Disorders - Anxiety Disorders
Bettis, A. H., Coiro, M. J., England, J., Murphy, L. K., Zelkowitz, R. L., Dejardins, L., Eskridge, R., Adery, L. H., Yarboi, J., Pardo, D., Compas, B. E.
OBJECTIVE: College students face a significant number of stressors, increasing risk for internalizing and externalizing psychopathology. The current study examines two promising avenues of intervention aimed to reduce stress and prevent psychopathology in this population: a coping skills group and a cognitive training program.
PARTICIPANTS: 62 undergraduate students from two universities were recruited from 2013 to 2015.
METHODS: Students were randomized to a 6-week coping skills group or cognitive training program and completed measures of stress, coping, executive function, and symptoms of anxiety, depression and Attention-Deficit Hyperactivity Disorder (ADHD) at pre- and post-intervention.
RESULTS: Participants in both conditions reported significant decreases in social stress, executive function difficulties, and anxiety symptoms post-intervention. Students in the cognitive program improved significantly more on measures of behavior regulation and ADHD symptoms compared to the coping group at post-intervention.
CONCLUSIONS: Brief stress management interventions targeting coping and executive function may benefit college students at risk for psychopathology.
Journal of American College Health, 65(5) : 313-322
- Year: 2017
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
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Stage: Universal prevention
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Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Cognitive remediation therapy, Skills training, Technology, interventions delivered using technology (e.g. online, SMS)
Jeitler, M., Zillgen, H., Hogl, M., Steckhan, N., Stockigt, B., Seifert, G., Michalsen, A., Kessler, C.
Question We aimed to evaluate potential effects of a 10-week yoga course as an alternative for regular school sport. Methods A cohort study design with an active control group (school sport) was implemented in two secondary schools. Primary outcome measure was stress (CPS) from baseline to week 10. Secondary outcomes included depression/anxiety (HADS), attention (D2), quality of life (WHO-5), mood states (POMS) and VAS for general pain, neck pain, headache, fatigue and sleep quality. Outcome parameters were assessed at baseline, at week 10, and at a 6-month follow-up. A per-protocol analysis using mixed linear models was performed. Furthermore qualitative interviews in 3 focus groups with 6 participants each were performed. Results 102 adolescents were screened for eligibility. 86 (53% female; mean age 20.2 +/- 2.3 years) were included into the study (50 participants in 3 yoga classes and 36 participants in 3 school sport classes). 85 data sets were included in the final analysis. Yoga significantly reduced anxiety/depression when compared to school sport after 10 weeks (p = 0.004). No significant treatment ef-fects were found for the other outcome measures. Although nonsignificant, yoga showed greater improvement compared to school sport for most other outcomes. The 6-month follow-up showed in-consistent results. In the qualitative interviews participants evaluated yoga classes enthusiastically and reported a variety of physical and psychological benefits as well as overall restorative effects. Conclusions Yoga may be an effective method for coping with anxiety/depression in school sport settings for adolescents. Well-designed RCTs including active control comparisons are warranted.
BMC Complementary & Alternative Medicine. Conference: World Congress Integrative Medicine & Health, 17(Supplement 1) : 322
- Year: 2017
- Problem: Anxiety Disorders (any)
- Type: Controlled clinical trials
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Stage: Universal prevention
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Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Mind-body exercises (e.g. yoga, tai chi, qigong)
, Physical activity, exercise
Kato, S., Shimizu, E.
Introduction: Many universal school-based preventative intervention trials for anxiety have been conducted in Western countries. This pilot study examined the efficacy and acceptability of a school-based, universal preventative program for anxiety among children aged 8-9 years in Japan. The program was based on cognitive-behavioral therapy (CBT) and was informed by similar universal programs (i.e., the Fun FRIENDS program; Barrett, 2007a, 2007b). Methods: Seventy-four children from a single school were allocated to an intervention or control group. The intervention comprised 10 CBT sessions, and assessments were conducted before and after the program. The primary outcome measure was the Spence Children's Anxiety Scale (SCAS) as children's self-report. Secondary outcome measures were the Depression Self-Rating Scale for Children (DSRS-C), Children's Hope Scale (Hope), Spence Children's Anxiety Scale-Parent Version (SCAS-P), and Strengths and Difficulties Questionnaire-Parent Version (SDQ-P). Results: The SCAS as the primary outcome showed no significant differences between the two groups. In addition, DSRS-C, Hope and SDQ-P also showed no significant differences. SCAS-P in the intervention group showed significant decrease compared to those in the control group. Conclusion: The results of this trial study suggest that a school-based universal preventative program for anxiety may have no significant effects on 8-9-year-old children. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Mental Health and Prevention, 8 : 32-38
- Year: 2017
- Problem: Anxiety Disorders (any)
- Type: Controlled clinical trials
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Stage: Universal prevention
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Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Capron, D. W., Norr, A. M., Allan, N. P., Schmidt, N. B.
Objective: Anxiety disorders contribute substantially to the overall public health burden. Anxiety sensitivity (AS), a fear of anxiety-related sensations, is one of the few known malleable risk factors for anxiety pathology. Previous AS reduction treatments have primarily utilized "top-down" (e.g., psychoeducation) interventions. The goal of the current study was to evaluate the effect of adding a "bottom-up" (interpretation bias modification; CBM-I) intervention to an AS psychoeducation intervention. Design: Single-site randomized controlled trial. Participants completed either a 1) Psychoeducation + active CBM-I or 2) Psychoeducation + control CBM-I intervention. Change in AS was assessed post-intervention and at a one-month follow-up. Participants: Individuals with elevated levels of AS. Intervention: Single-session computer-delivered intervention for AS. Results: Accounting for baseline ASI-3 scores, post-intervention ASI-3 scores were significantly lower in the combined condition than in the psychoeducation + control CBM-I condition (beta = 0.24, p < 0.05; d = 0.99). The active CBM-I plus psychoeducation AS intervention was successful in reducing overall AS (59% post-intervention; p < 0.05, Cohen's d = 0.99) and these reductions were maintained through one month post-intervention (52%; p < 0.05, Cohen's d = 1.18). Participants in the active condition reported significantly lower rates of panic responding to a vital-capacity CO2 challenge (OR = 6.34, 95% CI = 1.07 -37.66) ciange in interpretation bias significantly mediated the relationship between treatment condition and post-treatment AS reductions. Conclusions: The current intervention was efficacious in terms of immediate and one-month AS reductions. Given its brevity, low-cost, low-stigma and portability, this intervention could lead to reducing the burden of anxiety disorders. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Journal of Psychiatric Research, 85 : 75-82
- Year: 2017
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
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Stage: At risk (indicated or selected prevention)
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Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Psychoeducation, Attention/cognitive bias modification
, Technology, interventions delivered using technology (e.g. online, SMS)
Cobham, V. E., Filus, A., Sanders, M. R.
Little is known about the efficacy of parent-only interventions and the maintenance of gains over time with anxiety-disordered children and adolescents. The current study aimed to evaluate the efficacy of a 6-session parent-focused intervention (Fear-less Triple P) in reducing children's anxiety symptomatology. The parents of 61 anxiety-disordered children (7-14 years) were randomly assigned to either the 6-session parent-only group CBT intervention or a wait-list control (WL) group. Diagnostic and questionnaire measures were administered at post-treatment; as well as 3-, 6- and 12 months following the completion of treatment. Families in the WL group were re-assessed after 6 weeks (the duration of the active intervention) and were then offered the intervention. The parent-only intervention produced superior outcomes for children on diagnostic and questionnaire measures. The percentages of children free of any anxiety diagnosis following the intervention were 38.7% (post-treatment); 58.6% (3-mth); 69.2% (6-mth); and 84% (12-mth). At the post-treatment assessment point, 3.4% of children in the WL group were free of any anxiety diagnosis. Mother and child questionnaire measures demonstrated gains from pre to post-treatment that were maintained over time. This proof of concept study suggests that the brief, parent-only intervention evaluated is an efficacious treatment approach for child anxiety disorders. A parent-only, group CBT intervention such as the one described here offers a cost-effective, low intensity alternative to traditional child-focused interventions. Copyright © 2017 Elsevier Ltd
Behaviour Research and Therapy, 95 : 128-138
- Year: 2017
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
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Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Other Psychological Interventions
Eaton, J., Tieber, C.
This study tested whether the structure of a coloring task has an effect on anxiety, mood, and perseverance. Eighty-five undergraduate students were randomly assigned to 1 of 2 coloring conditions: free choice, where they could color an image using any colors they wanted, and forced choice, where they were instructed to copy the colors of a precolored image. Anxiety and mood were measured before and after coloring; in addition, perseverance was measured after coloring. Results showed positive effects of coloring, with greater anxiety reduction and evidence of higher perseverance in the free-choice group compared to the forced-choice group. This suggests that well-being might be facilitated by a coloring task that balances structure and engagement. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Art Therapy, 34(1) : 42-46
- Year: 2017
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
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Stage: Universal prevention
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Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Creative expression: music, dance, drama, art
Conley, C. S., Shapiro, J. B., Kirsch, A. C., Durlak, J. A.
This meta-analysis found empirical support for the effectiveness of indicated prevention programs for higher education students at risk for subsequent mental health difficulties based on their current subclinical levels of various presenting problems, such as depression, anxiety, or interpersonal difficulties. A systematic literature search identified 79 controlled published and unpublished interventions involving 4,470 college, graduate, or professional students. Programs were effective at post-intervention overall (ES = 0.49, CI [0.43, 0.55]), and for both targeted outcomes (ES = 0.58, CI [0.51, 0.64]) as well as additional nontargeted outcomes assessed in the studies (ES = 0.32, CI [0.25, 0.39]). Interventions compared with a no-intervention or a wait-list control (ES = 0.64, CI [0.57, 0.71], k = 68) demonstrated significantly larger effects overall than did interventions compared with an attention-placebo control (ES = 0.27, CI [0.11, 0.43], k = 11), although both were significant. Among the former group, modality and presenting problem emerged as significant moderators of intervention effectiveness, and among the 43 of these that assessed effectiveness at an average follow-up period of 35 weeks, the positive effects from intervention remained strong (ES = 0.59, CI [0.50, 0.68]). Overall, programs were fairly brief, attracted and retained students, were positively rated by students, and effective when administered by paraprofessionals as well as professionals. Current findings are promising and stimulate recommendations for improving future research, such as expanding the range of outcomes assessed, and clarifying moderators and mediators of intervention impact. (PsycINFO Database Record
Copyright (c) 2017 APA, all rights reserved).
Journal of Counseling Psychology, 64(2) : 121-140
- Year: 2017
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
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Stage: At risk (indicated or selected prevention)
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Treatment and intervention: Psychological Interventions (any)
Crowe, K., McKay, D.
A review of meta-analyses of cognitive-behavioral therapy (CBT) for childhood anxiety and depression was conducted. A total of 36 meta-analyses were identified that met inclusion criteria for this review. In most cases, medium-to-large effect sizes for treatment reduction were observed when CBT was compared to non-active control conditions. Small-to-medium effects were observed when CBT was compared to active control treatments. The available meta-analyses generally did not examine, or data were not sufficient to evaluate, potential moderators of outcome, differential effects for parental involvement, or changes in quality of life or functional outcomes associated with treatment. Accordingly, while CBT should be broadly considered an effective treatment approach for childhood anxiety and depression, additional research is warranted in order to establish guidelines for service delivery for complicating factors in client presentation. Copyright © 2017 Elsevier Ltd
Journal of Anxiety Disorders, 49 : 76-87
- Year: 2017
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
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Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Gaesser, A. H., Karan, O. C.
Objective: The objective of this pilot study was to compare the efficacy of Emotional Freedom Techniques (EFT) with that of Cognitive-Behavioral Therapy (CBT) in reducing adolescent anxiety. Design: Randomized controlled study. Settings: This study took place in 10 schools (8 public/2 private; 4 high schools/6 middle schools) in 2 northeastern states in the United States. Participants: Sixty-three high-ability students in grades 6-12, ages 10-18 years, who scored in the moderate to high ranges for anxiety on the Revised Children's Manifest Anxiety Scale-2 (RCMAS-2) were randomly assigned to CBT (n = 21), EFT (n = 21), or waitlist control (n = 21) intervention groups. Interventions: CBT is the gold standard of anxiety treatment for adolescent anxiety. EFT is an evidence-based treatment for anxiety that incorporates acupoint stimulation. Students assigned to the CBT or EFT treatment groups received three individual sessions of the identified protocols from trained graduate counseling, psychology, or social work students enrolled at a large northeastern research university. Outcome measures: The RCMAS-2 was used to assess preintervention and postintervention anxiety levels in participants. Results: EFT participants (n = 20; M = 52.16, SD = 9.23) showed significant reduction in anxiety levels compared with the waitlist control group (n = 21; M = 57.93, SD = 6.02) (p = 0.005, d = 0.74, 95% CI [-9.76, -1.77]) with a moderate to large effect size. CBT participants (n = 21; M = 54.82, SD = 5.81) showed reduction in anxiety but did not differ significantly from the EFT (p = 0.18, d = 0.34; 95% CI [-6.61, 1.30]) or control (p = 0.12, d = 0.53, 95% CI [-7.06, .84]). Conclusions: EFT is an efficacious intervention to significantly reduce anxiety for high-ability adolescents. © Copyright 2017, Mary Ann Liebert, Inc. 2017.
Journal of Alternative and Complementary Medicine, 23(2) : 102-108
- Year: 2017
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Other Psychological Interventions
Lindheimer, J. B., O'Connor, P. J., McCully, K. K., Dishman, R. K.
Objective: Prior attempts to measure psychological responses to exercise are potentially limited by a failure to account for participants' expectations, the absence of a valid exercise placebo, and demand characteristics. The purpose of this study was to explore the main and interactive effects of a manipulation designed to increase expectations about the psychological benefits of an acute bout of active, light-intensity (treatment), and passive (placebo) cycling on mood and cognition. Demand characteristics were attenuated during recruitment, informed consent, and interactions with test administrators by communicating to participants that the study purpose was to assess the effects of active and passive cycling on respiration, heart rate, and muscle activation. Methods: A repeated-measures, randomized, placebo-controlled design (n = 60) was used with cycling (active, passive) and information (informed, not informed) as between-subjects factors. State anxiety, feelings of energy, and working memory (percent accuracy and reaction time for correct responses) were measured at baseline (time 1), immediately after cycling (time 2) and 20 minutes after cycling (time 3). Results: Most participants did not guess the purpose of the study (~92%) or expect a reduction in state anxiety (85%) or an increase in energy (80%) or cognitive performance (~93%). Mood and cognitive performance were not improved by active or passive cycling (all p values >= .12). Conclusions: The methods used here to disguise the experimental hypotheses provide a potential framework for reducing demand characteristics and placebo responses in future investigations of psychological responses to exercise. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Psychosomatic Medicine, 79(2) : 243-253
- Year: 2017
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Physical activity, exercise
Lawrence, P. J., Rooke, S. M., Creswell, C.
Background: Anxiety disorders are common, often start in childhood and run a chronic course. As such there is a need for effective prevention. Methods: We conducted a systematic review and meta-analyses of randomized, controlled trials to prevent the onset of anxiety disorders in 'at risk' young people. Diagnostic and symptom outcomes were examined. Putative moderators were tested as was publication bias. Results: We included 16 trials (2545 young people). Two trials reported diagnostic outcomes, and significant effects were found for these at end-of-programme (RR = .09, 95%CI = .02 to .16), 6- (RR = .17, 95%CI = .06 to .27) and 12-month (RR = .31, 95%CI .17 to .45) follow-ups. Based on 16 trials, improved anxiety symptoms were significant compared to nonattention controls only, with small effect sizes reported by young people at the end-of-programmes, 6- and 12-month follow-ups; and by parents at the end of the programmes and 12-, but not 6-, month follow-ups. There was no evidence of significant moderation or publication bias. Conclusions: Fourteen studies included children and young people who presented with elevated anxiety symptoms, but anxiety disorder was not ruled out in the participants in these studies. Hence, these studies might be reporting results of mixed prevention/early intervention programmes. Prevention programmes that target developmental risk factors, not only disorder maintaining factors, appear most promising. The clinically meaningful impact of anxiety disorder prevention programmes remains unknown. Copyright © 2017 Association for Child and Adolescent Mental Health.
Child and Adolescent Mental Health., :
- Year: 2017
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
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Stage: At risk (indicated or selected prevention)
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Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Service Delivery & Improvement, Psychological Interventions (any)
Norr, A. M., Gibby, B. A., Schmidt, N. B.
Background Anxiety sensitivity (AS), or a fear of anxiety-related sensations, has become one of the most well researched risk factors for the development of psychopathology and comprises three subfactors: physical, cognitive, and social concerns. Fortunately, research has demonstrated brief protocols can successfully reduce AS, and in turn improve psychopathological symptoms. Computerized AS reduction protocols have combined psychoeducation with interoceptive exposure (IE), but they have not been dismantled to evaluate the effects of psychoeducation alone. Method: The current study sought to determine the efficacy of a brief single-session psychoeducation intervention for AS, compared to a control intervention, in a sample of at-risk individuals (N=54) with elevated AS cognitive concerns. Results Individuals in the active condition displayed greater reductions in self-reported AS (beta=.198, 95% CI [.065, .331]) and less fear reactivity (beta=.278, 95% CI [.069, .487]) to the induction of AS cognitive-relevant sensations through a behavioral challenge compared to those in the control condition. Further, fear reactivity to the challenge was mediated by reductions in self-reported AS cognitive concerns. Limitations Study limitations include use of an at-risk nonclinical student sample, lack of a long-term follow-up assessment, and inability to discern whether AS reductions due to CAST psychoeducation prevent future, or improve current, psychological symptoms. Conclusions These results suggest that psychoeducation alone can produce significant AS reduction. Copyright © 2017
Journal of Affective Disorders, 212 : 48-55
- Year: 2017
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
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Stage: At risk (indicated or selected prevention)
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Treatment and intervention: Psychological Interventions (any)
, Psychoeducation