Disorders - Anxiety Disorders
Harrer, M., Adam, S. H., Baumeister, H., Cuijpers, P., Karyotaki, E., Auerbach, R. P., Kessler, R.
C., Bruffaerts, R., Berking,
M., Ebert, D. D.
OBJECTIVES: Mental health disorders are
highly prevalent among university students. Universities could be an optimal setting to provide evidence-based care through the Internet. As part of
the World Mental Health International College Student initiative, this systematic review and meta-analysis synthesizes data on the efficacy of
Internet-based interventions for university students' mental health. METHOD(S): A systematic literature search of bibliographical databases
(CENTRAL, MEDLINE, and PsycINFO) for randomized trials examining psychological interventions for the mental health (depression, anxiety, stress,
sleep problems, and eating disorder symptoms), well-being, and functioning of university students was performed through April 30, 2018. RESULT(S):
Forty-eight studies were included. Twenty-three studies (48%) were rated to have low risk of bias. Small intervention effects were found on
depression (g = 0.18, 95% confidence interval [CI; 0.08, 0.27]), anxiety (g = 0.27, 95% CI [0.13, 0.40]), and stress (g = 0.20, 95% CI [0.02, 0.38]).
Moderate effects were found on eating disorder symptoms (g = 0.52, 95% CI [0.22-0.83]) and role functioning (g = 0.41, 95% CI [0.26, 0.56]). Effects
on well-being were non-significant (g = 0.15, 95% CI [-0.20, 0.50]). Heterogeneity was moderate to substantial in many analyses. After adjusting for
publication bias, effects on anxiety were not significant anymore. DISCUSSION: Internet interventions for university students' mental health can
have significant small-to-moderate effects on a range of conditions. However, more research is needed to determine student subsets for which
Internet-based interventions are most effective and to explore ways to increase treatment effectiveness. Copyright © 2018 John Wiley & Sons, Ltd.
International journal of methods in psychiatric
research, 28(2) : e1759
- Year: 2019
- Problem: Anxiety Disorders (any), Depressive Disorders, Eating Disorders
(any)
- 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), Cognitive & behavioural therapies (CBT), Technology, interventions delivered using technology (e.g. online, SMS)
Buckner, J. D., Zvolensky, M. J., Ecker, A. H., Schmidt, N.
B., Lewis, E. M., Paulus, D. J., Lopez-Gamundi, P., Crapanzano, K. A., Bakhshaie, J.
Cannabis use disorder (CUD) is
the most common illicit substance use disorder and individuals with CUD have high rates of comorbid anxiety disorders. Comorbidity between CUD and
anxiety disorders is of public health relevance given that although motivation enhancement therapy (MET) combined with cognitive-behavioral therapy
(CBT) is an efficacious intervention for CUD, outcomes are worse for patients with elevated anxiety. The current study tested the acceptability and
efficacy of the integration of a transdiagnostic anxiety CBT (i.e., treatment of patients with any anxiety disorder) with MET-CBT (integrated
cannabis and anxiety reduction treatment, or ICART) for CUD compared to MET-CBT alone. Treatment-seeking cannabis users (56.4% male, Mage
= 23.2, 63.3% non-Hispanic White) with CUD and at least one comorbid anxiety disorder were randomly assigned to ICART (n = 27) or MET-CBT (n = 28).
Patients in the ICART condition attended significantly more treatment sessions than those in the MET-CBT condition. Patients in the ICART condition
were more likely to be abstinent post-treatment than those in MET-CBT. Further, treatment produced decreases in cannabis use and related problems.
Notably, therapy type did not moderate the impact of treatment on frequency of use and related problems. Together, these data suggest that ICART may
be at least as efficacious as a gold-standard psychosocial CUD treatment, MET-CBT, for a difficult-to-treat subpopulation of cannabis users.
Copyright © 2018 Elsevier Ltd
Behaviour Research and
Therapy, 115 : 38-45
- Year: 2019
- Problem: Anxiety Disorders (any), Cannabis Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Motivational interviewing, includes Motivational Enhancing Therapy, Other Psychological Interventions
Makover,
H., Adrian, M., Wilks, C., Read, K., Stoep, A. V., McCauley, E.
This study examined the impact of a school-based indicated prevention program
on depression and anxiety symptoms for youth during the transition from middle to high school. The High School Transition Program (HSTP) was designed
to build social and academic problem-solving skills and engagement during this period of particular vulnerability for adolescents. Students (N=2664)
at six middle schools in the Pacific Northwest completed a universal emotional health screening during the second half of the 8th grade year, and
those with elevated depression scores and low conduct problem scores were invited to participate in the trial. Eligible students (N=497) were
randomized to either the HSTP (N=241) or control (N=256) conditions. Depression and anxiety symptoms were measured at five time points over an 18-
month period using validated self-report measures. Hierarchical linear modeling was used to assess prevention effects and moderators such as baseline
symptoms, race, and sex. Results suggested that students randomized to the HSTP group had accelerated rate of reduction in depressive symptoms over
time (d=.23) relative to the control group. Students randomized to the HSTP group also had significantly faster rates of change of anxiety scores
(d=0.25). Baseline anxiety severity, race, and sex did not differentially impact the trajectories of symptom outcomes between conditions.
Implications for prevention efforts during this normative but stressful period of transition for youth are discussed. ClinicalTrials.gov registration
number is NCT00071513.
Prevention
Science, 20(4) : 499-509
- 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
Jones, M. G., Rice, S. M., Cotton, S. M.
Introduction As interest in Animal-Assisted Interventions (AAI) grows, there is
increasing need to differentiate informal activities from formal and professionally directed therapies, including mental health focussed Canine-
Assisted Psychotherapy (CAP). There have been no reviews focusing exclusively on CAP and the distinct developmental period of adolescence. The aims
of this study were to identify the characteristics of CAP interventions, their impacts and their acceptability, tolerability and feasibility for
adolescents with mental health disorders. Method A systematic review identified studies incorporating canines into mental health treatments for
adolescents aged 10-19 years. Studies reporting qualitative or quantitative psychological or psychosocial outcomes were included. Results Seven
studies were scrutinised. Intervention characteristics varied, including a range of formats, settings, locations, doses, and facilitators.
Information on the role of the canines in sessions was sparse. CAP had a positive impact on primary diagnoses and symptomatology, conferring
additional benefits to standard treatments for internalising disorders, post-traumatic stress disorder, and equivalent effects for anxiety, anger and
externalising disorders. CAP was associated with positive impacts on secondary factors including increased engagement and socialisation behaviours,
and reductions in disruptive behaviours within treatment sessions. Global functioning also improved. There was insufficient evidence that CAP
improved factors associated with self-esteem, subjective wellbeing, or coping. Good attendance and retention rates indicated high levels of
acceptability. Moderate to high tolerability was also indicated. Feasibility may be limited by additional training and logistical requirements.
Recommendations We recommend the development of theoretically informed, standardised (manualised) intervention protocols that may subsequently form
the basis of efficacy and effectiveness testing. Such protocols should clearly describe canine-participant-facilitator interactions via a for-malised
nomenclature; spontaneous (animal-led), adjunctive (facilitator-led), and experiential (participant-led). Conclusions There is emerging evidence to
suggest that CAP improves the efficacy of mental health treatments in self-selected adolescent populations via reductions in primary symptomatology,
and via secondary factors that improve therapeutic processes and quality, such as engagement and retention. Copyright © 2019 Jones 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, 14 (1) (no
pagination)(e0210761) :
- Year: 2019
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder), At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Other complementary & alternative
interventions
Luna, P., Guerrero, J., Cejudo, J.
This study
aimed to evaluate the impact of a physical-sport education pilot programme on adolescents' subjective well-being (health-related quality of life,
positive affect and negative affect), trait emotional intelligence and social anxiety. The programme was based on the pedagogical sport education
model within a quality physical education framework, and approached from the perspective of social and emotional learning. Participants were 113
compulsory secondary education students aged 12-15 years that were assigned to a control group (n = 44) and an experimental group (n = 69). A quasi-
experimental design with repeated pre-test and post-test measures was used. Bonferroni correction was applied for multiple comparisons. The
preliminary results obtained in this investigation revealed that the physical-sport education pilot programme promoted significant improvements in a
specific indicator of subjective well-being and trait emotional intelligence in the experimental group. These encouraging findings support the
pedagogical efficiency of the programme with regard to the programme aim. The findings also highlight the feasibility and appropriateness of the
programme in terms of an innovative teaching proposal.
International Journal of Environmental Research & Public
Health, 16(10) :
- Year: 2019
- Problem: Anxiety Disorders (any), Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Physical activity, exercise
Singla, D. R., Waqas, A., Hamdani, S. U., Suleman, N., Zafar, S. W. Zill-e, H., Saeed, K., Servili, C., Rahman, A.
Background: Adolescence represents an unprecedented
opportunity to invest in health. Individual adolescent life skills programs in low- and middle-income countries (LMICs) have demonstrated success but
neither their relative effectiveness across multiple health arenas, including mental health, nor their key ingredients have been examined. Method(s):
We conducted a systematic review and meta-analysis to identify key implementation processes and effectiveness of life skills programs among
adolescents in LMICs which targeted at least one mental health outcome, as well as their relative effectiveness. Six academic databases, including
PubMed and PsychInfo and bibliographies of related reviews, were systematically searched until July 1, 2016, with no restrictions on language or
publication year. Studies were excluded if they were conducted in HIC settings, among chronically ill populations or lacking adolescents aged 10-19
years. Data from published reports related to the characteristics of RCTs and their implementation processes related to 'who, what, how and where'
were extracted, including the development of a taxonomy to determine which life skills constituted each program. Meta-analyses with random effects
models examined the overall trial effectiveness, as determined by their primary outcomes. Subsequent exploratory analyses determined which
implementation processes predicted trial effectiveness (PROSPERO CRD42016043448). Result(s): We included 50 eligible RCTs from 45 articles with a
focus on an adolescent health program, which targeted at least one or more mental health outcomes. Most of the RCTs, conducted across 19 LMICs,
targeted students (82%) and refugees (7%), and both genders (71%). Most of the interventions were delivered by teachers (n = 12), and specialist
providers (n = 11), and most were focused on high-risk groups rather than clinically-disordered populations. These interventions were effective in
reducing symptoms of anger (SMD = 1.234), improving life skills (SMD = 0.755) and functioning (SMD = 0.491), and decreasing PTSD (SMD = 0.327),
depression and anxiety (SMD = 0.305). Trial effectiveness was positively associated with the following life skills: interventions focused on parent-
child interactions (beta = 0.557, p < 0.05), assessing interpersonal relations (beta = 0.204, p < 0.05) and stress management (beta = 0.216, p <
0.05). Discussion(s): Our results demonstrate the benefits of life skills programs targeting one or more mental health outcomes and co-occurring risk
factors in school and community settings. Comprehensive programs focusing on multiple life skills related to the individual, his or her social
environment and, in particular, interventions promoting parent-child interactions may hold particular promise in LMICs to address the burden of poor
mental health and other health arenas. Copyright © 2019 Elsevier Ltd
Behaviour
Research and Therapy, 130(103402) :
- Year: 2019
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Skills training
Ezegbe, B. N., Eseadi, C., Ede, M. O., Igbo, J. N., Anyanwu, J. I., Ede, K. R., Egenti, N. T., Nwokeoma, B. N., Mezieobi, D. I., Oforka, T. O., Omeje, G. N., Ugwoezuonu,
A. U., Nwosu, N., Amoke, C. V., Offordile, E. E., Ezema, L. C., Ikechukwu-Ilomuanya, A. B., Ozoemena, L. C.
BACKGROUND: Anxiety is a common disorder which refers
to a significant and persistent fear of one or more social or performance situations. This study investigated the impacts of cognitive-behavioral
intervention on anxiety and depression among undergraduate students enrolled in social science education programs at public universities in the
Southeast Nigeria.\rMETHODS: Participants were 55 undergraduate students enrolled in social science education programs at public universities in the
Southeast Nigeria. The adequacy of the sample size used was determined using GPower software. Cognitive-behavioral treatment manuals on anxiety and
depression were used to deliver the intervention. Data analyses were completed using repeated measures analysis of variance.\rRESULTS: Results
indicated a significant positive impact of cognitive-behavioral intervention on anxiety and depression among social science education students
exposed to the cognitive-behavioral intervention when compared to the waitlisted group. Results also showed that there was a significant time x group
interaction for anxiety and depression. Follow-up tests showed that significant reduction in anxiety and depression persisted after 3 months for the
cognitive-behavioral intervention group in comparison to the waitlisted control group.\rCONCLUSION: We concluded that cognitive-behavioral
intervention was a successful intervention which decreased the symptoms of anxiety and depression in social science education students who
participated in the study. Additional studies are recommended to further corroborate the influence of cognitive-behavioral intervention in the
reduction of anxiety and depressive symptoms in the Nigerian undergraduate student population.
Medicine, 98(15) : e14935
- Year: 2019
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Fernie, B. A., Spada, M. M., Brown, R.
G.
Poor attentional
control leads to attentional biases that are implicated in psychological distress. Attention Training Technique (ATT) is an auditory intervention
designed to strengthen attentional control. Research indicates that ATT alleviates anxiety and depressive symptoms. This study is a randomised
control trial with repeated measures that tested if a lab-based, single-exposure of ATT strengthened attentional control. Forty-six nonclinical, high
anxiety/worry participants received either ATT or a sham control intervention. Attentional control was assessed using the standard and a modified
version of the colour-word Stroop task. The modified version incorporated tactile interference to increase perceptual load. A series of mixed effects
models, simple contrasts, and z-tests were used to evaluate if cross-modal interference worsened, and whether ATT was beneficial to, attentional
control. Tactile interference increased reaction times but, when Stroop interference was controlled for, this was only true on incongruent trials.
The impact of ATT was greatest under high perceptual load. Copyright © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.
Journal of Cognitive
Psychology., :
- Year: 2019
- 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
Tran, N., Zhebrak, M., Yacoub, C., Pelletier, J., Hawley, D.
Intro: There has been an increased interest in
understanding the therapeutic effect of gut-microbiota on health, particularly in mental health. However, limited research into the connection
between gut-microbiota and mental health makes this study an important endeavor in exploring the effect of gut-microbiota, through probiotics
intervention, on mental health like anxiety and factors related to anxiety (e.g., anxiety control, affect, negative mood regulation, and worry).
Method(s): Healthy college students (N = 86; 75.6% female), average age of 20.59, participated in a double-blind, placebo-control, and
randomization-control study. Eligible participants completed a baseline survey before being assigned to a condition, which consisted of four
probiotics conditions and one placebo condition. After 28 days of daily intake, the participants returned to complete their exit survey. Result(s):
Probiotics were observed to improve panic anxiety, neurophysiological anxiety, negative affect, worry, and increase negative mood regulation.
Furthermore, post hoc analyses revealed that the CFU (colony-forming unit) level was more effective than species counts in accounting for the number
of significant improvements. A ceiling effect was detected in the study, participants with high distress reported higher number of improvements than
those with normative distress. Conclusion(s): Overall, this study is the first to examine the effect of CFU and species count on probiotics'
efficacy. The study's finding suggested that probiotics may have the therapeutic potential to treat anxiety, however, further research is necessary
to make that determination. Copyright © 2019 Elsevier B.V.
Journal of Affective Disorders, 252 : 271-
277
- Year: 2019
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Vitamins and supplements
Lucibello, K., Parker, J., Heisz, J.
Background: An acute bout of exercise temporarily reduces state anxiety. The current study examined whether these benefits are greater
for those with higher levels of anxiety, and whether these benefits are augmented with exercise training. Methods: Young adults were randomized to
either a nine-week moderate-intensity exercise group or an inactive control group. We assessed changes in state anxiety in response to an acute bout
of exercise each week. Results: State anxiety reductions following acute exercise increased in the exercise subgroup with high anxiety at baseline as
training progressed (p = .029). No training effects were observed for the exercise subgroup with low baseline anxiety (p = .27). Limitations: A
predominantly female sample, a single state anxiety measure post exercise and a non-exercise control group should be addressed in future research.
Conclusions: The results support the use of regular physical activity as a method for managing state anxiety in young adults. In particular, regular
physical activity may be especially beneficial for those experiencing higher levels of anxiety. (PsycINFO Database Record (c) 2019 APA, all rights
reserved)
Journal of Affective Disorders, 247 : 29-
35
- Year: 2019
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Physical activity, exercise
Chang, S. W., Kuckertz, J. M., Bose, D., Carmona, A. R., Piacentini, J., Amir, N.
A growing evidence base supports attention bias modification
(ABM) as a novel intervention for anxiety. However, research has been largely conducted with adults and analogue samples, leaving the impact of ABM
for child anxiety be fully elucidated. Thus, we conducted a double-blind, randomized controlled trial testing ABM efficacy versus an attention
control condition (CC) in 31 children diagnosed with anxiety disorder. Youth were assigned to 4 weeks of ABM where attention was trained away from
threat, or a sham CC in which no bias training occurred. Findings indicate that significantly more youth in the ABM versus CC group were considered
treatment responders post training. The ABM versus CC group also demonstrated a greater decrease in anxiety severity, with this difference being
marginally significant. Findings lend support for the potential of ABM in reducing youth anxiety. Further work regarding mechanisms of action is
warranted to advance ABM research. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Child
Psychiatry and Human Development, 50(2) : 198-208
- Year: 2019
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Attention/cognitive bias
modification
Dobson, E. T., Bloch, M. H., Strawn, J.
R.
Objective: To evaluate the efficacy and tolerability of
pharmacotherapy in pediatric anxiety disorders using network meta-analysis. Data Sources: PubMed, Cochrane Database, Web of Science, PsycNET, and
ClinicalTrials.gov were searched for double-blind, controlled pharmacotherapy trials in youth with anxiety disorders from 1966 to September 2017.
Data Selection: All double-blind, placebo-controlled trials of pharmacotherapy in the treatment of pediatric patients with generalized, social,
and/or separation anxiety disorders were included. Data Extraction: We extracted demographic, symptom severity, global improvement, discontinuation,
and suicidality data. Risk of bias was assessed with the Cochrane risk-of-bias tool, and a network metaanalysis comparing the efficacy and
tolerability of medications and medication classes was performed using the gemtc package (R). Result(s): We identified 20 citations (22 RCTs, 24
treatment arms) with 2, 623 patients. Selective serotonin reuptake inhibitors (SSRIs) were the only class that was superior in reducing anxiety
(standardized mean difference: 5.2; credible interval [CrI]: [2.8 to 8.8]) and in likelihood of treatment response compared to placebo (odds ratio
[OR]: 4.6; CrI: [3.1 to 7.5]). Serotonin-norepinephrine reuptake inhibitor (SNRI) and a2 agonist treatment were associated with more frequent
treatment response compared to placebo. The likelihood of treatment response was greater for SSRIs compared to SNRIs (OR: 1.9; CrI: [1.1 to 3.5]).
Allcause discontinuation and treatment-emergent suicidality significantly differed among medications but not medication class. Conclusion(s):
Although multiple medications reduce anxiety in children and adolescents, treatment response, tolerability, and treatmentemergent suicidality differ
among these medications and medication classes. Determining whether efficacy and tolerability differences represent true differences (or reflect
differences in trial design) requires additional head-to-head medication trials and-to exclude the impact of missing treatment interventions-requires
trials of medications that successfully treat anxiety in adults but that have not been evaluated in youth. © Copyright 2019 Physicians Postgraduate
Press, Inc.
Journal of
Clinical Psychiatry, 80(1) : E1-E15
- Year: 2019
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any)