Disorders - Anxiety Disorders
Whiteside, S. P., Ale, C. M., Young, B., Dammann, J. E., Tiede, M. S., Biggs, B. K.
This preliminary randomized controlled
trial (RCT) examines the feasibility of dismantling cognitive behavioral therapy (CBT) for childhood anxiety disorders. Fourteen children (10 girls)
ages 7 to 14 (m = 10.2) with social phobia, generalized anxiety disorder, separation anxiety disorder, or panic disorder were randomized to receive 6
sessions of either a) the pre-exposure anxiety management strategies presented in traditional CBT, or b) parent-coached exposure therapy. The sample
was selected from a treatment seeking population and is representative of children in clinical settings. Examination of fidelity ratings, dropouts,
and satisfaction ratings indicated that the interventions were distinguishable, safe, and tolerable. The overall sample improved significantly with
pre-post effect sizes generally in the large range for both conditions. Between-group effect sizes indicating greater improvement with parent-coached
exposure therapy were moderate or large for ten of 12 variables (i.e., 0.53 to 1.52). Re-evaluation after three months of open treatment suggested
that the intervention emphasizing exposure early maintained its superiority while requiring fewer appointments. (PsycINFO Database Record (c) 2015
APA, all rights reserved) (journal abstract).
Behaviour Research & Therapy, 73 : 83-
89
- Year: 2015
- Problem: Anxiety Disorders (any), Panic
Disorder, Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Exposure therapy, Exposure
and response prevention
Strawn, J. R., Welge, J. A., Wehry, A. M., Keeshin, B., Rynn, M. A.
Background: Randomized controlled trials have demonstrated that antidepressants are efficacious in
the treatment of anxiety disorders in youth. However, there are no recent, systematic analyses of the efficacy, safety, or tolerability of these
medications in pediatric anxiety disorders.; Methods: A systematic review and meta-analysis of prospective, randomized, parallel-group, controlled
trials of selective serotonin reuptake inhibitors (SSRIs) and selective serotonin-norepinephrine reuptake inhibitors (SSNRIs) in pediatric patients
with non-obsessive compulsive disorder (OCD) anxiety disorders was undertaken using a search of PubMed/Medline (1966-2014). The meta-analysis
utilized random-effects models to evaluate change in the Pediatric Anxiety Rating Scale or similar anxiety scale, suicidality, and adverse events.
Additionally, pharmacologic variables were explored with regard to effect size, although no correction for multiple comparisons was made with regard
to these relationships.; Results: Nine trials involving 1,673 patients and six medications were included. All SSRI/SSNRIs evaluated demonstrated
efficacy, and the meta-analytic estimate of effect was of moderate magnitude (Cohen's d = 0.62, confidence interval [CI]: 0.34-0.89, P = .009) and
there was evidence of modest heterogeneity (I(2) = 0.29, P = .103). Activation trended toward being more likely with antidepressant treatment (OR:
1.86, CI: 0.98-3.53, P = .054), but no increased risk was observed for nausea/abdominal symptoms (P = .262), discontinuation as a result of an
adverse event (P = .132), or suicidality (OR: 1.3, CI: 0.53-3.2, P = .514). Finally, the effect size correlated with the serotonergic specificity of
the agent (R = .79, P = .021).; Conclusions: Data for nine SSRI/SSNRIs suggest superiority of antidepressants relative to placebo for the treatment
of pediatric anxiety disorders with a moderate effect size.; © 2014 Wiley Periodicals, Inc.
Depression & Anxiety, 32(3) : 149-157
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Serotonin-norepinephrine reuptake inhibitors
(SNRIs)
Swain, J., Hancock, K., Dixon, A., Bowman, J.
An emerging body of
research demonstrates the effectiveness of Acceptance and Commitment Therapy (ACT) in the treatment of adult psychopathology, with several reviews
and meta-analyses attesting to its effectiveness. While there are comparatively fewer empirical studies of child populations, the past few years has
seen burgeoning research interest in the utility of ACT for problems in childhood. A systematic review of the published and unpublished literature
was conducted to examine the evidence for ACT in the treatment of children and to provide support for clinical decision making in this area. Searches
of PsycInfo, PsycArticles, PsycExtra, Proquest and the Association for Contextual Behavioral Science databases were undertaken, as well as reference
lists and citation searches conducted, up to December 2014. Broad inclusion criteria were employed to maximise review breadth. Methodological quality
was assessed and a narrative synthesis approach adopted. Twenty-one studies covering a spectrum of presenting problems met inclusion criteria, with a
total of 707 participants. Studies were predominantly within-group designs, with a lesser proportion of case studies/series, between-group and
randomised controlled trials. The preponderance of evidence suggests ACT results in improvements in clinician, parent and self-reported measures of
symptoms, quality of life outcomes and/or psychological flexibility, with many studies demonstrating further gains at follow-up assessment. However,
several methodological weaknesses limit conclusions, including small samples, non-randomised designs, and few alternative treatment or control
comparisons. While larger scale, methodologically rigorous trials from a broader research teams are needed to consolidate these preliminary findings,
emerging evidence suggests ACT is effective in the treatment of children across a multitude of presenting problems. ACT may be a viable alternative
treatment option for clinicians working with young people.
Journal of Contextual
Behavioral Science, 4(2) : 73-85
- Year: 2015
- Problem: Anxiety Disorders (any), Depressive Disorders, Eating Disorders
(any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Acceptance & commitment therapy
(ACT)
Vallury, K. D., Jones, M., Oosterbroek, C.
Background: People living in rural and remote communities have greater difficulty accessing mental health services and
evidence-based therapies, such as cognitive behavior therapy (CBT), than their urban counterparts. Computerized CBT (CCBT) can be used to effectively
treat depression and anxiety and may be particularly useful in rural settings where there are a lack of suitably trained practitioners.; Objective:
To systematically review the global evidence regarding the clinical effectiveness and acceptability of CCBT interventions for anxiety and/or
depression for people living in rural and remote locations.; Methods: We searched seven online databases: Medline, Embase Classic and Embase,
PsycINFO, CINAHL, Web of Science, Scopus, and the Cochrane Library. We also hand searched reference lists, Internet search engines, and trial
protocols. Two stages of selection were undertaken. In the first, the three authors screened citations. Studies were retained if they reported the
efficacy, effectiveness or acceptability of CCBT for depression and/or anxiety disorders, were peer reviewed, and written in English. The qualitative
data analysis software, NVivo 10, was then used to run automated text searches for the word \"rural,\" its synonyms, and stemmed words. All studies
identified were read in full and were included in the study if they measured or meaningfully discussed the efficacy or acceptability of CCBT among
rural participants.; Results: A total of 2594 studies were identified, of which 11 met the selection criteria and were included in the review. The
studies that disaggregated efficacy data by location of participant reported that CCBT was equally effective for rural and urban participants. Rural
location was found to both positively and negatively predict adherence across studies. CCBT may be more acceptable among rural than urban
participants - studies to date showed that rural participants were less likely to want more face-to-face contact with a practitioner and found that
computerized delivery addressed confidentiality concerns.; Conclusions: CCBT can be effective for addressing depression and anxiety and is acceptable
among rural participants. Further work is required to confirm these results across a wider range of countries, and to determine the most feasible
model of CCBT delivery, in partnership with people who live and work in rural and remote communities.;
Journal of Medical Internet Research, 17(6) : e139-
e139
- 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), Cognitive & behavioural therapies (CBT), Technology, interventions delivered using technology (e.g. online, SMS)
Weaver, L. L., Darragh, A. R.
Objective: Anxiety disorders are the most prevalent psychological
disorders among children and youths. There is growing interest in intervention options for anxiety. Yoga is widely used in clinical, school, and
community settings, but consolidated sources outlining its effectiveness in reducing anxiety are limited.; Method: This systematic review examined
the evidence base (1990-2014) for yoga interventions addressing anxiety among children and adolescents (ages 3-18 yr).; Results: We identified 2,147
references and found 80 articles that were eligible for full-text review. The final analysis included 16: 6 randomized controlled trials, 2
nonrandomized preintervention-postintervention control-group designs, 7 uncontrolled preintervention-postintervention studies, and 1 case study.;
Conclusion: Nearly all studies indicated reduced anxiety after a yoga intervention. However, because of the wide variety of study populations,
limitations in some study designs, and variable outcome measures, further research is needed to enhance the ability to generalize and apply yoga to
reduce anxiety.; Copyright © 2015 by the American Occupational Therapy Association, Inc.
The American Journal of Occupational Therapy: Official Publication of the American Occupational
Therapy Association, 69(6) : 6906180070p1-9
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Mind-body exercises (e.g. yoga, tai chi, qigong)
Robert-Mccomb, J. J., Chyu, M. C., Tacon, A., Norman, R.
Background The biological response (heart-rate
variability; HRV) to an acute psychological stressor, as well as cognitive changes in anxiety and coping style following tai chi (TC) in healthy male
college students, has not been investigated in the literature. Objectives The purpose of this study was to examine the effects of TC on: (1) HRV
biomarkers of acute psychological stress, (2) state anxiety, and (3) coping style in healthy male college students. Methods The study was an RCT, in
which the experimental group (n=9) received TC (twice a week for 8 weeks) and the control (C) group (n=11) did not receive treatment. Reactions to an
acute psychological stressor were measured by the HRV's standard deviation of normal to normal intervals (SDNN), and Spielberger's State-Trait
Anxiety Inventory (STAI). Four 'trials' (baseline; stressor; recovery 1 and recovery 2) were conducted, with pre-tests/post-tests performed for
both study groups. The Problem-Focused Styles of Coping (PFSOC) questionnaire was used to examine coping styles pre-test/post-test for both groups.
Results Significant differences were found: (1) for group, test, and trial, the interaction of trial by group, and the interaction of test by trial
for SDNN, P<0.05; (2) for test, trial, and the interaction of test by group for STAI (P<0.05); and (3) for the interaction of group and test for the
suppressive coping style (P<0.05). Conclusions Tai chi affects biological reactions to an acute psychological stressor, perceptions of anxiety to an
acute stressor and coping styles in healthy male college students.
Focus on Alternative & Complementary
Therapies, 20(2) : 89-96
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Mind-body exercises (e.g. yoga, tai chi, qigong)
Rodgers, A., Dunsmuir, S.
Background: Anxiety constitutes the most common form
of psychopathology in childhood and adolescence. Methods: This randomised controlled study evaluated the 'FRIENDS for Life' school-based Cognitive
Behavioural Therapy programme on overall anxiety, anxiety subtypes and school adjustment. Sixty-two students aged 12-13 completed measures of anxiety
and school adjustment before, immediately after and 4 months after completing the programme. Parents and teachers also rated the students on overall
anxiety levels and school adjustment respectively. Results: The intervention group's 'overall anxiety' and specifically 'separation anxiety'
reduced significantly during the programme and continued to decrease at the 4-month follow-up. Conclusions: A significant negative correlation was
found between anxiety and school adjustment (r = -.464, p < .01). The professional implications of these findings are discussed. (PsycINFO Database
Record (c) 2015 APA, all rights reserved) (journal abstract).
Child & Adolescent Mental Health, 20(1) : 13-
19
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Ruggiero,
K. J., Price, M., Adams, Z., Stauffacher, K., McCauley, J., Danielson, C. K., Knapp, R., Hanson,
R. F., Davidson, T. M., Amstadter, A. B., Carpenter, M. J., Saunders, B. E., Kilpatrick, D. G., Resnick, H. S.
Objective: To assess the efficacy of Bounce Back Now (BBN), a modular, Web-based intervention for disaster-affected
adolescents and their parents. Method: A population-based randomized controlled trial used address-based sampling to enroll 2,000 adolescents and
parents from communities affected by tornadoes in Joplin, MO, and several areas in Alabama. Data collection via baseline and follow-up semi-
structured telephone interviews was completed between September 2011 and August 2013. All families were invited to access the BBN study Web portal
irrespective of mental health status at baseline. Families who accessed the Web portal were assigned randomly to 1 of 3 groups: BBN, which featured
modules for adolescents and parents targeting adolescents' mental health symptoms; BBN plus additional modules targeting parents' mental health
symptoms; or assessment only. The primary outcomes were adolescent symptoms of posttraumatic stress disorder (PTSD) and depression. Results: Nearly
50% of families accessed the Web portal. Intent-to-treat analyses revealed time × condition interactions for PTSD symptoms (B = -0.24, SE = 0.08, p
<.01) and depressive symptoms (B = -0.23, SE = 0.09, p <.01). Post hoc comparisons revealed fewer PTSD and depressive symptoms for adolescents in the
experimental versus control conditions at 12-month follow-up (PTSD: B = -0.36, SE = 0.19, p =.06; depressive symptoms: B = -0.42, SE = 0.19, p =
0.03). A time × condition interaction also was found that favored the BBN versus BBN + parent self-help condition for PTSD symptoms (B = 0.30, SE =
0.12, p =.02) but not depressive symptoms (B = 0.12, SE = 0.12, p =.33). Conclusion: Results supported the feasibility and initial efficacy of BBN as
a scalable disaster mental health intervention for adolescents. Technology-based solutions have tremendous potential value if found to reduce the
mental health burden of disasters. Clinical trial registration information: Web-based Intervention for Disaster-Affected Youth and Families;
http://clinicaltrials.gov; NCT01606514.
Journal of the American Academy of Child & Adolescent Psychiatry, 54(9) : 709-
717
- 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: Service Delivery & Improvement, Psychological Interventions
(any), Psychoeducation, Self-help, Technology, interventions delivered using technology (e.g. online, SMS)
Soleimani, M., Mohammadkhani, P., Dolatshahi, B., Alizadeh, H., Overmann, K. A., Coolidge, F. L.
Objective: This study compared the
effectiveness of two group treatments, behavioral activation (BA) and cognitive therapy (CT), in reducing subsyndromal anxiety and depressive
symptoms in a sample of Iranian university students. Method: Twenty-seven Iranian university students who scored 18 or higher on the depression
subscale and 16 or higher on the anxiety subscale of the Depression, Anxiety, and Stress Scale (DASS-42) were randomly assigned into treatment
groups. One group received 8 sessions of BA (n = 14), and the other received 8 sessions of group CT (n = 13). Result: Analysis of covariance revealed
that the BA group had a significantly greater reduction in depressive symptoms than the CT group. However, there were no significant differences
between the two groups in the levels of anxiety, stress symptoms or functional impairment after treatment. Conclusion: This study found evidence for
the effectiveness of BA in reducing anxiety, depressive and stress symptoms and functional impairment compared to CT. BA was more effective than CT
in improving depressive symptoms and was as effective as CT in decreasing anxiety, stress and functional impairment. BA is also a cost-effective
intervention, particularly in group formats.
Iranian Journal of Psychiatry, 10(2) : 71-78
- Year: 2015
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Song, C., Ikei, H., Igarashi, M., Takagaki, M., Miyazaki,
Y.
In recent times, attention has been focused on
the role of urban green spaces in promoting human health and well-being. However, there is a lack of evidence-based research on the physiological
effects of walking in urban green areas. This study aimed to clarify the physiological and psychological effects of walking in urban parks during
fall. Twenty-three males (mean age 22.3 ± 1.2 years) were instructed to walk predetermined 15-min courses in an urban park and in a nearby city area
(control). Heart rate and heart rate variability were measured to assess physiological responses, and the semantic differential method, Profile of
Mood States, and State-Trait Anxiety Inventory were used to measure psychological responses. We observed that walking in an urban park resulted in a
significantly lower heart rate, higher parasympathetic nerve activity, and lower sympathetic nerve activity than walking through the city area. In
subjective evaluations, participants were more \"comfortable,\" \"natural,\" \"relaxed,\" and \"vigorous\" after a walk in the urban park.
Furthermore, they exhibited significantly lower levels of negative emotions and anxiety. These findings provide scientific evidence for the
physiological and psychological relaxation effects of walking in urban parks during fall.
International Journal of Environmental Research & Public Health, 12(11) : 14216-
14228
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Physical activity, exercise
Song, Y., Lindquist, R.
Background: Nursing students often
experience depression, anxiety, stress and decreased mindfulness which may decrease their patient care effectiveness. Mindfulness-based stress
reduction (MBSR) effectively reduced depression, anxiety and stress, and increased mindfulness in previous research with other populations, but there
is sparse evidence regarding its effectiveness for nursing students in Korea.; Objectives: To examine the effects of MBSR on depression, anxiety,
stress and mindfulness in Korean nursing students.; Design: A randomized controlled trial.; Participants/setting: Fifty (50) nursing students at KN
University College of Nursing in South Korea were randomly assigned to two groups. Data from 44 students, MBSR (n=21) and a wait list (WL) control
(n=23) were analyzed.; Methods: The MBSR group practiced mindfulness meditation for 2 h every week for 8 weeks. The WL group did not receive MBSR
intervention. Standardized self-administered questionnaires of depression, anxiety, stress and mindfulness were administered at the baseline prior to
the MBSR program and at completion (at 8 weeks).; Results: Compared with WL participants, MBSR participants reported significantly greater decreases
in depression, anxiety and stress, and greater increase in mindfulness.; Conclusion: A program of MBSR was effective when it was used with nursing
students in reducing measures of depression, anxiety and stress, and increasing their mindful awareness. MBSR shows promise for use with nursing
students to address their experience of mild depression, anxiety and stress, and to increase mindfulness in academic and clinical work, warranting
further study.; Copyright © 2014 Elsevier Ltd. All rights reserved.
Nurse Education Today, 35(1) : 86-
90
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Mindfulness based
therapy
Zhang, S., Wang, H., Chen, C., Zhou,
J., Wang, X.
This randomized controlled study was conducted to
evaluate the efficacy of Williams LifeSkills Training (WLST) as a means of improving the psychological health of Chinese male juvenile violent
offenders. Sixty-six participants were assigned randomly to receive the usual intervention plus 8 weeks of WLST (study group, n = 33) or only the
usual intervention (control group, n = 33). We found that the study group exhibited significantly decreased State-Trait Anxiety Inventory (STAI X-1,
X-2) STAX2 scores and Trait Coping Style Questionnaire (TCSQ) negative scores, and increased Interpersonal Support Evaluation List (ISEL) tangible
scores from baseline to 9 weeks later (P <0.01). In addition, a between-group difference in changes of TCSQ negative score was observed at the end of
week 9 (P <0.05). These fndings suggest that WLST can improve trait anxiety, coping style, and interpersonal support in male Chinese juvenile violent
offenders.
Neuroscience Bulletin, 31(1) : 53-
60
- Year: 2015
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Skills training