Disorders - Generalized Anxiety Disorder
Zainal,
N. H., Newman, M. G.
Background Little is known about whether brief mindfulness ecological momentary interventions (MEMIs) yield clinically beneficial
effects. This gap exists despite the rapid growth of smartphone mindfulness applications. Specifically, no prior brief MEMI has targeted generalized
anxiety disorder (GAD). Moreover, although theories propose that MEMIs can boost executive functioning (EF), they have largely gone untested. Thus,
this randomized controlled trial (RCT) aimed to address these gaps by assessing the efficacy of a 14-day smartphone MEMI (versus self-monitoring
placebo [SMP]). Method Participants with GAD were randomly assigned to either condition (68 MEMI and 42 SMP). MEMI participants exercised multiple
core mindfulness strategies and were instructed to practice mindfulness continually. Comparatively, SMP participants were prompted to practice self-
monitoring and were not taught any mindfulness strategies. All prompts occurred five times a day for 14 consecutive days. Participants completed
self-reports and neuropsychological assessments at baseline, posttreatment, and 1-month follow-up (1MFU). Piecewise hierarchical linear modeling
analyses were conducted. Results MEMI (versus SMP) produced greater pre-1MFU reductions in GAD severity and perseverative cognitions (between-group d
= 0.393-0.394) and stronger improvements in trait mindfulness and performance-based inhibition (d = 0.280-0.303). Further, MEMI (versus SMP) led to
more considerable pre- to posttreatment reduction in state-level depression and anxiety and more mindfulness gains (d = 0.50-1.13). Overall,
between-treatment effects were stronger at pre-1MFU than pre- to posttreatment for trait-level than state-level treatment outcome measures.
Conclusions Preliminary findings suggest that the beneficial effect of an unguided brief MEMI to target pathological worry, trait mindfulness, and EF
is modest yet potentially meaningful. Other theoretical and clinical implications were discussed. Copyright © The Author(s), 2023. Published by
Cambridge University Press on behalf of the European Psychiatric Association.
European Psychiatry, 66(1) (no
pagination) :
- Year: 2023
- Problem: Generalized Anxiety Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Mindfulness based
therapy, Technology, interventions delivered using technology (e.g. online, SMS)
Strawn, J. R., Moldauer, L., Hahn, R. D., Wise, A., Bertzos, K., Eisenberg, B., Greenberg, E., Liu, C., Gopalkrishnan, M., McVoy, M., Knutson, J. A.
Objective: Generalized anxiety disorder (GAD) in children and adolescents is associated with
substantial morbidity and increases the risk of future psychopathology. However, relatively few psychopharmacologic studies have examined treatments
for GAD in pediatric populations, especially in prepubertal youth. Methods: Children and adolescents aged 7-17 years of age with a primary
diagnosis of GAD were treated with flexibly dosed escitalopram (10-20 mg daily, n = 138) or placebo (n = 137) for 8 weeks. Efficacy measures included
the Pediatric Anxiety Rating Scale (PARS) for GAD, Clinical Global Impression of Severity (CGI-S) scale, Children's Global Assessment Scale (CGAS);
safety measures included the Columbia-Suicide Severity Rating Scale (C-SSRS) as well as adverse events (AEs), vital signs, and electrocardiographic
and laboratory monitoring. Results: Escitalopram was superior to placebo in reducing anxiety symptoms of GAD, as seen in the difference in
mean change from baseline to week 8 on the PARS severity for GAD score (least squares mean difference = -1.42; p = 0.028). Functional improvement, as
reflected by CGAS score, was numerically greater in escitalopram-treated patients compared with those receiving placebo (p = 0.286), and
discontinuation owing to AEs did not differ between the two groups. Vital signs, weight, laboratory, and electrocardiographic results were consistent
with previous pediatric studies of escitalopram. Conclusions: Escitalopram reduced anxiety symptoms and was well tolerated in pediatric
patients with GAD. These findings confirm earlier reports of escitalopram efficacy in adolescents aged 12-17 years and extend the safety and
tolerability data to children with GAD aged 7-11 years. ClinicalTrials.gov Identifier: NCT03924323.
Journal of Child & Adolescent
Psychopharmacology, 33(3) : 91-100
- Year: 2023
- Problem: Generalized Anxiety Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Antidepressants
(any)
Stefansdottir, I. H., Ivarsson, T., Skarphedinsson, G.
Purpose: To assess the efficacy and safety of selective serotonin reuptake inhibitors (SSRIs) and
selective noradrenaline reuptake inhibitors (SNRIs) in comparison with various control contingencies (e.g. pill placebo and cognitive behavioral
treatment) for pediatric anxiety disorders. Additionally, we wanted to investigate whether serious adverse events or adverse events are more common
with medication treatment compared with pill placebo. Material(s) and Method(s): Studies were selected if they were randomized controlled trials
evaluating SSRIs or SNRIs. Eligible studies included participants aged 17 years or younger. Eleven studies were included, with 2122 participants.
Primary outcomes were (1) remission, (2) a continuous scale such as the Social Phobia and Anxiety Inventory for Children and (3) serious adverse
events. We also calculated number needed to treat and number needed to harm. Result(s): SSRIs and SNRIs are an effective treatment of childhood
anxiety disorders and are superior to pill placebo. While the risk of serious adverse events was low with SSRI/SNRI treatment, there was an increased
risk of experiencing behavioral activation with SSRI/SNRI treatment. Conclusion(s): SSRI and SNRI treatment is effective for childhood anxiety
disorders, with positive effect of treatment outweighing the negative effects. Copyright © 2022 The Nordic Psychiatric Association.
, 77(2) : 137-146
- Year: 2023
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, Social phobia (social anxiety disorder)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Serotonin-norepinephrine reuptake inhibitors
(SNRIs), Antidepressants
(any)
Lin, Z., Zhang, J., Wu, F., Xu, K., Peng, M., Wang,
C., Yang, C., Yang, X., Shen, X., Wang, W., Liu, Y., Chen, L.
Background: Although attentional bias modification training (ABM) and cognitive behavioural therapy (CBT) are two
effective methods to decrease the symptoms of generalized anxiety disorders (GAD), to date, no randomized controlled trials have yet evaluated the
effectiveness of an intervention combining internetbased cognitive behavioural therapy (ICBT) and ABM for adults with GAD.\rAims: This study aimed to
investigate the effectiveness of an intervention combining ICBT and ABM for adults with GAD.\rMethod: Sixty-three participants diagnosed with GAD
were randomly assigned to the treatment group (ICBT with ABM; 31 participants) or the control group (ICBT with ABM placebo; 32 participants), and
received 8 weeks of treatment and three evaluations. The CBT, ABM and ABM-placebo training were conducted via the internet. The evaluations were
conducted at baseline, 8 weeks later, and 1 month later, respectively.\rResults: Both the treatment and control groups reported significantly reduced
anxiety symptoms and attentional bias, with no clear superiority of either intervention. However, the treatment group showed a greater reduction in
negative automatic thoughts than the control group after treatment and at 1-month follow-up (
Behavioural and Cognitive Psychotherapy, 51(1) : 32-45
- Year: 2023
- Problem: Generalized Anxiety Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Attention/cognitive bias
modification, Technology, interventions delivered using technology (e.g. online, SMS)
LaFreniere, L. S., Newman, M. G.
OBJECTIVE: This study sought to determine if upregulating positive emotion both reduces symptoms and increases well-being for those with
generalized anxiety disorder (GAD).\rMETHOD: Eighty-five participants were diagnosed with GAD by both questionnaire and clinical interview. They were
then randomly assigned to one of two seven-day smartphone-delivered ecological momentary interventions (EMIs). SkillJoy, a savoring ecological
momentary intervention, prompted participants to attend to positive aspects of the present moment, engage in and savor planned enjoyable activities,
record and reflect on recent positive experiences, note events that turned out well, and look forward to positive events. The active self-monitoring
control (ASM) mirrored SkillJoy's activities and wording, yet omitted savoring. It included attending to current thoughts and feelings, planning
everyday activities, remembering and recording daily events, and anticipating important events. Participants were assessed at pre- and posttreatment
with a 30th day follow-up. Linear mixed models and simple slope analyses with multiple imputation examined outcome change between and within
conditions.\rRESULTS: Pretrial to posttrial, SkillJoy (vs. ASM) led to significantly greater reductions in worry and increases in positive emotions
and savoring. Depression symptoms significantly decreased for both EMIs. Pretrial to follow-up, SkillJoy (vs. ASM) users showed significantly greater
increases in savoring. Both SkillJoy and ASM significantly decreased worry (d = -1.02 vs. -0.51) and depression (d = -1.09 vs. -0.63) pre-to-follow-
up, yet SkillJoy had greater effect sizes. SkillJoy significantly increased positive emotions and savoring pre-to-follow-up, yet ASM did not.
\rCONCLUSION: SkillJoy may strengthen positive emotions and skills for enhancing them, while also reducing worry. (PsycInfo Database Record (c) 2023
APA, all rights reserved).
Journal of Consulting & Clinical Psychology, 91(6) : 381-
387
- Year: 2023
- Problem: Generalized Anxiety Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Bilek, E., Tomlinson, R. C., Whiteman, A. S., Johnson, T. D., Benedict, C., Phan, K. L., Monk, C.
S., Fitzgerald, K. D.
OBJECTIVE: The
relative contribution of individual cognitive behavioral therapy (CBT) components to treatment outcomes for child anxiety disorders (CADs) is
unclear. Recent meta-analyses suggest that exposure may be the primary active ingredient in CBT for CADs, and that relaxation may be relatively less
effective. This brief report tests the hypothesis that exposure-focused CBT (EF-CBT) would outperform a relaxation-based active therapy control
(Relaxation Mentorship Training; RMT) for the treatment of CADs. METHOD(S): Participants were 102 youth with CADs (mean age = 11.91, 26 males; 76.4%
White, 14.7% Multiracial, 3.9% Black, 3.9% Asian, 0.9% other/do not wish to identify) as part of an ongoing neuroimaging randomized controlled trial.
Participants were randomly assigned (ratio 2:1) to receive 12 sessions of EF-CBT (n = 70) or RMT (n = 32). Clinical improvement was measured at Week
12 (Clinical Global Impression - Improvement scale; CGI-I); treatment response was defined as receiving a rating of \"very much\" or \"much improved
\" on the CGI-I. Anxiety severity was measured at Weeks 1, 6, 9, 12 (Pediatric Anxiety Rating Scale; PARS). Outcome measures were completed by an
independent evaluator unaware of condition. RESULT(S): EF-CBT exhibited 2.98 times higher odds of treatment completion than RMT; 13 treatment non-
completers were included in analyses. Estimated treatment response rates were higher for EF-CBT (57.3%) than for RMT (19.2%). Longitudinal analyses
indicated that EF-CBT was associated with faster and more pronounced anxiety reductions than RMT on the PARS (Hedges' g = .77). CONCLUSION(S):
Results suggest that EF-CBT without relaxation is effective for CADs, and more effective than a relaxation-based intervention.
Journal of Clinical Child and Adolescent Psychology, 51
(4) : 410-418
- Year: 2022
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Exposure therapy, Exposure
and response prevention, Relaxation
Artiran, M., DiGiuseppe, R.
This study evaluated the effectiveness of Rational Emotive Behavior Therapy (REBT) for outpatients with GAD and mild depression
and tested the effectiveness of REBT to an active, alternative treatment, Humanistic, Client-Centered Therapy (HCCT) in a clinical setting. The study
aimed to understand whether REBT is a more effective treatment than HCCT through testing both pre-treatment and including three-month follow-up
results. Thirty-one participants were assessed for overall psychopathological variables such as anxiety, depression, levels of unhealthy negative
emotions and regret, activation, hope and nothingness as ontological well-being (OWB) variables before and after a 12 week intervention as well as
during a three-month follow-up. We randomly assigned participants to either REBT or HCCT. The psychotherapists followed strict guidelines to
incorporate the distinctive features of REBT. This included educating clients about irrational and rational beliefs, introducing the binary model of
emotional distress, using a range of disputing techniques (logical, philosophic, and functional), and discussing alternative rational beliefs such as
unconditional acceptance of self, others, and life. The HCCT group was treated with Rogerian techniques such as unconditional positive regard,
accepting negative emotions, and reflection. The clients completed the Beck Depression Inventory, Beck Anxiety Inventory, Shortened Attitude and
Beliefs Scale, the Ontological Well-being Scale, and the healthy and unhealthy negative emotions scale. The outcomes were analyzed using split plot
ANOVA with post hoc, Reliable Change Index, and Clinical Significance Change Index. Although split-plot ANOVA results showed that there was not
significant difference in main effect of treatment between REBT and HCCT groups, further detailed analysis such as main effect of time, time by
interaction values, Reliable Change Indices, clinically significant change analysis, and post hoc indicated that REBT treatment was more beneficial
than HCCT treatment at any of the three time points in most variables. Another experimental study with larger sample is needed to confirm the result
in future studies. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
, 40(2) : 206-233
- Year: 2022
- Problem: Generalized Anxiety Disorder, Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions, Positive
psychology
Zemestani, M., Beheshti, N., Rezaei, F., Van-Der-Heiden, C., Kendall, P. C.
Given the high
prevalence and adverse outcomes associated with generalized anxiety disorder (GAD), development and expansion of effective treatment modalities are
important. The present study compared the effectiveness of cognitive behavior therapy targeting intolerance of uncertainty (CBT-IU) and selective
serotonin reuptake inhibitors (SSRIs) for treating GAD. A total of 30 Iranian patients with GAD (Mage = 25.16 +/- 6.73) were randomised to receive
either CBT-IU (n = 15) or SSRI (n = 15). Measures included the Structured Clinical Interview for DSM-5 (SCID-5), Penn State Worry Questionnaire
(PSWQ), Why Worry-II (WW-II), Intolerance of Uncertainty Scale (IUS), and Negative Problem Orientation Questionnaire (NPOQ). Repeated measures
analysis of variance tested differential treatment outcomes. The results of intention-to-treat (ITT) analysis indicated that although both CBT-IU and
SSRI were effective treatments for GAD, CBT-IU produced significantly better results than SSRI at post-treatment. This clinical trial provides
preliminary cross-cultural support for the treatment of GAD using CBT-IU, with findings suggesting that this non-medication intervention reduces GAD
symptoms. Copyright © 2021 The Author(s). Published by Cambridge University Press on behalf of the Australian Association for Cognitive and Behaviour
Therapy.
, 38(4) : 250-262
- Year: 2021
- Problem: Generalized Anxiety Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Antidepressants
(any), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Perkins, A., Patrick, F., Wise, T., Meyer, N., Mazibuko,
N., Oates, A. E., van-der-Bijl, A. H. M., Danjou, P., OConnor, S. M., Doolin, E., Wooldridge, C., Rathjen, D., Macare, C., Williams, S. C. R., Young, A. H.
Drugs that are clinically
effective against anxiety disorders modulate the innate defensive behaviour of rodents, suggesting these illnesses reflect altered functioning in
brain systems that process threat. This hypothesis is supported in humans by the discovery that the intensity of threat-avoidance behaviour is
altered by the benzodiazepine anxiolytic lorazepam. However, these studies used healthy human participants, raising questions as to their validity in
anxiety disorder patients, as well as their generalisability beyond GABAergic benzodiazepine drugs. BNC210 is a novel negative allosteric modulator
of the alpha 7 nicotinic acetylcholine receptor and we recently used functional Magnetic Resonance Imaging to show it reduced amygdala responses to
fearful faces in generalised anxiety disorder patients. Here we report the effect of BNC210 on the intensity of threat-avoidance behaviour in 21
female GAD patients from the same cohort. We used the Joystick Operated Runway Task as our behavioural measure, which is a computerised human
translation of the Mouse Defense Test Battery, and the Spielberger state anxiety inventory as our measure of state affect. Using a repeated-measures,
within-subjects design we assessed the effect of BNC210 at two dose levels versus placebo (300 mg and 2000 mg) upon two types of threat-avoidance
behaviour (Flight Intensity and Risk Assessment Intensity). We also tested the effects of 1.5 mg of the benzodiazepine lorazepam as an active
control. BNC210 significantly reduced Flight Intensity relative to placebo and the low dose of BNC210 also significantly reduced self-reported state
anxiety. Risk Assessment Intensity was not significantly affected. Results show both human defensive behaviour and state anxiety are influenced by
cholinergic neurotransmission and there provide converging evidence that this system has potential as a novel target for anxiolytic
pharmacotherapy.
Transl Psychiatry
Psychiatry, 11(1) : 13
- Year: 2021
- Problem: Generalized Anxiety Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Anxiolytics including benzodiazepines, Other biological interventions
Newman, M. G., Kanuri, N., Rackoff, G. N., Jacobson, N. C., Bell, M. J., Taylor, C. B.
Online guided self-help may be an effective and scalable intervention for
symptoms of generalized anxiety dis-order (GAD) among university students in India. Based on an online screen for GAD administered at 4 Indian
universities, 222 students classified as having clinical (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria) or
subthreshold (Generalized Anxiety Disorder Questionnaire, Fourth Edition, score $ 5.7) GAD were randomly assigned to receive either 3 months of
guided self-help cognitive-behavioral therapy (n = 117) or a waitlist control condition (n = 105). Guided self-help participants recorded high
program usage on average across all participants enrolled (M = 9.99 hr on the platform; SD = 20.87). Intent-to-treat analyses indicated that
participants in the guided self-help condition experienced significantly greater reductions than participants in the waitlist condition on GAD
symptom severity (d = -.40), worry (d = -.43), and depressive symptoms (d = -.53). No usage variables predicted symptom change in the guided self-
help condition. Participants on average reported that the program was moderately helpful, and a majority (82.1%) said they would recommend the
program to a friend. Guided self-help appears to be a feasible and efficacious interven-tion for university students in India who meet clinical or
subthreshold GAD criteria. The trial is registered with ClinicalTrials.gov (NCT02410265). Copyright © 2021. American Psychological Association.
Psychotherapy, 58
(4) : 591-601
- Year: 2021
- Problem: Generalized Anxiety Disorder
- 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), Self-help, Technology, interventions delivered using technology (e.g. online, SMS)
Gordon, B.
R., McDowell, C. P., Lyons, M., Herring, M. P.
Introduction: The objective of this randomized controlled trial (RCT) was to
quantify the effects of eight weeks of World Health Organization and American College of Sports Medicine guidelines-based resistance exercise
training (RET) among participants meeting criteria for subclinical, or analogue-GAD (AGAD) Methods: Forty-four participants (mean age (y): 25.4.6+/-
4.9.2) were randomized to either an eight-week, fully-supervised, one-on-one RET intervention or wait-list control. AGAD status was determined using
validated cut-scores for both the Psychiatric Diagnostic Screening Questionnaire-GAD subscale (>=6) and Penn State Worry Questionnaire (>=45).
Remission, based on change in AGAD status, was assessed post-intervention, and quantified with number needed to treat (NNT). Primary analyses focused
on participants missing outcome data at <=1 time point (RET: n=12, Wait-list: n=15). RM-ANCOVA examined differences between RET and wait-list across
time. Simple effects analysis decomposed significant interactions. Hedges' d quantified magnitude of differences in change between conditions over
time. Result(s): Attendance was 81% and compliance to the RET was 77%. Participants significantly increased strength (all d>=1.24, p<=0.006) with no
adverse events. RET improved AGAD status (NNT=3, 95%CI: 2 to 7). Significant group X time interactions were found for worry (F(3,66) =
3.12, p<=0.043; d=0.93, 95%CI: 0.13 to 1.73) and anxiety symptoms (F(3,57.84)=2.91, epsilon=0.88, p<=0.045; d=0.71, 95%CI: -0.08 to 1.49).
RET significantly reduced worry (mean difference=-6.49, p<=0.045) and anxiety symptoms (mean difference=-10.50, p<=0.001). Limitation(s): Limitations
include a small sample size, and lack of attention-matched control condition. Conclusion(s): RET significantly improved AGAD severity, and elicited
large, clinically meaningful improvements in worry and anxiety symptoms among young adults with AGAD. Copyright © 2020
, 281 : 153-159
- Year: 2021
- Problem: Generalized Anxiety Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Physical activity, exercise
Abdian,
H., Rezaei, M., Eskandari, Z., Ramezani, S., Pirzeh, R., Dadashi, M.
Introduction: Generalized Anxiety Disorder (GAD) is one of the most common anxiety disorders that has
significant adverse effects on social functioning, occupational/academic performance, and daily living. This study aimed to evaluate the effect of
Quantitative Electroencephalography (QEEG)-based Neurofeedback (NFB) therapy on anxiety, depression, and emotion regulation of people with GAD.
Method(s): This research is a quasi-experimental study with a pre-test/post-test/follow-up design and a control group. The study participants were 29
college students with GAD living in Zanjan City, Iran, who were selected using a convenience sampling method. Then, they were randomly divided into
two groups of intervention (n=15) and control (n=14). The protocol of NFB therapy was designed based on the QEEG method. The intervention group
received QEEG-based NFB therapy for 8 weeks (20 sessions, 2 sessions per week, each session for 45 min), while the control group received no
intervention. The samples were surveyed and measured by using a 7-item GAD scale, Emotion Regulation Questionnaire (ERQ), 21-item Depression,
Anxiety, and Stress Scale (DASS), and Structured Clinical Interview for DSM (SCID) before and after the intervention and then at a 3-month follow-up.
The collected data were analyzed in SPSS software V. 22 using univariate ANCOVA and repeated measures ANOVA. Result(s): The within-subjects effect of
time (pre-test, post-test, and follow-up) was statistically significant (P=0.031). The intervention group showed significant changes in the post-test
and follow-up phases in comparison with the control group. The anxiety and depression levels of patients reduced significantly (P=0.001), and their
emotion regulation improved (P=0.001) after the intervention, and they remained unchanged in the follow-up period. Conclusion(s): QEEG-based NFB
therapy can reduce anxiety and depression and improve emotion regulation in patients with GAD. Copyright © 2021 Iran University of Medical Sciences.
All rights reserved.
Basic and Clinical Neuroscience, 12
(2) : 281-290
- Year: 2021
- Problem: Generalized Anxiety Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Biofeedback, neurofeedback, audio/video feedback