Disorders - Anxiety Disorders
Muriungi, S.
K., Ndetei, D. M.
Objective. To determine the effectiveness of psycho-education on symptom severity in depression, hopelessness, suicidality,
anxiety and risk of substance abuse among para-medical students at Kenya Medical Training College (KMTC). Methodology. A clinical trial drew
experimental (N=1 181) and control (N=1 926) groups from different KMTC campuses. Self-administered questionnaires were used to collect data: the
researcher-designed social demographic questionnaire was used at baseline only, while Beck's Depression Inventory, Beck's Hopelessness Scale,
Beck's Suicide Ideation Scale, Beck's Anxiety Inventory and World Health Organization alcohol, smoking and substance involvement screening test
(ASSIST) (for drug abuse) were used for baseline, mid-point and end-point assessments at 3-month intervals. The experimental group received a total
of 16 hours of structured psycho-education. All study participants gave informed consent. Results. Overall, there was no significant reduction in
symptom severity between the experimental and control groups at 3 months (p>0.05) but there was a significant difference at 6 months (p<0.05).
Conclusion. Psycho-education was effective in reducing the severity of symptoms of depression, hopelessness, suicidality, anxiety and risk of
substance abuse at 6 months.
South African Journal of Psychiatry, 19(2) : 41-
50
- Year: 2013
- Problem: Anxiety Disorders (any), Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm), Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation
Khalsa, S. B.
S., Butzer, B., Shorter, S. M., Reinhardt, K. M., Cope, S.
Context Professional musicians
often experience high levels of stress, music performance anxiety (MPA), and performance-related musculoskeletal disorders (PRMDs). Given the fact
that most professional musicians begin their musical training before the age of 12, it is important to identify interventions that will address these
issues from an early age. Objective This study intended to replicate and expand upon adult research in this area by evaluating the effects of a yoga
intervention on MPA and PRMDs in a population of adolescent musicians. The present study was the first to examine these effects. Design The research
team assigned participants, adolescent musicians, into two groups. The intervention group (n = 84) took part in a 6-wk yoga program, and the control
group (n = 51) received no treatment. The team evaluated the effects of the yoga intervention by comparing the scores of the intervention group to
those of the control group on a number of questionnaires related to MPA and PRMDs. Setting The study was conducted at the Boston University
Tanglewood Institute (BUTI). BUTI is a training academy for advanced adolescent musicians, located in Lenox, Massachusetts. Participants Participants
were adolescent, residential music students (mean age = 16 y) in a 6-wk summer program at the BUTI in 2007 and 2008. Intervention Participants in the
yoga intervention group were requested to attend three, 60-min, Kripalustyle yoga classes each wk for 6 wk. Outcome Measures MPA was measured using
the Performance Anxiety Questionnaire (PAQ) and the Music Performance Anxiety Inventory for Adolescents (MPAI-A). PRMDs were measured using the
Performance-Related Musculoskeletal Disorders Questionnaire (PRMD-Q). Results Yoga participants showed statistically significant reductions in MPA
from baseline to the end of the program compared to the control group, as measured by several subscales of the PAQ and MPAI-A; however, the results
for PRMDs were inconsistent. Conclusion The findings suggest that yoga may be a promising way for adolescents to reduce MPA and perhaps even prevent
it in the future. These findings also suggest a novel treatment modality that potentially might alleviate MPA and prevent the early disruption and
termination of musical careers.
Alternative Therapies in Health & Medicine, 19(2) : 34-45
- Year: 2013
- Problem: Anxiety Disorders (any)
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Mind-body exercises (e.g. yoga, tai chi, qigong)
Melnyk, B. M., Jacobson, D., Kelly, S., Belyea, M., Shaibi, G., Small, L., O'Haver, J., Marsiglia, F. F.
Background: Although
obesity and mental health disorders are two major public health problems in adolescents that affect academic performance, few rigorously designed
experimental studies have been conducted in high schools. Purpose: The goal of the study was to test the efficacy of the COPE (Creating Opportunities
for Personal Empowerment) Healthy Lifestyles TEEN (Thinking, Emotions, Exercise, Nutrition) Program, versus an attention control program (Healthy
Teens) on: healthy lifestyle behaviors, BMI, mental health, social skills, and academic performance of high school adolescents immediately after and
at 6 months post-intervention. Design: A cluster RCT was conducted. Data were collected from January 2010 to May of 2012 and analyzed in 2012-2013.
Setting/participants: A total of 779 culturally diverse adolescents in the U.S. Southwest participated in the trial. Intervention: COPE was a
cognitive-behavioral skills-building intervention with 20 minutes of physical activity integrated into a health course, taught by teachers once a
week for 15 weeks. The attention control program was a 15-session, 15-week program that covered common health topics. Main outcome measures: Primary
outcomes assessed immediately after and 6 months post-intervention were healthy lifestyle behaviors and BMI. Secondary outcomes included mental
health, alcohol and drug use, social skills, and academic performance. Results: Post-intervention, COPE teens had a greater number of steps per day
(p=0.03) and a lower BMI (p=0.01) than did those in Healthy Teens, and higher average scores on all Social Skills Rating System subscales (p-values
<0.05). Teens in the COPE group with extremely elevated depression scores at pre-intervention had significantly lower depression scores than the
Healthy Teens group (p=0.02). Alcohol use was 12.96% in the COPE group and 19.94% in the Healthy Teens group (p=0.04). COPE teens had higher health
course grades than did control teens. At 6 months post-intervention, COPE teens had a lower mean BMI than teens in Healthy Teens (COPE=24.72, Healthy
Teens=25.05, adjusted M=-0.34, 95% CI=-0.56, -0.11). The proportion of those overweight was significantly different from pre-intervention to 6-month
follow-up (chi-square=4.69, p=0.03), with COPE decreasing the proportion of overweight teens, versus an increase in overweight in control
adolescents. There also was a trend for COPE Teens to report less alcohol use at 6 months (p=0.06). Conclusions: COPE can improve short- and more
long-term outcomes in high school teens. (copyright) 2013 American Journal of Preventive Medicine.
American Journal of Preventive Medicine, 45(4) : 407-415
- Year: 2013
- Problem: Anxiety Disorders (any), Depressive Disorders, Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Physical activity, exercise
Misra, M., Katzman, D. K., Estella, N. M., Eddy, K. T., Weigel, T., Goldstein, M. A., Miller, K. K., Klibanski, A.
Objective: Anorexia nervosa is
characterized by low weight, aberrant eating attitudes, body image distortion, and hypogonadism. Anxiety is a common comorbid condition. Estrogen
replacement reduces anxiety in animal models, and reported variations in food intake across the menstrual cycle may be related to gonadal steroid
levels. The impact of estrogen replacement on anxiety, eating attitudes, and body image has not been reported in anorexia nervosa. We hypothesized
that physiologic estrogen replacement would ameliorate anxiety and improve eating attitudes without affecting body image in anorexia nervosa. Method:
Girls 13-18 years old with anorexia nervosa (DSM-IV) were randomized to transdermal estradiol (100 (mu)g twice weekly) with cyclic progesterone or
placebo patches and pills for 18-months, between 2002 and 2010. The State-Trait Anxiety Inventory for Children (STAIC), the Eating Disorders
Inventory-2 (EDI-2), and the Body Shape Questionnaire (BSQ-34) were administered. 72 girls completed these measures at baseline (n = 38 [girls
receiving estrogen] and n = 34 [girls receiving placebo]) and 37 at 18 months (n = 20 [girls receiving estrogen] and n = 17 [girls receiving
placebo]). The primary outcome measure was the change in these scores over 18 months. Results: Estrogen replacement caused a decrease in STAIC-trait
scores (-3.05 [1.22] vs 2.07 [1.73], P = .02), without impacting STAIC-state scores (-1.11 [2.17] vs 0.20 [1.42], P = .64). There was no effect of
estrogen replacement on EDI-2 or BSQ-34 scores. Body mass index (BMI) changes did not differ between groups, and effects of estrogen replacement on
STAIC-trait scores persisted after controlling for BMI changes (P = .03). Increases in serum estradiol were significantly associated with decreases
in STAIC-trait scores (Spearman (rho) = -0.45, P = .03). Conclusions: Estrogen replacement improved trait anxiety (the tendency to experience
anxiety) but did not impact eating attitudes or body shape perception. (copyright) Copyright 2013 Physicians Postgraduate Press, Inc.
Journal of Clinical Psychiatry, 74(8) : e765-
e771
- Year: 2013
- Problem: Anxiety Disorders (any), Eating Disorders
(any), Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Other biological interventions
Fu, Xiaoxue, Du, Yasong, Au, Shun, Lau, Jennifer Y. F.
Anxiety disorders are globally prevalent, debilitating and onset in early life. Cognitive bias modification of interpretations (CBM-I)
training has emerged as a targeted intervention for early emerging anxiety problems. While CBM-I can alter interpretational styles in unselected and
clinical-analogue samples of adolescents, no studies have assessed its capacity to change biases in clinical samples. Here, we assessed training
efficacy in ameliorating interpretation biases and anxious mood in adolescents with anxiety disorders. Twenty-eight Chinese adolescents meeting
criteria for a current anxiety disorder were randomly assigned to receive positive or neutral CBM-I training. Training involved completing a word-
fragment to resolve the outcomes of sixty ambiguous scenarios. During positive training, scenarios ended with benign/positive resolutions, but during
neutral training, half of the scenarios were resolved positively and half negatively. Positively trained patients interpreted new ambiguous scenarios
less negatively than the neutral training group although training effects were not observed on a questionnaire measure of interpretation bias.
Training effects on mood were also absent. Before the clinical implications of CBM-I can be considered in adolescents, research needs to establish
optimal training parameters for symptom-changes to occur.; Copyright © 2012 Elsevier Ltd. All rights reserved.
Developmental Cognitive Neuroscience, 4 : 29-37
- Year: 2013
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Attention/cognitive bias
modification
O'Callaghan, Paul, McMullen, John, Shannon, Ciaran, Rafferty, Harry, Black, Alastair
Objective: To assess the efficacy of trauma-focused cognitive behavioral therapy (TF-
CBT) delivered by nonclinical facilitators in reducing posttraumatic stress, depression, and anxiety and conduct problems and increasing prosocial
behavior in a group of war-affected, sexually exploited girls in a single-blind, parallel-design, randomized,+ controlled trial.; Method: Fifty-two
12- to 17-year-old, war-affected girls exposed to rape and inappropriate sexual touch in the Democratic Republic of Congo were screened for trauma,
depression and anxiety, conduct problems, and prosocial behavior. They were then randomized to a 15 session, group-based, culturally modified TF-CBT
(n = 24) group or a wait-list control group (n = 28). Primary analysis, by intention-to-treat, involving all randomly assigned participants occurred
at pre- and postintervention and at 3-month follow-up (intervention group only).; Results: Compared to the wait list control, the TF-CBT group
experienced significantly greater reductions in trauma symptoms (F(1,49) = 52.708, p<0·001, ?(p)2 = 0.518). In addition, the TF-CBT group showed a
highly significant improvement in symptoms of depression and anxiety, conduct problems, and prosocial behavior. At 3-months follow-up the effect size
(Cohen's d) for the TF-CBT group was 2.04 (trauma symptoms), 2.45 (depression and anxiety), 0.95 (conduct problems), and-1.57 (prosocial behavior).;
Conclusions: A group-based, culturally modified, TF-CBT intervention delivered by nonclinically trained Congolese facilitators resulted in a large,
statistically significant reduction in posttraumatic stress symptoms and psychosocial difficulties among war-affected girls exposed to rape or sexual
violence. Clinical trial registration information-An RCT of TF-CBT with sexually-exploited, war-affected girls in the DRC;
http://clinicaltrials.gov/; NCT01483261.; Copyright © 2013 American Academy of Child & Adolescent Psychiatry. Published by Elsevier Inc. All rights
reserved.
Journal of the
American Academy of Child & Adolescent Psychiatry, 52(4) : 359-369
- Year: 2013
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Trauma-focused cognitive behavioural therapy (TF-
CBT)
O'Leary-Barrett, M., Topper, L., Al-
Khudhairy, N., Pihl, R.
O., Castellanos-Ryan, N., Mackie, C. J., Conrod, P. J.
Objective To assess the 2-year impact of teacher-delivered, brief, personality-targeted interventions on internalizing and
externalizing symptoms in an adolescent U.K. sample. Method This cluster-randomized trial was run in 19 London schools (N = 1,024 adolescents).
Trained school-based professionals delivered two 90-minute, CBT-based group interventions targeting 1 of 4 personality-risk profiles: anxiety
sensitivity, hopelessness, impulsivity, or sensation seeking. Self-report depression, anxiety, and conduct disorder symptoms were assessed at 6-month
intervals. Results Interventions were associated with significantly reduced depressive, anxiety, and conduct symptoms (p <.05) over 2 years in the
full sample, reduced odds of severe depressive symptoms (odds ratio [OR] = 0.74, CI = 0.58-0.96), and conduct problems (OR = 0.79, CI = 0.65-0.96),
and a nonsignificant reduction in severe anxiety symptoms (OR = 0.79, CI = 0.59-1.05). Evaluating a priori personality-specific hypotheses revealed
strong evidence for impulsivity-specific effects on severe conduct problems, modest evidence of anxiety sensitivity-specific effects on severe
anxiety, and no evidence for hopelessness-specific effects on severe depressive symptoms. Conclusions Brief, personality-targeted interventions
delivered by educational professionals can have a clinically significant impact on mental health outcomes in high-risk youth over 2 years, as well as
personality-specific intervention effects in youth most at risk for a particular problem, particularly for youth with high levels of impulsivity.
Clinical trial registration information - Adventure: The Efficacy of Personality-Targeted Interventions for Substance Misuse and Other Risky
Behaviors as Delivered by Educational Professionals; http://clinicaltrials.gov; NCT00776685.
Journal of the
American Academy of Child & Adolescent Psychiatry, 52(9) : 911-920
- Year: 2013
- Problem: Anxiety Disorders (any), Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Abbass, A. A., Rabung,
S., Leichsenring, F., Refseth, J. S., Midgley, N.
Objective
Psychodynamically based brief psychotherapy is frequently used in clinical practice for a range of common mental disorders in children and
adolescents. To our knowledge, there have been no meta-analyses to evaluate the effectiveness of these therapies. Method After a broad search, we
meta-analyzed controlled outcome studies of short-term psychodynamic psychotherapies (STPP, 40 or fewer sessions). We also performed sensitivity
analyses and evaluated the risk of bias in this body of studies. Results We found 11 studies with a total of 655 patients covering a broad range of
conditions including depression, anxiety disorders, anorexia nervosa, and borderline personality disorder. STPP did not separate from what were
mostly robust treatment comparators, but there were some subgroup differences. Robust (g = 1.07, 95% CI = 0.80-1.34) within group effect sizes were
observed suggesting the treatment may be effective. These effects increased in follow up compared to post treatment (overall, g = 0.24, 95% CI =
0.00-0.48), suggesting a tendency toward increased gains. Heterogeneity was high across most analyses, suggesting that these data need be interpreted
with caution. Conclusion This review suggests that STPP may be effective in children and adolescents across a range of common mental disorders.
(copyright) 2013 American Academy of Child and Adolescent Psychiatry.
Journal of the American Academy of Child & Adolescent Psychiatry, 52(8) : 863-
875
- Year: 2013
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Psychodynamic/Psychoanalysis
Regehr, C., Glancy, D., Pitts, A.
Background: Recent research has revealed concerning rates of anxiety and depression among university students. Nevertheless, only a
small percentage of these students receive treatment from university health services. Universities are thus challenged with instituting preventative
programs that address student stress and reduce resultant anxiety and depression.; Method: A systematic review of the literature and meta-analysis
was conducted to examine the effectiveness of interventions aimed at reducing stress in university students. Studies were eligible for inclusion if
the assignment of study participants to experimental or control groups was by random allocation or parallel cohort design.; Results: Retrieved
studies represented a variety of intervention approaches with students in a broad range of programs and disciplines. Twenty-four studies, involving
1431 students were included in the meta-analysis. Cognitive, behavioral and mindfulness interventions were associated with decreased symptoms of
anxiety. Secondary outcomes included lower levels of depression and cortisol.; Limitations: Included studies were limited to those published in peer
reviewed journals. These studies over-represent interventions with female students in Western countries. Studies on some types of interventions such
as psycho-educational and arts based interventions did not have sufficient data for inclusion in the meta-analysis.; Conclusion: This review provides
evidence that cognitive, behavioral, and mindfulness interventions are effective in reducing stress in university students. Universities are
encouraged to make such programs widely available to students. In addition however, future work should focus on developing stress reduction programs
that attract male students and address their needs.; Copyright © 2012 Elsevier B.V. All rights reserved.
Journal of Affective
Disorders, 148(1) : 1-11
- Year: 2013
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any)
Palmer, R., Nascimento, L. N., Fonagy, P.
This article
reviews outcomes of psychodynamic psychotherapy (PP) for children and adolescents reported in articles identified by a comprehensive review of the
literature on treatment evaluations of psychological and medical interventions for mental disorders in pediatric populations. The review identified
48 reports based on 33 studies. While there is evidence of substantial clinical gains associated with PP, in almost all the studies, when contrasted
with family-based interventions, PP fares no better and appears to produce outcomes with some delay relative to family-based therapies. Further
rigorous evaluations are needed, but evidence to date suggests that the context in which PP is delivered should be extended from the traditional
context of individual therapy and parents should be included in the treatment of children. (copyright) 2013 Elsevier Inc.
Child & Adolescent Psychiatric Clinics of North America, 22(2) : 149-
214
- Year: 2013
- Problem: Anxiety Disorders (any), Depressive Disorders, Eating Disorders
(any), Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Psychodynamic/Psychoanalysis
Tang, T.
C., Huang, S. Y.
Background: This case-control study aimed to assess the
intervention effects of six-session interpersonal psychotherapy (IPT-A) on reducing the severity of anxiety and depression in adolescent victims.
Methods: A total of 30 adolescents who had clinical significant level after experiencing bullied experiences were allocated to a six-session course
of IPT-A (N =15) or to treatment as usual (TAU) (N = 15). T test was performed to examine the effect of IPT-A on reducing the severity of anxiety and
depression related to the bullied events. Results: Pre-intervention age, sex, anxiety and depression showed no significant difference between two
groups. As the preintervention severity of two groups were no significant different, results showed the IPT-A group to have significantly lower
post-intervention severity levels of anxiety and depression (p< .05) than the TAU group. Effective size showed moderate to high level between IPT-A
and TAU. Conclusions: The results of this study support the effectiveness of the IPT-A in improving anxiety symptoms and depression in adolescents
experiencing traumatic bullied experiences.
European
Psychiatry, 28 :
- Year: 2013
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Interpersonal therapy (IPT)
von-der-Embse, Nathaniel, Barterian, Justin, Segool, Natasha
High-stakes tests have played an increasingly important role in how
student achievement and school effectiveness are measured. Test anxiety has risen with the use of tests in educational decision making. Students with
high test anxiety perform poorly on tests when compared to students with low test anxiety. School psychologists can play an important role as experts
both in tests and measurement and mental health in providing consultation and treatment for students with test anxiety. This article describes the
results of a systematic literature review of the last 10 years of test-anxiety interventions. Results indicate that there are few studies that have
examined test-anxiety interventions with elementary and secondary school students. However, techniques including biofeedback, behavior therapy,
cognitive behavioral therapy, priming competency, and mixed approaches have demonstrated promising results. Suggestions are made for school
psychologists for the delivery of evidenced-based test anxiety interventions. (PsycINFO Database Record (c) 2013 APA, all rights reserved). (journal
abstract)
Psychology in the Schools, 50(1) : 57-
71
- Year: 2013
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any)