Disorders - Anxiety Disorders
Riemann, Bradley C., Kuckertz, Jennie
M., Rozenman, Michelle, Weersing, V. Robin, Amir, Nader
Background: Recent research suggests the efficacy of attention modification programs (AMP) in treating adult anxiety.([1]) Though some
research supports the success of AMP treatment in anxious youths,([2, 3]) to date no study has examined the efficacy of AMP as an adjunctive
treatment to other psychosocial and pharmacological interventions for anxious youths within the community.; Methods: In the current study, we
examined the efficacy of AMP as an adjunctive treatment to standard care at a residential anxiety treatment facility. Adolescents (N = 42) completed
either an active (attention modification program, AMP; n = 21) or a control (attention control condition, ACC; n = 21) condition, in addition to the
facility's standard treatment protocol, which included cognitive behavioral therapy with or without medication.; Results: While anxiety symptoms
decreased for participants across both groups, participants in the AMP group experienced a significantly greater decrease in anxiety symptoms from
point of intake to point of discharge, in comparison to participants in the ACC group.; Conclusions: These results suggest that AMP is an effective
adjunctive treatment to the standard treatments of choice for anxiety disorders, and may hold promise for improving treatment response in highly
anxious youths.; © 2013 Wiley Periodicals, Inc.
Depression & Anxiety, 30(9) : 822-
828
- 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
Sibinga, E. M. S., Perry-Parrish, C., Chung, S.
E., Johnson, S. B., Smith, M., Ellen, J. M.
Objectives: Mindfulness-based stress reduction (MBSR) has been shown to improve mental health and reduce stress in a variety of adult
populations. Here, we explore the effects of a school-based MBSR program for young urban males. Participants and methods: In fall 2009, 7th and 8th
graders at a small school for low-income urban boys were randomly assigned to 12-session programs of MBSR or health education (Healthy Topics-HT).
Data were collected at baseline, post-program, and three-month follow-up on psychological functioning; sleep; and salivary cortisol, a physiologic
measure of stress. Results: Forty-one (22 MBSR and 19 HT) of the 42 eligible boys participated, of whom 95% were African American, with a mean age of
12.5. years. Following the programs, MBSR boys had less anxiety (p = 0.01), less rumination (p = 0.02), and showed a trend for less negative coping
(p = 0.06) than HT boys. Comparing baseline with post-program, cortisol levels increased during the academic terms for HT participants at a trend
level (p = 0.07) but remained constant for MBSR participants (p = 0.33). Conclusions: In this study, MBSR participants showed less anxiety, improved
coping, and a possible attenuation of cortisol response to academic stress, when compared with HT participants. These results suggest that MBSR
improves psychological functioning among urban male youth. (copyright) 2013 Elsevier Inc.
Preventive
Medicine, 57(6) : 799-801
- Year: 2013
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Mindfulness based
therapy
Sportel, B. Esther, de-Hullu, Eva, de-Jong,
Peter J., Nauta, Maaike H.
Unlabelled: Social anxiety is a common mental
disorder among adolescents and is associated with detrimental long term outcomes. Therefore, this study investigated the efficacy of two possible
early interventions for adolescent social anxiety and test anxiety. An internet-based cognitive bias modification (CBM; n?=?86) was compared to a
school-based cognitive behavioral group training (CBT; n?=?84) and a control group (n?=?70) in reducing symptoms of social and test anxiety in high
socially and/or test anxious adolescents aged 13-15 years. Participants (n?=?240) were randomized at school level over the three conditions. CBM
consisted of a 20-session at home internet-delivered training; CBT was a 10-session at school group training with homework assignments; the control
group received no training. Participants were assessed before and after the intervention and at 6 and 12 month follow-up. At 6 month follow-up CBT
resulted in lower social anxiety than the control condition, while for CBM, this effect was only trend-significant. At 12 month follow-up this
initial benefit was no longer present. Test anxiety decreased more in the CBT condition relative to the control condition in both short and long
term. Interestingly, in the long term, participants in the CBM condition improved more with regard to automatic threat-related associations than both
other conditions. The results indicate that the interventions resulted in a faster decline of social anxiety symptoms, whereas the eventual end point
of social anxiety was not affected. Test anxiety was influenced in the long term by the CBT intervention, and CBM lead to increased positive
automatic threat-related associations.; Trial Registration: TrialRegister.nl NTR965.;
PLoS ONE, 8(5) : e64355-
e64355
- Year: 2013
- Problem: Anxiety Disorders (any), Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Attention/cognitive bias
modification
Zhang, Linxiu, Kleiman-Weiner, Max, Luo, Renfu, Shi, Yaojiang, Martorell,
Reynaldo, Medina, Alexis, Rozelle, Scott
Despite growing wealth and a strengthening government
commitment to improve livelihoods and welfare, many students across rural China have inadequate access to micronutrient-rich diets. Poor diets can
lead to nutritional problems, such as iron-deficiency anemia, that can adversely affect health, attention, learning, and mental health. The overall
goal of this paper is to assess the impact of multiple micronutrient supplementation (MMS) on anemia and anxiety among students in poor areas of
rural China. To achieve this goal, we conducted a randomized controlled trial in 54 randomly chosen elementary schools in 8 of the poorest counties
in Shaanxi Province in Northwest China. Study participants were 2730 fourth-grade students, mostly aged 10-12 y. Schools were randomly assigned to 1
of 2 groups: a control group that received no intervention and an intervention group that received a daily MMS with 5 mg of iron (ferrous sulfate)
for 5 mo. Our primary outcome measures were hemoglobin (Hb) concentrations (assessed by HemoCue 201+ technology), anemia prevalence (defined as Hb)
concentrations =120 g/L), and anxiety (using a written mental health test). The results showed that 42.4% of students were anemic at baseline. The Hb
concentration was 121.7 ± 10.7 g/L in the treatment group and 123.4 ± 11.4 g/L in the control group. MMS increased Hb concentrations by 1.7 g/L ±
0.15 and reduced anemia rates by 7.0 percentage points (P < 0.05). Anxiety was reduced by 0.30 SDs (P < 0.01). MMS reduced both anemia and anxiety.
Our results should encourage further research on the linkages between nutrition and mental health in a development context.;
Journal of Nutrition, 143(5) : 640-647
- Year: 2013
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Vitamins and supplements
Smith, A. P., Woods, M.
Recent research has indicated that chewing gum can relieve perceptions of stress in an occupational sample (Smith, 2009). In
the present study, 72 students completed 2. weeks of either chewing gum or refraining from chewing gum. They completed scales measuring perceived
stress, anxiety, depression, and single item measures of work levels and tiredness. These were completed both pre- and post-treatment. Perceived
stress decreased as a function of the amount of gum chewed. The chewing gum condition was also associated with a decrease in not getting enough
academic work done. There were no significant effects of chewing gum on mental health outcomes. These results confirm some of findings from previous
studies of chewing gum and stress in other samples. (copyright) 2012 Elsevier Ltd.
Appetite, 58(3) : 1037-
1040
- Year: 2012
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Other complementary & alternative
interventions
Siegenthaler,
E., Munder, T., Egger, M.
Mental illness in parents affects the mental health of their children. A systematic review and a meta-analysis of the
effectiveness of interventions to prevent mental disorders or psychological symptoms in the offspring were performed. The Cochrane, MEDLINE, EMBASE,
and PsycINFO databases were searched for randomized controlled trials of interventions in parents with mental disorders. Outcomes in the child
included incident mental disorders of the same nature and internalizing (negative emotions, depressive symptoms, anxiety) or externalizing
(hyperactivity, aggressiveness, behavioral problems) symptoms. Relative risks and standardized mean differences in symptom scores were combined in
random-effects meta-analysis. Thirteen trials including 1,490 children were analyzed. Interventions included cognitive, behavioral, or
psychoeducational components. Seven trials assessed the incidence of mental disorders and seven trials assessed symptoms. In total 161 new diagnoses
of mental illness were recorded, with interventions decreasing the risk by 40% (combined relative risk 0.60, 95% CI 0.450.79). Symptom scores were
lower in the intervention groups: standardized mean differences were -0.22 (95% CI -0.37 to -0.08) for internalizing symptoms (p =.003) and -0.16
(95% confidence interval -0.36 to 0.04) for externalizing symptoms (p =.12). Interventions to prevent mental disorders and psychological symptoms in
the offspring of parents with mental disorders appear to be effective. (copyright) 2012 American Academy of Child and Adolescent Psychiatry.
Journal of the American
Academy of Child & Adolescent Psychiatry, 51(1) : 8-17.e8
- Year: 2012
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any)
Sibinga, E., Perry-Parrish, C., Chung, S., Johnson,
S., Smith, M., Ellen, J.
Purpose: Our research of MBSR for mostly female
urban youth showed reductions in conflict, anxiety, and stress, as well as increased selfregulation. Reviews of mindfulness instruction suggest
benefit but call for increased methodological rigor, particularly active control conditions. Here, we explore the specific effects of MBSR compared
with an active control on stress and coping among young urban males. Methods: Participants were 7th and 8th grade boys in a small urban middle school
for boys. They were randomly assigned to MBSR or an active control (Healthy Topics-HT), an age-appropriate health education program, designed to
control for positive adult instructor, learning new information, and class time. Data were collected at baseline, postprogram, and three-month
follow-up on psychological symptoms, stress, mindfulness, coping; sleep; teacher-rated behavior; and salivary cortisol, a physiologic measure of
stress. Results: Forty-one (22 MBSR and 19 HT) boys participated. Ninety-five percent were African American, with a mean age of 12.5 years. There
were no significant differences at baseline between groups. Following the programs, MBSR boys had significantly less anxiety (p=0.01), less
rumination (p=0.02), and less negative coping (p=0.06) than HT boys. From pre- to post-program, daily cumulative cortisol levels increased during the
academic terms for HT participants at a trend level (p=0.07) but remained constant for MBSR participants (p=0.33). Otherwise, we did not detect
differences in outcomes. Conclusion: This study of MBSR compared with an active control for urban male youth shows less rumination, anxiety, and an
attenuation of cortisol increase among MBSR participants. These results suggest that MBSR specifically enhances self-regulatory processes for urban
male youth, including improved coping and emotion regulation. Additional research is needed to explore the impact of mindfulness instruction for
urban male youth on self-regulation, the duration of its effect, and related social, psychological, and behavioral outcomes.
BMC Complementary & Alternative
Medicine, 12 :
- Year: 2012
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Mindfulness based
therapy
Sousa, C. M., Goncalves, M., Machado, J., Efferth, T., Greten, T., Froeschen, P., Greten, H. J.
OBJECTIVE: Based on individual cases of treatment, we were interested in whether the effects of a
special kind of qigong, the \"White Ball\" exercises, can be objectified by physically measurable parameters and psychological scores. METHODS: We
performed a preliminary prospective controlled interventional study with the waiting list design. In the qigong group eight children were included.
They received specific qigong lessons of the \"White Ball\" qigong over seven weeks, twice a week, for 30 min with a waiting list design and
instructions to perform the same exercises at home daily. In the control group eight children were included in a waiting list design with no qigong
instruction. Subjective perception of anxiety was measured by the Portuguese version of the Depression, Anxiety and Stress Scale adapted for
children. In addition, salivary cortisol, heart rate variability, blood pressure, surface electromyography of the trapezius muscle and reaction time
were measured at the beginning and the end of the study prior to the regular public auditions. RESULTS: In comparison to the changes in the control
group, the qigong group scored significantly lower in heart rate. Otherwise the groups did not differ significantly; however, the effect size was
large for salivary cortisol, surface electromyography of the trapezius muscle and blood pressure. There were relevant reductions of subjective
perception of anxiety, salivary cortisol levels and heart rate. CONCLUSION: The heart rate of performing schoolchildren can be potentially reduced by
\"White Ball\" exercises. Based on a sample of 8/8, positive tendencies were also observed for anxiety and blood pressure. The next steps of
objectifying possible qigong effects are to increase the sample size, to study young people in other situations arousing anxiety, to develop an
appropriate control intervention, to solve the problem of blinding and double blinding, to find additional parameters that may be influenced by the
\"White Ball\" qigong, and to compare the qigong effects with other methods reducing anxiety such as more traditional biofeedback or systematic
desensitization.
Journal of
Chinese Integrative Medicine, 10(8) : 858-865
- Year: 2012
- 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)
Sandmire, David Alan, Gorham, Sarah Roberts, Rankin, Nancy Elizabeth, Grimm, David Robert
This study
examined the psychological effects of art making in a sample of 57 undergraduate students. One week prior to final examinations, participants were
randomly assigned to either an art-making group or a control group. The State-Trait Anxiety Inventory was administered before and after
participation. Art making activities included painting or coloring pre-designed mandalas, free-form painting, collage making, still life drawing, and
modeling with clay. The mean state anxiety score between pre-activity and post-activity decreased significantly in the art-making group, whereas no
difference was found in the control group. Similarly, the mean trait anxiety score between pre-activity and post-activity in the art-making group was
significantly lower, and no difference was observed in the controls. These findings suggest that a brief period of art making can significantly
reduce a persons state of anxiety, which may have implications for art and art therapy programs that offer methods for helping college students and
others coping with stress. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Art Therapy, 29(2) : 68-73
- Year: 2012
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Creative expression: music, dance, drama, art
Wuthrich, V. M., Rapee, R. M., Cunningham, M. J., Lyneham, H. J., Hudson, J. L., Schniering,
C. A.
Objective: Computerized cognitive behavioral interventions for anxiety disorders in adults have been shown to be efficacious, but
limited data are available on the use of computerized interventions with young persons. Adolescents in particular are difficult to engage in
treatment and may be especially suited to computerized technologies. This paper describes the results of a small randomized controlled trial of the
Cool Teens program for adolescent anxiety, and examines potential barriers to treatment and user preferences of computerized technology in this
population. Method: Forty-three adolescents with a primary diagnosis of anxiety were randomly allocated to the Cool Teens program, a 12-week
computerized cognitive-behavioral therapy program for anxiety management, or a 12-week wait list. Effects on symptoms, negative thoughts, and life
interference were assessed at post-treatment and 3-month follow-up, based on diagnosis as well as self and maternal report. Results: Using mixed-
model analyses, at post-treatment and follow-up assessments, adolescents in the Cool Teens condition, compared with those on the wait list, were
found to have significant reductions in the total number of anxiety disorders, the severity of the primary anxiety disorder, and the average severity
for all disorders. These results were matched by significant reductions in mother and child questionnaire reports of anxiety, internalizing symptoms,
automatic thoughts, and life interference. Further few barriers to treatment were found, and user preferences indicated that the computerized
treatment was well suited to adolescents with anxiety. Conclusions: The Cool Teens program is efficacious for treatment of adolescent anxiety.
Clinical trial registration informationA randomized controlled trial of the Cool Teens computerized program for anxious adolescents compared with
waist list; http://www.anzctr.org.au; ACTRN12611000508976. (copyright) 2012 American Academy of Child and Adolescent Psychiatry.
Journal of the American Academy of Child & Adolescent Psychiatry, 51(3) : 261-
270
- Year: 2012
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Technology, interventions delivered using technology (e.g. online, SMS)
Trudeau, L., Spoth, R., Randall, G. K., Mason, W. A., Shin, C.
This study examined the mediated
and moderated effects of a universal family-focused preventive intervention, delivered during young adolescence, on internalizing symptoms assessed
in young adulthood. Sixth grade students (N = 446; 52% female; 98% White) and their families from 22 rural Midwestern school districts were randomly
assigned to the experimental conditions in 1993. Self-report questionnaires were administered at seven time points (pre-test to young adulthood-age
21) to those receiving the Iowa Strengthening Families Program (ISFP) and to the control group. Results showed that growth factors of adolescent
internalizing symptoms (grades 6-12) were predicted by ISFP condition and risk status (defined as early substance initiation). Moderation of the
condition effect by risk status was found, with higher-risk adolescents benefitting more from the ISFP. Results also supported the hypothesis that
the ISFP's effect on internalizing symptoms in young adulthood was mediated through growth factors of adolescents' internalizing symptoms; risk
moderation, however, was only marginally significant in young adulthood. The relative reduction rate on clinical or subclinical levels of young adult
internalizing symptoms was 28%, indicating that for every 100 young adults displaying clinical or subclinical levels of internalizing symptoms from
school districts not offering an intervention, there could be as few as 72 displaying those levels of symptoms in school districts that offered
middle school prevention programming. These findings highlight how the positive effects of family-focused universal interventions can extend to non-
targeted outcomes and the related potential public-health impact of scaling up these interventions. (copyright) 2011 Springer Science+Business Media,
LLC.
Journal of Youth & Adolescence, 41(6) : 788-801
- Year: 2012
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Weisz, J. R., Chorpita, B. F., Palinkas, L.
A., Schoenwald, S. K., Miranda, J., Bearman, S. K., Daleiden, E. L., Ugueto, A. M., Ho, A., Martin, J., Gray, J., Alleyne, A., Langer, D. A., Southam-Gerow, M. A., Gibbons,
R. D., Glisson, C., Green, E. P., Hoagwood, K. E., Kelleher,
K., Landsverk, J., Mayberg, S.
Context: Decades of randomized controlled trials have produced separate evidence-based treatments for
depression, anxiety, and conduct problems in youth, but these treatments are not often used in clinical practice, and they produce mixed results in
trials with the comorbid, complex youths seen in practice. An integrative, modular redesign may help. Objective: Standard/separate and
modular/integrated arrangements of evidence-based treatments for depression, anxiety, and conduct problems in youth were compared with usual care
treatment, with the modular design permitting a multidisorder focus and a flexible application of treatment procedures. Design: Randomized
effectiveness trial. Setting: Ten outpatient clinical service organizations in Massachusetts and Hawaii. Participants: A total of 84 community
clinicians were randomly assigned to 1 of 3 conditions for the treatment of 174 clinically referred youths who were 7 to 13 years of age (70% of
these youths were boys, and 45% were white). The study was conducted during the period from January 12, 2005 to May 8, 2009. Interventions: Standard
manual treatment (59 youths [34% of the sample]; cognitive behavioral therapy for depression, cognitive behavioral therapy for anxiety, and
behavioral parent training for conduct problems), modular treatment (62 youths [36%]; integrating the procedures of the 3 separate treatments), and
usual care (53 youths [30%]). Main Outcome Measures: Outcomes were assessed using weekly youth and parent assessments. These assessments relied on a
standardized Brief Problem Checklist and a patient generated Top Problems Assessment (ie, the severity ratings on the problems that the youths and
parents had identified as most important). We also conducted a standardized diagnostic assessment before and after treatment. Results: Mixed effects
regression analyses showed that modular treatment produced significantly steeper trajectories of improvement than usual care and standard treatment
on multiple Brief Problem Checklist and Top Problems Assessment measures. Youths receiving modular treatment also had significantly fewer diagnoses
than youths receiving usual care after treatment. In contrast, outcomes of standard manual treatment did not differ significantly from outcomes of
usual care. Conclusions: The modular approach outperformed usual care and standard evidence-based treatments on multiple clinical outcome measures.
The modular approach may be a promising way to build on the strengths of evidence-based treatments, improving their utility and effectiveness with
referred youths in clinical practice settings. Trial Registration: clinicaltrials.gov Identifier: NCT01178554. (copyright)2012 American Medical
Association. All rights reserved.
Archives of General
Psychiatry, 69(3) : 274-282
- Year: 2012
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other service delivery and improvement
interventions