Dundas, Ingrid, Hagtvet, Knut A., Wormnes, Bjorn, Hauge, Helge

Does self-hypnosis add to the effectiveness of a cognitive-behavioral intervention against test anxiety?

This study examined whether self-hypnosis could enhance a cognitive-behavioral (CB) intervention against test anxiety. Students seeking help for test anxiety at the student welfare service (mean age = 24.7 years) received one group session of a CB intervention and were then randomized to either two sessions of the same CB intervention (CB only, N = 39) or two sessions of self-hypnosis training designed to enhance the CB intervention (CB with self-hypnosis, N = 34). Anxiety and self-confidence measures were administered at recruitment and 3 days prior to the student's exam, subsequent to the intervention. A comparison group of students who had not sought help completed the same questionnaires at the same time points relative to their exams (non-help-seeking group, N = 85). Self-hypnosis training did not add to the effectiveness of the CB intervention. On the contrary, the CB intervention was more effective without self-hypnosis on three measures: test anxiety, state anxiety and self-esteem. We suggest that self-hypnosis for test anxiety might be better reserved for students not responding to a CB-only intervention, or who clearly prefer a self-hypnosis intervention. (PsycINFO Database Record (c) 2013 APA, all rights reserved). (journal abstract)

Nordic Psychology, 65(3) : 224-241

Farrer, L., Gulliver, A., Chan, J. K., Batterham, P. J., Reynolds, J., Calear, A., Tait, R., Bennett, K., Griffiths, K. M.

Technology-based interventions for mental health in tertiary students: systematic review

Mental disorders are responsible for a high level of disability burden in students attending university. However, many universities have limited resources available to support student mental health. Technology-based interventions may be highly relevant to university populations. Previous reviews have targeted substance use and eating disorders in tertiary students. However, the effectiveness of technology-based interventions for other mental disorders and related issues has not been reviewed. To systematically review published randomized trials of technology-based interventions evaluated in a university setting for disorders other than substance use and eating disorders. The PubMed, PsycInfo, and Cochrane Central Register of Controlled Trials databases were searched using keywords, phrases, and MeSH terms. Retrieved abstracts (n=1618) were double screened and coded. Included studies met the following criteria: (1) the study was a randomized trial or a randomized controlled trial, (2) the sample was composed of students attending a tertiary institution, (3) the intervention was delivered by or accessed using a technological device or process, (4) the age range of the sample was between 18 and 25 years, and (5) the intervention was designed to improve, reduce, or change symptoms relating to a mental disorder. A total of 27 studies met inclusion criteria for the present review. Most of the studies (24/27, 89%) employed interventions targeting anxiety symptoms or disorders or stress, although almost one-third (7/24, 29%) targeted both depression and anxiety. There were a total of 51 technology-based interventions employed across the 27 studies. Overall, approximately half (24/51, 47%) were associated with at least 1 significant positive outcome compared with the control at postintervention. However, 29% (15/51) failed to find a significant effect. Effect sizes were calculated for the 18 of 51 interventions that provided sufficient data. Median effect size was 0.54 (range -0.07 to 3.04) for 8 interventions targeting depression and anxiety symptoms and 0.84 (range -0.07 to 2.66) for 10 interventions targeting anxiety symptoms and disorders. Internet-based technology (typically involving cognitive behavioral therapy) was the most commonly employed medium, being employed in 16 of 27 studies and approximately half of the 51 technology-based interventions (25/51, 49%). Distal and universal preventive interventions were the most common type of intervention. Some methodological problems were evident in the studies, with randomization methods either inadequate or inadequately described, few studies specifying a primary outcome, and most of the studies failing to undertake or report appropriate intent-to-treat analyses. The findings of this review indicate that although technological interventions targeting certain mental health and related problems offer promise for students in university settings, more high quality trials that fully report randomization methods, outcome data, and data analysis methods are needed.

Journal of Medical Internet Research, 15(5) : e101

Horigian, Viviana E., Weems, Carl F., Robbins, Michael S., Feaster, Daniel J., Ucha, Jessica, Miller, Michael, Werstlein, Robert

Reductions in anxiety and depression symptoms in youth receiving substance use treatment

Background and Objectives: Research shows that interventions for substance use disorders may be helpful in reducing internalizing disorders in adolescents. This paper examines the prevalence and reductions of anxiety and depression symptoms among youth receiving substance use treatment.; Methods: Four hundred eighty adolescents ages 12-17 who received treatment for substance abuse as part of the Brief Strategic Family Therapy effectiveness trial were screened for anxiety and depression using the Diagnostic Interview Schedule for Children-Predictive Scales (DISC-PS). Twelve-month post-randomization assessments were completed by 327 parents and 315 youth. Sixty-five percent of the sample was found to have probability of at least one anxiety disorder or depression diagnosis.; Results: Significant reduction of anxiety and depressive symptoms and significant reductions in probable anxiety and depression diagnoses were observed at follow-up. Few differences by treatment type and by ethnic group were noticed.; Conclusions and Scientific Significance: Findings indicate that substance use interventions might help reduce the prevalence of anxiety and depressive symptoms and the probability of these disorders.; Copyright © American Academy of Addiction Psychiatry.

American Journal on Addictions, 22(4) : 329-337

Hilton, Robert C., Rengasamy, Manivel, Mansoor, Brandon, He, Jiayan, Mayes, Taryn, Emslie, Graham J., Porta, Giovanna, Clarke, Greg N., Wagner, Karen Dineen, Birmaher, Boris, Keller, Martin B., Ryan, Neal, Shamseddeen, Wael, Asarnow, Joan Rosenbaum, Brent, David A.

Impact of treatments for depression on comorbid anxiety, attentional, and behavioral symptoms in adolescents with selective serotonin reuptake inhibitor-resistant depression

Objective: To assess the relative efficacy of antidepressant medication, alone and in combination with cognitive behavioral therapy (CBT), on comorbid symptoms of anxiety, attention, and disruptive behavior disorders in participants in the Treatment of Resistant Depression in Adolescents (TORDIA) trial.; Method: Adolescents with selective serotonin reuptake inhibitor (SSRI)-resistant depression (N = 334) were randomly assigned to a medication switch alone (to another SSRI or to venlafaxine) or to a medication switch plus CBT. Anxiety, attention-deficit/hyperactivity disorder (ADHD), and disruptive behavior disorder (DBD) symptoms were assessed by psychiatric interview and self-report at regular intervals between baseline and 24 weeks. The differential effects of medication and of CBT, and the impact of remission on the course of comorbid symptoms and diagnoses, were assessed using generalized linear mixed models.; Results: Remission was associated with a greater reduction in scalar measures of anxiety, ADHD, and DBDs, and a greater decrease in the rate of diagnosed anxiety disorders. The correlations between the changes in symptoms of depression on the CDRS-R and anxiety, ADHD, and oppositional symptoms were modest, ranging from r = 0.12 to r = 0.28. There were no significant differential treatment effects on diagnoses, or corresponding symptoms.; Conclusion: The achievement of remission had a beneficial effect on anxiety, ADHD, and DBD symptoms, regardless of the type of treatment received. There were no differential effects of medication or CBT on outcome, except for a nonsignificant trend that those adolescents treated with SSRIs showed a greater decrease in rates of comorbid DBDs relative to those treated with venlafaxine. Clinical trial registration information- Treatment of SSRI-Resistant Depression In Adolescents (TORDIA); http://clinicaltrials.gov/; NCT00018902.; Copyright © 2013. Published by Elsevier Inc.

Journal of the American Academy of Child & Adolescent Psychiatry, 52(5) : 482-492

Hides, L., Carroll, S., Scott, R., Cotton, S., Baker, A., Lubman, D. I.

Quik fix: A randomized controlled trial of an enhanced brief motivational interviewing intervention for alcohol/cannabis and psychological distress in young people

Psychotherapy & Psychosomatics, 82(2) : 122- 124

Garcia, C., Pintor, J., Vazquez, G., Alvarez-Zumarraga, E.

Project Wings, a Coping Intervention for Latina Adolescents: A Pilot Study

The authors examined the feasibility and preliminary outcomes of Project Wings Girls' Groups, a school-based mental health promotion program designed to improve well-being in Latina adolescents, as observed in outcomes, including perceived stress, depressive symptoms, coping, and connectedness. This pilot randomized controlled trial compared outcomes over 9 months postintervention for 42 9th and 10th grade adolescents attending two urban high schools. Girls were randomized to Project Wings Girls' Groups, a 16-session facilitated curriculum, including sharing circles, mind-body exercises, and coping skills building or the attention control (i.e., similar format but focused on general health topics). Feasibility of retention and long-term follow-up data collection was demonstrated, with lessons learned for future study. Although not statistically powered, this trial demonstrated findings in the expected direction, including reduced perceived stress and depression and increased connectedness. A trial with sufficient power is warranted to examine Project Wings' effects on mental health problems among Latina adolescents. (copyright) The Author(s) 2011.

Western Journal of Nursing Research, 35(4) : 434-458

Kanojia, S., Kumar-Sharma, V., Gandhi, A., Kapoor, R., Kukreja, A., Kumar-Subramanian, S.

Effect of yoga on autonomic functions and psychological status during both phases of menstrual cycle in young healthy females

Context: Premenstrual stress affects 75% of women of childbearing age and yoga has been found to be beneficial in many psycho-somatic disorders. Aims: To investigate the effect of integrated yoga on autonomic parameters and psychological well-being during both pre and post phases of menstrual cycle in healthy young female subjects. Settings and Design: Present study is a randomized control trial and was conducted in the Department of Physiology, Lady Hardinge Medical College, New Delhi, India. Material and Methods: Fifty apparently healthy females in the age group of 18-20 years were randomized into two groups: Group I (n=25) consisted of subjects who practiced yoga 35-40 minutes per day, six times per week for the duration of three menstrual cycles. Training was given by qualified yoga instructor. Group II (n=25) subjects acted as controls. Following parameters were recorded at the beginning and after completion of three menstrual cycles in all the subjects: Height, weight (BW), Resting Heart Rate (HR), Resting Systolic (SBP) and Diastolic Blood Pressure (DBP), parasympathetic reactivity tests including Expiration-Inspiration Ratio (E: I ratio) and 30:15 ratio, sympathetic reactivity tests including BP changes due to Isometric Hand Grip (IHG) exercise, and Cold Pressor Test (CPT). Assessment of psychological status was done by administering DIPAS (Defense Institute of Physiology and Allied Sciences) inventories of Anger self report scale, Trait Anxiety, Sense of well-being and Depression scale. Statistical Analysis: Intra-group comparison of physiological parameters was done by using paired 't' test, whereas intra-group comparison of non-parameteric data such as scores of anxiety, depression, anger and sense of well-being was done by Wilcoxon signed-rank test. Inter-group comparison of parameters was done by Students 't' test for parametric tests and Mann-Whitney 'U' test for non-parameteric tests. Results: There was significantly higher BW, resting SBP, DBP, sympathetic activity and blunting of parasympathetic reactivity and also, significantly higher scores of anger, depression, anxiety and decreased score of well-being in premenstrual phase as compared to postmenstrual phase in both the groups in initial cycle. There was significantly higher percentage decrease in BW, HR, SBP & DBP in yoga group as compared to control group in both the phases from initial to second and onwards between second and third menstrual cycle. Also, decrease in anger, depression and anxiety and increase in well-being score was significant in yoga group as compared to control group from initial to second and third cycle in premenstrual phase while the change was significant only in depression score in postmenstrual phase. Conclusion: Our study shows that there was significant alteration of autonomic functions and psychological status in premenstrual phase when compared with postmenstrual phase in young healthy females. Also, regular practice of yoga has beneficial effects on both phases of menstrual cycle by bringing parasympathodominance and psychological well-being probably by balancing neuro-endocrinal axis.

Journal of Clinical & Diagnostic Research, 7(10) : 2133- 2139

Gearing, Robin E., Schwalbe, Craig S. J., Lee, RaeHyuck, Hoagwood, Kimberly E.

The effectiveness of booster sessions in CBT treatment for child and adolescent mood and anxiety disorders

Background: To investigate the effects of booster sessions in cognitive behavioral therapy (CBT) for children and adolescents with mood or anxiety disorders, whereas controlling for youth demographics (e.g., gender, age), primary diagnosis, and intervention characteristics (e.g., treatment modality, number of sessions).; Methods: Electronic databases were searched for CBT interventions for youth with mood and anxiety disorders. Fifty-three (k = 53) studies investigating 1,937 youth met criteria for inclusion. Booster sessions were examined using two case-controlled effect sizes: pre-post and pre-follow-up (6 months) effect sizes and employing weighted least squares (WLSs) regressions.; Results: Meta-analyses found pre-post studies with booster sessions had a larger effect size r = .58 (k = 15; 95% CI = 0.52-0.65; P < .01) than those without booster sessions r = .45 (k = 38; 95% CI = 0.41-0.49; P < .001). In the WLS regression analyses, controlling for demographic factors, primary diagnosis, and intervention characteristics, studies with booster sessions showed larger pre-post effect sizes than those without booster sessions (B = 0.13, P < .10). Similarly, pre-follow-up studies with booster sessions showed a larger effect size r = .64 (k = 10; 95% CI = 0.57-0.70; P < .10) than those without booster sessions r = .48 (k = 20; 95% CI = 0.42-0.53; P < .01). Also, in the WLS regression analyses, pre-follow-up studies showed larger effect sizes than those without booster sessions (B = 0.08, P < .01) after accounting for all control variables.; Conclusions: Result suggests that CBT interventions with booster sessions are more effective and the effect is more sustainable for youth managing mood or anxiety disorders than CBT interventions without booster sessions.; © 2013 Wiley Periodicals, Inc.

Depression & Anxiety, 30(9) : 800-808

Korte, Kristina J., Schmidt, Norman B.

Motivational enhancement therapy reduces anxiety sensitivity

Anxiety sensitivity (AS), the fear of the consequences of anxiety, is known to be a risk factor in the development and maintenance of anxiety psychopathology. In recent years, AS has been shown to be responsive to a variety of interventions aimed at reducing this malleable risk factor. Motivational interviewing (MI) and motivation enhancement treatment (MET) have been shown to be effective in enhancing the treatment of anxiety disorders. Thus, it was hypothesized that motivational interventions may also be effective in those with elevated AS. The aim of the present study was to examine whether the use of MI/MET would be effective in reducing AS. Participants (N = 80) with elevated AS were randomized into an MET or health-focused psychoeducation control group. Results revealed that the MET condition showed a significant reduction in AS in comparison to the control group. These findings are comparable to reductions in AS observed in other AS interventions. Further, changes in motivation mediated the association between experimental group and post- intervention AS. This study is the first to demonstrate the efficacy of MI/MET strategies in the reduction of AS. Implications of the findings and directions for future research are discussed. (PsycINFO Database Record (c) 2013 APA, all rights reserved). (journal abstract)

Cognitive Therapy & Research, 37(6) : 1140-1150

Kim, Jong-Ho, Yang, Heewon, Schroeppel, Stephen

A pilot study examining the effects of Kouk Sun Do on university students with anxiety symptoms

The effects of Kouk Sun Do (KSD), a mind-body exercise on mental health in university students, were investigated in this pilot study. University students (N?=?30) with self-reported anxiety symptoms were randomly assigned to either the treatment group or the waiting list control group. Eighteen participants (N?=?18; seven in the treatment group and 11 in the waiting list control group) completed a pre-test and a post-test, and 12 participants dropped out before or during the intervention. Ten 70-min KSD exercise sessions were conducted three times per week over a 4-week period. Trait anxiety, depressive symptoms and general self-efficacy in coping with stress were measured with the pre-test and the post-test. Qualitative data were collected using open-ended questions regarding benefits of KSD at the last session. A two (group) by two (time) repeated- measure analysis of variance was used to analyse the data. Trait anxiety and depressive symptoms decreased whereas general self-efficacy increased over a 4-week period. The treatment group had significantly reduced trait anxiety and depressive symptoms compared with the control group across time. Qualitative data provided support that the self-induced relaxation effects of KSD may lead to reduced anxiety.; Copyright © 2012 John Wiley & Sons, Ltd.

Stress & Health, 29(2) : 99-107

McGowan, S. K., Behar, E.

A preliminary investigation of stimulus control training for worry: effects on anxiety and insomnia

For individuals with generalized anxiety disorder, worry becomes associated with numerous aspects of life (e.g., time of day, specific stimuli, environmental cues) and is thus under poor discriminative stimulus control (SC). In addition, excessive worry is associated with anxiety, depressed mood, and sleep difficulties. This investigation sought to provide preliminary evidence for the efficacy of SC procedures in reducing anxiety-, mood-, and sleep-related symptoms. A total of 53 participants with high trait worry were randomly assigned to receive 2 weeks of either SC training (consisting of a 30-min time- and place-restricted worry period each day) or a control condition called focused worry (FW; consisting of instructions to not avoid naturally occurring worry so that worry and anxiety would not paradoxically increase). At post-training, SC was superior to FW in producing reductions on measures of worry, anxiety, negative affect, and insomnia, but not on measures of depression or positive affect. Moreover, SC was superior to FW in producing clinically significant change on measures of worry and anxiety. Results provide preliminary support for the use of SC training techniques in larger treatment packages for individuals who experience high levels of worry.;

Behavior Modification, 37(1) : 90-112

Lewis, K. M., Dubois, D. L., Bavarian, N., Acock, A., Silverthorn, N., Day, J., Ji, P., Vuchinich, S., Flay, B. R.

Effects of positive action on the emotional health of urban youth: A cluster-randomized trial

Purpose We examined the effects of Positive Action (PA), a school-based social-emotional learning and health promotion program, on the emotional health of predominately low-income and ethnic minority urban youth. Methods The study was a matched-pair, cluster-randomized controlled trial involving 14 Chicago public schools. Outcomes were assessed over a 6-year period of program implementation for a cohort of youth in each school, followed from grades 3 to 8. Youth reported on their emotional health (positive affect, life satisfaction, depression, anxiety) and social-emotional and character development. Growth-curve and structural-equation modeling analyses assessed overall program effects on the emotional health outcomes as well as mediation of these effects via the program's impact on youths' social-emotional and character development. Results Students in PA schools, compared with those in control schools, had more favorable change over the course of the study in positive affect (standardized mean difference effect size [ES] =.17) and life satisfaction (ES =.13) as well as significantly lower depression (ES = -.14) and anxiety (ES = -.26) at study end point. Program effects for positive affect, depression, and anxiety were mediated by more favorable change over time in social-emotional and character development for students in PA schools. Conclusions Results suggest that universal, school-based programs can benefit the emotional health of youth in low-income, urban settings. The modest magnitude of effects over an extended period of program implementation, however, reflects the challenges of both mounting interventions and offsetting formidable risks for mental health problems in such environments. (copyright) 2013 Society for Adolescent Health and Medicine. All rights reserved.

Journal of Adolescent Health, 53(6) : 706- 711