Capron, D. W., Schmidt, N. B.

Development and randomized trial evaluation of a novel computer-delivered anxiety sensitivity intervention

Objective: Anxiety disorders contribute substantially to the overall public health burden of psychopathology. Anxiety sensitivity (AS), a fear of anxiety related sensations, is one of the few known malleable risk factors for anxiety pathology. Previous AS reduction treatments have utilized highly trained clinicians. A completely-computerized AS treatment would reduce costs and increase dissemination possibilities. Cognitive bias modification for interpretation biases (CBM-I) interventions have shown clinically significant reductions in anxiety symptoms. Another emerging literature focused on learning has shown context-shifting tasks can greatly increase learning without adding logistical burden to an intervention. The current study evaluated a CBM-I for AS that utilized a context-shifting task to deliver twice the treatment dose of extant interventions. Design: Single-site randomized controlled trial. Participants completed an intervention appointment, as well as one-week and one-month follow-up assessments. Participants: Individuals with elevated levels of AS. Intervention: Single-session computer-delivered CBM-I for AS. Results: Results indicate that the CBM-I for AS was successful in reducing overall AS (62% post-intervention) and these reductions were maintained through one-month post-intervention (64%). Results also revealed that individuals in the active condition reported significantly less incidents of panic responding to a physiological straw-breathing challenge and that change in interpretation bias significantly mediated the relationship between treatment condition and post-treatment AS reductions. Conclusions: Taken together, the results show that the current CBM-I intervention was strong in terms of immediate and one-month AS reductions. Given its brevity, low cost, low stigma and portability, this intervention could have substantial impact on reducing the burden of anxiety disorders. Copyright © 2016 Elsevier Ltd.

Behaviour Research and Therapy, 81 : 47- 55

Chu, B. C., Crocco, S. T., Esseling, P., Areizaga, M. J., Lindner, A. M., Skriner, L. C.

Transdiagnostic group behavioral activation and exposure therapy for youth anxiety and depression: Initial randomized controlled trial

Anxiety and depression are debilitating and commonly co-occurring in young adolescents, yet few interventions are designed to treat both disorder classes together. Initial efficacy is presented of a school-based transdiagnostic group behavioral activation therapy (GBAT) that emphasizes anti-avoidance in vivo exposure. Youth (N = 35; ages 12-14; 50.9% male) were randomly assigned to either GBAT (n = 21) or WL (n = 14) after completing a double-gated screening process. Multi-reporter, multi-domain outcomes were assessed at pretreatment, posttreatment, and four-month follow-up (FU). GBAT was associated with greater posttreatment remission rates than WL in principal diagnosis (57.1% vs. 28.6%; X12 = 2.76, p = .09) and secondary diagnosis (70.6% vs. 10%; X12 = 9.26, p = .003), and greater improvement in Clinical Global Impairment-Severity ratings, B = -1.10 (0.42), p = .01. Symptom outcomes were not significantly different at posttreatment. GBAT produced greater posttreatment behavioral activation (large effect size) and fewer negative thoughts (medium effect), two transdiagnostic processes, both at the trend level. Most outcomes showed linear improvement from pretreatment to FU that did not differ depending on initial condition assignment. Sample size was small, but GBAT is a promising transdiagnostic intervention for youth anxiety and unipolar mood disorders that can feasibly and acceptably be applied in school settings. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (journal abstract).

Behaviour Research & Therapy, 76 : 65-75

Calear, A. L., Batterham, P. J., Poyser, C. T., Mackinnon, A. J., Griffiths, K. M., Christensen, H.

Cluster randomised controlled trial of the e-couch Anxiety and Worry program in schools

Background: Anxiety is a common mental health problem in youth. The current study aimed to test the effectiveness of an online self-directed anxiety prevention program in a school-based sample and to compare two methods of implementing an anxiety program in schools. Methods: A three-arm cluster stratified randomised controlled trial was conducted with 30 Australian schools. Each school was randomly assigned to receive: (1) externally-supported intervention, (2) teacher-supported intervention, or (3) wait-list control. All consenting students (N = 1767) were invited to complete pre-intervention, post-intervention, 6- and 12-month follow-up questionnaires measuring generalised anxiety, social anxiety, anxiety sensitivity, depressive symptoms and mental wellbeing. Intervention participants completed the e-couch Anxiety and Worry program over 6 weeks. Results: At post-intervention, 6- and 12-month follow-up no significant differences were observed between the intervention and control conditions for generalised anxiety (Cohen's d = -0.14 to 0.15), social anxiety (d = 0.04-0.23), anxiety sensitivity (d = - 0.07 to 0.07), depressive symptoms (d = -0.05 to 0.04) or mental wellbeing (d = -0.06 to -0.30). Limitations: The current study only included self- report measures that may have been influenced by situational factors or biases. Conclusions: The e-couch Anxiety and Worry program did not have a significant positive effect on participant mental health or wellbeing. The addition of a mental health education officer to support classroom teachers in the delivery of the program also had no effect on intervention outcomes. Future prevention research should look to develop briefer and more interactive interventions that are more engaging for youth. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Journal of Affective Disorders, 196 : 210-217

Calear, A. L., Christensen, H., Brewer, J., Mackinnon, A., Griffiths, K. M.

A pilot randomized controlled trial of the e-couch anxiety and worry program in schools

The aim of this pilot study was to evaluate the acceptability and feasibility of delivering an online anxiety prevention program in schools, and to assess the effectiveness of the intervention in reducing symptoms of anxiety. Three schools located in South Australia and the Australian Capital Territory were recruited to participate in the trial, with classes randomly allocated to the intervention or wait-list control condition. All participants (N = 225) were invited to complete a pre-intervention, post-intervention and 3-month follow-up questionnaire. Participants in the intervention condition completed the online e-couch Anxiety and Worry program during one class period a week for six weeks. No significant differences were found between the intervention and control conditions at post-intervention or 3-month follow-up for generalised anxiety (Cohen's d = - 0.09-0.08), social anxiety (d = 0.09 & - 0.26), anxiety sensitivity (d = 0.19 & - 0.15), depressive symptoms (d = 0.01 & 0.08) or mental wellbeing (d = 0.17 & 0.30). Online anxiety prevention programs are acceptable and can be feasibly delivered in schools. Although not significant, the sizes of some of the effects obtained in this pilot trial are consistent with earlier studies, and warrant further investigation in a larger trial. Copyright © 2016 The Authors

Internet Interventions, 6 : 1-5

Bastounis, A., Callaghan, P., Banerjee, A., Michail, M.

The effectiveness of the Penn Resiliency Programme (PRP) and its adapted versions in reducing depression and anxiety and improving explanatory style: A systematic review and meta- analysis

Mental health problems in children can be precursors of psychosocial problems in adulthood. The aim of this study is to assess the effectiveness of the universal application of a resilience intervention (PRP and derivatives), which has been proposed for large scale roll-out. Electronic databases were searched for published randomized controlled trials of PRP and derivatives to prevent depression and anxiety and improve explanatory style in students aged 8-17 years. Studies were meta-analysed and effect sizes with confidence intervals were calculated. The Quality Assessment Tool for Quantitative Studies of the Effective Public Health Practice Project was used to determine the confidence in the effect estimates. Nine trials from Australia, the Netherlands and USA met the inclusion criteria. No evidence of PRP in reducing depression or anxiety and improving explanatory style was found. The large scale roll-out of PRP cannot be recommended. The content and structure of universal PRP should be re-considered.\rCopyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Journal of Adolescence, 52 : 37-48

Bunge, E. L., Dickter, B., Jones, M. K., Alie, G., Spear, A., Perales, R.

Behavioral intervention technologies and psychotherapy with youth: A review of the literature

The dominant model of delivering psychological interventions is face-to-face (F2F) in oneto- one psychotherapy. Behavioral Intervention Technologies (BITs) may have the capacity to expand delivery models and/or increase the outcomes of therapy. This article is a systematic review of the available literature on BITs for children and adolescents with DSM-5 mental health diagnoses. All articles on EBSCOhost published between 1^st January 2000 and 31^st December 2014 referencing terms related to youth, BITs, and therapy were collected for analysis (n=7179). After inclusion/exclusion criteria were applied, 53 articles were included in the review, discussing BIT interventions for Anxiety, Depression, Obsessive-Compulsive Disorder, Attention-Deficit/Hyperactivity Disorder, Conduct Disorder, and Oppositional Defiant Disorder. The review found general support for BITs as interventions for child and adolescent disorders. Limitations of the current research and suggestions for future directions are discussed. Copyright © 2016 Bentham Science Publishers.

Current Psychiatry Reviews, 12(1) : 14-28

Cheng, F. K.

Is meditation conducive to mental well-being for adolescents? An integrative review for mental health nursing

Childhood mental health problems not only incur a financial burden but more importantly damages individual and family well-being, which compels mental care practitioners to search for solutions, among which meditation is a more economical method. This integrative review investigates the effectiveness of meditation on psychological problems for adolescents under age of 20 through different types of meditation, though mainly mindfulness-based modes. The 36 reviewed publications include quantitative, qualitative and mixed methods research, conducted in North America, Europe, and the Asia Pacific region, related to developmental disabilities, emotional problems, and mental illnesses. Outcomes indicate a decrease in self-harm thoughts, disruptive behaviour, stress, anxiety, impulsivity, and psychological distress; and improvements in self-control, quality of sleep, emotional regulation, executive function, anger management, and social competence, resulting in better academic performance, quality of life, mental wellness, and child-parent relationships. This review suggests the integration of meditation into physical activities, and music and art therapies, as well as randomised controlled trials to examine such synthesis of these disciplines. In conclusion, meditation is a potential curative and preventive measure, both low cost and non-intrusive, for the promotion of adolescent mental wellness. This sheds light on nurses who look after children with mental health. Copyright © 2016 The Author.

International Journal of Africa Nursing Sciences, 4 : 7- 19

Tolnai, N., Szabó, Z., Koteles, F., Szabo, A.

Physical and psychological benefits of once-a-week Pilates exercises in young sedentary women: A 10-week longitudinal study

Physiology & behavior, 163 : 211-218

Burckhardt, R., Manicavasagar, V., Batterham, P. J., Hadzi-Pavlovic, D.

A randomized controlled trial of strong minds: A school-based mental health program combining acceptance and commitment therapy and positive psychology

To date, most early intervention programs have been based on emotion regulation strategies that address dysfunctional cognitive appraisals, problem-solving skills, and rumination. Another emotion regulation strategy, 'acceptance' training, has largely been overlooked. To examine the efficacy of this strategy, a school-based mental health program combining positive psychology with acceptance and commitment therapy (Strong Minds) was evaluated in a randomized controlled trial with a sample of 267 Year 10 and 11 high-school students in Sydney, Australia. Mixed models for repeated measures examined whether the program led to reductions in symptoms amongst students who commenced the program with high depression, anxiety, and stress scores, and increased wellbeing scores amongst all students. Results demonstrated that compared to controls, participants in the Strong Minds condition with elevated symptom scores (n=63) reported significant reductions in depression (p=.047), stress (p=.01), and composite depression/anxiety symptoms (p=.02) with medium to strong effect sizes (Cohen's d=0.53, 0.74, and 0.57, respectively). Increased wellbeing (p=.03) in the total sample and decreased anxiety scores (p=.048) for students with elevated symptoms were significant for Year 10 students with medium effect sizes (Cohen's d=0.43 and 0.54, respectively). This study tentatively suggests that including the emotion regulation strategy of acceptance in early intervention programs may be effective in reducing symptoms and improving wellbeing in high school students. Further research to investigate the generalizability of these findings is warranted. Copyright © 2016 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Journal of School Psychology, 57 : 41-52

Ebesutani, C. K., Helmi, K., Fierstein, M., Taghizadeh, M. E., Chorpita, B. F.

A pilot study of modular cognitive-behavioral therapy and cognitive- behavioral hypnotherapy for treating anxiety in Iranian girls

This study examined the effectiveness of two variations of cognitive behavior therapy (CBT)-modular CBT and cognitive- behavioral hypnotherapy-in reducing anxiety in Iranian youth. In Study 1, the Revised Child Anxiety and Depression Scale (RCADS) and Revised Children's Manifest Anxiety Scale (RCMAS) were translated into Persian and we examined the psychometric properties of their scores using 711 Iranian students. The RCADS and RCMAS anxiety scores evidenced good reliability, validity, and a well-fitting factor structure. In Study 2, we conducted a pilot study using a separate sample of 32 Iranian elementary students with clinically elevated anxiety to examine the effectiveness of two CBT treatment variants. Participants were randomized to one of three groups: modular CBT, cognitive-behavioral hypnotherapy, or a waitlist-control group. Results showed that both modular CBT and cognitive-behavioral hypnotherapy significantly reduced students' anxiety relative to waitlist. Depression symptoms also significantly reduced following both anxiety treatments. Implications regarding the effectiveness of CBT with diverse content across different settings and cultures are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved)

International Journal of Cognitive Therapy, 9(1) : 13- 37

Scholten, H., Malmberg, M., Lobel, A., Engels, R. C. M. E., Granic, I.

A randomized controlled trial to test the effectiveness of an immersive 3D video game for anxiety prevention among adolescents

Adolescent anxiety is debilitating, the most frequently diagnosed adolescent mental health problem, and leads to substantial long-term problems. A randomized controlled trial (n = 138) was conducted to test the effectiveness of a biofeedback video game (Dojo) for adolescents with elevated levels of anxiety. Adolescents (11-15 years old) were randomly assigned to play Dojo or a control game (Rayman 2: The Great Escape). Initial screening for anxiety was done on 1,347 adolescents in five high schools; only adolescents who scored above the \"at-risk\" cut-off on the Spence Children Anxiety Survey were eligible. Adolescents' anxiety levels were assessed at pre-test, post-test, and at three month follow-up to examine the extent to which playing Dojo decreased adolescents' anxiety. The present study revealed equal improvements in anxiety symptoms in both conditions at follow-up and no differences between Dojo and the closely matched control game condition. Latent growth curve models did reveal a steeper decrease of personalized anxiety symptoms (not of total anxiety symptoms) in the Dojo condition compared to the control condition. Moderation analyses did not show any differences in outcomes between boys and girls nor did age differentiate outcomes. The present results are of importance for prevention science, as this was the first full-scale randomized controlled trial testing indicated prevention effects of a video game aimed at reducing anxiety. Future research should carefully consider the choice of control condition and outcome measurements, address the potentially high impact of participants' expectations, and take critical design issues into consideration, such as individualversus group-based intervention and contamination issues. Copyright © 2016 Scholten 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, 11 (1) (no pagination)(e0147763) :

Garber, J., Brunwasser, S. M., Zerr, A. A., Schwartz, K. T., Sova, K., Weersing, V.

Treatment and prevention of depression and anxiety in youth: Test of cross-over effects

Anxiety and depression are highly comorbid and share several common etiological processes. Therefore, it may be more efficient to develop interventions that treat or prevent these problems together rather than as separate entities. The present meta-analytic review examined whether interventions for children and adolescents that explicitly targeted either anxiety or depression showed treatment specificity or also impacted the other outcome (i.e. cross-over effects). We addressed this question both within the same type of study (i.e. treatment, prevention) and across study types. Only randomized controlled trials (RCTs) that assessed both constructs with dimensional measures were included in this review. For treatment studies, RCTs targeting anxiety (n = 18) showed significant effects on both anxious and depressive symptoms, although more strongly on anxiety than depression; similarly, RCTs treating depression (n = 9) yielded significant effects on both depressive and anxious symptoms, but stronger effects on depression than anxiety. Thus, there were cross-over effects in treatments purportedly targeting either anxiety or depression, and also treatment specificity, such that larger effects were seen for the target problem at which the treatment was aimed. Anxiety prevention studies (n = 14) significantly affected anxious, but not depressive symptoms, indicating no cross-over effect of anxiety prevention trials on depression. For depression prevention studies (n = 15), the effects were not significant for either depressive or anxiety symptoms, although the effect was significantly larger for depressive than for anxious symptoms. Post-hoc analyses revealed that the effect on depressive symptoms was significant in depression preventions trials of targeted but not universal samples. Implications for transdiagnostic interventions are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)

Depression and Anxiety, 33(10) : 939-959