Disorders - Anxiety Disorders
Ferreira-Vorkapic, C., Feitoza, J. M., Marchioro, M., Simoes,
J., Kozasa, E., Telles, S.
Introduction. Yoga is a holistic system of varied mind-body practices that can be used to improve
mental and physical health and it has been utilized in a variety of contexts and situations. Educators and schools are looking to include yoga as a
cost-effective, evidence-based component of urgently needed wellness programs for their students. Objectives. The primary goal of this study was to
systematically examine the available literature for yoga interventions exclusively in school settings, exploring the evidence of yoga-based
interventions on academic, cognitive, and psychosocial benefits. Methods. An extensive search was conducted for studies published between 1980 and
October 31, 2014 (PubMed, PsycInfo, Embase, ISI, and the Cochrane Library). Effect size analysis, through standardized mean difference and Hedges'g,
allowed for the comparison between experimental conditions. Results and Conclusions. Nine randomized control trials met criteria for inclusion in
this review. Effect size was found for mood indicators, tension and anxiety in the POMS scale, self-esteem, and memory when the yoga groups were
compared to control. Future research requires greater standardization and suitability of yoga interventions for children.
Evidence-based Complementary & Alternative
Medicine, 2015 :
- Year: 2015
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Mind-body exercises (e.g. yoga, tai chi, qigong)
Heeren, A., Baeken, C., Vanderhasselt, M. A., Philippot, P., De-Raedt, R.
People with anxiety disorders show an attentional bias for
threat (AB), and Attention Bias Modification (ABM) procedures have been found to reduce this bias. However, the underlying processes accounting for
this effect remain poorly understood. One explanation suggests that ABM requires the modification of attention control, driven by the recruitment of
the dorsolateral prefrontal cortex (DLPFC). In the present double-blind study, we examined whether modifying left DLPFC activation influences the
effect of ABM on AB. We used transcranial direct current stimulation (tDCS) to directly modulate cortical excitability of the left DLPFC during an
ABM procedure designed to reduce AB to threat. Anodal tDCS increases excitability, whereas cathodal tDCS decreases it. We randomly assigned highly
trait-anxious individuals to one of three conditions: 1) ABM combined with cathodal tDCS, 2) ABM combined with anodal tDCS, or 3) ABM combined with
sham tDCS. We assessed the effects of these manipulations on both reaction times and eye-movements on a task indexing AB. Results indicate that
combining ABM and anodal tDCS over the left DLPFC reduces the total duration that participants' gaze remains fixated on threat, as assessed using
eye-tracking measurement. However, in contrast to previous studies, there were no changes in AB from baseline to post-training for participants that
received ABM without tDCS. As the tendency to maintain attention to threat is known to play an important role in the maintenance of anxiety, the
present findings suggest that anodal tDCS over the left DLPFC may be considered as a promising tool to reduce the maintenance of gaze to threat.
Implications for future translational research combining ABM and tDCS are discussed.
PLoS
ONE, 10(4) :
- Year: 2015
- 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
Hudson, J.
L., Keers, R., Roberts,
S., Coleman, J. R., Breen, G., Arendt, K., Bogels, S., Cooper,
P., Creswell, C., Hartman, C., Heiervang, E. R., Hotzel, K., In-Albon, T., Lavallee, K., Lyneham, H. J., Marin, C.
E., McKinnon, A., Meiser-Stedman, R., Morris, T., Nauta, M., Rapee, R. M., Schneider, S., Schneider, S. C., Silverman, W. K., Thastum, M., Thirlwall, K., Waite, P., Wergeland, G. J., Lester, K. J., Eley, T. C.
Objective: The Genes for Treatment study is an international, multisite collaboration exploring the role of genetic, demographic,
and clinical predictors in response to cognitive-behavioral therapy (CBT) in pediatric anxiety disorders. The current article, the first from the
study, examined demographic and clinical predictors of response to CBT. We hypothesized that the child's gender, type of anxiety disorder, initial
severity and comorbidity, and parents' psychopathology would significantly predict outcome. Method: A sample of 1,519 children 5 to 18 years of age
with a primary anxiety diagnosis received CBT across 11 sites. Outcome was defined as response (change in diagnostic severity) and remission (absence
of the primary diagnosis) at each time point (posttreatment, 3-, 6-, and/or 12-month follow-up) and analyzed using linear and logistic mixed models.
Separate analyses were conducted using data from posttreatment and follow-up assessments to explore the relative importance of predictors at these
time points. Results: Individuals with social anxiety disorder (SoAD) had significantly poorer outcomes (poorer response and lower rates of
remission) than those with generalized anxiety disorder (GAD). Although individuals with specific phobia (SP) also had poorer outcomes than those
with GAD at posttreatment, these differences were not maintained at follow-up. Both comorbid mood and externalizing disorders significantly predicted
poorer outcomes at posttreatment and follow-up, whereas self-reported parental psychopathology had little effect on posttreatment outcomes but
significantly predicted response (although not remission) at follow-up. Conclusion: SoAD, nonanxiety comorbidity, and parental psychopathology were
associated with poorer outcomes after CBT. The results highlight the need for enhanced treatments for children at risk for poorer outcomes. (PsycINFO
Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Journal of the American Academy of Child & Adolescent
Psychiatry, 54(6) : 454-463
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other service delivery and improvement
interventions
Ginsburg, G. S., Drake, K.
L., Tein, J-Y, Teetsel, R., Riddle, M. A.
Objective: The authors examined the efficacy of a family-based intervention
to prevent the onset of anxiety disorders in offspring of anxious parents. Method: Participants were 136 families with a parent meeting DSM-IV
criteria for an anxiety disorder and one child 6-13 years of age without an anxiety disorder. Families were randomly assigned to the family-based
intervention (N = 70) or to an information-monitoring control condition (N = 66). All families were expected to complete assessments, administered by
blind interviewers, at baseline, at the end of the intervention (or 8 weeks after randomization) and at 6- and 12-month follow-ups. Onset of any
anxiety disorder and anxiety symptom severity (assessed using the Anxiety Disorders Interview Schedule for Children) at 12 months were the primary
and secondary outcome measures, respectively. Results: The incidence of child anxiety disorders was 31% in the control group and 5% in the
intervention group (odds ratio = 8.54, 95% CI = 2.27, 32.06). At the 1-year follow-up, youths in the control group also had higher anxiety symptoms
ratings than those in the intervention group. Effect sizes were medium to large (0.81 at 6 months and 0.57 at 12 months for anxiety symptoms), and
the number needed to treat was 3.9 at 12 months. Significant moderators included baseline levels of child anxiety; significant mediators were
parental distress and modeling of anxiety. Child maladaptive cognitions and parental anxiety did not mediate outcomes. Conclusions: A brief
psychosocial prevention program holds promise for reducing the 1-year incidence of anxiety disorders among offspring of anxious parents. (PsycINFO
Database Record (c) 2016 APA, all rights reserved) (journal abstract).
The American Journal of Psychiatry, 172(12) : 1207-
1214
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Kosters, M.
P., Chinapaw, M. J., Zwaanswijk, M., van-der-Wal, M. F., Koot, H. M.
OBJECTIVES: We
investigated whether intervention effects of FRIENDS for Life, a school-based prevention program for children with anxiety or depression symptoms,
were maintained over a period of 12 months after the intervention in a naturalistic setting.\rMETHODS: We used a quasi-experimental design, with 339
children in the intervention group and 157 in the control group (aged 8-13 years) in schools in Amsterdam, the Netherlands. We collected self-,
teacher, and peer reports of anxiety and depression scores before and after intervention, and 6 and 12 months after intervention, from 2010 to 2012.
\rRESULTS: Intervention-group children reported a continuing and significant decrease in anxiety and depression scores compared with the control
group. Twelve months after the intervention, participants' anxiety and depression levels were comparable to those of the general population. Girls
reported a stronger decrease in anxiety scores than did boys. Teacher reports suggested no effects. Although classmates reported increased
internalizing problems in intervention-group children immediately after intervention, these effects disappeared over time.\rCONCLUSIONS: FRIENDS for
Life, an indicated prevention program, yielded long-lasting and continuing reduction in anxiety and depression problems when implemented in daily
school practice.
American Journal of Public
Health, 105(10) : 2005-2013
- Year: 2015
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Controlled clinical trials
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
James, A. C., James, G., Cowdrey,
F. A., Soler, A., Choke, A.
Background: A previous Cochrane review
(James 2005) showed that cognitive behavioural therapy (CBT) was effective in treating childhood anxiety disorders; however, questions remain
regarding (1) the relative efficacy of CBT versus non-CBT active treatments; (2) the relative efficacy of CBT versus medication and the combination
of CBT and medication versus placebo; and (3) the long-term effects of CBT. ; Objectives: To examine (1) whether CBT is an effective treatment for
childhood and adolescent anxiety disorders in comparison with (a) wait-list controls; (b) active non-CBT treatments (i.e. psychological placebo,
bibliotherapy and treatment as usual (TAU)); and (c) medication and the combination of medication and CBT versus placebo; and (2) the long-term
effects of CBT.; Search Methods: Searches for this review included the Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane
Depression, Anxiety and Neurosis Group Register, which consists of relevant randomised controlled trials from the bibliographic databases-The
Cochrane Library (1970 to July 2012), EMBASE, (1970 to July 2012) MEDLINE (1970 to July 2012) and PsycINFO (1970 to July 2012).; Selection Criteria:
All randomised controlled trials (RCTs) of CBT versus waiting list, active control conditions, TAU or medication were reviewed. All participants must
have met the criteria of the Diagnostic and Statistical Manual (DSM) or the International Classification of Diseases (ICD) for an anxiety diagnosis,
excluding simple phobia, obsessive-compulsive disorder, post-traumatic stress disorder and elective mutism.; Data Collection and Analysis: The
methodological quality of included trials was assessed by three reviewers independently. For the dichotomous outcome of remission of anxiety
diagnosis, the odds ratio (OR) with 95% confidence interval (CI) based on the random-effects model, with pooling of data via the inverse variance
method of weighting, was used. Significance was set at P < 0.05. Continuous data on each child's anxiety symptoms were pooled using the standardised
mean difference (SMD).; Main Results: Forty-one studies consisting of 1806 participants were included in the analyses. The studies involved children
and adolescents with anxiety of mild to moderate severity in university and community clinics and school settings. For the primary outcome of
remission of any anxiety diagnosis for CBT versus waiting list controls, intention-to-treat (ITT) analyses with 26 studies and 1350 participants
showed an OR of 7.85 (95% CI 5.31 to 11.60, Z = 10.26, P < 0.0001), but with evidence of moderate heterogeneity (P = 0.04, I² = 33%). The number
needed to treat (NNT) was 6.0 (95% CI 7.5 to 4.6). No difference in outcome was noted between individual, group and family/parental formats. ITT
analyses revealed that CBT was no more effective than non-CBT active control treatments (six studies, 426 participants) or TAU in reducing anxiety
diagnoses (two studies, 88 participants). The few controlled follow-up studies (n = 4) indicate that treatment gains in the remission of anxiety
diagnosis are not statistically significant.; Authors' Conclusions: Cognitive behavioural therapy is an effective treatment for childhood and
adolescent anxiety disorders; however, the evidence suggesting that CBT is more effective than active controls or TAU or medication at follow-up, is
limited and inconclusive.;
Cochrane Database of Systematic Reviews, (2) : CD004690
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Kallapiran, K., Koo, S., Kirubakaran, R., Hancock, K.
Background: Mindfulness-based interventions (MBIs) are increasingly used in the management
of various mental health disorders in children and adolescents. However, there is limited evidence about the efficacy of various interventions used.
Method: A systematic review was performed to examine the effects of different MBIs on mental health symptoms and quality of life in both clinical and
nonclinical samples of children and adolescents using data from only randomized control trials. The studies were also assessed for quality. Based on
the type of MBI, study population, and control arm we had three comparisons for meta-analyses. Results: Fifteen studies were included in the
qualitative analysis but only 11 trials with comparable interventions and controls were included for meta-analyses. Mindfulness-based stress
reduction/mindfulness-based cognitive therapy arm was more effective than nonactive control in the nonclinical populations. Acceptance commitment
therapy was comparable to active treatments in patients in the clinical range. Other MBIs were also effective improving anxiety and stress but not
depression in nonclinical populations compared to nonactive control. Conclusions: Mindfulness-based interventions can be effective in children and
adolescents with mental health symptoms. As there were significant limitations these results must be interpreted with caution.
Child & Adolescent Mental Health, 20(4) : 182-
194
- Year: 2015
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Mindfulness based
therapy
Gilomen, S. A., Lee, C. W.
Background and Objectives: Emotional Freedom Techniques (EFT) is a type of therapy involving
the stimulation of acupuncture points while using a spoken affirmation to target a psychological issue. While some studies cite data indicating EFT
is highly efficacious, findings in other studies are unconvincing. The aim of this meta-analysis was to examine the effect of EFT, particular
acupoint stimulation, in the treatment of psychological distress.; Method: A systematic review of the literature identified 18 randomised control
trials published in peer reviewed journals involving a total of 921 participants.; Results: A moderate effect size (Hedge's g = -0.66: 95% CI: -0.99
to -0.33) and significantly high heterogeneity (I(2) = 80.78) across studies was found using a random effects model indicating that EFT, even after
removing outliers (decreases in I(2) = 72.32 and Hedge's g = -0.51:95% CI:-0.78 to -0.23), appears to produce an effect. The analysis involved 12
studies comparing EFT with waitlist controls, 5 with adjuncts and only 1 comparison with an alternate treatment. Meta-regression and subgroup
analyses were conducted to examine the effect of moderators on effect size of symptom change following EFT.; Conclusions: Due to methodological
shortcomings, it was not possible to determine if the effect is due to acupoint stimulation or simply due to treatment elements common with other
therapies.; Copyright © 2015 Elsevier Ltd. All rights reserved.
Journal of Behavior Therapy & Experimental Psychiatry, 48 : 140-
148
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Acupuncture, acupressure
Lee, H-J., Goetz, A. R., Turkel, J. E., Siwiec, S. G.
Background and Objectives: Current cognitive-behavioral theorists conceptualize hypochondriasis as excessive health anxiety (HA).
Growing evidence suggests that elevated HA is associated with attentional bias (AB) toward potential health-threat information. Design: This study
aimed to examine the effects of attention retraining among individuals with elevated HA, using the established attention modification programs (AMP)
designed to train participants to disengage attention from ideographically chosen health-threat words. Methods: Thirty-six randomly assigned
individuals with elevated HA completed eight twice-weekly sessions of the AMP (n = 18) or the attention control condition (ACC; n = 18). Results:
Despite using the well-established AMP protocol widely used within the field of anxiety disorders, we did not find evidence for change in AB
following training. Further, AMP did not outperform ACC in reducing HA and other relevant emotional symptoms. However, both AMP and ACC evidenced
overall significant symptom reduction in most of the outcome measures, including overall HA, anxiety sensitivity, general depression and anxiety, and
somatic complaints. Conclusions: Further research is needed to better understand the effects and mechanisms of AMP as a possible cognitive
intervention for HA. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Anxiety, Stress & Coping, 28(2) : 226
-237
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Attention/cognitive bias
modification, Technology, interventions delivered using technology (e.g. online, SMS)
Langley, A. K., Gonzalez, A., Sugar, C.
A., Solis, D., Jaycox, L.
Objective: To evaluate the
feasibility and acceptability of a school-based intervention for diverse children exposed to a range of traumatic events, and to examine its
effectiveness in improving symptoms of posttraumatic stress, depression, and anxiety. Method: Participants were 74 schoolchildren (Grades 1-5) and
their primary caregivers. All participating students endorsed clinically significant posttraumatic stress symptoms. School clinicians were trained to
deliver Bounce Back, a 10-session cognitive-behavioral group intervention. Children were randomized to immediate or delayed (3-month waitlist)
intervention. Parent-and child-report of posttraumatic stress and depression, and child report of anxiety symptoms, were assessed at baseline, 3
months, and 6 months. Results: Bounce Back was implemented with excellent clinician fidelity. Compared with children in the delayed condition,
children who received Bounce Back immediately demonstrated significantly greater improvements in parent-and child-reported posttraumatic stress and
child-reported anxiety symptoms over the 3-month intervention. Upon receipt of the intervention, the delayed intervention group demonstrated
significant improvements in parent-and child-reported posttraumatic stress, depression, and anxiety symptoms. The immediate treatment group
maintained or showed continued gains in all symptom domains over the 3-month follow-up period (6-month assessment). Conclusions: Findings support the
feasibility, acceptability, and effectiveness of the Bounce Back intervention as delivered by school-based clinicians for children with traumatic
stress. Implications are discussed.
Journal of Consulting & Clinical
Psychology, 83(5) : 853-865
- Year: 2015
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Korte, K. J., Schmidt, N. B.
Anxiety sensitivity (AS), the fear of anxiety and its potential consequences, places individuals at an increased risk for the development
of anxiety disorders. While elevated AS is correctable, often through very brief interventions, individuals high in AS may be unaware of the risks
associated with this risk factor and, therefore, may be unaware or unmotivated to address this potential risk. The purpose of the present
investigation was to examine the use of motivation enhancement therapy (MET) to enhance motivation to utilize a preventive intervention in a non-
intervention seeking population with elevated levels of AS. We examined this issue in a randomized controlled pilot study. Participants (N = 23) were
randomized to one of two groups: (1) a MET group (n = 12) group or (2) a control group focused on healthy behaviors (n = 11). Those in the MET group
received MET focused on enhancing motivation to reduce AS, whereas those in the control group received psychoeducation about health and general well
being. At the end of the study, all of the participants were given the option to receive a computerized intervention previously found to be effective
at reducing AS. Results revealed that the MET group had significant changes in motivation to change anxiety and motivation to attend the AS
preventative intervention. Moreover, 50 % of individuals in the MET group completed the preventative intervention in comparison to 0 % in the control
group. Implications of the findings are discussed.
Cognitive Therapy & Research, 39(4) : 520-530
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Motivational interviewing, includes Motivational Enhancing Therapy, Psychoeducation
Klein, A. M., Rapee, R.
M., Hudson, J. L., Schniering, C. A., Wuthrich, V. M., Kangas, M., Lyneham, H. J., Souren, P. M., Rinck, M.
The present study was designed to examine the effects of training in positive interpretations in clinically anxious children. A total of
87 children between 7 and 12 years of age were randomly assigned to either a positive cognitive bias modification training for interpretation (CMB-I)
or a neutral training. Training included 15 sessions in a two-week period. Children with an interpretation bias prior to training in the positive
training group showed a significant reduction in interpretation bias on the social threat scenarios after training, but not children in the neutral
training group. No effects on interpretation biases were found for the general threat scenarios or the non-threat scenarios. Furthermore, children in
the positive training did not self-report lower anxiety than children in the neutral training group. However, mothers and fathers reported a
significant reduction in social anxiety in their children after positive training, but not after neutral training. This study demonstrated that
clinically anxious children with a prior interpretation bias can be trained away from negative social interpretation biases and there is some
evidence that this corresponds to reductions in social anxiety. This study also highlights the importance of using specific training stimuli.
(PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Behaviour Research &
Therapy, 75 : 78-84
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Attention/cognitive bias
modification