Cognitive behavioural therapy for anxiety disorders and insomnia: a commentary on future directions

2014 ◽  
Vol 7 ◽  
Author(s):  
Kristin M. Aho ◽  
Scott M. Pickett ◽  
Timothy S. Hamill
Keyword(s):  
Anxiety Disorders ◽  
Behavioural Therapy ◽  
Current Data ◽  
Future Research ◽  
Post Traumatic Stress ◽  
Similar Treatment ◽  
Comorbid Anxiety ◽  
Panic Disorders ◽  
Underlying Mechanisms ◽  
The Impact

AbstractAnxiety disorders and insomnia significantly impair daily functioning. Similar underlying mechanisms may account for the high comorbidity of both disorders, and respective treatments share pharmacological and behavioural features. This review suggests the utility of an integrated CBT approach in the treatment of generalized anxiety, post-traumatic stress, and panic disorders, and comorbid insomnia. Other anxiety disorders were not explored because current data are limited or inconsistent. A comprehensive, non-systematic review of the literature was conducted to evaluate the treatment of comorbid anxiety and insomnia disorders, and data reveal shared pharmacological and behavioural features of insomnia and anxiety disorders treatment. However, research demonstrates that CBT maintains successful treatment results longer than drug therapies. Despite similar treatment approaches, there is a paucity of research that explores integrated CBT approaches for comorbid anxiety and insomnia disorders. This review suggests that future research should assess the impact of combined therapeutic approaches on the simultaneous reduction of anxiety disorders, insomnia, and relapse rates.

The Effect of Comorbid Depression on Sudden Gains During Transdiagnostic Cognitive-Behavioural Therapy for Anxiety Disorders

2021 ◽  
pp. 1-11
Author(s):  
Sasha D'Arcy ◽  
Peter J. Norton
Keyword(s):  
Anxiety Disorders ◽  
Cognitive Behavioural Therapy ◽  
Depressive Disorders ◽  
Behavioural Therapy ◽  
Future Research ◽  
Comorbid Depression ◽  
Sudden Gains ◽  
Cognitive Behavioural ◽  
Patients Experience ◽  
The Impact

Abstract During psychotherapy some patients experience large symptom improvements between sessions, termed sudden gains. Most commonly, sudden gains are observed during treatment for depression (40–50% of participants), but these are occasionally also observed in treatment for anxiety (15–20%). This study investigated the impact of comorbid depression on sudden gains in a primary anxiety sample. It was hypothesised that sudden gains would occur more frequently in participants with anxiety and comorbid depression than anxiety-only participants. The sample consisted of 58 adults who participated in a 12-week transdiagnostic cognitive-behavioural therapy (tCBT) programme. Sudden gains were more frequent in the comorbid depression group than in the anxiety-only group. Sudden gains may be predominantly a function of depressive disorders, which supports the higher rates seen in depressive disorders compared with anxiety disorders. Future research should endeavour to replicate these findings, as this was the first study designed to specifically investigate comorbidity in sudden gains.

Comorbidity of ADHD and Anxiety Disorders in School-Age Children: Impact on Sleep and Response to a Cognitive-Behavioral Treatment

2015 ◽  
Vol 22 (5) ◽  
pp. 414-424 ◽  
Author(s):  
Maxime Bériault ◽  
Lyse Turgeon ◽  
Mélanie Labrosse ◽  
Claude Berthiaume ◽  
Martine Verreault ◽  
...  
Keyword(s):  
Anxiety Disorders ◽  
Sleep Disturbances ◽  
Behavioral Treatment ◽  
Sleep Onset ◽  
Cognitive Behavioral ◽  
Sleep Onset Latency ◽  
Sleep Habits ◽  
Children With Adhd ◽  
Comorbid Anxiety ◽  
The Impact

Objective: This exploratory study measured the impact of comorbid anxiety disorders on sleep in children with ADHD and tested the effect of cognitive-behavioral therapy (CBT) on these measures. Method: Fifty-seven children (8-12 years old) were assessed with the Child Sleep Habits Questionnaire. Four groups were formed: ADHD ( n = 20), ADHD + Anxiety ( n = 20), Anxiety ( n = 8), and Healthy Controls ( n = 9). A subgroup of 10 children with ADHD + Anxiety underwent CBT for anxiety. Results: The results showed that sleep difficulties were better associated with anxiety than with ADHD. CBT reduced sleep onset latency and marginally decreased the total amount of sleep problems. Conclusion: The present study demonstrates that comorbid anxiety in ADHD children is linked with specific sleep disturbances and is sensitive to CBT aimed at reducing anxiety.

scholarly journals The Impact of Childhood Psychological Maltreatment on Mental Health Outcomes in Adulthood: A Protocol for a Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Zhuoni Xiao ◽  
Mina Murat Baldwin ◽  
Franziska Meinck ◽  
Ingrid Obsuth ◽  
Aja Louise Murray
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Emotional Abuse ◽  
Meta Analysis ◽  
Psychological Maltreatment ◽  
Future Research ◽  
Long Term Effects ◽  
Post Traumatic Stress ◽  
Eligibility Criteria ◽  
The Impact

Abstract Background: Research suggests that childhood psychological maltreatment (i.e., emotional abuse and emotional neglect) is associated with mental and physical health problems that persist into adulthood, for example anxiety, depression, post-traumatic stress disorder (PTSD), suicidal ideation, and aggression; however, a systematic review and meta-analysis of the existing literature would help clarify the magnitude and moderators of these associations, and the extent to which they may be affected by publication bias, as well as the methodological strengths and weakness of studies in this area.Method: Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guideline will be employed to structure the review. Several searches will be carried out via databases including Web of Science, Medline, PubMed, PsycINFO, Applied Social Science Index and Abstract, ERIC and EMBASE. Empirical peer reviewed research articles that fit pre-specified eligibility criteria will be included in the review. This review will include literature written in either English or Chinese. Two independent reviewers will screen and assess studies for inclusion in the review as well as extract the data, with consensus reached through discussion in cases of discrepancy. A third reviewer will be consulted to resolve any discrepancies that cannot be resolved through discussion between the original reviewers. The relevant Newcastle-Ottawa scales will be used for assessing the quality of studies. If a sufficient number of comparable studies are retrieved, a meta-analysis will be conducted using a random effects model. Discussion: This systematic review will provide an understanding of the long-term effects of childhood psychological maltreatment on adult mental health, which adds to previous reviews focusing primarily on the effects of physical and sexual abuse. The results of the review will help inform clinical practice in approaches to treating those with a history of psychological maltreatment in childhood. The gaps and weaknesses in the evidence identified will also inform recommendations for future research.

Adolescent Outcome of ADHD: Impact of Childhood Conduct and Anxiety Disorders

CNS Spectrums ◽  
2004 ◽  
Vol 9 (9) ◽  
pp. 668-678 ◽  
Author(s):  
Jeffrey H. Newcorn ◽  
Scott R. Miller ◽  
Iliyan Ivanova ◽  
Kurt P. Schulz ◽  
Jessica Kalmar ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Child Behavior Checklist ◽  
Social Problems ◽  
Self Report ◽  
Comorbid Condition ◽  
Behavioral Outcome ◽  
Comorbid Anxiety ◽  
The Impact ◽  
Adolescent Outcome

ABSTRACTObjective: This study examines the impact of comorbidity of attention-deficit/hyperactivity disorder (ADHD) with disruptive and anxiety disorders in childhood on clinical course and outcome. We consider the relative contribution of each comorbid symptom constellation, and also their interaction, to assess the following questions: (1) Does early comorbidity with conduct disorder (CD) and anxiety disorders define specific developmental trajectories?; (2) Is comorbid anxiety disorders in childhood continuous with anxiety disorders in adolescence?; (3) Does comorbid anxiety disorders mitigate the negative behavioral outcome of youth with ADHD?; and (4) Is there an interaction between comorbid CD and anxiety disorders, when they occur simultaneously, that predicts a different outcome than either comorbid condition alone?Method: Thirty-two 15- to 18-year-old adolescent males, diagnosed with ADHD between 7 and 11 years of age, were re-evaluated for assessment of adolescent outcome 4.3–9.2 years later. Hierarchical regression analyses were run with each of the eight Child Behavior Checklist and Youth Self-Report problem scales, and the four anxiety symptom subscales of the Multidimensional Anxiety Scale for Children serving as outcome variables.Results: Findings indicate that comorbid CD at baseline predicteds parent reports of behavior problems in adolescence, while comorbid anxiety disorders in childhood predicted youth reports of anxiety and social problems. Anxiety disorders without CD did not predict poor behavioral outcome. Children with both comorbid CD and anxiety disorder had the highest levels of parent-rated symptoms on follow up. In particular, adolescent social problems were best predicted by the combination of comorbid CD and anxiety disorder in childhood.Conclusion: These data provide evidence that children with ADHD plus anxiety disorder do in fact have anxiety disorders, and that the combination of anxiety disorder and CD predicts a more rather than less severe course.

Childhood Maltreatment and Perinatal Mood and Anxiety Disorders

2016 ◽  
Vol 17 (5) ◽  
pp. 427-453 ◽  
Author(s):  
Karmel W. Choi ◽  
Kathleen J. Sikkema
Keyword(s):  
Anxiety Disorders ◽  
Childhood Maltreatment ◽  
Child Outcomes ◽  
Well Being ◽  
Traumatic Experiences ◽  
Empirical Literature ◽  
Future Research ◽  
Post Traumatic Stress ◽  
Treatment And Prevention ◽  
Mood And Anxiety Disorders

Perinatal mood and anxiety disorders (PMADs) compromise maternal and child well-being and may be influenced by traumatic experiences across the life course. A potent and common form of trauma is childhood maltreatment, but its specific impact on PMADs is not well understood. A systematic review was undertaken to synthesize empirical literature on the relationship between maternal histories of childhood maltreatment and PMADs. Of the 876 citations retrieved, 35 reports from a total of 26,239 participants met inclusion criteria, documenting substantial rates of childhood maltreatment and PMADs. Robust trends of association were observed between childhood maltreatment and perinatal depression, as well as post-traumatic stress disorder, but findings for anxiety were less consistent. Examining multivariate results suggested that childhood maltreatment predicts PMADs above and beyond sociodemographic, psychiatric, perinatal, and psychosocial factors, but may also be partially mediated by variables such as later victimization and moderated by protective early relationships. Future research should test mediating and moderating pathways using prospective cohorts, expanding to cross-cultural settings and other disorder outcomes. Treatment and prevention of childhood maltreatment and its sequelae may help mitigate risk for perinatal psychopathology and its impact on maternal and child outcomes.

Psychological Sequelae of Torture and Trauma in Chilean and Salvadorean Migrants: A Pilot Study

1995 ◽  
Vol 29 (1) ◽  
pp. 84-95 ◽  
Author(s):  
Maritza Thompson ◽  
Patrick McGorry
Keyword(s):  
Future Research ◽  
Torture Survivors ◽  
Post Traumatic Stress ◽  
Psychological Sequelae ◽  
Impact Of Event Scale ◽  
Event Scale ◽  
Research Perspective ◽  
Post Traumatic ◽  
Preliminary Study ◽  
The Impact

Torture has existed since the earliest times, usually as public punishment prior to death. Today it is predominantly used in secret with the aim of destroying the individual's personality. The effects of torture include severe physical and psychological sequelae which have only recently come under scrutiny. In recent years many Chilean and El Salvadorean migrants have left their countries after being tortured and severely traumatised as a result of organised violence. The aim of this study was to pilot an investigation into the psychological sequelae of torture. Subjects were 30 Chileans and El Salvadoreans classified into three groups: torture, trauma and non-torture/trauma migrants. It was found to be feasible to access and interview survivors from a clinical research perspective without causing additional psychological morbidity. The subjects were interviewed and administered three scales: the Post-Traumatic Stress Disorder Scale, SCL-90-R, and the Impact of Event Scale. The results from the scales and the descriptive data presented indicate some support for the hypothesis that torture survivors show higher levels of PTSD, psychosomatic impairment and stress response disturbance than the trauma and non-torture/trauma groups. Methodological issues are discussed. The strengths and limitations of this preliminary study are considered in relation to future research.

scholarly journals My Therapist is a Student? The Impact of Therapist Experience and Client Severity on Cognitive Behavioural Therapy Outcomes for People with Anxiety Disorders

2015 ◽  
Vol 44 (2) ◽  
pp. 193-202 ◽  
Author(s):  
Liam Mason ◽  
Nick Grey ◽  
David Veale
Keyword(s):  
Anxiety Disorders ◽  
Behavioural Therapy ◽  
Outcome Data ◽  
Symptom Improvement ◽  
Therapist Experience ◽  
Clinically Significant Change ◽  
Trainee Therapists ◽  
Significant Change ◽  
Clinically Significant ◽  
The Impact

Background: Allocation of trainee therapist cases is often performed based on intuition and clinical circumstances, with lack of empirical evidence on the role of severity of presenting problem. This has the potential to be anxiety-provoking for supervisors, trainees and service users themselves. Aims: To determine how therapist experience interacts with symptom severity in predicting client outcomes. Method: An intention-to-treat analysis of annual outcome data for primary and secondary care clients seen by a specialist anxiety disorders service. 196 clients were stratified into mild, moderate and baseline severe symptoms of anxiety (GAD-7) and depression (PHQ-9). We measured percentage change on these measures, as well as number of sessions and therapy dropout. We also examined rates of reliable and clinically significant change on disorder-specific measures. We hypothesized that qualified therapists would achieve better outcomes than trainees, particularly for severe presentations. Results: Overall, outcomes were comparable between trainee and qualified therapists on all measures, and trainees additionally utilized fewer therapy sessions. There was however an interaction between anxiety severity (GAD-7) and therapist group, such that severely anxious clients achieved greater symptom improvement with qualified as compared to trainee therapists. Further, for trainee but not qualified therapists, baseline anxiety was negatively associated with rate of reliable and clinically significant change on disorder-specific measures. Conclusions: These findings indicate generally favourable outcomes for trainee therapists delivering manualized treatments for anxiety disorders. They additionally suggest that trainee therapists may benefit from additional support when working with clients that present with severe anxiety.

scholarly journals Internet-delivered eye movement desensitization and reprocessing (iEMDR): an open trial

F1000Research ◽  
2013 ◽  
Vol 2 ◽  
pp. 79
Author(s):  
Jay Spence ◽  
Nickolai Titov ◽  
Luke Johnston ◽  
Blake F Dear ◽  
Bethany Wootton ◽  
...  
Keyword(s):  
Eye Movement ◽  
Treatment Protocol ◽  
Behavioural Therapy ◽  
Post Treatment ◽  
Effect Sizes ◽  
Future Research ◽  
Symptom Improvement ◽  
Post Traumatic Stress ◽  
Pre Treatment

Recent research indicates internet-delivered cognitive behavioural therapy (iCBT) can reduce symptoms of post traumatic stress disorder (PTSD). This study examined the efficacy of an internet-delivered treatment protocol that combined iCBT and internet-delivered eye movement desensitization and reprocessing (iEMDR), in an uncontrolled trial. Eleven of the 15 participants completed post-treatment questionnaires. Large effect sizes were found from pre-treatment to 3-month follow-up (d = 1.03 – 1.61) on clinician-assessed and self-reported measures of PTSD, anxiety and distress, with moderate effect sizes (d = 0.59 – 0.70) found on measures of depression and disability. At post-treatment, 55% of the participants no longer met criteria for PTSD and this was sustained at follow-up. Symptom worsening occurred in 3 of 15 (20%) of the sample from pre- to post-treatment; however, these participants reported overall symptom improvement by follow-up. Future research directions for iEMDR are discussed.

scholarly journals Internet-delivered eye movement desensitization and reprocessing (iEMDR): an open trial

F1000Research ◽  
2013 ◽  
Vol 2 ◽  
pp. 79 ◽  
Author(s):  
Jay Spence ◽  
Nickolai Titov ◽  
Luke Johnston ◽  
Blake F Dear ◽  
Bethany Wootton ◽  
...  
Keyword(s):  
Eye Movement ◽  
Treatment Protocol ◽  
Behavioural Therapy ◽  
Post Treatment ◽  
Effect Sizes ◽  
Future Research ◽  
Symptom Improvement ◽  
Post Traumatic Stress ◽  
Pre Treatment

Recent research indicates internet-delivered cognitive behavioural therapy (iCBT) can reduce symptoms of post traumatic stress disorder (PTSD). This study examined the efficacy of an internet-delivered treatment protocol that combined iCBT and internet-delivered eye movement desensitization and reprocessing (iEMDR), in an uncontrolled trial. Eleven of the 15 participants completed post-treatment questionnaires. Large effect sizes were found from pre-treatment to 3-month follow-up (d = 1.03 – 1.61) on clinician-assessed and self-reported measures of PTSD, anxiety and distress, with moderate effect sizes (d = 0.59 – 0.70) found on measures of depression and disability. At post-treatment, 55% of the participants no longer met criteria for PTSD and this was sustained at follow-up. Symptom worsening occurred in 3 of 15 (20%) of the sample from pre- to post-treatment; however, these participants reported overall symptom improvement by follow-up. Future research directions for iEMDR are discussed.

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