Disorders - Anxiety Disorders
deGroot, J., Cobham, V., Leong, J., McDermott, B.
Objective: The aim of the present study was to compare the relative effectiveness of group and individual formats of a family-focused cognitive-behavioural intervention, for the treatment of childhood anxiety disorders. Method: Twenty-nine clinically anxious children aged between 7 and 12 years were randomly allocated to either individual cognitive-behaviour therapy (ICBT) or group cognitive-behaviour therapy (GCBT). Results: At post-treatment assessment 57% of children in the ICBT condition no longer met criteria for any anxiety disorder, compared to 47% of children in the GCBT condition. At 3 month follow up these improvements were retained with some weakening. By the 6 month follow up 50% of children in the ICBT compared to 53% of children in the GCBT condition were anxiety diagnosis free. In terms of questionnaire data, no significant differences were detected between the ICBT and GCBT conditions at any of the follow-up points. However, a significant treatment effect for time was found, with both self-reports and parent reports indicating a significant reduction over time in anxiety symptoms. Conclusion: Overall, results suggest that children with anxiety disorders appear to improve following a family-focused cognitive behavioural intervention, regardless of individual or group administration. The interpretation and potential clinical implications of these findings are discussed, together with the limitations of this study and suggestions for future research.
Australian & New Zealand Journal of Psychiatry., 41(12) : 990-997
- Year: 2007
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Creswell, Cathy, Cartwright-Hatton, Sam
Anxiety of childhood is a common and serious condition. The past decade has seen an increase in treatment-focussed research, with recent trials tending to give greater attention to parents in the treatment process. This review examines the efficacy of family-based cognitive behaviour therapy and attempts to delineate some of the factors that might have an impact on its efficacy. The choice and timing of outcome measure, age and gender of the child, level of parental anxiety, severity and type of child anxiety and treatment format and content are scrutinised. The main conclusions are necessarily tentative, but it seems likely that Family Cognitive Behaviour Therapy (FCBT) is superior to no treatment, and, for some outcome measures, also superior to Child Cognitive Behaviour Therapy (CCBT). Where FCBT is successful, the results are consistently maintained at follow-up. It appears that where a parent is anxious, and this is not addressed, outcomes are less good. However, for children of anxious parents, FCBT is probably more effective than CCBT. What is most clear is that large, well-designed studies, examining these factors alone and in combination, are now needed. [References: 82]
Clinical Child & Family Psychology Review, 10(3) : 232-52
- Year: 2007
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Compton, S. N., Kratochvil, C. J., March, J. S.
Childhood-onset anxiety disorders are among the most common problems affecting children and adolescents, with an estimated prevalence of greater than 10%. Although common, childhood-onset anxiety disorders are not benign. Anxiety in children and adolescents can range from mild worries to incapacitating symptoms, which can significantly interfere with functioning. Children with anxiety disorders are at increased risk for later anxiety, depression, illicit drug dependence, educational underachievement, suicide attempts, and psychiatric hospitalization. Over the past three decades, researchers have investigated a variety of psychopharmacologic agents for the treatment of these disorders.
Pediatric Annals., 36(9) : 586-598
- Year: 2007
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
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Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Biological Interventions (any)
Levy, K., Hunt, C., Heriot, S.
OBJECTIVE: The aim of the study was to evaluate the effectiveness of an intervention that targeted both anxious and aggressive behaviors in children with anxiety disorders and comorbid aggression by parent report. METHOD: The effects of a cognitive-behavioral therapy intervention targeting comorbid anxiety and aggression problems were compared with a standard cognitive-behavioral therapy intervention targeting anxiety only. The study was conducted over a period of 2 years, and 69 families were included, with participating children ranging in age from 8 to 14 years. Intervention effects were evaluated at posttreatment and 3 months following treatment. RESULTS: An intent-to-treat analysis identified few significant differences between conditions in level of improvement following treatment and at follow-up, with the exception of parent-reported stress, anxiety, and depression, which improved in the anxiety treatment condition. Both treatment programs led to significant reductions in parent-reported child externalizing and internalizing problems and child-reported internalizing problems and to improved parenting practices. CONCLUSIONS: Comorbidity did not appear to significantly affect treatment outcome for anxiety disorders, and combining existing treatments to address comorbid problems did not enhance treatment effectiveness. Further trials are required to assess the effectiveness of an expanded combined treatment program that allows adequate time to address both internalizing and externalizing problems. Copyright 2007 copyright American Academy of Child and Adolescent Psychiatry.
Journal of the American Academy of Child & Adolescent Psychiatry., 46(9) : 1111-1118
- Year: 2007
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Ishikawa, S. I., Okajima, I., Matsuoka, H., Sakano, Y.
We conducted a meta-analysis using 20 randomised controlled studies of cognitive behavioural therapy (CBT) for anxiety disorders in children and adolescents. The mean pre-post effect size was d = 0.94, which was maintained at follow-up. The mean effect size when comparing the CBT and control group was d = 0.61. Within the CBT group, the mean effect size of university clinics (d = 0.77) was larger than that of other clinics (d = 0.37). The difference in effect sizes was hardly noticeable when comparing CBT with family or parents and CBT with child only (d = 0.03). Further studies are required to examine the effectiveness of family CBT versus child CBT. copyright 2007 Association for Child and Adolescent Mental Health.
Child & Adolescent Mental Health., 12(4) : 164-172
- Year: 2007
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
In-Albon, T., Schneider, S.
Background: The present study compared the efficacy of psychotherapy for childhood anxiety disorders (excluding trials solely treating post-traumatic stress disorder or obsessive-compulsive disorder). Methods: The meta-analysis included studies that met the basic CONSORT (consolidated standards of reporting trials) criteria. Several outcome variables (e.g. effect sizes, percentage of recovery) were analyzed using completer and intent-to-treat analyses during post-treatment and follow-up assessment. Twenty-four studies published by March 2005 were included in this meta-analysis. Results: In all the included studies, the active treatment condition was cognitive-behavioral. The overall mean effect of treatment was 0.86. No differences in outcome were found between individual and group treatments or child- and family-focused treatments. Follow-up data demonstrated that treatment gains were maintained up to several years after treatment. Conclusions: These findings provide evidence that anxiety disorders in children can be treated efficaciously. The gathered data support the clinical utility of cognitive-behavioral therapy in this regard. Randomized controlled trial studies investigating treatments other than cognitive-behavioral therapy are missing. Copyright copyright 2007 S. Karger AG.
Psychotherapy & Psychosomatics., 76(1) : 15-24
- Year: 2007
- Problem: Anxiety Disorders (any), Generalized Anxiety Disorder, Panic Disorder, Social phobia (social anxiety disorder)
, Specific Phobia
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
Reinblatt, S. P., Riddle, M. A.
Rationale: Pediatric anxiety is a prevalent psychiatric disorder that may have important implications for school, social, and academic function. Psychopharmacological approaches to the treatment of pediatric anxiety have expanded over the past 20 years and increasing empirical evidence helps guide current clinical practice. Objective: To review studies which examine the pharmacological treatment of pediatric anxiety disorders, including obsessive-compulsive disorder and to summarize treatment implications. Methods: All relevant studies were searched using MEDLINE and PsycINFO search engines, supplemented by a manual bibliographical search; studies published between 1985 and 2006 that met inclusion criteria were examined. Results: This article provides a systematic review of the psychopharmacological treatment of pediatric anxiety disorders based on available empirical evidence, with a focus on randomized controlled trials. General treatment principles and pharmacological management of specific pediatric anxiety disorders are also reviewed. Conclusion: There is good evidence to support the efficacy of several pharmacological agents including the selective serotonin reuptake inhibitors to treat pediatric anxiety and obsessive-compulsive disorder, although there are still many unanswered questions. copyright 2007 Springer-Verlag.
Psychopharmacology., 191(1) : 67-86
- Year: 2007
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
Spielmans, G. I., Pasek, L. F., McFall, J. P.
Prior meta-analytic reviews have indicated that cognitive and behavioral treatments are efficacious in treating child and adolescent depression and anxiety. Further, a meta-analysis has suggested that behavioral treatments are superior to nonbehavioral treatments for treating anxiety and depression in youth. However, the prior meta-analysis did not examine direct comparisons between cognitive and behavioral treatments (CBT) and non-CBT treatments, leaving open the possibility that their results were artifactual. The present meta-analysis aggregated results of studies in which CBT treatments were compared with either other bona fide treatments (including other CBT therapies) or non-bona fide therapies. The heterogeneity of the distribution of differences between bona fide treatments as well as a comparison of full (e.g. CBT + Parent training) versus component treatments (e.g., CBT only) were examined. The results indicated that: (a) CBT was more efficacious than non-bona fide therapies; (b) CBT was no more efficacious than bona fide non-CBT treatments (c) the differences between bona fide treatments were homogenously distributed around zero; and (d) full CBT treatments offered no significant benefit over their components. The results strongly suggest that the theoretically purported critical ingredients of CBT are not specifically ameliorative for child and adolescent depression and anxiety. copyright 2007 Elsevier Ltd. All rights reserved.
Clinical Psychology Review., 27(5) : 642-654
- Year: 2007
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
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Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Seligman, M. E. P., Schulman, P., Tryon, A. M.
To prevent depression and anxiety, we delivered a brief, classroom-based cognitive-behavioral workshop along with ongoing Web-based materials and e-mail coaching to college students at risk for depression. At risk was defined as having mild to moderate depressive symptoms on a self-report measure of depression. Two hundred forty students were randomized into either an eight-week workshop that met in groups of 10, once per week for 2 h or into an assessment-only control group. We plan to track participants for 3 years after the workshop and here we report the 6 month preventive effects on depression and anxiety. The workshop group had significantly fewer depressive symptoms and anxiety symptoms than the control group, but there was no significant difference between the conditions on depression or anxiety episodes at 6 month follow up. The workshop group had significantly better well being than the control group, and the workshop group had significantly greater improvement in optimistic explanatory style than the control group. Improved explanatory style was a significant mediator of the prevention effects from pre- to post-workshop for depressive and anxiety symptoms, as well as for improved well being. copyright 2006 Elsevier Ltd. All rights reserved.
Behaviour Research & Therapy., 45(6) : 1111-1126
- Year: 2007
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Technology, interventions delivered using technology (e.g. online, SMS)
Schmidt, N. B., Eggleston, A. M., Woolaway-Bickel, K., Fitzpatrick, K. K., Vasey, M. W., Richey, J. A.
Fear of arousal symptoms, often referred to as anxiety sensitivity (AS) appears to be associated with risk for anxiety pathology and other Axis I conditions. Findings from a longitudinal prevention program targeting AS are reported. Participants (n = 404) scoring high on the Anxiety Sensitivity Index (ASI) were randomly assigned to receive a brief intervention designed to reduce AS (Anxiety Sensitivity Amelioration Training (ASAT)) or a control condition. Participants were followed for up to 24 months. Findings indicate that ASAT produced greater reductions in ASI levels compared with the control condition. Moreover, reductions were specific to anxiety sensitivity relative to related cognitive risk factors for anxiety. ASAT also produced decreased subjective fear responding to a 20% CO2 challenge delivered postintervention. Data from the follow-up period show a lower incidence of Axis I diagnoses in the treated condition though the overall group difference was not statistically different at all follow-up intervals. Overall, findings are promising for the preventative efficacy of a brief, computer-based intervention designed to decrease anxiety sensitivity. copyright 2006 Elsevier Ltd. All rights reserved.
Journal of Anxiety Disorders., 21(3) : 302-319
- Year: 2007
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Spence, S. H., Holmes, J. M., March, S., Lipp, O. V.
Seventy-two clinically anxious children, aged 7 to 14 years, were randomly allocated to clinic-based, cognitive-behavior therapy, the same treatment partially delivered via the Internet, or a wait-list control (WL). Children in the clinic and clinic-plus-Internet conditions showed significantly greater reductions in anxiety from pre- to posttreatment and were more likely to be free of their anxiety diagnoses, compared with the WL group. Improvements were maintained at 12-month follow-up for both therapy conditions, with minimal difference in outcomes between interventions. The Internet treatment content was highly acceptable to families, with minimal dropout and a high level of therapy compliance. Copyright 2006 by the American Psychological Association.
Journal of Consulting & Clinical Psychology., 74(3) : 614-621
- Year: 2006
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Technology, interventions delivered using technology (e.g. online, SMS)
Rapee, R. M., Abbott, M. J., Lyneham, H. J.
The current trial examined the value of modifying empirically validated treatment for childhood anxiety for application via written materials for parents of anxious children. Two hundred sixty-seven clinically anxious children ages 6-12 years and their parents were randomly allocated to standard group treatment, waitlist, or a bibliotherapy version of treatment for childhood anxiety. In general, parent bibliotherapy demonstrated benefit for children relative to waitlist but was not as efficacious as standard group treatment. Relative to waitlist, use of written materials for parents with no therapist contact resulted in around 15% more children being free of an anxiety disorder diagnosis after 12 and 24 weeks. These results have implications for the dissemination and efficient delivery of empirically validated treatment for childhood anxiety. Copyright 2006 by the American Psychological Association.
Journal of Consulting & Clinical Psychology., 74(3) : 436-444
- Year: 2006
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Self-help