Disorders - Anxiety Disorders
Garrido, M., Espino, J., Gonzalez-Gomez, D., Lozano, M., Barriga, C., Paredes, S. D., Rodriguez, A. B.
Purpose: Jerte Valley cherries contain high levels of tryptophan, serotonin, and melatonin. These molecules have been shown to be involved in mood regulation. It has been suggested that a complex inter-relationship between brain serotonin, circulating levels of cortisol (the major stress hormone), and the hypothalamus-pituitary-adrenal axis exists in the regulation of stress responses, where cortisol and serotonin act as markers of mood disturbances. Moreover there is growing evidence that altered HPA activity is associated with various age-related pathologies. The present study evaluated the effect of the ingestion of a Jerte Valley cherry-based product, compared to a placebo product, on urine cortisol and 5-hydroxyindoleacetic acid (5-HIAA) levels, and on mood in young, middle-aged, and elderly participants. Methods: Cortisol and 5-HIAA acid levels were measured by commercial enzyme-linked immunosorbent assay kits. The mood state profile was analysed using a visual analogue scale and the state-trait anxiety inventory. Results: Our findings showed that the ingestion of the Jerte Valley cherry product decreased urinary cortisol and increased urinary 5-HIAA levels in all the experimental groups. Moreover, the cherry product was able to lessen anxiety status in the middle-aged and elderly participants, and enhanced subjective mood parameters, particularly family relationships in young participants, and frame of mind and fitness in both middle-aged and elderly subjects. Conclusions: The consumption of the Jerte Valley cherry product may protect against stress and act as a mood enhancer by increasing serotonin availability to the organism, particularly with advancing age. (copyright) 2012 Elsevier Inc.
Experimental Gerontology, 47(8) : 573-580
- Year: 2012
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Homeopathic, plant-based medicines
Gulliver, A., Griffiths, K. M., Christensen, H., Mackinnon, A., Calear, A. L., Parsons, A., Bennett, K., Batterham, P. J., Stanimirovic, R.
Mental disorders are more common in young adults than at any other life stage. Despite this, young people have low rates of seeking professional help for mental health problems. Young elite athletes have less positive attitudes toward seeking help than nonathletes and thus may be particularly unlikely to seek help. Interventions aimed at increasing help-seeking in young elite athletes are warranted. To test the feasibility and efficacy of three Internet-based interventions designed to increase mental health help-seeking attitudes, intentions, and behavior in young elite athletes compared with a control condition. We conducted a randomized controlled trial (RCT) of three brief fully automated Internet-based mental health help-seeking interventions with 59 young elite athletes recruited online in a closed trial in Australia. The interventions consisted of a mental health literacy and destigmatization condition, a feedback condition providing symptom levels, and a minimal content condition comprising a list of help-seeking resources, compared with a control condition (no intervention). We measured help-seeking attitudes, intentions and behavior using self-assessed surveys. Participation was open to elite athletes regardless of their mental health status or risk of mental illness. Of 120 athletes initially agreeing to participate, 59 (49%) submitted a preintervention or postintervention survey, or both, and were included in the present study. Adherence was satisfactory, with 48 (81%) participants visiting both weeks of assigned intervention material. None of the interventions yielded a significant increase in help-seeking attitudes, intentions, or behavior relative to control. However, at postintervention, there was a trend toward a greater increase in help-seeking behavior from formal sources for the mental health literacy/destigmatization condition compared with control (P = .06). This intervention was also associated with increased depression literacy (P = .003, P = .005) and anxiety literacy (P = .002, P = .001) relative to control at postintervention and 3-month follow-up, respectively, and a reduction in depression stigma relative to control at postintervention (P = .01, P = .12) and anxiety stigma at 3-month follow-up (P = .18, P = .02). The feedback and help-seeking list interventions did not improve depression or anxiety literacy or decrease stigmatizing attitudes to these conditions. However, the study findings should be treated with caution. Due to recruitment challenges, the achieved sample size fell significantly short of the target size and the study was underpowered. Accordingly, the results should be considered as providing preliminary pilot data only. This is the first RCT of an Internet-based mental health help-seeking intervention for young elite athletes. The results suggest that brief mental health literacy and destigmatization improves knowledge and may decrease stigma but does not increase help-seeking. However, since the trial was underpowered, a larger trial is warranted. 2009/373 (www.clinicaltrials.gov ID: NCT00940732), cited at http://www.webcitation.org/5ymsRLy9r.
Journal of Medical Internet Research, 14(3) : e69
- Year: 2012
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Psychoeducation, Self-help
, Technology, interventions delivered using technology (e.g. online, SMS)
Hoek, W., Schuurmans, J., Koot, H. M., Cuijpers, P.
Background: Symptoms of depression and anxiety are highly prevalent in adolescence and they are the cause of considerable suffering. Even so, adolescents are not inclined to seek professional help for emotional problems. Internet-based preventive interventions have been suggested as a feasible method of providing appropriate care to adolescents with internalizing symptoms. The objective of this study was to evaluate the effects of preventive Internet-based (guided) self-help problem-solving therapy (PST) for adolescents reporting mild to moderate symptoms of depression and/or anxiety as compared to a waiting list control group (WL). Methodology/Principal Findings: A total of 45 participants were randomized to the 2 conditions. PST consisted of 5 weekly lessons. Participants were supported by e-mail. Self-report measures of depression and anxiety were filled in at baseline and after 3 weeks, 5 weeks, and 4 months. Of the 45 participants, 28 (62.2%) completed questionnaires after 3 weeks, 28 (62.2%) after 5 weeks, and 27 (60%) after 4 months. Hierarchical linear modeling analyses revealed overall improvement over time for both groups on depressive and anxiety symptoms. However, no significant group x time interactions were found. No differences were found between completers and non-completers. Conclusions/Significance: Results show that depressive and anxiety symptoms declined in both groups. No support was found, however, for the assumption that Internet-based PST was efficacious in reducing depression and anxiety in comparison to the waiting list control group. This finding could represent lack of power. Trial Registration: Netherlands Trial Register NTR1322. (copyright) 2012 Hoek et al.
PLoS ONE, 7(8) :
- Year: 2012
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Problem solving therapy (PST)
, Self-help
, Technology, interventions delivered using technology (e.g. online, SMS)
Goldbeck, L., Ellerkamp, T.
Background: Music therapy has been shown to be effective for children with psychopathology, providing an alternative nonverbal approach to the treatment of children with anxiety disorders. Objective: This pilot study investigates the efficacy of Multimodal Music Therapy (MMT), a combination of music therapy and cognitive-behavioral therapy, compared to treatment as usual (TAU). Methods: Thirty-six children aged 8-12 years with a primary diagnosis of an anxiety disorder were randomly assigned to 15 sessions of MMT or to TAU. Diagnostic status and dimensional outcome variables were assessed at the end of treatment and 4 months later. Results: MMT was superior compared to TAU according to the remission rates after treatment (MMT 67%; TAU 33%; x2 5 4.0; p 5 0.046) and remissions persisted until four months post-treatment. Dimensional measures showed equivalent improvement after either MMT or TAU. Conclusions: The results regarding the efficacy of MMT are promising for children with anxiety disorders. Further evaluation with larger samples and comparisons to pure CBT are recommended. (copyright) 2012 by the American Music Therapy Association.
Journal of Music Therapy, 49(4) : 395-413
- Year: 2012
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, Social phobia (social anxiety disorder)
, Specific Phobia
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Creative expression: music, dance, drama, art
Hopkins, M. E., Davis, F. C., VanTieghem, M. R., Whalen, P. J., Bucci, D. J.
The effects of regular exercise versus a single bout of exercise on cognition, anxiety, and mood were systematically examined in healthy, sedentary young adults who were genotyped to determine brain-derived neurotrophic factor (BDNF) allelic status (i.e., Val-Val or Val66Met polymorphism). Participants were evaluated on novel object recognition (NOR) memory and a battery of mental health surveys before and after engaging in either (a) a 4-week exercise program, with exercise on the final test day, (b) a 4-week exercise program, without exercise on the final test day, (c) a single bout of exercise on the final test day, or (d) remaining sedentary between test days. Exercise enhanced object recognition memory and produced a beneficial decrease in perceived stress, but only in participants who exercised for 4 weeks including the final day of testing. In contrast, a single bout of exercise did not affect recognition memory and resulted in increased perceived stress levels. An additional novel finding was that the improvements on the NOR task were observed exclusively in participants who were homozygous for the BDNF Val allele, indicating that altered activity-dependent release of BDNF in Met allele carriers may attenuate the cognitive benefits of exercise. Importantly, exercise-induced changes in cognition were not correlated with changes in mood/anxiety, suggesting that separate neural systems mediate these effects. These data in humans mirror recent data from our group in rodents. Taken together, these current findings provide new insights into the behavioral and neural mechanisms that mediate the effects of physical exercise on memory and mental health in humans. (copyright) 2012 IBRO.
Neuroscience, 215 : 59-68
- Year: 2012
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Physical activity, exercise
Drake, K. L., Ginsburg, G. S.
It is now widely accepted that anxiety disorders run in families, and current etiological models have proposed both genetic and environmental pathways to anxiety development. In this paper, the familial role in the development, treatment, and prevention of anxiety disorders in children is reviewed. We focus on three anxiety disorders in youth, namely, generalized, separation, and social anxiety as they often co-occur both at the symptom and disorder level and respond to similar treatments. We begin by presenting an overview of a broad range of family factors associated with anxiety disorders. Findings from these studies have informed intervention and prevention strategies that are discussed next. Throughout the paper we shed light on the challenges that plague this research and look toward the future by proposing directions for much needed study and discussing factors that may improve clinical practice and outcomes for affected youth and their families. (copyright) 2012 Springer Science+Business Media, LLC.
Clinical Child & Family Psychology Review, 15(2) : 144-162
- Year: 2012
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, Social phobia (social anxiety disorder)
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
Francis, S. E., Mezo, P. G., Fung, S. L.
This review critically evaluates self-control skills interventions in the treatment of childhood anxiety and depression, outlining conditions under which these interventions are successful and the specific role of parents. Findings indicated that self-control skills interventions are successful with both children and adolescents, in the context of other cognitive behavioral techniques and as the primary treatment component, and with and without parental involvement. However, despite consistent evidence of success in both pre-post and waitlist control designs, self-control skills treatments have not demonstrated superior efficacy when compared to other active treatments. Continued application and evaluation of these interventions amongst children and adolescents are recommended.
Psychotherapy Research, 22(2) : 220-238
- Year: 2012
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Skills training
Eldar, S., Apter, A., Lotan, D., Edgar, K. P., Naim, R., Fox, N. A., Pine, D. S., Bar-Haim, Y.
Objective: While attention bias modification (ABM) is a promising novel treatment for anxiety disorders, clinical trial data remain restricted to adults. The authors examined whether ABM induces greater reductions in pediatric anxiety symptoms and symptom severity than multiple control training interventions. Method: From a target sample of 186 treatment-seeking children at a hospital-based child anxiety clinic, 40 patients with an ongoing anxiety disorder who met all inclusion criteria were enrolled in the study. Children were randomly assigned to one of three conditions: ABM designed to shift attention away from threat; placebo attention training using stimuli identical to those in the ABM condition; and placebo attention training using only neutral stimuli. All participants completed four weekly 480-trial sessions (1,920 total trials). Before and after the attention training sessions, children's clinical status was determined via semistructured interviews and questionnaires. Reduction in the number of anxiety symptoms and their severity was compared across the three groups. Results: Change in the number of anxiety symptoms and their severity differed across the three conditions. This reflected significant reductions in the number of anxiety symptoms and symptom severity in the ABM condition but not in the placebo attention training or placebo-neutral condition. Conclusions: ABM, compared with two control conditions, reduces pediatric anxiety symptoms and severity. Further study of efficacy and underlying mechanisms is warranted.
American Journal of Psychiatry, 169(2) : 213-220
- Year: 2012
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Attention/cognitive bias modification
Dias, M., Pagnin, D., de-Queiroz-Pagnin, V., Reis, R. L., Olej, B.
To assess the effects of electroacupuncture on stress-related symptoms-sleep disorders, anxiety, depression and burnout-in medical students, and provide data to inform a power analysis to determinate numbers for future trials. Twenty-five students were randomly assigned to an electroacupuncture (n=12) group or control group (n=13) that did not receive treatment. Electroacupuncture was applied at a continuous frequency 2 Hz for 20 min once a week for 8 weeks at sites on the extremities, face, ear and scalp. The outcomes of the students treated with electroacupuncture were compared with those of the control group at the endpoint, controlling the influence of baseline scores. The instruments used were self-administered questionnaires that comprised the validated Portuguese version of the mini-sleep questionnaire (MSQ), the Pittsburgh sleep quality index (PSQI), the Epworth sleepiness scale (ESS), the Beck depression inventory (BDI), the Beck anxiety inventory, the Maslach burnout inventory-student survey (MBI-SS), and World Health Organization quality of life assessment - abbreviated version (WHOQOL-bref). The medical students treated with electroacupuncture showed a significant decrease compared with the control group for MSQ scores (p=0.04) and PSQI (p=0.006). After treatment, 75% students in the electroacupuncture group presented a good sleep quality, compared with 23.1% of the students in the control group. No significant difference on daytime sleepiness was shown by the ESS. The electroacupuncture group showed significant improvement on depressive symptoms (BDI), the emotional exhaustion and cynicism dimensions of burnout (MBI-SS) and physical health (WHOQOL-bref). Electroacupuncture was associated with a significant reduction of stress-related symptoms, but because of the study design the authors cannot say what proportion of the reduction was due to needle stimulation.
Acupuncture in Medicine, 30(2) : 89-95
- Year: 2012
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Acupuncture, acupressure
De-Oliveira, D. C. G., Zuardi, A. W., Graeff, F. G., Queiroz, R. H. C., Crippa, J. A. S.
Oxytocin (OT) is known to be involved in anxiety, as well as cardiovascular and hormonal regulation. The objective of this study was to assess the acute effect of intranasally administered OT on subjective states, as well as cardiovascular and endocrine parameters, in healthy volunteers (n = 14) performing a simulated public speaking test. OT or placebo was administered intranasally 50 min before the test. Assessments were made across time during the experimental session: (1) baseline (-30 min); (2) pre-test (-15 min); (3) anticipation of the speech (50 min); (4) during the speech (1:03 h), post-test time 1 (1:26 h), and post-test time 2 (1:46 h). Subjective states were evaluated by self-assessment scales. Cortisol serum and plasma adrenocorticotropic hormone (ACTH) were measured. Additionally, heart rate, blood pressure, skin conductance, and the number of spontaneous fluctuations in skin conductance were measured. Compared with placebo, OT reduced the Visual Analogue Mood Scale (VAMS) anxiety index during the pre-test phase only, while increasing sedation at the pre-test, anticipation, and speech phases. OT also lowered the skin conductance level at the pre-test, anticipation, speech, and post-test 2 phases. Other parameters evaluated were not significantly affected by OT. The present results show that OT reduces anticipatory anxiety, but does not affect public speaking fear, suggesting that this hormone has anxiolytic properties. (copyright) The Author(s) 2012.
Journal of Psychopharmacology, 26(4) : 497-505
- Year: 2012
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Biological Interventions (any)
, Other biological interventions
Deacon, B. J., Lickel, J. J., Possis, E. A., Abramowitz, J. S., Mahaffey, B., Wolitzky-Taylor, K.
Interoceptive exposure (IE) is an effective procedure for reducing anxiety sensitivity (AS) and the symptoms of panic disorder. However, considerable variance exists in how IE is delivered among clinicians, and the extent to which IE is enhanced by the concurrent use of cognitive reappraisal (CR) and diaphragmatic breathing (DB) is unclear. Participants (N 5 58) with high AS were randomly assigned to one of four single-session interventions: (a) IE only, (b) IE 1 CR, (c) IE 1 CR 1 DB, or (d) expressive writing control. IE was superior to expressive writing in reducing AS and associated anxiety symptoms. The addition of CR and DB did not enhance the benefits of IE at either posttreatment or 1-week follow-up. These findings highlight the specific efficacy of IE in reducing AS and call into question the common practice of combining IE with cognitive and breathing strategies. Theoretical and clinical implications are discussed. (copyright) 2012 Springer Publishing Company.
Journal of Cognitive Psychotherapy, 26(3) : 257-269
- Year: 2012
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Exposure therapy, Exposure and response prevention, Creative expression: music, dance, drama, art
, Other complementary & alternative interventions
Cummings, C. M., Fristad, M. A.
This study examined the role of comorbid anxiety in treatment outcome for children with mood disorders (N=165; age 8-11) participating in Multi-Family Psychoeducational Psychotherapy (MF-PEP). Assessments occurred at baseline, 6, 12, and 18 months for two randomly assigned groups: immediate treatment and 1-year wait-list. Most children (69%) had comorbid anxiety disorders. Baseline comorbid anxiety, as reported on the Children's Interview for Psychiatric Syndromes (ChIPS), was associated with higher Children's Depression Rating Scale- Revised (CDRS-R) scores but not Young Mania Rating Scale (YMRS) scores. Higher levels of anxiety symptoms were associated with lower Children's Global Assessment Scale (C-GAS) scores. Participation in MF-PEP did not significantly reduce anxiety symptoms (p=0.62). However, presence of comorbid anxiety did not impede reduction in depressive (CDRS-R, p=0.74) or manic (YMRS scores, p=0.94) symptoms following MFPEP. More baseline anxiety symptoms were associated with greater improvement in C-GAS scores post-treatment (p=0.02). Implications are discussed. (copyright) Springer Science+Business Media, LLC 2011.
Journal of Abnormal Child Psychology, 40(3) : 339-351
- 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)
, Family therapy, Psychoeducation