Disorders - Anxiety Disorders
Wergeland, G. J. H., Fjermestad, K. W., Marin, C. E., Haugland, BS-M., Bjaastad, J. F., Oeding, K., Bjelland, I., Silverman, W. K., Ost, L-G., Havik, O. E., Heiervang, E. R.
Objective: Conducted a randomized controlled trial to investigate the effectiveness of cognitive behavioral therapy (CBT), and compared the relative effectiveness of individual (ICBT) and group (GCBT) treatment approaches for anxiety disorders in children and adolescents.; Methods: Referred youth (N = 182, M age = 11.5 years, range 8-15 years, 53% girls) with separation anxiety, social phobia, or generalized anxiety disorder were randomly assigned to ICBT, GCBT or a waitlist control (WLC) in community clinics. Pre-, post-, and one year follow-up assessments included youth and parent completed diagnostic interview and symptom measures. After comparing CBT (ICBT and GCBT combined) to WLC, ICBT and GCBT were compared along diagnostic recovery rates, clinically significant improvement, and symptom measures scores using traditional hypothesis tests, as well as statistical equivalence tests.; Results: Significantly more youth lost all anxiety disorders after CBT compared to WLC. Full diagnostic recovery rate was 25.3% for ICBT and 20.5% in GCBT, which was not significantly different. There was continued lack of significant differences between ICBT and GCBT at one year follow-up. However, equivalence between GCBT and ICBT could only be demonstrated for clinical severity rating of the principal anxiety disorder and child reported anxiety symptoms post-treatment.; Conclusion: Findings support the effectiveness of CBT compared to no intervention for youth with anxiety disorders, with no significant differences between ICBT and GCBT. However, the relatively low recovery rates highlight the need for further improvement of CBT programs and their transportability from university to community settings.; Copyright © 2014 Elsevier Ltd. All rights reserved.
Behaviour Research & Therapy, 57 : 1-12
- Year: 2014
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Other service delivery and improvement interventions
Wild, K., Scholz, M., Ropohl, A., Brauer, L., Paulsen, F., Burger, P. H. M.
Burnout and stress-related mental disorders (depression, anxiety) occur in medical students and physicians with a significantly higher prevalence than in the general population. At the same time, the learning of coping mechanisms against stress is still not an integral part of medical education. In this pilot study we developed an elective course for learning relaxation techniques and examined the condition of the students before and after the course. 42 students participated in the semester courses in 2012 and 2013 as well as in a survey at the start and end of each course. The students were instructed in autogenic training (AT) and progressive muscle relaxation according to Jacobsen (PMR) with the goal of independent and regular exercising. At the beginning and the end of the semester/course the students were interviewed using standardized, validated questionnaires on burnout (BOSS-II) and anxiety (STAI-G), depression (BDI), quality of life (SF-12) and sense of coherence (SOC-L9). We compared the results of our students participating in Relacs with results from eight semester medical students (n=88), assessed with the same questionnaires at similar points of time within their semester. Participating students showed a significant decline in cognitive and emotional burnout stress and in trait anxiety. Furthermore, they showed a reduction in state anxiety and a conspicuous decrease in mean depression. The sense of coherence increased at the same time. A comparative cohort of medical students of 8th semester students, showed lower values for the specified measurement parameters at the beginning, but showed no progressive changes. Our course introducing AT and PMR led to a significant reduction of burnout and anxiety within the participating group of medical students. Even the course attendance for just one semester resulted in significant improvements in the evaluated parameters in contrast to those students who did not attend the course.
PLoS ONE, 9(12) :
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Relaxation
Reyes-Portillo, J. A., Mufson, L., Greenhill, L. L., Gould, M. S., Fisher, P. W., Tarlow, N., Rynn, M. A.
Results Of the 14,001 citations initially identified, 25 articles met inclusion criteria for Web-based interventions. These described 9 programs, of which 8 were Internet based and 1 was a mobile application. No Web-based interventions for suicide prevention were identified. Of the randomized controlled trials (n = 14) and open trials (n = 3) identified, 10 reported significant postintervention reductions in symptoms of depression and/or anxiety or improvements in diagnostic ratings, with small to large effect sizes. Many of these studies also reported significant improvements at follow-up. The methodological quality of the studies varied. Many programs were limited by their small sample sizes and use of waitlist or no-treatment control groups.
Conclusion There is limited evidence for the effectiveness of Web-based interventions for youth depression and anxiety. Additional research and program development are needed to fill the current gaps in the literature.
Objective To review published reports on Web-based treatment and prevention programs for depression, anxiety, and suicide prevention in children, adolescents, and emerging adults.
Method A systematic search of the PsycINFO, PubMed, Medline, and Web of Science databases was conducted in December 2013. Programs were classified according to evidence-base level (Well-Established, Probably Efficacious, Possibly Efficacious, Experimental, and Of Questionable Efficacy).
Journal of the American Academy of Child & Adolescent Psychiatry, 53(12) : 1254-1270.e5
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Technology, interventions delivered using technology (e.g. online, SMS)
Pine, D. S.
Background: Data will be presented on attention bias in pediatric anxiety disorders. After reviewing published data, emphasis will be placed on unpublished or soon-to-be-published data, from three studies: a longitudinal study in children with behavioral inhibition and two randomized controlled trials (RCTs) for attention bias modification training (ABMT). Methods: The longitudinal study assessed anxiety, behavioral inhibition, and attention bias at ages five, seven, and nine in n=146 children. The first RCT compared changes in anxiety symptoms among n=63 children with anxiety disorders, randomized to receive one of three treatments in a parallel-group design: cognitive behavioral therapy (CBT) alone, CBT with placebo ABMT, or CBT with active ABMT. The second RCT compared changes in amygdala response on an attention bias task in n=30 sub-clinically anxious adolescents randomized to placebo or active ABMT. Results: In the 146 longitudinally followed children, attention bias towards threat at age five predicted increases in anxiety at the latter assessment points (R-squared=.40 for change in anxiety symptoms over time; F=16.5; p<.001). In the first RCT, anxious children randomized to CBT with active ABMT had greater reductions in parent and child-reported anxiety (F=5.5; p=.007), relative to anxious children randomized to CBT with placebo ABMT or CBT alone. Finally, in the second RCT, after treatment, adolescents randomized to placebo manifested greater bi-lateral amygdala activation to threatprobes in an attention task, compared to adolescents randomized to active ABMT (whole-brain corrected-p-values<.05). Conclusions: Attention bias relates to outcome and brain function in RCTs and longitudinal research among children and adolescents.
Biological Psychiatry, 75(9) : 5S-6S
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Attention/cognitive bias modification
Polat, S., Sener-Taplak, A.
Introduction Test anxiety is a different form of situational anxiety. Although it is favourable as long as it motivates the students to learn, extreme levels of it can cause academic failure and psychological problems on the part of the individual. Method This is a randomised controlled experimental study which aims at investigating the effect of visual day-dreaming and music therapy on reducing the test anxiety of the university students. The sample of the study consisted of 84 voluntary students, all of whom were included in the study. The students were selected on the basis of simple random sampling to form three different working groups: visual day-dreaming group, music therapy group and the control group. The data were collected by means of an information form about the participant's socio-demographic characteristics, their day-dreaming and musical preferences, and a scale for situational and persistent anxiety. Results The students in the three groups were found to be homogenous in terms of age, gender, marital status, income, and the place of longest stay. The mean scores of persistent anxiety for the students in visual day-dreaming group, music therapy group, and the control group were all found to be high. Statistically significant differences were observed between the three groups in terms of their mean scores of situational anxiety. Conclusion In this study, it was determined that visual day-dreaming was found to reduce university students' test anxiety, with significantly lower anxiety scores gauged from the day-dreaming group than the control group.
Archives of Disease in Childhood, 99 : A557
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Creative expression: music, dance, drama, art
Ozyurt, G., Gencer, O., Ozturk, Y., Ozbek, A.
Purpose: The aim of this study is to evaluate the long term effectiveness of Triple P Positive Parenting Program (Triple-P) which have demonstrated to be benefical for childhood anxiety disorders in the short term. Its effects on behavioral and emotional problems, general anxiety level, severity of the disorder and general psychosocial functioning are asessed. An additional aim is to evaluate potential long term effects of Triple-P on anxiety and psychological well-being of parents of children with anxiety disorders. Method: The study is randomized controlled prospective in design. The sample of the study consisted of 74 children, aged between 8-12 years, diagnosed as having an anxiety disorder confirmed by Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Life-time Kiddie (K-SADSPL). Following randomization into two equal groups, parents of the cases participated in Group Triple-P for 8 weeks whereas the control group did not. The two groups were compared right before, right after and 4 months after the implementation on rates of sociodemographic, emotional and behavioral variables. Data were collected by using sociodemographic data form, State Trait Anxiety Inventory, General Health Questionnaire-28, Strengths and Difficulties Questionnaire (SDQ), Screen for Child Anxiety Related Emotional Disorders Parent and Child Forms (SCARED), Children's Global Assessment Scale and Clinical Global Impression-Severity. The study data were evaluated with Friedman, Mann-Whitney U, Wilcoxon signed rank test and chisquare analysis. Results: Out of 74 children whose parents approved to participate 55 (74.3%) children and their parents completed the study (26 children for the case group and 29 children for the control group). Comparison of data obtained just before and just after implementation revealed significant reduction in peer relation, emotional problem subscale scores and total problem score of SDQ were observed (p = 0.02, p = 0.001, p = 0.008, respectively). Children's general anxiety level and anxiety disorder severity were significantly lower in the cases following Triple-P implementation (p<0.00, p<0.001, respectively). Children's social problems, parental anxiety and general well-being were not significantly different regarding these variables (p = 0.426, p = 0.380, p = 0.567, respectively). Four months after implementation 4 children from the control group were excluded from study. Significant improvements in peer relation, emotional problem subscale scores and total problem score of SDQ, children's general anxiety level and anxiety disorder severity were preserved (p = 0.000 for all analyses). Parental anxiety and general well-being scores were significantly lower in the case group (p = 0.002, p = 0.000, p = 0.001, respectively). Conclusion: Anxiety disorders are one of the most common types of psychopathology during childhood [1]. In Europe, more than 12%of the children is diagnosed with an anxiety disorder. In our knowledge, this is the first study to evaluate short and long term effectiveness of Triple-P on childhood anxiety disorders. Implemantation of group Triple-P displayed significant reduction in SCARED scores in the short and long term. This finding is in accordance with the results of studies which applied CBT group parent therapy to the parents of children with anxiety disorders [2,3]. Significant decrease in emotional and behavioral subscales of SDQ, a finding compatible with other studies which used Triple-P and SDQ for children with emotional and behavioral problems, indicate that Triple-P can also be effective to reduce emotional and behavioral problems in children with anxiety disorders.
European Neuropsychopharmacology, 24 : S613
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Putwain, D., Chamberlain, S., Daly, A. L., Sadreddini, S.
This paper evaluates the effectiveness of a multimodal and information technology (IT)-delivered intervention for test anxiety. Participants were randomly allocated to an intervention or waiting list group. Test anxiety was measured pre- and post-intervention and academic buoyancy, a construct that refers to students' capacity to withstand academic challenge and pressure, as a covariate. In the intervention group, 13.7% of participants completed the full intervention programme comprising six sessions; 25.5% partially completed the programme (one or more sessions); and 60.8% of participants chose not to complete any sessions. Results showed that, after completing the intervention and when controlling for academic buoyancy, highly test anxious students showed a reduction in the worry and tension components of test anxiety, relative to those who did not complete the intervention. The findings suggest that the intervention may offer highly test anxious students a means of reducing their anxiety that does not rely on face-to-face delivery. (PsycINFO Database Record (c) 2014 APA, all rights reserved). (journal abstract)
Educational Psychology in Practice, 30(4) : 420-440
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Self-help
, Technology, interventions delivered using technology (e.g. online, SMS)
Rathschlag, M., Memmert, D.
Background: The main aim of this pilot study was to investigate an advanced version of eye movement desensitization and reprocessing (EMDR) for reducing anxiety. Methods: Fifty participants were asked at two times of measurement (T1 and T2 with a rest of 4 weeks) to generate anxiety via the recall of autobiographical memories according to their anxiety. Furthermore, the participants were randomly assigned to an experimental group and a control group, and the experimental group received an intervention of 1-2 h with the advanced version of EMDR in order to their anxiety 2 weeks after T1. At T1 as well as T2, we measured the intensity of participants' anxiety with a Likert scale (LS) and collected participants' state (temporary) and trait (chronic) anxiety with the State-Trait Anxiety Inventory (STAI). In addition, we measured participants' physical performance in a test for the finger musculature under the induction of their anxiety. Results: The results showed that participant's ratings of their perceived intensity of anxiety (measured by a 9-point LS) and the state and trait anxiety decreased significantly in the experimental group but not in the control group from T1 to T2. Moreover, the physical performance under the induction of participants' anxiety increased significantly in the experimental group from T1 to T2 and there were no significant changes in the control group. Conclusions: The study could show that the advanced version of EMDR is an appropriate method to reduce anxiety. (copyright) 2014 The Authors. Brain and Behavior published by Wiley Periodicals, Inc.
Brain & Behavior, 4(3) : 348-355
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Eye movement desensitisation and reprocessing (EMDR)
Reavley, N. J., McCann, T. V., Cvetkovski, S., Jorm, A. F.
PURPOSE: The aim of the current study was to assess whether a multifaceted intervention could improve mental health literacy, facilitate help seeking and reduce psychological distress and alcohol misuse in students of a multicampus university in Melbourne, Australia.
METHODS: In this cluster randomized trial, nine university campuses were paired (some pairs included more than one campus), with one of each pair randomly assigned to either the intervention or control condition. The interventions were designed to be whole-of-campus and to run over 2 academic years with their effectiveness assessed through recruitment of a monitoring sample of students from each campus. Interventions included emails, posters, campus events, factsheets/booklets and mental health first aid training courses. Participants had a 20-min telephone interview at baseline and at the end of academic years 1 and 2. This assessed mental health literacy, help seeking, psychological distress and alcohol use. The primary outcomes were depression and anxiety levels and alcohol use and pertained to the individual level.
RESULTS: There were no effects on psychological distress and alcohol use. Recall of intervention elements was greater in the intervention group at the end of year 2. Students in the intervention group were more likely to say they would go to a drug and alcohol centre for alcohol problems at the end of 6 months.
CONCLUSION: Although education and awareness may play a role in improving mental health literacy, it is likely that, to achieve changes in psychological distress, interventions would need to be more personalized and intensive.
Social Psychiatry & Psychiatric Epidemiology, 49(10) : 1655-1666
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Psychoeducation, Other service delivery and improvement interventions
Niles, A. N., Haltom, K. E. B., Mulvenna, C. M., Lieberman, M. D., Stanton, A. L.
The current study assessed main effects and moderators (including emotional expressiveness, emotional processing, and ambivalence over emotional expression) of the effects of expressive writing in a sample of healthy adults. Young adult participants (N=116) were randomly assigned to write for 20 minutes on four occasions about deepest thoughts and feelings regarding their most stressful/traumatic event in the past five years (expressive writing) or about a control topic (control). Dependent variables were indicators of anxiety, depression, and physical symptoms. No significant effects of writing condition were evident on anxiety, depressive symptoms, or physical symptoms. Emotional expressiveness emerged as a significant moderator of anxiety outcomes, however. Within the expressive writing group, participants high in expressiveness evidenced a significant reduction in anxiety at three-month follow-up, and participants low in expressiveness showed a significant increase in anxiety. Expressiveness did not predict change in anxiety in the control group. These findings on anxiety are consistent with the matching hypothesis, which suggests that matching a person's naturally elected coping approach with an assigned intervention is beneficial. These findings also suggest that expressive writing about a stressful event may be contraindicated for individuals who do not typically express emotions. (copyright) 2013 Taylor & Francis.
Anxiety, Stress & Coping, 27(1) : 1-17
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Creative expression: music, dance, drama, art
Norr, A. M., Allan, N. P., Macatee, R. J., Keough, M. E., Schmidt, N. B.
Recently there has been increased interest in emotional and physical tolerance risk factors for mood and anxiety disorders. Three tolerance risk factors that have been shown to be related are anxiety sensitivity (AS), distress tolerance (DT), and discomfort intolerance (DI). Although previous research has demonstrated these constructs are malleable, no research has investigated the effects of an AS intervention on DT or DI. Further, no studies have investigated whether changes in DT or DI play a role in mood and anxiety symptom amelioration due to an AS intervention. Participants (N=104), who were selected for elevated levels of AS, completed a single-session computer-assisted AS intervention or a control intervention and follow-up assessments at 1-week and 1-month post intervention. Results revealed that the intervention reduced AS and increased DT, but did not affect DI at the 1-week follow-up. Mediation analyses revealed that changes in AS and DT both mediated changes in symptoms (depression, anxiety, worry) due to the intervention at 1-month follow-up, however, when AS and DT were considered in the same model only the effect via AS remained significant. These results have important implications for the nature of the relationships between AS, DT, and DI as well as the specific mechanistic pathways through which an AS intervention ameliorates symptoms. (copyright) 2014 Elsevier Ltd.
Behaviour Research & Therapy, 59 : 12-19
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Pallavi, P.
Background: As reported, cytokines and neurotrophic factors are causally related to depression. Administration of selective serotonin reuptake inhibitors (SSRI) in depression patients is known to modify cytokine and neurotrophin levels. The impact of yoga therapy as an adjunct to SSRI on anxiety, cytokines and neurotrophins in adolescent depression has not been investigated. Methods: In this 12 weeks single-blind randomized controlled study, 50 adolescents (13-18 years) with depression were randomly assigned to either (i) The standard SSRI treatment or (ii) yoga therapy in adjunct to SSRI. In the yoga therapy group, the subjects received sessions of 60 min yoga thrice a week for 12 weeks in addition to SSRI. The assessments at baseline and endpoint included Beck's Depression Inventory score, State-trait anxiety scores, serum cytokines (IL- 1(beta), IL-2, IL-6, IL-10, TNF-(alpha), IFN-g, TGF-(beta) and IL-17 using ELISA) and serum neurotrophins (BDNF, NGF, NT-3 and GDNF using ELISA). Results: At 12 weeks, we observed significant decrease (p<0.05) of IL-6 levels in Yoga group as compared to baseline. Also TGF-(beta) (p=0.008) and NGF (p=0.03) levels increased significantly at 12 weeks in Yoga group. Intergroup comparison at 12 weeks showed, significantly increased BDNF levels (p=0.001) and significantly decreased IL-2 levels (p=0.02) in Yoga group as compared to the control group. No significant difference appeared between the two groups at any baseline assessment. Conclusions: The results support the beneficial effects of the yoga therapy on adolescent depression patients as an adjunct to standard care as reflected in changes in psychometric scores, cytokine and neurotrophin levels.
Biological Psychiatry, 75(9) : 118S
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs), Complementary & Alternative Interventions (CAM)
, Mind-body exercises (e.g. yoga, tai chi, qigong)