Disorders - Anxiety Disorders
Hiller, R. M., Apetroaia, A., Clarke, K., Hughes, Z., Orchard, F., Parkinson, M., Creswell, C.
Following cognitive behavioural therapy for child anxiety a
significant minority of children fail to lose their diagnosis status. One potential barrier is high parental anxiety. We designed a pilot RCT to test
claims that parental intolerance of the child's negative emotions may impact treatment outcomes. Parents of 60 children with an anxiety disorder,
who were themselves highly anxious, received either brief parent-delivered treatment for child anxiety or the same treatment with strategies
specifically targeting parental tolerance of their child's negative emotions. Consistent with predictions, parental tolerance of the child's
negative emotions significantly improved from pre- to post-treatment. However, there was no evidence to inform the direction of this association as
improvements were substantial in both groups. Moreover, while there were significant improvements in child anxiety in both conditions, there was
little evidence that this was associated with the improvement in parental tolerance. Nevertheless, findings provide important clinical insight,
including that parent-led treatments are appropriate even when the parent is highly anxious and that it may not be necessary to adjust interventions
for many families. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Journal of Anxiety Disorders, 42 : 52-
59
- Year: 2016
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions
Das, J. K., Salam, R. A., Lassi, Z. S., Khan, M. N., Mahmood,
W., Patel, V., Bhutta, Z. A.
Many mental health disorders emerge in late childhood and early adolescence and contribute to the burden of these
disorders among young people and later in life. We systematically reviewed literature published up to December 2015 to identify systematic reviews on
mental health interventions in adolescent population. A total of 38 systematic reviews were included. We classified the included reviews into the
following categories for reporting the findings: school-based interventions (n = 12); community-based interventions (n = 6); digital platforms (n =
8); and individual-/family-based interventions (n = 12). Evidence from school-based interventions suggests that targeted group-based interventions
and cognitive behavioral therapy are effective in reducing depressive symptoms (standard mean difference [SMD]: -.16; 95% confidence interval [CI]:
-.26 to -.05) and anxiety (SMD: -.33; 95% CI: -.59 to -.06). School-based suicide prevention programs suggest that classroom-based didactic and
experiential programs increase short-term knowledge of suicide (SMD: 1.51; 95% CI: .57-2.45) and knowledge of suicide prevention (SMD: .72; 95% CI:
.36-1.07) with no evidence of an effect on suicide-related attitudes or behaviors. Community-based creative activities have some positive effect on
behavioral changes, self-confidence, self-esteem, levels of knowledge, and physical activity. Evidence from digital platforms supports Internet-based
prevention and treatment programs for anxiety and depression; however, more extensive and rigorous research is warranted to further establish the
conditions. Among individual- and family-based interventions, interventions focusing on eating attitudes and behaviors show no impact on body mass
index (SMD: -.10; 95% CI: -.45 to .25); Eating Attitude Test (SMD: .01; 95% CI: -.13 to .15); and bulimia (SMD: -.03; 95% CI: -.16 to .10). Exercise
is found to be effective in improving self-esteem (SMD: .49; 95% CI: .16-.81) and reducing depression score (SMD: -.66; 95% CI: -1.25 to -.08) with
no impact on anxiety scores. Cognitive behavioral therapy compared to waitlist is effective in reducing remission (odds ratio: 7.85; 95% CI: 5.31-
11.6). Psychological therapy when compared to antidepressants have comparable effect on remission, dropouts, and depression symptoms. The studies
evaluating mental health interventions among adolescents were reported to be very heterogeneous, statistically, in their populations, interventions,
and outcomes; hence, meta-analysis could not be conducted in most of the included reviews. Future trials should also focus on standardized
interventions and outcomes for synthesizing the exiting body of knowledge. There is a need to report differential effects for gender, age groups,
socioeconomic status, and geographic settings since the impact of mental health interventions might vary according to various contextual factors.
(PsycINFO Database Record (c) 2017 APA, all rights reserved)
Journal of Adolescent Health, 59(4,
Suppl) : S49-S60
- Year: 2016
- Problem: Anxiety Disorders (any), Depressive Disorders, Eating Disorders
(any), Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Complementary & Alternative
Interventions (CAM), Service Delivery & Improvement, Psychological Interventions
(any), Technology, interventions delivered using technology (e.g. online, SMS)
Everly-Jr, G. S., Lating, J. M., Sherman, M. F., Goncher, I.
The authors explored the efficacy of a randomized controlled trial to assess the potential
benefits of psychological first aid (PFA) compared with a social acknowledgement condition in a sample of 42 participants who spoke about a stressful
life event. Demographics and standardized questionnaires, including the state version of the State Trait Anxiety Inventory Scale and the Brief
Profile of Mood States, assessed anxiety and mood state. Those in the PFA group evidenced significantly lower anxiety scores at 30-minute
postdisclosure than at baseline and, although not significant, showed lowered distressed mood compared with baseline at 30-minute postdisclosure.
Those in the social acknowledgment condition evidenced increases in anxiety and distressed mood scores, albeit not significantly, at 30 minutes post
disclosure compared with their baseline scores. These results provide preliminary empirical evidence for the efficacy of PFA, and implications for
intervention and additional assessment are suggested. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Journal of Nervous and Mental Disease, 204(3) : 233-235
- Year: 2016
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Falsafi,
Nasrin
Background: Depression and anxiety disorders are two of the most
common mental disorders in the United States. These disorders are prevalent among college students. Objective: The main objective of this study is to
compare the effectiveness of two different types of intervention practices (mindfulness vs. yoga) and a noninterventional control group in mitigating
the effects of depression and/or anxiety in college students. Method: A sample of 90 students (both genders) over age 18 who had a diagnosis of
anxiety and/or depression was recruited from 11,500 undergraduate college students in a mid-size university. The study's design included
stratified-randomized controlled repeated measures with three groups: a mindfulness intervention group, a yoga-only intervention group, and a
noninterventional group. Participants were randomly assigned to the aforementioned three groups. Participants in the intervention groups received an
8-week training either in mindfulness or yoga. Depressive, anxiety, stress symptoms, self-compassion, and mindfulness were measured at baseline, Week
4, Week 8, and Week 12. Results: Depressive, anxiety, and stress symptoms decreased significantly (p < .01) from baseline to follow-up conditions in
both the mindfulness and yoga intervention groups. The changes in mindfulness scores were also significant in both groups. However, the changes in
self-compassion scores were significant only in the mindfulness intervention group. No significant changes in the control group were demonstrated.
Conclusions: The findings from this study can provide useful information to nurses and other health care providers. This study may have implications
for a cost-effective treatment for depression and anxiety. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Journal of the American Psychiatric Nurses Association, 22(6) : 483-
497
- Year: 2016
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Mindfulness based
therapy, Mind-body exercises (e.g. yoga, tai chi, qigong)
Dziembowska, I., Izdebski, P., Rasmus, A., Brudny, J., Grzelczak, M., Cysewski, P.
Heart rate variability biofeedback (HRV-BFB) has been shown as useful tool to manage stress in various
populations. The present study was designed to investigate whether the biofeedback-based stress management tool consisting of rhythmic breathing,
actively self-generated positive emotions and a portable biofeedback device induce changes in athletes' HRV, EEG patterns, and self-reported anxiety
and self-esteem. The study involved 41 healthy male athletes, aged 16-21 (mean 18.34 +/- 1.36) years. Participants were randomly divided into two
groups: biofeedback and control. Athletes in the biofeedback group received HRV biofeedback training, athletes in the control group didn't receive
any intervention. During the randomized controlled trial (days 0-21), the mean anxiety score declined significantly for the intervention group
(change-4 p < 0.001) but not for the control group (p = 0.817). In addition, as compared to the control, athletes in biofeedback group showed
substantial and statistically significant improvement in heart rate variability indices and changes in power spectra of both theta and alpha brain
waves, and alpha asymmetry. These changes suggest better self-control in the central nervous system and better flexibility of the autonomic nervous
system in the group that received biofeedback training. A HRV biofeedback-based stress management tool may be beneficial for stress reduction for
young male athletes. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Applied Psychophysiology and Biofeedback, 41(2) : 141-
150
- Year: 2016
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Biofeedback, neurofeedback, audio/video feedback
Eslami, A. A., Rabiei, L., Afzali, S. M., Hamidizadeh, S., Masoudi, R.
Background: Adolescence is a
transition period from childhood to early adulthood. Because of the immense pressure imposed on adolescents due to the complications and ambiguities
of this transition, their level of excitement increases and sometimes it appears in the form of sensitivity and intense excitement. Objectives: This
study aimed at determining the effectiveness of assertiveness training on the levels of stress, anxiety, and depression of high school students.
Materials and Methods: This quasi-experimental study was conducted on high school students of Isfahan in academic year 2012 -13. A total of 126
second grade high school students were collected according to simple random sampling method and divided into two groups: experimental with 63
participants and control with the same number. Data gathering instruments included a demographic questionnaire, Gambill-Richey assertiveness scale,
and depression anxiety stress scales (DASS-21). Assertiveness training was carried out on the experimental group in 8 sessions; after 8 weeks,
posttest was carried out on both groups. Statistical tests such as independent t test, repeated measures ANOVA, Chi-square test, and the Mann-Whitney
test were used to interpret and analyze the data. Results: The Chi-square and Mann-Whitney tests did not show significant statistical differences
between the two groups in terms of demographic variables (P = 0.05). Repeated measures ANOVA showed no significant difference between the mean scores
for assertiveness before (100.23 ± 7.37), immediately after (101.57 ± 16.06), and 2 months after (100.77 ± 12.50) the intervention in the control
group. However, the same test found a significant difference between the mean score for assertiveness in the experimental group before (101.6 ± 9.1),
immediately after (96.47 ± 10.84), and 2 months after (95.41 ± 8.37) implementing the training program (P = 0.002). The independent t test showed no
significant difference in the mean score for anxiety and stress between two groups before the assertiveness training program; however, 2 months after
the intervention, the mean score for anxiety in the experimental group was found significantly lower than the control group. As for the mean score
for depression, the independent t test showed no significant difference between two groups before training; however, despite the decrease in the mean
scores for depression in the experimental group following the intervention, the difference was not significant (P = 0.09). Conclusions: The results
of the current study show that conducting assertive training in high school students decreases their anxiety, stress, and depression. Given that high
school years are among the most sensitive stages of one's life plus the fact that conducting such training programs besides their safe and low cost
nature are effective and practical, it is highly recommended that such programs be carried out among high school adolescents.
Iranian Red Crescent Medical Journal, 18(1) : 1-10
- Year: 2016
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Skills training
Craske, M. G., Stein, M. B.
Anxiety disorders (separation anxiety disorder, selective mutism, specific phobias, social anxiety disorder, panic disorder,
agoraphobia, and generalised anxiety disorder) are common and disabling conditions that mostly begin during childhood, adolescence, and early
adulthood. They differ from developmentally normative or stress-induced transient anxiety by being marked (ie, out of proportion to the actual threat
present) and persistent, and by impairing daily functioning. Most anxiety disorders affect almost twice as many women as men. They often co-occur
with major depression, alcohol and other substance-use disorders, and personality disorders. Differential diagnosis from physical conditions-
including thyroid, cardiac, and respiratory disorders, and substance intoxication and withdrawal-is imperative. If untreated, anxiety disorders tend
to recur chronically. Psychological treatments, particularly cognitive behavioural therapy, and pharmacological treatments, particularly selective
serotonin-reuptake inhibitors and serotonin-noradrenaline-reuptake inhibitors, are effective, and their combination could be more effective than is
treatment with either individually. More research is needed to increase access to and to develop personalised treatments.\rCopyright © 2016 Elsevier
Ltd. All rights reserved.
Lancet, 388(10063) : 3048-
3059
- Year: 2016
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any)
Darragh, M., Booth, R. J., Consedine, N. S.
Objective: In order to harness the placebo effect for clinical
benefit, more research is needed to determine who might be responsive to a placebo treatment. Recently, a two-faceted Transactional Model of Placebo
Responding (TMPR) was offered, which suggests different personality types might respond to different contextual cues. The current study directly
tested this model by manipulating treatment descriptors to match the two purported facets of responsiveness. Methods: Physically healthy volunteers
(N = 77) experiencing life stress were randomised to either the: (1) wait-list control, (2) 'serotonin treatment' group; or (3) 'oxytocin
treatment' group. Both treatment groups received an 'antistress' intranasal spray (placebo). The 'serotonin' and 'oxytocin' treatments were
described to appeal to the two purported facets responsiveness set out in the TMPR, inward and outward orientation. The BIS/BAS scale was used as
proxies for inward (BIS) and outward (BAS) orientation. It was hypothesised that high BAS types would be more responsive to the 'oxytocin' and high
BIS types would be more responsive to the 'serotonin'. Results: Findings provide partial support for hypotheses, with high but not low BAS types
having a greater response to the 'oxytocin' placebo; but the pattern of responses from high BIS types were contrary to predictions. Conclusions:
Findings indicate interactions between personality type and environmental cues may contribute to placebo responding, but more research is needed to
investigate possible operationalisations of responsiveness and the contextual cues to which different types may respond. Copyright © 2016 Elsevier
Inc.
Journal of
Psychosomatic Research, 83 : 10-15
- Year: 2016
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Biological Interventions
(any), Other biological interventions, Psychological Interventions
(any), Other Psychological Interventions
Darragh, M., Yow, B., Kieser, A., Booth, R.
J., Kydd, R. R., Consedine, N. S.
Background: With a healthcare system burdened by
symptomatic and mental-health related conditions, the placebo effect may represent a useful clinical tool. First, however, there is a need to broaden
research attention and investigate placebo effects outside laboratories and beyond experimental pain. This study investigated the effectiveness of a
take-home placebo treatment in the short-term alleviation of stress, anxiety and symptoms of depression in a non-patient population. Method: A sample
of 77 participants was randomized to either the 'oxytocin' treatment group (n = 22), the 'serotonin' treatment group (n = 22) or the wait-list
control group (n = 33). The two treatment groups were given an 'anti-stress treatment spray' (placebo) to self-administer for 3 days, and completed
online measures of perceived stress (Perceived Stress Scale-10), anxiety (Cognitive Somatic Anxiety Questionnaire) and symptoms of depression (Centre
for Epidemiological Studies-Depression) before and after the 3-day protocol. Results: Both the 'serotonin' and 'oxytocin' treatment sprays were
effective in reducing symptoms of depression; however, only those in the 'oxytocin' group reported less stress and anxiety as compared with
controls. Overall, the 'oxytocin' was perceived as more effective. Conclusion: Placebo effects can be translated to a real-life setting in the
short-term reduction of stress, anxiety and symptoms of depression in a non-patient population. In treating psychological distress, placebos may be
useful addition to the treatment repertoire. The information given with treatment may also be an important consideration for practitioners. (PsycINFO
Database Record (c) 2016 APA, all rights reserved)
Australian and New Zealand Journal of Psychiatry, 50(9) : 858-
865
- Year: 2016
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Biological Interventions
(any), Other biological interventions, Psychological Interventions
(any), Other Psychological Interventions
de-
Voogd, E., Wiers, R., Prins, P., de-Jong, P., Boendermaker, W., Zwitser, R., Salemink, E.
Based on information processing models of anxiety and depression, we
investigated the efficacy of multiple sessions of online attentional bias modification training to reduce attentional bias and symptoms of anxiety
and depression, and to increase emotional resilience in youth. Unselected adolescents (N = 340, age: 11-18 years) were randomly allocated to eight
sessions of a dot-probe, or a visual search-based attentional training, or one of two corresponding placebo control conditions. Cognitive and
emotional measures were assessed pre- and post-training; emotional outcome measures also at three, six and twelve months follow-up. Only visual
search training enhanced attention for positive information, and this effect was stronger for participants who completed more training sessions.
Symptoms of anxiety and depression reduced, whereas emotional resilience improved. However, these effects were not especially pronounced in the
active conditions. Thus, this large-scale randomized controlled study provided no support for the efficacy of the current online attentional bias
modification training as a preventive intervention to reduce symptoms of anxiety or depression or to increase emotional resilience in unselected
adolescents. However, the absence of biased attention related to symptomatology at baseline, and the large drop-out rates at follow-up preclude
strong conclusions. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Behaviour Research and Therapy, 87 : 11-
22
- Year: 2016
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Attention/cognitive bias
modification, Technology, interventions delivered using technology (e.g. online, SMS)
de-Voogd, E., Wiers, R. W., Zwitser, R. J., Salemink,
E.
Objective: Anxiety and depression are highly
prevalent disorders in adolescence. They are associated with deficits in working memory (WM), which also appears to increase rumination, worry, and
negative mood. WM training, especially in an emotional context, might help in reducing or preventing these disorders. The current study investigated
the direct effects of online emotional WM training on WM capacity, and short- and long-term effects on symptoms of anxiety and depression, and
secondary measures of emotional functioning. Methods: Unselected adolescents (n = 168, aged 11-18) were randomised over an active or placebo
emotional WM training. WM was assessed before and after 4 weeks of bi-weekly training. Emotional functioning was assessed pre- and post-training and
at 3, 6, and 12 months follow-up. Results: Improvements in WM capacity and both shortand long-term emotional functioning were found in both training
groups, with the only group difference being a trend for a larger increase in self-esteem in the active group compared to the placebo group.
Conclusions: The general improvements irrespective of training condition suggest non-specific training or time effects, or some shared active
ingredient in both conditions. Future research is necessary to detect potentially effective components of (emotional) WM training and to increase
adolescent engagement with online training. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Australian Journal of Psychology, 68(3) : 228-
238
- Year: 2016
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Attention/cognitive bias
modification, Technology, interventions delivered using technology (e.g. online, SMS)
Dean, S., Britt, E., Bell, E., Stanley, J., Collings, S.
Background: The prevalence of anxiety and mood
disorders in adolescents is a growing public health concern worldwide. Given the high rates of drop-out and limited resources available in
psychiatric settings, the importance of engaging adolescents in evidence-based treatments cannot be understated. The aim of the study was to
determine the efficacy of motivational interviewing (MI), as a brief pre-treatment intervention, to enhance treatment engagement in a standard
therapy setting (group cognitive behavioral therapy; gCBT) for adolescents with anxiety and mood disorders. Method: Ninety-six adolescents (13-18
years) with a principal diagnosis of an anxiety or mood disorder participated in a trial conducted at two publicly funded outpatient services.
Participants were randomly assigned to individual MI for treatment engagement prior to gCBT (MI + gCBT), or to an individually administered active
control (befriending) prior to gCBT (befriending + gCBT). Eight pairs of gCBT were run in parallel. Outcome measures were the mean number of gCBT
sessions attended, treatment initiation, and ratings of readiness for treatment. Results: Participants randomized to MI as a pretreatment
intervention attended significantly more group therapy sessions compared to those in the active control condition. The MI group also demonstrated
greater treatment initiation, and ratings of treatment readiness were significantly higher for those randomized to MI. Conclusions: MI, used as a
pre-treatment intervention, enhanced group treatment engagement in adolescents diagnosed with anxiety and mood disorders compared to the active
control condition. MI is a promising intervention to facilitate engagement in adolescent mental health settings. (PsycINFO Database Record (c) 2016
APA, all rights reserved)
Psychological Medicine, 46(9) : 1961-
1969
- Year: 2016
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Motivational interviewing, includes Motivational Enhancing Therapy