Disorders - Anxiety Disorders
Macdonald, G., Higgins, J. P., Ramchandani, P., Valentine, J. C., Bronger, L. P., Klein, P., O'Daniel, R., Pickering, M., Rademaker, B., Richardson, G., Taylor, M.
Despite differences in how it is defined, there is a general consensus amongst clinicians and researchers that the sexual abuse of children and adolescents ('child sexual abuse') is a substantial social problem worldwide. The effects of sexual abuse manifest in a wide range of symptoms, including fear, anxiety, post-traumatic stress disorder and various externalising and internalising behaviour problems, such as inappropriate sexual behaviours. Child sexual abuse is associated with increased risk of psychological problems in adulthood. Cognitive-behavioural approaches are used to help children and their non-offending or 'safe' parent to manage the sequelae of childhood sexual abuse. This review updates the first Cochrane review of cognitive-behavioural approaches interventions for children who have been sexually abused, which was first published in 2006. To assess the efficacy of cognitive-behavioural approaches (CBT) in addressing the immediate and longer-term sequelae of sexual abuse on children and young people up to 18 years of age. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2011 Issue 4); MEDLINE (1950 to November Week 3 2011); EMBASE (1980 to Week 47 2011); CINAHL (1937 to 2 December 2011); PsycINFO (1887 to November Week 5 2011); LILACS (1982 to 2 December 2011) and OpenGrey, previously OpenSIGLE (1980 to 2 December 2011). For this update we also searched ClinicalTrials.gov and the International Clinical Trials Registry Platform (ICTRP). We included randomised or quasi-randomised controlled trials of CBT used with children and adolescents up to age 18 years who had experienced being sexually abused, compared with treatment as usual, with or without placebo control. At least two review authors independently assessed the eligibility of titles and abstracts identified in the search. Two review authors independently extracted data from included studies and entered these into Review Manager 5 software. We synthesised and presented data in both written and graphical form (forest plots). We included 10 trials, involving 847 participants. All studies examined CBT programmes provided to children or children and a non-offending parent. Control groups included wait list controls (n = 1) or treatment as usual (n = 9). Treatment as usual was, for the most part, supportive, unstructured psychotherapy. Generally the reporting of studies was poor. Only four studies were judged 'low risk of bias' with regards to sequence generation and only one study was judged 'low risk of bias' in relation to allocation concealment. All studies were judged 'high risk of bias' in relation to the blinding of outcome assessors or personnel; most studies did not report on these, or other issues of bias. Most studies reported results for study completers rather than for those recruited.Depression, post-traumatic stress disorder (PTSD), anxiety and child behaviour problems were the primary outcomes. Data suggest that CBT may have a positive impact on the sequelae of child sexual abuse, but most results were not statistically significant. Strongest evidence for positive effects of CBT appears to be in reducing PTSD and anxiety symptoms, but even in these areas effects tend to be 'moderate' at best. Meta-analysis of data from five studies suggested an average decrease of 1.9 points on the Child Depression Inventory immediately after intervention (95% confidence interval (CI) decrease of 4.0 to increase of 0.4; I(2) = 53%; P value for heterogeneity = 0.08), representing a small to moderate effect size. Data from six studies yielded an average decrease of 0.44 standard deviations on a variety of child post-traumatic stress disorder scales (95% CI 0.16 to 0.73; I(2) = 46%; P value for heterogeneity = 0.10). Combined data from five studies yielded an average decrease of 0.23 standard deviations on various child anxiety scales (95% CI 0.3 to 0.4; I(2) = 0%; P value for heterogeneity = 0.84). No study reported adverse effects. The conclusions of this updated review remain the same as those when it was first published. The eview confirms the potential of CBT to address the adverse consequences of child sexual abuse, but highlights the limitations of the evidence base and the need for more carefully conducted and better reported trials.
Cochrane Database of Systematic Reviews, 5 : CD001930
- Year: 2012
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Richards, J., Foster, C.
Introduction: It is estimated that, in any given year, at least 20% of adolescents experience mental health (MH) disorders that are consistent across cultures. High levels of psychological distress are common in post-conflict settings andMHdisorder rates tend to double. The sport-for-development (SfD) sector is rapidly emerging and claims to positively influenceMHin this context. This study examined the impact of a SfD programme on the MH of young adolescents in Gulu, Uganda. Methods: Voluntary male registrants for a SfD programme in Gulu aged 11-14 years were randomly allocated into an intervention (T, n = 73) or wait-list (W, n = 71) group. All voluntary female registrants aged 11-14 years were allocated into group T (n = 79). A non-registered control (O) group was also formed for both boys (n = 450) and girls (n = 727). The intervention comprised a 9-week competitive sport league (1x40 minute football match and at least 1x1.5 hour training per week). All groups undertook MH measurements before and after the intervention. The Acholi Psychosocial Assessment Instrument (APAI) was used to assess local depressionlike (DL) and anxiety-like (AL) syndromes. Within-group changes ((Delta)) were assessed using paired t-tests. The between-group comparisons of (Delta) were analysed using a repeat measures ANOVA adjusted for differences at baseline. Results: The deterioration in MHof the boys in Twas not statistically significant for DL [0.076] or AL [0.344]. This contrasted with the boys inWand O who experienced significant improvements in DL and AL [p<0.01]. There was a significant between-group difference in the adjusted data for boys (Delta)T vs. (Delta)W [p<0.01] and (Delta)T vs. (Delta)O [DL: p<0.05]. There was no significant change for the girls in T for DL [p = 0.155] or AL [p = 0.223]. Although the girls in O experi-enced significant improvements for DL and AL [p<0.01], there were no significant between-group differences in the (Delta)T vs. (Delta)O after adjusting the data [DL: p = 0.836, AL: p = 0.819]. Discussion: The SfD intervention appeared to negatively affect theMHof boys in T. This may have been caused by exposure to new emotional pressures and stress associated with competition. Girls in T did not experience the same deterioration in MH. This may be explained by an apparently less intense focus on winning by the girls and their coaches. The MH benefits experienced by the waitlisted boys may have been because they were exposed to improved local capacity for sport without the negative effects of a competitive league.
Journal of Science & Medicine in Sport, 15 : S345
- Year: 2012
- Problem: Anxiety Disorders (any)
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
McGrady, A., Brennan, J., Lynch, D., Whearty, K.
Entering medical students experience distress symptoms due to the demands of the intensive curriculum, adjustment to new environments and increased responsibilities. The purpose of this controlled, randomized study was to determine the effects of a structured wellness program on measures of anxiety, depression and frequency of acute illness in 449 first year medical students. The effects of eight sessions of stress management were compared to a wait list control group. High risk students were identified based on scores on psychological inventories and number of recent life events (WLE). Results showed that depression, anxiety scores and frequency of acute illness were higher in women than in men, and were higher in students with multiple life events. Significant decreases were observed in depression in the intervention group students when WLE was the covariate (p = .045). Further, the high risk group showed consistently lower depression scores after the intervention compared to high risk wait list controls (p = .003), and these changes were maintained at the end of school year. There were no significant changes in anxiety or frequency of acute illness. Wellness programs can be implemented in medical school and may be particularly useful for entering students with elevated psychological distress. (copyright) Springer Science+Business Media, LLC 2012.
Applied Psychophysiology Biofeedback, 37(4) : 253-260
- 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
McManus, F., Van-Doorn, K., Yiend, J.
Objective: While the efficacy and effectiveness of CBT protocols are well established, much less is known about the comparative contribution of the various techniques within CBT. The present study examined the relative efficacy, in comparison to a control condition, of two central techniques in CBT: thought records (TRs) and behavioral experiments (BEs). Method: A mixed within and between participants design was used to compare the efficacy of a single session TR and a single session BE intervention with a control intervention, in a non-clinical sample. Ninety one participants were randomly allocated to one of the three conditions. Results: The overall pattern of results suggests that both TR and BE had a beneficial therapeutic impact in comparison to the control condition on beliefs, anxiety, behavior and a standardized measure of symptoms. There was evidence of a small advantage of the BE over the TR intervention in that the target belief changed earlier and change generalized to beliefs about others as well as the self. Conclusions: The findings confirm the utility of both TR and BE interventions and point to BEs as more useful in effecting belief change in that the change in the BE condition occurred sooner and generalized further. (copyright) 2011 Elsevier Ltd. All rights reserved.
Journal of Behavior Therapy & Experimental Psychiatry, 43(1) : 540-547
- Year: 2012
- Problem: Anxiety Disorders (any)
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Other Psychological Interventions
Hofmann, S. G., Asnaani, A., Vonk, I. J. J., Sawyer, A. T., Fang, A.
Cognitive behavioral therapy (CBT) refers to a popular therapeutic approach that has been applied to a variety of problems. The goal of this review was to provide a comprehensive survey of meta-analyses examining the efficacy of CBT. We identified 269 meta-analytic studies and reviewed of those a representative sample of 106 metaanalyses examining CBT for the following problems: substance use disorder, schizophrenia and other psychotic disorders, depression and dysthymia, bipolar disorder, anxiety disorders, somatoform disorders, eating disorders, insomnia, personality disorders, anger and aggression, criminal behaviors, general stress, distress due to general medical conditions, chronic pain and fatigue, distress related to pregnancy complications and female hormonal conditions. Additional meta-analytic reviews examined the efficacy of CBT for various problems in children and elderly adults. The strongest support exists for CBT of anxiety disorders, somatoform disorders, bulimia, anger control problems, and general stress. Eleven studies compared response rates between CBT and other treatments or control conditions. CBT showed higher response rates than the comparison conditions in seven of these reviews and only one review reported that CBT had lower response rates than comparison treatments. In general, the evidencebase of CBT is very strong. However, additional research is needed to examine the efficacy of CBT for randomizedcontrolled studies. Moreover, except for children and elderly populations, no meta-analytic studies of CBT have been reported on specific subgroups, such as ethnic minorities and low income samples. (copyright) Springer Science+Business Media, LLC 2012.
Cognitive Therapy & Research, 36(5) : 427-440
- Year: 2012
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Kaslow, Nadine J., Broth, Michelle Robbins, Smith, Chaundrissa Oyeshiku, Collins, Marietta H.
Emotional and behavioral symptoms and disorders are prevalent in children and adolescents. There has been a burgeoning literature supporting evidence-based treatments for these disorders. Increasingly, family-based interventions have been gaining prominence and demonstrating effectiveness for myriad childhood and adolescent disorders. This article presents the current evidence in support of family-based interventions for mood, anxiety, attention-deficit hyperactivity, disruptive behavior, pervasive developmental particularly autism spectrum, and eating disorders. This review details recent data from randomized controlled trials (RCTs) and promising interventions not yet examined using a randomized controlled methodology. It highlights the evidence base supporting various specific family-based interventions, some of which are disorder dependent. A practitioner perspective is then offered with regard to recommendations for future practice and training. The article closes with a summary and directions for future research.; © 2012 American Association for Marriage and Family Therapy.
Journal of Marital & Family Therapy, 38(1) : 82-100
- Year: 2012
- Problem: Anxiety Disorders (any), Depressive Disorders, Anorexia Nervosa, Bulimia Nervosa
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Family therapy
Li, X., Lu, Y. M., Zhang, Z., Wang, J., Pan, H. T., Zhang, Q. X.
Studies on people-plant interaction indicated that visual exposure to nature or plants had positive influences on human health. The objective of this study was to explore the visual effects of red, pink, yellow and white flowers of gerbera (Gerbera jamesonii), carnation (Dianthus caryophyllus) and modern rose (Rosa hybrida) on human psycho-physiological responses as compared to a blank white picture as the control. The physiological measurements of 30 university students (15 males and 15 females) included blood pressure (BP), including systolic blood pressure (SBP) and diastolic blood pressure (DBP), heart rate (HR), galvanic skin response (GSR) and fingertip pulse (FP). The State-Trait Anxiety Inventory (STAI) and the Profile of Mood States (POMS) were used to record subjects' psychological reactions during the test. The participants showed physiological benefits as evidenced by decreased SBP, DBP, HR and FP, and increased GSR after receiving flower color stimuli. The results also suggested that exposure to flower colors had psychological improvements, including reduced levels of anxiety, irritability and fatigue. Significant color differences were found in SBP, DBP, STAI, irritability, vigor and fatigue responses. However, there were no significant differences among the three ornamental species tested in any of the physiological or psychological reactions. In conclusion, findings of this research indicated that pink and white flowers were effective in reducing negative feelings, such as anxiety, anger and fatigue; while red and yellow flowers were effective in promoting vigor level.
Journal of Food, Agriculture & Environment, 10(3-4) : 1294-1300
- Year: 2012
- Problem: Anxiety Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Other complementary & alternative interventions
Iglesias, S. L., Azzara, S., Argibay, J. C., Arnaiz, M. L., deValle Carpineta, M., Granchetti, H., Lagomarsino, E.
To design, implement, and examine the psychoneuroendocrine responses of three different types of stress management programs. Randomly assigned. A pre/post experimental design comparing variables between three different programs and a control group. The first program included training in deep breathing, relaxation response, meditation, and guided imagery techniques (RRGI). The second program included training in cognitive behavioral techniques (CB). The third program included both RRGI and CB (RRGICB). The study was conducted at Buenos Aires University. Participants (N = 52) were undergraduate students. Anxiety, anger, hopelessness, neuroticism, respiration rate, and salivary cortisol levels were assessed. Wilcoxon signed rank test was used to investigate differences in pre and post variables. Subjects in the RRGI group showed significantly lower levels of anxiety (p < .011), anger (p < .012), neuroticism (p < .01), respiratory rate (p < .002), hopelessness (p < .01), and salivary cortisol (p < .002) after the treatment. Subjects in the CB group showed significantly lower levels of anxiety (p < .018), anger (p < .037), and neuroticism (p < .03) after the treatment. Subjects in the RRGICB group showed significantly lower levels of anxiety (p < .001), anger (p < .001), neuroticism (p < .008), hopelessness (p < .01), respiratory rate (p < .001), and salivary cortisol (p < .002) after the treatment. Subjects in the control group showed only one variable modification, a significant increase in cortisol levels (p < .004). The combination of deep breathing, relaxation response, meditation, and guided imagery techniques with CB seems to be effective at helping people to deal with stress.
American Journal of Health Promotion, 26(6) : e149-158
- Year: 2012
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Other Psychological Interventions, Meditation
, Relaxation
Jarrett, M. A., Ollendick, T. H.
Objective: The present study evaluated a 10-week psychosocial treatment designed specifically for children with attention-deficit/hyperactivity disorder (ADHD) and a comorbid anxiety disorder. Method: Using a nonconcurrent multiple baseline design, the authors treated 8 children ages 8-12 with ADHD, combined type, and at least 1 of 3 major anxiety disorders (separation anxiety disorder, generalized anxiety disorder, social phobia). The integrated treatment protocol involved parent management training for ADHD and family-based cognitive-behavioral therapy for anxiety. Pretreatment assessments included semistructured diagnostic interviews and other standardized measures to determine study eligibility. Children were randomized to 1 of 3 baseline control conditions (i.e., 2, 3, or 4 weeks) and subsequently treated in a university-based psychosocial treatment clinic. Weekly assessments of ADHD and anxiety disorder symptoms occurred throughout treatment and comprehensive assessments were obtained at pretreatment, 1-week posttreatment, and 6-months posttreatment. Results: Single-case results supported greater success in the treatment phase relative to the baseline phase for both ADHD and anxiety symptoms, and ADHD and anxiety symptoms appeared to change concurrently. Pre-post group analyses revealed significant and clinically meaningful improvements in ADHD and anxiety symptoms at 1-week posttreatment, but only anxiety symptoms moved into the subclinical range. At 6-months follow-up, treatment effects were maintained with new movement into the subclinical range for ADHD. Conclusions: The present study provides initial data on an integrated treatment protocol for ADHD and anxiety. Further replication and evaluation are needed. Implications of the findings are discussed. (copyright) 2012 American Psychological Association.
Journal of Consulting & Clinical Psychology, 80(2) : 239-244
- Year: 2012
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Other Psychological Interventions
Goes, T. C., Antunes, F. D., Alves, P. B., Teixeira-Silva, F.
Objectives: The objective of this study was to evaluate the potential anxiolytic effect of sweet orange (Citrus sinensis) aroma in healthy volunteers submitted to an anxiogenic situation. Design: Forty (40) male volunteers were allocated to five different groups for the inhalation of sweet orange essential oil (test aroma: 2.5, 5, or 10 drops), tea tree essential oil (control aroma: 2.5 drops), or water (nonaromatic control: 2.5 drops). Immediately after inhalation, each volunteer was submitted to a model of anxiety, the video-monitored version of the Stroop Color-Word Test (SCWT). Outcome measures: Psychologic parameters (state-anxiety, subjective tension, tranquilization, and sedation) and physiologic parameters (heart rate and gastrocnemius electromyogram) were evaluated before the inhalation period and before, during, and after the SCWT. Results: Unlike the control groups, the individuals exposed to the test aroma (2.5 and 10 drops) presented a lack of significant alterations (p>0.05) in state-anxiety, subjective tension and tranquillity levels throughout the anxiogenic situation, revealing an anxiolytic activity of sweet orange essential oil. Physiologic alterations along the test were not prevented in any treatment group, as has previously been observed for diazepam. Conclusions: Although more studies are needed to find out the clinical relevance of aromatherapy for anxiety disorders, the present results indicate an acute anxiolytic activity of sweet orange aroma, giving some scientific support to its use as a tranquilizer by aromatherapists. (copyright) 2012, Mary Ann Liebert, Inc.
Journal of Alternative & Complementary Medicine, 18(8) : 798-804
- Year: 2012
- Problem: Anxiety Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Other complementary & alternative interventions
Jing, W., Wahab, M. N. A., Ming, G., Jingya, B.
Islamic prayer (Salah) is a practice of formal prayer in Islam. Salah is known to improve psychological, musculoskeletal and cerebral effects and gain significant health benefits students. This study explored the experience of devoutness-based Salah training for female college students in Salah practitioners and compared them with respective controls. The index of Phalange temperature (PT) is also surveyed by approaches of performing Salah, which is possible in using psychophysiological signals as strategies of relieving symptoms of stress. In this study, a group of subjects who practiced devoutness-based Salah for 22 days showed more pronounced improvement of PT on day 22 compared to day 1. The control group did not show important changes baseline and on day 22. PT was explored through the analysis of measured psychophysiological signals and for the analysis of procedures to performing Salah, which was explored. Psychophysiologically-driven instruments and data displays for mitigating stress, anxiety and depression symptoms and promoting health situation purposes were built. The findings are as follows: (1) Participation in performing devoutness- based Salah program can lead to significant reduction in levels of stress in female college students who suffered from stress disorders. (2) This study demonstrates that the protocol is an opportunity to spend a little time in performing devoutness-based Salah, makes psychophysiological benefits effectively by evaluating the PT.
HealthMED, 6(11) : 3548-3557
- Year: 2012
- Problem: Anxiety Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Other complementary & alternative interventions
Galla, B. M., Wood, J. J., Chiu, A. W., Langer, D. A., Jacobs, J., Ifekwunigwe, M., Larkins, C.
The current study sought to evaluate the relative long-term efficacy of a modularized cognitive behavioral therapy (CBT) program for children with anxiety disorders. Twenty four children (5-12 years old) randomly assigned to modular CBT or a 3-month waitlist participated in a 1-year follow-up assessment. Independent evaluators blind to treatment condition conducted structured diagnostic interviews, and caregivers and children completed symptom checklists at pre- and post-, and 1 year follow-up assessments. Analyses revealed that 71.4% of children who received CBT demonstrated a positive treatment response 1 year following treatment, and 83.3% were free of any anxiety diagnosis at 1 year follow-up. Analyses further revealed robust effects of intervention on diagnostic outcomes, caregiver- and child-report measures of anxiety at 1 year follow-up. Results provide evidence of an ongoing advantage on anxiety-specific outcomes for this modularized school-based CBT program 1 year post-treatment.
Child Psychiatry & Human Development, 43(2) : 219-226
- Year: 2012
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)