Disorders - Anxiety Disorders
Radhu, N., Daskalakis, Z. J., Guglietti, C. L., Farzan, F., Barr, M. S., Arpin-Cribbie, C. A., Fitzgerald, P. B., Ritvo, P.
Background: Several lines of evidence suggest that cognitive behavioral therapy (CBT) is an effective treatment for depression and anxiety disorders. Evidence suggests that the therapeutic effects of CBT are related to neurophysiologic changes in the cortex, particularly (gamma)-aminobutyric acid (GABA) potentiation. Transcranial magnetic stimulation (TMS) represents a noninvasive method of measuring cortical inhibition, which is a neurophysiologic mechanism associated with the pathophysiology of several psychiatric disorders. Objective/Hypothesis: To demonstrate the effectiveness of a 12-week CBT intervention compared with a wait list control group measuring cortical inhibition in participants with pathologic perfectionism. Participants within the CBT group would demonstrate increases in cortical inhibition and improvements on clinical outcomes relative to the wait list control group. Methods: Twenty-four right-handed perfectionists were randomly assigned to a 12-week CBT intervention or a wait list control group. Cortical inhibition was measured at pre- and postintervention with TMS paradigms specifically short-interval cortical inhibition and the cortical silent period, which index GABAA and GABAB receptor-mediated inhibitory neurotransmission, respectively. Results: The CBT group demonstrated a significant potentiation of the cortical silent period when compared with the wait list control group. The CBT group demonstrated a decrease in anxiety sensitivity and automatic thoughts relative to the control group. Conclusions: These findings demonstrate that CBT tailored for perfectionism is accompanied by an increase in cortical inhibition of the motor cortex and positive changes on clinical outcomes. These findings provide compelling evidence for an association between positive CBT effects and a potentiation of GABAergic inhibitory neurotransmission. (copyright) 2012 Elsevier Inc. All rights reserved.
Brain Stimulation, 5(1) : 44-54
- Year: 2012
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Pribis, P., Bailey, R. N., Russell, A. A., Kilsby, M. A., Hernandez, M., Craig, W. J., Grajales, T., Shavlik, D. J., Sabate, J.
Walnuts contain a number of potentially neuroprotective compounds like vitamin E, folate, melatonin, several antioxidative polyphenols and significant amounts of n-3 α-linolenic fatty acid. The present study sought to determine the effect of walnuts on verbal and non-verbal reasoning, memory and mood. A total of sixty-four college students were randomly assigned to two treatment sequences in a crossover fashion: walnuts-placebo or placebo-walnuts. Baseline data were collected for non-verbal reasoning, verbal reasoning, memory and mood states. Data were collected again after 8 weeks of intervention. After 6 weeks of washout, the intervention groups followed the diets in reverse order. Data were collected once more at the end of the 8-week intervention period. No significant increases were detected for mood, non-verbal reasoning or memory on the walnut-supplemented diet. However, inferential verbal reasoning increased significantly by 11.2%, indicating a medium effect size (P = 0.009; d = 0.567). In young, healthy, normal adults, walnuts do not appear to improve memory, mood or non-verbal reasoning abilities. However, walnuts may have the ability to increase inferential reasoning. Copyright © The Authors 2011.
British Journal of Nutrition, 107(9) : 1393-1401
- Year: 2012
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Dietary advice, dietary change
Pace, T., Negi, L., Donaldson-Lavelle, B., Ozawa-de-Silva, B., Reddy, S., Cole, S., Craighead, L., Raison, C.
Purpose: Children exposed to early life adversity (ELA) demonstrate elevated circulating concentrations of health-relevant inflammatory biomarkers which persist into adulthood. Increased inflammation in individuals with ELA is believed to contribute to the increased risk for medical and psychiatric illnesses observed in these individuals. The objective of this study was to determine whether Cognitively-Based Compassion Training (CBCT) reduces salivary concentrations of Creactive protein (CRP) in adolescents with high rates of ELA, and to evaluate the relationship between CBCT practice time and changes in CRP. CBCT is a meditation-based program designed to enhance compassion for self and others and to promote prosocial behavior. Based on prior findings, it was hypothesized that practice time during the study would be more strongly associated with reductions in CRP than would group assignment. Methods: Seventy-one adolescents between the ages of 13 and 17 (31 females) in the Georgia Foster Care system were randomized to either six weeks of CBCT or a wait-list control condition. Saliva was obtained upon awakening prior to randomization and again 6 weeks later, as were selfreport measures of depression and anxiety. Saliva was assayed for CRP using a high-sensitivity ELISA (Salimetrics, State College, PA). Trauma/ neglect history was obtained from state records. Participants completed practice time diaries as a means of assessing amount of engagement with the CBCT program. Results: No between group differences were observed in salivary CRP concentrations, self-reported depression or anxiety symptoms. Within the group randomized to CBCT, increased practice time was associated with reduced CRP from baseline to the six week assessment. Conclusion: Engagement with CBCT positively impacts an inflammatory biomarker relevant to health in adolescents at high risk for poor adult health and social functioning as a result of significant early life adversity, including placement in foster care.
BMC Complementary & Alternative Medicine, 12 :
- Year: 2012
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Mohebi, S., Sharifirad, G. H., Shahsiah, M., Botlani, S., Matlabi, M., Rezaeian, M.
Academic anxiety is an important educational problem that affects millions of students in colleges and schools over the world each year. Although a low level of anxiety can cause positive motivation for improvement of educational functioning, high levels of it can cause a disturbance in concentration, attention, storage of knowledge, recall and educational reduction. It has also been recently determined that there is a relationship between anxiety and assertiveness. Therefore, this study is an attempt to determine the effect of assertiveness training on reducing anxiety levels in pre-college academic students in Gonabad city in 2008. In this clinical trial study, all the pre-college students of Gonabad city were invited to participate and 89 students were divided into experimental and control groups. There were 3 questionnaires, namely demographic, academic anxiety and assertiveness Rathus questionnaires in which the validity and reliability were calculated and approved. The intervention for the experimental group was 5 sessions of assertiveness training using the PRECEDE model and 1 session for parents and teachers to help and support the intervention program. We had a post-test 8 weeks after the last training session for each group was conducted. The data was analyzed by SPSS. The results showed that anxiety levels and decisiveness in the target group were moderate to high and it is seen as a significant reverse relationship between these two factors (r = -0.69 and p < 0.001). The results also showed that there was a significant anxiety decrease in the experimental group after the intervention. On the one hand, there was a significant increase in decisiveness for both groups, but there was not a significant difference between academic anxiety and assertiveness in the control group.before and after the intervention. Due to a significant decrease in anxiety and increased decisiveness in the experimental group, it can be claimed that assertiveness training is an effective non-pharmacological method for reducing academic anxiety and it can improve academic performance.
Journal of the Pakistan Medical Association, 62(3 Suppl 2) : S37-41
- Year: 2012
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Noggle, J. J., Steiner, N. J., Minami, T., Khalsa, S. B. S.
Objective: To test feasibility of yoga within a high school curriculum and evaluate preventive efficacy for psychosocial well-being. Methods: Grade 11 or 12 students (N (less-than or equal to) 51) who registered for physical education (PE) were cluster-randomized by class 2:1 yoga:PE-as-usual. A Kripalu-based yoga program of physical postures, breathing exercises, relaxation, and meditation was taught 2 to 3 times a week for 10 weeks. Self-report questionnaires were administered to students 1 week before and after. Primary outcome measures of psychosocial well-being were Profile of Mood States-Short Form and Positive and Negative Affect Schedule for Children. Additional measures of psychosocial well-being included Perceived Stress Scale and Inventory of Positive Psychological Attitudes. Secondary measures of self-regulatory skills included Resilience Scale, State Trait Anger Expression Inventory-2(trademark), and Child Acceptance Mindfulness Measure. To assess feasibility, yoga students completed a program evaluation. Analyses of covariance were conducted between groups with baseline as the covariate. Results: Although PE-as-usual students showed decreases in primary outcomes, yoga students maintained or improved. Total mood disturbance improved in yoga students and worsened in controls (p (less-than or equal to) .015), as did Profile of Mood States-Short Form (POMS-SF) Tension-Anxiety subscale (p (less-than or equal to) .002). Although positive affect remained unchanged in both, negative affect significantly worsened in controls while improving in yoga students (p (less-than or equal to) .006). Secondary outcomes were not significant. Students rated yoga fairly high, despite moderate attendance. Conclusions: Implementation was feasible and students generally found it beneficial. Although not causal due to small, uneven sample size, this preliminary study suggests preventive benefits in psychosocial well-being from Kripalu yoga during high school PE. These results are consistent with previously published studies of yoga in school settings. (copyright) 2012 Lippincott Williams & Wilkins.
Journal of Developmental & Behavioral Pediatrics, 33(3) : 193-201
- Year: 2012
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Mind-body exercises (e.g. yoga, tai chi, qigong)
, Physical activity, exercise
Pina, A. A., Zerr, A. A., Villalta, I. K., Gonzales, N. A.
Objective: This trial of a randomized indicated anxiety prevention and early intervention explored initial program effects as well as the role of ethnicity and language on measured outcomes. Method: A total of 88 youth (M = 10.36 years; 45 girls, 52 Latino) received 1 of 2 protocols with varying degrees of parent involvement, and response was measured at posttest and 6-month follow-up. Results: Findings showed that child anxiety symptoms improved significantly across protocols, although additional gains were found for children in the child plus parent condition. Program effects did not vary by Latino ethnicity or Spanish language use in the intervention. Conclusions: The cognitive and behavioral strategies established for Caucasian children may be promising for Hispanic/Latino children when applied in a culturally responsive manner. (copyright) 2012 American Psychological Association.
Journal of Consulting & Clinical Psychology, 80(5) : 940-946
- Year: 2012
- 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)
, Other Psychological Interventions
Paul, M., Garg, K.
Coping with pressure and anxiety is an ineluctable demand of sports performance. Heart rate variability (HRV) Biofeedback (BFB) shall be used as a tool for self regulating physiological responses resulting in improved psycho physiological interactions. For further analysis, the present study has been designed to examine the relationship between anxiety and performance and also effectiveness of biofeedback protocol to create stress-eliciting situation in basketball players. Thirty basketball players of university level and above (both male and female) aged 18-28 years, who scored a minimum of 20 in state trait anxiety inventory, were randomly divided into three equal groups- Experimental (Biofeedback) group, Placebo group and Control (No Treatment) group. The BFB group received HRV BFB training for 10 consecutive days for 20 min that included breathing at individual's resonant frequency through a pacing stimulus; Placebo group was shown motivational video clips for 10 consecutive days for 10 min, whereas No Treatment Control group was not given any intervention. Two way repeated measure ANOVA was applied to analyze the differences within and between the groups. Anxiety, coping self-efficacy, heart rate variability, respiration rate, and performance (dribbling, passing and shooting) at session 1, 10 and 1 month follow up were statistically significant in each group along with interaction of group and time (p<0.001). Also, all the measures showed statistically significant inter group difference (p<0.05). The findings are harmonious with existing data on HRV BFB as a strategy for dealing with anxiety. The Placebo group showed improvement in self efficacy and performance post training. The Control group showed no change in any variable except performance. The results of the study support the idea that HRV BFB lowers the anxiety and thus there seems to be a potential association between HRV BFB and performance optimization. (copyright) Springer Science+Business Media, LLC 2012.
Applied Psychophysiology Biofeedback, 37(2) : 131-144
- Year: 2012
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Biofeedback, neurofeedback, audio/video feedback
Keough, M. E., Schmidt, N. B.
Objective: Anxiety disorders are the most prevalent psychiatric disorders in the United States and result in substantial burden to the individual and society. Although effective treatments for anxiety disorders have been developed, there has been substantially less focus on interventions aimed at the amelioration of anxiety-related risk and maintenance factors. Anxiety sensitivity (AS) is a well-established, malleable risk and maintenance factor for panic disorder and other psychopathology. The aim of the current investigation was to enhance the efficacy of AS treatment through the refinement of a previously validated intervention. Method: This 1-session intervention utilized psychoeducation and interoceptive exposure to target AS and was compared with a health-focused control intervention among a nontreatment seeking sample (N = 104) of individuals with elevated AS. Results: Study findings indicate that the active treatment group demonstrated significantly greater reductions in AS than the control group at posttreatment and across the 1-month study period. These treatment gains were seen across the ASI subscales. A Month 6 follow-up assessment indicated that the treatment group retained the majority of their AS reduction, whereas the control group retained their elevated AS scores. The intervention responses of participants meeting Axis I diagnostic criteria did not differ from the responses of those without a current diagnosis. Conclusions: Despite the brevity of the treatment intervention, findings demonstrate that it resulted in substantial reductions in AS that were largely maintained 6 months posttreatment. Anxiety treatment and prevention implications are discussed. (copyright) 2012 American Psychological Association.
Journal of Consulting & Clinical Psychology, 80(5) : 766-772
- Year: 2012
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Exposure therapy, Exposure and response prevention, Psychoeducation
Khalsa, S. B., Hickey-Schultz, L., Cohen, D., Steiner, N., Cope, S.
The goal of this study was to evaluate potential mental health benefits of yoga for adolescents in secondary school. Students were randomly assigned to either regular physical education classes or to 11 weeks of yoga sessions based upon the Yoga Ed program over a single semester. Students completed baseline and end-program self-report measures of mood, anxiety, perceived stress, resilience, and other mental health variables. Independent evaluation of individual outcome measures revealed that yoga participants showed statistically significant differences over time relative to controls on measures of anger control and fatigue/inertia. Most outcome measures exhibited a pattern of worsening in the control group over time, whereas changes in the yoga group over time were either minimal or showed slight improvements. These preliminary results suggest that implementation of yoga is acceptable and feasible in a secondary school setting and has the potential of playing a protective or preventive role in maintaining mental health.
Journal of Behavioral Health Services & Research, 39(1) : 80-90
- Year: 2012
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Mind-body exercises (e.g. yoga, tai chi, qigong)
, Physical activity, exercise
Khorvash, M., Askari, A., Rafiemanzelat, F., Botshekan, M., Khorvash, F.
Introduction: This study is performed to investigate the effect of strength and endurance training on the levels of depression, anxiety, and C-reactive proteins inflammatory biomarker changes. Materials and Methods: The research method was experimental, and the statistical population is formed of 300 volunteer male students. After the pre-test, 120 subjects with notable depression and anxiety levels obtained from Beacke and Ketel's questionnaires were selected and randomly divided into two groups of strength and endurance, each containing 60 subjects, and then, again into two groups of experimental and control, each with 30 subjects. All 120 subjects were blood-sampled in the first stage to determine CRP concentration. After 20 sessions of strength and endurance exercises again depression, anxiety, and C-reactive proteins testes were used for both control and experimental groups. Ultimately, the obtained data were analyzed by using t-test in dependent and independent groups and covariance analysis in P 0.05 level. Results: The results showed that the average of age is 25.1(plus or minus)3.2, average of weight is 70.4(plus or minus)8.4 and average of height is 169.8(plus or minus)12.1, in the subjects. Also, the strength and endurance training had reduced the anxiety by 27% (P =.0001), depression by 37% (P =.0001) and C-reactive proteins by 20% (P =.0001), in the subjects. Discussion: Regarding the different effects of training types on research variables, the results showed that the endurance training has a greater effect in reducing the depression, and strength training, in blood C-reactive proteins reduction, Although, no significant difference was observed between anxiety-reducing effects of strength and endurance training.
Journal of Research in Medical Sciences, 17(11) : 1072-1076
- Year: 2012
- 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
McFadden, K. L., Healy, K. M., Hoversten, K. P., Ito, T. A., Hernandez, T. D.
Objectives: Identifying a non-pharmacological intervention to reduce the stress response could be particularly beneficial to college students, a group prone to considerable stress. Acupressure has shown some efficacy in reducing stress in adults following stroke or traumatic brain injury (TBI), but multiple treatments were required. Results from single treatments in healthy populations have been mixed. Design: The current study used a randomised, placebo-controlled, single-blind design to investigate the use of a single acupressure treatment for stress reduction in healthy college students (. n=. 109) during a stressor. Interventions: Participants were randomly assigned to one of three single, 40-min interventions: active acupressure, placebo acupressure, or a relaxation CD control. A math task stressor administered before and after the intervention assessed intervention effects on stressor responsivity. Main outcome measures: Stress responses were measured by physiological (heart rate (HR), heart rate variability (HRV), skin conductance response (SCR)) and subjective measures (State Anxiety Inventory, nine-item Psychological Stress Measure) of anxiety and stress. Results: All interventions were associated with the following changes during the post-intervention stressor compared to the pre-intervention stressor: reduced HR (. p<. 0.001), increased HRV (. p<. 0.024), reduced SCR (. p<. 0.001), reduced subjective stress scores (. p<. 0.001), and increased correct answers (. p<. 0.001). Although all groups demonstrated stress reduction, there were no significant group differences after a single treatment. Conclusions: All interventions significantly reduced the stress response, although not differently. The lack of active acupressure-associated treatment effects appears to be due to insufficient dosing. (copyright) 2012 Elsevier Ltd.
Complementary Therapies in Medicine, 20(4) : 175-182
- Year: 2012
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Acupuncture, acupressure
Kidger, J., Araya, R., Donovan, J., Gunnell, D.
BACKGROUND AND OBJECTIVES: The evidence base for the importance of the school environment for adolescent emotional health has never been systematically reviewed. We aimed to synthesize the evidence for the effect on adolescent emotional health of (1) interventions targeting the school environment and (2) the school environment in cohort studies. METHODS: Searches of Medline, Embase, PsychINFO, CINAHL, ERIC, the Social Citation Index, and the gray literature were conducted. Criteria for inclusion were (1) cohort or controlled trial designs, (2) participants aged 11 to 18 years, (3) emotional health outcomes, and (4) school environment exposure or intervention. Relevant studies were retrieved and data extracted by 2 independent reviewers. RESULTS: Nine papers reporting 5 controlled trials were reviewed, along with 30 cohort papers reporting 23 studies. Two nonrandomized trials found some evidence that a supportive school environment improved student emotional health, but 3 randomized controlled trials did not. Six (20%) cohort papers examined school-level factors but found no effect. There was some evidence that individual perceptions of school connectedness and teacher support predict future emotional health. Multilevel studies showed school effects were smaller than individual-level effects. Methodological shortcomings were common. CONCLUSIONS: There is limited evidence that the school environment has a major influence on adolescent mental health, although student perceptions of teacher support and school connectedness are associated with better emotional health. More studies measuring schoollevel factors are needed. Randomized controlled trials evaluating 1 or 2 environmental components may have more success in establishing effective and feasible interventions compared with complex whole-school programs. Copyright (copyright) 2012 by the American Academy of Pediatrics.
Pediatrics, 129(5) : 925-949
- Year: 2012
- Problem: Anxiety Disorders (any), Depressive Disorders, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions