Disorders - anxiety disorders
Monga, S., Rosenbloom, B. N., Tanha, A., Owens, M., Young, A.
Objective Childhood anxiety disorders (AD) are prevalent, debilitating disorders. The most effective treatment approach for children less than 8 years old requires further investigation. The study's primary objective was to compare 2 cognitive-behavioral therapy (CBT) group programs. CBT was delivered to children 5 to 7 years old and their parents (child-parent) or only to parents (parent-only), whereas children attended group sessions but did not receive CBT. Method Using a prospective, repeated measures, longitudinal study design, 77 children (29 male, mean age = 6.8 years; SD = 0.8 year) with AD and their parents participated in either a 12-week child-parent or parent-only CBT group treatment after a 3-month no-treatment wait-time. Well-validated treatment outcome measures were completed at 5 assessment time points: initial assessment, pretreatment, immediately posttreatment, 6 months, and 12 months posttreatment. A mixed models analysis was used to assess change in AD severity and global functioning improvements from baseline within each treatment and between treatments. Results No significant changes were noted in child-parent or parent-only treatment during the 3-month no-treatment wait time. Both treatments saw significant improvements posttreatment and at longer-term follow-up with significant reductions in AD severity measured by clinician and parent report and increases in global functioning. Significantly greater improvements were observed in the child-parent compared to the parent-only treatment. Conclusion This study suggests that both parent-only and child-parent group CBT improves AD severity in children 5 to 7 years old. Study results suggest that involvement of both children and parents in treatment is more efficacious than working with parents alone.
Journal of the American Academy of Child & Adolescent Psychiatry, 54(2) : 138-146
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Other Psychological Interventions, Other service delivery and improvement interventions
Menezes, C. B., Bizarro, L.
Meditation has been associated with positive psychological outcomes, but few studies have investigated brief interventions. This randomized controlled pilot study assessed the effects of five days of focused meditation on positive and negative affect, state and trait anxiety, as well as concentrated attention in a nonclinical sample distributed in two groups (experimental = 14, 51.8% female, Mage = 23.9; control = 19, 62% female, Mage = 24.9). The instruments used were the Positive Affect and Negative Affect Scale, State and Trait Anxiety Inventory, and the Concentrated Attention Test. The meditation group reduced negative affect and trait anxiety, and also improved correct responses on the attention test, relative to controls. These preliminary findings indicate that even short focused meditation training may help improve some psychological variables. It is discussed that the early manifestation of these benefits may be especially relevant to strengthen the motivation to continue and practice regularly. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (journal abstract).
Paideia, 25(62) : 393-401
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Meditation
Menezes, C. B., Bizarro, L.
Meditation has been increasingly studied and applied as a form of mental training that seeks to foster healthier emotion regulation. This study investigated whether 6 weeks of training focused meditation (FM; n = 35) improves emotion regulation processes (i.e., general emotion dysregulation and difficulties in regulatory strategies) and emotion regulation outcomes (i.e., state and trait anxiety) in healthy college students compared with progressive relaxation (PR; n = 37) and a wait-list control (WLC) group (n = 27). Based on an intention-to-treat (ITT) analysis, only the FM group exhibited improvements in total emotion dysregulation, particularly 2 strategies (i.e., limited access to effective emotion regulation strategies and nonacceptance of emotional responses), and trait anxiety. The weekly frequency of practice correlated with lower limited access to effective emotion regulation strategies, impulse control difficulties, and lack of emotional clarity only among meditators. Additionally, reductions of emotion dysregulation correlated with reductions of trait anxiety. Conceptual considerations regarding the relationship between the type of meditation and emotion regulation processes are discussed. The present study provides evidence of the potential therapeutic efficacy of meditation.
Psychology & Neuroscience, 8(3) : 350-365
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Meditation
Mondin, T. C., de-Azevedo-Cardoso, T., Jansen, K., Del-Grande-da-Silva, G., de-Mattos-Souza, L. D., da-Silva, R. A.
Objective: To evaluate the effect of cognitive therapy on biological rhythm and depressive and anxious symptoms in a twelve-month follow-up period. In addition, correlations between the reduction of depression and anxiety symptoms and the regulation of biological rhythm were observed. Methods: This was a randomized clinical trial with young adults from 18 to 29 years of age who were diagnosed with depression. Two models of psychotherapy were used: Cognitive Behavioral Therapy (CBT) and Narrative Cognitive Therapy (NCT). Biological rhythm was assessed with the Biological Rhythm Interview of Assessment in Neuropsychiatry (BRIAN). Severity of depressive and anxious symptoms was assessed by the Hamilton Depression Rating Scale (HDRS) and the Hamilton Anxiety Rating Scale (HARS), respectively. The sample included 97 patients who were divided within the protocols of psychotherapy. Results: There was a significant reduction in depressive and anxious symptoms (p < 0.001) and an increase on regulation of biological rhythm (p < 0.05) at the twelve-month follow-up. Moreover, we showed a positive correlation between the reduction of depressive symptoms and regulation of biological rhythm (r = 0.638; p < 0.001) and between the reduction of anxious symptoms and regulation of biological rhythm (r = 0.438; p < 0.001). Conclusion: Both models showed that cognitive therapy was effective on the reduction of depressive and anxious symptoms and on the regulation of biological rhythm at a twelve-month follow-up evaluation. This study highlights the association between biological rhythm and symptoms of depression and anxiety. Limitation: We did not assess genetic, hormonal or neurochemical factors and we did not include patients under pharmaceutical treatment or those with severe symptomatology. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (journal abstract).
Journal of Affective Disorders, 187 : 1-9
- Year: 2015
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Other Psychological Interventions
Aboalshamat, K., Hou, X. Y., Strodl, E.
BACKGROUND: Psychological distress is well-documented worldwide among medical and dental students. Few studies have assessed the impact of self-development coaching programs on the students' psychological health. The aim of the study was to evaluate the effect of a self-development coaching programme on the psychological health and academic performance of preclinical medical and dental students at Umm Al-Qura University, Saudi Arabia.
METHODS: Four-hundred and twenty-two participants (n = 422, 20-22 years) fulfilled the study requirements and were invited into a parallel-randomised controlled trial that was partially blinded. Participants were stratified by faculty, gender, and academic year, and then randomised. A total of 156 students participated in the intervention group (IG) and 163 students participated in the control group (CG). The IG received the selfdevelopment programme, involving skills and strategies aimed to improve students' psychological health and academic performance, through a two-day workshop. Meanwhile, the CG attended an active placebo programme focussing on theoretical information that was delivered through a five-hour workshop. Both programmes were conducted by the same presenter during Week 1 of the second semester of the 2012-2013 academic year. Data were gathered immediately before (T1), one week after (T2) and five weeks (T3) after the intervention. Psychological health was measured using the Depression Anxiety Stress Scale (DASS-21), the General Self-Efficacy (GSE), and the Satisfaction With Life Scale (SWLS). Academic performance was measured using students' academic weighted grades (WG). Student cognitive and emotional perceptions of the intervention were measured using the Credibility/Expectancy Questionnaire (CEQ).
RESULTS: Data from 317 students, who completed the follow ups, were analysed across the three time periods (IG, n = 155; CG, n = 162). The baseline variables and demographic data of the IG and CG were not significantly different. The IG showed short-term significant reductions in depression and anxiety in compared to CG from T1 to T2. The short-term changes in stress, GSE and SWLS of the IG were not significantly different from those of the CG. While both groups showed a significant change on most of the psychological variables from T1 to T3, no significant differences were found between the groups in this period. In addition, no significant difference was found in WG between the IG and CG after the intervention. No harms relevant to the intervention were reported.
CONCLUSION: The investigated self-development coaching programme showed only a short-term improvement on depression and anxiety compared with an active control. There was no effect of the intervention on academic performance.
Trial registration: actrn12614000896673.
BMC Medical Education, 15 : 134
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Pachankis, J. E., Hatzenbuehler, M. L., Rendina, H. J., Safren, S. A., Parsons, J. T.
Objectives: We tested the preliminary efficacy of a transdiagnostic cognitive-behavioral treatment adapted to improve depression, anxiety, and co-occurring health risks (i.e., alcohol use, sexual compulsivity, condomless sex) among young adult gay and bisexual men. Treatment adaptations focused on reducing minority stress processes that underlie sexual orientation-related mental health disparities. Method: Young gay and bisexual men (n = 63; M age = 25.94) were randomized to immediate treatment or a 3-month waitlist. At baseline, 3-month, and 6-month assessments, participants completed self-reports of mental health and minority stress and an interview of past-90-day risk behavior. Results: Compared to waitlist, treatment significantly reduced depressive symptoms (b =-2.43, 95% CI:-4.90, 0.35, p <.001), alcohol use problems (b =-3.79, 95% CI:-5.94,-1.64, p <.001), sexual compulsivity (b =-5.09, 95% CI:-8.78,-1.40, p <.001), and past-90-day condomless sex with casual partners (b =-1.09, 95% CI:-1.80,-0.37, p <.001), and improved condom use self-efficacy (b = 10.08, 95% CI: 3.86, 16.30, p <.001). The treatment yielded moderate and marginally significant greater improvements than waitlist in anxiety symptoms (b =-2.14, 95% CI:-4.61, 0.34, p =.09) and past-90-day heavy drinking (b =-0.32, 95% CI:-0.71, 0.07, p =.09). Effects were generally maintained at follow-up. Minority stress processes showed small improvements in the expected direction. Conclusion: This study demonstrated preliminary support for the first intervention adapted to address gay and bisexual men's co-occurring health problems at their source in minority stress. If found to be efficacious compared to standard evidence-based treatments, the treatment will possess substantial potential for helping clinicians translate LGB-affirmative treatment guidelines into evidence-based practice.
Journal of Consulting & Clinical Psychology, 83(5) : 875-886
- Year: 2015
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Niles, A. N., Craske, M. G., Lieberman, M. D., Hur, C.
Exposure is an effective treatment for anxiety but many patients do not respond fully. Affect labeling (labeling emotional experience) attenuates emotional responding. The current project examined whether affect labeling enhances exposure effectiveness in participants with public speaking anxiety. Participants were randomized to exposure with or without affect labeling. Physiological arousal and self-reported fear were assessed before and after exposure and compared between groups. Consistent with hypotheses, participants assigned to Affect Labeling, especially those who used more labels during exposure, showed greater reduction in physiological activation than Control participants. No effect was found for self-report measures. Also, greater emotion regulation deficits at baseline predicted more benefit in physiological arousal from exposure combined with affect labeling than exposure alone. The current research provides evidence that behavioral strategies that target prefrontal-amygdala circuitry can improve treatment effectiveness for anxiety and these effects are particularly pronounced for patients with the greatest deficits in emotion regulation.
Copyright © 2015 Elsevier Ltd. All rights reserved.
Behaviour Research & Therapy, 68 : 27-36
- Year: 2015
- Problem: Anxiety Disorders (any), Specific Phobia
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Exposure therapy, Exposure and response prevention, Other Psychological Interventions
Ratanasiripong, P., Park, J. F., Ratanasiripong, N., Kathalae, D.
Background: The current study investigated the efficacy of two brief intervention programs-biofeedback and mindfulness meditation-on levels of state anxiety and perceived stress in second-year Thai nursing students as they began clinical training.; Method: Eighty-nine participants from a public nursing college in Thailand were randomly assigned to one of three groups: biofeedback group, mindfulness meditation group, or a control group. All participants were given pre- and postintervention surveys, which included demographic information; the State-Trait Anxiety Inventory (State Anxiety Scale); and the Perceived Stress Scale.; Results: Findings indicated that biofeedback significantly reduced anxiety and maintained stress levels in nursing students. Mindfulness meditation similarly decreased anxiety levels, while also significantly lowering stress levels. The biofeedback group exhibited significant reduction in anxiety levels among the three groups at postintervention.; Conclusion: Despite stressors and demands nursing students experience as they begin clinical practice, study findings support the use of biofeedback and mindfulness meditation interventions to assist nursing students in managing stress and anxiety.; Copyright 2015, SLACK Incorporated.
Journal of Nursing Education, 54(9) : 520-524
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Mindfulness based therapy, Biofeedback, neurofeedback, audio/video feedback
Peris, T. S., Compton, S. N., Kendall, P. C., Birmaher, B., Sherrill, J., March, J., Gosch, E., Ginsburg, G., Rynn, M., McCracken, J.T., Keeton, C. P., Sakolsky, D., Suveg, C., Aschenbrand, S., Almirall, D., Iyengar, S., Walkup, J. T., Albano, A. M., Piacentini, J.,
Objective: To evaluate changes in the trajectory of youth anxiety following the introduction of specific cognitive-behavior therapy (CBT) components: relaxation training, cognitive restructuring, and exposure tasks. Method: Four hundred eighty-eight youths ages 7-17 years (50% female; 74% < 12 years) were randomly assigned to receive either CBT, sertraline (SRT), their combination (COMB), or pill placebo (PBO) as part of their participation in the Child/Adolescent Anxiety Multimodal Study (CAMS). Youths in the CBT conditions were evaluated weekly by therapists using the Clinical Global Impression Scale-Severity (CGI-S; Guy, 1976) and the Children's Global Assessment Scale (CGAS; Shaffer et al., 1983) and every 4 weeks by blind independent evaluators (IEs) using the Pediatric Anxiety Ratings Scale (PARS; RUPP Anxiety Study Group, 2002). Youths in SRT and PBO were included as controls. Results: Longitudinal discontinuity analyses indicated that the introduction of both cognitive restructuring (e.g., changing self-talk) and exposure tasks significantly accelerated the rate of progress on measures of symptom severity and global functioning moving forward in treatment; the introduction of relaxation training had limited impact. Counter to expectations, no strategy altered the rate of progress in the specific domain of anxiety that it was intended to target (i.e., somatic symptoms, anxious self-talk, avoidance behavior). Conclusions: Findings support CBT theory and suggest that cognitive restructuring and exposure tasks each make substantial contributions to improvement in youth anxiety. Implications for future research are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (journal abstract).
Journal of Consulting & Clinical Psychology, 83(2) : 239-252
- Year: 2015
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, Specific Phobia
- 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)
O'Dea, B., Calear, A. L., Perry, Y.
Purpose of review: Depression and anxiety are prevalent among adolescents; however, many young people do not seek help from professional services. This is due, in part, to the inadequacies of existing healthcare systems. This article aims to review the current evidence for e-health interventions for depression and anxiety in youth, as a potential solution to the gaps in mental health service provision. Recent findings: Five randomized controlled trials reporting on e-health interventions for youth depression or anxiety were identified. Of these, two trials focused exclusively on anxiety symptoms, and three trials examined both anxiety and depression. The majority of trials assessed online cognitive behavioral therapy and focused on prevention rather than treatment. In all but one trial, results demonstrated positive effects for the e-health interventions, relative to the control. Summary: There is growing evidence for the effectiveness of online cognitive behaviour therapy interventions for reducing the level of anxiety and depressive symptoms in adolescents aged between 12 and 18 years, when delivered in school and clinical settings, with some level of supervision. However, there are a number of gaps in the literature. More research is needed to strengthen the evidence base for prevention and treatment programs that are delivered via the internet, particularly for depression. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Current Opinion in Psychiatry, 28(4) : 336-342
- Year: 2015
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Technology, interventions delivered using technology (e.g. online, SMS)
Ori, R., Amos, T., Bergman, H., Soares-Weiser, K., Ipser, J. C., Stein, D. J.
Background: A significant number of patients who suffer with anxiety and related disorders (that is post-traumatic stress disorder (PTSD), social anxiety disorder (SAnD), panic disorder with or without agoraphobia (PD), specific phobia (SPh) and obsessive compulsive disorder (OCD)) fail to respond optimally to first-line treatment with medication or cognitive and behavioural therapies. The addition of d-cycloserine (DCS) to cognitive and behavioural therapies may improve treatment response by impacting the glutamatergic system. This systematic review aimed to investigate the effects of adding DCS to cognitive and behavioural therapies by synthesising data from relevant randomised controlled trials and following the guidelines recommended by Cochrane.; Objectives: To assess the effect of DCS augmentation of cognitive and behavioural therapies compared to placebo augmentation of cognitive and behavioural therapies in the treatment of anxiety and related disorders. Additionally, to assess the efficacy and tolerability of DCS across different anxiety and related disorders.; Search Methods: This review fully incorporates studies identified from a search of the Cochrane Depression, Anxiety and Neurosis Controlled Trials Register (CCDANCTR) to 12 March 2015. This register includes relevant randomised controlled trials (RCTs) from: the Cochrane Library (all years), EMBASE (1974 to date), MEDLINE (1950 to date), PsycINFO (1967 to date), the World Health Organization's trials portal (ICTRP) and ClinicalTrials.gov . Reference lists from previous meta-analyses and reports of RCTs were also checked. No restrictions were placed on language, setting, date or publication status.; Selection Criteria: All RCTs of DCS augmentation of cognitive and behavioural therapies versus placebo augmentation of cognitive and behavioural therapies for anxiety and related disorders were included.; Data Collection and Analysis: Two authors (RO and TA) independently assessed RCTs for eligibility and inclusion, extracted outcomes and risk of bias data and entered these into a customised extraction form. Investigators were contacted to obtain missing data. In addition, data entry and analysis were performed by two review authors (KSW and HB).; Main Results: Twenty-one published RCTs, with 788 participants in outpatient settings, were included in the review. Sixteen studies had an age range of 18 to 75 years, while four investigated paediatric populations aged 8 to 17 years and one included children, adolescents and adults. The 21 RCTs investigated OCD (number of RCTs (N) = 6), PTSD (N = 5), SAnD (N = 5), SPh (N = 3) and PD (N = 2). Most information from the studies was rated as having either low risk or unclear risk of bias.There was no evidence of a difference between DCS augmentation of cognitive and behavioural therapies and placebo augmentation of cognitive and behavioural therapies for the treatment of anxiety and related disorders in adults at the endpoint (treatment responders, N = 9, risk ratio (RR) 1.10; 95% confidence interval (CI) 0.89 to 1.34; number of participants (n) = 449; low quality evidence) and between 1 and 12 months follow-up (N = 7, RR 1.08; 95% CI 0.90 to 1.31; n = 383). DCS augmentation of cognitive and behavioural therapies was not superior to placebo augmentation of cognitive and behavioural therapies for children and adolescents, both at the endpoint (N = 4, RR 1.01; 95% CI 0.78 to 1.31; n = 121; low quality evidence) and between 3 and 12 months follow-up (N = 3, RR 0.86; 95% CI 0.67 to 1.09; n = 91).There was no evidence of a difference in treatment acceptability for DCS augmentation of cognitive and behavioural therapies compared with placebo augmentation of cognitive and behavioural therapies in adults (N = 16, RR 0.88; 95% CI 0.61 to 1.25; n = 740), nor in children and adolescents (N = 4, RR 0.90; 95% CI 0.17 to 4.69; n = 131). These conclusions were based on moderate quality evidence for adults, and very low quality evidence for children and adolescents. Although the observed difference was small, it is noteworthy that there was a high efficacy of exposure-based therapies alone in the included trials. Due to the limited number of studies, subgroup analysis of moderating factors for clinical and methodological effect could not take place.; Authors' Conclusions: This review found no evidence of a difference between DCS augmentation of cognitive and behavioural therapies and placebo augmentation of cognitive and behavioural therapies for treating anxiety and related disorders in children, adolescents and adults. These findings are based on low quality evidence from heterogenous studies with small sample sizes and incomplete data for clinical response, which precludes us from drawing conclusions on the use of DCS augmentation of cognitive and behavioural therapies at this stage. Given there is some promising preliminary data from individual studies, further research is necessary to assess DCS compared with placebo augmentation of cognitive and behavioural therapies, and determine mechanisms of action as well as magnitude of effect in anxiety and related disorders.;
Cochrane Database of Systematic Reviews, (5) : CD007803
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, D-cycloserine (DCS)
Pennant, M. E., Loucas, C. E., Whittington, C., Creswell, C., Fonagy, P., Fuggle, P., Kelvin, R., Naqvi, S., Stockton, S., Kendall, T., Bevington, D., Fairburn, C., Keen, D., Lamb, S., Larsson, L., Murphy, M., Pilling, S., Pugh, K., Ringwood, S., Sealey, C., Williams, P.
One quarter of children and young people (CYP) experience anxiety and/or depression before adulthood, but treatment is sometimes unavailable or inadequate. Self-help interventions may have a role in augmentingtreatment and this work aimed to systematically review the evidence for computerised anxiety and depression interventions in CYP aged 5-25 years old. Databases were searched for randomised controlled trials and 27 studies were identified. For young people (12-25 years) with risk of diagnosed anxiety disorders or depression, computerised CBT (cCBT) had positive effects for symptoms of anxiety (SMD-0.77, 95% CI-1.45 to-0.09, k=6, N=220) and depression (SMD-0.62, 95% CI-1.13 to-0.11, k=7, N=279). In a general population study of young people, there were small positive effects for anxiety (SMD-0.15, 95% CI-0.26 to-0.03; N=1273) and depression (SMD-0.15, 95% CI-0.26 to-0.03; N=1280). There was uncertainty around the effectiveness of cCBT in children (5-11 years). Evidence for other computerised interventions was sparse and inconclusive. Computerised CBT has potential for treating and preventing anxiety and depression in clinical and general populations of young people. Further program development and research is required to extend its use and establish its benefit in children.
Behaviour Research & Therapy, 67 : 1-18
- Year: 2015
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
, Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Technology, interventions delivered using technology (e.g. online, SMS)