Disorders - Anxiety Disorders
O'Dea, B., Calear, A. L., Perry, Y.
Purpose of review: Depression and anxiety are prevalent among adolescents; however, many
young people do not seek help from professional services. This is due, in part, to the inadequacies of existing healthcare systems. This article aims
to review the current evidence for e-health interventions for depression and anxiety in youth, as a potential solution to the gaps in mental health
service provision. Recent findings: Five randomized controlled trials reporting on e-health interventions for youth depression or anxiety were
identified. Of these, two trials focused exclusively on anxiety symptoms, and three trials examined both anxiety and depression. The majority of
trials assessed online cognitive behavioral therapy and focused on prevention rather than treatment. In all but one trial, results demonstrated
positive effects for the e-health interventions, relative to the control. Summary: There is growing evidence for the effectiveness of online
cognitive behaviour therapy interventions for reducing the level of anxiety and depressive symptoms in adolescents aged between 12 and 18 years, when
delivered in school and clinical settings, with some level of supervision. However, there are a number of gaps in the literature. More research is
needed to strengthen the evidence base for prevention and treatment programs that are delivered via the internet, particularly for depression.
(PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Current Opinion in Psychiatry, 28(4) : 336-
342
- 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: Service Delivery & Improvement, Psychological Interventions
(any), Technology, interventions delivered using technology (e.g. online, SMS)
Ori, R., Amos, T., Bergman, H., Soares-Weiser, K., Ipser, J. C., Stein, D. J.
Background: A significant number of patients who suffer with anxiety and related disorders (that is post-traumatic stress disorder (PTSD),
social anxiety disorder (SAnD), panic disorder with or without agoraphobia (PD), specific phobia (SPh) and obsessive compulsive disorder (OCD)) fail
to respond optimally to first-line treatment with medication or cognitive and behavioural therapies. The addition of d-cycloserine (DCS) to cognitive
and behavioural therapies may improve treatment response by impacting the glutamatergic system. This systematic review aimed to investigate the
effects of adding DCS to cognitive and behavioural therapies by synthesising data from relevant randomised controlled trials and following the
guidelines recommended by Cochrane.; Objectives: To assess the effect of DCS augmentation of cognitive and behavioural therapies compared to placebo
augmentation of cognitive and behavioural therapies in the treatment of anxiety and related disorders. Additionally, to assess the efficacy and
tolerability of DCS across different anxiety and related disorders.; Search Methods: This review fully incorporates studies identified from a search
of the Cochrane Depression, Anxiety and Neurosis Controlled Trials Register (CCDANCTR) to 12 March 2015. This register includes relevant randomised
controlled trials (RCTs) from: the Cochrane Library (all years), EMBASE (1974 to date), MEDLINE (1950 to date), PsycINFO (1967 to date), the World
Health Organization's trials portal (ICTRP) and ClinicalTrials.gov . Reference lists from previous meta-analyses and reports of RCTs were also
checked. No restrictions were placed on language, setting, date or publication status.; Selection Criteria: All RCTs of DCS augmentation of cognitive
and behavioural therapies versus placebo augmentation of cognitive and behavioural therapies for anxiety and related disorders were included.; Data
Collection and Analysis: Two authors (RO and TA) independently assessed RCTs for eligibility and inclusion, extracted outcomes and risk of bias data
and entered these into a customised extraction form. Investigators were contacted to obtain missing data. In addition, data entry and analysis were
performed by two review authors (KSW and HB).; Main Results: Twenty-one published RCTs, with 788 participants in outpatient settings, were included
in the review. Sixteen studies had an age range of 18 to 75 years, while four investigated paediatric populations aged 8 to 17 years and one included
children, adolescents and adults. The 21 RCTs investigated OCD (number of RCTs (N) = 6), PTSD (N = 5), SAnD (N = 5), SPh (N = 3) and PD (N = 2). Most
information from the studies was rated as having either low risk or unclear risk of bias.There was no evidence of a difference between DCS
augmentation of cognitive and behavioural therapies and placebo augmentation of cognitive and behavioural therapies for the treatment of anxiety and
related disorders in adults at the endpoint (treatment responders, N = 9, risk ratio (RR) 1.10; 95% confidence interval (CI) 0.89 to 1.34; number of
participants (n) = 449; low quality evidence) and between 1 and 12 months follow-up (N = 7, RR 1.08; 95% CI 0.90 to 1.31; n = 383). DCS augmentation
of cognitive and behavioural therapies was not superior to placebo augmentation of cognitive and behavioural therapies for children and adolescents,
both at the endpoint (N = 4, RR 1.01; 95% CI 0.78 to 1.31; n = 121; low quality evidence) and between 3 and 12 months follow-up (N = 3, RR 0.86; 95%
CI 0.67 to 1.09; n = 91).There was no evidence of a difference in treatment acceptability for DCS augmentation of cognitive and behavioural therapies
compared with placebo augmentation of cognitive and behavioural therapies in adults (N = 16, RR 0.88; 95% CI 0.61 to 1.25; n = 740), nor in children
and adolescents (N = 4, RR 0.90; 95% CI 0.17 to 4.69; n = 131). These conclusions were based on moderate quality evidence for adults, and very low
quality evidence for children and adolescents. Although the observed difference was small, it is noteworthy that there was a high efficacy of
exposure-based therapies alone in the included trials. Due to the limited number of studies, subgroup analysis of moderating factors for clinical and
methodological effect could not take place.; Authors' Conclusions: This review found no evidence of a difference between DCS augmentation of
cognitive and behavioural therapies and placebo augmentation of cognitive and behavioural therapies for treating anxiety and related disorders in
children, adolescents and adults. These findings are based on low quality evidence from heterogenous studies with small sample sizes and incomplete
data for clinical response, which precludes us from drawing conclusions on the use of DCS augmentation of cognitive and behavioural therapies at this
stage. Given there is some promising preliminary data from individual studies, further research is necessary to assess DCS compared with placebo
augmentation of cognitive and behavioural therapies, and determine mechanisms of action as well as magnitude of effect in anxiety and related
disorders.;
Cochrane Database of Systematic
Reviews, (5) : CD007803
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), D-cycloserine (DCS)
Pennant, M. E., Loucas, C. E., Whittington, C., Creswell, C., Fonagy,
P., Fuggle, P., Kelvin, R., Naqvi, S., Stockton, S., Kendall, T., Bevington, D., Fairburn, C., Keen, D., Lamb, S., Larsson, L., Murphy, M., Pilling, S., Pugh, K., Ringwood, S., Sealey, C., Williams, P.
One quarter of children and young people (CYP) experience anxiety and/or depression before
adulthood, but treatment is sometimes unavailable or inadequate. Self-help interventions may have a role in augmentingtreatment and this work aimed
to systematically review the evidence for computerised anxiety and depression interventions in CYP aged 5-25 years old. Databases were searched for
randomised controlled trials and 27 studies were identified. For young people (12-25 years) with risk of diagnosed anxiety disorders or depression,
computerised CBT (cCBT) had positive effects for symptoms of anxiety (SMD-0.77, 95% CI-1.45 to-0.09, k=6, N=220) and depression (SMD-0.62, 95% CI-
1.13 to-0.11, k=7, N=279). In a general population study of young people, there were small positive effects for anxiety (SMD-0.15, 95% CI-0.26 to-
0.03; N=1273) and depression (SMD-0.15, 95% CI-0.26 to-0.03; N=1280). There was uncertainty around the effectiveness of cCBT in children (5-11
years). Evidence for other computerised interventions was sparse and inconclusive. Computerised CBT has potential for treating and preventing anxiety
and depression in clinical and general populations of young people. Further program development and research is required to extend its use and
establish its benefit in children.
Behaviour Research & Therapy, 67 : 1-18
- Year: 2015
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder), Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Technology, interventions delivered using technology (e.g. online, SMS)
Stulmaker, H. L., Ray, D. C.
Traditional methods of
treating anxiety have been less effective with young children. The researchers sought to explore effects of child-centered play therapy (CCPT) on
young children with anxiety symptoms. Fifty-three participants between 6 and 8 years old were randomly assigned to the experimental or active control
group. Children who received CCPT significantly decreased their overall levels of anxiety and worry. Overall, CCPT may be considered a
developmentally appropriate treatment for young children who are anxious. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal
abstract).
Children & Youth Services
Review, 57 : 127-133
- 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
Swain, J., Hancock, K., Hainsworth, C., Bowman, J.
Described as a
\"third wave\" behavioural and cognitive therapy, Acceptance and Commitment Therapy (ACT) reflects a synthesis and reformulation of concepts
underpinned by prior waves including traditional cognitive behaviour therapy (CBT). This exploratory study aimed to examine the ACT hexaflex model as
a mediator for therapeutic change among adolescents. The specific indirect effects of the core processes - acceptance and defusion,
mindfulness/self-as-context and valued living/committed action (valued action) - collected at multiple time points, using measures with established
psychometric reliability/validity, were also explored in terms of their actual and relative contribution to mediation effects. Finally, the
specificity of observed mediation effects to ACT were identified through comparison to CBT. Data for the present investigation were collected as part
of a larger randomised controlled trial of ACT versus CBT in the treatment of anxiety disorders among children aged 7-17 years. Participants were 49
adolescent outpatients (12-17 years) diagnosed with a DSM-IV anxiety disorder and their parent/caregivers, and were randomised into ACT (n=16), CBT
(n=10) or waitlist control (WLC; n=23). The results do not support the finding that ACT processes mediated quality of life outcomes for ACT or CBT,
and acceptance and defusion were the only predictors of outcome change. These findings add weight to the emergent idea that investigation into
overarching mediators for the behavioural and cognitive therapies may be warranted. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Journal of Contextual Behavioral Science, 4(1) : 56-
67
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Acceptance & commitment therapy
(ACT)
Trousselard, M., Dutheil, F., Ferrer, M. H., Babouraj, N., Canini, F.
Background: Chronic work-related stress is a
well-known public health problem, and it concerns Military populations. Stress responses lead to specific changes in immunity, physiologic systems,
and regulation of stress hormones. Overexposure to stress has an important role in the development and courses of mental diseases, as well as being a
factor in increased abdominal obesity, osteoporosis, infections, and cardiovascular problems. The aim of this research was to evaluate the
effectiveness of two stress psychologic fitness management programs based on a mind-body approach to stress perception and stress reactivity in a
Military population subjected to daily operational stress. Method: 180 young military fire fighter recruits were randomly assigned to a controlled
intervention trial including three groups: a cognitive stress program (tactics to Optimized the Potential - TOP) group, an emotional
CardioBioFeedback stress program (CBF) group, or a control group. The stress programs training lasted eight weeks, with one hour training per week. A
placebo was administered as a nutriceutical in all three groups during the time of the training. Primary outcome variables included the perceived
stress; second outcome variables included stress reactivity (mindfulness, negative mood, Immunoglobulin A levels). Post intervention effectiveness on
the long-term programs' benefits was evaluated. Results: Both TOP and CBF stress programs reduce operational stress in military population. Although
the size of the effects was small, they must be considered at the clinical level. Long-term effects depend on the frequency of daily practice.
Results were discussed with reference to mind-body theory. Conclusions: Short stress programs intervention improved stress perception and stress
reactivity in healthy workers. Recommendations about mind-body interventions were proposed for the military population.
Medical Acupuncture, 27(5) : 367-
375
- Year: 2015
- 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
Tang, T. C., Yang, P., Yen, C. F., Liu, T. L.
In this case-control study, we aimed to
assess the intervention effects of foursession eye movement desensitization and reprocessing (EMDR) on reducing the severity of disaster-related
anxiety, general anxiety, and depressive symptoms in Taiwanese adolescents who experienced Typhoon Morakot. A total of 83 adolescents with
posttraumatic stress disorder related to Typhoon Morakot, major depressive disorder, or current moderate or high suicide risk after experiencing
Typhoon Morakot were allocated to a four-session course of EMDR (N=41) or to treatment as usual (TAU; N = 42). A multivariate analysis of covariance
was performed to examine the effects of EMDR in reducing the severity of disaster-related anxiety, general anxiety, and depressive symptoms in
adolescents by using preintervention severity values as covariates. The multivariate analysis of covariance results indicated that the EMDR group
exhibited significantly lower preintervention severity values of general anxiety and depression than did the TAU group. In addition, the
preintervention severity value of disaster-related anxiety in the EMDR group was lower than that in the TAU group (p=0.05). The results of this study
support that EMDR could alleviate general anxiety and depressive symptoms and reduce disaster-related anxiety in adolescents experiencing major
traumatic disasters.
Kaohsiung Journal of Medical Sciences, 31(7) : 363-
369
- Year: 2015
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder), At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Eye movement desensitisation and reprocessing (EMDR)
Storch, E. A., Salloum, A., King, M. A., Crawford, E. A., Andel, R., McBride, N. M., Lewin, A. B.
Objective This study aims to examine the real-world effectiveness of a computer-assisted cognitive behavioral therapy (CBT) protocol
relative to treatment as usual (TAU) among anxious children presenting at community mental health centers. Methods One hundred children (7-13 years)
with clinically significant anxiety were randomized to receive either 12 weekly computer-assisted CBT sessions or TAU for an equivalent duration.
Assessments were conducted by independent evaluators at screening/baseline, midtreatment, posttreatment, and 1-month followup (for computer-assisted
CBT treatment responders). Results There were significant between-group effects favoring the computer-assisted CBT condition on primary anxiety
outcomes. Thirty of 49 (61.2%) children randomized to computer-assisted CBT responded to treatment, which was superior to TAU (6/51, 11.8%). Relative
to TAU, computer-assisted CBT was associated with greater reductions in parent-rated child impairment and internalizing symptoms, but not child-rated
impairment and anxiety and depressive symptoms. Treatment satisfaction and therapeutic alliance in those receiving computer-assisted CBT was high.
Treatment gains in computer-assisted CBT responders were maintained at 1-month followup. Conclusions Within the limitations of this study, computer-
assisted CBT is an effective and feasible treatment for anxious children when used in community mental health centers by CBT-naïve clinicians.
Depression &
Anxiety, 32(11) : 843-852
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Technology, interventions delivered using technology (e.g. online, SMS)
Waters, A. M., Groth, T. A., Sanders, M., O'Brien, R., Zimmer-Gembeck, M. J.
Clinical scientists are calling for strong partnerships in the provision of evidence-based treatments for child mental health
problems in real-world contexts. In the present study, we describe the implementation of a cognitive-behavioral intervention (CBI) to address grade 5
children's anxiety symptoms. The CBI arose from a long-standing partnership between University and Education Department stakeholders. The
partnership integrates school-based, evidence-informed treatment delivery with clinical education, and also supports a school-based psychology clinic
to provide assessment and treatment services to children attending schools within the catchment area and clinical training for university graduate
students. Children in the active condition (. N=. 74) completed the CBI during regular class time, while children in the control condition (. N=. 77)
received the standard classroom curriculum. Children's anxiety and depressive symptoms, threat interpretation biases (perceived danger and coping
ability), and perceptions of their social skills were assessed before and after condition. Children in the active condition reported significant
improvements in self-reported anxiety symptoms, and perceptions of their social skills and coping ability, whereas no significant differences were
observed for children in the control condition from pre- to post-assessment. For a subset of children assessed 12. months after the CBI (. n=. 76),
symptom improvement remained stable over time and estimates of danger and coping ability showed even greater improvement. Results demonstrate the
value of strong stakeholder partnerships in innovative youth mental health services, positive child outcomes, and clinical education.
Behavior Therapy, 46(6) : 844-
855
- Year: 2015
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Waters, A. M., Zimmer-Gembeck, M. J., Craske, M. G., Pine, D.
S., Bradley, B. P., Mogg, K.
Attention bias modification training (ABMT) is a promising treatment for anxiety disorders. Recent evidence suggests that attention training
towards positive stimuli, using visual-search based ABMT, has beneficial effects on anxiety and attention biases in children. The present study
extends this prior research using distinctive techniques designed to increase participant learning, memory consolidation, and treatment engagement.
Fifty-nine clinically anxious children were randomly assigned to the active treatment condition (ATC) (N = 31) or waitlist control condition (WLC) (N
= 28). In the ATC, children completed 12 treatment sessions at home on computer in which they searched matrices for a pleasant or calm target amongst
unpleasant background pictures, while also engaging in techniques designed to consolidate learning and memory for these search strategies. No contact
was made with children in the WLC during the wait period. Diagnostic, parent- and child-reports of anxiety and depressive symptoms, externalising
behaviour problems and attention biases were assessed pre- and post-condition and six-months after treatment. Children in the ATC showed greater
improvements on multiple clinical measures compared to children in the WLC. Post-treatment gains improved six-months after treatment. Attention
biases for angry and happy faces did not change significantly from pre-to post-condition. However, larger pre-treatment attention bias towards threat
was associated with greater reduction in anxiety at post-treatment. Also, children who showed greater consolidation of learning and memory strategies
during treatment achieved greater improvement in global functioning at post-treatment. Attention training towards positive stimuli using enhanced
visual-search procedures appears to be a promising treatment for childhood anxiety disorders. (PsycINFO Database Record (c) 2015 APA, all rights
reserved) (journal abstract).
Behaviour
Research & Therapy, 73 : 111-123
- 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
Yang, W. L., Zhai, F., Gao, Y. M., Zhang, Q. H.
Objective: Study the auxiliary therapeutic effect of psychological counseling treatment after collective rehabilitation training of the
patients with anxiety disorder. Methods: 38 college students with anxiety disorder are randomly divided into an experiment group and a control group,
each of which consists of 19 students. The experiment group only receives psychological counseling treatment; the control group, based on
psychological counseling treatment, receives the collective rehabilitation training, that is, the joint therapy. Results: before the treatment, the
inter-group difference of the general data about the patients in 2 groups shows no statistically significance, P > 0.05, which is comparable; after 8
weeks' treatment, HAMA and SAS scores of the patients in 2 groups are significantly improved compared with those before treatment, P < 0.05;
meanwhile, the improvement effect of the experiment group is better than that of the control group P < 0.05. After 3 months' follow-up, it is found
that the recurrence rate of the experiment group is obviously lower than that of the control group P < 0.05. Conclusion: the joint treatment,
consisting of psychological counseling and collective rehabilitation training, exercises synergetic effect on the college students who are anxiety
disorder patients and its curative effect is obviously superior to the single psychological counseling and its recurrence rate is low.
International Journal of Clinical & Experimental Medicine, 8(6) : 9949-
9954
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Supportive
therapy, Physical activity, exercise
White, D. J., Cox, K. H. M., Peters, R., Pipingas, A., Scholey, A.
B.
This study
explored the effects of four-week multi-vitamin and mineral (MVM) supplementation on mood and neurocognitive function in healthy, young adults.
Fifty-eight healthy adults, 18 - 40 years of age (M= 25.82 years, SD = 4.87) participated in this randomised, double-blind, placebo-controlled trial,
in which mood and blood biomarkers were assessed at baseline and after four weeks of supplementation. Compared to placebo, MVM supplementation was
associated with significantly lowered homocysteine and increased blood B-vitamin levels (p < 0.01). MVMtreatment was also associated with
significantly improved mood, as measured by reduced scores on the \"depression-dejection\" subscale of the Profile of Mood States (p = 0.018). These
findings suggest that the four weeks of MVM supplementation may have beneficial effects on mood, underpinned by elevated B-vitamins and lowered
homocysteine in healthy young adults.
Nutrients, 7(11) : 9005-
9017
- Year: 2015
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Vitamins and supplements