Disorders - Anxiety Disorders
Niles, A. N., Haltom, K. E. B., Mulvenna, C. M., Lieberman, M. D., Stanton, A. L.
The current study assessed main effects and moderators
(including emotional expressiveness, emotional processing, and ambivalence over emotional expression) of the effects of expressive writing in a
sample of healthy adults. Young adult participants (N=116) were randomly assigned to write for 20 minutes on four occasions about deepest thoughts
and feelings regarding their most stressful/traumatic event in the past five years (expressive writing) or about a control topic (control). Dependent
variables were indicators of anxiety, depression, and physical symptoms. No significant effects of writing condition were evident on anxiety,
depressive symptoms, or physical symptoms. Emotional expressiveness emerged as a significant moderator of anxiety outcomes, however. Within the
expressive writing group, participants high in expressiveness evidenced a significant reduction in anxiety at three-month follow-up, and participants
low in expressiveness showed a significant increase in anxiety. Expressiveness did not predict change in anxiety in the control group. These findings
on anxiety are consistent with the matching hypothesis, which suggests that matching a person's naturally elected coping approach with an assigned
intervention is beneficial. These findings also suggest that expressive writing about a stressful event may be contraindicated for individuals who do
not typically express emotions. (copyright) 2013 Taylor & Francis.
Anxiety, Stress & Coping, 27(1) : 1-17
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Creative expression: music, dance, drama, art
Norr, A.
M., Allan, N. P., Macatee, R. J., Keough, M. E., Schmidt, N. B.
Recently there has been increased interest in
emotional and physical tolerance risk factors for mood and anxiety disorders. Three tolerance risk factors that have been shown to be related are
anxiety sensitivity (AS), distress tolerance (DT), and discomfort intolerance (DI). Although previous research has demonstrated these constructs are
malleable, no research has investigated the effects of an AS intervention on DT or DI. Further, no studies have investigated whether changes in DT or
DI play a role in mood and anxiety symptom amelioration due to an AS intervention. Participants (N=104), who were selected for elevated levels of AS,
completed a single-session computer-assisted AS intervention or a control intervention and follow-up assessments at 1-week and 1-month post
intervention. Results revealed that the intervention reduced AS and increased DT, but did not affect DI at the 1-week follow-up. Mediation analyses
revealed that changes in AS and DT both mediated changes in symptoms (depression, anxiety, worry) due to the intervention at 1-month follow-up,
however, when AS and DT were considered in the same model only the effect via AS remained significant. These results have important implications for
the nature of the relationships between AS, DT, and DI as well as the specific mechanistic pathways through which an AS intervention ameliorates
symptoms. (copyright) 2014 Elsevier Ltd.
Behaviour Research & Therapy, 59 : 12-
19
- 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), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Pallavi, P.
Background: As reported, cytokines and neurotrophic factors are
causally related to depression. Administration of selective serotonin reuptake inhibitors (SSRI) in depression patients is known to modify cytokine
and neurotrophin levels. The impact of yoga therapy as an adjunct to SSRI on anxiety, cytokines and neurotrophins in adolescent depression has not
been investigated. Methods: In this 12 weeks single-blind randomized controlled study, 50 adolescents (13-18 years) with depression were randomly
assigned to either (i) The standard SSRI treatment or (ii) yoga therapy in adjunct to SSRI. In the yoga therapy group, the subjects received sessions
of 60 min yoga thrice a week for 12 weeks in addition to SSRI. The assessments at baseline and endpoint included Beck's Depression Inventory score,
State-trait anxiety scores, serum cytokines (IL- 1(beta), IL-2, IL-6, IL-10, TNF-(alpha), IFN-g, TGF-(beta) and IL-17 using ELISA) and serum
neurotrophins (BDNF, NGF, NT-3 and GDNF using ELISA). Results: At 12 weeks, we observed significant decrease (p<0.05) of IL-6 levels in Yoga group as
compared to baseline. Also TGF-(beta) (p=0.008) and NGF (p=0.03) levels increased significantly at 12 weeks in Yoga group. Intergroup comparison at
12 weeks showed, significantly increased BDNF levels (p=0.001) and significantly decreased IL-2 levels (p=0.02) in Yoga group as compared to the
control group. No significant difference appeared between the two groups at any baseline assessment. Conclusions: The results support the beneficial
effects of the yoga therapy on adolescent depression patients as an adjunct to standard care as reflected in changes in psychometric scores, cytokine
and neurotrophin levels.
Biological
Psychiatry, 75(9) : 118S
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Complementary & Alternative
Interventions (CAM), Mind-body exercises (e.g. yoga, tai chi, qigong)
Perry,
Y., Petrie, K., Buckley, H., Cavanagh, L., Clarke, D., Winslade, M., Hadzi-Pavlovic, D., Manicavasagar, V., Christensen, H.
Evidence suggests that poor mental health literacy is a key barrier to help-seeking for mental health difficulties in adolescence.
Educational programs have shown positive effects on literacy, however, the evidence base remains limited and available studies have many
methodological limitations. Using cluster Randomised Control Trial (RCT) methodology, the current study examines the impact of 'HeadStrong', a
school-based educational intervention, on mental health literacy, stigma, help-seeking, psychological distress and suicidal ideation. A total of 380
students in 22 classes (clusters) from 10 non-governmentsecondary schools was randomised to receive either HeadStrong or Personal Development, Health
and Physical Education (PDHPE) classes. Participants were assessed pre- and post-intervention, and at 6-month follow-up. Literacy improved and stigma
reduced in both groups at post-intervention and follow-up, relative to baseline. However, these effects were significantly greater in the HeadStrong
condition. The study demonstrates the potential of HeadStrong to improve mental health literacy and reduce stigma. (copyright) 2014 The Foundation
for Professionals in Services for Adolescents.
Journal of Adolescence, 37(7) : 1143-
1151
- Year: 2014
- Problem: Anxiety Disorders (any), Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation
Piacentini,
J., Bennett, S., Compton, S. N., Kendall, P. C., Birmaher, B., Albano, A. M., March, J., Sherrill, J., Sakolsky, D., Ginsburg,
G., Rynn, M., Bergman, R. L., Gosch, E., Waslick, B., Iyengar, S., McCracken, J., Walkup, J.
Objective We report active treatment group differences on response and
remission rates and changes in anxiety severity at weeks 24 and 36 for the Child/Adolescent Anxiety Multimodal Study (CAMS). Method CAMS youth (N =
488; 74% (less-than or equal to)12 years of age) with DSM-IV separation, generalized, or social anxiety disorder were randomized to 12 weeks of
cognitive-behavioral therapy (CBT), sertraline (SRT), CBT+SRT (COMB), or medication management/pill placebo (PBO). Responders attended 6 monthly
booster sessions in their assigned treatment arm; youth in COMB and SRT continued on their medication throughout this period. Efficacy of COMB, SRT,
and CBT (n = 412) was assessed at 24 and 36 weeks postrandomization. Youth randomized to PBO (n = 76) were offered active CAMS treatment if
nonresponsive at week 12 or over follow-up and were not included here. Independent evaluators blind to study condition assessed anxiety severity,
functioning, and treatment response. Concomitant treatments were allowed but monitored over follow-up. Results The majority (>80%) of acute
responders maintained positive response at both weeks 24 and 36. Consistent with acute outcomes, COMB maintained advantage over CBT and SRT, which
did not differ, on dimensional outcomes; the 3 treatments did not differ on most categorical outcomes over follow-up. Compared to COMB and CBT, youth
in SRT obtained more concomitant psychosocial treatments, whereas those in SRT and CBT obtained more concomitant combined (medication plus
psychosocial) treatment. Conclusions COMB maintained advantage over CBT and SRT on some measures over follow-up, whereas the 2 monotherapies remained
indistinguishable. The observed convergence of COMB and monotherapy may be related to greater use of concomitant treatment during follow-up among
youth receiving the monotherapies, although other explanations are possible. Although outcomes were variable, most CAMS-treated youth experienced
sustained treatment benefit. Clinical trial registration information - Child and Adolescent Anxiety Disorders (CAMS); URL: http://clinicaltrials.
gov. Unique identifier: NCT00052078.
Journal of the American Academy of Child & Adolescent Psychiatry, 53(3) : 297-
310
- 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: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Mohamadi, A., Hajiamin, Z., Ebadi, A., Fathi-Ashtian, A., Ali-Asgari, M.
Anxiety disorders are among the most common psychological disorders in children. Considering the effects of the
relationship between parents (especially mothers) and children on the mental health of children, we conducted this study to evaluate the effect of
communication skills training of mothers by multimedia software. This clinical trial was conducted on 109 first-grade students in one of the zones in
Tehran. For data collection, we used the School Anxiety Scale - Teacher Report and the Queendom Communication Skill Test to assess mothers'
communication skills. Students' anxiety levels and mothers' communication skills were assessed (in both groups before and after of intervention).
Then students were randomly assigned to two groups: case and control. The case group received multimedia CD for communication skills training during
2 months. The total prevalence rate of anxiety in students before intervention was 16.1%. It significantly decreased in the multimedia group after
intervention (P < 0.05), as shown by the Wilcoxon test, but the difference was not significant in the control group. Furthermore, the mean (SD) score
of the communication skills of mothers was (114 ± 9.8) before intervention, which significantly increased in the case group (P < 0.05). Communication
skills training for mothers using multimedia software programs is an effective way to reduce children's anxiety. Therefore, this kind of training
should be provided to parents because it is inexpensive and can be used frequently. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
(journal abstract)
Psychology, 5(8) : 950-955
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Skills training
Musiat, P., Conrod, P., Treasure, J., Tylee, A., Williams, C., Schmidt, U.
Background: A large proportion of university students show symptoms of common mental disorders, such as depression, anxiety, substance use
disorders and eating disorders. Novel interventions are required that target underlying factors of multiple disorders. Aims: To evaluate the efficacy
of a transdiagnostic trait-focused web-based intervention aimed at reducing symptoms of common mental disorders in university students. Method:
Students were recruited online (n = 1047, age: M= 21.8, SD = 4.2) and categorised into being at high or low risk for mental disorders based on their
personality traits. Participants were allocated to a cognitive-behavioural trait-focused (n = 519) or a control intervention (n = 528) using
computerised simple randomisation. Both interventions were fully automated and delivered online (trial registration: ISRCTN14342225). Participants
were blinded and outcomes were selfassessed at baseline, at 6 weeks and at 12 weeks after registration. Primary outcomes were current depression and
anxiety, assessed on the Patient Health Questionnaire (PHQ9) and Generalised Anxiety Disorder Scale (GAD7). Secondary outcome measures focused on
alcohol use, disordered eating, and other outcomes. Results: Students at high risk were successfully identified using personality indicators and
reported poorer mental health. A total of 520 students completed the 6-week follow-up and 401 students completed the 12-week follow-up. Attrition was
high across intervention groups, but comparable to other web-based interventions. Mixed effects analyses revealed that at 12-week follow up the
trait-focused intervention reduced depression scores by 3.58 (p,.001, 95%CI [5.19, 1.98]) and anxiety scores by 2.87 (p = .018, 95%CI [1.31, 4.43])
in students at high risk. In high-risk students, between group effect sizes were 0.58 (depression) and 0.42 (anxiety). In addition, self-esteem was
improved. No changes were observed regarding the use of alcohol or disordered eating. Conclusions: This study suggests that a transdiagnostic web-
based intervention for university students targeting underlying personality risk factors may be a promising way of preventing common mental disorders
with a low-intensity intervention. © 2014 Musiat et al.
PLoS ONE, 9(4) :
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders, Eating Disorders
(any), Alcohol
Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Technology, interventions delivered using technology (e.g. online, SMS)
Micco, J. A., Henin, A., Hirshfeld-Becker, D. R.
This study evaluated the efficacy of a four-session Cognitive Bias Modification-
Interpretation program for 45 depressed adolescents and young adults (14-21 years old; 12 males, 33 females; Beck Depressive Inventory, Second
Edition (greater-than or equal to)14) randomized to an active intervention condition (repeated exposure to positive outcomes of depression-relevant
ambiguous scenarios; n = 23) or a control condition (n = 22). Both conditions experienced reductions on a Test of Interpretation Bias at post-
treatment, with no significant between-group differences. When limited to those with negative bias at baseline, the intervention group showed greater
improvement in interpretation bias at mid- and post-treatment. In addition, the intervention group overall had greater improvements in self-reported
negative cognitions than the control group at post-intervention and two-week follow-up. However, there were no differences between groups in
depression or anxiety symptom change. Potential factors contributing to mixed findings are discussed. (copyright) 2013 Springer Science+Business
Media.
Cognitive Therapy & Research, 38(2) : 89-
102
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Attention/cognitive bias
modification
Matsumoto, T., Asakura, H., Hayashi, T.
Objective: This study investigated the soothing effects of fragrance from yuzu, a Japanese citrus fruit
(Citrus junos Sieb. ex Tanaka), with salivary chromogranin A (CgA) used as an endocrinologic stress marker reflecting sympathetic nervous system
activity. Methods: Twenty healthy women (mean age, 20.5(plus or minus)0.1 years) participated in a randomized, controlled, crossover study.
Participants were examined on two separate occasions - once using the yuzu scent and once using unscented water as a control - in the follicular
phase. This experiment measured salivary CgA and the Profile of Mood States (POMS) as a psychological index before and after the aromatic
stimulation. Results: Ten-minute inhalation of the yuzu scent significantly decreased salivary CgA. At 30 minutes after the inhalation period, the
salivary CgA level further decreased. In addition, POMS revealed that inhalation of the aromatic yuzu oil significantly decreased total mood
disturbance, a global measure of affective state, as well as four subscores of emotional symptoms (tension-anxiety, depression-dejection, anger-
hostility, and confusion), as long as 30 minutes after the olfactory stimulation. Conclusions: Yuzu's aromatic effects may alleviate negative
emotional stress, which, at least in part, would contribute to the suppression of sympathetic nervous system activity. (copyright) Copyright 2014,
Mary Ann Liebert, Inc. 2014.
Journal of Alternative & Complementary
Medicine, 20(6) : 500-506
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Other complementary & alternative
interventions
Mavilidi, M. F., Hoogerheide, V., Paas, F.
The negative
thoughts that anxious children experience while sitting for an exam consume working memory resources at the cost of resources for performing on the
exam. In a randomized field experiment (N=117) with primary school students, we investigated the hypothesis that stimulating students to look through
the problems of a math test before they start solving them would reduce anxiety, release these anxiety-related working memory resources, and lead to
higher test performance than not allowing students to look ahead in the test. The results confirmed the hypothesis, indicating that the positive
effects of looking ahead applied to all students, regardless of their anxiety level (low, medium, or high). The results suggest that by looking ahead
in a test, less working memory resources are consumed by intrusive thoughts, and consequently, more resources can be used for performing on the test.
Theoretical and practical implications of the results are discussed.
Applied Cognitive Psychology, 28(5) : 720-
726
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Medina, J. L., Deboer, L. B., Davis, M. L., Rosenfield, D., Powers, M. B., Otto, M. W., Smits, J. A.
J.
A moderate to vigorous intensity exercise program is emerging as a promising strategy for reducing anxiety
sensitivity (AS). Initial evidence suggests that the effects of exercise on mental health outcomes may vary as a function of gender, with men
benefitting more than women. Building upon this evidence, the present study tested the hypothesis that the effect of exercise on AS would vary as a
function of gender, such that the effect would be stronger for men than for women. We tested this hypothesis using the data from a published study
(Smits, Berry, Rosenfield, et al., 2008). In this study, participants (N = 60) with elevated levels of AS were randomly assigned to a two-week
exercise intervention [EX] or a waitlist control condition [WL]. Results revealed that males showed significantly greater initial AS reductions
relative to females (following 1 week of exercise). However, these gender differences were no longer evident at the end of the intervention. Possible
mechanisms for the observed findings and directions for future research are discussed.
Mental Health & Physical Activity, 7(3) : 147-
151
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Physical activity, exercise
Loucas, C., Pennant, M., Whittington, C., Naqvi, S., Sealey, C., Stockton, S., Kelvin, R., Fonagy, P., Kendall, T.
Aims
To review the effectiveness of e-mediated therapies and computer applications for children and young people (CYP) with mental health (MH) problems.
To conduct focus groups eliciting service users views on computer-based applications. This work is part of a DH-commissioned website which will
provide e-learning to people assisting CYP with MH problems, overseen by the MindEd Consortium at RCPCH. Methods Medical, psychological/sociological,
educational and grey literature databases were searched for randomised controlled trials of interventions for MH problems in CYP, either through
remote therapist contact (e-mediated therapy) or computer-based applications. Studies were included if the mean age of participants was <18 years or
all participants were (less-than or equal to)25 years. In addition, two focus groups of young people aged (less-than or equal to)25 years used four
computerised CBT (cCBT) programs for anxiety and/or depression followed by facilitated discussion. Results The review included studies of e-mediated
and computer-based therapies for anxiety and depression (N=26), phobia (N=2), OCD (N=2), PTSD (N=1), eating disorders (N=6), ADHD (N=10), conduct
disorder (N=2), substance misuse (N=11), autism (N=1), Tourette syndrome (N=1) and psychosis (N=1). Based on the GRADE system, the evidence was
predominantly low quality with limited data, inadequate study design and unreliable outcome measures being major contributors to downgrading. The
strongest evidence was for cCBT programs for depression in adolescents, and there was some promise for cCBT programs for anxiety in adolescents. The
focus groups identified several key issues, including: the need for products to be engaging and up-to-date; the desire to set own goals; being active
in therapy; continued contact with therapists; and the importance of endorsement by professionals. Conclusions Computer-based applications such as
cCBT show promise and e-mediated strategies are potentially useful. In the provision and development of new products, input is needed from
specialists in software design as well as psychology, with consideration given to the software's technological suitability, therapeutic benefit and
acceptability, as well as individual autonomy and integration with MH services. There should be continued robust evaluation of the evidence for
effectiveness and cost effectiveness.
Archives of Disease in Childhood, 99 : A58
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: 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)