Disorders - Anxiety Disorders
Norr, A. M., Gibby, B. A., Schmidt, N. B.
Background Anxiety sensitivity (AS), or a fear of anxiety-related sensations, has become one of the most well researched risk
factors for the development of psychopathology and comprises three subfactors: physical, cognitive, and social concerns. Fortunately, research has
demonstrated brief protocols can successfully reduce AS, and in turn improve psychopathological symptoms. Computerized AS reduction protocols have
combined psychoeducation with interoceptive exposure (IE), but they have not been dismantled to evaluate the effects of psychoeducation alone.
Method: The current study sought to determine the efficacy of a brief single-session psychoeducation intervention for AS, compared to a control
intervention, in a sample of at-risk individuals (N=54) with elevated AS cognitive concerns. Results Individuals in the active condition displayed
greater reductions in self-reported AS (beta=.198, 95% CI [.065, .331]) and less fear reactivity (beta=.278, 95% CI [.069, .487]) to the induction of
AS cognitive-relevant sensations through a behavioral challenge compared to those in the control condition. Further, fear reactivity to the challenge
was mediated by reductions in self-reported AS cognitive concerns. Limitations Study limitations include use of an at-risk nonclinical student
sample, lack of a long-term follow-up assessment, and inability to discern whether AS reductions due to CAST psychoeducation prevent future, or
improve current, psychological symptoms. Conclusions These results suggest that psychoeducation alone can produce significant AS reduction. Copyright
© 2017
Journal of Affective Disorders, 212 : 48-
55
- Year: 2017
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation
Pella, J. E., Drake, Kelly
L., Tein, J.-Y., Ginsburg, G. S.
This study examined the impact of a
selective anxiety prevention program for offspring of clinically anxious parents on three domains of child functioning: (1) social, (2) familial, and
(3) emotional/behavioral. Dyads were randomized into either the Coping and Promoting Strength program (CAPS; n = 70) or Information Monitoring (IM; n
= 66) comparison group. Multi-informant assessments were conducted at baseline, post intervention, and 6 and 12 months follow-ups. Random effects
mixed models under the linear growth modeling (LGM) framework was used to assess the impact of CAPS on growth trajectories. Over time, children in
the CAPS group had significantly lower anxiety, anxious/depressed symptoms, and lower total behavior problems (parent report), compared to children
in IM group. The intervention did not impact other domains assessed (e.g., social functioning), which may be due to ''floor effects'' on these
measures. Longitudinal follow-up data is needed to provide valuable information about this high risk population. (PsycINFO Database Record (c) 2017
APA, all rights reserved)
Child Psychiatry and Human
Development, 48(3) : 400-410
- Year: 2017
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions
Mychailyszyn, M. P.
To conduct a meta-analysis to synthesize
the available research on the family of studies belonging to the Cool Kids Program, a cognitive-behavioral intervention for anxiety disorders in
youth, and evaluate its overall effectiveness in addressing anxious symptomatology. A search of online databases, combined with reference list
examination and communication with program implementers/developers, led to the identification of (16) studies that explored the effects of the Cool
Kids Program (N = 1579), or its forerunners or extensions. Analyses focused on child- and parent-report of anxiety, with effect sizes aggregated
according to a random effects model and calculated as differences between intervention and control groups at posttreatment (standardized mean
difference [SMD]) as well as by considering the changes in scores between time points (e.g., standardized mean gain [SMG]). Analyses indicate
superior improvement for youth receiving the Cool Kids intervention as compared with controls according to SMD analyses for both child- and parent-
report, as well as for SMG analyses according to parent-report, though not according to child self-report despite a nearly identical aggregated
effect size; the latter was attributable to greater gains reported by youth in control conditions; secondary analyses also suggest significantly
greater improvements in automatic thoughts for Cool Kids participants. This intervention has been implemented in different modalities, holds
considerable promise, and in the contemporary context of evidence-based practice, should be considered a program with strong empirical support.
(PsycINFO Database Record (c) 2017 APA, all rights reserved) Abstract (French) Realiser une meta-analyse visant a faire le sommaire de la recherche
actuelle sur le programme Cool Kids, une intervention cognitivo-comportementale pour les troubles anxieux chez les jeunes, et evaluer son efficacite
globale quant a la symptomatologie anxieuse. Une recherche dans les bases de donnees en ligne, le depouillement des listes de references et des
echanges avec des prestataires et des concepteurs du programme, ont permis de cerner 16 etudes ayant analyse les effets du programme Cool Kids lui-
meme (N = 1579), de ses ancetres et de ses derives. Les analyses se sont centrees sur les reponses des enfants et des parents au sujet de l'anxiete,
l'ampleur des effets ayant ete combinee selon un modele a effets aleatoires et calculee en tant que difference entre les mesures de post-traitement
des groupes ayant eu des interventions et celles des groupes temoins (difference des moyennes standardisees), de meme qu'en tenant compte des
changements dans les scores entre deux temps de mesure (gain moyen standardise). Les analyses ont revele une amelioration superieure chez les jeunes
beneficiant des interventions du programme Cool Kids, comparativement aux groupes temoins, selon les analyses de la difference des moyennes
standardisees, pour les reponses a la fois des enfants et des parents, et selon les analyses du gain moyen standardise, pour les reponses des
parents, mais non pour celles des enfants, en depit d'une ampleur des effets combinee quasi identique; cette difference etait attribuable a de plus
grands gains rapportes par les jeunes de groupes temoins; des analyses secondaires suggerent egalement une amelioration superieure sur le plan des
pensees automatiques parmi les participants au programme. Cette intervention a ete mise en vigueur selon differentes formules, elle est prometteuse
et, dans le contexte actuel de la pratique axee sur les preuves, elle peut etre percue comme ayant une solide base empirique. (PsycINFO Database
Record (c) 2017 APA, all rights reserved)
Canadian Psychology/Psychologie canadienne, 58(2) : 105-
115
- Year: 2017
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Oldham-Cooper, R., Loades, M.
Background:
Coping Cat (CC), a generic cognitive-behavioral intervention for anxiety disorders in children and young people, is recommended in the United Kingdom
for social anxiety disorder (SAD), generalized anxiety disorder, separation anxiety (SA), and specific phobias (SP), with disorder-specific
approaches generally favored in treatment of anxiety disorders in adults. Objectives: To compare CC with disorder-specific cognitive-behavioral
therapy (CBT) interventions based on anxiety-related treatment outcomes. Study Selection: Primary research articles describing treatment of children
and young people aged 7-17 for SAD, generalized anxiety disorder, SA, and SP, using CC or disorder-specific CBT. Results: Ten studies implemented CC
and four implemented disorder-specific CBT. One study compared CC with a disorder-specific approach. There was a lack of data to support use of CC in
treatment of SPs. However, CC was equally effective as disorder-specific treatments for SA and SAD. Conclusions: A lack of data exists for disorder-
specific CBT interventions compared to CC. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Journal
of Child and Adolescent Psychiatric Nursing, 30(1) : 6-17
- Year: 2017
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, Social phobia (social anxiety disorder), Specific
Phobia
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Strawn, J. R., Compton, S. N., Robertson, B., Albano, A.
M., Hamdani, M., Rynn, M. A.
Objective: This is a feasibility study evaluating the safety, tolerability, and
potential anxiolytic efficacy of the alpha2 agonist guanfacine extended-release (GXR) in children and adolescents with generalized anxiety disorder
(GAD), separation anxiety disorder (SAD), or social phobia/social anxiety disorder. Methods: Youth aged 6-17 years with a primary diagnosis of GAD,
SAD, and/or social anxiety disorder were treated with flexibly dosed GXR (1-6 mg daily, n = 62) or placebo (n = 21) for 12 weeks. The primary aim of
this study was to determine the safety and tolerability of GXR in youth with anxiety disorders, which involved the analysis of treatment-emergent
adverse events (TEAEs), the emergence of suicidal ideation and behaviors, vital signs, and electrocardiographic/laboratory parameters. Exploratory
efficacy measures included dimensional anxiety scales (Pediatric Anxiety Rating Scale [PARS] and Screen for Child Anxiety Related Emotional Disorders
[SCARED]), as well as the Clinical Global Impression-Improvement (CGI-I) scale. As this was an exploratory study, no inferential statistical analyses
were performed. Results: GXR was safe and well tolerated. Treatment-related mean +/- standard deviation changes in heart rate (GXR: 1.8 +/- 12 beats
per minute [bpm] decrease; placebo: 0.5 +/- 11 bpm decrease), systolic blood pressure (GXR: 2.3 +/- 11 mm Hg decrease; placebo: 1.7 - 11 mm Hg
decrease), or diastolic blood pressure (GXR: 1.3 +/- 9 mm Hg decrease; placebo: 0.9 -7 mm Hg increase) were similar between treatment groups. TEAEs,
including headache, somnolence/fatigue, abdominal pain, and dizziness, were consistent with the known safety profile of GXR.No differences were
observed between treatment groups for PARS and SCARED scores, although at endpoint, a higher proportion of subjects receiving GXR versus placebo
demonstrated CGI-I scores <=2 (54.2% vs. 31.6%), as rated by the clinician investigator. Conclusions: GXR was well tolerated in pediatric subjects
with GAD, SAD, and/or social anxiety disorder. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Journal of Child and Adolescent
Psychopharmacology, 27(1) : 29-37
- Year: 2017
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Other biological interventions
Unno, K., Yamada, H., Iguchi, K., Ishida,
H., Iwao, Y., Morita, A., Nakamura, Y.
Theanine, an amino acid in tea, has significant anti-stress effects on animals and humans. However, the effect of theanine was blocked by
caffeine and gallate-type catechins, which are the main components in tea. We examined the anti-stress effect of green tea with lowered caffeine,
low-caffeine green tea, on humans. The study design was a single-blind group comparison and participants (n=20) were randomly assigned to low-
caffeine or placebo tea groups. These teas (>=500 mL/d), which were eluted with room temperature water, were taken from 1 week prior to pharmacy
practice and continued for 10 d in the practice period. The participants ingested theanine (ca. 15 mg/d) in low-caffeine green tea. To assess the
anxiety of participants, the state-trait anxiety inventory test was used before pharmacy practice. The subjective stress of students was
significantly lower in the low-caffeine-group than in the placebo-group during pharmacy practice. The level of salivary alpha-amylase activity, a
stress marker, increased significantly after daily pharmacy practice in the placebo-group but not in the low-caffeine-group. These results suggested
that the ingestion of low-caffeine green tea suppressed the excessive stress response of students. This study was registered at the University
Hospital Medical Information Network (ID No. UMIN14942). Copyright © 2017 The Pharmaceutical Society of Japan.
Biological and Pharmaceutical Bulletin, 40(6) : 902-
909
- Year: 2017
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Other complementary & alternative
interventions
Weibel, D. T., McClintock, A. S., Anderson, T.
Although loving-kindness
meditation (LKM) has shown some promise as a psychological intervention, little is known about the effectiveness of LKM for reducing one of the most
prevalent mental health problems: anxiety. To build knowledge in this area, we conducted a randomized controlled trial, assigning non-clinical
undergraduates to either a four-session, group-based LKM intervention (n = 38) or a waitlist control (n = 33). Self-reported anxiety, compassionate
love, and self-compassion were assessed at pretreatment, posttreatment, and 8-week follow-up. Relative to control participants, participants in the
LKM intervention reported higher compassionate love and self-compassion at posttreatment and higher self-kindness (a component of self-compassion) at
follow-up. Anxiety ratings did not significantly differ between conditions at posttreatment or follow-up. Study limitations and directions for future
research are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Mindfulness, 8(3) : 565-571
- Year: 2017
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Meditation
Xu, M., Purdon, C., Seli, P., Smilek, D.
Mind wandering can be costly, especially when we are engaged in
attentionally demanding tasks. Preliminary studies suggest that mindfulness can be a promising antidote for mind wandering, albeit the evidence is
mixed. To better understand the exact impact of mindfulness on mind wandering, we had a sample of highly anxious undergraduate students complete a
sustained-attention task during which off-task thoughts including mind wandering were assessed. Participants were randomly assigned to a meditation
or control condition, after which the sustained-attention task was repeated. In general, our results indicate that mindfulness training may only have
protective effects on mind wandering for anxious individuals. Meditation prevented the increase of mind wandering over time and ameliorated
performance disruption during off-task episodes. In addition, we found that the meditation intervention appeared to promote a switch of attentional
focus from the internal to present-moment external world, suggesting important implications for treating worrying in anxious populations. Copyright ©
2017 Elsevier Inc.
Consciousness and
Cognition, 51 : 157-165
- Year: 2017
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Mindfulness based
therapy, Meditation
van-Genugten, L., Dusseldorp, E., Massey, E. K., van-Empelen, P.
Mental wellbeing is influenced by self-regulation processes. However, little is known on the efficacy of
change techniques based on self-regulation to promote mental wellbeing. The aim of this meta-analysis is to identify effective self-regulation
techniques (SRTs) in primary and secondary prevention interventions on mental wellbeing in adolescents. Forty interventions were included in the
analyses. Techniques were coded into nine categories of SRTs. Meta-analyses were conducted to identify the effectiveness of SRTs, examining three
different outcomes: internalising behaviour, externalising behaviour, and self-esteem. Primary interventions had a small-to-medium ([Formula: see
text]=0.16-0.29) on self-esteem and internalising behaviour. Secondary interventions had a medium-to-large short-term effect (average [Formula: see
text]=0.56) on internalising behaviour and self-esteem. In secondary interventions, interventions including asking for social support [Formula: see
text] 95% confidence interval, CI=1.11-1.98) had a great effect on internalising behaviour. Interventions including monitoring and evaluation had a
greater effect on self-esteem [Formula: see text] 95% CI=0.21-0.57). For primary interventions, there was not a single SRT that was associated with a
greater intervention effect on internalising behaviour or self-esteem. No effects were found for externalising behaviours. Self-regulation
interventions are moderately effective at improving mental wellbeing among adolescents. Secondary interventions promoting 'asking for social
support' and promoting 'monitoring and evaluation' were associated with improved outcomes. More research is needed to identify other SRTs or
combinations of SRTs that could improve understanding or optimise mental wellbeing interventions.
Health Psychology Review, 11(1) : 53-71
- Year: 2017
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Weisz, J. R., Kuppens, S., Ng, M. Y., Eckshtain, D., Ugueto, A. M., Vaughn-Coaxum, R., Jensen-Doss, A., Hawley, K. M., Krumholz Marchette, L. S., Chu, B. C., Weersing, V. R., Fordwood, S. R.
Across 5 decades, hundreds of
randomized trials have tested psychological therapies for youth internalizing (anxiety, depression) and externalizing (misconduct, attention deficit
and hyperactivity disorder) disorders and problems. Since the last broad-based youth meta-analysis in 1995, the number of trials has almost tripled
and data-analytic methods have been refined. We applied these methods to the expanded study pool (447 studies; 30,431 youths), synthesizing 50 years
of findings and identifying implications for research and practice. We assessed overall effect size (ES) and moderator effects using multilevel
modeling to address ES dependency that is common, but typically not modeled, in meta-analyses. Mean posttreatment ES was 0.46; the probability that a
youth in the treatment condition would fare better than a youth in the control condition was 63%. Effects varied according to multiple moderators,
including the problem targeted in treatment: Mean ES at posttreatment was strongest for anxiety (0.61), weakest for depression (0.29), and
nonsignificant for multiproblem treatment (0.15). ESs differed across control conditions, with \"usual care\" emerging as a potent comparison
condition, and across informants, highlighting the need to obtain and integrate multiple perspectives on outcome. Effects of therapy type varied by
informant; only youth-focused behavioral therapies (including cognitive-behavioral therapy) showed similar and robust effects across youth, parent,
and teacher reports. Effects did not differ for Caucasian versus minority samples, but more diverse samples are needed. The findings underscore the
benefits of psychological treatments as well as the need for improved therapies and more representative, informative, and rigorous intervention
science. (PsycINFO Database Record\rCopyright (c) 2017 APA, all rights reserved).
American
Psychologist, 72(2) : 79-117
- Year: 2017
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)
Smith, M. M., McLeod, B. D., Southam-Gerow, M. A., Jensen-Doss, A., Kendall, P.
C., Weisz, J. R.
Does delivery of the same manual-based individual cognitive-behavioral treatment (ICBT) program for youth anxiety
differ across research and practice settings? We examined this question in a sample of 89 youths (M age = 10.56, SD = 1.99; 63.70% Caucasian; 52.80%
male) diagnosed with a primary anxiety disorder. The youths received (a) ICBT in a research setting, (b) ICBT in practice settings, or (c) non-
manual-based usual care (UC) in practice settings. Treatment delivery was assessed using four theory-based subscales (Cognitive-behavioral,
Psychodynamic, Client-Centered, Family) from the Therapy Process Observational Coding System for Child Psychotherapy-Revised Strategies scale
(TPOCS-RS). Reliable independent coders, using the TPOCS-RS, rated 954 treatment sessions from two randomized controlled trials (1 efficacy and 1
effectiveness trial). In both settings, therapists trained and supervised in ICBT delivered comparable levels of cognitive-behavioral interventions
at the beginning of treatment. However, therapists trained in ICBT in the research setting increased their use of cognitive-behavioral interventions
as treatment progressed whereas their practice setting counterparts waned over time. Relative to the two ICBT groups, the UC therapists delivered a
significantly higher dose of psychodynamic and family interventions and a significantly lower dose of cognitive-behavioral interventions. Overall,
results indicate that there were more similarities than differences in manual-based ICBT delivery across research and practice settings. Future
research should explore why the delivery of cognitive-behavioral interventions in the ICBT program changed over time and across settings, and whether
the answers to these questions could inform implementation of ICBT programs. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Behavior Therapy, 48(4) : 501-516
- Year: 2017
- Problem: Anxiety Disorders (any)
- 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
Shangani, S., Operario, D., Genberg, B., Kirwa, K., Midoun, M., Atwoli, L., Ayuku, D., Galarraga, O., Braitstein, P.
Background
Orphaned and vulnerable adolescents (OVA) in sub-Saharan Africa are at greater risk for adverse psychological outcomes compared with their non-OVA
counterparts. Social interventions that provide cash transfers (CTs) have been shown to improve health outcomes among young people, but little is
known about their impact on the psychological wellbeing of OVA. Objective Among OVA in western Kenya, we assessed the association between living in a
household that received monthly unconditional government CTs and psychological wellbeing. Methods We examined the likelihood of depression, anxiety,
post-traumatic stress symptoms (PTSS) and positive future outlook among 655 OVA aged between 10 and 18 years who lived in 300 randomly selected
households in western Kenya that either received or did not receive unconditional monthly CTs. Results The mean age was 14.0 (SD 2.4) years and 329
(50.2%) of the participants were female while 190 (29.0%) were double orphans whose biological parents were both deceased. After adjusting for
socio-demographic, caregiver, and household characteristics and accounting for potential effects of participant clustering by sub-location of
residence, OVA living in CT households were more likely to have a positive future outlook (odds ratio [OR] 1.47, 95% confidence interval [CI] 1.08,
1.99), less likely to be anxious (OR 0.57, 95% CI 0.42, 0.78), and less likely to have symptoms of post-traumatic stress (OR 0.50, 95% CI 0.29,
0.89). We did not find statistically significant differences in odds of depression by CT group. Conclusion OVA in CT households reported better
psychological wellbeing compared to those in households not receiving CTs. CT interventions may be effective for improving psychological wellbeing
among vulnerable adolescents in socioeconomically deprived households. Copyright © 2017 Shangani 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, 12(5) : e0178076
- Year: 2017
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Other service delivery and improvement
interventions