Disorders - Anxiety Disorders
Dear, B.
F., Fogliati, V. J., Fogliati, R., Johnson, B., Boyle, O., Karin, E., Gandy, M., Kayrouz, R., Staples, L. G., Titov, N.
Background: Internet-delivered cognitive behaviour therapy may increase access by young adults to evidence-
based treatments for anxiety and depression. Objective: The aim of this study was to compare the efficacy of an Internet-delivered cognitive
behaviour therapy intervention designed for adults aged 18-24 years, when delivered in clinician-guided versus self-guided formats. Design: The
intervention, the Mood Mechanic Course, is a transdiagnostic treatment that simultaneously targets symptoms of anxiety and depression using cognitive
and behavioural skills. The brief intervention comprised four lessons, delivered over 5 weeks. Following a brief telephone interview, young adults (n
= 191) with symptoms of anxiety and depression were randomly allocated to either (1) clinician-guided treatment (n = 96) or (2) self-guided treatment
(n = 95). Results: At post treatment, large reductions (average improvement; clinician guided vs self-guided) were observed in symptoms of anxiety
(44% vs 35%) and depression (40% vs 31%) in both groups. Significant improvements were also observed in general psychological distress (33% vs 29%),
satisfaction with life (18% vs 15%) and disability (36% vs 29%). No marked or consistent differences in clinical outcomes emerged between conditions
at post-treatment, at 3-month or 12-month follow-up. Satisfaction was high with both treatment formats, but slightly higher for clinician-guided
treatment. Conclusion: These results indicate the potential of carefully developed Internet-delivered cognitive behaviour therapy interventions for
young adults with anxiety and depression provided in either self or therapist-guided format. Further large-scale research is required to determine
the short- and long-term advantages and disadvantages of different models of support. Copyright © 2017, The Royal Australian and New Zealand College
of Psychiatrists 2017.
Australian and New Zealand Journal of Psychiatry, 52(7) : 668-
679
- Year: 2018
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Self-help, Technology, interventions delivered using technology (e.g. online, SMS)
De-Voogd,
L., Wiers, R. W., De-Jong, P. J., Zwitser, R. J., Salemink, E.
Introduction Negatively biased interpretations play an important role in anxiety and depression, which are highly prevalent in
adolescence, and changing such biases might thus reduce or prevent emotional disorders. We investigated the short- and long-term effects of an online
interpretation bias modification training in unselected adolescents to explore its potential in preventing anxiety and depression. Methods
Participants (N = 173) were randomly allocated to eight online sessions of interpretation or placebo training. Interpretation bias was assessed pre-
and post-training. Primary outcomes of anxiety and depression, and secondary measures of emotional resilience were assessed pre- and post-training
and at three, six, and twelve months follow-up. Results Compared to placebo, interpretation training marginally increased positive interpretations.
Irrespective of training condition, symptoms of anxiety and depression showed a decline post-training and at follow-up, and indices of resilience
showed an increase. Change in interpretation bias, baseline interpretation bias, stressful life events, or number of training sessions completed did
not moderate the effects on anxiety or depression. Conclusions Results suggest that interpretation training as implemented in this study has no added
value in reducing symptoms or enhancing resilience in unselected adolescents. Copyright © 2018 de Voogd 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, 13 (3) (no
pagination)(e0194274) :
- Year: 2018
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Attention/cognitive bias
modification, Technology, interventions delivered using technology (e.g. online, SMS)
Grol,
M., Schwenzfeier, A. K., Stricker, J., Booth, C., Temple-McCune, A., Derakshan, N., Hirsch, C., Becker, E., Fox, E.
Worry refers to the experience of uncontrollable
negative thoughts. Cognitive models suggest that the combination of negative information processing biases along with diminished attentional control
contribute to worry. In the current study we investigate whether promoting a) adaptive interpretation bias and b) efficient deployment of attentional
control would influence the tendency to worry. Worry-prone individuals (n = 60) received either active cognitive bias modification for interpretation
bias (CBM-I) combined with sham working memory training (WMT), adaptive WMT combined with sham CBM-I, or sham WMT combined with sham CBM-I. Neither
of the active training conditions reduced worry during a breathing focus task relative to the control condition. However, when considering inter-
individual differences in training-related improvements, we observed a relation between increases in positive interpretation bias and a decrease in
negative intrusions. Moreover, increases in working memory performance were related to a reduction in reactivity of negative intrusions to a worry
period. Our findings show that facilitating a more benign interpretation bias and improving working memory capacity can have beneficial effects in
terms of worry, but also highlight that transfer related gains from existing training procedures can be dependent upon improvement levels on the
training task. Copyright © 2018 Elsevier Ltd
Behaviour Research and Therapy, 103 : 1-11
- Year: 2018
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions, Attention/cognitive bias
modification
Hakamata, Y., Mizukami, S., Komi, S., Sato, E., Moriguchi, Y., Motomura,
Y., Maruo, K., Izawa, S., Kim, Y., Hanakawa, T., Inoue,
Y., Tagaya, H.
Introduction: Attentional
bias modification (ABM) alleviates anxiety by moderating biased attentional processing toward threat; however, its neural mechanisms remain unclear.
We examined how ABM changes functional connectivity (FC) and functional network measures, leading to anxiety reduction. Method(s): Fifty-four healthy
anxious individuals received either ABM or sham training for 1 month in a double-blind randomized controlled trial. Anxious traits, attentional
control, and attentional bias were assessed. Thirty-five participants completed resting-state functional magnetic resonance imaging (MRI) scans
before and after training. Result(s): ABM significantly mitigated an anxious traits regarding physical stress vulnerability (eta2 = 0.12,
p = 0.009). As compared to sham training, ABM significantly strengthened FC between the pulvinar and transverse gyrus along the temporoparietal
junction (T = 3.90, FDR-corrected p = 0.010), whereas it decreased FC between the postCG and ventral fronto-parietal network (vFPN)
regions such as the anterior insula and ventrolateral prefrontal cortex (all T <= - 3.19, FDR-corrected p <= 0.034). Although ABM
diminished network measures of the postcentral gyrus (postCG) (all T <= - 4.30, FDR-corrected p <= 0.006), only the pulvinar-related FC
increase was specifically correlated with anxiety reduction (r = - 0.46, p = 0.007). Limitation(s): Per-protocol analysis and reduced sample size in
MRI analysis. Conclusion(s): ABM might augment the pulvinar's control over vFPN to maintain endogenous attention to a behavioral goal, while
diminishing the information exchanges of the postCG with vFPN to inhibit the capture of exogenous attention by potential threats. The pulvinar might
play a critical role in ABM anxiolytic efficacy. Copyright © 2018 Elsevier B.V.
Journal of Affective Disorders, 238 : 472-
481
- Year: 2018
- 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
Hancock, K. M., Swain, J., Hainsworth, C. J., Dixon, A. L., Koo, S., Munro, K.
Acceptance and Commitment Therapy (ACT) has a growing
empirical base in the treatment of anxiety among adults and children with other concerns. This study reports on the main outcomes of a randomized
controlled trial of ACT and traditional cognitive behavioral therapy (CBT) in children with a Diagnostic and Statistical Manual of Mental Disorders
(4th ed.) anxiety disorder. Participants were 193 children from urban Sydney, Australia, who were block-randomized to a 10-week group-based program
of ACT or CBT or a 10-week waitlist control (WLC). Completers included 157 children (ACT = 54, CBT = 57, WLC = 46; M = 11 years, SD = 2.76; 78%
Caucasian, 58% female). Pretreatment, posttreatment, and 3 months posttreatment assessments included clinician/self/parent-reported measures of
anxiety, quality of life (QOL; anxiety interference, psychosocial and physical health-related QOL), and acceptance/defusion outcomes. Completer and
intention-to-treat analyses revealed that ACT and CBT were both superior to WLC across outcomes, reflecting statistically and clinically significant
differences, with gains maintained at 3 months posttreatment. Both completer and intention-to-treat analyses found ACT and CBT to produce similar
outcomes. There was some support for ACT having greater effect sizes for QOL outcomes but not for avoidance/fusion. Although this study does not
suggest that ACT is equivalent to CBT or should be adopted in its place, it does provide evidence that ACT might be another empirically supported
treatment option for anxious youth. Further research is needed to replicate these findings. (PsycINFO Database Record (c) 2018 APA, all rights
reserved)
Journal of Clinical Child & Adolescent Psychology, 47(2) : 296-
311
- 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), Acceptance & commitment therapy
(ACT)
Hunt, M., Al-Braiki, F., Dailey, S., Russell, R., Simon, K.
Mindfulness-
based stress reduction (MBSR) can help college students cope effectively with stress, reducing negative affect in the short term and resulting in
higher (more adaptive) heart rate variability (HRV). However, HRV is a measure of cardiovascular fitness, as well as parasympathetic control of the
stress response. MBSR is a multicomponent intervention and it is unclear to what extent movement, including gentle yoga, mindfulness training, or the
synergy between the two, has an impact on emotional and physiological outcomes. The current study dismantled yoga and explicit mindfulness training
in a brief stress reduction intervention in college students. Participants were randomly assigned to either mindfulness training and meditation alone
(no movement); yoga alone (no explicit mindfulness training); combined yoga and mindfulness training and meditation; an active placebo control
consisting of study breaks with party games, access to a therapy dog, and healthful snacks; or a no-treatment control. All active treatments resulted
in decreases in anxiety and dysphoria over the 4 weeks of treatment relative to the no-treatment control, although by week 4, only the combined and
yoga groups were significantly different from the control group on both measures. The no-treatment control group showed the lowest HRV at rest and
during the challenge. The combined and yoga groups showed the highest HRV at rest, followed by moderate declines in HRV during the challenge,
suggesting adaptive vagal withdrawal. The mindfulness training alone group was the only group to show no decrease in HRV during the challenge,
suggesting that they were the least stressed by the challenge. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Mindfulness, 9(2) : 512-520
- Year: 2018
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Mindfulness based
therapy, Mind-body exercises (e.g. yoga, tai chi, qigong)
Liu, P., Taber-Thomas, B. C., Fu,
X., Perez-Edgar, K. E.
Objective: Children with behavioral inhibition, a temperament characterized by biologically based
hypervigilance to novelty and social withdrawal, are at high risk for developing anxiety. This study examined the effect of a novel attention
training protocol, attention bias modification (ABM), on symptomatic, behavioral, and neural risk markers in children with behavioral inhibition.
Method(s): Nine- to 12-year-old typically developing children identified as having behavioral inhibition (N = 84) were assigned to a 4-session active
ABM training (n = 43) or placebo protocol (n = 41) using a double-blinded, randomized, controlled trial approach. Anxiety symptoms (Diagnostic
Interview Schedule for Children-Fourth Edition), attention bias (AB; measured by a dot-probe task; AB = incongruent reaction time - congruent
reaction time), and AB-related neural activation (measured by functional magnetic resonance imaging activation for the incongruent > congruent
contrast in the dot-probe task) were assessed before and after the training sessions. Result(s): Results showed that active ABM (n = 40)
significantly alleviated participants' symptoms of separation anxiety, but not social anxiety, compared with the placebo task (n = 40); ABM did not
modify behavioral AB scores in the dot-probe task; and at the neural level, active ABM (n = 15) significantly decreased amygdala and insula
activation and increased activation in the ventrolateral prefrontal cortex compared with placebo (n = 19). Conclusion(s): These findings provide
important evidence for ABM as a potentially effective protective tool for temperamentally at-risk children in a developmental window before the
emergence of clinical disorder and open to prevention and intervention. Clinical trial registration information-Attention and Social Behavior in
Children (BRAINS); http://clinicaltrials.gov/; NCT02401282. Copyright © 2017 American Academy of Child and Adolescent Psychiatry
Journal of the American Academy of Child & Adolescent Psychiatry, 57(2) : 103-
110
- Year: 2018
- 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
Lopresti, A. L., Drummond, P. D., Inarejos-Garcia, A. M., Prodanov, M.
Background: Saffron has antidepressant and anxiolytic effects
in adults with mild-to-moderate depression. However, this is the first study examining its mood-related effects in teenagers. Methods: In this 8-
week, randomised, double-blind, placebo-controlled study, youth aged 12-16 years, with mild-to-moderate anxiety or depressive symptoms were given
tablets containing placebo or a saffron extract (affron, 14 mg b.i.d). The youth and parent versions of the Revised Child Anxiety and Depression
Scale (RCADS) were used as outcome measures. Results: 80 participants were enrolled and 68 completed the study. Based on youth self-reports, affron
was associated with greater improvements in overall internalising symptoms (p = 0.049), separation anxiety (p = 0.003), social phobia (p = 0.023),
and depression (p = 0.016). Total internalising scores decreased by an average of 33% compared to 17% in the placebo group (p = 0.029). However,
parental reports of improvements were inconsistent as mean improvements in RCADS scores were greater in the saffron group (40% vs 26%) (p = 0.026),
although no other significant differences were identified. affron was well-tolerated and there was a trend of reduced headaches in participants on
the active treatment. Limitations: The use of a self-report instrument, limited study duration, single treatment dose, and non-clinical sample used
in this study limit the generalisability of study findings. Conclusion: The administration of a standardised saffron extract (affron) for 8 weeks
improved anxiety and depressive symptoms in youth with mild-to-moderate symptoms, at least from the perspective of the adolescent. However, these
beneficial effects were inconsistently corroborated by parents. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Journal of Affective Disorders, 232 : 349-
357
- Year: 2018
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Homeopathic, plant-based medicines
Mason, J. E., Asmundson, G. J. G.
Interventions that reduce anxiety sensitivity (AS) may have far reaching benefits for the prevention
and treatment of mental disorders. Exercise, even when limited to a single session, appears to be an efficacious intervention for reducing AS. This
effect has been largely examined using moderate intensity continuous (i.e., without rest) training (MICT). High intensity exercise protocols, such as
sprint interval training (SIT), have not been investigated as a strategy for reducing AS or related constructs. We examined the effects of a single
session of either SIT or MICT on AS, distress tolerance (DT), and intolerance of uncertainty (IU). A total of 56 participants were randomized into
either a 50-min MICT group, a 10-min SIT group, or a waitlist control group. AS, DT, and IU were measured at baseline, post-exercise session, and at
3-day and 7-day follow-ups. Both exercise groups experienced similar reductions in AS; however, these changes appeared attributable to reductions
across different AS dimensions. Specifically, significant reductions in the AS Physical Concerns were noted in the SIT group whereas the MICT group
experienced significant reductions in both the AS Social and Cognitive Concerns dimensions. Both DT and IU were not changed by either exercise
protocol. These findings suggest that exercise protocols varying in intensity and duration can reduce AS. This knowledge could help contribute to the
optimization of exercise strategies for reducing AS. Furthermore, as lack of time is frequently reported as a barrier to exercising regularly,
findings that SIT reduces overall AS to a similar extent as MICT in a fraction of the time, could inform both research and practice aimed at
increasing adherence to exercise protocols for psychological wellbeing. Copyright © 2018 Elsevier Ltd
Mental Health & Physical Activity, 14 : 103-112
- Year: 2018
- 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
Nematolahi, P., Mehrabani, M., Karami-Mohajeri, S., Dabaghzadeh, F.
OBJECTIVE: To evaluate the effects of oral rosemary on memory performance,
anxiety, depression, and sleep quality in university students.\rMETHODS: In this double-blinded randomized controlled trial, the 68 participating
students randomly received 500 mg rosemary and placebo twice daily for one month. Prospective and retrospective memory performance, depression,
anxiety and sleep quality of the students were measured using Prospective and Retrospective Memory Questionnaire, Hospital Anxiety and Depression
Scale, and Pittsburgh Sleep Quality Inventory at baseline and after one month.\rRESULTS: The scores of all the scales and subscales except the sleep
latency and sleep duration components of Pittsburgh Sleep Quality Inventory were significantly decreased in the rosemary group in comparison with the
control group after one month.\rCONCLUSIONS: Rosemary as a traditional herb could be used to boost prospective and retrospective memory, reduce
anxiety and depression, and improve sleep quality in university students.
Complementary Therapies in Clinical Practice, 30 : 24-28
- Year: 2018
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Homeopathic, plant-based medicines
Putwain, D. W., Pescod, M.
The aim of the study
was to conduct a randomized control trial of a targeted, facilitated, test anxiety intervention for a group of adolescent students, and to examine
the mediating role of uncertain control. Fifty-six participants (male = 19, white = 21, mean age = 14.7 years) were randomly allocated to an early
intervention or wait-list control group. Participants completed the Revised Test Anxiety Scale and the Uncertain Control Scale from the Motivation
and Engagement Scale at baseline, after the early intervention group had received the intervention, and again, after the wait-list control group had
received the intervention. Participants showed moderate to large reductions in the worry and tension components of test anxiety, and uncertain
control, after the intervention. The reduction in worry and tension was partially mediated by the reduction in uncertain control. Findings contribute
to the evidence base for test anxiety interventions designed for school age populations and highlight uncertain control as an important factor in
test anxiety intervention. (PsycINFO Database Record (c) 2019 APA, all rights reserved) Impact Statement Impact and Implications-This study uses a
robust design to show that it is possible to reduce the anxiety associated with high-stakes tests in secondary school students. One key factor in
reducing testing anxiety is increasing student's sense of being in control. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
School Psychology Quarterly, 33(2) : 283-
292
- Year: 2018
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Service Delivery & Improvement, Other Psychological Interventions, Relaxation, Technology, interventions delivered using technology (e.g. online, SMS)
Salari, E., Shahrivar, Z., Mahmoudi-Gharaei, J., Shirazi, E., Sepasi, M.
Objective: Parents play an
important role in development and continuation of anxiety disorders in children. Yet the evidence on parent contribution in cognitive behavioral
therapy (CBT) for childhood anxiety is limited. This open randomized trial examined the effectiveness of a parent-directed group CBT to manage
children with anxiety disorders. Method: Parents of 42 children aged 6-12 with primary anxiety disorders were allocated to a six, two-hour weekly
intervention and a wait-list (WL) control. The Revised Children's Manifest Anxiety, Children's Depression Inventory, Strengths and Difficulties
Questionnaire-Home Version, Depression-Anxiety-Stress Scale, Children Global Assessment Scale, and Global Relational Assessment of Functioning were
used to assess children's and parents' functioning and emotional symptoms. Parents completed consumer satisfaction questionnaire. Results: Parents
in the CBT group reported significant improvement in their depressive symptoms (p=0.006) and the family functioning (p=0.04), as well as reduction in
children's emotional symptoms (p=0.007). Clinician rating of children's functioning showed significant improvement in the CBT group(p=0.001). There
was no significant difference in children rating of their anxiety within groups from pre- to post-intervention. Parents were satisfied mostly with
the intervention. Conclusion: A brief parent-only CBT based intervention can be effective in the management of childhood anxiety. Copyright © 2018,
Canadian Academy of Child and Adolescent Psychiatry. All rights reserved.
Journal of the Canadian Academy of Child and Adolescent Psychiatry, 27(2) : 130-
136
- 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), Other Psychological Interventions