Disorders - Anxiety Disorders
Huang, J., Nigatu, Y. T., Smail-Crevier, R., Zhang, X., Wang, J.
Common mental health problems (CMHPs), such as depression, anxiety disorder, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD) are internalizing disorders with high comorbidity. University and college students are under many stressors and transitional events, and students fall within the age range when CMHPs are at their developmental peak. Compared to the expanded effort to explore and treat CMHPs, there has been no a meta-analysis that comprehensively reviewed the interventions for CMHPs and examined the effects of interventions for CMHPs in college students. The objective of this review is to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) examining interventions for CMHPs among university and college students and to estimate their post-intervention effect size (ES), as well as follow-up ES, for depression, anxiety disorder, OCD and PTSD separately. Meta-analytic procedures were conducted in accordance with PRISMA guidelines. We reviewed 7768 abstracts from which 331 full-text articles were reviewed and 51 RCTs were included in the analysis. We found moderate effect sizes for both depression (Hedges' g = -0.60) and anxiety disorder (Hedges' g = -0.48). There was no evidence that existing interventions for OCD or PTSD were effective in this population. For interventions with high number of papers, we performed subgroup analysis and found that cognitive behavioral therapy (CBT) and mindfulness-based interventions were effective for both depression and generalized anxiety disorder (GAD), and attention/perception modification was effective for GAD; other interventions (i.e. art, exercise and peer support) had the highest ES for both depression and GAD among university and college students. Copyright © 2018 Elsevier Ltd
Journal of Psychiatric Research, 107 : 1-10
- Year: 2018
- Problem: Anxiety Disorders (any), Obsessive Compulsive Disorder, 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)
, Other Psychological Interventions, Mindfulness based therapy
Ozyurt, G., Gencer, O., Ozturk, Y., Ozbek, A.
OBJECTIVES: Considering the role of parenting in the aetiology and maintenance of anxiety disorders, working with parents is a promising treatment strategy. Triple P-positive parenting programme is a parent-focused cognitive behaviour therapy. In this study, we aimed to investigate the effectiveness of Triple P in improvement in childhood anxiety disorders and also to assess its effects on behavioural and emotional problems, general anxiety level, severity of the disorder, and general psychosocial functioning. Parents' mental health and general well-being were also evaluated. METHOD(S): In this randomized controlled study, the sample consisted of 74 children, aged between 8 and 12 years, who were diagnosed as anxiety disorder by Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Life-time Kiddie (K-SADS-PL). Following randomization into two equal groups, mothers of the first group participated to Group Triple P Programme, while the second group was receiving no treatment. The two groups were compared right before and after the intervention on rates of anxiety symptoms, emotional, and behavioural variables. RESULT(S): Children's general anxiety level was significantly lower in the intervention group following Triple P implementation. Behavioural and emotional problems were also reduced in the intervention group. Parental anxiety and general well-being were not significantly different between two groups. CONCLUSION(S): It is considered that Triple P may be useful in the treatment of children's anxiety disorder but further studies about Triple P on children's anxiety disorders are needed. Copyright © 2018, © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
Psychiatry and Clinical Psychopharmacology., 29(4) : 570-578
- Year: 2018
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Skills training, Other Psychological Interventions
Waldron, S.M., Stallard, P., Grist, R., Hamilton-Giachritsis, C.
Objective: Previous reviews demonstrate that universal school-based anxiety prevention programs are generally effective in the short-term, but have not yet provided a clear evaluation of the longer-term effects. This review focuses exclusively on randomized controlled trials (RCTs) of universal school-based anxiety prevention programs that included a follow-up at 12-months or beyond. Method: In total, 359 references from previous reviews in the field were screened; PubMed and PsychInfo were also systematically searched. Eight studies met criteria (each based on cognitive-behavioural principles) comprising 7522 children aged nine-18 years. Risk of bias in most studies was high, thus a formal meta-analysis was not conducted. Results: Three of the eight studies reported greater reductions in anxiety symptomology in the prevention group compared to the control group at post-intervention (immediate effect), and each of these studies also reported maintenance of this effect at 12-month follow-up. Two further studies reported a 'delayed' effect at 12-month follow-up. All five studies that reported prevention effects were evaluating the FRIENDS program, and estimated effect sizes at 12-months follow-up varied from 0.2 to 0.69 (Hedges g). The final three studies (evaluating different programs) reported no immediate or long-term effects. Conclusions: The findings from this review suggest that the effects of some universally delivered school-based anxiety prevention trials can last up to 12-months, but this may depend on various factors (including program-type). It was not possible to draw firm conclusions regarding the influence of delivery mode (teacher versus health professional), parent sessions or child booster sessions. Further high quality RCTs with long-term follow-up periods are needed. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Mental Health and Prevention, 11 : 8-15
- Year: 2018
- Problem: Anxiety Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Johnstone, K. M., Kemps, E., Chen, J.
Anxiety and depression are among the most common mental health issues experienced in childhood. Implementing school-based prevention programs during childhood, rather than adolescence, is thought to provide better mental health outcomes. The present meta-analysis aimed to investigate the efficacy of universal school-based prevention programs that target both anxiety and depression in children (aged 13 years or below), and examine three moderators (i.e., program type, primary target of program, and number of sessions) on prevention effects. PsycINFO, PubMED, and Google Scholar were systematically searched for relevant articles published up to and including January 2018. Fourteen randomised controlled trials, consisting of 5970 children, met eligibility criteria. Prevention programs led to significantly fewer depressive symptoms at post-program (g = 0.172) and at long-term follow-up periods (g = 0.180), but not at short-term follow-up. Programs were not found to prevent anxiety symptoms across any time point. Considerable heterogeneity was observed for all effects. Program type and length were found to moderate the relationship between prevention program and outcomes. Prevention programs were effective in preventing depressive symptoms at post-program and long-term follow-up, while no significant preventative effect on anxiety symptoms was observed. The FRIENDS Program and programs which contained a greater number of sessions showed beneficial effects on anxiety and depressive symptoms. Universal programs aimed at preventing both anxiety and depression in children are limited. Future research should investigate the long-term evaluation of school-based prevention programs for anxiety and depression in children.
Clinical Child & Family Psychology Review, 21(4) : 466-481
- Year: 2018
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Other Psychological Interventions
Ponnuthurai, S. A., Brown, J.
Objectives: School-based interventions aiming to intervene early in mental disorder in young people have been tested since the 1990s. Most previous reviews looked at both targeted and universal interventions; we have only compared randomized controlled trials of universal interventions, considering them as an implementable preventative intervention at a public health level. We have included other outcomes of therapy, such as self-esteem, well-being, resilience, and mentalization, to also compare the effectiveness of interventions on outcomes that appear to be associated with prevention. Method(s): A meta-analysis was performed of universal RCTs of school-based psychological interventions using CBT, acceptance and commitment therapy (ACT), mindfulness, and interpersonal therapy methodologies. PsycINFO, MEDLINE, and Embase were searched. The outcome data were analyzed using RevMan 5.3. Result(s): The data on depression are presented as follows: 1) as in the other analyses, there was evidence of a significant small effect on symptoms of depression for the interventions as a whole; and 2) this effect was maintained after 12 months overall. The data on anxiety are presented as follows: 1) overall, the effect on anxiety symptoms was also small; and 2) this small effect was slightly better maintained with anxiety >= 12 months after intervention (d = 0.17 in anxiety compared with d = 0.12 with depressive symptoms). Secondary outcomes are indicated as follows: 1) no trial-measured outcomes of interventions have been associated with relapse prevention (eg, meta-cognition or mentalization); and 2) only one trial measured other markers of recovery, such as well-being. Conclusion(s): 1) Universal school-based interventions appear to have a small but significant effect on depression and anxiety symptoms that are maintained >=12 months postintervention, although the amount of long-term data is small. 2) Possible markers of treatment effectiveness against relapse and of recovery, such as meta-cognition and self-esteem, are not being monitored as outcomes. 3) Other factors, such as age and type of intervention, were also involved. For example, mindfulness and use of a facilitator, who was a nonteacher with some education or training in mental health, appear significant in terms of the effectiveness of these interventions. 4) Trial quality was low overall. Further trials with large sample groups, using attention control groups as their control with a longer period of follow-up, are needed. EBP, PUP, SC Copyright © 2018
Journal of the American Academy of Child and Adolescent Psychiatry, 57 (10 Supplement) : S189
- Year: 2018
- Problem: Anxiety Disorders (any), Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Interpersonal therapy (IPT)
, Mindfulness based therapy, Acceptance & commitment therapy (ACT)
Kohut, S. A., Jelen, A., Ruskin, D., Stinson, J.
Context Mindfulness-based interventions (MBIs) have emerged as a promising strategy for individuals with chronic health conditions, given their versatility in targeting both physical and mental health outcomes. However, research to date has focused on adult or community-based populations. Yet, a recent meta-analysis revealed that MBIs are 3 times more impactful for clinical versus nonclinical pediatric populations and are particularly helpful for internalizing symptoms (eg, depression, anxiety). Objective To summarize and critically appraise the available literature on the feasibility and effectiveness of MBIs for clinical samples of youth diagnosed with internalizing disorders (eg, anxiety, depression, posttraumatic stress). Design A systematic review of the literature with electronic searches conducted by a library information specialist familiar with the feld using EMBASE, PsycINFO, MEDLINE, CINAHL, Web of Science, and EBM Reviews databases. Two reviewers independently selected articles for review and extracted data. Results Of a total of 4710 articles, 5 articles met inclusion criteria. Study designs were primarily randomized controlled trials with 1 prospective pre-post intervention study. Sample sizes varied across studies from 24 to 102 participants. No studies included inpatient participants or participants with comorbid internalizing and physical disorders. The MBIs included in this review were primarily group-based and did not offer remote or online options. All MBIs were feasible, and studies consistently found that following MBI completion, youth reported considerable improvements in internalizing symptoms (eg, anxiety, depression, posttraumatic stress).Conclusion Mindfulness-based interventions are a promising approach to coping with internalizing symptomsin youth. Clinical populations of youth are an essential sample to target for future work in mindfulness owing to the substantial impairment in quality of life and function related to living with mental illness. Future research with rigorous study design is warranted to determine definitive treatment effectiveness of MBIs for internalizing symptoms.
Canadian Family Physician, 64 (2 Supplement 1) : S79
- Year: 2018
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Mindfulness based therapy
Rasing, S. P. A., Creemers, D. H. M., Vermulst, A. A., Janssens, J. M. A. M., Engels, R. C. M. E., Scholte, R. H. J.
A randomized controlled trail was conducted to examine the effectiveness of a depression and anxiety prevention program 'Een Sprong Vooruit' (A Leap Forward) among adolescent girls with a high familial risk (N = 142). The results showed neither effects of the prevention program directly after the intervention, nor at 6 or 12 months follow-up on depression and anxiety symptoms. Further, latent growth curve modeling (LGCM) was used to examine whether the growth functions for the intervention and the control condition were different. The slope representing the change in depression symptoms was not significantly different between the intervention and the control condition. For anxiety symptoms, the difference between slopes was also not significant. Based on these results, we suggested that these high-risk adolescent girls might benefit more from a more intensive prevention program. Copyright © 2018 by the authors. Licensee MDPI, Basel, Switzerland.
International Journal of Environmental Research and Public Health, 15 (7) (no pagination)(1457) :
- Year: 2018
- 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)
Swan, A.J., Kendall, P.C., Olino, T., Ginsburg, G., Keeton, C., Compton, S., etal.
Objective: To report functional outcomes from the multisite Child/Adolescent Anxiety Multimodal Extended Long-term Study (CAMELS), which examined the impact of youth anxiety treatment (cognitive-behavioral therapy [CBT], coping cat; Sertraline, SRT; COMB [CBT + SRT]; pill placebo) on (a) global and (b) domain-specific functioning assessed an average of 3.1 times, 3- to 12-years postrandomization (first assessment = mean 6.5 years postrandomization). Method: Three-hundred and 19 of 488 families from the Child/Adolescent Anxiety Multimodal Study (CAMS; Walkup et al., 2008) participated. Growth curve modeling examined the impact of treatment condition and acute treatment outcomes (i.e., response, remission) on global functioning, global and domain-specific impairment, and life satisfaction across follow-up visits. Logistic regressions explored the impact of treatment remission and condition on low frequency events (arrests/convictions) and education. Results: Treatment responders and remitters demonstrated better global functioning, decreased overall impairment, and increased life satisfaction at follow-up. Treatment remission, but not response, predicted decreased domain-specific impairment (social relationships, self-care/independence, academic functioning), and maintenance of increased life satisfaction across follow-ups. Participants in the CBT condition, compared with pill placebo, demonstrated improved trajectories pertaining to life satisfaction, overall impairment, and impairment in academic functioning. Randomization to CBT or COMB treatment was associated with increasing employment rates. Trajectories for participants randomized to SRT was not significantly different from placebo. Treatment outcome and condition did not predict legal outcomes, school/work variables, or family life. Conclusion: Positive early intervention outcomes are associated with improved overall functioning, life satisfaction, and functioning within specific domains 6.5 years posttreatment. Treatment type differentially predicted trajectories of functioning. Findings support the positive impact of pediatric anxiety treatment into adolescence and early adulthood. (PsycINFO Database Record (c) 2018 APA, all rights reserved) Impact Statement What is the public health significance of this article?-The findings indicate that successful intervention for youth anxiety is associated with improved functioning, decreased overall impairment, and enhanced life satisfaction an average of 6.5 years later during the transition to late adolescence/early adulthood. Cognitive-behavioral therapy (CBT, coping cat) was associated with decreasing impairment and increasing life satisfaction over time, compared with pill placebo. Findings support the positive impact of efficacious early intervention for anxiety on later functioning. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Journal of Consulting and Clinical Psychology, 86(9) : 738-750
- Year: 2018
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs), Antidepressants (any)
, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Ginsburg, G.S., Becker-Haimes, E.M., Keeton, C., Kendall, P.C., Iyengar, S., Sakolsky, D., Albano, A.M., Peris, T., Compton, S.N., Piacentini, J.
Objective: To report anxiety outcomes from the multisite Child/Adolescent Anxiety Multimodal Extended Long-term Study (CAMELS). Rates of stable anxiety remission (defined rigorously as the absence of all DSM-IV TR anxiety disorders across all follow-up years) and predictors of anxiety remission across a 4-year period, beginning 4 to 12 years after randomization to 12 weeks of medication, cognitive-behavioral therapy (CBT), their combination, or pill placebo were examined. Examined predictors of remission included acute treatment response, treatment assignment, baseline child and family variables, and interim negative life events. Method: Data were from 319 youths (age range 10.9-25.2 years; mean age 17.12 years) originally diagnosed with separation, social, and/or generalized anxiety disorders and enrolled in the multi-site Child/Adolescent Anxiety Multimodal Study (CAMS). Participants were assessed annually by independent evaluators using the age-appropriate version of the Anxiety Disorders Interview Schedule and completed questionnaires (eg, about family functioning, life events, and mental health service use). Results: Almost 22% of youth were in stable remission, 30% were chronically ill, and 48% were relapsers. Acute treatment responders were less likely to be in the chronically ill group (odds ratio = 2.73; confidence interval = 1.14-6.54; p < .02); treatment type was not associated with remission status across the follow-up. Several variables (eg, male gender) predicted stable remission from anxiety disorders. Conclusion: Findings suggest that acute positive response to anxiety treatment may reduce risk for chronic anxiety disability; identified predictors can help tailor treatments to youth at greatest risk for chronic illness. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Journal of the American Academy of Child & Adolescent Psychiatry, 57(7) : 471-480
- Year: 2018
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs), Antidepressants (any)
, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Leung, B., Takeda, W., Holec, V.
Aim: This pilot study investigated the use of acupuncture in the treatment of paediatric anxiety. Method(s): Children with anxiety, aged 8-16, were randomised to either the acupuncture or waitlist control groups. Anxiety was measured using the Hamilton Anxiety Rating Scale (HAM-A) for children and adolescents with generalised anxiety disorder and Multidimensional Anxiety Scale for Children 2nd Edition (MASC-2) self-rated and parent-rated forms. Result(s): Twenty participants were enrolled in the study and 19 completed all the questionnaires to be included in the analysis. There were no differences in socio-demographic characteristics at baseline between the two groups. At the second assessment, the mean MASC-parent score for the acupuncture group was significantly lower than the waitlist group (65.6 (SD 15.0) compared to 81.0 (SD 11.9), P = 0.025) with an effect size = 1.13. The pre- and post-treatment comparisons were also significantly lower for both groups in the anxiety measures. In the acupuncture group, MASC-parent (P = 0.008, effect size 0.75) and the HAM-A (P < 0.001, effect size 1.4). In the waitlist group, MASC-self (P = 0.022; effect size 0.4), MASC-parent (P = 0.048; effect size 0.75) and HAM-A (P = 0.007; effect size 1.21). Conclusion(s): This study provided promising results on the potential use of acupuncture to treat children and adolescents with general anxiety. Future research using a randomised control trial with a sufficient sample size to control for confounders and sham (placebo) comparators is warranted. Copyright © 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians)
Journal of Paediatrics and Child Health, 54(8) : 881-888
- Year: 2018
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Acupuncture, acupressure
Manos, B. E., Bravender, T. D., Harrison, T. M., Lange, H. L. H., Cottrill, C. B., Abdel-Rasoul, M., Bonny, A. E.
Objective: To evaluate the effectiveness and tolerability of omega-3 polyunsaturated fatty acid (PUFA) supplementation for treatment of trait anxiety among adolescent females with restrictive anorexia nervosa (AN). Method(s): A pilot double-blind, placebo-controlled randomized trial of adolescent females with AN (N = 24) entering Partial Hospitalization Program (PHP) from January 2015 to February 2016. Participants were randomized to four daily PUFA (2,120 mg eicosapentaenoic acid/600 mg docosohexaenoic acid) or placebo capsules for 12 weeks. A 9-item questionnaire of side effect frequency assessed medication tolerability. The Beck Anxiety Inventory-Trait measured anxiety at baseline, 6, and 12 weeks. Linear mixed models evaluated associations between randomization group and study outcomes. Twenty-two and 18 participants completed 6 and 12 weeks of data collection, respectively. Result(s): Medication side effect scores were low and were not significantly different between randomization groups at Week 6 (p =.20) or 12 (p =.41). Mean trait anxiety score significantly (p <.01) decreased from baseline to 12 weeks in both groups, and the rate of change over the course of time did not differ between omega-3 PUFA and placebo groups (p =.55). Conclusion(s): Omega-3 PUFA supplementation was well tolerated in adolescent females with AN. Although power to detect differences was limited, we found no evidence that omega-3 PUFA benefited anxiety beyond nutritional restoration. Copyright © 2018 Wiley Periodicals, Inc.
International Journal of Eating Disorders, 51(12) : 1367-1372
- Year: 2018
- Problem: Anxiety Disorders (any), Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
, 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)
Viskovich, S., Pakenham, K. I.
OBJECTIVE: This study evaluated a 4-week web-based acceptance and commitment therapy (ACT) mental health promotion program called YOLO (You Only Live Once) for university students. METHOD(S): A total of 130 participants were randomized to one of three intervention groups investigating varied program delivery methods. Primary outcomes assessed: depression, anxiety, stress, well-being, self-compassion, alcohol use, and life satisfaction. ACT processes assessed: acceptance, cognitive fusion, education values, valued living, and mindfulness. RESULT(S): Improvement on the primary outcomes and ACT processes did not differ among the three intervention groups. Analyses showed significant improvements on all primary outcomes (except alcohol use), and on all ACT processes. All ACT processes mediated changes on one or more primary outcomes in the intent-to-treat sample. Intervention effects were consistent on most primary outcomes and ACT processes across three sample groupings. CONCLUSION(S): These preliminary findings provide support for a web-based ACT mental health promotion program for university students. Copyright © 2018 Wiley Periodicals, Inc.
Journal of Clinical Psychology, 74(12) : 2047-2069
- Year: 2018
- Problem: Anxiety Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Acceptance & commitment therapy (ACT)
, Technology, interventions delivered using technology (e.g. online, SMS), Other service delivery and improvement interventions