Disorders - Anxiety Disorders
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)
McMakin, D. L., Ricketts, E.
J., Forbes, E. E., Silk, J. S., Ladouceur, C. D., Siegle, G. J., Milbert, M., Trubnick, L., Cousins, J. C., Ryan, N. D., Harvey, A. G., Dahl, R. E.
Sleep disturbance is prevalent in anxious youth and prospectively predicts poor emotional adjustment in
adolescence. Study 1 examined whether anxiety treatment improves subjective and objective sleep disturbance in anxious youth. Study 2 examined
whether a sleep intervention called Sleeping TIGERS can further improve sleep following anxiety treatment. Study 1 examined 133 youth (ages 9-14; 56%
female; 11% ethnic/racial minority) with generalized, social, or separation anxiety over the course of anxiety treatment (cognitive behavioral
treatment or client-centered treatment). Sleep-related problems (parent-, child-report) and subjective (diary) and objective (actigraphy) sleep
patterns were assessed across treatment in an open trial design. Study 2 included 50 youth (ages 9-14; 68% female; 10% ethnic/racial minority) who
continued to report sleep-related problems after anxiety treatment and enrolled in an open trial of Sleeping TIGERS. Pre- and postassessments
duplicated Study 1 and included the Focal Interview of Sleep to assess sleep disturbance. Study 1 demonstrated small reductions in sleep problems and
improvements in subjective sleep patterns (diary) across anxiety treatment, but outcomes were not deemed clinically significant, and 75% of youth
stayed above clinical cutoff. Study 2 showed clinically significant, large reductions in sleep problems and small changes in some subjective sleep
patterns (diary). Anxiety treatment improves, but does not resolve, sleep disturbance in peri-pubertal youth, which may portend risk for poor
emotional adjustment and mental health. The open trial provides preliminary support that Sleeping TIGERS can improve sleep in anxious youth to a
clinically significant degree.
Journal of Clinical Child & Adolescent Psychology, 48(Supplement1) : S284-
S297
- Year: 2019
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions
Melvin, G. A., Gordon, M. S.
Cognitive-behavioral therapy (CBT) is an evidence-based treatment for school refusal. However, some youth do not respond to CBT. The serious
risks associated with school nonattendance call for novel approaches to help those who do not respond to CBT. Because school refusal is commonly
associated with anxiety disorders, and the combination of CBT and antidepressant medication enhances outcomes in the treatment of anxiety disorders,
combined treatment may be effective for school refusal. This narrative review evaluates the current evidence base for adding antidepressant treatment
to CBT for school refusal. Six randomized controlled trials (RCTs), two open trials, six case studies/series, and one observational study were
identified and reviewed. There is support for combined CBT and imipramine, but this medication is not typically used due to the risk of concerning
side effects. Two recent RCTs failed to provide evidence for the superiority of combined CBT and fluoxetine. Further research in this area is
required because the extant studies have a number of methodological limitations. Recommendations are provided for clinicians who consider prescribing
antidepressant medication or referring for adjunctive antidepressant treatment for school refusal. Copyright © 2018
Cognitive and Behavioral Practice, 26(1) : 107-
118
- Year: 2019
- Problem: Anxiety Disorders (any), Specific
Phobia
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Antidepressants
(any), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Beloe, P., Derakshan, N.
Adolescents can be at heightened risk for anxiety and depression, with accumulating research reporting on associations between anxiety
and depression and cognitive impairments, implicating working memory and attentional control deficits. Several studies now point to the promise of
adaptive working memory training to increase attentional control in depressed and anxious participants and reduce anxiety and depression symptoms,
but this has not been explored in a non-clinical adolescent population. The current study explored the effects of adaptive dual n-back working memory
training on sub-clinical anxiety and depression symptomology in adolescents. Participants trained on either an online adaptive working memory task or
non-adaptive control task for up to 20 days. Primary outcome measures were self-reported anxiety and depression symptomology, before and after
intervention, and at 1-month follow-up. Self-reported depression (p = .003) and anxiety (p = .04) decreased after training in the adaptive n-back
group relative to the non-adaptive control group in the intention-to-treat sample (n = 120). These effects were sustained at follow-up. Our findings
constitute proof of principle evidence that working memory training may help reduce anxiety and depression vulnerability in a non-clinical adolescent
population. We discuss the findings' implications for reducing risk of internalising disorders in youth and the need for replication. This article
is protected by copyright. All rights reserved.
Developmental
Science, : e12831
- Year: 2019
- Problem: Anxiety Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Attention/cognitive bias
modification
Calear, A. L.
Objectives: This presentation will test the effectiveness of 2 universal online, self-directed CBT
programs in preventing and reducing symptoms of depression and anxiety in an adolescent school-based population. Method(s): Two cluster RCTs were
conducted. In the first trial (n = 1477), the MoodGYM program was compared with a wait-list control condition and delivered over 5 weeks to
adolescents aged 12-17 years. The second trial (n = 540) was also implemented over 5 weeks to adolescents aged 15-16 years, evaluating SPARX-R
against an attention control condition. Both trials measured depressive and anxiety symptom outcomes at preintervention, postintervention, and at 6
months follow-up and were analyzed using mixed-model repeated measure intention-to-treat approaches. Result(s): At postintervention and 6 months
follow-up, the MoodGYM program was found to have a significant effect on anxiety for both males and females (Cohen's d = 0.15-0.25) and on
depression for males only (d = 0.27-0.43). The SPARX-R program had a significant effect on depression, but not anxiety, at postintervention and at 6
months follow-up (d = 0.13-0.29). Greater adherence to the MoodGYM program was indicative of stronger intervention effects, with improved adherence
associated with being in year 9 (ages 14-15 years), living in a rural location, and/or having higher preintervention levels of depressive symptoms or
self-esteem. Conclusion(s): Although small to moderate, the effects obtained in the current studies provide support for the use of universal online
prevention programs for depression in schools. Future research into methods to increase adherence and engagement with online programs is needed. DDD,
TVM, CBT Copyright © 2018
Journal of the American Academy of Child and Adolescent Psychiatry, 57 (10
Supplement) : S35
- Year: 2018
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Technology, interventions delivered using technology (e.g. online, SMS)
Saoji, A. A., Raghavendra, B. R., Madle, K., Manjunath, N.
K.
BACKGROUND AND OBJECTIVE:
The practice of yoga is associated with enhanced psychological wellbeing. The current study assessed the correlation between the duration of yoga
practice with state mindfulness, mind-wandering and state anxiety. Also, we examined if an additional 20 min of yoga breathing with intermittent
breath holding (experimental group) for 8 weeks would affect these psychological variables more than regular yoga practice (control group) alone.
\rMETHODS: One hundred sixteen subjects were randomly assigned to experimental (n = 60) and control (n = 56) groups. State mindfulness attention
awareness scale (SMAAS), Mind-Wandering Questionnaire (MWQ) and State anxiety inventory were administered at baseline and at the end of 8 weeks.
\rRESULTS: Baseline assessment revealed a positive correlation between duration of yoga practice with SMAAS scores and negative correlation with MWQ
and state anxiety scores. At the end of 8 weeks, both groups demonstrated enhanced psychological functions, but the experimental group receiving
additional yoga breathing performed better than the group practicing yoga alone.\rCONCLUSION: An additional practice of yoga breathing with
intermittent breath holding was found to enhance the psychological functions in young adult yoga practitioners.
Explore: The Journal of Science & Healing, 14(5) : 379-
384
- Year: 2018
- 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)
Bettis, A. H., Forehand, R., Sterba, S. K., Preacher, K. J., Compas, B.
E.
The current study examined effects of a preventive intervention on patterns of change in symptoms of anxiety and
depression in a sample of children of depressed parents. Parents with a history of depression (N = 180) and their children (N = 242; 50% female; Mage
= 11.38; 74% Euro-American) enrolled in an intervention to prevent psychopathology in youth. Families were randomized to a family group cognitive
behavioral intervention (FGCB) or a written information (WI) control condition. Parents and youth completed the Child Behavior Checklist and Youth
Self Report at baseline, 6-, 12-, 18-, and 24-month follow up. Youth in the FGCB intervention reported significantly greater declines in symptoms of
both anxiety and depression at 6, 12, and 18 months compared to youth in the WI condition. Youth with higher baseline levels of each symptom (e.g.,
anxiety) reported greater declines in the other symptom (e.g., depression) from 0 to 6 months in the FGCB intervention only. Changes in anxiety
symptoms from 0 to 6 months predicted different patterns of subsequent changes in depressive symptoms from 6 to 12 months for the two conditions,
such that declines in anxiety preceded and predicted greater declines in depression for FGCB youth but lesser increases in depression for WI youth.
Findings inform transdiagnostic approaches to preventive interventions for at-risk youth, suggesting that both initial symptom levels and initial
magnitude of change in symptoms are important to understand subsequent patterns of change in response to intervention.
Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent
Psychology, American Psychological Association, Division 53, 47(4) : 581-
594
- Year: 2018
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Psychoeducation, Skills training