N., Hoid,
D., Gu, R. L., Li, X.
Rumination
is an important etiological factor of anxiety pathology, with its mechanism related to the deficit of working memory. The current study examined
whether working memory training (WM-T) and emotional working memory training (EWM-T) could reduce rumination in anxious individuals. The participants
with high trait anxiety underwent 21 days of mobile applications-based WM-T (n = 34), EWM-T (n = 36) or placebo control (n = 36), with
questionnaires, cognitive tasks, and resting electroencephalogram (EEG) as the pre-post-test indicators. The results revealed that two training
groups obtained comparable operation span increases (WM-T: d = 0.53; EWM-T: d = 0.65), updating improvement (WM-T: d = 0.43; EWM-T: d = 0.60) and
shifting improvement (WM-T: d = 0.49; EWM-T: d = 0.72). Furthermore, compared to the control group, the EWM-T showed significant self-reported
rumination reduction (d = 0.69), increased inhibition ability (d = 0.72), as well as modification of resting EEG microstate C parameters (Duration C:
d = 0.42, Coverage C: d = 0.39), which were closely related to rumination level (r ~ 0.4). The WM-T group also showed the potential to reduced self-
reported rumination (d = 0.45), but with the absence of the observable inhibition improvement and resting EEG changes. The correlation analysis
suggested that the emotional benefits of WM-T depending more on improved updating and shifting, and that of EWM-T depending more on improved
inhibition ability. The advantage to add emotional distractions into general working memory training for targeting rumination related anxiety has
been discussed. Copyright © 2020
NeuroImage: Clinical, 28 (no
pagination) :
- Year: 2020
- 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, Technology, interventions delivered using technology (e.g. online, SMS)
Odgers, K., Dargue, N., Creswell, C., Jones, M.
P., Hudson, J. L.
Anxiety disorders are common mental health problems amongst youth with harmful
impacts often extending into adulthood. Mindfulness-based interventions (MBIs) have become increasingly popular for addressing mental health issues,
particularly in schools; however, it remains unclear how effective they are for reducing youth anxiety. This meta-analysis aimed to evaluate the
efficacy and effect moderators of MBIs on anxiety outcomes in children and adolescents. Eligible studies were published randomised controlled trials
(RCTs) of MBIs conducted with participants aged 18 years or younger, investigating anxiety outcomes using a well-validated anxiety scale. A
systematic search of RCTs published through to February 2019 identified 20 studies for inclusion (n=1582). A random effects model was used to
synthesise MBI effects. Stratified meta-analyses as well as individual, random effects meta-regressions were performed to examine how effects varied
by age group, intervention setting, control type, research location, and intervention dosage. Although, across all studies, there was a small
beneficial effect of MBIs on anxiety post treatment (d=0.26), this was significantly moderated by research location, with RCTs conducted in Iran
producing large effects (d=1.25), and RCTs conducted in Western countries demonstrating no significant beneficial effect compared to controls (very
small, d=0.05). Effects were non-significant at follow-up assessment points. Post-treatment effects were significant for MBIs conducted with children
(d=0.41) and for MBIs when compared to passive controls (d=0.33), but non-significant for adolescents (d=0.21), for MBIs conducted in schools
(d=0.30) and in clinics (d=0.13), and when MBIs were compared to active controls (d=0.12). Results suggest that MBIs are likely to have a small to
medium, yet temporary effect in reducing anxiety symptoms in children (not adolescents), but amongst Western youth populations the most likely
outcome, from RCTs to date, is that MBIs produce no beneficial effect in anxiety reduction. Results revealed a lack of evidence to support investment
in school-based MBIs to address youth anxiety.
Clinical child and family psychology review, 23(3) : 407-
426
- Year: 2020
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Mindfulness based
therapy
OConnor, K., Bagnell, A., McGrath, P., Wozney, L., Radomski, A., Rosychuk, R. J., Curtis, S., Jabbour, M., Fitzpatrick, E., Johnson, D.
W., Ohinmaa, A., Joyce, A., Newton, A.
Background:
Internet-based cognitive behavioral therapy (ICBT) is a treatment approach recently developed and studied to provide frontline treatment to
adolescents with anxiety disorders. Objective(s): This study aimed to pilot procedures and obtain data on methodological processes and intervention
satisfaction to determine the feasibility of a definitive randomized controlled trial (RCT) to test the effectiveness of a self-managed ICBT program,
Breathe (Being Real, Easing Anxiety: Tools Helping Electronically), for adolescents with anxiety concerns. Method(s): This study employed a two-arm,
multisite, pilot RCT. Adolescents aged 13 to 17 years with a self-identified anxiety concern were recruited online from health care settings and
school-based mental health care services across Canada between April 2014 and May 2016. We compared 8 weeks of ICBT with ad hoc telephone and email
support (Breathe experimental group) to access to a static webpage listing anxiety resources (control group). The primary outcome was the change in
self-reported anxiety from baseline to 8 weeks (posttreatment), which was used to determine the sample size for a definitive RCT. Secondary outcomes
were recruitment and retention rates, a minimal clinically important difference (MCID) for the primary outcome, intervention acceptability and
satisfaction, use of cointerventions, and health care resource use, including a cost-consequence analysis. Result(s): Of the 588 adolescents
screened, 94 were eligible and enrolled in the study (49 adolescents were allocated to Breathe and 45 were allocated to the control group). Analysis
was based on 74% (70/94) of adolescents who completed baseline measures and progressed through the study. Enrolled adolescents were, on average, 15.3
years old (SD 1.2) and female (63/70, 90%). Retention rates at 8 weeks were 28% (13/46; Breathe group) and 58% (24/43; control group). Overall, 39%
(14/36) of adolescents provided feedback on completion of the Breathe program. Adolescents' scores on a satisfaction survey indicated a moderate
level of satisfaction. All but one adolescent indicated that Breathe was easy to use and they understood all the material presented. The most
frequent barrier identified for program completion was difficulty in completing exposure activities. The power analysis indicated that 177
adolescents per group would be needed to detect a medium effect size (d=0.3) between groups in a definitive trial. Data for calculating an MCID or
conducting a cost-consequence analysis were insufficient due to a low response rate at 8 weeks. Conclusion(s): Adolescents were moderately satisfied
with Breathe. However, program adjustments will be needed to address attrition and reduce perceived barriers to completing key aspects of the
program. A definitive RCT to evaluate the effectiveness of the program is feasible if protocol adjustments are made to improve recruitment and
retention to ensure timely study completion and increase the completeness of the data at each outcome measurement time point. Copyright © Kathleen
O'Connor, Alexa Bagnell, Patrick McGrath, Lori Wozney, Ashley Radomski, Rhonda J Rosychuk, Sarah Curtis, Mona Jabbour, Eleanor Fitzpatrick, David W
Johnson, Arto Ohinmaa, Anthony Joyce, Amanda Newton. Originally published in JMIR Mental Health (http://mental.jmir.org), 24.07.2020. This is an
open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which
permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Mental Health, is
properly cited. The complete bibliographic information, a link to the original publication on http://mental.jmir.org/, as well as this copyright and
license information must be included.
JMIR Mental Health, 7(7) :
- Year: 2020
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Technology, interventions delivered using technology (e.g. online, SMS)
Novella, J. K., Ng, K. M., Samuolis, J.
OBJECTIVE: This study compared online, synchronous video counseling to in-person counseling using solution-focused brief therapy for
college students with mild to moderate anxiety. Participant(s): Participants were 49 undergraduate students who were seeking counseling for mild to
moderate anxiety. The study was conducted from November, 2017 to December 2018. Method(s): In a randomized, non-inferiority design, undergraduate
participants were randomly assigned to online, synchronous video counseling or in-person treatment for anxiety using solution-focused brief therapy
(SFBT). Participants completed the Beck's Anxiety Inventory (BAI) and College Counseling Assessment of Psychological Symptoms (CCAPS) to assess
outcomes. Result(s): The results showed significant changes in scores on the BAI and the CCAPS Generalized Anxiety and Social Anxiety subscales for
participants in both study conditions, and no significant differences in effectiveness of the two delivery methods. Conclusion(s): The findings
provide support for the treatment of college students with anxiety with SFBT through online, synchronous video counseling. Limitations related to
sample size and diversity are discussed.
Journal of American college health : J of ACH, : 1-
8
- Year: 2020
- 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, Technology, comparing delivery mode (e.g. online vs. face-to-face)
Nelson, H. D., Cantor, A., Pappas, M., Weeks, C.
Background: Anxiety disorders are infrequently recognized during
routine health care even though they are common in adolescent girls and adult women. Purpose(s): To evaluate evidence on the effectiveness of
screening for anxiety disorders in primary care in improving symptoms, function, and quality of life; harms of screening; accuracy of screening
instruments; and effectiveness and harms of treatments. Data Sources: English-language searches of Ovid MEDLINE, Cochrane Central Register of
Controlled Trials, Cochrane Database of Systematic Reviews, and Health and Psychosocial Instruments (1 January 1996 to 4 November 2019);
ClinicalTrials.gov (November 2019); and reference lists of studies and reviews. Study Selection: Studies that enrolled adolescent girls and adult
women not currently diagnosed with anxiety disorders, including pregnant or postpartum women, and compared clinical outcomes and harms between women
who were and were not screened; diagnostic accuracy studies of screening instruments; and systematic reviews of randomized trials of behavioral and
pharmacologic treatments. Data Extraction: Dual extraction and quality assessment of individual studies. Data Synthesis: No studies evaluated the
overall effectiveness or harms of screening. Thirty-three studies and 2 systematic reviews (171 studies; 112 574 participants) evaluated the
diagnostic accuracy of 27 screening instruments and their variations against a clinical diagnosis or other instruments. Most demonstrated moderate to
high accuracy for adults (Generalized Anxiety Disorder scale: Sensitivity, 70% to 97%; specificity, 50% to 89%), pregnant and postpartum women
(Edinburgh Postnatal Depression Scale: Sensitivity, 74%; specificity, 64%), and adolescents (Screen for Child Anxiety Related Emotional Disorders:
Sensitivity, 64% to 74%; specificity, 64% to 73%). Anxiety symptoms improved with cognitive behavioral therapy (246 randomized controlled trials; 17
209 participants) and antianxiety medications (126 randomized controlled trials; 8225 participants). Limitation(s): Limited data on long-term harms
of treatment and no treatment trials in pregnant or postpartum women. Conclusion(s): Evidence on the overall effectiveness and harms of screening for
anxiety is insufficient. Most screening instruments are moderately to highly accurate. Behavioral therapies and antianxiety medications effectively
improve anxiety symptoms. Copyright © 2020 American College of Physicians. All rights reserved.
Annals of Internal Medicine, 173(1) : 29-
41
- Year: 2020
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Psychological Interventions
(any)
Marshall, M., McClanahan, M., Warren, S. M., Rogers, R., Ballmann, C.
Yoga is a frequently recommended stress management strategy; however, the acute stress response to varying types of yoga are
not fully clear. Thus, the purpose of this study was to compare the acute effects of meditative and power yoga on indices of physiological and
psychological stress. In a crossover counterbalanced design, physically active females (n = 13; age = 20.8 yrs +/- 0.8, height = 164.5 cm +/- 6.1,
body mass = 65.0 kg +/- 13.8) who did not regularly participate in yoga or mindful training enrolled in this study. Participants completed two visits
each, with a standardized instructional-video 30-min yoga session with either A) meditative (Hatha style) yoga or B) power (Vinyasa style) yoga.
Prior to and immediately after each yoga bout, psychological stress was assessed using the State-Trait Anxiety Inventory (STAI) questionnaire, and
salivary cortisol samples were obtained to measure indices of physiological stress. State anxiety scores were significantly lower following
meditative yoga (p = 0.047) but were not different following power yoga (p = 0.625). Salivary cortisol levels were significantly lower following
meditative yoga (p = 0.020) but not following power yoga (p = 0.242). Results indicate that acute engagement in meditative yoga decreases markers of
psychological and physiological stress, while power yoga does not impart a significant stress-relieving benefit. Findings indicate that differing
types of yoga may have various stress-relieving capabilities and should be considered by individuals seeking anxiolytic benefits. Copyright © 2020 by
the authors.Licensee MDPI, Basel, Switzerland.
International Journal of Environmental Research and Public
Health, 17(17) : 1-8
- Year: 2020
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Meditation, Mind-body exercises (e.g. yoga, tai chi, qigong)
Lotfi, S., Ward, R. T., Ayazi, M., Bennett, K. P., Larson, C. L., Lee, H. J.
Background: Trait anxiety is characterized by impaired gating of threat from working memory (WM), allowing unnecessary maintenance of
anxious cognitions. Improving filtering efficiency of threatening information through computerized WM training might reduce intrusive, worrisome
thoughts. Method(s): We randomized high-trait anxious individuals to 9 sessions of high-potency n-back (n = 19) or low-potency 1-back (n = 18)
training to examine their effects on various neurocognitive indices of WM functioning and emotional symptoms. Result(s): Following the interventions,
multilevel modeling analyses revealed both training conditions resulted in significant improvements in attentional (Flanker), WM capacity (operation
and spatial span tasks), and WM filtering efficiency (change detection task) measures, and increased N2 amplitudes. However, the high-potency
training produced more favorable results at post-training, indexed by larger ERN amplitudes. We also observed significant reductions in trait anxiety
and worry symptoms for the high-potency training following the intervention, although, low-potency training caught up at follow-up with comparably
reduced symptoms. Conclusion(s): These results show that emotional WM training can improve neurocognitive processes of attention and WM as well as
symptoms of worrying. Overall, this study encourages the development of a standalone or adjunctive cognitive intervention focused on WM for
vulnerable populations with high trait anxiety or worry symptoms. Copyright © 2020, Springer Science+Business Media, LLC, part of Springer
Nature.
Cognitive Therapy and
Research., :
- Year: 2020
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Kachaturoff, M., Caboral-Stevens, M., Gee, M., Lan, V. M.
BACKGROUND: Nursing students, whether undergraduate or graduate, are at a higher risk for stress and anxiety due to
competitiveness and complexities of nursing school. There is evidence in the literature on the effects of peer mentoring among nursing students. Peer
mentoring has been associated with increased retention, student engagement, and skills competence among nursing students. There is, however, paucity
in the literature about peer mentoring's effect on stress and anxiety levels of undergraduate nursing students.\rPURPOSE: To examine the literature
on the effect of peer mentoring on stress and anxiety levels among undergraduate nursing students.\rTHEORETICAL FRAMEWORK: Bandura's Self-Efficacy
Theory was used to guide this review.\rMETHOD: An integrative review of the literature was conducted. Electronic databases searched included PubMed,
CINAHL, PsychINFO, and ERIC using keywords: nurse*, student*, undergrad*, stress and nursing students, anxiety and nursing students, and mentor*.
Review was limited to peer reviewed articles published in the English language from January 2000 to August 2018. Articles were independently reviewed
by three authors, and the quality of data was evaluated using established criteria.\rRESULTS: Eight articles were included in the review. Review
suggested that peer mentoring decreases stress, and situation or short-term anxiety levels of undergraduate nursing students. However, results should
be interpreted with caution based on limited studies identified.
Journal of Professional Nursing, 36(4) : 223-
228
- Year: 2020
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions