Disorders - Anxiety Disorders
Quach, D., Jastrowski-Mano, K. E., Alexander, K.
Purpose:
To investigate the effectiveness of a mindfulness meditation intervention on working memory capacity (WMC) in adolescents via a randomized controlled
trial comparing mindfulness meditation to hatha yoga and a waitlist control group. Methods: Participants (N = 198 adolescents) were recruited from a
large public middle school in southwest United States and randomly assigned to mindfulness meditation, hatha yoga, or a waitlist control condition.
Participants completed a computerized measure of WMC (Automated Operational Span Task) and self-report measures of perceived stress (Perceived Stress
Scale) and anxiety (Screen for Childhood Anxiety Related Emotional Disorders) at preintervention and postintervention/waitlist. A series of mixed-
design analyses of variance were used to examine changes in WMC, stress, and anxiety at preintervention and postintervention. Results: Participants
in the mindfulness meditation condition showed significant improvements in WMC, whereas those in the hatha yoga and waitlist control groups did not.
No statistically significant between-group differences were found for stress or anxiety. Conclusions: This is the first study to provide support for
the benefits of short-term mindfulness practice, specifically mindfulness meditation, in improving WMC in adolescents. Results highlight the
importance of investigating the components of mindfulness-based interventions among adolescents given that such interventions may improve cognitive
function. More broadly, mindfulness interventions may be delivered in an abridged format, thus increasing their potential for integration into school
settings and into existing treatment protocols. Copyright © 2016 Society for Adolescent Health and Medicine. All rights reserved.
Journal of Adolescent Health, 58(5) : 489-
496
- Year: 2016
- 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)
Rapee, R. M., Jones,
M. P., Hudson, J. L., Malhi, G. S., Lyneham, H. J., Schneider, S. C.
Use of
the partial NMDA receptor agonist d-Cycloserine (DCS) to increase extinction to feared cues among anxious adults has shown mixed, although overall
positive effects. Few studies have extended this effect to youth and none have addressed young people with broad-based anxiety such as separation
anxiety, social anxiety, or generalised anxiety. In the current trial 51 children and adolescents with diagnosed anxiety disorders, aged 7-14 years
received four sessions of graduated, experimenter-led, in vivo exposure to a hierarchy of feared cues relevant to their primary fear. They were
randomly allocated to receive either 50 mg of DCS or a matched placebo capsule in a fully double-blind design. Both groups showed large reductions
across sessions in their primary fear according to both parent and child report, but there were no significant differences between conditions at any
session. The results are consistent with most studies to date of DCS-augmented exposure in young people. (PsycINFO Database Record (c) 2016 APA, all
rights reserved)
Behaviour Research and Therapy, 87 : 225-231
- Year: 2016
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Exposure therapy, Exposure
and response prevention, D-cycloserine (DCS)
Rasanen, P., Lappalainen, P., Muotka, J., Tolvanen, A., Lappalainen, R.
Stress, anxiety and depression are relatively common problems among university students. This study examined whether an online
psychological intervention aiming at enhancing the wellbeing of university students could be an effective and practical alternative for meeting the
needs of a university population. University students (= 68; 85% female; 19-32 years old) were randomly assigned to either a guided seven-week online
Acceptance and Commitment Therapy (iACT) intervention or a waiting list control condition (WLC). A between-groups pre-post (iACT vs WLC) design with
12-month follow-up for the iACT participants was conducted. The intervention participants were offered two face-to-face meetings, completed online
exercises during a five-week period, and received personal weekly written feedback via the website from their randomly assigned, trained student
coaches. Waitlist participants were offered the intervention program soon after the post measurements. Results in this small efficacy trial showed
that the iACT participants had significantly higher gains in wellbeing (between group, d = 0.46), life satisfaction (= 0.65), and mindfulness skills
(= 0.49). In addition, iACT participants' self-reported stress (= 0.54) and symptoms of depression (= 0.69) were significantly reduced compared to
the participants in the control group. These benefits were maintained over a 12-month follow-up period (within iACT group, d = 0.65-0.69, for primary
measures). The results suggest that an online-based, coach-guided ACT program with blended face-to-face and online sessions could be an effective and
well-accepted alternative for enhancing the wellbeing of university students.
Behaviour Research & Therapy, 78 : 30-
42
- Year: 2016
- 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), Acceptance & commitment therapy
(ACT), Technology, interventions delivered using technology (e.g. online, SMS)
Ozyurt, G., Gencer, O., Ozturk, Y., Ozbek, A.
The aim of this study is to evaluate the effectiveness of Triple P Positive
Parenting Program, which has been shown to be effective in reducing children's behavior problems in a variety of populations, on childhood anxiety
disorders. This is an open-labelled continuation study of the randomized, single-blinded, controlled trial which is done 4 months after the
intervention. A total of 50 subjects ages between 8 and 12 diagnosed with anxiety disorder were enrolled to the open-labelled phase of the study. The
two groups were compared right before and 4 months after the implementation with various questionnares which measured the children's amotional and
behavioral problems and anxiety severity and parental general well being and axiety were also evaluated. Children's general anxiety level and
anxiety disorder severity of intervention group were significantly lower than waiting list group. In this study, it is shown that parental anxiety
and general well being were also improved. Our results suggest that Triple P may be an effective and useful method of treatment for anxious children.
Large sample sized studies are needed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Journal of Child and Family
Studies, 25(5) : 1646-1655
- Year: 2016
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Panahi, F., Faramarzi, M.
Objective: Little research has been done regarding the role of psychotherapy in the treatment of Premenstrual Syndrome (PMS).
The aim of this study was to examine the effect of mindfulness-based cognitive therapy (MBCT) on the PMS symptoms and depression and anxiety symptoms
in women with PMS. Design. In a randomized controlled trial, a total of 60 students at Mazandaran University with mild to moderate PMS who had
depressive symptoms (Beck depression scores 16-47) were randomly allocated to either an experimental (n = 30) or a control (n = 30) group. The
experimental group received MBCT in eight group sessions (120 min each) over 8 weeks. The control group received no intervention. All participants
completed the Premenstrual Assessment Scale (PAS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) at the beginning and the end of
the study. Repeated-measure ANOVA was used to analyze the data. Results: At the end of study, the experimental and control groups showed the
following scores, respectively (mean +/- SD): depression, 15.73 +/- 6.99 and 25.36 +/- 7.14; anxiety, 16.96 +/- 7.78 and 26.60 +/- 9.38; and total
PAS, 42.86 +/- 8.02 and 58.93 +/- 8.47. MBCT improved depression and anxiety symptoms and total PAS score. Conclusion: MBCT intervention is
acceptable and potentially beneficial in women with PMS symptoms. Psychotherapy should be considered as a treatment option for mild to moderate PMS
in women with depressive symptoms. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Depression Research and Treatment Vol 2016 2016, ArtID
9816481, 2016 :
- Year: 2016
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Mindfulness based
therapy
Parker, A. G., Hetrick, S. E., Jorm, A. F., Mackinnon, A. J., McGorry, P. D., Yung, A. R., Scanlan,
F., Stephens, J., Baird, S., Moller, B., Purcell, R.
Background: The prevalence and
burden of disease of depression and anxiety disorders in young people necessitates effective early intervention strategies. The aim of this study was
to evaluate the effectiveness of low-intensity interventions (problem solving therapy (PST) and physical activity promotion) in young people (15-25
years) with mild-moderate depression and/or anxiety. Method: A 2 x 2 factorial randomised controlled trial (RCT) with factors of PST versus
supportive counselling (control) and behavioural activation physical activity versus lifestyle psychoeducation (control). Help-seeking participants
(n=176) were randomised to receive up to 6 manualised intervention sessions. Primary outcomes were post-intervention depressive symptoms (Beck
Depression Inventory-II (BDI-II), anxiety symptoms (Beck Anxiety Inventory), and Montgomery-Asberg Depression Rating Scale (MADRS)). Trial
registration ACTRN12608000550303. Results: Depression symptoms were significantly reduced in the physical activity group compared to psychoeducation
(BDI-II: d = 0.41 (95% CI: 0.07-0.76); MADRS: d = 0.48 (95% CI: 0.13-0.82), but not post-intervention anxiety symptoms. PST was not superior to
supportive counselling, nor were any interactions between interventions significant. Limitations: As self reported levels of physical activity did
not significantly differ between baseline and end-point in those randomised to the physical activity intervention, it is unclear as to whether some
form of physical activity not measured in the trial may have led to the difference in depression symptoms. Conclusions: PST was not superior to
supportive counselling in reducing depression and anxiety symptoms in young people. Participants who received the physical activity intervention
reported the greatest reduction in depression symptoms, however further research is required to establish the mechanism of action and to determine
its effectiveness as an adjunct intervention in routine clinical practice. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (journal
abstract).
Journal of Affective Disorders, 196 : 200-209
- Year: 2016
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Psychoeducation, Problem solving therapy (PST), Supportive
therapy, Physical activity, exercise
Perrino, T., Pantin, H., Huang, S., Brincks,
A., Brown, C. H., Prado, G.
Familias Unidas is an intervention that has been found to be efficacious in preventing and reducing
substance use, sexual risk, and problem behaviors among Hispanic youth. While it does not specifically target youth internalizing symptoms, the
intervention works to strengthen parenting and family factors associated with reduced risk of internalizing symptoms (i.e., depression, anxiety
symptoms). This study examines the effects of Familias Unidas on internalizing symptoms among high-risk youth, as well as the role of family level
factors in the intervention's effects. A total of 242 12-17-year-old Hispanic youth with a history of delinquency and their primary caregivers were
recruited from the school and juvenile justice systems, and randomly assigned to the Familias Unidas intervention or community practice control. A
linear latent growth model was used to examine intervention effects on the trajectory of adolescent internalizing symptoms from baseline to 6 and 12
months post-baseline. Results show that the Familias Unidas intervention was more efficacious than control in reducing youth internalizing symptoms.
Baseline youth externalizing and internalizing symptoms did not moderate the intervention's effects on the trajectory of youth internalizing
symptoms. While parent-adolescent communication did not significantly moderate the intervention's effects, changes in parent-adolescent
communication mediated the intervention's effects on internalizing symptoms, showing stronger intervention effects for youth starting with poorer
communication. Findings indicate that the Familias Unidas intervention can reduce internalizing symptoms among high-risk Hispanic youth, and that
improving parent-youth communication, a protective family factor, may be one of the mechanisms by which the intervention influences youth
internalizing symptoms.\rCopyright © 2015 Family Process Institute.
Family Process, 55(1) : 91-
106
- Year: 2016
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Moir, F., Henning, M., Hassed, C., Moyes, S. A., Elley, C. R.
PROBLEM: There is evidence that
peer-support programs can improve mental health indices and help-seeking behavior among students in some secondary school and university settings and
that mindfulness can improve mental health in medical students. Peer-led programs have not been formally assessed in a medical student population,
where psychological issues exist and where it has been shown that students approach peers for help in preference to staff members or professional
services.\rINTERVENTION: Medical students elected peer leaders who underwent training and then provided the intervention. The peer leaders provided
support to students in the intervention group, as well as offering teaching in mindfulness meditation.\rCONTEXT: An exploratory study was conducted
with 2nd- and 3rd-year medical students at 1 medical school in New Zealand randomized into 2 groups. In addition to existing mental health resources,
intervention participants received a program including peer support and peer-taught mindfulness practice. Study participants not offered the
intervention participants could use existing mental health resources. Primary measures included depression (PHQ-9) and anxiety (GAD-7) scores.
Secondary measures were quality of life, resilience (15-item resilience scale), academic self-concept, and motivation to learn, assessed at baseline
and 6 months.\rOUTCOME: Of the 402 students eligible, 275 (68%) participated and 232 (58%) completed the study. At baseline, 53% were female and mean
age was 21 years (SD = 3)-PHQ-9 score (M = 5.2, SD = 3.7) and GAD-7 score (M = 4.5, SD = 3.4). Twelve peer leaders were elected. There was good
participation in the intervention. One fourth of intervention students used the face-to-face peer support and more than 50% attended a peer social
event and/or participated in the mindfulness program. Although improvements in mental health were seen in the intervention group, the difference
between the intervention and nonintervention groups did not reach statistical significance.\rLESSONS LEARNED: Although evidence exists for
effectiveness of peer support and mindfulness in other contexts, this exploratory study was not able to show a statistically significant effect.
Future studies could consider using a longer training period for the peer leaders, as well as targeting the study population to those most likely to
benefit such as those with poorer mental health, or using a more intensive intervention or larger sample size. A cluster randomized study design
would also reduce the risk of contamination.
Teaching & Learning in Medicine, 28(3) : 293-302
- Year: 2016
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Mindfulness based
therapy
Morris, J., Firkins, A., Millings, A., Mohr, C., Redford, P., Rowe, A.
Background and Objectives: Anxiety and
insomnia can be treated with internet-delivered Cognitive Behavioral Therapy (iCBT). iCBT may be well-suited to students who are known to be poor
help-seekers and suffer these symptoms. iCBT can offer easy access to treatment and increase service availability. The aim of this study was to
evaluate the efficacy of anxiety and insomnia iCBT programs in students. Design: A randomized, controlled study. Methods: Students were randomly
allocated to intervention (\"Anxiety Relief\": n = 43; \"Insomnia Relief\": n = 48; control: n = 47). Interventions lasted six weeks. Outcome
measures were the State-Trait Anxiety Inventory and the Pittsburgh Sleep Quality Index. Results: Significant within-group reductions in anxiety (t
(31) = 2.00, p = .03) with moderate between-groups (compared to control) effect size (d = .64) and increases in sleep quality (t(31) = 3.46, p =
.002) with a moderate between-groups effect size (d = .55) were found for completers of the anxiety program from pre- to post-intervention.
Significant within-group increases in sleep quality were found for completers of the insomnia program from pre- to post-intervention (t(35) = 4.28, p
> .001) with a moderate between-groups effect size (d = .51). Conclusions: Findings support the use of iCBT for anxiety and insomnia in students, and
indicate that further research is needed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Anxiety, Stress & Coping: An International Journal, 29(4) : 415-
431
- Year: 2016
- 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), Technology, interventions delivered using technology (e.g. online, SMS)
Macdonald, G., Livingstone, N., Hanratty, J., McCartan, C., Cotmore, R., Cary, M., Glaser, D., Byford,
S., Welton, N. J., Bosqui, T., Bowes, L., Audrey, S., Mezey, G., Fisher, H. L., Riches, W., Churchill, R.
Background: Child maltreatment is a substantial social problem that affects large numbers of children and young
people in the UK, resulting in a range of significant short- and long-term psychosocial problems. Objectives: To synthesise evidence of the
effectiveness, cost-effectiveness and acceptability of interventions addressing the adverse consequences of child maltreatment. Study design: For
effectiveness, we included any controlled study. Other study designs were considered for economic decision modelling. For acceptability, we included
any study that asked participants for their views. Participants: Children and young people up to 24 years 11 months, who had experienced maltreatment
before the age of 17 years 11 months. Interventions: Any psychosocial intervention provided in any setting aiming to address the consequences of
maltreatment. Main outcome measures: Psychological distress [particularly post-traumatic stress disorder (PTSD), depression and anxiety, and self-
harm], behaviour, social functioning, quality of life and acceptability. Methods: Young Persons and Professional Advisory Groups guided the project,
which was conducted in accordance with Cochrane Collaboration and NHS Centre for Reviews and Dissemination guidance. Departures from the published
protocol were recorded and explained. Meta-analyses and costeffectiveness analyses of available data were undertaken where possible. Results: We
identified 198 effectiveness studies (including 62 randomised trials); six economic evaluations (five using trial data and one decision-analytic
model); and 73 studies investigating treatment acceptability. Pooled data on cognitive-behavioural therapy (CBT) for sexual abuse suggested post-
treatment reductions in PTSD [standardised mean difference (SMD) -0.44 (95% CI -4.43 to -1.53)], depression [mean difference -2.83 (95% CI -4.53 to
-1.13)] and anxiety [SMD -0.23 (95% CI -0.03 to -0.42)]. No differences were observed for post-treatment sexualised behaviour, externalising
behaviour, behaviour management skills of parents, or parental support to the child. Findings from attachment-focused interventions suggested
improvements in secure attachment [odds ratio 0.14 (95% CI 0.03 to 0.70)] and reductions in disorganised behaviour [SMD 0.23 (95% CI 0.13 to 0.42)],
but no differences in avoidant attachment or externalising behaviour. Few studies addressed the role of caregivers, or the impact of the therapist-
child relationship. Economic evaluations suffered methodological limitations and provided conflicting results. As a result, decision-analytic
modelling was not possible, but cost-effectiveness analysis using effectiveness data from meta-analyses was undertaken for the most promising
intervention: CBT for sexual abuse. Analyses of the cost-effectiveness of CBT were limited by the lack of cost data beyond the cost of CBT itself.
Conclusions: It is not possible to draw firm conclusions about which interventions are effective for children with different maltreatment profiles,
which are of no benefit or are harmful, and which factors encourage people to seek therapy, accept the offer of therapy and actively engage with
therapy. Little is known about the cost-effectiveness of alternative interventions. Copyright © Queen's Printer and Controller of HMSO 2016.
Health Technology
Assessment, 20(69) :
- Year: 2016
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Service Delivery & Improvement, Psychological Interventions
(any)
Melton, T. H., Croarkin, P. E., Strawn, J. R., McClintock, S. M.
Background: A large and extensive body of research has examined comorbid anxiety and depression in adults. Children and adolescents also
frequently present with comorbid anxiety and depression; however, research and treatment require unique environmental and neurodevelopmental
considerations in children. As a result, our understanding of comorbid anxiety and depression in children and adolescents is limited. Objective: The
goal of this systematic review was to examine the current literature focused on comorbid anxiety and depression in children and adolescents. The
review included theoretical conceptualizations as well as diagnostic, neurobiological, prevention, and treatment considerations. In addition, a
proposed algorithm for the treatment of comorbid anxiety and depression in children/adolescents is provided. Methods: This systematic literature
review included 3 discrete searches in Ovid SP Medline, PsycINFO, and PubMed. Results: The review included and synthesized 115 articles published
between 1987 and 2015. The available evidence suggests that anxiety and depression are common in clinical populations of children and adolescents,
and that comorbidity is likely underestimated in children and adolescents. Children and adolescents with comorbid anxiety and depression have unique
presentations, greater symptom severity, and treatment resistance compared with those who have either disease in isolation. A dimensional approach
may be necessary for the future development of diagnostic strategies and treatments for this population. Nascent neuroimaging work suggests that
anxiety and depression each represents a distinct neurobiological phenotype. Conclusions: The literature that is currently available suggests that
comorbid anxiety and depression is a common presentation in children and adolescents. This diagnostic picture underscores the importance of
comprehensive dimensional assessments and multimodal evidence-based approaches given the high disease severity. Future research on the neurobiology
and the treatment of these common clinical conditions is warranted. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Journal of Psychiatric Practice, 22(2) : 84-
98
- Year: 2016
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any)
Murota, M., Iwawaki, Y., Uebaba, K., Yamamoto, Y., Takishita, Y., Harada, K., Shibata, A., Narumoto, J., Fukui, K.
Objective: To clarify the physical and psychological effects of head massage performed in the
supine position using Ayurveda-based techniques (head treatment). Design: Twenty-four healthy female students were included in the study. Using a
crossover study design, the same participants were enrolled in both the head treatment intervention group and control group. There was an interval of
1 week or more between measurements. Outcome measures: The physiologic indices measured included blood pressure and heart rate fluctuations (high
frequency and low frequency/high frequency). The psychological markers measured included liveliness, depression, and boredom using the visual
analogue scale method. State anxiety was measured using the State-Trait Anxiety Inventory method. Results: The parasympathetic nerve activity
increased immediately after head treatment. Upon completion of head treatment, the parasympathetic nerve predominance tended to gradually ease. Head
treatment boosted freshness and relieved anxiety. Conclusions: The results suggest that head treatment has a relaxing and refreshing effect and may
be used to provide comfort. Copyright © Masako Murota et al., 2016; Published by Mary Ann Liebert, Inc.
Journal of Alternative and Complementary Medicine, 22(7) : 526-
532
- Year: 2016
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Massage