Disorders - Anxiety Disorders
Stevanovic, D., Tadic, I., Knez, R.
There is some evidence indicating that
psychotropic medications might lead to health-related quality of life (QOL) improvements among children and adolescents with psychiatric disorders.
The aim of this systematic review is to assess evidence regarding whether antidepressant treatment improves QOL among children and adolescents with
depressive or anxiety disorders. A comprehensive search resulted in 5 clinical trials to be included in this review: 4 trials with major depressive
disorder (MDD) and 1 trial with social anxiety disorder (SAD). In one MDD trial, fluoxetine combined with cognitive behavior therapy (CBT)
significantly improved QOL compared to fluoxetine or CBT alone (effect sizes were 0.53 and 0.69, respectively). In 2 combined trials, sertraline
alone significantly improved QOL among adolescents with MDD (effect size was 0.29), but not among children with MDD. Essentially, it was observed
that antidepressants in these trials had minor positive effects on QOL improvement, which were lower than their potential to improve depressive
symptoms. Although fluoxetine with CBT or sertraline monotherapy were shown to have some potential to improve QOL, this systematic review found
inconclusive evidence that antidepressant treatments improve QOL among children and adolescents with depressive or anxiety disorders. More research
is required, considering that QOL is currently under-evaluated in clinical trials with antidepressants among children and adolescents and available
trials have limited methodological quality when reporting QOL data.
CNS Spectrums, 19(2) : 134-141
- Year: 2014
- Problem: Anxiety Disorders (any), Social phobia (social anxiety disorder), Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs)
Thulin, U., Svirsky, L., Serlachius, E., Andersson, G., Ost, L-G.
Among clinicians, it is common practice to include
parents in treatment, and it has been taken for granted that parents' involvement in their children's treatment is beneficial for therapy outcome,
although research on this issue is far from clear. A meta-analysis was carried out in order to investigate whether parent involvement potentiates the
outcome for children with anxiety disorders when treated with cognitive-behavior therapy. Sixteen studies, which directly compared parent-involved
treatments with child-only treatments, were included in the meta-analysis. The results showed a small, nonsignificant effect size of - 0.10 in favor
of the child-only treatments. There was no indication of publication bias in the analysis. Implications of the results are discussed.;
Cognitive Behaviour Therapy, 43(3) : 185-
200
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions
Wong, N, Kady, L, Mewton, L, Sunderland, M, Andrews, G
The aims of the current study were to 1) establish the efficacy of
two Internet-based prevention programmes to reduce anxiety and depressive symptoms in adolescents; and 2) investigate the distribution of
psychological symptoms in a large sample of Australian adolescents prior to the implementation of the intervention. A cluster randomised controlled
trial was conducted with 976 Year 9-10 students from twelve Australian secondary schools in 2009. Four schools were randomly allocated to the Anxiety
Internet-based prevention programme (n = 372), five schools to the Depression Internet-based prevention programme (n = 380) and three to their usual
health classes (n = 224). The Thiswayup Schools for Anxiety and Depression prevention courses were presented over the Internet and consist of 6-7
evidence-based, curriculum consistent lessons to improve the ability to manage anxiety and depressive symptoms. Participants were assessed at
baseline and post-intervention. Data analysis was constrained by both study attrition and data corruption. Thus post-intervention data were only
available for 265/976 students. Compared to the control group, students in the depression intervention group showed a significant improvement in
anxiety and depressive symptoms at the end of the course, whilst students in the anxiety intervention demonstrated a reduction in symptoms of
anxiety. No significant differences were found in psychological distress. The Thiswayup Schools Depression and Anxiety interventions appear to reduce
anxiety and depressive symptoms in adolescents using a curriculum based, blended online and offline cognitive behavioural therapy programme that was
implemented by classroom teachers. Given the study limitations, particularly the loss of post-intervention data, these findings can only be
considered preliminary and need to be replicated in future research. (copyright) 2014.
Internet Interventions, 1(2) : 90-94
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Technology, interventions delivered using technology (e.g. online, SMS)
Wergeland,
G. J. H., Fjermestad, K. W., Marin, C. E., Haugland, BS-M., Bjaastad, J. F., Oeding, K., Bjelland, I., Silverman, W. K., Ost, L-G., Havik, O.
E., Heiervang, E. R.
Objective: Conducted a randomized controlled trial to
investigate the effectiveness of cognitive behavioral therapy (CBT), and compared the relative effectiveness of individual (ICBT) and group (GCBT)
treatment approaches for anxiety disorders in children and adolescents.; Methods: Referred youth (N = 182, M age = 11.5 years, range 8-15 years, 53%
girls) with separation anxiety, social phobia, or generalized anxiety disorder were randomly assigned to ICBT, GCBT or a waitlist control (WLC) in
community clinics. Pre-, post-, and one year follow-up assessments included youth and parent completed diagnostic interview and symptom measures.
After comparing CBT (ICBT and GCBT combined) to WLC, ICBT and GCBT were compared along diagnostic recovery rates, clinically significant improvement,
and symptom measures scores using traditional hypothesis tests, as well as statistical equivalence tests.; Results: Significantly more youth lost all
anxiety disorders after CBT compared to WLC. Full diagnostic recovery rate was 25.3% for ICBT and 20.5% in GCBT, which was not significantly
different. There was continued lack of significant differences between ICBT and GCBT at one year follow-up. However, equivalence between GCBT and
ICBT could only be demonstrated for clinical severity rating of the principal anxiety disorder and child reported anxiety symptoms post-treatment.;
Conclusion: Findings support the effectiveness of CBT compared to no intervention for youth with anxiety disorders, with no significant differences
between ICBT and GCBT. However, the relatively low recovery rates highlight the need for further improvement of CBT programs and their
transportability from university to community settings.; Copyright © 2014 Elsevier Ltd. All rights reserved.
Behaviour
Research & Therapy, 57 : 1-12
- Year: 2014
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, Social phobia (social anxiety disorder)
- Type: Randomised controlled 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
Wild, K., Scholz, M., Ropohl, A., Brauer, L., Paulsen, F., Burger, P. H. M.
Burnout and stress-related mental disorders (depression, anxiety) occur in medical students and physicians with a significantly higher
prevalence than in the general population. At the same time, the learning of coping mechanisms against stress is still not an integral part of
medical education. In this pilot study we developed an elective course for learning relaxation techniques and examined the condition of the students
before and after the course. 42 students participated in the semester courses in 2012 and 2013 as well as in a survey at the start and end of each
course. The students were instructed in autogenic training (AT) and progressive muscle relaxation according to Jacobsen (PMR) with the goal of
independent and regular exercising. At the beginning and the end of the semester/course the students were interviewed using standardized, validated
questionnaires on burnout (BOSS-II) and anxiety (STAI-G), depression (BDI), quality of life (SF-12) and sense of coherence (SOC-L9). We compared the
results of our students participating in Relacs with results from eight semester medical students (n=88), assessed with the same questionnaires at
similar points of time within their semester. Participating students showed a significant decline in cognitive and emotional burnout stress and in
trait anxiety. Furthermore, they showed a reduction in state anxiety and a conspicuous decrease in mean depression. The sense of coherence increased
at the same time. A comparative cohort of medical students of 8th semester students, showed lower values for the specified measurement parameters at
the beginning, but showed no progressive changes. Our course introducing AT and PMR led to a significant reduction of burnout and anxiety within the
participating group of medical students. Even the course attendance for just one semester resulted in significant improvements in the evaluated
parameters in contrast to those students who did not attend the course.
PLoS ONE, 9(12) :
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Relaxation
Reyes-Portillo, J. A., Mufson, L., Greenhill, L. L., Gould, M. S., Fisher, P. W., Tarlow, N., Rynn, M. A.
Results Of the 14,001 citations initially identified, 25 articles met inclusion criteria for Web-
based interventions. These described 9 programs, of which 8 were Internet based and 1 was a mobile application. No Web-based interventions for
suicide prevention were identified. Of the randomized controlled trials (n = 14) and open trials (n = 3) identified, 10 reported significant
postintervention reductions in symptoms of depression and/or anxiety or improvements in diagnostic ratings, with small to large effect sizes. Many of
these studies also reported significant improvements at follow-up. The methodological quality of the studies varied. Many programs were limited by
their small sample sizes and use of waitlist or no-treatment control groups.\rConclusion There is limited evidence for the effectiveness of Web-based
interventions for youth depression and anxiety. Additional research and program development are needed to fill the current gaps in the literature.
\rObjective To review published reports on Web-based treatment and prevention programs for depression, anxiety, and suicide prevention in children,
adolescents, and emerging adults.\rMethod A systematic search of the PsycINFO, PubMed, Medline, and Web of Science databases was conducted in
December 2013. Programs were classified according to evidence-base level (Well-Established, Probably Efficacious, Possibly Efficacious, Experimental,
and Of Questionable Efficacy).
Journal of the American Academy of Child & Adolescent
Psychiatry, 53(12) : 1254-1270.e5
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Technology, interventions delivered using technology (e.g. online, SMS)
Pine, D. S.
Background: Data will be presented on attention bias in pediatric anxiety disorders. After reviewing published data, emphasis will be
placed on unpublished or soon-to-be-published data, from three studies: a longitudinal study in children with behavioral inhibition and two
randomized controlled trials (RCTs) for attention bias modification training (ABMT). Methods: The longitudinal study assessed anxiety, behavioral
inhibition, and attention bias at ages five, seven, and nine in n=146 children. The first RCT compared changes in anxiety symptoms among n=63
children with anxiety disorders, randomized to receive one of three treatments in a parallel-group design: cognitive behavioral therapy (CBT) alone,
CBT with placebo ABMT, or CBT with active ABMT. The second RCT compared changes in amygdala response on an attention bias task in n=30 sub-clinically
anxious adolescents randomized to placebo or active ABMT. Results: In the 146 longitudinally followed children, attention bias towards threat at age
five predicted increases in anxiety at the latter assessment points (R-squared=.40 for change in anxiety symptoms over time; F=16.5; p<.001). In the
first RCT, anxious children randomized to CBT with active ABMT had greater reductions in parent and child-reported anxiety (F=5.5; p=.007), relative
to anxious children randomized to CBT with placebo ABMT or CBT alone. Finally, in the second RCT, after treatment, adolescents randomized to placebo
manifested greater bi-lateral amygdala activation to threatprobes in an attention task, compared to adolescents randomized to active ABMT (whole-
brain corrected-p-values<.05). Conclusions: Attention bias relates to outcome and brain function in RCTs and longitudinal research among children and
adolescents.
Biological Psychiatry, 75(9) : 5S-
6S
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Attention/cognitive bias
modification
Polat, S., Sener-Taplak, A.
Introduction Test anxiety is a different form of situational anxiety. Although it is favourable as long as it motivates the
students to learn, extreme levels of it can cause academic failure and psychological problems on the part of the individual. Method This is a
randomised controlled experimental study which aims at investigating the effect of visual day-dreaming and music therapy on reducing the test anxiety
of the university students. The sample of the study consisted of 84 voluntary students, all of whom were included in the study. The students were
selected on the basis of simple random sampling to form three different working groups: visual day-dreaming group, music therapy group and the
control group. The data were collected by means of an information form about the participant's socio-demographic characteristics, their day-dreaming
and musical preferences, and a scale for situational and persistent anxiety. Results The students in the three groups were found to be homogenous in
terms of age, gender, marital status, income, and the place of longest stay. The mean scores of persistent anxiety for the students in visual day-
dreaming group, music therapy group, and the control group were all found to be high. Statistically significant differences were observed between the
three groups in terms of their mean scores of situational anxiety. Conclusion In this study, it was determined that visual day-dreaming was found to
reduce university students' test anxiety, with significantly lower anxiety scores gauged from the day-dreaming group than the control group.
Archives of Disease in
Childhood, 99 : A557
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Creative expression: music, dance, drama, art
Ozyurt, G., Gencer, O., Ozturk, Y., Ozbek,
A.
Purpose: The aim of this study is to evaluate the long term
effectiveness of Triple P Positive Parenting Program (Triple-P) which have demonstrated to be benefical for childhood anxiety disorders in the short
term. Its effects on behavioral and emotional problems, general anxiety level, severity of the disorder and general psychosocial functioning are
asessed. An additional aim is to evaluate potential long term effects of Triple-P on anxiety and psychological well-being of parents of children with
anxiety disorders. Method: The study is randomized controlled prospective in design. The sample of the study consisted of 74 children, aged between
8-12 years, diagnosed as having an anxiety disorder confirmed by Schedule for Affective Disorders and Schizophrenia for School Age Children Present
and Life-time Kiddie (K-SADSPL). Following randomization into two equal groups, parents of the cases participated in Group Triple-P for 8 weeks
whereas the control group did not. The two groups were compared right before, right after and 4 months after the implementation on rates of
sociodemographic, emotional and behavioral variables. Data were collected by using sociodemographic data form, State Trait Anxiety Inventory, General
Health Questionnaire-28, Strengths and Difficulties Questionnaire (SDQ), Screen for Child Anxiety Related Emotional Disorders Parent and Child Forms
(SCARED), Children's Global Assessment Scale and Clinical Global Impression-Severity. The study data were evaluated with Friedman, Mann-Whitney U,
Wilcoxon signed rank test and chisquare analysis. Results: Out of 74 children whose parents approved to participate 55 (74.3%) children and their
parents completed the study (26 children for the case group and 29 children for the control group). Comparison of data obtained just before and just
after implementation revealed significant reduction in peer relation, emotional problem subscale scores and total problem score of SDQ were observed
(p = 0.02, p = 0.001, p = 0.008, respectively). Children's general anxiety level and anxiety disorder severity were significantly lower in the cases
following Triple-P implementation (p<0.00, p<0.001, respectively). Children's social problems, parental anxiety and general well-being were not
significantly different regarding these variables (p = 0.426, p = 0.380, p = 0.567, respectively). Four months after implementation 4 children from
the control group were excluded from study. Significant improvements in peer relation, emotional problem subscale scores and total problem score of
SDQ, children's general anxiety level and anxiety disorder severity were preserved (p = 0.000 for all analyses). Parental anxiety and general well-
being scores were significantly lower in the case group (p = 0.002, p = 0.000, p = 0.001, respectively). Conclusion: Anxiety disorders are one of the
most common types of psychopathology during childhood [1]. In Europe, more than 12%of the children is diagnosed with an anxiety disorder. In our
knowledge, this is the first study to evaluate short and long term effectiveness of Triple-P on childhood anxiety disorders. Implemantation of group
Triple-P displayed significant reduction in SCARED scores in the short and long term. This finding is in accordance with the results of studies which
applied CBT group parent therapy to the parents of children with anxiety disorders [2,3]. Significant decrease in emotional and behavioral subscales
of SDQ, a finding compatible with other studies which used Triple-P and SDQ for children with emotional and behavioral problems, indicate that
Triple-P can also be effective to reduce emotional and behavioral problems in children with anxiety disorders.
European Neuropsychopharmacology, 24 : S613
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Putwain, D., Chamberlain, S., Daly, A. L., Sadreddini, S.
This
paper evaluates the effectiveness of a multimodal and information technology (IT)-delivered intervention for test anxiety. Participants were randomly
allocated to an intervention or waiting list group. Test anxiety was measured pre- and post-intervention and academic buoyancy, a construct that
refers to students' capacity to withstand academic challenge and pressure, as a covariate. In the intervention group, 13.7% of participants
completed the full intervention programme comprising six sessions; 25.5% partially completed the programme (one or more sessions); and 60.8% of
participants chose not to complete any sessions. Results showed that, after completing the intervention and when controlling for academic buoyancy,
highly test anxious students showed a reduction in the worry and tension components of test anxiety, relative to those who did not complete the
intervention. The findings suggest that the intervention may offer highly test anxious students a means of reducing their anxiety that does not rely
on face-to-face delivery. (PsycINFO Database Record (c) 2014 APA, all rights reserved). (journal abstract)
Educational Psychology in Practice, 30(4) : 420-
440
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Self-help, Technology, interventions delivered using technology (e.g. online, SMS)
Rathschlag,
M., Memmert, D.
Background: The main aim of
this pilot study was to investigate an advanced version of eye movement desensitization and reprocessing (EMDR) for reducing anxiety. Methods: Fifty
participants were asked at two times of measurement (T1 and T2 with a rest of 4 weeks) to generate anxiety via the recall of autobiographical
memories according to their anxiety. Furthermore, the participants were randomly assigned to an experimental group and a control group, and the
experimental group received an intervention of 1-2 h with the advanced version of EMDR in order to their anxiety 2 weeks after T1. At T1 as well as
T2, we measured the intensity of participants' anxiety with a Likert scale (LS) and collected participants' state (temporary) and trait (chronic)
anxiety with the State-Trait Anxiety Inventory (STAI). In addition, we measured participants' physical performance in a test for the finger
musculature under the induction of their anxiety. Results: The results showed that participant's ratings of their perceived intensity of anxiety
(measured by a 9-point LS) and the state and trait anxiety decreased significantly in the experimental group but not in the control group from T1 to
T2. Moreover, the physical performance under the induction of participants' anxiety increased significantly in the experimental group from T1 to T2
and there were no significant changes in the control group. Conclusions: The study could show that the advanced version of EMDR is an appropriate
method to reduce anxiety. (copyright) 2014 The Authors. Brain and Behavior published by Wiley Periodicals, Inc.
Brain & Behavior, 4(3) : 348-355
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Eye movement desensitisation and reprocessing (EMDR)
Reavley, N. J., McCann, T. V., Cvetkovski, S., Jorm, A. F.
PURPOSE: The aim of the current study was to assess whether a multifaceted intervention could improve mental health literacy, facilitate
help seeking and reduce psychological distress and alcohol misuse in students of a multicampus university in Melbourne, Australia.\rMETHODS: In this
cluster randomized trial, nine university campuses were paired (some pairs included more than one campus), with one of each pair randomly assigned to
either the intervention or control condition. The interventions were designed to be whole-of-campus and to run over 2 academic years with their
effectiveness assessed through recruitment of a monitoring sample of students from each campus. Interventions included emails, posters, campus
events, factsheets/booklets and mental health first aid training courses. Participants had a 20-min telephone interview at baseline and at the end of
academic years 1 and 2. This assessed mental health literacy, help seeking, psychological distress and alcohol use. The primary outcomes were
depression and anxiety levels and alcohol use and pertained to the individual level.\rRESULTS: There were no effects on psychological distress and
alcohol use. Recall of intervention elements was greater in the intervention group at the end of year 2. Students in the intervention group were more
likely to say they would go to a drug and alcohol centre for alcohol problems at the end of 6 months.\rCONCLUSION: Although education and awareness
may play a role in improving mental health literacy, it is likely that, to achieve changes in psychological distress, interventions would need to be
more personalized and intensive.
Social Psychiatry & Psychiatric Epidemiology, 49(10) : 1655-
1666
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Psychoeducation, Other service delivery and improvement
interventions