Behavioral Treatment Of Anxiety Research Articles

Parent-Led Exposure Therapy: A Pilot Study of a Brief Behavioral Treatment for Anxiety in Young Children

Despite prevalence rates as high as 9.4%, few studies have examined the applicability of cognitive-behavioral therapy for treatment of anxiety disorders in very young children (i.e., below the age of 7 years). The present study examined the preliminary efficacy of a parent-led exposure therapy protocol (PLET) designed for young children with anxiety disorders. Twenty-two youth aged 4–7 years and their parents participated in this pilot randomized control trial. Families of youth with significant anxiety concerns were randomized to either PLET (n = 12), a 10 session/5-week family-based exposure therapy program designed to target anxiety in young children, or treatment as usual (TAU; n = 10). Children in the PLET condition demonstrated a greater reduction in anxiety symptoms compared to TAU (d = 3.18), with 90.91% of PLET participants (active condition) being classified as treatment responders at post-treatment as opposed to 0 in the TAU condition. Gains were maintained at 1 month-follow-up. Although pilot in nature, these data suggest in a preliminary fashion that a parent led exposure therapy protocol that is adapted appropriately for developmental age and incorporates an active coaching component for parents may be efficacious for the treatment of young children with anxiety disorders. This clinical trial was registered through clinicaltrials.gov under the following identifier: NCT02051192.

Anxiety and Related Disorders and Concealment in Sexual Minority Young Adults

Sexual minorities face greater exposure to discrimination and rejection than heterosexuals. Given these threats, sexual minorities may engage in sexual orientation concealment in order to avoid danger. This social stigma and minority stress places sexual minorities at risk for anxiety and related disorders. Given that three fourths of anxiety disorder onset occurs before the age of 24, the current study investigated the symptoms of generalized anxiety disorder, social phobia, panic disorder, posttraumatic stress disorder, and depression in sexual minority young adults relative to their heterosexual peers. Secondarily, the study investigated sexual orientation concealment as a predictor of anxiety and related disorders. A sample of 157 sexual minority and 157 heterosexual young adults matched on age and gender completed self-report measures of the aforementioned disorders, and indicated their level of sexual orientation concealment. Results revealed that sexual minority young adults reported greater symptoms relative to heterosexuals across all outcome measures. There were no interactions between sexual minority status and gender, however, women had higher symptoms across all disorders. Sexual minority young women appeared to be at the most risk for clinical levels of anxiety and related disorders. In addition, concealment of sexual orientation significantly predicted symptoms of social phobia. Implications are offered for the cognitive and behavioral treatment of anxiety and related disorders in this population.

Do Benzodiazepines Impair Fear Extinction

Benzodiazepines are thought to impair behavioral treatment of anxiety in anxious patients, but the evidence has been inconsistent, despite many animal studies clearly demonstrating such an effect. In an elegant group of animal studies, researchers have now examined and clarified this effect. Rats were trained to fear a context or discrete cue. The fear was then extinguished either in …

Cognitive and Behavioral Treatments for Anxiety and Depression in a Patient with an Implantable Cardioverter Defibrillator (ICD): A Case Report and Clinical Discussion

Implantable cardioverter-defibrillators (ICDs) are the treatment of choice for patients at risk for potentially life threatening arrhythmias. The associated stress of living with an implanted device and receiving ICD shock therapy has been noted to exert a psychological toll on the individual patient and family. Anxious and depressive symptomatology is frequently reported by these patients, thus creating a demand for tailored psychological interventions for this population. The current case report describes the components, delivery, and effectiveness of a targeted treatment approach for anxiety and depression in an individual with an ICD. Test results and interview data revealed significant improvements in multiple domains of cognitive, emotional, and behavioral functioning. Improvements in marital relations were also achieved. These treatment effects were maintained at follow-up and in the context of acute, medical stressors. Future clinical and research directions are also discussed.

Brain mechanisms in pharmacological and behavioral treatment of anxiety

The use of SSRIs for the treatment of depression and anxiety in young people is increasing. However, the effects of SSRIs in adolescence, a time when there are substantial changes in neural, cognitive, and social functioning, are not well understood. Here, we review evidence from clinical trials about the benefits and risks of SSRIs in young people and consider their mechanisms of action, as shown through human experimental work and animal models. We emphasise key outstanding questions about the effects of SSRIs in youth, identified through gaps in the literature and in consultation with young people with lived experience. It is crucial to characterise the mechanisms underpinning risks and benefits of SSRIs in this age group to progress the field, and to narrow the chasm between the widespread use of SSRIs in youth and the science on which this use is based.

An information processing model of anxiety: Automatic and strategic processes

A three-stage schema-based information processing model of anxiety is described that involves: (a) the initial registration of a threat stimulus; (b) the activation of a primal threat mode; and (c) the secondary activation of more elaborative and reflective modes of thinking. The defining elements of automatic and strategic processing are discussed with the cognitive bias in anxiety reconceptualized in terms of a mixture of automatic and strategic processing characteristics depending on which stage of the information processing model is under consideration. The goal in the treatment of anxiety is to deactivate the more automatic primal threat mode and to strengthen more constructive reflective modes of thinking. Arguments are presented for the inclusion of verbal mediation as a necessary but not sufficient component in the cognitive and behavioral treatment of anxiety.

Putting the client in control: The perception of control in the behavioral treatment of anxiety

Abstract Traditional explanations of anxiety reduction through behavioral interventions such as extinction, habituation, reciprocal inhibition, and counterconditioning do not adequately account for all instances and aspects of anxiety reduction and clinical methods employed in contemporary behavior therapy. This article examines the role of an additional process — the alterations of perceptions of control — believed to be operative in anxiety reduction. We discuss three targets for establishing control in behavioral treatments of anxiety: (1) control over one's physiological responding while in an anxiety-producing situation, (2) control over the anxiety-producing stimulus or situation itself, and (3) control over the conduct of exposure. These three types of control perceptions are differentially important for different types of anxiety disorders. Implications for the conduct of behavioral treatments and possibilities for increasing client perceptions of control in anxiety treatment programs are outlined. We also recommend that client perceptions of control should be systematically assessed in order to relate them to treatment successes and failures.

Lack of Correlation between Frontalis Electromyography and Self-Ratings of Either Frontalis Tension or State Anxiety

Since training in deep muscular relaxation is common to most behavioral treatments for anxiety and tension-related disorders, muscle tension measures, such as electromyography (EMG), would provide valuable information as to the efficacy of these treatments. In the past, however, the majority of clinical reports on behavioral treatments employing muscular relaxation have based results primarily on self-rated outcome measures, despite evidence in the literature of a lack of correspondence between self-ratings and physiological measures of muscle tension. An experiment was performed on 20 normal subjects comparing self-ratings of anxiety and frontalis muscle tension with frontalis EMG before and after a 15-min. relaxation period accompanied by frontalis EMG biofeedback. Analysis showed that the self-ratings of anxiety and frontalis tension correlated significantly both before and after the relaxation period. However, no correlation was observed between self-rated anxiety or frontalis tension and frontalis EMG either before or after the relaxation period. The relaxation period had no significant effect on the dependent measures. It is suggested that, if people are unable to report accurately on their somatic states, then physiological outcome measures, such as EMG, would be preferable to self-rated measures in assessments of relaxation training procedures.