Disorders - Anxiety Disorders
Rith-Najarian, L. R., Mesri, B., Park, A. L., Sun, M., Chavira, D. A., Chorpita, B. F.
Cognitive behavioral therapies (CBT)
for youth with anxiety, traumatic stress, and depression have demonstrated strong effects in individual studies and meta-analyses. Relatively more
attention has been given to posttreatment effects, though, and assessment of follow-up effects has been limited at the meta-analytic level. The
current meta-analysis aimed to (a) examine the effects of youth CBT at posttreatment, 1-month, 3-month, 6-month, 1-year, and long-term (2+ years)
follow-up as well as (b) identify research-related variables (e.g., measure respondent type) that relate to effects. Using a random effects model
across 110 child and adolescent CBT groups, within-group effect sizes were large at posttreatment (g = 1.24) and from 1-month through long-term
follow-up (g = 1.23-1.82), and effect sizes did not significantly differ by treatment target (i.e., anxiety, traumatic stress, depression). However,
availability of outcome data for effect sizes diminished across later follow-up assessments. Moreover, effect sizes were significantly associated
with outcome respondent type across assessment timing, with outcome measures from caregiver and youth respondents associated with smaller effect
sizes (B = -0.97, p < 0.001) relative to outcome measures that were evaluator-reported. Results provide initial support for the durability of
treatment effects for youth CBTs and highlight the importance of some confounding variables. Implications for improving treatment research standards
and prioritizing assessment of long-term follow-up assessment are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Behavior Therapy, 50(1) : 225-
240
- Year: 2019
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Morgan, A. J., Fischer, J. A. A., Hart, L. M., Kelly, C. M., Kitchener, B.
A., Reavley, N. J., Yap, M. B. H., Cvetkovski, S., Jorm, A. F.
Background: There is well-established evidence that Mental Health First Aid (MHFA) training improves
knowledge about how to support someone developing a mental health problem, but less evidence that this support improves the mental health of the
recipient of aid. This randomised controlled trial aimed to assess the long-term effects of MHFA training of parents on the mental health of their
adolescent children. Method(s): 384 Australian parents of an adolescent aged 12-15 were randomised to receive either the 14-h Youth MHFA course or
the 15-h Australian Red Cross Provide First Aid course. Outcomes were assessed at baseline, 1-year, and 2-year follow-up in both parents and
adolescents. Primary outcomes were cases of adolescent mental health problems, and parental support towards their adolescent if they developed a
mental health problem, rated by the parent and adolescent. Secondary outcomes included parent knowledge about mental health problems, intentions and
confidence in supporting a young person, stigmatizing attitudes, and help-seeking for mental health problems. Result(s): Parent and adolescent
reports showed no significant difference between training groups in the proportion of cases of adolescents with a mental health problem over time (ps
>.05). There was also no significant difference between training groups in the quality of parental support provided to their adolescent at 1- or 2-
year follow-up (ps >.05). In contrast, some secondary outcomes showed benefits from the Youth MHFA training relative to the control, with increased
parental knowledge about mental health problems at 1-year (d = 0.43) and 2-year follow-up (d = 0.26), and increased confidence to help a young person
(d = 0.26) and intentions to provide effective support (d = 0.22) at 1-year follow-up. Conclusion(s): The study showed some improvements in mental
health literacy in training recipients, but could not detect changes in the mental health of adolescents and the support provided to them by their
parents if they had a mental health problem. However, there was a lack of power to detect primary outcome effects and therefore the question of
whether MHFA training leads to better outcomes in the recipients of aid remains to be further explored. Trial registration: ACTRN12612000390886,
registered retrospectively 5/4/2012. Copyright © 2019 The Author(s).
BMC Psychiatry, 19 (1) (no
pagination)(99) :
- Year: 2019
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation
Shum, A. K., Lai, E. S., Leung, W. G., Cheng, M.
N., Wong, H. K., So, S. W., Law, Y. W., Yip, P. S.
BACKGROUND: In Hong Kong, with an
increasing number of children experiencing mental health issues, there is a need to not only develop innovative interventions but also develop
comprehensive prevention interventions so as to reduce their anxiety symptoms and enhance their emotional management and interpersonal relationships.
OBJECTIVE(S): The aim of this study was to determine the effectiveness of The Adventures of DoReMiFa, an integration model of the cognitive-
behavioral approach and positive psychology by using digital game-based and school-based mental health enhancement intervention to magnify the social
and emotional health and well-being of the school children in Hong Kong aged 9 to 11 years. METHOD(S): A quasi-experimental design method was used to
evaluate this digital game and school-based intervention. The Adventures of DoReMiFa was piloted in 4 primary schools where students were allocated
to either an intervention or a control group. The participants were assessed at pre- and postintervention with a 6-month follow-up measuring their
mental health knowledge, levels of anxiety symptoms, positive and negative thinking, perspective-taking, and self-esteem. RESULT(S): A total of 459
primary school students from 4 primary schools participated in the study. The response rate on the questionnaires answered on the Web was up to 85.1%
(391/459). Compared with the control group, the intervention group was found to have significant association with improved mental health knowledge at
the time immediately after the intervention (beta=.46; P=.01) and in the 6-month postintervention period (beta=.66; P<.001); for perspective-taking,
the intervention group had exhibited a significant improvement 6 months after the completion of the universal program (beta=1.50; P=.03). The
intervention, however, was found not to be effective in reducing the rates of anxiety symptoms and negative thinking among the participating
students. CONCLUSION(S): The Adventures of DoReMiFa, an integration of a digital game-based and school-based mental health enhancement intervention,
was shown to be effective in elevating the knowledge of mental health and promoting perspective-taking in the primary school students of Hong Kong.
Although there was insufficient evidence to support a reduction in symptoms of anxiety and negative automatic thoughts, the overall results were
still encouraging in that a preventive effect was found, indicating that the program has the potential to enhance the mental well-being of
schoolchildren. It also suggests that knowledge enhancement may not necessarily lead to behavior change, and more focused effort may be needed to
achieve the translation. The implications and limitations of this study and suggestions for future research were also discussed. Copyright ©Angie KY
Shum, Eliza SY Lai, Wing Gi Leung, Mabel NS Cheng, Ho Kit Wong, Sam WK So, Yik Wa Law, Paul SF Yip. Originally published in the Journal of Medical
Internet Research (http://www.jmir.org), 05.04.2019.
Journal of Medical
Internet Research, 21(4) : e12003
- Year: 2019
- Problem: Anxiety Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Hill, M. D., Gibson, A. M., Wagerman, S. A., Flores, E. D., Kelly, L. A.
Background: There is a paucity of data directly comparing the effects of aerobic versus resistance
exercise within a single cohort. Objective(s): The study aimed to investigate the effects of an acute bout of aerobic and resistance exercise on
state anxiety and cognitive function. Equipment and methods: Participants completed three laboratory visits randomized between aerobic exercise
(cycling at a self-selected intensity), resistance exercise (three sets; 10 repetitions; six exercises), and a control condition (seated rest). State
anxiety and cognitive function were assessed before and after each condition. Result(s): Reductions in state anxiety that approached significance
were seen immediately following aerobic exercise yet were non-significant in the resistance and control conditions. Cognitive function significantly
improved following aerobic exercise yet this was not evident in the resistance or control conditions. Conclusion(s): Acute aerobic exercise at a
self-selected intensity may be an effective way of reducing state anxiety and improving cognitive function, when compared to seated rest or
resistance training. Copyright © 2018
Science and Sports., 34(4) : 216-221
- Year: 2019
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Physical activity, exercise
Zhou, X., Zhang, Y., Furukawa, T.A., Cuijpers, P., Pu, J., Weisz, J.R., etal.
Importance: Anxiety disorders are common in children and adolescents, and uncertainty remains
regarding the optimal strategy of psychotherapies in this population. Objective: To compare and rank the different types of psychotherapies and the
different ways of delivering psychological treatments for anxiety disorders in children and adolescents. Data Sources: PubMed, Cochrane Central
Register of Controlled Trials, EMBASE, PsycINFO, Web of Science, CINAHL (Cumulative Index to Nursing and Allied Health Literature), ProQuest
Dissertations, LILACS (Literatura Latino Americana em Ciencias da Saude), international trial registers, and US Food and Drug Administration reports
were searched from inception to November 30, 2017. Study Selection: Randomized clinical trials that compared any structured psychotherapy with
another psychotherapy or a control condition for anxiety disorders in children and adolescents were selected. Data Extraction and Synthesis: Four
researchers independently performed data extraction and quality assessment. Pairwise meta-analyses and Bayesian network meta-analysis within the
random-effects model were used to synthesize data. Main Outcomes and Measures: Efficacy (change in anxiety symptoms) posttreatment and at follow-up,
acceptability (all-cause discontinuation), and quality of life and functional improvement were measured. The certainty of evidence was assessed using
the Grading of Recommendations Assessment, Development and Evaluation framework. Results: A total of 101 unique trials including 6625 unique
participants compared 11 different psychotherapies with 4 specific control conditions. The certainty of evidence was rated as low or very low for
most comparisons. For efficacy, most psychotherapies were significantly more effective than the wait list condition posttreatment (standardized mean
difference [SMD], -1.43 to -0.61) and at the longest follow-up (SMD, -1.84 to -1.64). However, only group cognitive behavioral therapy (CBT) was
significantly more effective than the other psychotherapies and all control conditions posttreatment. For acceptability, bibliotherapy CBT had
significantly more all-cause discontinuations than some psychotherapies and control conditions (range of odds ratios, 2.48-9.32). In terms of quality
of life and functional improvement, CBT (delivered in different ways) was significantly beneficial compared with psychological placebo and the wait
list condition (SMDs, 0.73 to 1.99). Conclusions and Relevance: Group CBT would be the more appropriate choice of psychotherapy for anxiety disorders
in children and adolescents, based on these findings. Other types of psychotherapies and different ways of delivering psychological treatment can be
alternative options. Further research is needed to explore specific anxiety disorders, disorder-specific psychotherapy, and moderators of treatment
effect. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
JAMA Psychiatry, 76(1) : 41-
50
- Year: 2019
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)
Nnamani, A., Akabogu, J., Otu, M. S., Ukoha, E., Uloh-Bethels, A. C., Omile, J. C., Obiezu, M. N., Dike, A. E., Ike, C. V., Iyekekpolor, O. M.
OBJECTIVE: To determine the effectiveness of a cognitive behaviour
language therapy (CBLT) programme to reduce speech anxiety among stuttering school adolescents. METHOD(S): This was a group randomized clinical trial
that enrolled stuttering school adolescents who had severe speech anxiety. The participants were randomized to either the treatment group or the
control group. The Speech Anxiety Thoughts Inventory (SATI) score was recorded before and after a 12-week CBLT programme was delivered in 24 group
sessions to the treatment group. The control group did not receive any therapy. RESULT(S): A total of 92 stuttering school adolescents who met the
inclusion criteria were randomized to the treatment group ( n=46; 22 males, 24 females; mean+/-SD age, 16.36+/-2.20 years) or the control group (
n=46; 28 males, 18 females; mean+/-SD age, 15.45+/-2.10 years). Results showed that the CBLT intervention significantly reduced speech anxiety among
stuttering school adolescents compared with the control group (post-test SATI assessment, mean+/-SD 26.52+/-1.67 versus 89.92+/-3.17, respectively).
CONCLUSION(S): These findings suggest that speech educators and therapists in educational institutions and hospitals should follow the principles of
CBLT when treating speech anxiety.
Journal of International Medical Research, 47(7) : 3109-
3114
- Year: 2019
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Mahdi, M., Jhawar, S., Bennett, S. D., Shafran, R.
Background: High rates of comorbidity among
children and adolescents with anxiety disorders are widely documented. To date the question of what happens to comorbid disorders upon treatment of
the primary anxiety disorder has received little attention and the optimal treatment strategy for cases with comorbidity remains to be determined.
Objective(s): This review examines the literature on the impact of disorder-specific CBT on comorbid mood and behavioral disorders in young people
with a primary anxiety disorder. Search Method(s): PsycINFO, EMBASE, MEDLINE and the Cochrane Library were systematically searched using predefined
selection criteria. Two reviewers independently assessed the relevance of studies, obtained data using a data extraction form and undertook
methodological quality analysis. Result(s): Ten studies (1647 children in total) were included in the review. All studies demonstrated positive
outcomes for CBT focused on the primary anxiety disorder on untargeted comorbid mood and/or externalising disorders. Conclusion(s): Findings suggest
CBT focused on the primary anxiety disorder successfully reduces comorbid mood and/or behavioral diagnoses and symptoms of these co-occurring
clinical diagnoses. Therefore, the implementation of disorder-specific CBT for the primary disorder is a valid alternative to transdiagnostic
interventions and is recommended in cases of comorbidity in children and adolescents with a primary anxiety disorder. Copyright © 2019
Journal of Affective Disorders, 251 : 141-148
- Year: 2019
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Dowling, K., Simpkin, A.
J., Barry, M. M.
School-based social and emotional learning programs aim to provide students with the skills they
need to deal with life challenges, thereby enhancing their social and emotional wellbeing, academic outcomes, and reducing their risk of mental
health difficulties. While there is a robust evidence base on the effectiveness of these programs originating from the US, there is a relative
paucity of research on how these programs impact young people in other county contexts, especially for older adolescents and those at higher risk.
This study sets out to address this research gap by evaluating the effectiveness of a social emotional learning program designed for older
adolescents in Ireland, the MindOut program. MindOut is a universal school-based social and emotional learning program designed for older adolescents
in Ireland which was developed based on a common elements approach underpinned by CASEL's framework. Employing a cluster randomized-controlled
trial, data on social and emotional skills, academic performance and mental health outcomes were collected from students (n=497; 51.1% female) ages
15-18 years in 32 disadvantaged schools. There were significant improvements in intervention students' social and emotional skills including,
reduced suppression of emotions (p=0.035), use of more positive coping strategies [reduced avoidance coping p=<0.001) and increased social support
coping p=0.044)]. Improvements in mental health and wellbeing were also found with significantly reduced levels of stress (p=0.017) and depressive
symptoms (p=0.030) as well as reduced anxiety scores for females students (p=0.044). These short-term evaluation findings support the positive impact
of school-based social and emotional learning programs, such as MindOut, when designed to be both age and culturally appropriate and delivered to
older adolescents in disadvantaged schools.
Journal of youth and adolescence., :
- Year: 2019
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Other service delivery and improvement
interventions
Sun, D., Reziwan, K., Wang, J., Zhang, J., Cao, M., Wang, X., etal.
OBJECTIVE: Nail biting leads to a variety of health issues. Habit reversal
treatment is a major approach to cease nail biting, but is often ineffective since patients continue to suffer from anxiety, a major trigger. This
study investigated whether the potential anxiety relief provided by auricular acupressure could improve the efficacy of habit reversal treatment, as
evidenced by improved stomatological and other outcomes.\rMETHODS: In a pragmatic, randomized, crossover, pilot clinical trial, 83 nail biters (8-12
years old) received habit reversal treatment in combination with either auricular acupressure intended to reduce anxiety (Method A) or placebo
auricular acupressure (Method B). The alternative protocol was employed after a two-month washout period. The primary outcome measured was the 41-
item child self-reported version of the Screen for Child Anxiety Related Emotional Disorders, while the secondary outcomes were the nail growth
status (NS), which represented the fingernail growth of each finger during habit reversal treatment, simplified plaque index (SPI), and the
simplified gingival index (SGI) as measures of oral health. A paired sample t-test was used to assess the differences between Methods A and B, and
the differences in the anxiety scores, NS, SGI, and SPI between the baseline and each time point.\rRESULTS: Forty-one children successfully completed
both arms of the treatments and attended all appointments. There were significant differences in the efficacy of habit reversal treatment, the
anxiety score, the nail status, and the SGI in favor of Method A (p < 0.001).\rCONCLUSION: Auricular acupressure appears to improve the efficacy of
habit reversal treatment, likely by reducing anxiety.
Journal of Alternative & Complementary
Medicine, 25(1) : 79-85
- Year: 2019
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Acupuncture, acupressure
Dai, Q., Hu, L., Feng,
Z.
Difficulty in clinical antidepressant treatment leads to the pursuit of alternative treatments, such as
cognitive-behavior therapy (CBT). CBT combined with regular antidepressants have indicated an optimal therapeutic effect in clinic. Attentional bias
is important in the occurrence and remission of depression, however, few studies have explored the effect of attentional bias modification (ABM) on
depression, and inconsistent results have been obtained due to the heterogeneity in the targeted populations, training tasks, strategies, and
materials. Hence, the current study aimed to explore the therapeutic effect of ABM on depression in clinical depression. Study I was designed to
explore the optimal training methods regarding task (dot-probe vs. cue-target), material (faces vs. self-referent words), and strategy (mixed ABM
toward positive and away from negative stimuli vs. positive ABM toward positive stimuli) in unselected undergraduates once daily for 10 days (N =
309). Study II was carried out to observe the effect of 10 days ABM toward positive and away from negative faces (based on Study I) on clinical
depression (N = 32). Depression level was assessed via a self-reporting questionnaire and a structured interview, while attentional bias was tested
by cue-target task and attention to positive and negative inventory (APNI). In unselected undergraduates (Study I), two strategies significantly
reduced the self-reporting depression scores: mixed ABM toward positive stimuli and away from negative stimuli with emotional faces, and positive ABM
toward positive materials only with self-referent words. In patients with major depressive disorder (MDD) (Study II), the mixed ABM with emotional
faces resulted in enhanced attentional bias toward happy materials in the cue-target task and APNI, which predicted a delayed depression reduction in
clinical depression at the one-month follow-up investigation. Our finding confirms the literature and broadens the knowledge with the evidence of the
optimal therapeutic effect of ABM combined with regular antidepressants in clinical depression. The findings that a quick enhancement in positive
attentional bias, predicting a later therapeutic effect on clinical depression reduction, indicate a potential mechanism that could underlie the
therapeutic process of ABM in depression. The findings that two training strategies are effective in depression reduction suggest that different
strategies should be utilized to treat different types of depression. This study offers a potential way to cure depression and could be further
practiced in clinic. Copyright © 2018
Journal of
Psychiatric Research, 109 : 145-155
- Year: 2019
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Attention/cognitive bias
modification
Vera, F. M., Manzaneque, J. M., Rodriguez, F. M., Vadillo, M., Navajas, F., Heiniger, A. I., Perez, V., Blanca, M. J.
Qigong is an ancient form of health maintenance, which is part of Traditional China
Medicine. Numerous beneficial mental and physical effects have been classically ascribed to this traditional psychosomatic method. The purpose of
this work has been to assess the effects of Taoist qigong practice on several hormonal parameters of the Hipotalamic-Pituitary-Adrenal axis and
specific measures of psychological well-being in healthy subjects. Forty-three healthy volunteers participated in the study, of whom 22 were randomly
allocated to the experimental group, and 21 were assigned to the control group. Experimental participants underwent a qigong training program for one
month. Blood samples for the quantification of hormonal parameters, and several instruments to assess anxiety and depression symptoms as well as
subjective sleep quality, were obtained before and after the program. Statistically significant differences were found between the experimental and
control groups, with the experimental group showing lower blood levels of adrenocorticotropic hormone (ACTH). This study shows that Taoist qigong is
a psychosomatic method able to exert a modulatory action on ACTH levels in healthy subjects. We consider the need to continue exploring the
psychobiological modulation of this qigong method and its possible repercussion for human health care.
Scandinavian Journal of Psychology, 60(1) : 43-
49
- 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)
Weisz, J.
R., Kuppens, S., Ng, M. Y., Vaughn-Coaxum, R. A., Ugueto, A. M., Eckshtain, D., Corteselli, K.
A.
With the development of empirically
supported treatments over the decades, have youth psychotherapies grown stronger? To investigate, we examined changes over time in treatment effects
for four frequently treated youth mental-health problems: anxiety, depression, attention-deficit hyperactivity disorder (ADHD), and conduct
disorders. We used PubMed and PsycINFO to search for randomized controlled trials (RCTs) that were published between January 1960 and May 2017
involving youths between the ages of 4 and 18 years. We also searched reviews and meta-analyses of youth psychotherapy research, followed reference
trails in the reports we identified, and obtained additional studies identified by therapy researchers whom we contacted. We identified 453 RCTs
(31,933 participants) spanning 53 years (1963-2016). Effect sizes for the problem-relevant outcome measures were synthesized via multilevel meta-
analysis. We tracked temporal trends for each problem domain and then examined multiple study characteristics that might moderate those trends. Mean
effect size increased nonsignificantly for anxiety, decreased nonsignificantly for ADHD, and decreased significantly for depression and conduct
problems. Moderator analyses involving multiple study subgroups showed only a few exceptions to these surprising patterns. The findings suggest that
new approaches to treatment design and intervention science may be needed, especially for depression and conduct problems. We suggest intensifying
the search for mechanisms of change, making treatments more transdiagnostic and personalizable, embedding treatments within youth ecosystems,
adapting treatments to the social and technological changes that alter youth dysfunction and treatment needs, and resisting old habits that can make
treatments unduly skeuomorphic.
Perspectives on Psychological Science : A Journal of the
Association for Psychological Science, 14(2) : 216-237
- Year: 2019
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)