Disorders - Anxiety Disorders
Lee, J., Tsunetsugu, Y., Takayama, N., Park, B. J., Li, Q., Song, C., Komatsu,
M., Ikei, H., Tyrvainen, L., Kagawa, T., Miyazaki, Y.
Background. Despite increasing attention toward
forest therapy as an alternative medicine, very little evidence continues to be available on its therapeutic effects. Therefore, this study was
focused on elucidating the health benefits of forest walking on cardiovascular reactivity. Methods. Within-group comparisons were used to examine the
cardiovascular responses to walking in forest and urban environments. Forty-eight young adult males participated in the two-day field research.
Changes in heart rate variability, heart rate, and blood pressure were measured to understand cardiovascular reactivity. Four different
questionnaires were used to investigate the changes in psychological states after walking activities. Results. Forest walking significantly increased
the values of ln(HF) and significantly decreased the values of ln(LF/HF) compared with the urban walking. Heart rate during forest walking was
significantly lower than that in the control. Questionnaire results showed that negative mood states and anxiety levels decreased significantly by
forest walking compared with urban walking. Conclusion. Walking in the forest environment may promote cardiovascular relaxation by facilitating the
parasympathetic nervous system and by suppressing the sympathetic nervous system. In addition, forest therapy may be effective for reducing negative
psychological symptoms. (copyright) 2014 Juyoung Lee et al.
Evidence-based Complementary & Alternative Medicine, 2014 :
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Physical activity, exercise
Katzman, M. A., Bleau, P., Blier, P., Chokka, P., Kjernisted, K., Van-Ameringen, M., Antony, M. M., Bouchard, S., Brunet, A., Flament, M., Grigoriadis, S., Mendlowitz, S., O'Connor, K., Rabheru, K., Richter, P. M. A., Robichaud, M., Walker, J. R.
Background: Anxiety and related disorders are among the most common
mental disorders, with lifetime prevalence reportedly as high as 31%. Unfortunately, anxiety disorders are under-diagnosed and under-treated.;
Methods: These guidelines were developed by Canadian experts in anxiety and related disorders through a consensus process. Data on the epidemiology,
diagnosis, and treatment (psychological and pharmacological) were obtained through MEDLINE, PsycINFO, and manual searches (1980-2012). Treatment
strategies were rated on strength of evidence, and a clinical recommendation for each intervention was made, based on global impression of efficacy,
effectiveness, and side effects, using a modified version of the periodic health examination guidelines.; Results: These guidelines are presented in
10 sections, including an introduction, principles of diagnosis and management, six sections (Sections 3 through 8) on the specific anxiety-related
disorders (panic disorder, agoraphobia, specific phobia, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, and
posttraumatic stress disorder), and two additional sections on special populations (children/adolescents, pregnant/lactating women, and the elderly)
and clinical issues in patients with comorbid conditions.; Conclusions: Anxiety and related disorders are very common in clinical practice, and
frequently comorbid with other psychiatric and medical conditions. Optimal management requires a good understanding of the efficacy and side effect
profiles of pharmacological and psychological treatments.;
BMC Psychiatry, 14 Suppl 1 : S1-
S1
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Psychological Interventions
(any)
Kim, S., Kim, G., Ki, J.
The purpose of this study is to investigate the effects of group art
therapy, including breath meditation, on the subjective well-being of depressed and anxious youngsters. The subjects were 24 first-grade students at
high school in a urban city (Daegu) of South Korea. The art therapy program was implemented in 13, 80-min sessions, held once or twice a week from
September 28, 2010 to February 2011. The study tool was the subjective well-being scale of Han (1997), which was adapted from the subjective well-
being scale of Campbell, Converse, and Rodgers (1976). The data were analyzed using SPSS WIN 18.0. To determine the homogeneity of the pre-test
results, one-way analysis of variance (ANOVA) was performed. To analyze effect of subjective well-being, two-way repeated measures ANOVA was
performed. Scores were significantly higher in experimental group 1 (who experienced art therapy combined with breath meditation) and 2 (who
experienced only art therapy), than in the control group (who received no therapy). Scores were significantly higher in group 1 than in group 2. The
results were the same in the follow-up test, which indicated the durability of the effects.
Arts in Psychotherapy, 41(5) : 519-
526
- 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), Creative expression: music, dance, drama, art, Meditation
Johnstone, J., Rooney,
R. M., Hassan, S., Kane, R. T.
Anxiety and depression are the most commonly reported mental health problems amongst
Australian children and adolescents. The Aussie Optimism: Program-Positive Thinking Skills (AOP-PTS) is a universal intervention program based on
cognitive and behavioral strategies and aimed to prevent anxiety and depression in the middle primary school children aged 9 - 10 years old. 370
students randomly assigned to the intervention and control condition participated in the 42 and 54 months follow-up study. The intervention group
received the AOP-PTS 10-week program and the control group received the regular health education curriculum. Students were assessed on anxiety,
depression and attribution style at school whilst parents reported on their child's externalizing and internalizing problems at home. Results showed
there were no significant reductions across groups in the depressive and anxiety symptoms, and attribution style at either 42 or 54 months follow-up.
These findings suggest that AOP-PTS has short and medium term effects but were not sustained in longer term period. Future strategies to achieve the
desirable outcomes in a longitudinal study are discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved). (journal abstract)
Frontiers in
Psychology, 5 :
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Hudson, J. L., Newall, C., Rapee, R. M., Lyneham, H. J., Schniering, C. C., Wuthrich, V. M., Schneider, S., Seeley-Wait, E., Edwards, S., Gar, N. S.
Parental anxiety is a risk to optimal treatment outcomes for childhood anxiety
disorders. The current trial examined whether the addition of a brief parental anxiety management (BPAM) program to family cognitive behavioral
therapy (CBT) was more efficacious than family CBT-only in treating childhood anxiety disorders. Two hundred nine children (aged 6-13 years, 104
female, 90% Caucasian) with a principal anxiety disorder were randomly allocated to family CBT with a five-session program of BPAM (n = 109) or
family CBT-only (n = 100). Family CBT comprised the Cool Kids program, a structured 12-week program that included both mothers and fathers. Overall,
results revealed that the addition of BPAM did not significantly improve outcomes for the child or the parent compared to the CBT-only group at
posttreatment or 6-month follow-up. Overall, however, children with nonanxious parents were more likely to be diagnosis free for any anxiety disorder
compared to children with anxious parents at posttreatment and 6-month follow-up. BPAM did not produce greater reductions in parental anxiety. The
results support previous findings that parent anxiety confers poorer treatment outcomes for childhood anxiety disorders. Nevertheless the addition of
BPAM anxiety management for parents in its current format did not lead to additional improvements when used as an adjunct to family CBT in the
treatment of the child's anxiety disorder. Future benefits may come from more powerful methods of reducing parents' anxiety. (copyright) 2014
Copyright Jennifer L. Hudson, Carol Newall, Ronald M. Rapee, Heidi J. Lyneham, Carolyn C. Schniering, Viviana M. Wuthrich, Sophie Schneider,
Elizabeth Seeley-Wait, Susan Edwards, and Natalie S. Gar.
Journal of
Clinical Child & Adolescent Psychology, 43(3) : 370-380
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions
Ginsburg, G. S., Becker, E. M., Keeton, C. P., Sakolsky, D., Piacentini, J., Albano, A. M., Compton, S. N., Iyengar, S., Sullivan, K., Caporino, N., Peris, T., Birmaher, B., Rynn, M., March,
J., Kendall, P. C.
IMPORTANCE
Pediatric anxiety disorders are highly prevalent and impairing and are considered gateway disorders in that they predict adult psychiatric problems.
Although they can be effectively treated in the short term, data are limited on the long-term outcomes in treated children and adolescents,
particularly those treated with medication., OBJECTIVE To determine whether acute clinical improvement and treatment type (ie, cognitive behavioral
therapy, medication, or their combination) predicted remission of anxiety and improvement in global functioning at a mean of 6 years after
randomization and to examine predictors of outcomes at follow-up., DESIGN, SETTING, AND PARTICIPANTS This naturalistic follow-up study, as part of
the Child/Adolescent Anxiety Multimodal Extended Long-term Study (CAMELS), was conducted at 6 academic sites in the United States and included 288
youths (age range, 11-26 years; mean age, 17 years). Youths were randomized to 1 of 4 interventions (cognitive behavioral therapy, medication,
combination, or pill placebo) in the Child/Adolescent Anxiety Multimodal Study (CAMS) and were evaluated a mean of 6 years after randomization.
Participants in this study constituted 59.0%of the original CAMS sample. EXPOSURES Participants were assessed by independent evaluators using a
semistructured diagnostic interview to determine the presence of anxiety disorders, the severity of anxiety, and global functioning. Participants and
their parents completed questionnaires about mental health symptoms, family functioning, life events, and mental health service use., MAIN OUTCOMES
AND MEASURES Remission, defined as the absence of all study entry anxiety disorders. RESULTS Almost half of the sample (46.5%) were in remission a
mean of 6 years after randomization. Responders to acute treatment were significantly more likely to be in remission (odds ratio, 1.83; 95%CI, 1.08-
3.09) and had less severe anxiety symptoms and higher functioning; the assigned treatment arm was unrelated to outcomes. Several predictors of
remission and functioning were identified., CONCLUSIONS AND RELEVANCE Youths rated as responders during the acute treatment phase of CAMS were more
likely to be in remission a mean of 6 years after randomization, although the effect size was small. Relapse occurred in almost half (48%) of acute
responders, suggesting the need for more intensive or continued treatment for a sizable proportion of youths with anxiety disorders. (copyright) 2014
American Medical Association.
JAMA Psychiatry, 71(3) : 310
-318
- 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)
Gottken, T., White, L. O., Klein, A. M., Von-Klitzing, K.
Few studies report treatment outcome for early childhood internalizing disorders following psychotherapy, especially psychodynamic
techniques. We aimed to investigate effectiveness of a novel, developmentally appropriate, short-term psychodynamic treatment program for 4-to 10-
year-olds with anxiety disorders in an outpatient setting. We conducted a quasi-experimental wait-list controlled study. Thirty children (12 females)
with Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) anxiety disorders and their families received 20-25 sessions of manualized
short-term Psychoanalytic Child Therapy (PaCT). We assessed outcome with standardized diagnostic interviews and parent reports of internalizing and
total problems at all time points. Child puppet interviews and teacher reports were also available for pre-post treatment and follow-up analyses.
While 18 families entered treatment immediately, 12 families were first wait-listed before receiving treatment. Analyses of symptom improvement were
based on comparisons between groups (treatment vs. wait-list) as well as pre-post and 6-month follow-up data across all families (including wait-
listed families). Among the 27 completers, 66.67% (n = 18) no longer met criteria for any anxiety disorder (59.88% in intent-to-treat analysis) while
no children remitted across the wait-list interval. Parent-reported child internalizing and total problems significantly declined during treatment
relative to wait-list. Child and teacher reports also revealed significant pre-post symptom reductions on internalizing and total problems.
Diagnostic and symptom remission rates were maintained at 6-month follow-up except on child reports. This preliminary study adds to a growing
database showing that psychodynamic treatments may offer an effective line of treatment for childhood internalizing symptoms and disorders in the
eyes of clinicians, children, parents, and teachers. (copyright) 2013 American Psychological Association.
Psychotherapy, 51(1) : 148-158
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Psychodynamic/Psychoanalysis
Hellhammer, J., Vogt, D., Franz, N., Freitas, U., Rutenberg, D.
Background: Supplementation with a phosphatidylserine and phosphatidylserine/ phosphatidic acid complex (PAS) has been
observed to normalize stress induced dysregulations of the hypothalamus-pituitary-adrenal axis (HPAA). Prolonged stress first induces a hyper-
activation of the HPAA, which then can be followed by a state of hypo-activation.The aim of this study was to examine effects of an oral
supplementation with 400 mg PS & 400 mg PA (PAS 400) per day on the endocrine stress response (ACTH, saliva and serum cortisol) to a psychosocial
stressor. A special focus was to analyze subgroups of low versus high chronically stressed subjects as well as to test efficacy of 200 mg PS & 200 mg
PA (PAS 200).\rMethods. 75 healthy male volunteers were enrolled for this double-blind, placebo-controlled study, stratified by chronic stress level,
and randomly allocated to one of three study arms (placebo, PAS 200 and PAS 400 per day, respectively). Study supplementation was administered for 42
days for each participant. Chronic stress was measured with the Trier Inventory for Chronic Stress (TICS), and subgroups of high and low chronic
stress were differentiated by median values as provided by the TICS authors. A six week period of supplementation was followed by an acute stress
test (Trier Social Stress Test - TSST). Results: Chronic stress levels and other baseline measures did not differ between treatment groups (all p >
0.05). Acute stress was successfully induced by the TSST and resulted in a hyper-responsivity of the HPAA in chronically stressed subjects. Compared
to placebo, a supplementation with a daily dose of PAS 400 was effective in normalizing the ACTH (p = 0.010), salivary (p = 0.043) and serum cortisol
responses (p = 0.035) to the TSST in chronically high but not in low stressed subjects (all p > 0.05). Compared to placebo, supplementation with PAS
200 did not result in any significant differences in these variables (all p > 0.05). There were no significant effects of supplementation with PAS on
heart rate, pulse transit time, or psychological stress response (all p > 0.05).\rConclusion: In chronically stressed subjects, a supplementation
with PAS 400 (MemreePlus(trademark)) can normalize the hyper-responsivity of the HPAA to an acute stressor.\rTrial registration. Trial registration:
DRKS-ID: DRKS00005125.
Lipids in Health &
Disease, 13(1) :
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Vitamins and supplements
Gruzelier, J. H., Thompson, T., Redding, E., Brandt, R., Steffert, T.
As one in a series on the impact of EEG-neurofeedback in the performing arts, we set out to replicate a previous dance
study in which alpha/theta (A/T) neurofeedback and heart rate variability (HRV) biofeedback enhanced performance in competitive ballroom dancers
compared with controls. First year contemporary dance conservatoire students were randomised to the same two psychophysiological interventions or a
choreology instruction comparison group or a no-training control group. While there was demonstrable neurofeedback learning, there was no impact of
the three interventions on dance performance as assessed by four experts. However, HRV training reduced anxiety and the reduction correlated with
improved technique and artistry in performance; the anxiety scale items focussed on autonomic functions, especially cardiovascular activity. In line
with the putative impact of hypnogogic training on creativity A/T training increased cognitive creativity with the test of unusual uses, but not
insight problems. Methodological and theoretical implications are considered.; Copyright © 2013 Elsevier B.V. All rights reserved.
International Journal of Psychophysiology, 93(1) : 105-
111
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Biofeedback, neurofeedback, audio/video feedback
Hoppitt, L., Illingworth, J. L., MacLeod, C., Hampshire, A., Dunn, B. D., Mackintosh, B.
Modifying threat related biases in attention and
interpretation has been shown to successfully reduce global symptoms of anxiety in high anxious and clinically anxious samples (termed Cognitive Bias
Modification, CBM). However, the possibility that CBM can be used as a way to prevent anxiety associated with an upcoming real-life stressful event
in vulnerable populations has yet to be systematically examined. The present study aimed to assess whether a two-week course of online CBM for
interpretations (CBM-I) could reduce social evaluative fear when starting university. Sixty-nine students anxious about starting university completed
five sessions of online CBM in the two weeks prior to starting university, or completed a placebo control intervention. Results indicated that CBM-I
reduced social evaluative fear from baseline to day one of starting university to a greater extent than the placebo control intervention. Also, there
was a greater reduction in state anxiety and a trend indicating a greater reduction in social evaluative fear in the CBM-I group at 4 weeks follow-
up. Results suggest that CBM-I could be used as a preventative tool to help reduce anxiety specific to challenging life events. (copyright) 2013 The
Authors.
Behaviour Research & Therapy, 52(1) : 45-
52
- 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), Attention/cognitive bias
modification, Technology, interventions delivered using technology (e.g. online, SMS)
Corrieri, S., Heider,
D., Conrad, I., Blume, A., Konig, H-H., Riedel-Heller, S. G.
School-based interventions are considered a promising effort to prevent the
occurrence of mental disorders in adolescents. This systematic review focuses on school-based prevention interventions on depression and anxiety
disorders utilizing an RCT design, starting from the year 2000. Based on an online search (PubMed, Scirus, OVID, ISI) and bibliographic findings in
the eligible articles, 28 studies providing information were reviewed. The search process ended on 2 May 2011. The majority of interventions turn out
to be effective, both for depression (65%) and anxiety (73%). However, the obtained overall mean effect sizes calculated from the most utilized
questionnaires can be considered rather small (CDI: -0.12; RCMAS: -0.29). The majority of the reviewed school-based interventions shows effectiveness
in reducing or preventing mental disorders in adolescents. However, effect size computation revealed only small-scale effectiveness. Future studies
have to consider the impact of program implementation variations.; © The Author (2013). Published by Oxford University Press. All rights reserved.
For Permissions, please email: [email protected].
Health Promotion International, 29(3) : 427-
441
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any)
Davies, E. B., Morriss, R., Glazebrook,
C.
Background: Depression and anxiety are common
mental health difficulties experienced by university students and can impair academic and social functioning. Students are limited in seeking help
from professionals. As university students are highly connected to digital technologies, Web-based and computer-delivered interventions could be used
to improve students' mental health. The effectiveness of these intervention types requires investigation to identify whether these are viable
prevention strategies for university students. Objective: The intent of the study was to systematically review and analyze trials of Web-based and
computer-delivered interventions to improve depression, anxiety, psychological distress, and stress in university students. Methods: Several
databases were searched using keywords relating to higher education students, mental health, and eHealth interventions. The eligibility criteria for
studies included in the review were: (1) the study aimed to improve symptoms relating to depression, anxiety, psychological distress, and stress, (2)
the study involved computer-delivered or Web-based interventions accessed via computer, laptop, or tablet, (3) the study was a randomized controlled
trial, and (4) the study was trialed on higher education students. Trials were reviewed and outcome data analyzed through random effects meta-
analyses for each outcome and each type of trial arm comparison. Cochrane Collaboration risk of bias tool was used to assess study quality. Results:
A total of 17 trials were identified, in which seven were the same three interventions on separate samples; 14 reported sufficient information for
meta-analysis. The majority (n = 13) were website-delivered and nine interventions were based on cognitive behavioral therapy (CBT). A total of 1795
participants were randomized and 1480 analyzed. Risk of bias was considered moderate, as many publications did not sufficiently report their methods
and seven explicitly conducted completers' analyses. In comparison to the inactive control, sensitivity meta-analyses supported intervention in
improving anxiety (pooled standardized mean difference [SMD] -0.56; 95% CI -0.77 to -0.35, P < .001), depression (pooled SMD -0.43; 95% CI -0.63 to
-0.22, P < .001), and stress (pooled SMD -0.73; 95% CI -1.27 to -0.19, P=.008). In comparison to active controls, sensitivity analyses did not
support either condition for anxiety (pooled SMD -0.18; 95% CI -0.98 to 0.62,P = .66) or depression (pooled SMD -0.28; 95% CI -0.75 to -0.20, P =
.25). In contrast to a comparison intervention, neither condition was supported in sensitivity analyses for anxiety (pooled SMD -0.10; 95% CI -0.39
to 0.18, P = .48) or depression (pooled SMD -0.33; 95% CI -0.43 to 1.09, P = .40). Conclusions: The findings suggest Web-based and computer-delivered
interventions can be effective in improving students' depression, anxiety, and stress outcomes when compared to inactive controls, but some caution
is needed when compared to other trial arms and methodological issues were noticeable. Interventions need to be trialed on more heterogeneous student
samples and would benefit from user evaluation. Future trials should address methodological considerations to improve reporting of trial quality and
address post-intervention skewed data. (PsycINFO Database Record (c) 2014 APA, all rights reserved). (journal abstract)
Journal of Medical Internet
Research, 16(5) : 18-39
- Year: 2014
- 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)