Disorders - Anxiety Disorders
Stulmaker, H. L., Ray, D. C.
Traditional methods of treating anxiety have been less effective with young children. The researchers sought to explore effects of child-centered play therapy (CCPT) on young children with anxiety symptoms. Fifty-three participants between 6 and 8 years old were randomly assigned to the experimental or active control group. Children who received CCPT significantly decreased their overall levels of anxiety and worry. Overall, CCPT may be considered a developmentally appropriate treatment for young children who are anxious. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Children & Youth Services Review, 57 : 127-133
- 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
Swain, J., Hancock, K., Hainsworth, C., Bowman, J.
Described as a "third wave" behavioural and cognitive therapy, Acceptance and Commitment Therapy (ACT) reflects a synthesis and reformulation of concepts underpinned by prior waves including traditional cognitive behaviour therapy (CBT). This exploratory study aimed to examine the ACT hexaflex model as a mediator for therapeutic change among adolescents. The specific indirect effects of the core processes - acceptance and defusion, mindfulness/self-as-context and valued living/committed action (valued action) - collected at multiple time points, using measures with established psychometric reliability/validity, were also explored in terms of their actual and relative contribution to mediation effects. Finally, the specificity of observed mediation effects to ACT were identified through comparison to CBT. Data for the present investigation were collected as part of a larger randomised controlled trial of ACT versus CBT in the treatment of anxiety disorders among children aged 7-17 years. Participants were 49 adolescent outpatients (12-17 years) diagnosed with a DSM-IV anxiety disorder and their parent/caregivers, and were randomised into ACT (n=16), CBT (n=10) or waitlist control (WLC; n=23). The results do not support the finding that ACT processes mediated quality of life outcomes for ACT or CBT, and acceptance and defusion were the only predictors of outcome change. These findings add weight to the emergent idea that investigation into overarching mediators for the behavioural and cognitive therapies may be warranted. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Journal of Contextual Behavioral Science, 4(1) : 56-67
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Acceptance & commitment therapy (ACT)
Trousselard, M., Dutheil, F., Ferrer, M. H., Babouraj, N., Canini, F.
Background: Chronic work-related stress is a well-known public health problem, and it concerns Military populations. Stress responses lead to specific changes in immunity, physiologic systems, and regulation of stress hormones. Overexposure to stress has an important role in the development and courses of mental diseases, as well as being a factor in increased abdominal obesity, osteoporosis, infections, and cardiovascular problems. The aim of this research was to evaluate the effectiveness of two stress psychologic fitness management programs based on a mind-body approach to stress perception and stress reactivity in a Military population subjected to daily operational stress. Method: 180 young military fire fighter recruits were randomly assigned to a controlled intervention trial including three groups: a cognitive stress program (tactics to Optimized the Potential - TOP) group, an emotional CardioBioFeedback stress program (CBF) group, or a control group. The stress programs training lasted eight weeks, with one hour training per week. A placebo was administered as a nutriceutical in all three groups during the time of the training. Primary outcome variables included the perceived stress; second outcome variables included stress reactivity (mindfulness, negative mood, Immunoglobulin A levels). Post intervention effectiveness on the long-term programs' benefits was evaluated. Results: Both TOP and CBF stress programs reduce operational stress in military population. Although the size of the effects was small, they must be considered at the clinical level. Long-term effects depend on the frequency of daily practice. Results were discussed with reference to mind-body theory. Conclusions: Short stress programs intervention improved stress perception and stress reactivity in healthy workers. Recommendations about mind-body interventions were proposed for the military population.
Medical Acupuncture, 27(5) : 367-375
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Biofeedback, neurofeedback, audio/video feedback
Tang, T. C., Yang, P., Yen, C. F., Liu, T. L.
In this case-control study, we aimed to assess the intervention effects of foursession eye movement desensitization and reprocessing (EMDR) on reducing the severity of disaster-related anxiety, general anxiety, and depressive symptoms in Taiwanese adolescents who experienced Typhoon Morakot. A total of 83 adolescents with posttraumatic stress disorder related to Typhoon Morakot, major depressive disorder, or current moderate or high suicide risk after experiencing Typhoon Morakot were allocated to a four-session course of EMDR (N=41) or to treatment as usual (TAU; N = 42). A multivariate analysis of covariance was performed to examine the effects of EMDR in reducing the severity of disaster-related anxiety, general anxiety, and depressive symptoms in adolescents by using preintervention severity values as covariates. The multivariate analysis of covariance results indicated that the EMDR group exhibited significantly lower preintervention severity values of general anxiety and depression than did the TAU group. In addition, the preintervention severity value of disaster-related anxiety in the EMDR group was lower than that in the TAU group (p=0.05). The results of this study support that EMDR could alleviate general anxiety and depressive symptoms and reduce disaster-related anxiety in adolescents experiencing major traumatic disasters.
Kaohsiung Journal of Medical Sciences, 31(7) : 363-369
- Year: 2015
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Eye movement desensitisation and reprocessing (EMDR)
Storch, E. A., Salloum, A., King, M. A., Crawford, E. A., Andel, R., McBride, N. M., Lewin, A. B.
Objective This study aims to examine the real-world effectiveness of a computer-assisted cognitive behavioral therapy (CBT) protocol relative to treatment as usual (TAU) among anxious children presenting at community mental health centers. Methods One hundred children (7-13 years) with clinically significant anxiety were randomized to receive either 12 weekly computer-assisted CBT sessions or TAU for an equivalent duration. Assessments were conducted by independent evaluators at screening/baseline, midtreatment, posttreatment, and 1-month followup (for computer-assisted CBT treatment responders). Results There were significant between-group effects favoring the computer-assisted CBT condition on primary anxiety outcomes. Thirty of 49 (61.2%) children randomized to computer-assisted CBT responded to treatment, which was superior to TAU (6/51, 11.8%). Relative to TAU, computer-assisted CBT was associated with greater reductions in parent-rated child impairment and internalizing symptoms, but not child-rated impairment and anxiety and depressive symptoms. Treatment satisfaction and therapeutic alliance in those receiving computer-assisted CBT was high. Treatment gains in computer-assisted CBT responders were maintained at 1-month followup. Conclusions Within the limitations of this study, computer-assisted CBT is an effective and feasible treatment for anxious children when used in community mental health centers by CBT-naïve clinicians.
Depression & Anxiety, 32(11) : 843-852
- Year: 2015
- 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)
Waters, A. M., Groth, T. A., Sanders, M., O'Brien, R., Zimmer-Gembeck, M. J.
Clinical scientists are calling for strong partnerships in the provision of evidence-based treatments for child mental health problems in real-world contexts. In the present study, we describe the implementation of a cognitive-behavioral intervention (CBI) to address grade 5 children's anxiety symptoms. The CBI arose from a long-standing partnership between University and Education Department stakeholders. The partnership integrates school-based, evidence-informed treatment delivery with clinical education, and also supports a school-based psychology clinic to provide assessment and treatment services to children attending schools within the catchment area and clinical training for university graduate students. Children in the active condition (. N=. 74) completed the CBI during regular class time, while children in the control condition (. N=. 77) received the standard classroom curriculum. Children's anxiety and depressive symptoms, threat interpretation biases (perceived danger and coping ability), and perceptions of their social skills were assessed before and after condition. Children in the active condition reported significant improvements in self-reported anxiety symptoms, and perceptions of their social skills and coping ability, whereas no significant differences were observed for children in the control condition from pre- to post-assessment. For a subset of children assessed 12. months after the CBI (. n=. 76), symptom improvement remained stable over time and estimates of danger and coping ability showed even greater improvement. Results demonstrate the value of strong stakeholder partnerships in innovative youth mental health services, positive child outcomes, and clinical education.
Behavior Therapy, 46(6) : 844-855
- Year: 2015
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Waters, A. M., Zimmer-Gembeck, M. J., Craske, M. G., Pine, D. S., Bradley, B. P., Mogg, K.
Attention bias modification training (ABMT) is a promising treatment for anxiety disorders. Recent evidence suggests that attention training towards positive stimuli, using visual-search based ABMT, has beneficial effects on anxiety and attention biases in children. The present study extends this prior research using distinctive techniques designed to increase participant learning, memory consolidation, and treatment engagement. Fifty-nine clinically anxious children were randomly assigned to the active treatment condition (ATC) (N = 31) or waitlist control condition (WLC) (N = 28). In the ATC, children completed 12 treatment sessions at home on computer in which they searched matrices for a pleasant or calm target amongst unpleasant background pictures, while also engaging in techniques designed to consolidate learning and memory for these search strategies. No contact was made with children in the WLC during the wait period. Diagnostic, parent- and child-reports of anxiety and depressive symptoms, externalising behaviour problems and attention biases were assessed pre- and post-condition and six-months after treatment. Children in the ATC showed greater improvements on multiple clinical measures compared to children in the WLC. Post-treatment gains improved six-months after treatment. Attention biases for angry and happy faces did not change significantly from pre-to post-condition. However, larger pre-treatment attention bias towards threat was associated with greater reduction in anxiety at post-treatment. Also, children who showed greater consolidation of learning and memory strategies during treatment achieved greater improvement in global functioning at post-treatment. Attention training towards positive stimuli using enhanced visual-search procedures appears to be a promising treatment for childhood anxiety disorders. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Behaviour Research & Therapy, 73 : 111-123
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Attention/cognitive bias modification
Yang, W. L., Zhai, F., Gao, Y. M., Zhang, Q. H.
Objective: Study the auxiliary therapeutic effect of psychological counseling treatment after collective rehabilitation training of the patients with anxiety disorder. Methods: 38 college students with anxiety disorder are randomly divided into an experiment group and a control group, each of which consists of 19 students. The experiment group only receives psychological counseling treatment; the control group, based on psychological counseling treatment, receives the collective rehabilitation training, that is, the joint therapy. Results: before the treatment, the inter-group difference of the general data about the patients in 2 groups shows no statistically significance, P > 0.05, which is comparable; after 8 weeks' treatment, HAMA and SAS scores of the patients in 2 groups are significantly improved compared with those before treatment, P < 0.05; meanwhile, the improvement effect of the experiment group is better than that of the control group P < 0.05. After 3 months' follow-up, it is found that the recurrence rate of the experiment group is obviously lower than that of the control group P < 0.05. Conclusion: the joint treatment, consisting of psychological counseling and collective rehabilitation training, exercises synergetic effect on the college students who are anxiety disorder patients and its curative effect is obviously superior to the single psychological counseling and its recurrence rate is low.
International Journal of Clinical & Experimental Medicine, 8(6) : 9949-9954
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Supportive therapy, Physical activity, exercise
White, D. J., Cox, K. H. M., Peters, R., Pipingas, A., Scholey, A. B.
This study explored the effects of four-week multi-vitamin and mineral (MVM) supplementation on mood and neurocognitive function in healthy, young adults. Fifty-eight healthy adults, 18 - 40 years of age (M= 25.82 years, SD = 4.87) participated in this randomised, double-blind, placebo-controlled trial, in which mood and blood biomarkers were assessed at baseline and after four weeks of supplementation. Compared to placebo, MVM supplementation was associated with significantly lowered homocysteine and increased blood B-vitamin levels (p < 0.01). MVMtreatment was also associated with significantly improved mood, as measured by reduced scores on the "depression-dejection" subscale of the Profile of Mood States (p = 0.018). These findings suggest that the four weeks of MVM supplementation may have beneficial effects on mood, underpinned by elevated B-vitamins and lowered homocysteine in healthy young adults.
Nutrients, 7(11) : 9005-9017
- Year: 2015
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Vitamins and supplements
Whiteside, S. P., Ale, C. M., Young, B., Dammann, J. E., Tiede, M. S., Biggs, B. K.
This preliminary randomized controlled trial (RCT) examines the feasibility of dismantling cognitive behavioral therapy (CBT) for childhood anxiety disorders. Fourteen children (10 girls) ages 7 to 14 (m = 10.2) with social phobia, generalized anxiety disorder, separation anxiety disorder, or panic disorder were randomized to receive 6 sessions of either a) the pre-exposure anxiety management strategies presented in traditional CBT, or b) parent-coached exposure therapy. The sample was selected from a treatment seeking population and is representative of children in clinical settings. Examination of fidelity ratings, dropouts, and satisfaction ratings indicated that the interventions were distinguishable, safe, and tolerable. The overall sample improved significantly with pre-post effect sizes generally in the large range for both conditions. Between-group effect sizes indicating greater improvement with parent-coached exposure therapy were moderate or large for ten of 12 variables (i.e., 0.53 to 1.52). Re-evaluation after three months of open treatment suggested that the intervention emphasizing exposure early maintained its superiority while requiring fewer appointments. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Behaviour Research & Therapy, 73 : 83-89
- Year: 2015
- Problem: Anxiety Disorders (any), Panic Disorder, Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Exposure therapy, Exposure and response prevention
Strawn, J. R., Welge, J. A., Wehry, A. M., Keeshin, B., Rynn, M. A.
Background: Randomized controlled trials have demonstrated that antidepressants are efficacious in the treatment of anxiety disorders in youth. However, there are no recent, systematic analyses of the efficacy, safety, or tolerability of these medications in pediatric anxiety disorders.; Methods: A systematic review and meta-analysis of prospective, randomized, parallel-group, controlled trials of selective serotonin reuptake inhibitors (SSRIs) and selective serotonin-norepinephrine reuptake inhibitors (SSNRIs) in pediatric patients with non-obsessive compulsive disorder (OCD) anxiety disorders was undertaken using a search of PubMed/Medline (1966-2014). The meta-analysis utilized random-effects models to evaluate change in the Pediatric Anxiety Rating Scale or similar anxiety scale, suicidality, and adverse events. Additionally, pharmacologic variables were explored with regard to effect size, although no correction for multiple comparisons was made with regard to these relationships.; Results: Nine trials involving 1,673 patients and six medications were included. All SSRI/SSNRIs evaluated demonstrated efficacy, and the meta-analytic estimate of effect was of moderate magnitude (Cohen's d = 0.62, confidence interval [CI]: 0.34-0.89, P = .009) and there was evidence of modest heterogeneity (I(2) = 0.29, P = .103). Activation trended toward being more likely with antidepressant treatment (OR: 1.86, CI: 0.98-3.53, P = .054), but no increased risk was observed for nausea/abdominal symptoms (P = .262), discontinuation as a result of an adverse event (P = .132), or suicidality (OR: 1.3, CI: 0.53-3.2, P = .514). Finally, the effect size correlated with the serotonergic specificity of the agent (R = .79, P = .021).; Conclusions: Data for nine SSRI/SSNRIs suggest superiority of antidepressants relative to placebo for the treatment of pediatric anxiety disorders with a moderate effect size.; © 2014 Wiley Periodicals, Inc.
Depression & Anxiety, 32(3) : 149-157
- Year: 2015
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs), Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Swain, J., Hancock, K., Dixon, A., Bowman, J.
An emerging body of research demonstrates the effectiveness of Acceptance and Commitment Therapy (ACT) in the treatment of adult psychopathology, with several reviews and meta-analyses attesting to its effectiveness. While there are comparatively fewer empirical studies of child populations, the past few years has seen burgeoning research interest in the utility of ACT for problems in childhood. A systematic review of the published and unpublished literature was conducted to examine the evidence for ACT in the treatment of children and to provide support for clinical decision making in this area. Searches of PsycInfo, PsycArticles, PsycExtra, Proquest and the Association for Contextual Behavioral Science databases were undertaken, as well as reference lists and citation searches conducted, up to December 2014. Broad inclusion criteria were employed to maximise review breadth. Methodological quality was assessed and a narrative synthesis approach adopted. Twenty-one studies covering a spectrum of presenting problems met inclusion criteria, with a total of 707 participants. Studies were predominantly within-group designs, with a lesser proportion of case studies/series, between-group and randomised controlled trials. The preponderance of evidence suggests ACT results in improvements in clinician, parent and self-reported measures of symptoms, quality of life outcomes and/or psychological flexibility, with many studies demonstrating further gains at follow-up assessment. However, several methodological weaknesses limit conclusions, including small samples, non-randomised designs, and few alternative treatment or control comparisons. While larger scale, methodologically rigorous trials from a broader research teams are needed to consolidate these preliminary findings, emerging evidence suggests ACT is effective in the treatment of children across a multitude of presenting problems. ACT may be a viable alternative treatment option for clinicians working with young people.
Journal of Contextual Behavioral Science, 4(2) : 73-85
- Year: 2015
- Problem: Anxiety Disorders (any), Depressive Disorders, Eating Disorders (any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Acceptance & commitment therapy (ACT)