Disorders - Anxiety Disorders
Lo, K., Waterland, J., Todd, P., Gupta, T., Bearman, M., Hassed, C., Keating, J. L.
Effects of interventions for improving mental health of health professional students has
not been established. This review analysed interventions to support mental health of health professional students and their effects. The full
holdings of Medline, PsycINFO, EBM Reviews, Cinahl Plus, ERIC and EMBASE were searched until 15th April 2016. Inclusion criteria were randomised
controlled trials of undergraduate and post graduate health professional students, group interventions to support mental health compared to
alternative education, usual curriculum or no intervention; and post-intervention measurements for intervention and control participants of
mindfulness, anxiety, depression, stress/distress or burnout. Studies were limited to English and short term effects. Studies were appraised using
the PEDro scale. Data were synthesised using meta-analysis. Four comparisons were identified: psychoeducation or cognitive-behavioural interventions
compared to alternative education, and mindfulness or relaxation compared to control conditions. Cognitive-behavioural interventions reduced anxiety
(-0.26; -0.5 to -0.02), depression (-0.29; -0.52 to -0.05) and stress (0.37; -0.61 to -0.13). Mindfulness strategies reduced stress (-0.60; -0.97 to
-0.22) but not anxiety (95% CI -0.21 to 0.18), depression (95% CI -0.36 to 0.03) or burnout (95% CI -0.36 to 0.10). Relaxation strategies reduced
anxiety (SMD -0.80; 95% CI -1.03 to -0.58), depression (-0.49; -0.88 to -0.11) and stress (-0.34; -0.67 to -0.01). Method quality was generally poor.
Evidence suggests that cognitive-behavioural, relaxation and mindfulness interventions may support health professional student mental health. Further
high quality research is warranted.
Advances in health sciences education : theory and practice, 23(2) : 413-
447
- Year: 2018
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Psychoeducation, Mindfulness based
therapy
Salum, G. A., Petersen, C.
S., Jarros, R. B., Toazza, R., Desousa, D., Borba, L. N., etal.
Background: The objective of this study is to assess group differences in symptom reduction between individuals receiving
group cognitive behavioral therapy (G-CBT) and attention bias modification (ABM) compared to their respective control interventions, control therapy
(CT), and attention control training (ACT), in a 2 x 2 factorial design. Method(s): A total of 310 treatment-naive children (7-11 years of age) were
assessed for eligibility and 79 children with generalized, separation or social anxiety disorder were randomized and received G-CBT (n = 42) or CT (n
= 37). Within each psychotherapy group, participants were again randomized to ABM (n = 38) or ACT (n = 41) in a 2 x 2 factorial design resulting in
four groups: G-CBT + ABM (n = 21), G-CBT + ACT (n = 21), CT + ABM (n = 17), and CT + ACT (n = 20). Primary outcomes were responder designation as
defined by Clinical Global Impression-Improvement (CGI-I) scale (<=2) and change on the Pediatric Anxiety Rating Scale (PARS). Result(s): There were
significant improvements of symptoms in all groups. No differences in response rates or mean differences in PARS scores were found among groups: G-
CBT + ABM group (23.8% response; 3.9 points, 95% confidence interval [CI]-0.3 to 8.1), G-CBT + ACT (42.9% response; 5.6 points, 95% CI 2.2-9.0), CT +
ABM (47.1% response; 4.8 points 95% CI 1.08-8.57), and CT + ACT (30% response; 0.8 points, 95% CI-3.0 to 4.7). No evidence or synergic or
antagonistic effects were found, but the combination of G-CBT and ABM was found to increase dropout rate. Conclusion(s): We found no effect of G-CBT
or ABM beyond the effects of comparison groups. Results reveal no benefit from combining G-CBT and ABM for anxiety disorders in children and suggest
potential deleterious effects of the combination on treatment acceptability. Copyright © 2018 Mary Ann Liebert, Inc. publishers.
Journal of Child and Adolescent Psychopharmacology, 28(9) : 620-
630
- Year: 2018
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Attention/cognitive bias
modification
McKinnon, A., Keers, R., Coleman, J. R. I., Lester, K. J., Roberts, S., Arendt, K., etal.
BACKGROUND: Several delivery formats of cognitive behaviour therapy (CBT) for child anxiety have been
proposed, however, there is little consensus on the optimal delivery format. The primary goal of this study was to investigate the impact of the
child's primary anxiety diagnosis on changes in clinical severity (of the primary problem) during individual CBT, group CBT and guided parent-led
CBT. The secondary goal was to investigate the impact of the child's primary anxiety diagnosis on rates of remission for the three treatment
formats. METHOD(S): A sample of 1,253 children (5-12 years; Mage = 9.3, SD = 1.7) was pooled from CBT trials carried out at 10 sites. Children had a
primary diagnosis of generalised anxiety disorder (GAD), social anxiety disorder (SoAD), specific phobia (SP) or separation anxiety disorder (SAD).
Children and parents completed a semistructured clinical interview to assess the presence and severity of DSM-IV psychiatric disorders at
preintervention, postintervention and follow-up. Linear mixture modelling was used to evaluate the primary research question and logistic modelling
was used to investigate the secondary research question. RESULT(S): In children with primary GAD, SAD or SoAD, there were no significant differences
between delivery formats. However, children with primary SP showed significantly larger reductions in clinical severity following individual CBT
compared to group CBT and guided parent-led CBT. The results were mirrored in the analysis of remission responses with the exception that individual
CBT was no longer superior to group CBT for children with a primary SP. The difference between individual and group was not significant when follow-
up data were examined separately. CONCLUSION(S): Data show there may be greater clinical benefit by allocating children with a primary SP to
individual CBT, although future research on cost-effectiveness is needed to determine whether the additional clinical benefits justify the additional
resources required. 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 &
Psychiatry, & Allied Disciplines, 59(7) : 763-772
- Year: 2018
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, Social phobia (social anxiety disorder), Specific
Phobia
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other service delivery and improvement
interventions
Liu,
M., Cao, Y.
Objectives: Recently, there
has been an escalating trend in Chinese adolescents' psychological problems, which include emotional problems such as anxiety, stress and so on. As
predicted by World Health Organization, by 2020 there will be an increase of 50% in the number of adolescents with psychological problems worldwide,
which ranks in the top five causes of adolescents' diseases, disabilities and deaths. Therefore, adolescents' psychological problems demand
immediate attention. As a mind-body exercise, sun-style tai chi chuan originated in China, and is characterized by slow gentle motions including
physical and respiratory movements. Extensive research indicates that Sun-style tai chi chuan is conducive to the mind and body. In addition, if
people do tai chi exercise often, it is also beneficial for people's health as well. This paper aims to investigate the impact of Sun-style tai chi
chuan on college students' anxiety, stress as well as explore the relationship between psychological resilience and anxiety and stress respectively.
Method(s): 50 participants were selected from Zunyi Normal College, Zunyi Medical College. Randomly divided the 50 participants into Tai chi Group
(Sun-style Tai chi chuan) and the Control Group (Health Education) and signed informed consents. The Tai chi Group practices three times a week for
12 weeks (1 hour each time by aerobic exercise) after mastering the basics of Sun-style Tai chi chuan and both two groups could not attend other
exercise but Sun-style tai chi chuan after the intervention. We conducted pre- and post- tests of the two groups by means of the Self-Rating Anxiety
Scale (SAS), Stress Scale for College Students (SSCS) and the Connor-Davidson Resilience Scale (CD-RISC). Result(s): 12-week Sun-style Tai chi chuan
can alleviate college students' stress level, but has no significant difference in easing anxiety. In addition, psychological resilience is
negatively correlated to anxiety and stress respectively. Conclusion(s): The results of the Sun-style Tai chi chuan intervention indicate that it is
beneficial to mitigate college students' stress, but not significantly in anxiety, this may be partially attributed to the short experimental
duration. The experimental results would be more significant if the duration were 24 or 48 weeks. In addition, the result provides certain evidence
that the intervention of other exercise for people suffering from mental problem would be extremely beneficial.
Basic and Clinical Pharmacology and Toxicology, 124 (Supplement
2) : 44
- Year: 2018
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Mind-body exercises (e.g. yoga, tai chi, qigong), Physical activity, exercise
Ismayilova, L., To-Camier, A.
Objective.-Behavioral interventions alone may be insufficient for improving mental health in low-income countries. This study tests the
effects of economic intervention, alone and in combination with a family-focused component, on the mental health of children and women living in
ultra-level poverty. Methods.- Funded by the Network of European Foundations, this three-arm cluster-RCT included 10-15 year-old children and women
from 360 ultra-poor households from twelve villages in Burkina Faso. Villages were randomized (4 villages/120 households per arm) to the wait-list
arm, the economic intervention (Trickle Up/TU arm), or to the economic strengthening plus family coaching component (TU+ arm). Intervention effects
were tested using repeated-measures mixed-effects regressions. Results.- At 12 months, compared to the control arm, mothers from both intervention
groups receiving economic intervention demonstrated a reduction in the PHQ-9 depression score (Cohen's d =-0.67, P = .001 and d =-0.48, P = .005)
and the GAD-7 anxiety score (d =-0.64, P = .001 and d =-0.51, P = .002), maintaining effects at24months. However, only children from theTU+showeda
reduction in depressive symptoms at 12 months (medium effect size d = -0.53, P = .003) and 24 months (d = -0.50, P = .004), compared to the control
condition and the economic intervention alone (at 24 months d = -0.37, P = .041). At 24 months, small effect size improvements in self-esteem were
detected in the TU+ group, compared to the control and TU conditions (d = 0.30 and d = 27, respectively). Trauma symptoms significantly reduced in
the TU+ group at 12 months (IRR = 0.62, P = .042), compared to the control. Conclusion.- Integrating psycho-social intervention involving all family
members with economic empowerment strategies may be an innovative approach for improving emotional well-being among ultra-poor families.
European
Psychiatry, 48 (Supplement 1) : S90
- Year: 2018
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Other service delivery and improvement
interventions
Ozyurt, G., Gencer, O., Ozturk, Y., Ozbek, A.
OBJECTIVES:
Considering the role of parenting in the aetiology and maintenance of anxiety disorders, working with parents is a promising treatment strategy.
Triple P-positive parenting programme is a parent-focused cognitive behaviour therapy. In this study, we aimed to investigate the effectiveness of
Triple P in improvement in childhood anxiety disorders and also to assess its effects on behavioural and emotional problems, general anxiety level,
severity of the disorder, and general psychosocial functioning. Parents' mental health and general well-being were also evaluated. METHOD(S): In
this randomized controlled study, the sample consisted of 74 children, aged between 8 and 12 years, who were diagnosed as anxiety disorder by
Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Life-time Kiddie (K-SADS-PL). Following randomization into two
equal groups, mothers of the first group participated to Group Triple P Programme, while the second group was receiving no treatment. The two groups
were compared right before and after the intervention on rates of anxiety symptoms, emotional, and behavioural variables. RESULT(S): Children's
general anxiety level was significantly lower in the intervention group following Triple P implementation. Behavioural and emotional problems were
also reduced in the intervention group. Parental anxiety and general well-being were not significantly different between two groups. CONCLUSION(S):
It is considered that Triple P may be useful in the treatment of children's anxiety disorder but further studies about Triple P on children's
anxiety disorders are needed. Copyright © 2018, © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
Psychiatry and Clinical Psychopharmacology., 29(4) : 570-
578
- Year: 2018
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Skills training, Other Psychological Interventions
Waldron, S.M., Stallard, P., Grist,
R., Hamilton-Giachritsis, C.
Objective: Previous reviews demonstrate
that universal school-based anxiety prevention programs are generally effective in the short-term, but have not yet provided a clear evaluation of
the longer-term effects. This review focuses exclusively on randomized controlled trials (RCTs) of universal school-based anxiety prevention programs
that included a follow-up at 12-months or beyond. Method: In total, 359 references from previous reviews in the field were screened; PubMed and
PsychInfo were also systematically searched. Eight studies met criteria (each based on cognitive-behavioural principles) comprising 7522 children
aged nine-18 years. Risk of bias in most studies was high, thus a formal meta-analysis was not conducted. Results: Three of the eight studies
reported greater reductions in anxiety symptomology in the prevention group compared to the control group at post-intervention (immediate effect),
and each of these studies also reported maintenance of this effect at 12-month follow-up. Two further studies reported a 'delayed' effect at 12-
month follow-up. All five studies that reported prevention effects were evaluating the FRIENDS program, and estimated effect sizes at 12-months
follow-up varied from 0.2 to 0.69 (Hedges g). The final three studies (evaluating different programs) reported no immediate or long-term effects.
Conclusions: The findings from this review suggest that the effects of some universally delivered school-based anxiety prevention trials can last up
to 12-months, but this may depend on various factors (including program-type). It was not possible to draw firm conclusions regarding the influence
of delivery mode (teacher versus health professional), parent sessions or child booster sessions. Further high quality RCTs with long-term follow-up
periods are needed. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Mental Health and Prevention, 11 : 8-
15
- Year: 2018
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Johnstone, K. M., Kemps, E., Chen, J.
Anxiety and depression are among the most common mental health issues experienced in childhood. Implementing school-based
prevention programs during childhood, rather than adolescence, is thought to provide better mental health outcomes. The present meta-analysis aimed
to investigate the efficacy of universal school-based prevention programs that target both anxiety and depression in children (aged 13 years or
below), and examine three moderators (i.e., program type, primary target of program, and number of sessions) on prevention effects. PsycINFO, PubMED,
and Google Scholar were systematically searched for relevant articles published up to and including January 2018. Fourteen randomised controlled
trials, consisting of 5970 children, met eligibility criteria. Prevention programs led to significantly fewer depressive symptoms at post-program (g
= 0.172) and at long-term follow-up periods (g = 0.180), but not at short-term follow-up. Programs were not found to prevent anxiety symptoms across
any time point. Considerable heterogeneity was observed for all effects. Program type and length were found to moderate the relationship between
prevention program and outcomes. Prevention programs were effective in preventing depressive symptoms at post-program and long-term follow-up, while
no significant preventative effect on anxiety symptoms was observed. The FRIENDS Program and programs which contained a greater number of sessions
showed beneficial effects on anxiety and depressive symptoms. Universal programs aimed at preventing both anxiety and depression in children are
limited. Future research should investigate the long-term evaluation of school-based prevention programs for anxiety and depression in children.
Clinical Child & Family Psychology Review, 21(4) : 466-
481
- Year: 2018
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions
Ponnuthurai, S. A., Brown, J.
Objectives: School-based interventions aiming to intervene early in mental disorder in young people have been
tested since the 1990s. Most previous reviews looked at both targeted and universal interventions; we have only compared randomized controlled trials
of universal interventions, considering them as an implementable preventative intervention at a public health level. We have included other outcomes
of therapy, such as self-esteem, well-being, resilience, and mentalization, to also compare the effectiveness of interventions on outcomes that
appear to be associated with prevention. Method(s): A meta-analysis was performed of universal RCTs of school-based psychological interventions using
CBT, acceptance and commitment therapy (ACT), mindfulness, and interpersonal therapy methodologies. PsycINFO, MEDLINE, and Embase were searched. The
outcome data were analyzed using RevMan 5.3. Result(s): The data on depression are presented as follows: 1) as in the other analyses, there was
evidence of a significant small effect on symptoms of depression for the interventions as a whole; and 2) this effect was maintained after 12 months
overall. The data on anxiety are presented as follows: 1) overall, the effect on anxiety symptoms was also small; and 2) this small effect was
slightly better maintained with anxiety >= 12 months after intervention (d = 0.17 in anxiety compared with d = 0.12 with depressive symptoms).
Secondary outcomes are indicated as follows: 1) no trial-measured outcomes of interventions have been associated with relapse prevention (eg, meta-
cognition or mentalization); and 2) only one trial measured other markers of recovery, such as well-being. Conclusion(s): 1) Universal school-based
interventions appear to have a small but significant effect on depression and anxiety symptoms that are maintained >=12 months postintervention,
although the amount of long-term data is small. 2) Possible markers of treatment effectiveness against relapse and of recovery, such as meta-
cognition and self-esteem, are not being monitored as outcomes. 3) Other factors, such as age and type of intervention, were also involved. For
example, mindfulness and use of a facilitator, who was a nonteacher with some education or training in mental health, appear significant in terms of
the effectiveness of these interventions. 4) Trial quality was low overall. Further trials with large sample groups, using attention control groups
as their control with a longer period of follow-up, are needed. EBP, PUP, SC Copyright © 2018
Journal of the American Academy of Child and Adolescent Psychiatry, 57 (10
Supplement) : S189
- Year: 2018
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Interpersonal therapy (IPT), Mindfulness based
therapy, Acceptance & commitment therapy
(ACT)
Kohut, S. A., Jelen, A., Ruskin, D., Stinson, J.
Context Mindfulness-based interventions (MBIs) have emerged as a promising
strategy for individuals with chronic health conditions, given their versatility in targeting both physical and mental health outcomes. However,
research to date has focused on adult or community-based populations. Yet, a recent meta-analysis revealed that MBIs are 3 times more impactful for
clinical versus nonclinical pediatric populations and are particularly helpful for internalizing symptoms (eg, depression, anxiety). Objective To
summarize and critically appraise the available literature on the feasibility and effectiveness of MBIs for clinical samples of youth diagnosed with
internalizing disorders (eg, anxiety, depression, posttraumatic stress). Design A systematic review of the literature with electronic searches
conducted by a library information specialist familiar with the feld using EMBASE, PsycINFO, MEDLINE, CINAHL, Web of Science, and EBM Reviews
databases. Two reviewers independently selected articles for review and extracted data. Results Of a total of 4710 articles, 5 articles met inclusion
criteria. Study designs were primarily randomized controlled trials with 1 prospective pre-post intervention study. Sample sizes varied across
studies from 24 to 102 participants. No studies included inpatient participants or participants with comorbid internalizing and physical disorders.
The MBIs included in this review were primarily group-based and did not offer remote or online options. All MBIs were feasible, and studies
consistently found that following MBI completion, youth reported considerable improvements in internalizing symptoms (eg, anxiety, depression,
posttraumatic stress).Conclusion Mindfulness-based interventions are a promising approach to coping with internalizing symptomsin youth. Clinical
populations of youth are an essential sample to target for future work in mindfulness owing to the substantial impairment in quality of life and
function related to living with mental illness. Future research with rigorous study design is warranted to determine definitive treatment
effectiveness of MBIs for internalizing symptoms.
Canadian Family Physician, 64 (2 Supplement
1) : S79
- Year: 2018
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Mindfulness based
therapy
Rasing, S. P. A., Creemers, D. H. M., Vermulst, A. A., Janssens,
J. M. A. M., Engels, R. C. M. E., Scholte, R. H. J.
A randomized controlled trail was conducted to examine the effectiveness of a depression and anxiety
prevention program 'Een Sprong Vooruit' (A Leap Forward) among adolescent girls with a high familial risk (N = 142). The results showed neither
effects of the prevention program directly after the intervention, nor at 6 or 12 months follow-up on depression and anxiety symptoms. Further,
latent growth curve modeling (LGCM) was used to examine whether the growth functions for the intervention and the control condition were different.
The slope representing the change in depression symptoms was not significantly different between the intervention and the control condition. For
anxiety symptoms, the difference between slopes was also not significant. Based on these results, we suggested that these high-risk adolescent girls
might benefit more from a more intensive prevention program. Copyright © 2018 by the authors. Licensee MDPI, Basel, Switzerland.
International Journal of Environmental Research
and Public Health, 15 (7) (no pagination)(1457) :
- 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)
Leung, B., Takeda,
W., Holec, V.
Aim: This
pilot study investigated the use of acupuncture in the treatment of paediatric anxiety. Method(s): Children with anxiety, aged 8-16, were randomised
to either the acupuncture or waitlist control groups. Anxiety was measured using the Hamilton Anxiety Rating Scale (HAM-A) for children and
adolescents with generalised anxiety disorder and Multidimensional Anxiety Scale for Children 2nd Edition (MASC-2) self-rated and parent-rated forms.
Result(s): Twenty participants were enrolled in the study and 19 completed all the questionnaires to be included in the analysis. There were no
differences in socio-demographic characteristics at baseline between the two groups. At the second assessment, the mean MASC-parent score for the
acupuncture group was significantly lower than the waitlist group (65.6 (SD 15.0) compared to 81.0 (SD 11.9), P = 0.025) with an effect size = 1.13.
The pre- and post-treatment comparisons were also significantly lower for both groups in the anxiety measures. In the acupuncture group, MASC-parent
(P = 0.008, effect size 0.75) and the HAM-A (P < 0.001, effect size 1.4). In the waitlist group, MASC-self (P = 0.022; effect size 0.4), MASC-parent
(P = 0.048; effect size 0.75) and HAM-A (P = 0.007; effect size 1.21). Conclusion(s): This study provided promising results on the potential use of
acupuncture to treat children and adolescents with general anxiety. Future research using a randomised control trial with a sufficient sample size to
control for confounders and sham (placebo) comparators is warranted. Copyright © 2018 Paediatrics and Child Health Division (The Royal Australasian
College of Physicians)
Journal of Paediatrics and Child
Health, 54(8) : 881-888
- Year: 2018
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Acupuncture, acupressure