Disorders - Anxiety Disorders
Sawyer, M. C., Nunez, D. E.
Anxiety is the most common mental health problem in children, yet less than one third of children with anxiety disorders seek treatment. Cognitive-behavioral therapy (CBT) is recommended as a first-line treatment for childhood anxiety. However, current practice generally does not include CBT due to issues of feasibility, affordability, and transportability. The primary purpose of this review was to appraise current literature regarding the effectiveness of individual CBT for childhood anxiety. Secondary purposes were to identify reasons for the discrepancy between current evidence and practice as well as to offer suggestions to overcome this dilemma. A systematic review of the literature published between 2007 and 2012 was conducted, searching four databases--Cochrane, PubMed, CINAHL, and PsycINFO. In all 10 studies reviewed, individual CBT significantly reduced rates of anxiety diagnoses when compared with controls, and was equally effective or superior to comparison therapies. The only exception was when CBT was compared to a combination of CBT and pharmacological management, in which case the latter was more effective. Each study included in this review employed hour-long sessions over a minimum of 12 visits. In order to meet clinical demands and patient preferences, affordability, and feasibility of CBT interventions must be addressed. A brief, manualized CBT program that can be supported to be clinically effective is proposed as an evidence-based solution for anxious children in outpatient mental health and primary care settings. (copyright) 2014 Sigma Theta Tau International.
Worldviews on Evidence-Based Nursing, 11(1) : 65-71
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Scholey, A., Gibbs, A., Neale, C., Perry, N., Ossoukhova, A., Bilog, V., Kras, M., Scholz, C., Sass, M., Buchwald-Werner, S.
Lemon balm (Melissa officinalis) has been used historically and contemporarily as a modulator of mood and cognitive function, with anxiolytic effects following administration of capsules, coated tablets and topical application. Following a pilot study with lemon balm extract administered as a water based drink, which confirmed absorption of rosmarinic acid effects on mood and cognitive function, we conducted two similar double-blind, placebo-controlled, crossover studies. These evaluated the mood and cognitive effects of a standardised M. officinalis preparation administered in palatable forms in a beverage and in yoghurt. In each study a cohort of healthy young adultsnull self-rated aspects of mood were measured before and after a multi-tasking framework (MTF) administered one hour and three hours following one of four treatments. Both active lemon balm treatments were generally associated with improvements in mood and/or cognitive performance, though there were some behavioral nullcostsnull at other doses and these effects depended to some degree on the delivery matrix.
Nutrients, 6(11) : 4805-4821
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Homeopathic, plant-based medicines
Shechner, T., Rimon-Chakir, A., Britton, J. C., Lotan, D., Apter, A., Bliese, P. D., Pine, D. S., Bar-Haim, Y.
Objective: Attention bias modification treatment (ABMT) is a promising novel treatment for anxiety disorders, but clinical trials have focused largely on stand-alone formats among adults. This randomized controlled trial examined the augmenting effects of threat-based ABMT on cognitive behavioral therapy (CBT) in clinically anxious youth. Method: Sixty-three treatment-seeking children with anxiety disorder were randomly assigned to 1 of the following 3 treatment groups: ABMT + CBT; ABMT placebo + CBT; and CBT-alone. Participants in the 2 ABMT conditions received repeated training on dot-probe tasks either designed to shift attention away from threats (active) or designed to induce no changes in attention patterns (placebo). Primary outcome measures were frequency and severity of anxiety symptoms as determined by a clinician using a semi-structured interview. Self- and parent-rated anxiety measures and threat-related attention bias scores were also measured before and after treatment. Results: Both the active and placebo ABMT groups showed greater reductions in clinician-rated anxiety symptoms than the CBT-alone group. Furthermore, only the active ABMT group showed significant reduction in self- or parent-rated anxiety symptoms. Finally, all groups showed a shift in attention patterns across the study, starting with a bias toward threat at baseline and shifting attention away from threat after treatment. Conclusions: Active and placebo ABMT might augment the clinical response to CBT for anxiety. This effect could arise from benefits associated with performing computer-based paradigms such as the dot-probe task. Given the absence of group differences in attention-bias changes during treatment, possible mechanisms and methodological issues underlying the observed findings are discussed.
Journal of the American Academy of Child & Adolescent Psychiatry, 53(1) : 61-71
- Year: 2014
- 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)
, Attention/cognitive bias modification
Sanal, A. M., Gorsev, S.
This randomized controlled trial aimed to quantify the effects of choir singing on emotional state and anxiety levels of singers. Salivary amylase, PANAS (Positive and Negative Affect Schedule) and STAI-s/-t(State-Trait Anxiety Inventory) were applied before and after a 1-hour single choir session for an experimental group (n = 35) and unstructured time for control group (n = 35). Amylase decreased in the experimental group but increased in the control group (p > 0.05 for Fgroup; p = 0.014 for Ftestbygroup). Follow-up analysis showed this interaction to be due to baseline differences between the two groups. Negative affect decreased in the experimental group and increased in the control group (p > 0.05 for Ftest and Fgroup; p = 0.006 for Ftest by group). A decrease in positive affect was found between the pre- and post-test for the control group (p = 0.023 for Ftest; p = 0.004 for Ftest by group). State anxiety decreased in the experimental group and increased in the control group (p > 0.05 for Ftest and Fgroup; p = 0.001 for Ftest by group). Singing in a choir was found to have a positive impact on psychological indicators of affect and anxiety, however, its physiological effect could not be shown using salivary amylase in this study. (PsycINFO Database Record (c) 2014 APA, all rights reserved). (journal abstract)
Psychology of Music, 42(3) : 420-429
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
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Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Creative expression: music, dance, drama, art
Schmidt, M., Freund, Y., Alves, M., Monsel, A., Labbe, V., Darnal, E., Messika, J., Bokobza, J., Similowski, T., Duguet, A.
Background: Oral presentations of clinical cases by medical students during medical rounds in hospital wards are a source of anxiety and little is known about how this anxiety can be alleviated. The objective of this study was to investigate whether video-based feedback of public oral presentations can reduce anxiety in 4th year medical students.; Methods: Multicentre randomized study conducted in six intensive care units (ICU) and emergency departments (ED) in France over a 9-month period in 2012. One hundred and forty two 4th year medical students were randomized to two groups: intervention and control. Students in the intervention group were recorded while making an oral presentation of a patient during morning ward rounds, followed by video-based feedback. Students in the control group conducted presented classical oral presentations without being filmed and with no formal feedback. Anxiety levels during a public oral presentation were assessed using the Spielberger State Anxiety Inventory (STAI-S). The primary outcome was the difference in STAI-S scores between groups at the beginning and at the end of a 3-month ICU or ED internship.; Results: Seventy four students were randomized to the 'video-based feedback' group and 68 were randomized to the control group. In both groups, STAI-S scores were significantly lower after 3 months of internship. However, the reduction in STAI-S scores was significantly greater in the "video-based feedback" group than in controls (-9.2 ± 9.3 vs. -4.6 ± 8.2, p = 0.024. Compared to the control group, significantly fewer students with high-level anxiety were observed in the "video-based feedback" group after 3 months of internship (68 vs. 28%, p <0.001).; Conclusions: Compared to "usual practice", video-assisted oral feedback reduced anxiety and significantly decreased the proportion of students experiencing severe anxiety.;
BMC Medical Education, 14 : 103-103
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
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Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Biofeedback, neurofeedback, audio/video feedback
Saravanan, C., Kingston, R.
Test anxiety aggravates psychological distress and reduces the motivation among graduate students. This study aimed to identify psychological intervention for test anxiety, which reduces the level of psychological distress, amotivation and increases the intrinsic and extrinsic motivation among medical students. Materials and Methods: Westside test anxiety scale, Kessler Perceived Stress Scale and Academic Motivation Scale were used to measure test anxiety, psychological distress and motivation on 436 1st year medical students. Out of 436 students, 74 students who exhibited moderate to high test anxiety were randomly divided into either experimental or waiting list group. In this true randomized experimental study, 32 participants from the intervention group received five sessions of psychological intervention consist of psychoeducation, relaxation therapy and systematic desensitization. Thirty-three students from waiting list received one session of advice and suggestions. Results: After received psychological intervention participants from the intervention group experienced less anxiety, psychological distress, and amotivation (P < 0.01) and high intrinsic and extrinsic motivation (P < 0.01) in the postassessment compared with their preassessment scores. Conclusion: Overall psychological intervention is eff ective to reduce anxiety scores and its related variables.
Journal of Research in Medical Sciences, 19(5) : 391-397
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
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Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Psychoeducation, Other Psychological Interventions, Relaxation
Sadjadi, S. A., Hashemian, P.
Background: Anxiety disorders are one of the most common psychiatric disorders in children. Its incidence is 2-5% of children and adolescents under age 18. Anxiety disorders are more common in girls than boys. It may start in pre-school, but mostly are in age of 7 to 8 years old. Method: The main objective of this article was to find out the effect of neurofeedback therapy in children with separation-anxiety disorder. Study population was Children from 7 to 12 years old with separation anxiety disorder who were referred to the child psychiatric clinic and they were divided randomly into two groups of 12. One group (N=12) received neurofeedback therapy and the other group (N=12) received sham neurofeedback therapy (placebo). Data was analyzed with t- test by 21th version SPSS software. Results: According to calculated t-test in neurofeedback group (8.18), neurofeedback was effective in reducing separation anxiety and the efficacy of treatment was great. But according to calculated t-test in sham group (4.42), reduction of separation anxiety was moderate. Therefore the efficacy of treatment in neurofeedback and sham groups was different. Conclusion: The results revealed that the efficacy of treatment of neurofeedback and sham groups on separation anxiety in children is different. Comparison of efficacy shows that effectiveness of neurofeedback treatment on separation anxiety was much more in the group treated with Neurofeedback than in the sham group.
African Journal of Psychiatry (South Africa), 17(6) :
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Biofeedback, neurofeedback, audio/video feedback
Zandvakili, M., Jalilvand, M., Nikmanesh, Z.
Background: The positive psychology always seeks to recognize and describe the pleasure and subjective well-being. The main issue of this field is to improve the well-being and recognize the positive aspects in order to reinforce them to prevent and develop the mental health. The aim of the present study is to investigate the effect of positive thinking training workshop on reduction of depression, stress and anxiety of juveniles at Correction and Rehabilitation Centers. Methods: The quasi-experimental method was used in this study and the depression, anxiety and stress scale (DASS-21) was used. Forty one subjects participated in this research and were divided into two homogeneous groups based on their pretest scores and were randomly included in the experimental and control groups. The positive thinking training workshop was performed for 10 sessions within three weeks on experimental group and after that the posttest and after one month the follow up test were performed. Results: The results have shown that the positive thinking training courses have effects on reduction of depression and anxiety. But it had not effects on stress in the follow up study. Conclusion: Thus, this training can be used for reduction of depression and anxiety of juvenile at Correction and Rehabilitation Center. (copyright) 2014 Forensic Medicine and Toxicology Department.
International Journal of Medical Toxicology & Forensic Medicine, 4(2) : 55-62
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Controlled clinical trials
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Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Positive psychology
Ye, X., Bapuji, S. B., Winters, S. E., Struthers, A., Raynard, M., Metge, C., Kreindler, S. A., Charette, C. J., Lemaire, J. A., Synyshyn, M., Sutherland, K.
METHODS: We searched five literature databases (PubMed, EMBASE, CINAHL, PsychInfo, and Google Scholar) for studies published between January 1990 and December 2012. We included studies evaluating the effectiveness of internet-based interventions for children, youth, and young adults (age <25 years) with anxiety and/or depression and their parents. Two reviewers independently assessed the risk of bias regarding selection bias, allocation bias, confounding bias, blinding, data collection, and withdrawals/dropouts. We included studies rated as high or moderate quality according to the risk of bias assessment. We conducted meta-analyses using the random effects model. We calculated standardized mean difference and its 95% confidence interval (95% CI) for anxiety and depression symptom severity scores by comparing internet-based intervention vs. waitlist control and internet-based intervention vs. face-to-face intervention. We also calculated pooled remission rate ratio and 95% CI.
RESULTS: We included seven studies involving 569 participants aged between 7 and 25 years. Meta-analysis suggested that, compared to waitlist control, internet-based interventions were able to reduce anxiety symptom severity (standardized mean difference and 95% CI = -0.52 [-0.90, -0.14]) and increase remission rate (pooled remission rate ratio and 95% CI =3.63 [1.59, 8.27]). The effect in reducing depression symptom severity was not statistically significant (standardized mean difference and 95% CI = -0.16 [-0.44, 0.12]). We found no statistical difference in anxiety or depression symptoms between internet-based intervention and face-to-face intervention (or usual care).
CONCLUSIONS: The present analysis indicated that internet-based interventions were effective in reducing anxiety symptoms and increasing remission rate, but not effective in reducing depression symptom severity. Due to the small number of higher quality studies, more attention to this area of research is encouraged.
TRIAL REGISTRATION: PROSPERO registration: CRD42012002100.
BACKGROUND: The majority of internet-based anxiety and depression intervention studies have targeted adults. An increasing number of studies of children, youth, and young adults have been conducted, but the evidence on effectiveness has not been synthesized. The objective of this research is to systematically review the most recent findings in this area and calculate overall (pooled) effect estimates of internet-based anxiety and/or depression interventions.
BMC health services research, 14 : 313
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: 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)
Stevanovic, D., Tadic, I., Knez, R.
There is some evidence indicating that psychotropic medications might lead to health-related quality of life (QOL) improvements among children and adolescents with psychiatric disorders. The aim of this systematic review is to assess evidence regarding whether antidepressant treatment improves QOL among children and adolescents with depressive or anxiety disorders. A comprehensive search resulted in 5 clinical trials to be included in this review: 4 trials with major depressive disorder (MDD) and 1 trial with social anxiety disorder (SAD). In one MDD trial, fluoxetine combined with cognitive behavior therapy (CBT) significantly improved QOL compared to fluoxetine or CBT alone (effect sizes were 0.53 and 0.69, respectively). In 2 combined trials, sertraline alone significantly improved QOL among adolescents with MDD (effect size was 0.29), but not among children with MDD. Essentially, it was observed that antidepressants in these trials had minor positive effects on QOL improvement, which were lower than their potential to improve depressive symptoms. Although fluoxetine with CBT or sertraline monotherapy were shown to have some potential to improve QOL, this systematic review found inconclusive evidence that antidepressant treatments improve QOL among children and adolescents with depressive or anxiety disorders. More research is required, considering that QOL is currently under-evaluated in clinical trials with antidepressants among children and adolescents and available trials have limited methodological quality when reporting QOL data.
CNS Spectrums, 19(2) : 134-141
- Year: 2014
- Problem: Anxiety Disorders (any), Social phobia (social anxiety disorder)
, Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs)
Thulin, U., Svirsky, L., Serlachius, E., Andersson, G., Ost, L-G.
Among clinicians, it is common practice to include parents in treatment, and it has been taken for granted that parents' involvement in their children's treatment is beneficial for therapy outcome, although research on this issue is far from clear. A meta-analysis was carried out in order to investigate whether parent involvement potentiates the outcome for children with anxiety disorders when treated with cognitive-behavior therapy. Sixteen studies, which directly compared parent-involved treatments with child-only treatments, were included in the meta-analysis. The results showed a small, nonsignificant effect size of - 0.10 in favor of the child-only treatments. There was no indication of publication bias in the analysis. Implications of the results are discussed.;
Cognitive Behaviour Therapy, 43(3) : 185-200
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Other Psychological Interventions
Wong, N, Kady, L, Mewton, L, Sunderland, M, Andrews, G
The aims of the current study were to 1) establish the efficacy of two Internet-based prevention programmes to reduce anxiety and depressive symptoms in adolescents; and 2) investigate the distribution of psychological symptoms in a large sample of Australian adolescents prior to the implementation of the intervention. A cluster randomised controlled trial was conducted with 976 Year 9-10 students from twelve Australian secondary schools in 2009. Four schools were randomly allocated to the Anxiety Internet-based prevention programme (n = 372), five schools to the Depression Internet-based prevention programme (n = 380) and three to their usual health classes (n = 224). The Thiswayup Schools for Anxiety and Depression prevention courses were presented over the Internet and consist of 6-7 evidence-based, curriculum consistent lessons to improve the ability to manage anxiety and depressive symptoms. Participants were assessed at baseline and post-intervention. Data analysis was constrained by both study attrition and data corruption. Thus post-intervention data were only available for 265/976 students. Compared to the control group, students in the depression intervention group showed a significant improvement in anxiety and depressive symptoms at the end of the course, whilst students in the anxiety intervention demonstrated a reduction in symptoms of anxiety. No significant differences were found in psychological distress. The Thiswayup Schools Depression and Anxiety interventions appear to reduce anxiety and depressive symptoms in adolescents using a curriculum based, blended online and offline cognitive behavioural therapy programme that was implemented by classroom teachers. Given the study limitations, particularly the loss of post-intervention data, these findings can only be considered preliminary and need to be replicated in future research. (copyright) 2014.
Internet Interventions, 1(2) : 90-94
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Technology, interventions delivered using technology (e.g. online, SMS)