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"Anxiety Prevention."
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Reducing children’s anxiety and pain in dental environment using an eye massage device combined with natural sounds—a randomized controlled trial
This study evaluated the efficacy of an eye massage device that uses acupressure points combined with natural sounds to reduce anxiety and pain in children receiving dental anesthesia for the first time. A total of 105 children aged between 8 and 10 years whose dental treatment required inferior alveolar nerve block (IANB) injection participated in this randomized controlled clinical trial. The participants were randomly divided into three groups: Group A: eye massage with natural sounds; Group B: eye massage only; and Group C (control group): traditional behavior management techniques. Anxiety and pain were assessed before, during, and after anesthesia using the Children’s Fear Scale (CFS), Wong-Baker pain rating scale (WBS), the Face-Legs-Activity-Cry-Consolability (FLACC) observational pain assessment scale, and pulse rate as a physiological scale. Anxiety and pain significantly decreased in groups A and B compared with those in the control group (p < 0.05), with group A showing a greater decrease in pulse rate and objective pain assessed during injection via the FLACC scale than group B (p < 0.05); however, no significant difference was noted between groups A and B regarding the data recorded after anesthesia using the WBS and CFS (p > 0.05). Changes in pulse rate and anxiety levels (CFS) measured before and after the procedure in each group revealed a significant decrease in fear and pulse rate in group A and no significant change in group B, whereas group C showed a significant increase in pulse rate and fear at the end of the procedure. Eye massage with natural sounds can effectively alleviate children’s anxiety in the dental setting and reduce pain related to anesthesia, and the combination of these two interventions has the best relaxation effect on children.
Journal Article
Anxiety-focused cognitive behavioral therapy delivered by non-specialists to prevent postnatal depression: a randomized, phase 3 trial
Anxiety experienced by women during pregnancy is highly prevalent, especially in resource-poor settings and strongly predicts postnatal common mental disorders (CMDs), anxiety and depression. We evaluated the effectiveness of an anxiety-focused early prenatal intervention on preventing postnatal CMDs. This study was a phase 3, two-arm, single-blind, randomized controlled trial conducted in Pakistan with women who were ≤22 weeks pregnant and had at least mild anxiety without clinical depression. Participants were randomized to the Happy Mother–Healthy Baby program, based on cognitive behavioral therapy, consisting of six one-on-one intervention sessions in pregnancy delivered by non-specialist providers, or to enhanced care alone. The primary outcome was major depression, generalized anxiety disorder or both at 6 weeks after delivery. Overall, 755 women completed postnatal assessments (380 (50.3%), intervention arm; 375 (49.7%) enhanced-care arm). The primary outcomes were met. Examined jointly, we found 81% reduced odds of having either a major depressive episode (MDE) or moderate-to-severe anxiety for women randomized to the intervention (adjusted odds ratio (aOR) = 0.19, 95% CI 0.14–0.28). Overall, 12% of women in the intervention group developed MDE at 6 weeks postpartum, versus 41% in the control group. We found reductions of 81% and 74% in the odds of postnatal MDE (aOR = 0.19, 95% CI 0.13–0.28) and of moderate-to-severe anxiety (aOR = 0.26, 95% CI 0.17–0.40), respectively. The Happy Mother–Healthy Baby program early prenatal intervention focusing on anxiety symptoms reduced postpartum CMDs. ClinicalTrials.gov identifier
NCT03880032
.
In a phase 3 trial, an anxiety-focused cognitive behavioral therapy intervention delivered during pregnancy by non-specialist providers in Pakistan reduced the incidence of postnatal depression and anxiety compared to enhanced care.
Journal Article
A Randomized Trial of a Family-Support Intervention in Intensive Care Units
In a cluster-randomized trial conducted in five ICUs, a nurse-led family-support intervention did not affect surrogates’ scores for anxiety and depression 6 months after the patients’ hospitalization, but it improved surrogates’ ratings of the patient-centeredness of care.
Journal Article
Effects of a prenatal mindfulness program on longitudinal changes in stress, anxiety, depression, and mother–infant bonding of women with a tendency to perinatal mood and anxiety disorder: a randomized controlled trial
Background
Stress is a risk factor for poor physical and mental health, affecting new mothers’ ability, especially those with perinatal mood and anxiety disorders, to maintain their everyday lives. Over the past 50 years, global incidences of depression and anxiety disorders have increased, reaching pandemic levels. These incidences represent major public health issues that are challenging to detect and treat. Mindfulness programs are viable for reducing stress, anxiety, and depression. The present study evaluates mindfulness intervention effects on stress, anxiety, depression, and mother–infant bonding.
Methods
We collected data on 102 women participating in a prenatal mindfulness program between July 2021 and March 2022; they were parallel and randomly assigned to experimental or control groups. The intervention group received an 8-week course in a prenatal mindfulness program, and the control group received usual standard prenatal care. The self-reported stress, pregnancy-related anxiety, and depression were assessed before and after the intervention and at 36 weeks of gestation. At 2 and 4 months postpartum, all participants provided self-reported their levels of stress, depression, and quality of mother-infant bonding.
Results
Compared to the control group, the experimental group that received the prenatal mindfulness intervention experienced reduced prenatal stress, anxiety, and depression and reduced postnatal stress and depression. Despite this, there was no significant difference between the groups in terms of the quality of mother-infant bonding.
Conclusions
Mindfulness prenatal programs are convenient and effective methods of decreasing stress, anxiety, and depression during the perinatal period. Based on our findings, prenatal mindfulness may play a role in mitigating mood and anxiety disorders and should be considered in future approaches to preventing psychological distress.
Trial registration number
This trial has been prospectively registered at ClinicalTrials.gov (NCT04693130) and the first registration date was 12/24/2020.
Journal Article
A synergistic mindsets intervention protects adolescents from stress
Social-evaluative stressors—experiences in which people feel they could be judged negatively—pose a major threat to adolescent mental health
1
–
3
and can cause young people to disengage from stressful pursuits, resulting in missed opportunities to acquire valuable skills. Here we show that replicable benefits for the stress responses of adolescents can be achieved with a short (around 30-min), scalable 'synergistic mindsets' intervention. This intervention, which is a self-administered online training module, synergistically targets both growth mindsets
4
(the idea that intelligence can be developed) and stress-can-be-enhancing mindsets
5
(the idea that one’s physiological stress response can fuel optimal performance). In six double-blind, randomized, controlled experiments that were conducted with secondary and post-secondary students in the United States, the synergistic mindsets intervention improved stress-related cognitions (study 1,
n
= 2,717; study 2,
n
= 755), cardiovascular reactivity (study 3,
n
= 160; study 4,
n
= 200), daily cortisol levels (study 5,
n
= 118 students,
n
= 1,213 observations), psychological well-being (studies 4 and 5), academic success (study 5) and anxiety symptoms during the 2020 COVID-19 lockdowns (study 6,
n
= 341). Heterogeneity analyses (studies 3, 5 and 6) and a four-cell experiment (study 4) showed that the benefits of the intervention depended on addressing both mindsets—growth and stress—synergistically. Confidence in these conclusions comes from a conservative, Bayesian machine-learning statistical method for detecting heterogeneous effects
6
. Thus, our research has identified a treatment for adolescent stress that could, in principle, be scaled nationally at low cost.
An online training module that synergistically targets two different mindsets can reduce stress levels in adolescents in the context of social-evaluative stressors—stressful experiences in which individuals fear that others are judging them negatively.
Journal Article
A Pilot Study on Telephone Cognitive Behavioral Therapy for Patients Six-Months Post-Bariatric Surgery
Objective
This study aimed to determine the feasibility and preliminary efficacy of a post-operative telephone-based cognitive behavioral therapy intervention (Tele-CBT) in improving eating pathology and psychosocial functioning.
Methods
Six-month post-operative bariatric surgery patients (
n
= 19) received six sessions of Tele-CBT. Study outcome variables included binge eating (BES), emotional eating (EES), depressive symptoms (PHQ-9), and anxiety symptoms (GAD-7).
Results
Retention was 73.7 % post-intervention. Tele-CBT resulted in significant reductions in mean difference scores on BES, EES-Total, EES-Anxiety, EES-Anger, PHQ9, and GAD7. Tele-CBT patients experienced a mean weight loss of 8.62 ± 15.02 kg between 6-months post-surgery (pre-Tele-CBT) and 12-months post-surgery.
Conclusions
These preliminary results suggest that post-surgery Tele-CBT is feasible and can improve post-surgery symptoms of psychopathology in this uncontrolled study, supporting the need for a randomized controlled trial.
Journal Article
Does an app designed to reduce repetitive negative thinking decrease depression and anxiety in young people? (RETHINK): a randomized controlled prevention trial
Background
The first onset of common mental health disorders, such as mood and anxiety disorders, mostly lies in adolescence or young adulthood. Hence, effective and scalable prevention programs for this age group are urgently needed. Interventions focusing on repetitive negative thinking (RNT) appear especially promising as RNT is an important transdiagnostic process involved in the development of depression and anxiety disorders. First clinical trials indeed show positive effects of preventative interventions targeting RNT on adult as well as adolescent mental health. Self-help interventions that can be delivered via a mobile phone app may have the advantage of being highly scalable, thus facilitating prevention on a large scale. This trial aims to investigate whether an app-based RNT-focused intervention can reduce depressive and anxiety symptoms in young people at risk for mental health disorders.
Methods
The trial will be conducted in a sample (planned
N
= 351) of individuals aged 16–22 years with elevated levels of RNT but no current depression or anxiety disorder. In a randomized controlled between-subjects design, two versions of the app-based self-help intervention will be compared to a waiting list control condition. The full RNT-focused intervention encompasses a variety of RNT-reducing strategies, whereas the concreteness training intervention focuses on only one of these strategies, i.e., concrete thinking. The primary outcome (depressive symptoms) and secondary outcomes (anxiety symptoms and RNT) will be measured at pre-intervention, post-intervention (6 weeks after pre-intervention), and follow-up (18 weeks after pre-intervention).
Discussion
This trial aims to find out whether targeting RNT via an app is an effective and feasible way of preventing depression and anxiety disorders in adolescents. Since app-based interventions are highly scalable, this trial might contribute to tackling challenges related to the increasing rates of mental health disorders among young people.
Trial registration
https://www.drks.de
, DRKS00027384. Registered on 21 February 2022—prospectively registered.
Journal Article