Disorders - Anxiety Disorders
Perry, Y., Petrie, K., Buckley, H., Cavanagh, L., Clarke, D., Winslade, M., Hadzi-Pavlovic, D., Manicavasagar, V., Christensen, H.
Evidence suggests that poor mental health literacy is a key barrier to help-seeking for mental health difficulties in adolescence. Educational programs have shown positive effects on literacy, however, the evidence base remains limited and available studies have many methodological limitations. Using cluster Randomised Control Trial (RCT) methodology, the current study examines the impact of 'HeadStrong', a school-based educational intervention, on mental health literacy, stigma, help-seeking, psychological distress and suicidal ideation. A total of 380 students in 22 classes (clusters) from 10 non-governmentsecondary schools was randomised to receive either HeadStrong or Personal Development, Health and Physical Education (PDHPE) classes. Participants were assessed pre- and post-intervention, and at 6-month follow-up. Literacy improved and stigma reduced in both groups at post-intervention and follow-up, relative to baseline. However, these effects were significantly greater in the HeadStrong condition. The study demonstrates the potential of HeadStrong to improve mental health literacy and reduce stigma. (copyright) 2014 The Foundation for Professionals in Services for Adolescents.
Journal of Adolescence, 37(7) : 1143-1151
- Year: 2014
- Problem: Anxiety Disorders (any), Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation
Piacentini, J., Bennett, S., Compton, S. N., Kendall, P. C., Birmaher, B., Albano, A. M., March, J., Sherrill, J., Sakolsky, D., Ginsburg, G., Rynn, M., Bergman, R. L., Gosch, E., Waslick, B., Iyengar, S., McCracken, J., Walkup, J.
Objective We report active treatment group differences on response and remission rates and changes in anxiety severity at weeks 24 and 36 for the Child/Adolescent Anxiety Multimodal Study (CAMS). Method CAMS youth (N = 488; 74% (less-than or equal to)12 years of age) with DSM-IV separation, generalized, or social anxiety disorder were randomized to 12 weeks of cognitive-behavioral therapy (CBT), sertraline (SRT), CBT+SRT (COMB), or medication management/pill placebo (PBO). Responders attended 6 monthly booster sessions in their assigned treatment arm; youth in COMB and SRT continued on their medication throughout this period. Efficacy of COMB, SRT, and CBT (n = 412) was assessed at 24 and 36 weeks postrandomization. Youth randomized to PBO (n = 76) were offered active CAMS treatment if nonresponsive at week 12 or over follow-up and were not included here. Independent evaluators blind to study condition assessed anxiety severity, functioning, and treatment response. Concomitant treatments were allowed but monitored over follow-up. Results The majority (>80%) of acute responders maintained positive response at both weeks 24 and 36. Consistent with acute outcomes, COMB maintained advantage over CBT and SRT, which did not differ, on dimensional outcomes; the 3 treatments did not differ on most categorical outcomes over follow-up. Compared to COMB and CBT, youth in SRT obtained more concomitant psychosocial treatments, whereas those in SRT and CBT obtained more concomitant combined (medication plus psychosocial) treatment. Conclusions COMB maintained advantage over CBT and SRT on some measures over follow-up, whereas the 2 monotherapies remained indistinguishable. The observed convergence of COMB and monotherapy may be related to greater use of concomitant treatment during follow-up among youth receiving the monotherapies, although other explanations are possible. Although outcomes were variable, most CAMS-treated youth experienced sustained treatment benefit. Clinical trial registration information - Child and Adolescent Anxiety Disorders (CAMS); URL: http://clinicaltrials. gov. Unique identifier: NCT00052078.
Journal of the American Academy of Child & Adolescent Psychiatry, 53(3) : 297-310
- 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: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs), Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Mohamadi, A., Hajiamin, Z., Ebadi, A., Fathi-Ashtian, A., Ali-Asgari, M.
Anxiety disorders are among the most common psychological disorders in children. Considering the effects of the relationship between parents (especially mothers) and children on the mental health of children, we conducted this study to evaluate the effect of communication skills training of mothers by multimedia software. This clinical trial was conducted on 109 first-grade students in one of the zones in Tehran. For data collection, we used the School Anxiety Scale - Teacher Report and the Queendom Communication Skill Test to assess mothers' communication skills. Students' anxiety levels and mothers' communication skills were assessed (in both groups before and after of intervention). Then students were randomly assigned to two groups: case and control. The case group received multimedia CD for communication skills training during 2 months. The total prevalence rate of anxiety in students before intervention was 16.1%. It significantly decreased in the multimedia group after intervention (P < 0.05), as shown by the Wilcoxon test, but the difference was not significant in the control group. Furthermore, the mean (SD) score of the communication skills of mothers was (114 ± 9.8) before intervention, which significantly increased in the case group (P < 0.05). Communication skills training for mothers using multimedia software programs is an effective way to reduce children's anxiety. Therefore, this kind of training should be provided to parents because it is inexpensive and can be used frequently. (PsycINFO Database Record (c) 2014 APA, all rights reserved). (journal abstract)
Psychology, 5(8) : 950-955
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
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Treatment and intervention: Psychological Interventions (any)
, Skills training
Musiat, P., Conrod, P., Treasure, J., Tylee, A., Williams, C., Schmidt, U.
Background: A large proportion of university students show symptoms of common mental disorders, such as depression, anxiety, substance use disorders and eating disorders. Novel interventions are required that target underlying factors of multiple disorders. Aims: To evaluate the efficacy of a transdiagnostic trait-focused web-based intervention aimed at reducing symptoms of common mental disorders in university students. Method: Students were recruited online (n = 1047, age: M= 21.8, SD = 4.2) and categorised into being at high or low risk for mental disorders based on their personality traits. Participants were allocated to a cognitive-behavioural trait-focused (n = 519) or a control intervention (n = 528) using computerised simple randomisation. Both interventions were fully automated and delivered online (trial registration: ISRCTN14342225). Participants were blinded and outcomes were selfassessed at baseline, at 6 weeks and at 12 weeks after registration. Primary outcomes were current depression and anxiety, assessed on the Patient Health Questionnaire (PHQ9) and Generalised Anxiety Disorder Scale (GAD7). Secondary outcome measures focused on alcohol use, disordered eating, and other outcomes. Results: Students at high risk were successfully identified using personality indicators and reported poorer mental health. A total of 520 students completed the 6-week follow-up and 401 students completed the 12-week follow-up. Attrition was high across intervention groups, but comparable to other web-based interventions. Mixed effects analyses revealed that at 12-week follow up the trait-focused intervention reduced depression scores by 3.58 (p,.001, 95%CI [5.19, 1.98]) and anxiety scores by 2.87 (p = .018, 95%CI [1.31, 4.43]) in students at high risk. In high-risk students, between group effect sizes were 0.58 (depression) and 0.42 (anxiety). In addition, self-esteem was improved. No changes were observed regarding the use of alcohol or disordered eating. Conclusions: This study suggests that a transdiagnostic web-based intervention for university students targeting underlying personality risk factors may be a promising way of preventing common mental disorders with a low-intensity intervention. © 2014 Musiat et al.
PLoS ONE, 9(4) :
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders, Eating Disorders (any), Alcohol Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Technology, interventions delivered using technology (e.g. online, SMS)
Micco, J. A., Henin, A., Hirshfeld-Becker, D. R.
This study evaluated the efficacy of a four-session Cognitive Bias Modification-Interpretation program for 45 depressed adolescents and young adults (14-21 years old; 12 males, 33 females; Beck Depressive Inventory, Second Edition (greater-than or equal to)14) randomized to an active intervention condition (repeated exposure to positive outcomes of depression-relevant ambiguous scenarios; n = 23) or a control condition (n = 22). Both conditions experienced reductions on a Test of Interpretation Bias at post-treatment, with no significant between-group differences. When limited to those with negative bias at baseline, the intervention group showed greater improvement in interpretation bias at mid- and post-treatment. In addition, the intervention group overall had greater improvements in self-reported negative cognitions than the control group at post-intervention and two-week follow-up. However, there were no differences between groups in depression or anxiety symptom change. Potential factors contributing to mixed findings are discussed. (copyright) 2013 Springer Science+Business Media.
Cognitive Therapy & Research, 38(2) : 89-102
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Attention/cognitive bias modification
Matsumoto, T., Asakura, H., Hayashi, T.
Objective: This study investigated the soothing effects of fragrance from yuzu, a Japanese citrus fruit (Citrus junos Sieb. ex Tanaka), with salivary chromogranin A (CgA) used as an endocrinologic stress marker reflecting sympathetic nervous system activity. Methods: Twenty healthy women (mean age, 20.5(plus or minus)0.1 years) participated in a randomized, controlled, crossover study. Participants were examined on two separate occasions - once using the yuzu scent and once using unscented water as a control - in the follicular phase. This experiment measured salivary CgA and the Profile of Mood States (POMS) as a psychological index before and after the aromatic stimulation. Results: Ten-minute inhalation of the yuzu scent significantly decreased salivary CgA. At 30 minutes after the inhalation period, the salivary CgA level further decreased. In addition, POMS revealed that inhalation of the aromatic yuzu oil significantly decreased total mood disturbance, a global measure of affective state, as well as four subscores of emotional symptoms (tension-anxiety, depression-dejection, anger-hostility, and confusion), as long as 30 minutes after the olfactory stimulation. Conclusions: Yuzu's aromatic effects may alleviate negative emotional stress, which, at least in part, would contribute to the suppression of sympathetic nervous system activity. (copyright) Copyright 2014, Mary Ann Liebert, Inc. 2014.
Journal of Alternative & Complementary Medicine, 20(6) : 500-506
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Other complementary & alternative interventions
Mavilidi, M. F., Hoogerheide, V., Paas, F.
The negative thoughts that anxious children experience while sitting for an exam consume working memory resources at the cost of resources for performing on the exam. In a randomized field experiment (N=117) with primary school students, we investigated the hypothesis that stimulating students to look through the problems of a math test before they start solving them would reduce anxiety, release these anxiety-related working memory resources, and lead to higher test performance than not allowing students to look ahead in the test. The results confirmed the hypothesis, indicating that the positive effects of looking ahead applied to all students, regardless of their anxiety level (low, medium, or high). The results suggest that by looking ahead in a test, less working memory resources are consumed by intrusive thoughts, and consequently, more resources can be used for performing on the test. Theoretical and practical implications of the results are discussed.
Applied Cognitive Psychology, 28(5) : 720-726
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Medina, J. L., Deboer, L. B., Davis, M. L., Rosenfield, D., Powers, M. B., Otto, M. W., Smits, J. A. J.
A moderate to vigorous intensity exercise program is emerging as a promising strategy for reducing anxiety sensitivity (AS). Initial evidence suggests that the effects of exercise on mental health outcomes may vary as a function of gender, with men benefitting more than women. Building upon this evidence, the present study tested the hypothesis that the effect of exercise on AS would vary as a function of gender, such that the effect would be stronger for men than for women. We tested this hypothesis using the data from a published study (Smits, Berry, Rosenfield, et al., 2008). In this study, participants (N = 60) with elevated levels of AS were randomly assigned to a two-week exercise intervention [EX] or a waitlist control condition [WL]. Results revealed that males showed significantly greater initial AS reductions relative to females (following 1 week of exercise). However, these gender differences were no longer evident at the end of the intervention. Possible mechanisms for the observed findings and directions for future research are discussed.
Mental Health & Physical Activity, 7(3) : 147-151
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Physical activity, exercise
Loucas, C., Pennant, M., Whittington, C., Naqvi, S., Sealey, C., Stockton, S., Kelvin, R., Fonagy, P., Kendall, T.
Aims To review the effectiveness of e-mediated therapies and computer applications for children and young people (CYP) with mental health (MH) problems. To conduct focus groups eliciting service users views on computer-based applications. This work is part of a DH-commissioned website which will provide e-learning to people assisting CYP with MH problems, overseen by the MindEd Consortium at RCPCH. Methods Medical, psychological/sociological, educational and grey literature databases were searched for randomised controlled trials of interventions for MH problems in CYP, either through remote therapist contact (e-mediated therapy) or computer-based applications. Studies were included if the mean age of participants was <18 years or all participants were (less-than or equal to)25 years. In addition, two focus groups of young people aged (less-than or equal to)25 years used four computerised CBT (cCBT) programs for anxiety and/or depression followed by facilitated discussion. Results The review included studies of e-mediated and computer-based therapies for anxiety and depression (N=26), phobia (N=2), OCD (N=2), PTSD (N=1), eating disorders (N=6), ADHD (N=10), conduct disorder (N=2), substance misuse (N=11), autism (N=1), Tourette syndrome (N=1) and psychosis (N=1). Based on the GRADE system, the evidence was predominantly low quality with limited data, inadequate study design and unreliable outcome measures being major contributors to downgrading. The strongest evidence was for cCBT programs for depression in adolescents, and there was some promise for cCBT programs for anxiety in adolescents. The focus groups identified several key issues, including: the need for products to be engaging and up-to-date; the desire to set own goals; being active in therapy; continued contact with therapists; and the importance of endorsement by professionals. Conclusions Computer-based applications such as cCBT show promise and e-mediated strategies are potentially useful. In the provision and development of new products, input is needed from specialists in software design as well as psychology, with consideration given to the software's technological suitability, therapeutic benefit and acceptability, as well as individual autonomy and integration with MH services. There should be continued robust evaluation of the evidence for effectiveness and cost effectiveness.
Archives of Disease in Childhood, 99 : A58
- 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)
Lowther, H., Newman, E.
Background Attention Bias Modification (ABM) is a novel computer based treatment for anxiety disorders. It has been proposed as an efficient, accessible psychological therapy and is based on cognitive theories of attention. The present review sought to investigate the efficacy of ABM as a potential treatment for child and adolescent anxiety. Method A systematic literature review was conducted, using three main databases, PsycINFO, Embase and Medline, to identify original research articles which measured the effect of ABM on anxiety levels in children and/or adolescents. Results Ten articles met the inclusion criteria and of these 10, three were randomised control trials. A lack of standardisation in relation to the treatment protocol was observed; nonetheless the identified studies generally provided evidence for the efficacy of ABM as an anxiety treatment. Limitations Due to the nature of the studies found, a statistical meta-analysis was not possible. Conclusions ABM seems to be a promising, novel treatment for child and/or adolescent anxiety disorders with merits over lengthier, talking based therapies. However, more rigorous research trials are needed to clarify the mechanisms behind ABM and establish effective, standardised treatment protocols. (copyright) 2014 Elsevier B.V.
Journal of Affective Disorders, 168 : 125-135
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
, Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Attention/cognitive bias modification
Lundkvist-Houndoumadi, I., Hougaard, E., Thastum, M.
Background: Cognitive behavioural therapy (CBT) has been found to be effective for children and adolescents (6-18 years) with anxiety disorders, but the non-response rate is high-a fact that may argue for the importance of studies on pre-treatment characteristics of children and their families that predict treatment outcome. Aims: To provide a systematic review of clinical and demographic pre-treatment child and family predictors of treatment outcome in CBT for anxiety disorders in youth. Method: A systematic literature search was conducted based on electronic databases (PsycINFO, Embase and PubMed), and retrieved studies were analysed according to the box-score method of counting significant findings. Results: 24 studies with a sample size (greater-than or equal to) 60 were located. Most studies dealt with the following predictors: child age, gender, comorbidity, symptom severity and parental psychopathology. There was some evidence that a higher degree of pre-treatment symptomatic severity and non-anxiety comorbidity predicted higher end-state severity, but not a lesser degree of improvement. There was some but inconsistent support for a negative influence of parental psychopathology. Conclusion: Studies on pre-treatment child and family predictors of outcome in CBT for youth anxiety disorders have until now resulted in few findings of clinical or theoretical significance.
Nordic Journal of Psychiatry, 68(8) : 524-535
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Langford, R., Bonell, CP., Jones, HE., Pouliou, T., Murphy, SM., Waters, E., Komro, KA., Gibbs LF., Magnus, D., Campbell, R.
Background: The World Health Organization's (WHO's) Health Promoting Schools (HPS) framework is an holistic, settings-based approach to promoting health and educational attainment in school. The effectiveness of this approach has not been previously rigorously reviewed.Objectives: To assess the effectiveness of the Health Promoting Schools (HPS) framework in improving the health and well-being of students and their academic achievement.Search methods: We searched the following electronic databases in January 2011 and again in March and April 2013: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO, CINAHL, Campbell Library, ASSIA, BiblioMap, CAB Abstracts, IBSS, Social Science Citation Index, Sociological Abstracts, TRoPHI, Global Health Database, SIGLE, Australian Education Index, British Education Index, Education Resources Information Centre, Database of Education Research, Dissertation Express, Index to Theses in Great Britain and Ireland, ClinicalTrials.gov, Current controlled trials, and WHO International Clinical Trials Registry Platform. We also searched relevant websites, handsearched reference lists, and used citation tracking to identify other relevant articles.Selection criteria: We included cluster-randomised controlled trials where randomisation took place at the level of school, district or other geographical area. Participants were children and young people aged four to 18 years, attending schools or colleges. In this review, we define HPS interventions as comprising the following three elements: input to the curriculum; changes to the school's ethos or environment or both; and engagement with families or communities, or both. We compared this intervention against schools that implemented either no intervention or continued with their usual practice, or any programme that included just one or two of the above mentioned HPS elements.Data collection and analysis: At least two review authors identified relevant trials, extracted data, and assessed risk of bias in the trials. We grouped different types of interventions according to the health topic targeted or the approach used, or both. Where data permitted, we performed random-effects meta-analyses to provide a summary of results across studies.Main results: We included 67 eligible cluster trials, randomising 1443 schools or districts. This is made up of 1345 schools and 98 districts. The studies tackled a range of health issues: physical activity (4), nutrition (12), physical activity and nutrition combined (18), bullying (7), tobacco (5), alcohol (2), sexual health (2), violence (2), mental health (2), hand-washing (2), multiple risk behaviours (7), cycle-helmet use (1), eating disorders (1), sun protection (1), and oral health (1). The quality of evidence overall was low to moderate as determined by the GRADE approach. 'Risk of bias' assessments identified methodological limitations, including heavy reliance on self-reported data and high attrition rates for some studies. In addition, there was a lack of long-term follow-up data for most studies.We found positive effects for some interventions for: body mass index (BMI), physical activity, physical fitness, fruit and vegetable intake, tobacco use, and being bullied. Intervention effects were generally small but have the potential to produce public health benefits at the population level. We found little evidence of effectiveness for standardised body mass index (zBMI) and no evidence of effectiveness for fat intake, alcohol use, drug use, mental health, violence and bullying others; however, only a small number of studies focused on these latter outcomes. It was not possible to meta-analyse data on other health outcomes due to lack of data. Few studies provided details on adverse events or outcomes related to the interventions. In addition, few studies included any academic, attendance or school-related outcomes. We therefore cannot draw any clear conclusions as to the effectiveness of this approach for improving academic achievement.Authors' conclusions: The resu ts of this review provide evidence for the effectiveness of some interventions based on the HPS framework for improving certain health outcomes but not others. More well-designed research is required to establish the effectiveness of this approach for other health topics and academic achievement.
Cochrane Database of Systematic Reviews, (4) : CD008959
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders, Eating Disorders (any), Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement