Disorders - Anxiety Disorders
Crane, M. F., Boga,
D., Karin, E., Gucciardi, D. F., Sinclair, L.
Objective: This group-randomized control trial examined the efficacy of guided coping and emotion regulatory self-reflection
as a means to strengthen resilience by testing the effects of the training on anxiety and depression symptoms and perceived stressor frequency after
an intensive stressor period. Method(s): The sample was 226 officer cadets training at the Royal Military College, Australia. Cadets were randomized
by platoon to the self-reflection (n = 130) or coping skills training (n = 96). Surveys occurred at 3 time points: Baseline, immediately following
the final reflective session (4-weeks postbaseline), and longer-term follow-up (3-months postinitial follow-up). Result(s): There were no significant
baseline differences in demographic or outcome variables between the intervention groups. On average, cadets commenced the resilience training with
mild depression and anxiety symptoms. Analyses were conducted at the individual-level after exploring group-level effects. No between-groups
differences were observed at initial follow-up. At longer-term follow-up, improvements in mental health outcomes were observed for the self-
reflection group, compared with the coping skills group, on depression (Cohen's d = 0.55; 95% CI [0.24, 0.86]), anxiety symptoms (Cohen's d = 0.69;
95% CI [0.37, 1.00]), and perceived stressor frequency (Cohen's d = 0.46; 95% CI [0.15, 0.77]). Longitudinal models demonstrated a time by condition
interaction for depression and anxiety, but there was only an effect of condition for perceived stressor frequency. Mediation analyses supported an
indirect effect of the intervention on both anxiety and depression via perceived stressor frequency. Conclusion(s): Findings provide initial support
for the use of guided self-reflection as an alternative to coping skills approaches to resilience training. Copyright © 2019 American Psychological
Association.
Journal of Consulting and Clinical
Psychology, 87(2) : 125-140
- Year: 2019
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Skills training, Other Psychological Interventions
Wolpert, M., Dalzell,
K., Ullman, R., Garland, L., Cortina, M., Hayes, D., Patalay, P., Law, D.
This Review reports on a scoping review
followed by a systematic review to consider interventions designed to address or manage depression or anxiety in children and young people up to the
age of 25 years without the need to involve mental health professionals. The scoping review identified 132 approaches, 103 of which referred to
children or young people (younger than 25 years). These approaches included social interaction, engagement with nature, relaxation, distraction,
sensory stimulation, physical activity, altering perceptions, engaging in hobbies, self-expression, and exploration. A systematic review of
effectiveness studies from the literature identified in the scoping review found only 38 studies on seven types of intervention that met the
inclusion criteria. 16 studies were based on cognitive or behavioural principles (15 on digital interventions and one on bibliotherapy), ten focused
on physical exercise, five on light therapy, three on dietary supplements, two on massage therapy, one on online peer support, and one on contact
with a dog. Most studies focused on adolescents or young adults. Evidence suggested that light therapy could be effective for season depression and
that digital interventions based on attention bias modification are ineffective for anxiety. Mixed evidence was available on the effectiveness of
computerised cognitive behavioural therapy for depression and anxiety, and of physical exercise for depression. All other studies had insufficient
certainty to obtain even tentative conclusions about effectiveness. These results highlight the disparity between the extensive range of approaches
identified in the scoping review and the restricted number and focus found in the systematic review of effectiveness of these approaches. We call for
an expanded research agenda that brings evaluation rigour to a wide range of self or community approaches. (PsycINFO Database Record (c) 2019 APA,
all rights reserved)
The Lancet Psychiatry, 6(1) : 46-
60
- Year: 2019
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Service Delivery & Improvement, Psychological Interventions
(any), Other complementary & alternative
interventions, Technology, interventions delivered using technology (e.g. online, SMS), Other service delivery and improvement
interventions
Davenport, C., Arentz, S., Sekyere, E., Steel, A.
Higher education students are at increased risk of
stress. Self-care and clinical prescription of vitamin supplements is common. B-Vitamins are often indicated due to their co-enzymatic roles in
glucose metabolism and maintenance of healthy nervous system function. Activated-B-Vitamins are a new generation of B-Vitamins with theoretical
advantages. However, there's limited evidence comparing the effects of Standard-B-Vitamins with Activated-B-Vitamins. This RCT compared the
effectiveness of Activated-B-Vitamins against Standard-B-Vitamins over three-weeks on stress, anxiety, fatigue and depression in students.
Interventions were supplied by Herbs-of-Gold and 133-tertiary-students were randomised to Standard-B-Complex \"Mega-B-Complex\" or Activated-B-
Complex \"Activated-B-Complex\". Primary outcome was stress according to Depression-Anxiety-Stress-Scale (DASS21). Secondary outcomes were anxiety,
depression and fatigue according to the DASS21 and Fatigue-Severity-Scale (FSS). Feasibility was evaluated through recruitment from Endeavour's
Sydney Campus, retention and acceptability. Participants were randomised to one of two parallel groups. There were no differences between groups at
baseline for student demographics, course/year-of-study, dietetics or mean scores for stress, anxiety, fatigue and depression. At three-weeks, a
significant difference between groups was found for the primary outcome of stress (p = 0.005) favouring Standard-B-Vitamin. The mean score of the
Standard-B-Group was 11.6 +/- 6.7 compared to 15.3 +/- 7.9 in the Activated-B-Group. No difference between groups was found for anxiety, fatigue or
depression. However, both groups reported improvement over time with a higher proportion of participants moving into the 'normal' category for
anxiety and depression. There were four adverse reactions, however no serious or unresolved adverse effects. This trial provides evidence for the
superior effectiveness of Standard-B-Vitamins compared to Activated-B-Vitamins for reducing stress in students. Copyright © 2019
Advances in Integrative Medicine, 6 (Supplement
1) : S121
- Year: 2019
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Vitamins and supplements
Brown, J. S., Blackshaw, E., Stahl, D., Fennelly, L., McKeague, L., Sclare, I., Michelson, Daniel
Introduction: Schools may provide a convenient intervention setting for young people with mental health problems generally, as
well as for those who are unwilling or unable to access traditional clinic-based mental health services. However, few studies focus on older
adolescents, or those from ethnic minority groups. This study aims to assess the feasibility of a brief school-based psychological intervention for
self-referred adolescents aged 16-19 years. Methods: A two-arm cluster randomised controlled trial was conducted in 10 inner-city schools with block
randomisation of schools. The intervention comprised a one-day CBT Stress management programme with telephone follow-up (DISCOVER) delivered by 3
psychology (2 clinical and 1 assistant) staff. The control was a waitlist condition. Primary outcomes were depression (Mood and Feelings
Questionnaire; MFQ) and anxiety (Revised Child Anxiety and Depression Scale; RCADS-anxiety subscale). Data were analysed descriptively and
quantitatively to assess feasibility. Results: 155 students were enrolled and 142 (91.6%) followed up after 3 months. Participants were predominantly
female (81%) and the mean age was 17.3 years, with equal numbers enrolled from Year 12 and Year 13. Over half (55%) of students were from ethnic
minority groups. Intraclass correlations were low. Variance estimates were calculated to estimate the sample size for a full RCT. Preliminary
outcomes were encouraging, with reductions in depression (d = 0.27 CI-0.49 to -0.04, p = 0.021) and anxiety (d = 0.25, CI-0.46 to -0.04, p = 0.018)
at follow-up. Conclusions: Results support the feasibility of a school-based, self-referral intervention with older adolescents in a definitive
future full-scale trial (Trial no. ISRCTN88636606). (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Journal of Adolescence, 71 : 150-
161
- Year: 2019
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions
Dunning, D. L., Griffiths, K., Kuyken, W., Crane, C., Foulkes, L., Parker, J., Dalgleish, T.
BACKGROUND: Mindfulness based interventions (MBIs) are an increasingly popular way of attempting to improve the behavioural, cognitive
and mental health outcomes of children and adolescents, though there is a suggestion that enthusiasm has moved ahead of the evidence base. Most
evaluations of MBIs are either uncontrolled or nonrandomized trials. This meta-analysis aims to establish the efficacy of MBIs for children and
adolescents in studies that have adopted a randomized, controlled trial (RCT) design. METHOD(S): A systematic literature search of RCTs of MBIs was
conducted up to October 2017. Thirty-three independent studies including 3,666 children and adolescents were included in random effects meta-analyses
with outcome measures categorized into cognitive, behavioural and emotional factors. Separate random effects meta-analyses were completed for the
seventeen studies (n = 1,762) that used an RCT design with an active control condition. RESULT(S): Across all RCTs we found significant positive
effects of MBIs, relative to controls, for the outcome categories of Mindfulness, Executive Functioning, Attention, Depression, Anxiety/Stress and
Negative Behaviours, with small effect sizes (Cohen's d), ranging from .16 to .30. However, when considering only those RCTs with active control
groups, significant benefits of an MBI were restricted to the outcomes of Mindfulness (d = .42), Depression (d = .47) and Anxiety/Stress (d = .18)
only. CONCLUSION(S): This meta-analysis reinforces the efficacy of using MBIs for improving the mental health and wellbeing of youth as assessed
using the gold standard RCT methodology. Future RCT evaluations should incorporate scaled-up definitive trial designs to further evaluate the
robustness of MBIs in youth, with an embedded focus on mechanisms of action. Copyright © 2018 The Authors. Journal of Child Psychology and Psychiatry
published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.
Journal of child psychology and psychiatry, and allied
disciplines, 60(3) : 244-258
- Year: 2019
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Mindfulness based
therapy
Albanese, B. J., Bauer, B. W., Raudales, A. M., Capron, D. W., Schmidt, N. B.
Background: Anxiety sensitivity cognitive concerns (ASCC), or fear of cognitive dyscontrol sensations, confers risk for anxiety and mood
psychopathology. Recent work demonstrated that novel perceptual challenges generated by a head mounted display can elicit fear among those with
elevated ASCC. This suggests that interoceptive exposure to perceptual challenges may offer a means to mitigate ASCC. This study was designed to
evaluate whether repeated exposure to novel perceptual challenges can reduce ASCC, and if these effects are stronger among those experiencing greater
negative emotionality as a proxy for individuals likely to present for treatment. Method(s): Participants with elevated ASCC (N = 57) were randomized
to one of three experimental conditions utilizing a head-mounted display. In the rotations condition (n = 20), participants viewed themselves
spinning in a circle. In the opposite directions condition (n = 20), participants turned their head while the camera moved in the opposite direction
creating dissonance in their visual field. In the control condition (n = 17), participants completed a series of simple arithmetic problems. Result
(s): Participants in the rotation condition, relative to control, reported significant reductions in ASCC from pre- to post-exposure and these
effects were strongest for those with elevated negative affect. The main effect of the opposite directions exposure on post-treatment ASCC was non-
significant, but follow-up analyses revealed that reductions in ASCC were observed among those with elevated negative affectivity. Discussion(s):
Perceptual illusion challenges appear to have utility for reducing ASCC through repeated exposure. There was evidence for the perceptual illusion
exercises, particularly the rotations condition, specifically reducing ASCC, making this challenge the first we are aware of that specifically
targets ASCC-related concerns. Limitation(s): As a proof-of-concept study, the present sample was not recruited for clinically-significant
psychopathology, and only a brief follow-up was utilized. Future research should utilize a longer follow-up and test if these exposures mitigate
ASCC-relevant psychopathology among clinical samples. Copyright © 2019
Behavior
Therapy., 56 : 1173-1184
- Year: 2019
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Fergus, T. A., Limbers, C. A.
Researchers have called for the examination of test anxiety
interventions that extend beyond the delivery of individual services by a trained professional. Following from conceptual models and research
findings underscoring the importance of metacognitive beliefs to test anxiety, a controlled pilot study examined whether a group format delivery of
the attention training technique (ATT) component of metacognitive therapy reduces test anxiety among eighth-grade students. Students completed
baseline study measures and were allocated based upon class period to five sessions of ATT (n = 39) or a music listening control (n = 34) delivered
within a group format during a school week. Students completed postintervention study measures on the final day of the intervention and completed
follow-up study measures approximately 3 weeks following the intervention. As predicted, students receiving ATT reported less postintervention test
anxiety than the control when they held stronger baseline metacognitive beliefs about worry. The patterns of findings held at the follow-up and when
specifically examining the cognitive (i.e., worry) dimension of test anxiety. Study results suggest that ATT may be a viable test anxiety
intervention for students holding heightened metacognitive beliefs about worry. Future directions are discussed. Copyright © 2018
Behavior Therapy, 50(4) : 803-816
- Year: 2019
- Problem: Anxiety Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Attention/cognitive bias
modification
Deng, F.
To explore the effect of Ideological and political education on the recovery of
hippocampal neuron damage in college students. One hundred students suffering from anxiety disorder were randomly divided into two groups, the
observation group and the control group, 50 cases in each group. The two groups of patients were treated with the same combination of traditional
Chinese and Western medicine anti-anxiety treatment. The control group was given routine nursing during the experiment. The observation group was
given ideological and Political Education on the basis of the control group. Hamilton Anxiety Scale (HAMA) and Depression Scale (HAMD) were used to
evaluate the efficacy of the two groups of patients. The total effective rate of the observation group (98.2 %) was significantly higher than that of
the control group (62.3 %, p<0.05). The scores of somatization, depression, anxiety, interpersonal sensitivity and psychosis in the observation group
were significantly lower than those in the control group (p<0.05). Ideological and political education is conducive to improve college students'
awareness of anxiety disorders, enhance their ability of self-regulation, improve bad mood, and improve the treatment effect.
Indian Journal of Pharmaceutical Sciences, 81 (1 Supplement
1) : 54
- Year: 2019
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Waite, P., Marshall, T., Creswell, C.
Background:
Computerized treatments have been shown to be effective in young people with anxiety disorders within research settings. The aims of this study were
to evaluate a self-completed, therapist-supported online treatment for adolescent anxiety disorders in a routine clinical care setting and examine
whether additional sessions for parents improved treatment outcome. Method(s): Sixty adolescents (13-18 years) referred by primary and secondary care
services for treatment of an anxiety disorder and their parent(s) were randomly allocated to begin treatment immediately or after a 16-week waitlist.
Half the parents (receiving treatment immediately or after a waitlist) were allocated to receive sessions themselves. Assessments were conducted pre-
and posttreatment and at 6-month follow-up. Result(s): There was no significant difference posttreatment between the immediate treatment and waitlist
groups in remission of primary anxiety disorder (Odds Ratio (OR) = 2.19, 95% CI: 0.72-6.70). Parent sessions did not significantly improve adolescent
outcomes immediately or at 6-month follow-up (OR = 0.75, 95% CI: 0.26-2.15; OR = 1.14, 95% CI: 0.42-3.15). Conclusion(s): Within a routine clinical
care setting, a therapist-supported online treatment failed to deliver significantly better outcomes for adolescents with anxiety disorders than a
waitlist. Further research is needed to develop more effective treatments for this population. Copyright © 2019 Association for Child and Adolescent
Mental Health
Child and Adolescent Mental Health., 24(3) : 242-
250
- Year: 2019
- 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), Technology, interventions delivered using technology (e.g. online, SMS), Other service delivery and improvement
interventions
Pettit, J. W., Bechor, M., Rey, Y., Vasey, M. W., Abend, R., Pine, D. S., Bar-Haim, Y., Jaccard, J., Silverman, W. K.
OBJECTIVE: Randomized clinical trials of augmentation
strategies for youth with treatment-resistant anxiety disorders do not exist. We present findings from an efficacy trial of attention bias
modification treatment (ABMT) as an augment for this population, in comparison with attention control training (ACT). METHOD(S): Sixty-four youths
(34 boys; M age=11.7 years) who continued to meet for anxiety diagnoses after completing cognitive behavior therapy (CBT) were randomized to either
ABMT or ACT. ABMT and ACT consisted of dot-probe attention training trials presenting angry and neutral faces; probes appeared in the location of
neutral faces on 100% of trials in ABMT and 50% of trials in ACT. Independent evaluators, youths, and parents completed ratings of youth anxiety
severity, and youths completed measures of attention bias to threat and attention control at pretreatment, posttreatment, and two-month follow-up.
RESULT(S): Both arms produced significant reductions in anxiety severity, with no differences between arms. Specifically, across informants, anxiety
severity was significantly reduced at posttreatment and reductions were maintained at follow-up. Primary anxiety disorder diagnostic recovery
combined across arms was 50% at posttreatment and 58% at follow-up. Attention control, but not attention bias to threat, was significantly improved
at posttreatment in both arms. CONCLUSION(S): This is the first study to show anxiety can be reduced in youth who did not respond to CBT, and that
anxiety-reducing effect is found using both attention training contingency schedules. These findings, along with increases in attention control in
both arms, raise intriguing questions about mechanisms of anxiety reduction in treatment-resistant youth with attention training that require further
research. Copyright © 2019. Published by Elsevier Inc.
Journal of the American Academy of Child
and Adolescent Psychiatry., 59(1) : 157-165
- Year: 2019
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Treatment resistant/treatment refractory
-
Treatment and intervention: Psychological Interventions
(any), Attention/cognitive bias
modification
Kennedy, S. M., Bilek, E. L., Ehrenreich-May, J.
The Unified Protocol for Transdiagnostic
Treatment of Emotional Disorders in Children (UP-C) is an intervention for children aged 7 to 13 targeting high negative emotion, emotional
reactivity, and emotion regulation deficits common across emotional disorders. Our objective was to collect pilot randomized controlled trial (RCT)
data on the efficacy of the UP-C, comparing UP-C with an active, anxiety-focused intervention. Participants were 47 children with at least one
primary anxiety disorder; approximately one half had elevated depression symptoms. Participants received either UP-C or the anxiety-focused control
treatment. No condition-related differences were found with respect to diagnostic remission and anxiety symptoms. However, differences in favor of
UP-C were observed with respect to treatment response at follow-up, depression symptoms, sadness dysregulation, and cognitive reappraisal. Results
provide preliminary evidence that the UP-C may be at least as efficacious in treating anxiety as well-supported anxiety-specific treatment protocols
and may produce greater gains in certain emotion reactivity and regulation variables.
Behavior Modification, 43(3) : 330-360
- Year: 2019
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Papp, M. E., Nygren-Bonnier, M., Gullstrand, L., Wandell, P. E., Lindfors, P.
Objective: Modern hatha yoga exercises (YE) provide an alternative form of
physical activity which may reduce stress, facilitate recovery and improve health. This study investigated the short-term effects of high intensity
hatha yoga exercises (HIY) on health-related outcomes. Method(s): A 6-week randomized controlled study was performed to compare HIY with a control
group not changing their exercise behavior. Healthy students (N = 44; median age: 25 years, range 20-39 years; HIY: n = 21, including 3 men; control
group: n = 23, including 3 men) novice to yoga participated in the intervention which included one weekly class and recommended home training.
Participants provided self-reports in questionnaires before and after the intervention. Self-reports included anxiety and depression (Hospital
Anxiety and Depression Scale), stress (Perceived Stress Scale), sleep quality (Pittsburgh Sleep Quality Index), insomnia (Insomnia Severity Index),
subjective health complaints (Common Symptoms in General Practice Index) and self-rated health (single-item). Result(s): After the 6-week
intervention, there were no between-group differences in anxiety, depression, stress, sleep or self-rated health. However, when investigating
associations within the HIY-group, a higher HIY-dose was related to less depression (r = 0.47; p = 0.03), improved sleep quality (r = 0.55; p =
0.01), and less insomnia (r = 0.49; p = 0.02). Conclusion(s): There were no short-term between-group effects of HIY on mental distress, sleep or
self-rated health. However, within the HIY-group, a higher dose was associated with improved mental health in terms of depression and with improved
sleep. Although future studies with larger samples are needed, these preliminary findings suggest short-term positive effects of HIY on health-
related outcomes among students. Trial registration number: NCT01305096. Copyright © 2019 Elsevier Ltd
Journal of Bodywork & Movement
Therapies., :
- Year: 2019
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Mind-body exercises (e.g. yoga, tai chi, qigong)