Disorders - Anxiety Disorders
Fu, Xiaoxue, Du, Yasong, Au, Shun, Lau, Jennifer Y. F.
Anxiety disorders are globally prevalent, debilitating and onset in early life. Cognitive bias modification of interpretations (CBM-I) training has emerged as a targeted intervention for early emerging anxiety problems. While CBM-I can alter interpretational styles in unselected and clinical-analogue samples of adolescents, no studies have assessed its capacity to change biases in clinical samples. Here, we assessed training efficacy in ameliorating interpretation biases and anxious mood in adolescents with anxiety disorders. Twenty-eight Chinese adolescents meeting criteria for a current anxiety disorder were randomly assigned to receive positive or neutral CBM-I training. Training involved completing a word-fragment to resolve the outcomes of sixty ambiguous scenarios. During positive training, scenarios ended with benign/positive resolutions, but during neutral training, half of the scenarios were resolved positively and half negatively. Positively trained patients interpreted new ambiguous scenarios less negatively than the neutral training group although training effects were not observed on a questionnaire measure of interpretation bias. Training effects on mood were also absent. Before the clinical implications of CBM-I can be considered in adolescents, research needs to establish optimal training parameters for symptom-changes to occur.; Copyright © 2012 Elsevier Ltd. All rights reserved.
Developmental Cognitive Neuroscience, 4 : 29-37
- Year: 2013
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Attention/cognitive bias modification
O'Callaghan, Paul, McMullen, John, Shannon, Ciaran, Rafferty, Harry, Black, Alastair
Objective: To assess the efficacy of trauma-focused cognitive behavioral therapy (TF-CBT) delivered by nonclinical facilitators in reducing posttraumatic stress, depression, and anxiety and conduct problems and increasing prosocial behavior in a group of war-affected, sexually exploited girls in a single-blind, parallel-design, randomized,+ controlled trial.; Method: Fifty-two 12- to 17-year-old, war-affected girls exposed to rape and inappropriate sexual touch in the Democratic Republic of Congo were screened for trauma, depression and anxiety, conduct problems, and prosocial behavior. They were then randomized to a 15 session, group-based, culturally modified TF-CBT (n = 24) group or a wait-list control group (n = 28). Primary analysis, by intention-to-treat, involving all randomly assigned participants occurred at pre- and postintervention and at 3-month follow-up (intervention group only).; Results: Compared to the wait list control, the TF-CBT group experienced significantly greater reductions in trauma symptoms (F(1,49) = 52.708, p<0·001, χ(p)2 = 0.518). In addition, the TF-CBT group showed a highly significant improvement in symptoms of depression and anxiety, conduct problems, and prosocial behavior. At 3-months follow-up the effect size (Cohen's d) for the TF-CBT group was 2.04 (trauma symptoms), 2.45 (depression and anxiety), 0.95 (conduct problems), and-1.57 (prosocial behavior).; Conclusions: A group-based, culturally modified, TF-CBT intervention delivered by nonclinically trained Congolese facilitators resulted in a large, statistically significant reduction in posttraumatic stress symptoms and psychosocial difficulties among war-affected girls exposed to rape or sexual violence. Clinical trial registration information-An RCT of TF-CBT with sexually-exploited, war-affected girls in the DRC; http://clinicaltrials.gov/; NCT01483261.; Copyright © 2013 American Academy of Child & Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
Journal of the American Academy of Child & Adolescent Psychiatry, 52(4) : 359-369
- Year: 2013
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Trauma-focused cognitive behavioural therapy (TF-CBT)
O'Leary-Barrett, M., Topper, L., Al-Khudhairy, N., Pihl, R. O., Castellanos-Ryan, N., Mackie, C. J., Conrod, P. J.
Objective To assess the 2-year impact of teacher-delivered, brief, personality-targeted interventions on internalizing and externalizing symptoms in an adolescent U.K. sample. Method This cluster-randomized trial was run in 19 London schools (N = 1,024 adolescents). Trained school-based professionals delivered two 90-minute, CBT-based group interventions targeting 1 of 4 personality-risk profiles: anxiety sensitivity, hopelessness, impulsivity, or sensation seeking. Self-report depression, anxiety, and conduct disorder symptoms were assessed at 6-month intervals. Results Interventions were associated with significantly reduced depressive, anxiety, and conduct symptoms (p <.05) over 2 years in the full sample, reduced odds of severe depressive symptoms (odds ratio [OR] = 0.74, CI = 0.58-0.96), and conduct problems (OR = 0.79, CI = 0.65-0.96), and a nonsignificant reduction in severe anxiety symptoms (OR = 0.79, CI = 0.59-1.05). Evaluating a priori personality-specific hypotheses revealed strong evidence for impulsivity-specific effects on severe conduct problems, modest evidence of anxiety sensitivity-specific effects on severe anxiety, and no evidence for hopelessness-specific effects on severe depressive symptoms. Conclusions Brief, personality-targeted interventions delivered by educational professionals can have a clinically significant impact on mental health outcomes in high-risk youth over 2 years, as well as personality-specific intervention effects in youth most at risk for a particular problem, particularly for youth with high levels of impulsivity. Clinical trial registration information - Adventure: The Efficacy of Personality-Targeted Interventions for Substance Misuse and Other Risky Behaviors as Delivered by Educational Professionals; http://clinicaltrials.gov; NCT00776685.
Journal of the American Academy of Child & Adolescent Psychiatry, 52(9) : 911-920
- Year: 2013
- Problem: Anxiety Disorders (any), Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Abbass, A. A., Rabung, S., Leichsenring, F., Refseth, J. S., Midgley, N.
Objective Psychodynamically based brief psychotherapy is frequently used in clinical practice for a range of common mental disorders in children and adolescents. To our knowledge, there have been no meta-analyses to evaluate the effectiveness of these therapies. Method After a broad search, we meta-analyzed controlled outcome studies of short-term psychodynamic psychotherapies (STPP, 40 or fewer sessions). We also performed sensitivity analyses and evaluated the risk of bias in this body of studies. Results We found 11 studies with a total of 655 patients covering a broad range of conditions including depression, anxiety disorders, anorexia nervosa, and borderline personality disorder. STPP did not separate from what were mostly robust treatment comparators, but there were some subgroup differences. Robust (g = 1.07, 95% CI = 0.80-1.34) within group effect sizes were observed suggesting the treatment may be effective. These effects increased in follow up compared to post treatment (overall, g = 0.24, 95% CI = 0.00-0.48), suggesting a tendency toward increased gains. Heterogeneity was high across most analyses, suggesting that these data need be interpreted with caution. Conclusion This review suggests that STPP may be effective in children and adolescents across a range of common mental disorders. (copyright) 2013 American Academy of Child and Adolescent Psychiatry.
Journal of the American Academy of Child & Adolescent Psychiatry, 52(8) : 863-875
- Year: 2013
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Psychodynamic/Psychoanalysis
Regehr, C., Glancy, D., Pitts, A.
Background: Recent research has revealed concerning rates of anxiety and depression among university students. Nevertheless, only a small percentage of these students receive treatment from university health services. Universities are thus challenged with instituting preventative programs that address student stress and reduce resultant anxiety and depression.; Method: A systematic review of the literature and meta-analysis was conducted to examine the effectiveness of interventions aimed at reducing stress in university students. Studies were eligible for inclusion if the assignment of study participants to experimental or control groups was by random allocation or parallel cohort design.; Results: Retrieved studies represented a variety of intervention approaches with students in a broad range of programs and disciplines. Twenty-four studies, involving 1431 students were included in the meta-analysis. Cognitive, behavioral and mindfulness interventions were associated with decreased symptoms of anxiety. Secondary outcomes included lower levels of depression and cortisol.; Limitations: Included studies were limited to those published in peer reviewed journals. These studies over-represent interventions with female students in Western countries. Studies on some types of interventions such as psycho-educational and arts based interventions did not have sufficient data for inclusion in the meta-analysis.; Conclusion: This review provides evidence that cognitive, behavioral, and mindfulness interventions are effective in reducing stress in university students. Universities are encouraged to make such programs widely available to students. In addition however, future work should focus on developing stress reduction programs that attract male students and address their needs.; Copyright © 2012 Elsevier B.V. All rights reserved.
Journal of Affective Disorders, 148(1) : 1-11
- Year: 2013
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
Palmer, R., Nascimento, L. N., Fonagy, P.
This article reviews outcomes of psychodynamic psychotherapy (PP) for children and adolescents reported in articles identified by a comprehensive review of the literature on treatment evaluations of psychological and medical interventions for mental disorders in pediatric populations. The review identified 48 reports based on 33 studies. While there is evidence of substantial clinical gains associated with PP, in almost all the studies, when contrasted with family-based interventions, PP fares no better and appears to produce outcomes with some delay relative to family-based therapies. Further rigorous evaluations are needed, but evidence to date suggests that the context in which PP is delivered should be extended from the traditional context of individual therapy and parents should be included in the treatment of children. (copyright) 2013 Elsevier Inc.
Child & Adolescent Psychiatric Clinics of North America, 22(2) : 149-214
- Year: 2013
- Problem: Anxiety Disorders (any), Depressive Disorders, Eating Disorders (any), Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Psychodynamic/Psychoanalysis
Tang, T. C., Huang, S. Y.
Background: This case-control study aimed to assess the intervention effects of six-session interpersonal psychotherapy (IPT-A) on reducing the severity of anxiety and depression in adolescent victims. Methods: A total of 30 adolescents who had clinical significant level after experiencing bullied experiences were allocated to a six-session course of IPT-A (N =15) or to treatment as usual (TAU) (N = 15). T test was performed to examine the effect of IPT-A on reducing the severity of anxiety and depression related to the bullied events. Results: Pre-intervention age, sex, anxiety and depression showed no significant difference between two groups. As the preintervention severity of two groups were no significant different, results showed the IPT-A group to have significantly lower post-intervention severity levels of anxiety and depression (p< .05) than the TAU group. Effective size showed moderate to high level between IPT-A and TAU. Conclusions: The results of this study support the effectiveness of the IPT-A in improving anxiety symptoms and depression in adolescents experiencing traumatic bullied experiences.
European Psychiatry, 28 :
- Year: 2013
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Interpersonal therapy (IPT)
von-der-Embse, Nathaniel, Barterian, Justin, Segool, Natasha
High-stakes tests have played an increasingly important role in how student achievement and school effectiveness are measured. Test anxiety has risen with the use of tests in educational decision making. Students with high test anxiety perform poorly on tests when compared to students with low test anxiety. School psychologists can play an important role as experts both in tests and measurement and mental health in providing consultation and treatment for students with test anxiety. This article describes the results of a systematic literature review of the last 10 years of test-anxiety interventions. Results indicate that there are few studies that have examined test-anxiety interventions with elementary and secondary school students. However, techniques including biofeedback, behavior therapy, cognitive behavioral therapy, priming competency, and mixed approaches have demonstrated promising results. Suggestions are made for school psychologists for the delivery of evidenced-based test anxiety interventions. (PsycINFO Database Record (c) 2013 APA, all rights reserved). (journal abstract)
Psychology in the Schools, 50(1) : 57-71
- Year: 2013
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
Riemann, Bradley C., Kuckertz, Jennie M., Rozenman, Michelle, Weersing, V. Robin, Amir, Nader
Background: Recent research suggests the efficacy of attention modification programs (AMP) in treating adult anxiety.([1]) Though some research supports the success of AMP treatment in anxious youths,([2, 3]) to date no study has examined the efficacy of AMP as an adjunctive treatment to other psychosocial and pharmacological interventions for anxious youths within the community.; Methods: In the current study, we examined the efficacy of AMP as an adjunctive treatment to standard care at a residential anxiety treatment facility. Adolescents (N = 42) completed either an active (attention modification program, AMP; n = 21) or a control (attention control condition, ACC; n = 21) condition, in addition to the facility's standard treatment protocol, which included cognitive behavioral therapy with or without medication.; Results: While anxiety symptoms decreased for participants across both groups, participants in the AMP group experienced a significantly greater decrease in anxiety symptoms from point of intake to point of discharge, in comparison to participants in the ACC group.; Conclusions: These results suggest that AMP is an effective adjunctive treatment to the standard treatments of choice for anxiety disorders, and may hold promise for improving treatment response in highly anxious youths.; © 2013 Wiley Periodicals, Inc.
Depression & Anxiety, 30(9) : 822-828
- Year: 2013
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Attention/cognitive bias modification
Sibinga, E. M. S., Perry-Parrish, C., Chung, S. E., Johnson, S. B., Smith, M., Ellen, J. M.
Objectives: Mindfulness-based stress reduction (MBSR) has been shown to improve mental health and reduce stress in a variety of adult populations. Here, we explore the effects of a school-based MBSR program for young urban males. Participants and methods: In fall 2009, 7th and 8th graders at a small school for low-income urban boys were randomly assigned to 12-session programs of MBSR or health education (Healthy Topics-HT). Data were collected at baseline, post-program, and three-month follow-up on psychological functioning; sleep; and salivary cortisol, a physiologic measure of stress. Results: Forty-one (22 MBSR and 19 HT) of the 42 eligible boys participated, of whom 95% were African American, with a mean age of 12.5. years. Following the programs, MBSR boys had less anxiety (p = 0.01), less rumination (p = 0.02), and showed a trend for less negative coping (p = 0.06) than HT boys. Comparing baseline with post-program, cortisol levels increased during the academic terms for HT participants at a trend level (p = 0.07) but remained constant for MBSR participants (p = 0.33). Conclusions: In this study, MBSR participants showed less anxiety, improved coping, and a possible attenuation of cortisol response to academic stress, when compared with HT participants. These results suggest that MBSR improves psychological functioning among urban male youth. (copyright) 2013 Elsevier Inc.
Preventive Medicine, 57(6) : 799-801
- Year: 2013
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Mindfulness based therapy
Sportel, B. Esther, de-Hullu, Eva, de-Jong, Peter J., Nauta, Maaike H.
Unlabelled: Social anxiety is a common mental disorder among adolescents and is associated with detrimental long term outcomes. Therefore, this study investigated the efficacy of two possible early interventions for adolescent social anxiety and test anxiety. An internet-based cognitive bias modification (CBM; n = 86) was compared to a school-based cognitive behavioral group training (CBT; n = 84) and a control group (n = 70) in reducing symptoms of social and test anxiety in high socially and/or test anxious adolescents aged 13-15 years. Participants (n = 240) were randomized at school level over the three conditions. CBM consisted of a 20-session at home internet-delivered training; CBT was a 10-session at school group training with homework assignments; the control group received no training. Participants were assessed before and after the intervention and at 6 and 12 month follow-up. At 6 month follow-up CBT resulted in lower social anxiety than the control condition, while for CBM, this effect was only trend-significant. At 12 month follow-up this initial benefit was no longer present. Test anxiety decreased more in the CBT condition relative to the control condition in both short and long term. Interestingly, in the long term, participants in the CBM condition improved more with regard to automatic threat-related associations than both other conditions. The results indicate that the interventions resulted in a faster decline of social anxiety symptoms, whereas the eventual end point of social anxiety was not affected. Test anxiety was influenced in the long term by the CBT intervention, and CBM lead to increased positive automatic threat-related associations.; Trial Registration: TrialRegister.nl NTR965.;
PLoS ONE, 8(5) : e64355-e64355
- Year: 2013
- Problem: Anxiety Disorders (any), Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Attention/cognitive bias modification
Zhang, Linxiu, Kleiman-Weiner, Max, Luo, Renfu, Shi, Yaojiang, Martorell, Reynaldo, Medina, Alexis, Rozelle, Scott
Despite growing wealth and a strengthening government commitment to improve livelihoods and welfare, many students across rural China have inadequate access to micronutrient-rich diets. Poor diets can lead to nutritional problems, such as iron-deficiency anemia, that can adversely affect health, attention, learning, and mental health. The overall goal of this paper is to assess the impact of multiple micronutrient supplementation (MMS) on anemia and anxiety among students in poor areas of rural China. To achieve this goal, we conducted a randomized controlled trial in 54 randomly chosen elementary schools in 8 of the poorest counties in Shaanxi Province in Northwest China. Study participants were 2730 fourth-grade students, mostly aged 10-12 y. Schools were randomly assigned to 1 of 2 groups: a control group that received no intervention and an intervention group that received a daily MMS with 5 mg of iron (ferrous sulfate) for 5 mo. Our primary outcome measures were hemoglobin (Hb) concentrations (assessed by HemoCue 201+ technology), anemia prevalence (defined as Hb) concentrations ≤120 g/L), and anxiety (using a written mental health test). The results showed that 42.4% of students were anemic at baseline. The Hb concentration was 121.7 ± 10.7 g/L in the treatment group and 123.4 ± 11.4 g/L in the control group. MMS increased Hb concentrations by 1.7 g/L ± 0.15 and reduced anemia rates by 7.0 percentage points (P < 0.05). Anxiety was reduced by 0.30 SDs (P < 0.01). MMS reduced both anemia and anxiety. Our results should encourage further research on the linkages between nutrition and mental health in a development context.;
Journal of Nutrition, 143(5) : 640-647
- Year: 2013
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Vitamins and supplements