Disorders - Anxiety Disorders
Dray, J., Bowman, J., Campbell, E., Freund, M., Wolfenden, L., Hodder, R. K., McElwaine, K., Tremain, D., Bartlem, K., Bailey, J., Small, T., Palazzi, K., Oldmeadow, C., Wiggers, J.
Objective To examine the effect of universal, school-based,
resilience-focused interventions on mental health problems in children and adolescents. Method Eligible studies were randomized controlled trials
(RCTs) of universal, school-based interventions that included strategies to strengthen a minimum of 3 internal resilience protective factors, and
included an outcome measure of mental health problems in children and adolescents aged 5 to 18 years. Six databases were searched from 1995 to 2015.
Results were pooled in meta-analyses by mental health outcome (anxiety symptoms, depressive symptoms, hyperactivity, conduct problems, internalizing
problems, externalizing problems, and general psychological distress), for all trials (5-18 years). Subgroup analyses were conducted by age (child:
5-10 years; adolescent: 11-18 years), length of follow-up (short: post-<=12 months; long: >12 months), and gender (narrative). Results A total of 57
included trials were identified from 5,984 records, with 49 contributing to meta-analyses. For all trials, resilience-focused interventions were
effective relative to a control in reducing 4 of 7 outcomes: depressive symptoms, internalizing problems, externalizing problems, and general
psychological distress. For child trials (meta-analyses for 6 outcomes), interventions were effective for anxiety symptoms and general psychological
distress. For adolescent trials (meta-analyses for 5 outcomes), interventions were effective for internalizing problems. For short-term follow-up,
interventions were effective for 2 of 7 outcomes: depressive symptoms and anxiety symptoms. For long-term follow-up (meta-analyses for 5 outcomes),
interventions were effective for internalizing problems. Conclusion The findings may suggest most promise for using universal resilience-focused
interventions at least for short-term reductions in depressive and anxiety symptoms for children and adolescents, particularly if a cognitive-
behavioral therapy-based approach is used. The limited number of trials providing data amenable for meta-analysis for some outcomes and subgroups,
the variability of interventions, study quality, and bias mean that it is not possible to draw more specific conclusions. Identifying what
intervention qualities (such as number and type of protective factor) achieve the greatest positive effect per mental health problem outcome remains
an important area for future research. Systematic review protocol and registration Systematic Review of Universal Resilience Interventions Targeting
Child and Adolescent Mental Health in the School Setting; http://dx.doi.org/10.1186/s13643-015-0172-6; PROSPERO CRD42015025908. Copyright © 2017
American Academy of Child and Adolescent Psychiatry
Journal of the
American Academy of Child & Adolescent Psychiatry, 56(10) : 813-824
- Year: 2017
- 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
Dwyer, J., Telang, S., Reed, M., Bloch, M.
Background: Selective serotonin reuptake inhibitors (SSRIs) are the first line
pharmacologic for anxiety, OCD and depressive disorders in the pediatric population. Many clinicians report that many children prescribed SSRI
medication experience a Pediatric Behavioral Activation Syndrome, which exists along a spectrum from mild activation, increased energy, insomnia or
irritability up through agitation, hyperactivity, and possibly even manic behavior. However, evidence of Pediatric Behavioral Activation Syndrome
from randomized, placebo-controlled trials of SSRI medications remains sparse. Efforts to quantify the degree of risk have been hampered by
inconsistent reporting across clinical trials, and the range of behaviors which might constitute an activation syndrome. Here we have undertaken a
meta-analysis of pediatric SSRI clinical trials in an effort to better define the risk of symptoms of the behavioral activation syndromes in
pediatric populations. Methods: PubMed was searched for randomized, placebocontrolled trials of SSRIs in pediatric populations (less than 18 years of
age). The reference list from previous metaanalyses examining the efficacy of antidepressant medications in pediatric populations was searched for
further eligible trials. We extracted the rates of several adverse event outcomes associated with the behavioral activation syndrome in children
(insomnia, irritability, agitation, hyperactivity, anxiety/nervousness and akathisia/restlessness) as well as mania (manic behavior). Comprehensive
Meta-Analysis version 3.0 was used to examine the risk ratio of adverse events on SSRI medications compared to placebo. Results: A minority of
studies reported adverse event rates for the outcome of interest, especially manic behavior. SSRI use was associated with a significantly increased
risk of insomnia, irritability, agitation and hyperactivity in children compared to placebo. There was no evidence of publication bias or significant
heterogeneity among included trials. We plan to additionally examine the FDA database of medication trials as well as industry trial databases to
identify additional data on side-effects from trials that may not have reported these outcomes in peer-reviewed publications. Conclusions: Peer-
reviewed published reports of pediatric SSRI trials appear to support that symptoms of Pediatric Behavioral Activation Syndrome are more common with
these medications as compared to placebo. Caution is warranted as these spontaneously reported adverse events may have issues with reporting and
measurement bias that may have affected the suicidality literature with these same medications. Additionally, although we did not detect publication
or reporting bias in the included trials, there exists a strong possibility that the risk of adverse events reported in peer-reviewed publication may
systematically differ from those not published.
Neuropsychopharmacology, 43 (Supplement 1) : S133
- Year: 2017
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs)
Wright, B., Tindall, L., Littlewood, E., Allgar, V., Abeles,
P., Trepel, D., Ali, S.
OBJECTIVES: Computer-administered cognitive-behavioural therapy (CCBT) may be a promising treatment for
adolescents with depression, particularly due to its increased availability and accessibility. The feasibility of delivering a randomised controlled
trial (RCT) comparing a CCBT program (Stressbusters) with an attention control (self-help websites) for adolescent depression was evaluated.\rDESIGN:
Single centre RCT feasibility study.\rSETTING: The trial was run within community and clinical settings in York, UK.\rPARTICIPANTS: Adolescents (aged
12-18) with low mood/depression were assessed for eligibility, 91 of whom met the inclusion criteria and were consented and randomised to
Stressbusters (n=45) or websites (n=46) using remote computerised single allocation. Those with comorbid physical illness were included but those
with psychosis, active suicidality or postnatal depression were not.\rINTERVENTIONS: An eight-session CCBT program (Stressbusters) designed for use
with adolescents with low mood/depression was compared with an attention control (accessing low mood self-help websites).\rPRIMARY AND SECONDARY
OUTCOME MEASURES: Participants completed mood and quality of life measures and a service Use Questionnaire throughout completion of the trial and 4
months post intervention. Measures included the Beck Depression Inventory (BDI) (primary outcome measure), Mood and Feelings Questionnaire (MFQ),
Spence Children's Anxiety Scale (SCAS), the EuroQol five dimensions questionnaire (youth) (EQ-5D-Y) and Health Utility Index Mark 2 (HUI-2). Changes
in self-reported measures and completion rates were assessed by treatment group.\rRESULTS: From baseline to 4 months post intervention, BDI scores
and MFQ scores decreased for the Stressbusters group but increased in the website group. Quality of life, as measured by the EQ-5D-Y, increased for
both groups while costs at 4 months were similar to baseline. Good feasibility outcomes were found, suggesting the trial process to be feasible and
acceptable for adolescents with depression.\rCONCLUSIONS: With modifications, a fully powered RCT is achievable to investigate a promising treatment
for adolescent depression in a climate where child mental health service resources are limited.\rTrial registration number: isrctn31219579.
BMJ
Open, 7(1) : e012834
- Year: 2017
- 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), Cognitive & behavioural therapies (CBT), Technology, interventions delivered using technology (e.g. online, SMS)
Xu, L., Liu,
H.
This study tested the efficacy of an 8-weeks Rational Emotive Behavior Therapy (REBT) programme on adjusted
irrational beliefs and mental symptoms. The sample of 60 female college students was randomly assigned to a REBT (n = 25) and non-REBT group (n =
35). We expected increase mental symptoms in the non-REBT group, but not in the REBT group, due to the REBT programme intervention. According to our
data, adjusted irrational beliefs increased in the REBT group but remained unchanged in the non-REBT group. Even a REBT programme intervention of 8-
sessions can protect female college students from an increase in mental symptoms during the university period. Copyright © 2018, Anka Publishers. All
rights reserved.
NeuroQuantology, 15(4) : 156-161
- Year: 2017
- 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), Other Psychological Interventions
Topper, M., Emmelkamp, P. M., Watkins, E., Ehring, T.
BACKGROUND: This randomized controlled trial evaluated the efficacy of a preventive
intervention for anxiety disorders and depression by targeting excessive levels of repetitive negative thinking (RNT; worry and rumination) in
adolescents and young adults.\rMETHODS: Participants (N = 251, 83.7% female) showing elevated levels of RNT were randomly allocated to a 6-week
cognitive-behavioral training delivered in a group, via the internet, or to a waitlist control condition. Self-report measures were collected at
pre-intervention, post-intervention, 3 m and 12 m follow-up.\rRESULTS: Both versions of the preventive intervention significantly reduced RNT (d =
0.53 to 0.89), and symptom levels of anxiety and depression (d = 0.36 to 0.72). Effects were maintained until 12 m follow-up. The interventions
resulted in a significantly lower 12 m prevalence rate of depression (group intervention: 15.3%, internet intervention: 14.7%) and generalized
anxiety disorder (group intervention: 18.0%, internet intervention: 16.0%), compared to the waitlist (32.4% and 42.2%, respectively). Mediation
analyses demonstrated that reductions in RNT mediated the effect of the interventions on the prevalence of depression and generalized anxiety
disorder.\rCONCLUSIONS: Results provide evidence for the efficacy of this preventive intervention targeting RNT and support a selective prevention
approach that specifically targets a known risk factor to prevent multiple disorders.
Behaviour Research & Therapy, 90 : 123-
136
- Year: 2017
- 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), Cognitive & behavioural therapies (CBT), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Vaclavik, D., Buitron, V., Rey, Y., Marin, C. E., Silverman, W. K., Pettit, J.W.
Cognitive-behavioral therapies (CBTs) are efficacious
treatments for anxiety disorders in Latino youth. However, there is a gap in knowledge about moderators of CBT outcomes in Latino youth. This study
addresses this gap by examining parental acculturation as a moderator of youth anxiety outcomes in a randomized controlled trial (RCT) of parent-
involved CBT (CBT/P) and peer-involved group CBT (GCBT) in 139 Latino youth (ages 6 to 16 years; mean age = 9.68 years). Comparable youth anxiety
reduction effects were found for CBT/P and GCBT. Parental acculturation to majority United States culture, but not identification with country of
origin, significantly moderated youth anxiety outcomes: at low levels of parental acculturation to majority United States culture, youth
posttreatment anxiety scores were lower in GCBT than CBT/P; at high levels of parental acculturation to majority United States culture, youth
posttreatment anxiety scores were lower in CBT/P than GCBT. These findings provide further evidence for the efficacy of CBTs for anxiety disorders in
Latino youth and also provide guidance for moving toward personalization of CBTs' selection depending on parental acculturation levels. (PsycINFO
Database Record (c) 2019 APA, all rights reserved) Abstract (French) Las terapias cognitivo-conductuales (CBT) son tratamientos eficaces para los
trastornos de ansiedad en jovenes Latinos. Sin embargo, existe una limitacion en el conocimiento sobre los moderadores de los resultados de CBT en
jovenes Latinos. El presente estudio aborda esta limitacion al examinar el nivel de aculturacion de los padres como moderador de resultados de CBT
para la ansiedad en un estudio clinico controlado aleatorizado de CBT con participacion de los padres (CBT/P) y CBT con pares en formato de grupo
(GCBT) en 139 jovenes Latinos (de 6 a los 16 anos; edad promedio = 9.68 anos). Se encontraron efectos comparables en la reduccion de la ansiedad de
los jovenes entre CBT/P y GCBT. El nivel de aculturacion de los padres modero significativamente los resultados de la ansiedad de los jovenes: a
niveles bajos de aculturacion de los padres, las puntuaciones de ansiedad de los jovenes de postratamiento fueron mas bajas en GCBT que en CBT/P; a
niveles altos de aculturacion de los padres, las puntuaciones de ansiedad de los jovenes de postratamiento fueron mas bajas en CBT/P que en GCBT.
Estos resultados sugieren evidencia sobre la eficacia de las CBTs para los trastornos de ansiedad en jovenes Latinos y tambien ofrecen una guia hacia
la personalizacion de la seleccion de las CBTs segun el nivel de aculturacion de los padres. (PsycINFO Database Record (c) 2019 APA, all rights
reserved)
Journal of Latina/o Psychology, 5(4) : 261-
274
- Year: 2017
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Perry, J. E., Ross, M., Weinstock,
J., Weaver, T.
Research has supported mindfulness as a predictor of athletic success. This study used a parallel trial
design to examine the benefit of a brief one-session mindfulness training for performance on an individual, nonpacing, closed skill athletic task
(i.e., golf putting). All participants (N = 65) answered questionnaires and engaged in two trials of the putting task. Participants were randomly
assigned to an intervention or control group using a simple randomization strategy. Between trials, the intervention group received a mindfulness
intervention. Mindfulness intervention included psychoeducation, reflection upon previous sport experiences, an experiential exercise, and putting
applications. Repeated-measures ANOVAs demonstrated that the intervention group exhibited more successful outcomes on objective putting performance,
flow state experience, and state anxiety (p < .05). Results suggest mindfulness may prevent performance deterioration and could produce psychological
benefits after a brief training session. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
The Sport Psychologist, 31(4) : 410-421
- Year: 2017
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Mindfulness based
therapy
Sekizaki, R., Nemoto,
T., Tsujino, N., Takano, C., Yoshida, C., Yamaguchi, T., Katagiri, N., Ono, Y., Mizuno, M.
Aim: Preventive intervention and treatment using internet-based
cognitive behaviour therapy (iCBT) can be easily administered to school students, as they are quite familiar with internet tools. This study aims to
investigate the effectiveness and contribution of iCBT to mental healthcare in a school setting. Methods: Eighty Japanese high school boys who were
participating in a sports specialist course were enrolled in this study. The participants were randomly assigned to either the iCBT intervention
group or the control group. Both programmes were administered for 4 weeks. To evaluate the effects, physical and mental health problems and self-
efficacy were assessed. Results: The mean number of times that the iCBT website was accessed during the intervention period was 16.9, and the mean
access frequency (percentage of the number of times the website was accessed during the intervention period) was 40.1% in the iCBT group. A
statistically significant interaction between group and time in favour of the iCBT group was observed based on the Kessler-6 (K6) scale for
depression and anxiety. Conclusions: The results suggest that a school mental healthcare programme using iCBT is suitable for students and useful for
coping with stress and reducing depressed mood and anxiety in young people, especially athletes, who are regarded as needing special mental health
support. Copyright © 2017 Wiley Publishing Asia Pty Ltd.
Early Intervention in
Psychiatry., :
- Year: 2017
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Technology, interventions delivered using technology (e.g. online, SMS)
Sampl, J., Maran, T., Furtner, M. R.
The present randomized pilot intervention study examines the effects of a
mindfulness-based self-leadership training (MBSLT) specifically developed for academic achievement situations. Both mindfulness and self-leadership
have a strong self-regulatory focus and are helpful in terms of stress resilience and performance enhancements. Based on several theoretical points
of contact and a specific interplay between mindfulness and self-leadership, the authors developed an innovative intervention program that improves
mood as well as performance in a real academic setting. The intervention was conducted as a randomized controlled study over 10 weeks. The purpose
was to analyze the effects on perceived stress, test anxiety, academic self-efficacy, and the performance of students by comparing an intervention
and control group (n = 109). Findings demonstrated significant effects on mindfulness, self-leadership, academic self-efficacy, and academic
performance improvements in the intervention group. Results showed that the intervention group reached significantly better grade point averages than
the control group. Moreover, the MBSLT over time led to a reduction of test anxiety in the intervention group compared to the control group.
Furthermore, while participants of the control group showed an increase in stress over time, participants of the intervention group maintained
constant stress levels over time. The combination of mindfulness and self-leadership addressed both positive effects on moods and on objective
academic performance. The effects demonstrate the great potential of combining mindfulness with self-leadership to develop a healthy self-regulatory
way of attaining achievement-related goals and succeeding in high-stress academic environments. (PsycINFO Database Record (c) 2017 APA, all rights
reserved)
Mindfulness, 8(5) : 1393-1407
- Year: 2017
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Mindfulness based
therapy
Rapee, R. M., Lyneham, H. J., Wuthrich, V., Chatterton, M. L., Hudson, J.
L., Kangas, M., Mihalopoulos, C.
Objective Stepped care is embraced as an ideal model of service delivery but is minimally evaluated. The aim of this study was to
evaluate the efficacy of cognitive-behavioral therapy (CBT) for child anxiety delivered via a stepped-care framework compared against a single,
empirically validated program. Method A total of 281 youth with anxiety disorders (6-17 years of age) were randomly allocated to receive either
empirically validated treatment or stepped care involving the following: (1) low intensity; (2) standard CBT; and (3) individually tailored
treatment. Therapist qualifications increased at each step. Results Interventions did not differ significantly on any outcome measures. Total
therapist time per child was significantly shorter to deliver stepped care (774 minutes) compared with best practice (897 minutes). Within stepped
care, the first 2 steps returned the strongest treatment gains. Conclusion Stepped care and a single empirically validated program for youth with
anxiety produced similar efficacy, but stepped care required slightly less therapist time. Restricting stepped care to only steps 1 and 2 would have
led to considerable time saving with modest loss in efficacy. Clinical trial registration information-A Randomised Controlled Trial of Standard Care
Versus Stepped Care for Children and Adolescents With Anxiety Disorders; http://anzctr.org.au/; ACTRN12612000351819. Copyright © 2017 American
Academy of Child and Adolescent Psychiatry
Journal of the American Academy of Child and Adolescent Psychiatry, 56(10) : 841-
848
- Year: 2017
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled 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
Rosenblum, K. L., Muzik, M., Morelen, D. M., Alfafara, E. A., Miller, N. M., Waddell, R. M., Schuster, M. M., Ribaudo, J.
We conducted a study to evaluate the
effectiveness of Mom Power, a multifamily parenting intervention to improve mental health and parenting among high-risk mothers with young children
in a community-based randomized controlled trial (CB-RCT) design. Participants (N = 122) were high-risk mothers (e.g., interpersonal trauma
histories, mental health problems, poverty) and their young children (age <6 years), randomized either to Mom Power, a parenting intervention
(treatment condition), or weekly mailings of parenting information (control condition). In this study, the 13-session intervention was delivered by
community clinicians trained to fidelity. Pre- and post-trial assessments included mothers' mental health symptoms, parenting stress and
helplessness, and connection to care. Mom Power was delivered in the community with fidelity and had good uptake (>65%) despite the risk nature of
the sample. Overall, we found improvements in mental health and parenting stress for Mom Power participants but not for controls; in contrast,
control mothers increased in parent-child role reversal across the trial period. The benefits of Mom Power treatment (vs. control) were accentuated
for mothers with interpersonal trauma histories. Results of this CB-RCT confirm the effectiveness of Mom Power for improving mental health and
parenting outcomes for high-risk, trauma-exposed women with young children. ClinicalTrials.gov Identifier: NCT01554215. Copyright © 2017, Springer-
Verlag Wien.
Archives of Women's Mental Health, 20(5) : 673-
686
- Year: 2017
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, 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
Saelid, G. A., Nordahl, H. M.
Rational
emotive behaviour therapy (REBT) is effective in reducing distress in several target groups. No other study has tested the mental health effects on
adolescents in a high school setting while expanding a Cognitive Behaviour-based therapy, REBT, into the concept of mental health literacy. The
format of the ABC model, which is an important element of REBT, functioned as a working manual in and between three sessions. This study tested
whether knowledge and practical use of the ABC model increased self-esteem and hope, and reduced symptoms of anxiety and depression, and
dysfunctional thinking. Sixty-two high school students with subclinical levels of anxiety and depression were randomly allocated into three groups;
three individual REBT sessions, or three individual attentional placebo (ATP) sessions or no sessions (control). However, dysfunctional thinking,
self-esteem and hope were not measured in the control group. Repeated measures with ANOVA and t-tests were conducted. Both REBT and ATP significantly
reduced symptoms of anxiety and depression, but only REBT was significantly different from the control group at the six-month follow-up. Only REBT
significantly reduced dysfunctional thinking, and both REBT and ATP significantly increased self-esteem and hope. REBT had both an immediate and a
long-term effect. The findings show the potential positive effects of educating well-documented psychological techniques as ordinary education in
school. Further research might contribute to decide whether or not to change the school system by enclosing mental health literacy classes for all
students.
Cognitive Behaviour Therapy, 46(3) : 196-
210
- Year: 2017
- 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), Other Psychological Interventions