Disorders - Anxiety Disorders
Fisak-Jr, Brian J, Richard, Dan, Mann, Angela
The purpose of this study was to provide a comprehensive review of the effectiveness of child and adolescent anxiety prevention programs. Mean weighted effect sizes were calculated, and studies were encoded for potential moderator variables. A statistically significant effect size of .18 was obtained at post-intervention, which is consistent with effect sizes reported in reviews of depression, eating disorder, and substance abuse prevention programs. However, the effect sizes obtained at follow-up yielded mixed results. Significant moderators of program effectiveness were found including provider type (professional versus lay provider) and the use of the FRIENDS program. In contrast, program duration, participant age, gender, and program type (universal versus targeted) were not found to moderate program effectiveness. Clinical implications and directions for future research are discussed, including the need for more long-term follow-up, early prevention programs, and studies that systematically examine the impact of parent involvement on program effectiveness.
© Society for Prevention Research 2011
Prevention Science, 12(3) : 255-268
- Year: 2011
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
Davis-III, TE., May, Anna., Whiting, Sara E.
Research on treatments for childhood anxiety disorders has increased greatly in recent decades. As a result, it has become increasingly necessary to synthesize the findings of these treatment studies into reviews in order to draw wider conclusions on the efficacy of treatments for childhood anxiety. Previous reviews of this literature have used varying criteria to determine the evidence base. For the current review, stricter criteria consistent with the original Task Force (1995) guidelines were used to select and evaluate studies. Studies were divided by anxiety disorder; however, many studies combine various anxiety disorders in their samples. As a result, these were included in a combined anxiety disorder group. Using more traditional guidelines, studies were assigned a status of well-established, probably efficacious, or experimental based on the available literature and the quality of the studies. While some treatments do meet the criteria for well-established status, it is clear from this examination that gaps remain and replication is necessary to establish many of these treatments as efficacious. In addition, there still appears to be a lack of research on the effects of treatment on the physiological and cognitive aspects of fear and anxiety. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Clinical Psychology Review, 31(4) : 592-602
- Year: 2011
- Problem: Anxiety Disorders (any), Obsessive Compulsive Disorder, Post Traumatic Stress Disorder, Social phobia (social anxiety disorder)
, Specific Phobia
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Psychological Interventions (any)
Hongratanaworakit, T.
Although blended essential oils are increasingly being used for the improvement of the quality of life and for the relief of various symptoms in patients, the scientific evaluation of the aroma-therapeutic effects of blended essential oils in humans is rather scarce. In this study, we hypothesized that applying blended essential oil would provide a synergistic effect that would have a chance for success in treating depression or anxiety. Therefore, the main objective of this study was to investigate the effects of the blended essential oil on autonomic parameters and on emotional responses in humans following transdermal absorption. The blended essential oil consisted of lavender and bergamot oils. Human autonomic parameters, i.e. blood pressure, pulse rate, breathing rate, and skin temperature, were recorded as indicators of the arousal level of the autonomic nervous system. In addition, subjects had to rate their emotional condition in terms of relaxation, vigor, calmness, attentiveness, mood, and alertness in order to assess subjective behavioral arousal. Forty healthy volunteers participated in the experiments. Blended essential oil was applied topically to the skin of the abdomen of each subject. Compared with placebo, blended essential oil caused significant decreases of pulse rate, and systolic and diastolic blood pressure, which indicated a decrease of autonomic arousal. At the emotional level, subjects in the blended essential oil group rated themselves as 'more calm' and 'more relaxed' than subjects in the control group. This finding suggests a decrease of subjective behavioral arousal. In conclusion, our investigation demonstrates the relaxing effect of a mixture of lavender and bergamot oils. This synergistic blend provides evidence for its use in medicine for treating depression or anxiety in humans.
Natural Product Communications, 6(8) : 1199-1204
- Year: 2011
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Other complementary & alternative interventions
Grassi, Alessandra, Gaggioli, Andrea, Riva, Giuseppe
A Stress Inoculation Training-based protocol tested if multimedia audio-video content induced emotional changes and reduced exam anxiety in university students. Seventy-five participants took part in six experimental sessions consisting of viewing multimedia content and performing relaxation exercises. Participants were randomly assigned to five experimental groups: 1) audio and video narrative on mobile phone (UMTS); 2) audio and video narrative on DVD (DVD), 3) audio narrative on MP3 player (M3), 4) audio narrative on CD (CD), 5) control group (CTRL). Results showed that audio/video content induced a significant reduction in exam anxiety and an increase of relaxation in students, compared to the audio-only contents.
Studies in Health Technology & Informatics, 167 : 57-62
- Year: 2011
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Service Delivery & Improvement, Psychological Interventions (any)
, Other Psychological Interventions, Relaxation
, Technology, interventions delivered using technology (e.g. online, SMS)
Heiervang, E, Wergeland, G. J., Fjermestad, K., Haugland, B. S. M., Ost, L. G., Havik, O. E., Oeding, K., Bjanullstad, J. F.
Introduction: Efficacy studies of CBT for childhood anxiety disorders have found significant effects for up to 70% of the patients, but less is known about the effectiveness with youths in routine clinical care. We have therefore studied the effectiveness of the FRIENDS for Life program in seven child and adolescent mental health outpatient clinics in Western Norway. Method: Subjects were randomized to group or individual treatment, some with a preceding wait-list period with a mean duration equal to the treatment period of 10 weeks. A total of 183 referred youths aged 8-15 years with separation anxiety, generalized anxiety or social anxiety disorder were included. There were few exclusion criteria. Pre-, post- and 1 year follow-up assessments included the Anxiety Disorder Interview Schedule for children and parents, Spence Children's Anxiety Scale and the Short Mood and Feelings Questionnaire. Results: Significant improvement was observed both for individual and group treatment with regard to diagnostic status, anxiety symptoms and depressive symptoms, with little change after the wait-list period. Post-treatment around had recovered from their principal diagnosis. There was a moderate effect size on anxiety and depressive symptoms. Preliminary data show continuing effects at 1 year follow-up, with no significant effect of treatment format. Discussion: The study is one of the largest studies of CBT for anxiety in children carried out in regular clinics with regular clinicians. The FRIENDS for Life CBT program seems to be an effective treatment when delivered in ordinary clinical settings, with equal effects for individual and group formats. Conclusion: Manualised CBT is effective for childhood anxiety disorders in ordinary clinical care both at short- and long-term (1 year) and may be recommended for clinical use.
European Child & Adolescent Psychiatry, 20 : S45
- Year: 2011
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, 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)
Ginsburg, Golda S., Kendall, Philip C., Sakolsky, Dara, Compton, Scott N., Piacentini, John, Albano, Anne Marie, Walkup, John T., Sherrill, Joel, Coffey, Kimberly A., Rynn, Moira A., Keeton, Courtney P., McCracken, James T., Bergman, Lindsey, Iyengar, Satish, Birmaher, Boris, March, John
Objective: To report on remission rates in anxious youth who participated in the Child/Adolescent Anxiety Multimodal Study (CAMS). The CAMS, a multisite clinical trial, randomized 488 children and adolescents (ages 7–17 years; 79% Caucasian; 50% female) with separation, social, and/or generalized anxiety disorder to a 12-week treatment of sertraline (SRT), cognitive behavioral therapy (CBT), their combination (COMB), or clinical management with pill placebo (PBO). Method: The primary definition of remission was loss of all study-entry anxiety disorder diagnoses; additional definitions of remission were used. All outcomes were rated by independent evaluators blind to treatment assignment. Predictors of remission were also examined. Results: Remission rates after 12 weeks of treatment ranged from 46% to 68% for COMB, 34% to 46% for SRT, 20% to 46% for CBT, and 15% to 27% for PBO. Rates of remission (i.e., achieving a nearly symptom-free state) were significantly lower than rates of response (i.e., achieving a clinically meaningful improvement relative to baseline) for the entire sample. Youth who received COMB had significantly higher rates of remission compared to all other treatment groups. Both monotherapies had higher remission rates compared to PBO, but rates were not different from each other. Predictors of remission were younger age, nonminority status, lower baseline anxiety severity, absence of other internalizing disorders (e.g., anxiety, depression), and absence of social phobia. Conclusions: For the majority of children, some symptoms of anxiety persisted, even among those showing improvement after 12 weeks of treatment, suggesting a need to augment or extend current treatments for some children. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Journal of Consulting & Clinical Psychology, 79(6) : 806-813
- Year: 2011
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, Social phobia (social anxiety disorder)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs), Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Other Psychological Interventions
Heyne, David, Sauter, Floor M., Van-Widenfelt, Brigit M., Vermeiren, Robert, Westenberg, P. Michiel
The main objectives were to evaluate efficacy and acceptability of a developmentally sensitive cognitive behavioral therapy for anxiety-based school refusal in adolescence. Twenty school-refusing adolescents meeting DSM-IV anxiety disorder criteria participated in a non-randomized trial, together with parents and school staff. Outcome was assessed at post-treatment and 2-month follow-up. Treated adolescents showed significant and maintained improvements across primary outcome variables (school attendance; school-related fear; anxiety), with medium to large effect sizes. Half of the adolescents were free of any anxiety disorder at follow-up. Additional improvements were observed across secondary outcome variables (depression; overall functioning; adolescent and parent self-efficacy). The treatment was rated as acceptable by adolescents, parents, and school staff, which may help explain the very low attrition rate. Social anxiety disorder was the most common disorder among adolescents still meeting anxiety disorder criteria at follow-up. Treatment modifications to improve efficacy for school-refusing adolescents presenting with social anxiety disorder are suggested.
Copyright © 2011 Elsevier Ltd. All rights reserved.
Journal of Anxiety Disorders, 25(7) : 870-878
- Year: 2011
- Problem: Anxiety Disorders (any)
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Ho, P., Tsao, J. C. I., Bloch, L., Zeltzer, L. K.
Low-income youth experience social-emotional problems linked to chronic stress that are exacerbated by lack of access to care. Drumming is a non-verbal, universal activity that builds upon a collectivistic aspect of diverse cultures and does not bear the stigma of therapy. A pretest-post-test non-equivalent control group design was used to assess the effects of 12 weeks of school counselor-led drumming on social-emotional behavior in two fifth-grade intervention classrooms versus two standard education control classrooms. The weekly intervention integrated rhythmic and group counseling activities to build skills, such as emotion management, focus and listening. The Teachers Report Form was used to assess each of 101 participants (n = 54 experimental, n = 47 control, 90 Latino, 53.5 female, mean age 10.5 years, range 1012 years). There was 100 retention. ANOVA testing showed that intervention classrooms improved significantly compared to the control group in broad-band scales (total problems (P <.01), internalizing problems (P <.02)), narrow-band syndrome scales (withdrawn/depression (P <.02), attention problems (P <.01), inattention subscale (P <.001)), Diagnostic and Statistical Manual of Mental Disorders-oriented scales (anxiety problems (P <.01), attention deficit/hyperactivity problems (P <.01), inattention subscale (P <.001), oppositional defiant problems (P <.03)), and other scales (post-traumatic stress problems (P <.01), sluggish cognitive tempo (P <.001)). Participation in group drumming led to significant improvements in multiple domains of social-emotional behavior. This sustainable intervention can foster positive youth development and increase student-counselor interaction. These findings underscore the potential value of the arts as a therapeutic tool. Copyright (copyright) 2011 Ping Ho et al.
Evidence-based Complementary & Alternative Medicine, 2011 :
- Year: 2011
- Problem: Anxiety Disorders (any)
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Other Psychological Interventions, Creative expression: music, dance, drama, art
Kaviani, Hossein, Javaheri, Foroozan, Hatami, Neda
A randomized, controlled study was conducted in a non-clinical population to investigate the impact of mindfulness-based cognitive therapy (MBCT) on depression, anxiety, automatic thoughts, and dysfunctional attitudes, normally induced by exam as a real stressful setting. The participants were randomly assigned either to receive 8 weekly 2.5- hour MBCT or remain in a waiting list control group. A series of two-way ANOVA with repeated measures were performed to detect if the application of MBCT would result in a systematic reduction in the dependent variables over five assessment points: pre-test, session 4, session 8, first follow-up (1 month) and second follow-up (6 months). The results indicated that MBCT was effective at helping participants to deal with their anxiety and depressive feelings before, during and after stressful circumstances. In addition, the reductions in negative automatic thoughts and dysfunctional attitudes in those who received MBCT were significant. The findings provide further evidence that MBCT might be a useful intervention for enhancing well-being in non-clinical populations who are susceptible to experience anxiety and depression in real life situations. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
International Journal of Psychology & Psychological Therapy, 11(2) : 285-296
- Year: 2011
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Mindfulness based therapy
Knox, M., Lentini, J., Cummings, T. S., McGrady, A., Whearty, K., Sancrant, L.
Twenty-four children and adolescents aged 9-17 who were referred for treatment for anxiety were assigned to either a game-based biofeedback group or a waiting list comparison group. The eight-session biofeedback intervention included psychoeducation, identification of triggers and signs of anxiety, and in vivo practice. The intervention used computer-based gaming technology to teach and practise relaxation. Analyses using ANCOVA revealed significant differences in posttest scores of anxiety and depression measures between the two groups. The intervention group reduced anxiety and depression scores on standardised tests. Findings suggest that biofeedbackassisted relaxation training can be useful in decreasing anxiety and depressive symptoms in anxious youths. (copyright) 2011 Radcliffe Publishing.
Mental Health in Family Medicine, 8(3) : 195-203
- Year: 2011
- Problem: Anxiety Disorders (any)
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Service Delivery & Improvement, Psychological Interventions (any)
, Biofeedback, neurofeedback, audio/video feedback, Relaxation
, Technology, interventions delivered using technology (e.g. online, SMS)
Kiecolt-Glaser, Janice K., Belury, Martha A., Andridge, Rebecca, Malarkey, William B., Glaser, Ronald
Observational studies have linked lower omega-3 (n-3) polyunsaturated fatty acids (PUFAs) and higher omega-6 (n-6) PUFAs with inflammation and depression, but randomized controlled trial (RCT) data have been mixed. To determine whether n-3 decreases proinflammatory cytokine production and depressive and anxiety symptoms in healthy young adults, this parallel group, placebo-controlled, double-blind 12-week RCT compared n-3 supplementation with placebo. The participants, 68 medical students, provided serial blood samples during lower-stress periods as well as on days before an exam. The students received either n-3 (2.5 g/d, 2085 mg eicosapentaenoic acid and 348 mg docosahexanoic acid) or placebo capsules that mirrored the proportions of fatty acids in the typical American diet. Compared to controls, those students who received n-3 showed a 14% decrease in lipopolysaccharide (LPS) stimulated interleukin 6 (IL-6) production and a 20% reduction in anxiety symptoms, without significant change in depressive symptoms. Individuals differ in absorption and metabolism of n-3 PUFA supplements, as well as in adherence; accordingly, planned secondary analyses that used the plasma n-6:n-3 ratio in place of treatment group showed that decreasing n-6:n-3 ratios led to lower anxiety and reductions in stimulated IL-6 and tumor necrosis factor alpha (TNF-α) production, as well as marginal differences in serum TNF-α. These data suggest that n-3 supplementation can reduce inflammation and anxiety even among healthy young adults. The reduction in anxiety symptoms associated with n-3 supplementation provides the first evidence that n-3 may have potential anxiolytic benefits for individuals without an anxiety disorder diagnosis. ClinicalTrials.gov identifier: NCT00519779. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Brain, Behavior & Immunity, 25(8) : 1725-1734
- Year: 2011
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Fish oil (Omega-3 fatty acids)
, Omega 3 fatty acids (e.g. fish oil, flax oil)
Lemmens, S. G., Born, J. M., Martens, E. A., Martens, M. J., Westerterp-Plantenga, M. S.
Consumption of meals with different macronutrient contents, especially high in carbohydrates, may influence the stress-induced physiological and psychological response. The objective of this study was to investigate effects of consumption of a high-protein vs. high-carbohydrate meal on the physiological cortisol response and psychological mood response. Subjects (n = 38, 19 m/19f, age =25 (plus or minus) 9 yrs, BMI = 25.0 (plus or minus) 3.3 kg/m2) came to the university four times, fasted, for either condition: rest-protein, stress-protein, rest-carbohydrate, stress-carbohydrate (randomized cross-over design). Stress was induced by means of a psychological computer-test. The test-meal was either a high-protein meal (En% P/C/F 65/5/30) or a high-carbohydrate meal (En% P/C/F 6/64/30), both meals were matched for energy density (4 kJ/g) and daily energy requirements (30%). Per test-session salivary cortisol levels, appetite profile, mood state and level of anxiety were measured. High hunger, low satiety (81 (plus or minus) 16, 12 (plus or minus) 15 mm VAS) confirmed the fasted state. The stress condition was confirmed by increased feelings of depression, tension, anger, anxiety (AUC stress vs. rest p < 0.02). Consumption of the high-protein vs. high-carbohydrate meal did not affect feelings of depression, tension, anger, anxiety. Cortisol levels did not differ between the four test-sessions in men and women (AUC nmol(middle dot)min/L p > 0.1). Consumption of the test-meals increased cortisol levels in men in all conditions (p < 0.01), and in women in the rest-protein and stress-protein condition (p < 0.03). Men showed higher cortisol levels than women (AUC nmol(middle dot)min/L p < 0.0001). Consumption of meals with different macronutrient contents, i.e. high-protein vs. high-carbohydrate, does not influence the physiological and psychological response differentially. Men show a higher meal-induced salivary cortisol response compared with women.
PLoS ONE, 6(2) : e16826
- Year: 2011
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Dietary advice, dietary change