Stresspac: A Controlled Trial of a Self-Help Package for the Anxiety Disorders

1995 ◽  
Vol 23 (2) ◽  
pp. 89-107 ◽  
Author(s):  
Jim White
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Controlled Trial ◽  
Individual Therapy ◽  
Anxiety Management ◽  
Ways Of Coping ◽  
Self Help ◽  
Management Advice ◽  
Post Therapy

In order to test the efficacy of a self-help anxiety management package, sixty-two individuals meeting DSM-III-R criteria for an anxiety disorder were randomly allocated to one of three conditions: Stresspac patients were given a self-help/information package. Advice only patients were offered verbal advice on ways of coping with anxiety. Patients in both conditions were seen on one occasion shortly after referral for assessment and management advice. They were then placed back on the waiting list for a three month period. Patients in the No intervention condition also completed measures during this time. They were not seen until the end of this period when formal assessment took place. All patients were then followed through individual therapy and to 12 month follow-up. Results clearly support the superiority of the Stresspac condition after the waiting period, at post therapy and at follow-up on a range of measures. Possible explanations for the results are discussed.

“STRESSPAC”: THREE-YEAR FOLLOW-UP OF A CONTROLLED TRIAL OF A SELF-HELP PACKAGE FOR THE ANXIETY DISORDERS

1998 ◽  
Vol 26 (2) ◽  
pp. 133-141 ◽  
Author(s):  
Jim White
Keyword(s):  
Anxiety Disorder ◽  
Controlled Trial ◽  
Anxiety Management ◽  
Ways Of Coping ◽  
Self Help ◽  
Data Points ◽  
Management Advice ◽  
One Year ◽  
Intervention Condition

In order to test the efficacy of a self-help anxiety management package, 62 anxiety disorder patients were randomly allocated to one of three conditions. “Stress-pac” patients were given a self-help package, “Advice Only” patients were offered verbal advice on ways of coping. Patients in both conditions were seen on one occasion shortly after referral for assessment and management advice. They were then placed back on the waiting list for a three-month period. Patients in the “No Intervention” condition also completed measures during this time. They were formally assessed at the end of this period. All patients were then followed through therapy. Results from a previous paper clearly indicated the superiority of the Stresspac condition at all data points up to one year follow-up. This paper looks at three-year follow-up and, while finding generally good outcome across conditions, finds further evidence of the superiority of the Stresspac condition on a range of measures.

Effects of a transdiagnostic unguided Internet intervention (‘velibra’) for anxiety disorders in primary care: results of a randomized controlled trial

2016 ◽  
Vol 47 (1) ◽  
pp. 67-80 ◽  
Author(s):  
T. Berger ◽  
A. Urech ◽  
T. Krieger ◽  
T. Stolz ◽  
A. Schulz ◽  
...  
Keyword(s):  
Primary Care ◽  
Randomized Controlled Trial ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Controlled Trial ◽  
Post Treatment ◽  
Depression Symptom ◽  
Behavioural Treatment ◽  
Randomized Controlled

BackgroundInternet-based cognitive–behavioural treatment (ICBT) for anxiety disorders has shown some promise, but no study has yet examined unguided ICBT in primary care. This randomized controlled trial (RCT) investigated whether a transdiagnostic, unguided ICBT programme for anxiety disorders is effective in primary care settings, after a face-to-face consultation with a physician (MD). We hypothesized that care as usual (CAU) plus unguided ICBT would be superior to CAU in reducing anxiety and related symptoms among patients with social anxiety disorder (SAD), panic disorder with or without agoraphobia (PDA) and/or generalized anxiety disorder (GAD).MethodAdults (n = 139) with at least one of these anxiety disorders, as reported by their MD and confirmed by a structured diagnostic interview, were randomized. Unguided ICBT was provided by a novel transdiagnostic ICBT programme (‘velibra’). Primary outcomes were generic measures, such as anxiety and depression symptom severity, and diagnostic status at post-treatment (9 weeks). Secondary outcomes included anxiety disorder-specific measures, quality of life, treatment adherence, satisfaction, and general psychiatric symptomatology at follow-up (6 months after randomization).ResultsCAU plus unguided ICBT was more effective than CAU at post-treatment, with small to medium between-group effect sizes on primary (Cohen's d = 0.41–0.47) and secondary (Cohen's d = 0.16–0.61) outcomes. Treatment gains were maintained at follow-up. In the treatment group, 28.2% of those with a SAD diagnosis, 38.3% with a PDA diagnosis, and 44.8% with a GAD diagnosis at pretreatment no longer fulfilled diagnostic criteria at post-treatment.ConclusionsThe unguided ICBT intervention examined is effective for anxiety disorders when delivered in primary care.

Translational delivery of Cool Little Kids to prevent child internalising problems: Randomised controlled trial

2017 ◽  
Vol 52 (2) ◽  
pp. 181-191 ◽  
Author(s):  
Jordana K Bayer ◽  
Ruth Beatson ◽  
Lesley Bretherton ◽  
Harriet Hiscock ◽  
Melissa Wake ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Confidence Interval ◽  
Anxiety Disorders ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Controlled Trial ◽  
Secondary Outcomes ◽  
Randomised Controlled ◽  
Internalising Problems

Objective: To determine whether a population-delivered parenting programme assists in preventing internalising problems at school entry for preschool children at-risk with temperamental inhibition. Methods: Design: a randomised controlled trial was used. Setting: the setting was 307 preschool services across eight socioeconomically diverse government areas in Melbourne, Australia. Participants: a total of 545 parents of inhibited 4-year-old children: 498 retained at 1-year follow up. Early intervention: Cool Little Kids parenting group programme was implemented. Primary outcomes: the primary outcomes were child DSM-IV anxiety disorders (assessor blind) and internalising problems. Secondary outcomes: the secondary outcomes were parenting practices and parent mental health. Results: At 1-year follow up (mean (standard deviation) age = 5.8 (0.4) years), there was little difference in anxiety disorders between the intervention and control arms (44.2% vs 50.2%; adjusted odds ratio = 0.86, 95% confidence interval = [0.60, 1.25], p = 0.427). Internalising problems were reduced in the intervention arm (Strengths and Difficulties Questionnaire: abnormal – 24.2% vs 33.0%; adjusted odds ratio = 0.56, 95% confidence interval = [0.35, 0.89], p = 0.014; symptoms – mean (standard deviation) = 2.5 (2.0) vs 2.9 (2.2); adjusted mean difference = –0.47, 95% confidence interval = [–0.81, –0.13], p = 0.006). Parents’ participation in the intervention was modest (29.4% attended most groups, 20.5% used skills most of the time during the year). A priori interaction tests suggested that for children with anxious parents, the intervention reduced anxiety disorders and internalising symptoms after 1 year. Conclusion: Offering Cool Little Kids across the population for inhibited preschoolers does not impact population outcomes after 1 year. Effects may be emerging for inhibited children at highest risk with parent anxiety. Trial outcomes will continue into mid-childhood.

Characteristics of Parent- and Child-Reported Anxiety in Psychostimulant Medication Naïve, Clinically Referred Children with Attention Deficit Hyperactivity Disorder, Combined Type (ADHD-CT)

2002 ◽  
Vol 36 (2) ◽  
pp. 234-239 ◽  
Author(s):  
Alasdair Vance ◽  
Jan Costin ◽  
Rebecca Barnett ◽  
Ernest Luk ◽  
Paul Maruff ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Child Anxiety ◽  
Parent Report ◽  
School Age Children ◽  
Systematic Research ◽  
Child Report ◽  
Hyperactivity Disorder ◽  
Primary School Age

Objective: Anxiety is a frequent comorbid condition in referred primary school-age children with attention deficit hyperactivity disorder, combined type (ADHD-CT), yet there has been relatively little systematic research of the nature of this comorbid anxiety. We describe the characteristics of parent-reported child anxiety disorders and child-reported anxiety disorders in primary school-age children with ADHD-CT. Method: A cross-sectional study of 75 clinically-referred psychostimulant medication naïve children with ADHD-CT examining separately parent and child reports of anxiety, defined categorically and dimensionally. A two-year follow up of 12 children with parent-reported child anxiety and 12 children with child-reported anxiety was also completed. Results: There was no significant association between the child and parent reports of anxiety. Generalized anxiety disorder (GAD), separation anxiety disorder (SAD), specific phobia (SpPh) and social phobia (SoPh) were the most common anxiety disorder diagnoses reported by parents and children. Two-year follow-up data revealed no decrease in the parent report but a significant decrease in the child report of anxiety disorders. Conclusions: The dissonance between the parent report of child anxiety and the child report of anxiety, emphasizes the importance of careful and thorough clinical assessment of the child's perspective. The nature of parent-reported child anxiety and children's self-report of anxiety requires further systematic research.

scholarly journals Online Attention Bias Modification in Combination With Cognitive-Behavioural Therapy for Children and Adolescents With Anxiety Disorders: A Randomised Controlled Trial

2019 ◽  
Vol 36 (4) ◽  
pp. 200-215 ◽  
Author(s):  
Jasmijn M. de Lijster ◽  
Gwendolyn C. Dieleman ◽  
Elisabeth M.W.J. Utens ◽  
Jan van der Ende ◽  
Tamsin M. Alexander ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Children And Adolescents ◽  
Controlled Trial ◽  
Attention Bias ◽  
Behavioural Therapy ◽  
Attention Bias Modification ◽  
Cognitive Behavioural ◽  
Secondary Outcomes ◽  
Bias Modification

AbstractAttention Bias Modification (ABM) targets attention bias (AB) towards threat, which is common in youth with anxiety disorders. Previous clinical trials showed inconsistent results regarding the efficacy of ABM, and few studies have examined the effect of online ABM and its augmented effect with cognitive behavioural therapy (CBT). The aim of the current study was to examine the efficacy of online ABM combined with CBT for children and adolescents with anxiety disorders in a randomised, double-blind, placebo-controlled trial. Children (aged 8–16 years) completed nine online sessions of ABM (n= 28) or online sessions of the Attention Control Condition (ACC;n= 27) over a period of 3 weeks (modified dot-probe task with anxiety disorder-congruent stimuli), followed by CBT. Primary outcomes were clinician-reported anxiety disorder status. Secondary outcomes were patient-reported anxiety and depression symptoms and AB. Results showed a continuous decrease across time in primary and secondary outcomes (ps < .001). However, no differences across time between the ABM and ACC group were found (ps > .50). Baseline AB and age did not moderate treatment effects. Online ABM combined with CBT does not show different efficacy compared with online ACC with CBT for children and adolescents with anxiety disorders.

ONE YEAR FOLLOW-UP OF COGNITIVE THERAPY, ANALYTIC PSYCHOTHERAPY AND ANXIETY MANAGEMENT TRAINING FOR GENERALIZED ANXIETY DISORDER: SYMPTOM CHANGE, MEDICATION USAGE AND ATTITUDES TO TREATMENT

1999 ◽  
Vol 27 (1) ◽  
pp. 19-35 ◽  
Author(s):  
Robert C. Durham ◽  
Peter L. Fisher ◽  
Linda R. Trevling ◽  
Cathryn M. Hau ◽  
Karen Richard ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Cognitive Therapy ◽  
Generalized Anxiety Disorder ◽  
Management Training ◽  
Generalized Anxiety ◽  
Medication Usage ◽  
Anxiety Management ◽  
Clinically Significant ◽  
One Year

A one year follow-up is reported of a randomized clinical trial with generalized anxiety disorder (GAD) in which the main comparison was between analytic psychotherapy (AP) and cognitive therapy (CT), each delivered at weekly or fortnightly intervals over a six month period. CT was found to be significantly more effective than AP. However, GAD is a chronic and relapsing condition and follow-up data are needed to assess the durability of improvement and the possibility that the benefits of analytic psychotherapy may be more apparent over the longer term. Data were collected in three areas: (1) symptomatology and overall improvement; (2) medication usage and contact with GPs; and (3) attitudes to therapy. CT was clearly superior to AP on the main outcome measures and only a minority of AP patients made significant improvements. CT but not AP was associated with significant reductions in medication usage, and patients receiving CT were generally more positive about treatment received. Differences between treatments were less evident in the less intensive treatment condition where overall results were relatively poor. The most positive outcomes were achieved in the more intensive CT condition in which approximately two-thirds of patients achieved clinically significant improvements.

Anxiety disorders and the onset of depression among adults in the community

2002 ◽  
Vol 32 (6) ◽  
pp. 1121-1124 ◽  
Author(s):  
RENEE D. GOODWIN
Keyword(s):  
Anxiety Disorder ◽  
Major Depression ◽  
Anxiety Disorders ◽  
Panic Attack ◽  
Panic Attacks ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Sociodemographic Differences ◽  
Co Morbidity

Objective. To determine the association between anxiety disorders, panic attack and the risk of major depression among adults in the community.Method. Data were drawn from the Epidemiologic Catchment Area Program survey waves 1 (N = 20291) and 2 (N = 15849). Multivariate logistic regression analyses were used to determine the risk of incident major depression at 12-month follow-up (wave 2) associated with each anxiety disorder and panic attacks assessed at wave 1, adjusting for differences in sociodemographic characteristics, and then controlling simultaneously for all anxiety disorders, and other psychiatric co-morbidity.Results. Specific phobia (OR = 1.7 (1.6, 1.8)), agoraphobia (OR = 2.3 (2.2, 2.5)), obsessive–compulsive disorder (OR = 5.4 (5.0, 5.8)) and panic attack (OR = 1.9 (1.8, 2.1)) each made an independent contribution to the risk of major depression, which persisted after adjusting simultaneously for sociodemographic differences and other psychiatric co-morbidity. Conclusions. Each anxiety disorder and panic attacks appear to confer an independent risk for the onset of major depression within 12-months among adults in the community. Understanding the key role played by anxiety in depression onset is needed for prevention strategies.

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