Sabourin, B. C., Watt, M. C., Krigolson, O. E., Stewart, S .H.

Two interventions decrease anxiety sensitivity among high anxiety sensitive women: Could physical exercise be the key?

A brief group-based cognitive behavioral therapy (CBT), with running as an interoceptive exposure (IE) component, was effective in reducing anxiety sensitivity (AS) levels in undergraduate women (Watt, Stewart, Lefaivre, & Uman, 2006). This study investigated whether the CBT/IE intervention would result in decreases in AS and emotional distress that would be maintained over 14 weeks. Female undergraduates, high (n = 81) or low (n = 73) in AS, were randomized to 3-day CBT plus forty-two 10-min running IE trials (n = 83) or 3-day health education control (HEC) with interactive discussions and problem solving on exercise, nutrition, and sleep (n = 71). The CBT/IE intervention led to decreases in AS, depression, and stress symptoms for high AS participants, which were maintained at 14 weeks. Unexpectedly, HEC participants experienced similar and lasting decreases in AS, depression, and anxiety symptoms. Furthermore, there were no post- intervention differences between CBT/IE and HEC participants in any of the outcomes. Low AS participants experienced few sustained changes. Clinical implications and the possible role of aerobic exercise in explaining outcomes of both interventions are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)

Journal of Cognitive Psychotherapy, 30(2) : 131- 146

Schleider, J. L., Weisz, J. R.

Reducing risk for anxiety and depression in adolescents: Effects of a single-session intervention teaching that personality can change

Efforts to reduce youth mental health problems have advanced greatly but have not lowered overall rates of youth mental illness. Thus, a need exists for disseminable, mechanism-targeted approaches to reducing risk of youth psychopathology. Accordingly, we conducted a randomized-controlled trial testing whether a single-session intervention teaching growth personality mindsets (the belief that personality is malleable) reduced known risk factors for anxiety and depression in adolescents experiencing or at risk for internalizing problems (N = 96, ages 12-15). Compared to a supportive- therapy control, a 30-min computer-guided mindset intervention strengthened adolescents' perceived control; this improvement was associated with increases in growth mindsets. Further, electrodermal activity recovery slopes showed that youths receiving the mindset intervention recovered from a lab-based social stressor over three times as fast as control group youths. Improvements in growth mindsets and perceived control were linked with faster stress recovery. Results suggest a disseminable strategy for reducing internalizing problem risk among adolescents. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Behaviour Research and Therapy, 87 : 170- 181

Yap, M. B. H., Morgan, A. J., Cairns, K., Jorm, A. F., Hetrick, S. E., Merry, S.

Parents in prevention: A meta-analysis of randomized controlled trials of parenting interventions to prevent internalizing problems in children from birth to age 18

Purpose of the research Burgeoning evidence that modifiable parental factors can influence children's and adolescents' risk for depression and anxiety indicates that parents can play a crucial role in prevention of these disorders in their children. However, it remains unclear whether preventive interventions that are directed primarily at the parent (i.e. where the parent receives more than half of the intervention) are effective in reducing child internalizing (including both depression and anxiety) problems in the longer term. Principal results Compared to a range of comparison conditions, parenting interventions reduced child internalizing problems, at a minimum of 6 months after the intervention was delivered. Mean effects were very small for measures of internalizing and depressive symptoms, and small for measures of anxiety symptoms. Pooled effects for anxiety diagnoses were significant and indicated a number needed to treat (NNT) of 10. Pooled effects for depression diagnoses approached significance but suggested a NNT of 11. These results were based on effects reported at the longest follow-up interval for each included study, which ranged from 6 months up to 15 years for internalizing measures, 5.5 years for depressive measures, and 11 years for anxiety measures. Major conclusions Our findings underscore the likely benefits of increasing parental involvement in preventing internalizing problems, particularly anxiety problems, in young people. Copyright © 2016 Elsevier Ltd

Clinical Psychology Review, 50 : 138- 158

Ruocco, S., Gordon, J., McLean, L. A.

Effectiveness of a school-based early intervention CBT group programme for children with anxiety aged 5-7 years

AbstractEarly manifestations of anxiety in childhood confer significant distress and life interference. This study reports on the first controlled trial of the Get Lost Mr Scary programme, a Cognitive Behavioural Therapy group intervention for children with anxiety aged 5-7 years. Participants were 134 children (65 males and 69 females) drawn from 23 public schools located in Western Sydney, Australia. A non-randomised control group design was used to assign schools to an intervention group or wait-time control group. Post-intervention results obtained from parent and teacher measures indicated that children who received the intervention showed significant reductions in their anxiety and behaviour symptoms compared to children in the wait-time group who showed no significant change. After receiving the intervention, the wait-time group showed a similar pattern of improvement. At 12-month follow-up, the intervention gains for anxiety were maintained. Clinical implications for the school setting and future directions for research are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)

Advances in School Mental Health Promotion, 9(1) : 29- 49

Tan, L. B.

A critical review of adolescent mindfulness-based programmes.

Clinical child psychology and psychiatry, 21(2) : 193- 207

Stockings, E. A., Degenhardt, L., Dobbins, T., Lee, Y. Y., Erskine, H. E., Whiteford, H. A., Patton, G.

Preventing depression and anxiety in young people: a review of the joint efficacy of universal, selective and indicated prevention

Depression and anxiety (internalizing disorders) are the largest contributors to the non-fatal health burden among young people. This is the first meta-analysis to examine the joint efficacy of universal, selective, and indicated preventive interventions upon both depression and anxiety among children and adolescents (5-18 years) while accounting for their co-morbidity. We conducted a systematic review of reviews in Medline, PsycINFO and the Cochrane Library of Systematic Reviews, from 1980 to August 2014. Multivariate meta-analysis examined the efficacy of preventive interventions on depression and anxiety outcomes separately, and the joint efficacy on both disorders combined. Meta-regressions examined heterogeneity of effect according to a range of study variables. Outcomes were relative risks (RR) for disorder, and standardized mean differences (Cohen's d) for symptoms. One hundred and forty-six randomized controlled trials (46 072 participants) evaluated universal (children with no identified risk, n = 54) selective (population subgroups of children who have an increased risk of developing internalizing disorders due to shared risk factors, n = 45) and indicated prevention (children with minimal but detectable symptoms of an internalizing disorder, n = 47), mostly using psychological-only strategies (n = 105). Reductions in internalizing disorder onset occurred up to 9 months post-intervention, whether universal [RR 0.47, 95% confidence interval (CI) 0.37- 0.60], selective (RR 0.61, 95% CI 0.43-0.85) or indicated (RR 0.48, 95% CI 0.29-0.78). Reductions in internalizing symptoms occurred up to 12 months post-intervention for universal prevention; however, reductions only occurred in the shorter term for selective and indicated prevention. Universal, selective and indicated prevention interventions are efficacious in reducing internalizing disorders and symptoms in the short term. They might be considered as repeated exposures in school settings across childhood and adolescence. (PROSPERO registration: CRD42014013990.).

Psychological Medicine, 46(1) : 11- 26

Uliaszek, A. A., Rashid, T., Williams, G. E., Gulamani, T.,

Group therapy for university students: A randomized control trial of dialectical behavior therapy and positive psychotherapy

The present study examined the efficacy of two evidence- based group treatments for significant psychopathology in university students. Fifty-four treatment-seeking participants were randomized to a semester-long dialectical behavior therapy (DBT) or positive psychotherapy (PPT) group treatment. Mixed modeling was used to assess improvement over time and group differences on variables related to symptomatology, adapative/maladaptive skill usage, and well-being/acceptability factors. All symptom and skill variables improved over the course of treatment. There were no statistically significant differences in rate of change between groups. The DBT group evidenced nearly all medium to large effect sizes for all measures from pre-to post-treatment, with mostly small to medium effect sizes for the PPT group. There was a significant difference in acceptability between treatments, with the DBT group demonstrating significantly lower attrition rates, higher attendance, and higher overall therapeutic alliance. While both groups demonstrated efficacy in this population, the DBT group appeared to be a more acceptable and efficacious treatment for implementation. Results may specifically apply to group therapy as an adjunctive treatment because a majority of participants had concurrent individual therapy.

Behaviour Research & Therapy, 77 : 78-85

Vigerland, S., Ljotsson, B., Thulin, U., Ost, L.-G., Andersson, G., Serlachius, E.

Internet-delivered cognitive behavioural therapy for children with anxiety disorders: A randomised controlled trial

Background: Cognitive behaviour therapy (CBT) has been shown to be an effective treatment for anxiety disorders in children, but few affected seek or receive treatment. Internet-delivered CBT (ICBT) could be a way to increase the availability of empirically supported treatments. Aims: A randomised controlled trial was conducted to evaluate ICBT for children with anxiety disorders. Method: Families (N = 93) with a child aged 8-12 years with a principal diagnosis of generalised anxiety disorder, panic disorder, separation anxiety, social phobia or specific phobia were recruited through media advertisement. Participants were randomised to 10 weeks of ICBT with therapist support, or to a waitlist control condition. The primary outcome measure was the Clinician Severity Rating (CSR) and secondary measures included child- and parent-reported anxiety. Assessments were made at pre-treatment, post-treatment and at three-month follow-up. Results: At post-treatment, there were significant reductions on CSR in the treatment group, with a large between-group effect size (Cohen's d = 1.66). Twenty per cent of children in the treatment group no longer met criteria for their principal diagnosis at post-treatment and at follow-up this number had increased to 50%. Parent-reported child anxiety was significantly lower in the treatment group than in the waitlist group at post-treatment, with a small between-group effect size (Cohen's d = 0.45). There were no significant differences between the groups regarding child-ratings of anxiety at post-treatment. Improvements were maintained at three-month follow-up, although this should be interpreted cautiously due to missing data. Conclusions: Within the limitations of this study, results suggest that ICBT with therapist support for children with anxiety disorders can reduce clinician- and parent-rated anxiety symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Behaviour Research and Therapy, 76 : 47-56

Torabizadeh, C., Bostani, S., Yektatalab, S.

Comparison between the effects of muscle relaxation and support groups on the anxiety of nursing students: A randomized controlled trial

OBJECTIVE: To compare the effects of the two methods of muscle relaxation and support group on the anxiety levels of the nursing students.\rMETHODS: In this randomized controlled trial, 150 nursing students who met the inclusion criteria were divided into three equal groups- muscle relaxation, support group, and control-using the permuted-block randomization method. The experimental groups received 5 sessions of intervention, while the control group did not receive any intervention at all. Using Spielberger's inventory, the researchers measured the anxiety levels of all three groups before and after the intervention.\rRESULTS: The results showed that both methods had a significant impact on anxiety levels of the nursing students; however, a comparison between their effects revealed that muscle relaxation had been more effective than support group.\rCONCLUSIONS: Considering the seriousness of the issue of anxiety for nursing students, it is important that measures be taken to reduce anxiety in this group.

Complementary Therapies in Clinical Practice, 25 : 106- 113

Urao, Y., Yoshinaga, N., Asano, K., Ishikawa, R., Tano, A., Sato, Y., Shimizu, E.

Effectiveness of a cognitive behavioural therapy-based anxiety prevention programme for children: A preliminary quasi-experimental study in Japan

Background: As children's mental health problems become more complex, more effective prevention is needed. Though various anxiety and depression prevention programmes based on cognitive behavioural therapy (CBT) were developed and evaluated in Europe, North America, and Australia recently, there are no programmes in Japan. This study developed a CBT programme for Japanese children and tried to verify its effectiveness in reducing anxiety. Methods: A CBT-based anxiety prevention programme, 'Journey of the Brave', was developed to prevent anxiety disorders for Japanese children. Children from 4th through 6th grades (9-12 years old) in Japanese elementary schools and their parents (13 sample pairs) were the intervention group. For comparison purposes, 16 pairs were the control group. Ten weekly programme sessions and two follow-ups were conducted. Children's anxiety levels in both groups were evaluated by child and parent self-reports using the spence children anxiety scale (SCAS) three times: pre-programme (baseline), post-programme, and 3 months following the end of the programme. Results: At 3-month follow-up, no significant difference was shown between the intervention and control groups on children's SCAS scores in changes from baseline by using mixed-effects model for repeated measures analysis (SCAS-C: -8.92 (95 % CI = -14.12 to -3.72) and -3.17 (95 % CI = -8.02 to 1.66) respectively; the between group difference was 5.747 (95 % CI = -1.355 to -12.85, p = 0.062). On the other hand, significant reduction was shown in the intervention group on parents' SCAS (SCAS-P) scores in change from baseline -9.554 (95 % CI = -12.91 to -6.19) and 0.154 (95 % CI = -2.88 to 3.19) respectively; the between group difference was 9.709 (95 % CI = 5.179 to 14.23, p = 0.0001). Conclusion: These preliminary results suggest this anxiety prevention programme for Japanese children was partially effective from parents' evaluations. However, it is important to note that this study was conducted on a small sample with unbalanced groups at pre-intervention with no randomization. The positive results may require discounting due to the research limitations. A larger-scale study of the programme in elementary school classes to verify its effectiveness with a more rigorous research design is necessary. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Child and Adolescent Psychiatry and Mental Health Vol 10 2016, ArtID 4, 10 :

Podina, I. R., Mogoase, C., David, D., Szentagotai, A., Dobrean, A.

A meta-analysis on the efficacy of technology mediated CBT for anxious children and adolescents

Several meta-analyses indicate that cognitive-behavioral therapy (CBT) via electronic/technological devices or applications (i.e., eCBT) is an effective alternative to standard therapist-delivered CBT for anxious adults. However, we know little about the efficacy of eCBT interventions for anxious children and adolescents. The present meta-analysis set out to investigate the efficacy of eCBT in comparison to standard CBT or waitlist control for anxious children and adolescents. Eight randomized controlled studies (N = 404 participants) that targeted anxiety at post-intervention and follow-up were included in the analysis. The results indicated that eCBT was as effective as standard CBT (g = .295) and more effective than waitlist (g = 1.410) in reducing anxiety symptoms. Moderation analyses revealed that anxious children and adolescents benefited the most from eCBT in the minimal therapist involvement condition (g = 2.682) in contrast to the significant therapist involvement group (g = .326). Furthermore, older participants seemed to extract greater clinical benefits from eCBT in contrast to younger participants (slope = .514). Current eCBT interventions for anxious children and adolescents appear to be promising, but require further investigation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Journal of Rational-Emotive & Cognitive-Behavior Therapy, 34(1) : 31- 50

Pophillat, E., Rooney, R. M., Nesa, M., Davis, M. C., Baughman, N., Hassan, S., Kane, R.T.

Preventing internalizing problems in 6-8 year old children: A universal school-based program

The Aussie Optimism Program: Feelings and Friends (AOP-FF) is a 10 week, universal mental health promotion program based on social/emotional and cognitive and behavioral strategies. The aim of the current study was to evaluate the efficacy of a universal Cognitive Behavioral Therapy based program in preventing and reducing internalizing problems in 6-8 year olds (Years 1-3 in Australia). Year 1-3 students from a low SES primary school (N = 206) were randomly assigned in classes to either an intervention or a control group and assessed at baseline and post- test. Results showed a significant (p = 0.009) and small to moderate (partial eta-squared = 0.034) pre-post decrease in parent-reported anxiety symptoms for the intervention group, in conjunction with a non-significant (p = 0.708) and negligible (partial eta-squared = 0.001) pre-post increase for the control group. A larger randomized controlled trial assessing longer term effects is needed. In addition the program needs to be simplified for year 1-2 students with a separate more developmentally appropriate program for year 3 students. (PsycINFO Database Record (c) 2017 APA, all rights reserved)

Frontiers in Psychology Vol 7 2016, ArtID 1928, 7 :