Disorders - anxiety disorders
Dugailly, P. M., Fassin, S., Maroye, L., Evers, L., Klein, P., Feipel, V.
Objective: The objective of this study is to assess the effect of a single session of a general osteopathic treatment (OG) on several psychological features. Methods: Thirty-four asymptomatic female volunteers (age) completed baseline auto-questionnaires about anxiety, body satisfaction and global self-perception. Then, they were randomly assigned to OG or to control group (restful state). Each intervention was performed during 30min. After the session, psychological data were collected using the same auto-questionnaires. To test the effect of treatment we used ANOVA for repeated measures and compared changes over time between OG and control groups. Results: At baseline, characteristics were comparable between groups. Following the intervention, we observed improvements in psychological state in both OG and control groups. Nevertheless, OG had a significant larger effect over restful state for anxiety and global self-perception (p<0.02). Conclusions: The present study suggests that an osteopathic approach using articular and soft tissue mobilisations has an effect, at least in the short term, on anxiety and global body perception. Further investigation is needed to confirm the relevance and broaden the scope of the present study. (copyright) 2013 Elsevier Ltd.
International Journal of Osteopathic Medicine, 17(2) : 94-101
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Other complementary & alternative interventions
Fergus, T. A., Wheless, N. E., Wright, L. C.
Self-focused attention is an important target of intervention within Wells's (2009) metacognitive therapy and the attention training technique (ATT) is one component of metacognitive therapy that purportedly alters focus of attention. However, we do not yet fully understand whether ATT causes changes in focus of attention, the effectiveness of ATT compared to other techniques in reducing self-focused attention, and how ATT leads to its therapeutic gains. A laboratory-based component study was completed to address these gaps in the literature. Nonclinical participants were randomly assigned to one session of ATT (n=38) or a mindfulness-based task (n=38). ATT and the mindfulness-based task differentially changed focus of attention, with ATT causing greater external focus of attention and the mindfulness-based task causing greater self-focused attention from pre-to-post manipulation. ATT and the mindfulness-based task both led to reductions in anxiety. Reductions in self-focused attention were related to less anxiety following ATT, whereas increases in self-focused attention were related to less anxiety following the mindfulness-based task. Conceptual and therapeutic implications are discussed.
Behaviour Research & Therapy, 61 : 150-155
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Mindfulness based therapy, Attention/cognitive bias modification
Collins, S., Woolfson, L.M., Durkin, K.
Anxiety disorders are common in children and may signal risk of depression, social, or academic difficulties. This study evaluated the effects of a universal mental health promotion intervention delivered in primary schools. Three hundred and seventeen 9- to 10-year-olds were randomly allocated by class group to intervention conditions (psychologist-led or teacher-led), or a comparison condition. Coping and anxiety were measured pre- and post-intervention and at six-month follow-up. Significant anxiety reduction and improved coping were found post-intervention and at follow-up. There were no significant differences between the teacher- and psychologist-led intervention groups. Results indicated that a universal school programme delivered by teachers can have positive effects on anxiety and coping. (PsycINFO Database Record (c) 2014 APA, all rights reserved). (journal abstract)
School Psychology International, 35(1) : 85-100
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Skills training
Crawley, S. A., Caporino, N. E., Birmaher, B., Ginsburg, G., Piacentini, J., Albano, A. M., Sherrill, J, Sakolsky, D., Compton, S. N., Rynn, M., McCracken, J., Gosch, E., Keeton, C., March, J., Walkup, J. T., Kendall, P. C.
This study examined (a) demographic and clinical characteristics associated with physical symptoms in anxiety-disordered youth and (b) the impact of cognitive-behavioral therapy (Coping Cat), medication (sertraline), their combination, and pill placebo on physical symptoms. Youth (N = 488, ages 7 - 17 years) with a principal diagnosis of generalized anxiety disorder, separation anxiety disorder, or social phobia participated as part of a multi-site, randomized controlled trial and received treatment delivered over 12 weeks. Diagnostic status, symptom severity, and impairment were assessed at baseline and week 12. The total number and severity of physical symptoms was associated with age, principal diagnosis, anxiety severity, impairment, and the presence of comorbid internalizing disorders. Common somatic complaints were headaches, stomachaches, head cold or sniffles, sleeplessness, and feeling drowsy or too sleepy. Physical symptoms decreased over the course of treatment, and were unrelated to treatment condition. Clinical implications and directions for future research are discussed (ClinicalTrials.gov number, NCT00052078). (PsycINFO Database Record (c) 2014 APA, all rights reserved). (journal abstract)
Child Psychiatry & Human Development, 45(4) : 398-407
- Year: 2014
- Problem: Anxiety Disorders (any), 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)
De-Voogd, E. L., Wiers, R. W., Prins, P. J. M., Salemink, E.
Background and objectives An attentional bias for negative information plays an important role in the development and maintenance of (social) anxiety and depression, which are highly prevalent in adolescence. Attention Bias Modification (ABM) might be an interesting tool in the prevention of emotional disorders. The current study investigated whether visual search ABM might affect attentional bias and emotional functioning in adolescents. Methods A visual search task was used as a training paradigm; participants (n = 16 adolescents, aged 13-16) had to repeatedly identify the only smiling face in a 4 null 4 matrix of negative emotional faces, while participants in the control condition (n = 16) were randomly allocated to one of three placebo training versions. An assessment version of the task was developed to directly test whether attentional bias changed due to the training. Self-reported anxiety and depressive symptoms and self-esteem were measured pre- and post-training. Results After two sessions of training, the ABM group showed a significant decrease in attentional bias for negative information and self-reported social phobia, while the control group did not. There were no effects of training on depressive mood or self-esteem. Limitations No correlation between attentional bias and social phobia was found, which raises questions about the validity of the attentional bias assessment task. Also, the small sample size precludes strong conclusions. Conclusions Visual search ABM might be beneficial in changing attentional bias and social phobia in adolescents, but further research with larger sample sizes and longer follow-up is needed. (copyright) 2013 Elsevier Ltd. All rights reserved.
Journal of Behavior Therapy & Experimental Psychiatry, 45(2) : 252-259
- Year: 2014
- Problem: Anxiety Disorders (any), Social phobia (social anxiety disorder)
, Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Attention/cognitive bias modification
Dennis, T. A., O'Toole, L. J.
Interest in the use of mobile technology to deliver mental-health services has grown in light of the economic and practical barriers to treatment. Yet research on alternative delivery strategies that are more affordable, accessible, and engaging is in its infancy. Attention-bias modification training (ABMT) has the potential to reduce treatment barriers as a mobile intervention for stress and anxiety, but the degree to which ABMT can be embedded in a mobile gaming format and its potential for transfer of benefits is unknown. In the present study, we examined effects of a gamified ABMT mobile application in highly trait-anxious participants (N = 78). A single session of the active training relative to the placebo training reduced subjective anxiety and observed stress reactivity. Critically, the long (45 min) but not the short (25 min) active training condition reduced the core cognitive process implicated in ABMT (threat bias) as measured by an untrained, gold-standard protocol. (PsycINFO Database Record (c) 2014 APA, all rights reserved). (journal abstract)
Clinical Psychological Science, 2(5) : 576-590
- 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)
, Attention/cognitive bias modification
, Technology, interventions delivered using technology (e.g. online, SMS)
Di-Simplicio, M., Doallo, S., Costoloni, G., Rohenkohl, G., Nobre, A. C., Harmer, C. J.
Anxiety and depression are associated with altered ocular exploration of facial stimuli, which could have a role in the misinterpretation of ambiguous emotional stimuli. However, it is unknown whether a similar pattern is seen in individuals at risk for psychopathology and whether this can be modified by pharmacological interventions used in these disorders. In Study I, eye gaze movement during face discrimination was compared in volunteers with high vs low neuroticism scores on the Eysenck Personality Questionnaire. Facial stimuli either displayed a neutral, happy, or fearful expression. In Study 2, volunteers with high neuroticism were randomized in a double-blind design to receive the selective serotonin reuptake inhibitor citalopram (20 mg) or placebo for 7 days. On the last day of treatment, eye gaze movement during face presentation and the recognition of different emotional expressions was assessed. In Study I, highly neurotic volunteers showed reduced eye gaze towards the eyes vs mouth region of the face compared with low neurotic volunteers. In Study 2, citalopram increased gaze maintenance over the face stimuli compared with placebo and enhanced recognition of positive vs negative facial expressions. Longer ocular exploration of happy faces correlated positively with recognition of positive emotions. Individuals at risk for psychopathology presented an avoidant pattern of ocular exploration of faces. Short-term SSRI administration reversed this bias before any mood or anxiety changes. This treatment effect may improve the capacity to scan social stimuli and contribute to the remediation of clinical symptoms related to interpersonal difficulties. (PsycINFO Database Record (c) 2015 APA, all rights reserved). (journal abstract)
Neuropsychopharmacology, 39(13) : 3059-3066
- 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)
Di-Simplicio, M., Norbury, R., Reinecke, A., Harmer, C. J.
Short-term antidepressant administration has been reported to decrease amygdala response to threat in healthy volunteers and depressed patients. Neuroticism (N) is a risk factor for depression but has also been associated with slow or incomplete remission with antidepressant drug treatment. Our aim was to investigate early selective serotonin reuptake inhibitor (SSRI) administration neural effects on implicit processing of fearful facial expressions in volunteers with high levels of N. Highly neurotic subjects received 20 mg/day citalopram versus placebo for 7 days in a double-blind, between-groups design. On the last day haemoperfusion and functional magnetic resonance imaging (fMRI) data during a gender discrimination task with fearful and happy faces were acquired. A control group of non-neurotic volunteers was also tested. High-N volunteers had reduced responses to threatening facial expressions across key neural circuits compared to low-N volunteers. SSRI treatment was found to elevate resting perfusion in the right amygdala, increase bilateral amygdalae activation to positive and negative facial expressions and increase activation to fearful versus happy facial expressions in occipital, parietal, temporal and prefrontal cortical areas. These results suggest that 7 days of SSRI administration can increase neural markers of fear reactivity in subjects at the high end of the N dimension and may be related to early increases in anxiety and agitation seen early in treatment. Such processes may be involved in the later therapeutic effects through decreased avoidance and increased learning about social 'threat' cues.
Psychological Medicine, 44(2) : 241-252
- 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)
Adelman, C. B., Panza, K. E., Bartley, C. A., Bontempo, A., Bloch, M. H.
Objective: Access to qualified cognitive-behavioral therapy (CBT) remains a major barrier to improving clinical outcomes in anxiety disorders. The current meta-analysis examined the efficacy of computerized CBT (cCBT) for anxiety disorders and the durability of treatment gains during follow-up. Data Sources: We searched PubMed and references from included trials and previous meta-analyses in the area. Study Selection: We included randomized controlled trials assessing the efficacy of cCBT for non-OCD and non-PTSD anxiety disorders. Data Extraction: Forty trials involving 2,648 participants were included in this meta-analysis. We used a fixed-effect model to examine standardized mean difference in posttreatment anxiety levels. cCBT was compared to wait-list, in-person CBT, and Internet control. We also examined moderators of cCBT treatment gains over follow-up. Results: Meta-analysis indicated that cCBT was significantly more effective than wait-list control in the treatment of anxiety disorders (standardized mean difference [SMD] = 0.92 [95% CI, 0.83 to 1.02], k = 31, z = 18.8, P < .001). Moderator analyses also found that cCBT targeting specific anxiety disorders had greater efficacy than that targeting mixed anxiety symptoms. The efficacy of cCBT was equivalent to in-person CBT in studies that compared them head-to-head, for both children and adults (SMD = 0.05 [95% CI, -0.09 to 0.19], k = 15, z = 0.7, P = .46). Longitudinal studies indicate that individuals undergoing cCBT tended to continue to improve after completion of treatment, with longer follow-up periods associated with greater symptom reduction. Conclusions: cCBT represents an efficacious intervention for the treatment of anxiety disorders and may circumvent barriers to accessing traditional CBT treatments. Further research is needed to examine the effectiveness of cCBT in real-world settings, for individuals with clinical comorbidities, and in comparison with more ecologically valid comparison conditions. (copyright) Copyright 2014 Physicians Postgraduate Press, Inc.
Journal of Clinical Psychiatry, 75(7) : e695-e704
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
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)
Chavira, D. A., Drahota, A., Garland, A. F., Roesch, S., Garcia, M., Stein, M. B.
In this study, we examine the feasibility of cognitive behavior therapy (CBT) for children with anxiety in primary care, using two modes of treatment delivery. A total of 48 parents and youth (8-13) with anxiety disorders were randomly assigned to receive 10-sessions of CBT either delivered by a child anxiety specialist in the primary care clinic or implemented by the parent with therapist support by telephone (i.e., face-to-face or therapist-supported bibliotherapy). Feasibility outcomes including satisfaction, barriers to treatment participation, safety, and dropout were assessed. Independent evaluators, blind to treatment condition, administered the Anxiety Disorders Interview Schedule for Children (ADIS) and the Clinical Global Impression of Improvement (CGI-I) at baseline, post-treatment and 3-month follow-up; clinical self-report questionnaires were also administered. Findings revealed high satisfaction, low endorsement of barriers, low drop out rates, and no adverse events across the two modalities. According to the CGI-I, 58.3%-75% of participants were considered responders (i.e., much or very much improved) at the various time points. Similar patterns were found for remission from "primary anxiety disorder" and "all anxiety disorders" as defined by the ADIS. Clinically significant improvement was seen on the various parent and child self-report measures of anxiety. Findings suggest that both therapy modalities are feasible and associated with significant treatment gains in the primary care setting. (clinicaltrials.gov unique identifier: NCT00769925). (copyright) 2014 Elsevier Ltd.
Behaviour Research & Therapy, 60 : 60-66
- Year: 2014
- 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)
Baldwin, D.S., Anderson, I. M., Nutt, D. J., Allgulander, C., Bandelow, B., den-Boer, J. A., Christmas, D. M., Davies, S., Fineberg, N., Lidbetter, N., Malizia, A., McCrone, P., Nabarro, D., O'Neill, C, Scott, J., van-der-Wee, N., Wittchen, H-U.,
This revision of the 2005 British Association for Psychopharmacology guidelines for the evidence-based pharmacological treatment of anxiety disorders provides an update on key steps in diagnosis and clinical management, including recognition, acute treatment, longer-term treatment, combination treatment, and further approaches for patients who have not responded to first-line interventions. A consensus meeting involving international experts in anxiety disorders reviewed the main subject areas and considered the strength of supporting evidence and its clinical implications. The guidelines are based on available evidence, were constructed after extensive feedback from participants, and are presented as recommendations to aid clinical decision-making in primary, secondary and tertiary medical care. They may also serve as a source of information for patients, their carers, and medicines management and formulary committees.;
Journal of Psychopharmacology, 28(5) : 403-439
- Year: 2014
- Problem: Anxiety Disorders (any), Obsessive Compulsive Disorder, Post Traumatic Stress Disorder
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Psychological Interventions (any)
Christensen, H., Batterham, P., Calear, A.
Purpose Of Review: The present article updates knowledge regarding the evidence base for online interventions for anxiety disorders, and provides an overview of recent advances in online interventions for anxiety over the past 18 months.; Recent Findings: Computerized self-help is an effective strategy for providing evidence-based treatments for symptoms of anxiety and depression. Online delivery has numerous advantages for clinicians and patients, including greater accessibility, anonymity, convenience and cost-effectiveness. These may be particularly important for populations experiencing anxiety, which may face more pronounced barriers to accessing care. Recent meta-analyses have confirmed that computerized cognitive behaviour therapy (CBT) for anxiety demonstrates comparable clinical outcomes as face-to-face psychotherapy for individuals with anxiety. This review updates the status of current knowledge by providing a focused review of randomized controlled trials of computerized (including Internet and portable device-delivered) treatments for anxiety.; Summary: Recent studies have confirmed the utility of computerized psychotherapy for anxiety. Future trials are required to elucidate the active constituents of effective programs, evaluate targeted approaches for specific groups, and to ascertain the optimal degree of guidance required. Clarification of these issues will assist in refining effective online programs operating within standalone virtual clinics or incorporated into clinician-supported stepped care approaches.;
Current Opinion in Psychiatry, 27(1) : 7-13
- Year: 2014
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Technology, interventions delivered using technology (e.g. online, SMS)