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1
Åhlén, Johan. "Universal prevention of anxiety and depression in school children." Doctoral thesis, Uppsala universitet, Institutionen för psykologi, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-333033.
Full textAbstract:
Anxiety and depression are common in children and adolescents, and involve individual suffering, risk of future psychiatric problems, and high costs to society. However, only a limited number of children experiencing debilitating anxiety and depression are identified and receive professional help. One approach that could possibly reduce the prevalence of these conditions is universal school-based prevention aimed at reducing the impact of risk factors and strengthening protective factors involved in the development of anxiety and depression. The current thesis aimed to contribute to the literature on universal prevention of anxiety and depression in children. Study I involved a meta-analysis of earlier randomized, and cluster-randomized trials of universal prevention of anxiety and depression. Overall, the meta-analysis showed small but significant effects of universal preventive interventions, meaning that lower levels of anxiety and depression were evident after intervention completion and partially evident at follow-up assessments. No variables were found to significantly enhance the effects, however, there was a tendency for larger effects to be associated with mental health professionals delivering the interventions. In Study II, a widely adopted prevention program called Friends for Life was evaluated in a large school-based cluster-randomized effectiveness trial. The results showed no evidence of an intervention effect for the whole sample. However, children with elevated depressive symptoms at baseline and children with teachers who highly participated in supervision, seemed to benefit from the intervention in the short term. Study III involved a 3-year follow-up of Study II and an examination of the effects of sample attrition. The results showed no long-term effects for the whole sample and no maintenance of the short-term subgroup effects observed in Study II. Finally, to increase our understanding of the development of anxiety in children and to assist future improvements of universal prevention, Study IV evaluated different trajectories of overall anxiety together with related patterns of disorder-specific symptoms in a school-based sample over 39 months. Evidence favored a model of three different developmental trajectories across age. One trajectory was characterized by increasing levels of overall anxiety, but fluctuating disorder-specific symptoms arguably related to the normal challenges of children’s developmental level, which warrants an increased focus on age-relevant challenges in universal prevention. The four studies provide further understanding of the overall effectiveness of universal prevention of anxiety and depression in children, the short- and long-term effects of universal prevention in a Swedish context, and ideas for further development of preventive interventions.
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Grigorie, Maria Simona. "Anxiety and depression among participants in an early ovarian cancer diagnosis program." Thesis, McGill University, 2014. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=121587.
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Background: Despite its low incidence, ovarian cancer is associated with very poor prognosis and this is common knowledge in the general population. There is limited knowledge about the levels of anxiety and depression in women who undergo diagnostic testing for suspected ovarian cancer. The setting of this study was the DOvE (Diagnosing Ovarian cancer Early) project, an ongoing study providing cancer antigen (CA125) testing and trans-vaginal ultrasound (TVUS) at dedicated diagnostic centres in Montreal for women with symptoms that have been found to be associated with ovarian cancer. Objectives: Our aim was to examine whether taking part in this program had an impact on depression and anxiety from baseline; in particular, we wanted to assess whether a false positive test had a persistent effect, defined as lasting 4 months or more, after women had been informed that the test was negative. Methods: 706 symptomatic women, 50 years or older, who took part in DOvE between July 2010 and September 2012, completed psychological questionnaires, the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory-II (BDI-II) at two key points in the diagnostic process: at the clinic immediately before evaluation, and at follow-up (FU) visit, 4 months later. Results: While anxiety rates and scores were similar at initial assessment and follow-up visit, we saw a decrease in depression rates and scores over time (p<.001). There were no significant differences on demographic variables and anxiety/depression scores between the patients testing positive in the absence of disease (false positives) and those with negative results correctly diagnosed (true negatives). Women who had true negative results (77%) had a significantly lower score for depression at FU than at the beginning of the program (p<.001). Conclusions: Overall, taking part in DOvE did not appear to negatively affect women's medium term anxiety and depression scores. Moreover, participants appeared to benefit from the reassurance provided by negative result, which is of relevance in the context of a low incidence disease with a reputation for poor outcome.Mise en Contexte: Malgré sa faible incidence, le cancer de l'ovaire est associé avec de très mauvais pronostique et c'est de notoriété publique dans la population générale. Les connaissances sont limitées sur les niveaux d'anxiété et de dépression chez les femmes qui subissent des tests de diagnostic pour la suspicion du cancer de l'ovaire. Cette étude a été menée dans le cadre de l'essai clinique DOvE (Diagnostic du cancer de l'ovaire précoce), un projet en cours fournissant le test de l'antigène du cancer (CA125) et l'échographie trans-vaginale (ÉTV) dans les centres de diagnostics spécialisés à Montréal, pour les femmes présentant des symptômes qui ont été considérés associée à un cancer de l'ovaire. Objectifs: Notre objectif était d'examiner si la participation à ce programme a eu un impact sur la dépression et l'anxiété initiale ; nous avons voulu évaluer en particulier si un test faussement positif a eu un effet persistant, définie comme une durée de 4 mois ou plus, après que les femmes ont été informées que le test a été négatif. Méthodes: 706 femmes symptomatiques, ayant 50 ans ou plus, qui ont participé à DOvE entre juillet 2010 et septembre 2012 ont été invitées à remplir des questionnaires psychologiques, le Beck Anxiety Inventory (BAI), le Beck Depression Inventory-II (BDI-II) en deux points clés dans le processus de diagnostic: à la clinique, immédiatement avant l'évaluation et à la visite de suivi, 4 mois plus tard. Résultats: Bien que les taux d'anxiété et les scores étaient similaires lors de l'évaluation initiale et la visite de suivi, nous avons vu une diminution du taux et du niveau de dépression dans le temps (p <.001). Il n'y avait pas de différence significative sur les variables démographiques et les scores d'anxiété / dépression entre les patientes testées positives dans l'absence de la maladie (faux positifs) et celles avec des résultats négatifs correctement diagnostiqués (vrais négatifs). Les femmes qui avaient de vrais résultats négatifs (77%) avaient un score significativement plus faible de la dépression au suivi qu'au début du programme (p <.001).Conclusions: Globalement, faire partie du DOvE ne semble pas affecter négativement au moyen terme les scores d'anxiété et de dépression des femmes. En outre, les participants ont semblé bénéficier de l'assurance fournie par un résultat négatif, ce qui donne de la pertinence dans le contexte d'une maladie de faible incidence avec une réputation de mauvais résultats.
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Bacchus, Natashia Soraiya. "Teacher Implementation of a School Based Anxiety Prevention Program in British Columbia." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5303.
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The Friends for Life program is an evidence-based practice being used in schools to assist children to learn skills to manage anxiety. The Friends for Life program has been used by school districts in British Columbia, Canada, for over 10 years, yet there is little research on how the program is being implemented in schools by teachers. This qualitative case study investigated the implementation practice of the Friends for Life program by teachers in Grades 4 and 5. Semi-structured interviews were conducted with 8 teachers from a smaller school district in British Columbia, Canada. The results yielded themes, which described critical factors that helped or hindered teachers in implementing the program with fidelity. A key finding of the study demonstrated teachers were running the program weekly, as per program guidelines. A key factor that was identified as helping teachers to implement the program with fidelity was support of school counselors, district staff, and the building administrator. The implications for social change include providing school administrators with information, which can help them to support teachers to implement the Friends for Life program with fidelity. As a result of these findings the Friends for Life program may consider updating the training materials and program implementation protocols in order to ensure teachers are implementing the program with fidelity and therefore, children are learning the skills they need to manage their anxieties and worries.
4
Johnson, Norman Chris. "A Follow-Up Study of a Primary Prevention Program Targeting Childhood Depression." DigitalCommons@USU, 2000. https://digitalcommons.usu.edu/etd/5576.
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Children have not historically been the subject of research focusing on internalizing disorders (i.e., childhood depression), even though childhood depression continues to be viewed as one of the most prevalent affective problem within this population. Over the past two decades, a small portion of that literature describes prevention efforts in public schools. There has been a growing body of literature centered on childhood depression. However, there are only three studies that report on longitudinal findings that have taken a primary prevention approach.
The present study was a follow-up investigation to delineate the effects of a school-based primary prevention program. The original study utilized a social/ interpersonal and cognitive-behavioral model incorporated into the health education curriculum of the school.
The results of the study suggest that the students continued to report normal to low levels of depressive symptoms at one-year follow-up . The results also suggest that students maintained the social skills gained during the intervention at the one-year followup. In addition, reports of depressive symptomatology slightly declined from posttest to one-year follow-up.
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Pucci, Nicole Christine. "The Girls Link Program: An Examination of the Efficacy of a Brief Prevention Program for Behaviorally Inhibited Female Adolescents." Case Western Reserve University School of Graduate Studies / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=case1410467175.
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Cheng, Ka-lai, and 鄭嘉麗. "Evidence-based guideline for antenatal interpersonal psychotherapy education program." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193048.
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Background
Postnatal depression (PND) has become a world-wide public health problem. Maternal Child Health Centers (MCHCs) provide maternal and child healthcare with community-based Comprehensive Child Development Services (CCDS) aimed for early identification for provision of appropriate referral for intervention. There were 13.8% suspected PND cases in 2011(Department of Health PND Report, 2011). Antenatal Interpersonal Psychotherapy (IPT) has found efficacious for high depression risk (HDR) pregnant women. Evidence-based practice (EBP) antenatal IPT guideline best suited for MCHCs implementation.
Purpose
This dissertation intends to develop an effective EBP antenatal IPT guideline for HDR pregnant women, and to offer plans for implementation and evaluation.
Methods
Six electronic databases searched for updated relevant studies. Randomized controlled trails (RCTs) with antenatal IPT intervention for HDR pregnant women targeted. Evidence data related to EBP guideline development were extracted for critical appraisal. Program implementation potentials assessed for transferability, feasibility and cost-benefit ratio. Guideline with level of evidence and recommendation grading developed. Communication plan for different stakeholders and potential users were developed. Pilot test planned for process evaluation. Impact evaluation, outcome evaluation and economic evaluation planned to verify empirical evidences to initial changes in MCHCs.
Results
Eight RCTs studies, which compare group receiving antenatal IPT intervention with routine antenatal education group, were reviewed. Target population was HDR pregnant women. Antenatal IPT intervention found effective for HDR pregnant women with PND. The studies suggest antenatal IPT intervention give0.89 reductions in EPDS, improved psychological well-being, 0.77 reductions in GHQ and improved role competence2.43 increases in PSOC-E.
After critical appraisal of reviewed studies, antenatal IPT guideline developed. Pregnant women should be screened between 20 to 32 gestation weeks. Those with EPDS≥13 scores should enrolled into two 2-hour antenatal IPT program educated by trained nurse educators in class size ≤10. Those refusing to join the program receive routine education. Three-point measurements of EPDS, GHQ and PSOC-E at baseline, postnatal 6 to 8 weeks and 3 to 6 months of both groups are conducted. Postnatal EPDS ≥13 participants referred for psychiatric services upon their consent.
Program will propose implementation in MCHCs. Steering Committee is established and communicates with various stakeholders. Pilot test implement in one MCHC and reviewed for clinical applicability, feasibility and to obtain process evaluation for quality improvement.
Program should have quasi-experimental non- equivalent pretest-posttest control group and analyze data with ‘two-sample t-test’, ‘paired t-tests’ and ‘chi-square test’. Target achievement should be:
i. Primary outcomes: EPDS score reduced to0.89, GHQ reduced to0.77 and PSOC-E score increased to2.43;
ii. Secondary outcomes: Reduction of PND incidence and PND management caseloads by 20%.
Participants’ gestation ages, program attendance and satisfactory rates recorded. Economic evaluation indicates for every $1invested, the return is $8.45, program is a sound investment suggested.
Conclusions
Eight RCT studies provide evidence that antenatal IPT program is effective for HDR pregnant women in reducing PND, and in promoting higher maternal role efficacy level and psychological well-being. Implementation of this EBP program guideline can potentially help PND prevention and ease antenatal depression management of HDR pregnant women in MCHCs.published_or_final_version
Nursing Studies
Master
Master of Nursing
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Webster, Hayley Monique, and n/a. "An Ecological Approach to the Prevention of Anxiety Disorders during Childhood." Griffith University. School of Applied Psychology, 2003. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20030807.105928.
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Research shows that anxiety disorders are common and problematic in children. Treatment studies demonstrate that cognitive-behavioural interventions for children can successfully minimise these problems. Further, when implemented as early intervention or prevention programs, these interventions can prevent the onset of anxiety problems in 7 to 14 year olds and reduce existing levels of anxiety. This type of preventive approach has enormous potential for improving community mental health in a low cost model of service delivery. Yet, to develop this as a viable service model, these programs need to be evaluated under 'real world' conditions as opposed to specialist university clinical teams. In this research, the long-term effectiveness of an ecological model of the prevention of anxiety disorders for children was conducted. In the first study, teachers (N = 17) were trained intensively in the principles of anxiety and the FRIENDS anxiety prevention program (Barrett, Lowry-Webster & Holmes, 1999). Measures were taken of the PROXIMAL effects of training on the knowledge and self-efficacy of participating teachers at two points in time. Compared to teachers in a control group (N= 17) and a group comprised of psychologists regarded as experts in the FRIENDS anxiety program (N= 22), trained teachers demonstrated significant increases in the levels of knowledge and self-efficacy at time two. These increases approached levels exhibited by experts in terms of knowledge, and were not significantly different from experts in their levels of self-efficacy to implement the FRIENDS program following training. This study also explored the quality or fidelity of program implementation by these trained teachers (INTERMEDIATE EFFECTS). Results demonstrated that trained teachers implemented the program with high levels of integrity in accordance with the FRIENDS intervention manual. The second study sought to investigate the outcomes for participating children in terms of actually preventing and reducing existing levels of anxiety. Also of interest was the impact this intervention had on levels of depression. Participants were 594 children aged 10-13 years from 7 schools in Brisbane Australia. Children, and parents reported on children's social, emotional and behavioural characteristics at three-assessment points over 12 months. Results were examined universally (for all children) and for children who scored above the clinical cut-off for anxiety at pre-test. Results revealed that children in the FRIENDS intervention group reported fewer anxiety symptoms regardless of their risk status at posttest. In terms of reported levels of depression, only the high anxiety group who completed the FRIENDS intervention evidenced significant improvements at posttest. The results indicated that intervention gains were maintained over a period of 12 months, as measured by self-reports and diagnostic interviews. Moreover, evidence of a prevention effect was also demonstrated, with a significantly greater percentage of children in the control group progressed to "at risk" or "remained at risk" compared to children in the intervention group. Additionally, 85% of children in the intervention group who were scoring above the clinical cut-off for anxiety and depression were diagnosis free in the intervention condition at 12-month follow-up, compared to only 31.2% of children in the control group. Implications of these findings are examined, alongside limitations of the study and directions for future research.
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Lock, Sally, and n/a. "A Developmental Approach to the Prevention of Anxiety Disorders During Childhood." Griffith University. School of Applied Psychology, 2004. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20040615.140812.
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The studies presented in this thesis sought to investigate a number of developmental factors that influence the efficacy of preventive intervention for child anxiety disorders. Preventive intervention has emerged as a vital step forward in clinical research following data indicating anxiety disorders are among the most common forms of psychopathology in youngsters (Kashani & Orvaschel, 1990; Mattison, 1992). Several risk and protective factors associated with childhood anxiety disorders have been identified, along with effective treatment protocols (Kendall, 1994; Howard & Kendall, 1996; Barrett, 1998, 1999; Silverman et al., 1999a, 1999b), as prerequisites to the development of preventive programs for child anxiety problems (Spence, 2001). The first objective of this research was to add to the literature on risk and protective factors by investigating the role of peer interaction in the development of child anxiety problems. Study one examined developmental differences in the influence of peer interaction on children's anxiety-related cognition and behaviour. One hundred and sixty two children enrolled in grade 6 (n = 96) aged between 9 and 10 years, and grade 9 (n = 66) aged between 14 and 16 years participated in the study. Participants were stratified into either an at risk group or to a healthy group, based on their anxiety scores on the Spence Child Anxiety Scale (SCAS; Spence, 1997), and further allocated to a peer group comprising of 3 'healthy' (non-anxious) and 3 'at risk' (high anxious) children. Prior to and following a peer discussion, participants completed a standardised self-report measure of threat interpretation and response plans to two ambiguous vignettes (Barrett, Rapee, Dadds, & Ryan, 1996; Dadds, Barrett, Rapee, & Ryan, 1996). Results showed all participants evidenced changes in threat interpretation and response plans following the discussion with peers (p < .001). Overall, findings highlight the potential importance of peer interaction in the development of anxiety-related cognition and behaviour. The findings of study one have important implications for the future development of school-based intervention programs; specifically those conducted in the classroom. Study two sought to advance the current research on preventive intervention for child anxiety by establishing the age at which youngsters benefit the most from the FRIENDS program as a classroom-based universal intervention. Study two presents the results of a longitudinal study evaluating the effects of a universal school-based intervention for child anxiety at two developmental stages. The study involved a cohort of 733 children enrolled in grade 6 (n = 336, 45.6%) aged between 9 and 10 years, and grade 9 (n = 401, 54.4%) aged between 14 and 16 years, Participants were allocated to either a school-based cognitive behavioural intervention or to a monitoring group. Participants completed standardised measures of anxiety, depression and coping style. Participants identified as 'at risk' of an anxiety disorder were assessed for a clinical diagnosis with a structured diagnostic interview. Results indicated the universal intervention effective in significantly reducing anxiety (p < .001), depression (p < .001) and behaviour avoidance in children at post- intervention and 12-month follow-up intervals. Grade 6 children reported significantly higher anxiety at pre-intervention and greater reductions in anxiety at post intervention compared with the grade 9 (p < .001), although both primary and secondary school participants showed equal reductions in anxiety at 12-month follow up. Overall, findings suggest universal intervention potentially successful in reducing symptoms of anxiety and increasing coping skills in children. Primary school children reported the greatest changes in anxiety symptoms, suggesting earlier preventive intervention potentially more advantageous than later intervention. Developmental differences in anxiety, depression and coping strategies are discussed in addition to the implications and limitations of this study and directions for future research.
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Barbaro, Parma. "Preventing depressive symptomatology in children aged eight to eleven years : Application of the positive thinking program." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2004. https://ro.ecu.edu.au/theses/775.
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Recent research has demonstrated that exposure to prevention programs can decrease the incidence of depressive symptomatology in children. Universal prevention programs for children younger than 10 years of age are scarce. The current study examined the effectiveness of an eight week cognitive-behavioural prevention program in decreasing depressive symptoms and anxiety and, promoting a more optimistic explanatory style in children aged 8 to 11 years. Effectiveness of the program for children with initially low or high scores based on the pre-intervention median score of the Children's Depression Inventory (CDI; Kovacs, 1992) scores was also examined. Children were matched on grade and initial CDI score. Forty four children were allocated to the experimental group and participated in the program and 47 children were allocated to the wait-list control group. Comparisons of the experimental and control groups CDI, Revised Children's Manifest Anxiety Scale (Reynolds & Richmond, 2000) and Children's Attributional Style Questionnaire (Seligman et al., 1984) scores at post intervention and the six months follow-up found no significant differences. Additionally no significant differences were found between the initially high and low symptomatic children across time. It was concluded that the current program had little effect in preventing depressive symptoms in children when applied at an universal level. Future research on the Positive Thinking program will clarify the effectiveness of the current program in decreasing depressive symptoms in children.
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Bhaskara, Lavanya. "Effects of a six-week interdisciplinary program on depression, anxiety and pain in patients with fibromyalgia." Access to abstract only; dissertation is embargoed until after 12/19/2006, 2005. http://www4.utsouthwestern.edu/library/ETD/etdDetails.cfm?etdID=117.
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Cowen, Sherry Lynn. "A Meta-Analysis of School-Based Depression Prevention Programs for Children and Adolescents." BYU ScholarsArchive, 2014. https://scholarsarchive.byu.edu/etd/3970.
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School-based depression prevention programs are being implemented in schools across the world in efforts to inoculate children and adolescents from depressive symptoms. This meta-analysis examined 56 manuscripts with a total of 82 studies which focused on school-based programs to determine how they affect depression, anxiety, cognitive skills, self-esteem, coping, and internalizing behaviors. For these specific outcomes, effect sizes ranged from .08 to .25. All combined outcomes yielded a significant effect size of .15. Moderator analyses revealed key differences that identified characteristics of the most effective programs. Targeted programs servicing at-risk students yielded an effect size of .31, while universal programs produced a significant but small effect size of .07. However, the program facilitator seemed to impact the effectiveness of all types of programs. Non-school personnel produced a .39 effect size with targeted samples, and .17 with universal samples, while school personnel produced about one half to a third of the effect.
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Fukushima-Flores, Marnie. "FRIENDS parent project : effectiveness of parent training in reducing parent anxiety in a universal prevention program for anxiety symptoms in school children." Thesis, University of British Columbia, 2009. http://hdl.handle.net/2429/7975.
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Anxiety is one of the most pervasive childhood mental health disorders of our day. This is reflected in the growing body of research investigating the most effective ways to treat and prevent childhood anxiety. This study adds to the discussion by examining the parent component of a school based universal prevention and intervention program. Participating parents (N = 122) completed four measures on anxiety, the Anxiety Sensitivity Index (ASI, Reiss, Peterson, Gursky, & McNally, 1986), the Center for Epidemiological Studies-Depression (CES-D, Radloff, 1977), the Penn State Worry Questionnaire (PSWQ, Meyer, Miller, Metzger, & Borkovec, 1990), and the Screen for Child Anxiety Related Emotional Disorders (SCARED, Birmaher et al., 1999) before and after the parent program. The effectiveness of the program was investigated by analysing mean scores of the parent self-reported anxiety symptoms and parent reports of child anxiety symptoms. The main analyses conducted were 2 x 2 between-within ANOVAs for each measure. The hypothesis that parents who participated in the program (n = 20) would report reduced anxiety symptoms for themselves and for their children when compared to parents who did not attend (n = 120) was not confirmed. The parent’s satisfaction level with the program was also studied with high acceptability ratings providing strong social validity for this program. Implications of the findings, strengths, limitations and suggestions for further research are discussed.
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Lewis, Krystal Monique. "An Ounce of Prevention: Evaluation of the Fun FRIENDS Program for Kindergarteners in a Rural School." Diss., Virginia Tech, 2013. http://hdl.handle.net/10919/49691.
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Anxiety disorders are among the most common psychological disorders in childhoodwith reported rates as high as 41.2% (Cartwright-Hatton, McNicol, & Doubleday, 2006; Cooley,
Boyd, & Grados, 2004). A majority of the anxiety intervention programs target children who are
7 years of age and older. Yet, many anxiety disorders develop in the preschool years (APA,
2000). Therefore, it seems desirable to work with young children who display early signs of
anxiety to provide them with skills that would protect them from later full-blown
psychopathology. Early intervention and prevention programs may be effective ways to modify
the developmental trajectory of anxiety disorders.
The present research reports findings from an anxiety prevention program for 4-7 year
olds. One hundred and ten children from two schools in a rural part of Southwest Virginia
participated. Fifty-seven children from one school received a classroom-based prevention
program on a weekly basis over 20 weeks. Fifty-three children from a second school served as a control group. The mean age of the sample was 5.11 years. Results suggested that anxiety was positively correlated with emotional symptoms (r = .67, p<.001), peer difficulties (r = .21,p<.05), and total difficulties (r =.29, p<.03) on the Strengths and Difficulties Questionnaire for all children. Overall, there were significant decreases in anxiety symptoms from pre to follow-up for both groups of children [F (1, 105) = 7.79, p =.006]. Unexpectedly, anxiety symptoms increased from pre to post for children in the intervention school whereas they decreased for children in the control school. Although these findings are reversed of what was expected, these results may have important implications concerning the importance of providing anxiety education and awareness for teachers. Implications of the current findings, limitations of the study, and directions for future research and dissemination are discussed.
Ph. D.
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Deacon, Sharon. "Evaluation of a Training on Teachers' Identification of Anxiety in Students." University of Dayton / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=dayton1437651008.
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Thomson, Victoria. "Common mental health problems in later life : considering new approaches to meet the challenges of an ageing population." Thesis, University of Edinburgh, 2016. http://hdl.handle.net/1842/25763.
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Provisional Question for the thesis to address: Indicated and selective prevention of common mental health problems in later life: Is there a theoretical rationale for an Acceptance and Commitment Therapy approach? Background The burden of late life depression and anxiety is significant. Even subthreshold symptoms result in great individual, community, economic and societal cost. However, common mental health problems in later life are under‐recognised and under‐treated despite evidence in support of pharmacological and psychological intervention. Previous research regarding psychological therapy for late life mental health problems has been dominated by cognitive behavioural therapy. However, the effectiveness of this approach has been questioned, leading researchers to explore alternative approaches. Acceptance and Commitment Therapy has received increasing attention from researchers keen to explore an alternative and some have argued that this approach is particularly suited to older people. In the context of demographic change and a significant increase in the proportion of community dwelling elderly there is a need to provide evidence to support the use of alternative management strategies for late life mental health problems, for example, focusing on prevention. Methods A systematic review will evaluate the current evidence for the use of ‘indicated’ and ‘selective’ prevention interventions for older people at risk of developing a major depressive or anxiety disorder due to the experience of subsyndromal symptoms or the presence of significant physical, socioeconomic, and psychosocial risk factors. This paper will be followed by an empirical article in which the relationship between psychological processes and ageing will be explored. Specifically, this study will explore psychological flexibility, the use of Selection, Optimisation and Compensation strategies, and the presence of psychopathology in a non clinical sample of community dwelling older people. Results Findings of the systematic review provide preliminary evidence for indicated and selective prevention of late life depression, however there is no clear evidence of benefits of these interventions in late life anxiety. The relationships between variables in the empirical study were explored using descriptive statistics, correlation analysis, and conditional process modelling. Although the study did not find age to be a specific predictor of variance in psychological variables explored, the study did provide empirical support for the potential to use Acceptance and Commitment Therapy with older people. Discussion The systematic review article provided preliminary evidence for the efficacy of selective and indicated prevention interventions for late life depression. However, further research is required to consolidate these findings. The empirical paper found significant relationships between the perception of positive health, reduced psychopathology and theoretical variables including cognitive fusion, engagement in valued living, and the use of Selection, Optimisation, and Compensation strategies. Cognitive fusion was found to mediate these relationships and as such, findings provide support for the use of an Acceptance and Commitment Therapy approach with older people. The theoretical and clinical implications of these findings are discussed in detail.
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Grinnell, Renée M. "Follow-up Evaluation of Treatment for Anxiety and Depression Provided in a University-based Primary Care Clinic." VCU Scholars Compass, 2014. http://scholarscompass.vcu.edu/etd/3654.
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Although integrated primary care psychology services are becoming increasingly common, the literature lacks adequate research support for the longitudinal durability of treatment effects following the conclusion of brief primary care interventions. This study served as a follow-up program evaluation of psychological services for depression and anxiety provided at the Medical College of Virginia’s Ambulatory Care Center in Richmond, Virginia. Data were collected on 47 adult primary care patients who received treatment for depression and/or anxiety between six and 18 months prior to the follow-up telephone call. Data were collected on the trajectory of depression scores throughout and following treatment, treatment received by patients in the interim, and reasons provided by patients for discontinuing treatment. Analyses of these data indicated that primary care psychology services were effective in reducing patient anxiety and depression as measured by the GAD-7 and PHQ-9 respectively, even when controlling for additional treatment in the interim, and that patients as a group continued to improve over time following the conclusion of treatment. These preliminary results should be interpreted with caution, however, due to the study’s small sample size and lack of a control group. Study limitations, strengths, and future directions are addressed.
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Rodell, Alexa Mary. "A yoga therapy program to increase positive mental health for adults experiencing symptoms of anxiety or depression| A grant proposal." Thesis, California State University, Long Beach, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=1585966.
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Depression and anxiety affects approximately 25 million adults within the United States each year. Furthermore, the population of adults experiencing some form of mental illness is expected to grow 15% by the year 2020. While there are many traditional therapeutic approaches to treating mental health challenges, evidence-based alternative therapies are gaining credibility. One such form of alternative treatment is yoga therapy. Therefore, the purpose of this project was to create an innovative yoga therapy program for adults to reduce the symptoms associated with anxiety or depression. This project was developed on behalf of the Jewish Federation and Family Services of Orange County. The goals of this yoga therapy program are to increase mind-body connection, decrease symptoms of anxiety or depression, and improve the overall quality of one's life. The actual submission and/or funding of this grant were not required for the successful completion of this thesis project.
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Rodebaugh, Helen Davis. "A follow-up study of rural adolescents : career maturity, self-concept, personality, anxiety and participation in substance abuse prevention program /." The Ohio State University, 1986. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487323583621138.
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Cummings, Colleen M. "The Impact of Comorbid Anxiety on Treatment Outcome of a Family-Based Psychoeducational Psychotherapy Program for Children With Mood Disorders." The Ohio State University, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=osu1274738537.
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Dockstader, Carole Ohlendorf. "Adolescent suicide: Noncontemplators, contemplators, and attempters." CSUSB ScholarWorks, 1996. https://scholarworks.lib.csusb.edu/etd-project/1276.
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Brock, Jillian Leigh. "A Preliminary Evaluation of the Parent Resilience Program: A Program for the Parents of Shy and Anxious Preschool-Aged Children." UNF Digital Commons, 2012. http://digitalcommons.unf.edu/etd/342.
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The purpose of this study was to evaluate the effectiveness of a new anxiety prevention program, the Parent Resilience Program. The program is a cognitive-behavioral based prevention program designed to reduce the risk of anxiety in young children, specifically by reducing parent stress and teaching coping skills. The sample consisted of the parents and/or caregivers of 12 preschool-aged children. Parents attended eight weekly sessions of a psychologist-led intervention. Significant reductions were observed related to the impact of shyness on the child’s quality of life as well as parental anxiety and stress, both of which are risk factors for developing an anxiety disorder. In line with this, trends toward reduction were also seen in child anxiety symptoms and behavioral inhibition. These preliminary results suggest that the Parent Resilience Program may be effective at reducing the risk factors associated with the development of anxiety disorders.
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Kuo, Li-An. "The effects of social skills training on the prevention of perceived stress, depression, and social anxiety of Taiwanese graduate students in the United States." W&M ScholarWorks, 1993. https://scholarworks.wm.edu/etd/1539618785.
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The purpose of this study was to determine the effects of an Banduraian-based group social skills training in the prevention of stress, depression, and social anxiety of Taiwanese graduate students in the U.S.;The subjects of this study were 60 Taiwanese students recruited at four seminars sponsored by the Taiwan Ministry of Education, which aimed to prepare students for future overseas study. Thirty subjects were randomly assigned to the experimental condition and were trained with social skills before they left for U.S. The other thirty subjects were assigned to the control group without any treatment.;It was hypothesized that: (1) There would be a significant difference at the.05 level in subjects receiving pre-arrival social skills training as contrast with subjects receiving no treatment in their level of stress, depression, and social anxiety at the posttest (1 week after treatment); (2) There would be a significant difference at the.05 level in subjects receiving pre-arrival social skills training as contrast with subjects receiving no treatment in their level of stress, depression, and social anxiety at the follow-up (1 to 2 month after subjects' arrival in U.S.).;The results indicated that participation in an Banduraian-based group skills training course for Taiwanese graduate students did not have short term effects on their perceived stress, depression, and social anxiety. However, results demonstrated a general trend toward more positive outcomes. Although there was also no evidence for the effectiveness of social skills training in the prevention of future perceived depression and social anxiety, the analysis of followup data revealed that the effects of social skills training on prevention of perceived stress for Taiwanese graduate students was supported.
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Sevim, Burcu. "The Effects Of Stress Management Program For Mothers Of Children With Autism." Master's thesis, METU, 2007. http://etd.lib.metu.edu.tr/upload/12608638/index.pdf.
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The purpose of the present study was to prepare a Stress Management Program for the mothers of children with autism and to evaluate the effects of the program on depression, anxiety, and suicidal probability. It was hypothesized that the mothers of children with autism who attended the Stress Management Program would have lower depression, anxiety and suicidal probability whereas there would be no change
in the depression, anxiety, and suicidal probability of mothers of children withautism who did not get any treatment. The participants of the study were 44 mothers of children with autism from Uyum Special Education Center and Ilgi Special
Education Center. The data were gathered by administering four instrumentsBeck Depression Inventory, Back Anxiety Inventory, Suicidal Probability Scale, and Demographic Information Form. Repeated Measures Analysis of Variance Technique was used to analyze the data. The findings of the study indicated that there was a significant decrease in depression levels of mothers of children with autism after the Stress Management Program whereas anxiety and suicidal probability did not change significantly as a function of the Stress Management Program. For the mothers of children with autism who did not get any treatment, it was indicated that there were no difference in depression, anxiety and suicidal probability. The results were discussed within the context of the relevant literature.
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Cassimatis, Mandy. "Development and evaluation of the Ontrack Diabetes Program : an automated, web-based type 2 diabetes self-management and dysphoria intervention." Thesis, Queensland University of Technology, 2014. https://eprints.qut.edu.au/74485/1/Mandy_Cassimatis_Thesis.pdf.
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This research was conducted in the area of Clinical and Health Psychology. The study involved the development and evaluation of a novel, web-based program aimed to improve Type 2 diabetes self-management and mood. The program was developed as an original technological intervention aimed to improve access to support for rural and remote communities, and is currently being trialled across Australia with a larger sample size. The researcher aims to continue research into the field of clinical psychology, and in particular is interested in working on further interventions to support those with comorbid physical and mental health conditions.
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Cairns, Paula L. "Prevention of Post Intensive Care Syndrome-Family with Sensation Awareness Focused Training Intervention: A Randomized Controlled Trial Pilot Study." Scholar Commons, 2018. https://scholarcommons.usf.edu/etd/7606.
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Post Intensive Care Syndrome-Family (PICS-F) refers to acute and chronic psychological effects of critical illness on family members of patients in intensive care units (ICU). Evidence about the increase and persistence of PICS-F warrants the need for prevention interventions. This study evaluated the feasibility of providing Sensation Awareness Focused Training (SĀF-T) during the ICU stay for spouses of mechanically ventilated patients. Methods: A randomized controlled trial of SĀF-T versus a control group was conducted (n=10) to assess safety, acceptability, feasibility, and effect size of the intervention on PICS-F symptoms. Symptoms assessed as outcome measures included stress, anxiety, depression, posttraumatic stress disorder, and sleep efficiency. Those randomly assigned to SĀF-T received one session daily over 3-days in the ICU. Repeated measures (day 1, day 3, day 30, and day 90) of PICS-F symptoms in both groups were analyzed. Results: Mean age was 58 ± 12 years; 70% were female. Feasibility success criteria were met in weekly recruitment (8 ± 3.5), enrollment rate (67%), SĀF-T acceptability (100% of doses received, no adverse events) with significantly lower post SĀF-T stress levels (p<.05) compared to pre SĀF-T stress levels, ActiWatch acceptability rate (90% agreed to wear, no adverse events) with no significant difference in sleep efficiency between groups (p>.05), and repeated measures completion rate (>90%). Conclusions: This study provided guidance for modifications to protocol outcome measures and evidence of a large effect size, which will inform a larger clinical trial to assess the effectiveness of the SĀF-T intervention in reducing PICS-F.
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Smart, N. J. "Anxiety, depression, stress and trauma in couples attending an Assisted Conception Unit and reasons for their reluctance to participate in a Stress Management Program." Thesis, University of Edinburgh, 2002. http://hdl.handle.net/1842/30767.
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Introduction: Infertility has a major impact on the emotional well being of a couple. As many as one quarter of couples could experience some delay in starting a family (Green and Vassey, 1990). However, many of these couples are reluctant to attend therapy sessions intended to help them with the stresses involved in experiencing infertility. Objectives: To investigate the levels of anxiety, depression, stress and trauma in couples attending an Assisted Conception Unit (ACU) compared to the general population and to investigate the ACU patients' reluctance to participate in a Clinical Psychologist-led stress management group. Design: A between subjects design was employed to compare results from participants attending an ACU to a matched control group from the general population. Members of the control group were matched for age, gender, relationship status and level of qualifications with individual ACU participants. Methods: All subjects were invited to complete a short questionnaire consisting of assessments of anxiety, depression, stress and trauma along with demographic questions. Couples attending the ACU were also asked to complete a questionnaire designed specifically for this study to elicit their reasons for non-participation in a stress management program. Results: As hypothesised the results indicate that the ACU group was more stressed than the general population and that the women in this group appeared to be more severely affected. Their reasons for reluctance to participate in stress management varied as a function of the distress levels experienced. All results are discussed in relation to previously published findings. Conclusions: Although the experience of infertility is stressful infertile couples are reluctant to attend stress management groups. The introduction of any psychosocial intervention should take these findings into consideration. Clinical implications and suggestions for future research are discussed.
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LINZER, MARC RUBIN. "EFFECTIVENESS OF A CLINICAL INTERVENTION PROGRAM FOR REDUCTION OF PAIN, AND CONCOMITANT SYMPTOMS OF ANXIETY, DEPRESSION, AND HOSTILITY IN INDIVIDUALS EXPERIENCING CHRONIC PAIN (REHABILITATION)." Diss., The University of Arizona, 1986. http://hdl.handle.net/10150/183962.
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This study was designed to determine the effectiveness of a clinical intervention program for reduction of pain and concomitant symptoms of anxiety, depression and hostility in individuals experiencing chronic pain. The program consisted of 36 weeks of supportive group therapy, education and sessions of progressive muscle relaxation induced hypnosis. Single subject research design was used to analyze the clinical effectiveness of treatment. Data was collected and compiled weekly. Serial position curves were generated for a Reported Pain Index, SCL-90-R Symptom Indices for Anxiety, Depression, Hostility and the SCL-90-R Global Severity Index. The three subjects were adults whose ages ranged from 39 to 65, with five or more years of chronic pain due to orthopedic or arthritic conditions. Qualitative analysis of the data indicated dramatic reductions in pain and secondary symptoms. Reductions in reported pain ranged from 17% to 31% with the mean pain reduction for the group of 20.6%. Reduction in the SCL-90-R Global Severity Index ranged from 13.1% to 49.4% with the mean reduction for the group of 36.1%. Reduction in depression ranged from 12.7% to 50% with the mean reduction for the group of 32.6%. Anxiety was reduced for two subjects with a slight increase of .02% for the third subject. Range of anxiety change was .02% increase to 59% reduction with a group mean reduction of 36.3%. Reduction in hostility ranged from 29.5% to 54.4% with a group mean reduction of 39.9%. Progressive muscle relaxation induced hypnosis contributed to further reduction of pain and secondary symptoms with reductions ranging from 4 to 49%. The results of this study show dramatic reductions in pain, depression, hostility and anxiety in chronic pain patients. These findings are not meant to be generalized to other populations, but may point the way for future research utilizing long-term therapeutic approaches and single subject research design.
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Rawlings, Jodie. "The role of a working memory training program in reducing repetitive negative thinking in older adults." Thesis, University of Exeter, 2017. http://hdl.handle.net/10871/29037.
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Objective: Recent research has supported the construction of a model of depression and anxiety in older adults ( > 60years), in which the decline in working memory with age is implicated in increasing propensity to engage in repetitive negative thinking, thereby predisposing older adults to anxiety and depression. The study detailed here intended to extend these research findings by exploring the efficacy and acceptability of a working memory intervention in older adults. Methods: The study employed a randomised multiple-baseline single case research design, in which six older adults participated in baseline assessment of mood, repetitive negative thinking and working memory. Participants then tracked their repetitive negative thinking daily throughout a baseline phase, the length of which was defined by the randomisation procedure. Following phase change, participants continued to rate their repetitive thinking daily, as well as engaging in a daily working memory training intervention. On completion of the intervention phase, outcome measures of mood, repetitive negative thinking and working memory were repeated. Full visual and statistical analysis of all data was undertaken to support exploration of the findings. Results: Results of the study indicated that that the working memory training program was unlikely to have elicited a significant impact upon participants’ working memory. However, two participants demonstrated reliable improvement in both repetitive thinking and mood. Analysis of relevant variables to predict the selective impact of the intervention was not fruitful, but may indicate that improvements in working memory underscore the improvements in thinking and mood, lending support to the proposed model. There appeared to be a small, non-significant decrease in daily repetitive negative thinking across five of the six participants. Conclusion: Further research is needed to identify factors that may predict response to working memory training within older adult populations. The research supports the on-going investigation of innovative working memory interventions within an older adult population, although results are not sufficiently robust to indicate wider adoption of these models within health services or as routine treatments for this population.
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Calitz, Margaretha. "The effect of an aerobic exercise program on the health-related quality of life of HIV-positive employees." Diss., University of Pretoria, 2008. http://hdl.handle.net/2263/28851.
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The human immunodeficiency virus (HIV) together with acquired immunodeficiency syndrome (AIDS) is a world wide pandemic. Sub Sahara Africa, of which South Africa forms a part, is host to the highest HIV population in the world. In the light of this, it is significant to conduct a study of the effect that aerobic exercise might have on the management of disease symptoms. HIV and AIDS seriously affect the quality of life of the infected person. Decreased quality of life leads to decreases in productivity and increase in absenteeism. This has a negative effect on the economy. Several symptoms of HIV and AIDS cause quality of life to decrease. In this study the following parameters of health related quality of life were investigated: body composition, functional capacity, pain, anxiety and depression and fatigue. Absenteeism was monitored. The study further investigates how and why each of these parameters affects health related quality of life, and also the effect of aerobic exercise on the above mentioned parameters. The body composition of HIV positive persons is affected in one of three ways: wasting of muscle mass due to the virus, obesity because of too high energy intake and too little activity in an attempt to stop wasting, or lipodystrophy due to anti retroviral therapy. HIV patients have a decreased functional capacity. This may lead to fatigue, another common symptom in HIV patients. The prevalence of anxiety and depression is high in the HIV population, and even more so in South Africa. It is clear from the literature that aerobic exercise for HIV patients is safe. It is also clear that aerobic exercise has a positive effect on the mentioned parameters – not only on the HIV population, but also on other diseases and the healthy population. Thus the assumption was made that aerobic exercise can be used as a tool to increase health related quality of life in HIV positive persons. Initially, a quantitative pre-post test experimental design was proposed. In an attempt to recruit enough participants, the discovery was made that HIV is still a highly stigmatised disease in both Mpumalanga and Gauteng. After eighteen months of negotiations with AIDS clinics, mine groups and a newspaper advertisement, only three participants were enrolled. It must be kept in mind, however, that an important factor which influenced recruitment of participants was availability of funds. The indication was that HIV patients are willing to participate if there is proper compensation. In order to continue with the study, the design changed to a case study. It combined two approaches: qualitative and quantitative. This seems to work well in HIV research. The qualitative and quantitative data supported each other and provided the bigger picture. The results of this study support the expectation that aerobic exercise enhances the quality of life in HIV infected persons. Body composition and functional capacity improved. Feelings of anxiety and depression decreased and there were indications that pain and fatigue decreased as well. Absenteeism from work decreased in one person. The conclusion was made that aerobic exercise definitely contributes to the enhancement of quality of life in HIV positive employees. Biokineticists, as exercise specialists, are ideally positioned to provide exercise tests and program prescriptions to this population and should play a bigger role in the management of HIV and AIDS symptoms. CopyrightDissertation (MA)--University of Pretoria, 2008.
Biokinetics, Sport and Leisure Sciences
unrestricted
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Holmgren, Eva. "Getting up when falling down : reducing fall risk factors after stroke through an exercise program." Doctoral thesis, Umeå universitet, Sjukgymnastik, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-34209.
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The purpose of this thesis was to identify fall risk individuals (+55) after stroke by validating a fall risk index and in post-stroke individuals with high risk of falls evaluate the impact of an intervention program on fall risk factors.A previously developed fall risk index was validated, modified and re-validated. The validation showed a sensitivity of 97% and a specificity of 26%. This result was not considered sufficiently accurate. Therefore a modified index was created in the Validation sample and re-validated back in the Model fit sample. The modified index was reduced to three items and included postural stability + visuospatial hemi-inattention + male sex.The randomized controlled trial contained an intervention program (IP) with High-Intensity Functional Exercises as well as implementation these exercises in to real life situations together with educational group discussions. The participants were enrolled and randomized three to six months after their stroke. The assessments were performed at the Clinical Research Center at Norrlands University Hospital. The Intervention Group (IG) received a program of 35 sessions (exercise and group discussions) and the Control Group (CG) received five group discussions.Performing daily activities at 6 months follow-up and falls-efficacy post-intervention and at the 3 months follow-up showed significant improvement in the IG compared with the CG (p<0.05). The IP did not have a statistically significant impact on Balance or Lifestyle activities. When evaluating gait, step time variability for the paretic leg and the variability in Cycle Time for the paretic and non-paretic leg were improved for the IG. The time spent on the non –paretic leg in the gait cycles’ most stable phase, Double Support, was reduced by almost half (0.9 sec to 0.4 sec) since baseline for the IG after the intervention and remained reduced to the three month follow-up. Quality of Life showed an improvement in the CG compared with the IG for the mental scales, Mental Component Scale and Mental Health subscale at the 3 month follow-up (p=.02).In conclusion, this intervention program significantly improved performance of everyday life activities, falls-efficacy and the variability in gait. These are three major fall risk factors and might in the long run have an impact on decreasing falls in persons that had a stroke.
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Sampson, Marlene J. "Intervention Effects of a Cognitive Behavioral Skills Building Program onNewly Licensed Registered Nurses." The Ohio State University, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=osu1555516147835511.
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Forsström, Sara, and Louise Lennéer. "Rumineringsfokuserad kognitiv beteendeterapi: en preventiv insats i gruppformat för ungdomar." Thesis, Örebro universitet, Institutionen för juridik, psykologi och socialt arbete, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-65595.
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Siddall, Darralynn. "An action research mixed method evaluation of the implementation of an anxiety intervention/prevention program for year 3 children at a language development centre preparing to enter into mainstream education." Thesis, Siddall, Darralynn (2010) An action research mixed method evaluation of the implementation of an anxiety intervention/prevention program for year 3 children at a language development centre preparing to enter into mainstream education. Professional Doctorate thesis, Murdoch University, 2010. https://researchrepository.murdoch.edu.au/id/eprint/11128/.
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This study examines the effectiveness of implementing a modified cognitive behavioural (CBT) anxiety intervention/prevention program to meet the specific needs of speech and language impaired (SLI) children enrolled in a Language Development Centre (LDC), as they prepare to exit the LDC and enter into mainstream education. The study implemented the anxiety CBT program over two consecutive school years incorporating two different Year 3 cohorts (age range 7 to 9 years) and is reported in three stages.
The first study aimed to modify an anxiety CBT intervention/prevention program (namely the FRIENDS for Life program) for SLI children enrolled in Year 3 at a LDC as they prepared to exit the LDC and enter into mainstream education. All children offered the program participated in the study however, parent participation was low.
Previous research (Barrett et al, 1996, Barrett, 1999; Bett, 2002; Mendlowitz, 1996 & Rapee et al, 2005) found that in order for anxiety intervention/prevention programs to be efficacious for children, the program focus needed to include parents. The inclusion of parent participation for children with language impairment is considered essential, as the children are more likely to benefit from having the CBT strategies consolidated and supported at home (Bett, 2002).
Therefore, the second study involved a re-implementation of the modified FRIENDS for Life program to a second cohort of SLI children in Year 3 the following year. Due to low participation of parent involvement in the first study, this study aimed for improved parent involvement and participation of the parent FRIENDS for Life sessions.
Thirty-two children participated in study one and thirty-three children participated in study two. Both studies used an action research mixed method evaluation approach to gain a comprehensive assessment of the effectiveness of the program. The outcomes, using standardised outcome measures showed no significant difference between the control group and the intervention group. However using program specific descriptive and nontraditional measures indicate that differential and positive changes were attained for the intervention group.
Investigation of a complex data set using a variety of methods during various points in the evaluation process provided complementary information, this formed the foundation for more comprehensively assessing children with speech/language impairment. The intervention groups developed an increased awareness of their own and other people’s emotions and most importantly they developed a wider array of ‘emotion language’ when compared to the control group at post intervention. In addition, the intervention group attained a sound understanding of the FRIENDS plan and skills at post intervention.
A one year follow-up, of the original study, to explore the long-term benefits of the FRIENDS program for SLI children was not completed following a poor response rate. This is discussed and explored as it may benefit the way future research is conducted for families of children with SLI.
The studies highlighted the benefits of the FRIENDS program for children with SLI and the need to explore more effective ways to increase parent participation at the FRIENDS for Life parent sessions. Implications of the findings are examined, alongside limitations and directions for future research.
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Long, Meghan. "Comparison of High Intensity Interval Training Versus Moderate Intensity Continuous Training in a Phase II Cardiac Rehabilitation Program." Bowling Green State University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1498769361795025.
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Bunjaku, Lili. "Livskvalitet hos personer med hypotyreos." Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-24231.
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Primär hypotyreos är i Sverige en folksjukdom som främst drabbar kvinnor i alla åldrar. Sjukdomens symtom är omfattande och kan ge allvarliga konsekvenser för patientens hälsa om sjukdomen inte upptäcks och behandlas i tid. Symptom som sjukdomen uppvisar påverkar patientens livskvalitet. Sjuksköterskans ansvar är att främja patientens livskvalitet genom att bland annat hjälpa individen med anpassningen till de förändringar som sjukdomen medför. Syftet med denna litteraturstudie är att belysa hur primär hypotyreos påverkar livskvalitet hos vuxna individer. Metoden är en litteraturstudie baserad på tio vetenskapliga artiklar. Resultatet: ångest och depression är vanligt förekommande besvär och orsakar mental ohälsa hos individen med primär hypotyreos. En del patienter upplever begränsningar i det dagliga livets aktiviteter, reducerad generell hälsa, sociala problem, minskad vitalitet samt emotionella begränsningar. Psykiska, fysiska samt sociala aspekter påverkar patientens livskvalitet.Primary hypothyroidism is in Sweden a national disease that afflicts primarily women of all ages. The disease’s symptoms are extensive and can give serious consequences to the patient’s health if not detected and treated in time. This could greatly affect the patient’s quality of life. Nursing interventions are aimed at promoting the patient's quality of life through helping the individual with adaptation to changes caused by the disease. The aim was to illustrate how primary hypothyroidism affects the quality of life in adult patients. The method chosen was a literature review based on 10 scientific articles. The result showed that anxiety and depression are common problems that can cause mental illness in individuals with primary hypothyroidism. Patients could experience restrictions in activities in their daily life, reduced overall health, social problems, decreased vitality and emotional limitations. Psychological, physical and social aspects affect the patient’s quality of life.
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Wilkins, Phyllis Elaine. "What are the factors that predict cigarette smoking among African-American adults?" CSUSB ScholarWorks, 1994. https://scholarworks.lib.csusb.edu/etd-project/970.
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The psychosocial and cultural predictors of cigarette smoking were examined among a sample of 175 African-American adults. Participants completed a self-report inventory containing the Beck Depression Inventory, the Perceived Stress Scale, the Speilberger State-Trait Anxiety, the African-American Acculturation Scale, and questions regarding their smoking, demographics, and risk-taking tendencies.
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Godzik, Cassandra. "Feasibility of an Online Cognitive Behavioral Therapy Program to Improve Insomnia, Mood, and Quality of Life in Bereaved Adults Ages 55 and Older." eScholarship@UMMS, 2020. https://escholarship.umassmed.edu/gsn_diss/59.
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Objective: To determine the feasibility of an online cognitive behavioral therapy for insomnia (CBT-I) in bereaved older adults.
Participants: The study participants include adults aged 55 and older (N = 30) that lost a loved one within the past five years and are currently experiencing symptoms of insomnia.
Methods: This study used an experimental design and was guided by the Transitions Theory developed by Meleis. Descriptive statistics and t-tests were used to measure changes within and between groups. Experimental arm had the CBT-I online treatment and the control arm had attention controlled online tasks. Intervention fidelity was measured.
Results: The online CBT-I intervention is a feasible intervention for bereaved older adults with insomnia. High retention rates were shown in both groups, and both groups’ insomnia and mood symptoms improved at post- study measurement. There were no statistically significant differences seen in any measure between groups.
Conclusions: Transitions in older adult life includes loss of friends and family as well as development of sleep issues. The Transitions Theory is useful for informing the design of behavioral interventions in this older population. Further research is needed to understand how sleep can be improved by cost effective online interventions that might not include solely CBT-I.
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Vilela, Juliana Camargo. "Efeitos de uma intervenção cognitivo-comportamental sobre fatores de risco e qualidade de vida em pacientes cardíacos." Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/59/59137/tde-19052008-155805/.
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As doenças cardiovasculares se apresentam como uma das principais causas de morte e incapacidade na atualidade. Tais alterações compreendem a doença arterial coronariana ou isquêmica e apresentam etiologia multi-fatorial. No presente estudo objetivou-se avaliar os efeitos de uma intervenção cognitivo-comportamental sobre a qualidade de vida, sintomas depressivos, ansiosos e sob fatores de risco em pacientes isquêmicos que haviam apresentado um episódio agudo da doença nos últimos três meses. Participaram do estudo 71 pacientes, os quais foram divididos em dois grupos; controle (n=35) e experimental (n=36) e avaliados em três momentos: logo após o primeiro contato com pesquisadora; após 14 semanas (reavaliação) e depois de seis meses (seguimento). Nas avaliações os pacientes responderam a uma entrevista estruturada, ao Inventário de qualidade de vida da Organização Mundial de Saúde (WHOQUOL), ao Inventário de depressão de Beck (BDI) e ao Inventário de ansiedade de Beck (BAI). O grupo experimental foi submetido a um programa de intervenção cognitivo-comportamental, entre as duas primeiras avaliações. Este programa foi estruturado em oito sessões grupais semanais, com duração de duas horas cada. Durante as sessões foram trabalhadas técnicas de manejo de ansiedade, relaxamento e visualização, técnicas de resolução de problemas e discutidas informações sobre a doença cardíaca e seus fatores de risco (psicoeducação). Dentre os participantes, a maioria era do sexo masculino, tinham mais de 55 anos, era casada, haviam estudado por um período máximo de dez anos e se encontravam aposentados. Com relação aos dados sociodemográficos, não foram encontradas diferenças estatísticas entre os dois grupos. Verificou-se uma diminuição significativa do peso corporal e do índice de massa corpórea dentre os sujeitos do grupo experimental no decorrer das avaliações, bem como um aumento no número de atividades de lazer. Os resultados sugerem ainda uma diminuição dos sintomas depressivos dos pacientes do grupo experimental em relação aos do grupo controle, na reavaliação e no seguimento, e uma melhora na qualidade de vida do grupo experimental no decorrer das progressivas avaliações, o que não foi observado com relação ao grupo controle. Considera-se que o programa de intervenção cognitivo-comportamental apresentou resultados positivos na reabilitação de pacientes isquêmicos e na prevenção secundária da doença arterial coronariana, promovendo alterações físicas e emocionais importantes.Cardiovascular diseases are presented as a major cause of death and disability in actuality. These changes include coronary artery disease or ischemic etiology and present multi-factorial. This study aimed to evaluate the effects of a cognitive-behavioral intervention on quality of life, depression, anxiety and under risk factors in ischemic patients who had shown an episode of acute illness in the last three months. Study participants were 71 patients, who were divided into two groups; control (n = 35) and experimental (n = 36) and evaluated in three times: soon after the first contact with researcher; after 14 weeks (revaluation) and after six months (follow up). In assessments the patients responded to a structured interview, the inventory quality of life of the World Health Organization (WHOQUOL), the Beck Depression Inventory (BDI) and the anxiety of Beck Inventory (BAI). The experimental group was subjected to a program of cognitive-behavioral intervention, between the top two ratings. This program has been structured into eight weekly group sessions, with duration of two hours each. During the sessions were worked techniques of management of anxiety, relaxation and visualization, techniques for solving problems and discussed information about heart disease and its risk factors. Among the participants, the majority were male, had more than 55 years, was married, had studied for a maximum period of ten years and were retired. With respect to sociodemographic data, no statistical differences were found between the two groups. There was a significant decrease in body weight and body mass index among the subjects of the experimental group in the course of the evaluations, as well as an increase in the number of leisure activities. The results also suggest a decrease in depressive symptoms of patients in the experimental group in relation to the control group, and following the revaluation, and an improvement in the quality of life of the experimental group in the course of progressive evaluations, which was not observed with respect the control group. It is considered that the programme of cognitive-behavioral intervention showed positive results in the rehabilitation of patients ischemic and secondary prevention of coronary artery disease, promoting physical and emotional changes important.
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Löfgren, Hans O. "Preventive psychosocial parental and school programmes in a general population." Doctoral thesis, Umeå universitet, Barn- och ungdomspsykiatri, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-140737.
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Introduction Numerous preventive programmes have emerged, and need to be investigated to determine their effects on the normal population. Earlier studies have shown a decrease in depressive symptoms, positive effects on children’s disruptive behaviour problems, and an improvement in parental competence. About a fifth of the parents in previous studies had problem-oriented (targeted) reasons for enrolment, whereas the rest of the parents had general (universal) reasons. The results of those studies suggest that the programmes are cost effective in terms of Quality-Adjusted Life Years. Aim Four sub-studies were performed, and their aims were to investigate the effect of parental training programmes (PTPs) in a naturalistic setting on parents’ mental health in the general population, to investigate how PTPs affect parents’ sense of parental competence, to investigate how PTPs affect parental stress and analyse the parents open questions about the PTPs, and to investigate the feasibility and to measure the effect on depression, anxiety, and social problems of two preventive school programmes for pupils in grade 7. Method In a longitudinal quantitative study in a real-world setting, 279 parents from the general population in northern Sweden participated in five PTPs. A comparison group of 702 parents without intervention was included. Simultaneously, a community sample of 59 pupils in grade 7 participated in two preventive school programmes. Both studies were conducted from 2010 to 2013. Parents were assigned to professionally supported interventions that included 5-10 two-hour sessions. Respondents filled in a web-based questionnaire with the General Health Questionnaire (GHQ), the Parents Sense of Competence (PSOC) for parents who had children aged 0-17 years, and the Swedish Parenthood Stress Questionnaire (SPSQ) for parents who had children aged 0-10 years. The intervention groups’ results were compared to comparison group of 702 parents from northern Sweden that had not participated in any parental training programme. In the school study, one of the preventive programmes was an ongoing programme called “Life-Skills”, and the other was an implemented Canadian programme called “Choosing Healthy Actions and Thoughts” (CHAT). The pupils completed a test battery including the Sense of Coherence (SOC), the Children’s Depression Inventory (CDI), and the Youth Self-Report (YSR) instruments. Follow up of the parental programme study was done six months after the post-intervention measure, and follow up of the school study was at one year. Results The improvements in GHQ were statistically significant for the mean of the 279 parents in the intervention group compared to the mean of a comparison group of the 702 parents who did not receive any intervention. This suggests that evidence-based PTPs enhance parental well-being even for parents without problems. The intervention group showed a statistically significant improvement in parental competence compared to the comparison group over time. The intervention itself had a significant effect on parental satisfaction, but the efficacy effect was not sustained when taking into account potential confounders. In the SPSQ, the intervention group was smaller due to the fact that the instrument was not validated for children over the age of 10 and one of the parental training groups was only for parents of teenagers. A reduction of stress in the sub-scale of health problems was detected, but no other subscale showed the intervention to have a significant effect when controlling for confounding variables. In the school study, both programmes had good feasibility according to the stake- holders and had several positive mental health outcomes over time. Compared to Life-Skills, CHAT had more significant positive effects on reducing anxious/depressive symptoms and girls experienced significant positive effects on reduced anxious/depressive behaviour, while boys reduced their aggressive behaviours. Conclusions Earlier studies indicate that PTPs enhance perceived parental competence among referred parents. The present study shows that PTPs applied in the general population might also enhance perceived parental benefits such as improved health and satisfaction, suggesting that PTPs can be an important preventive strategy to enhance parenthood. The results suggest that parents who feel a need to increase their parenting competence might participate in PTPs based on lower scores than the comparison control group both before and after the intervention. The school-based programme shows that schools may be a suitable arena for preventive programmes because there was a significant short-term improvement in depression symptoms. Further studies need to explore how parents’ participation in PTPs affects children’s mental health in the general population in quantitative longitudinal studies in real-word settings. There is also a need for bigger studies and RCTs on school preventions and on how children’s health develops naturally in the population.
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Hawkins, Misty Anne. "Affective traits and adiposity : a prospective, bidirectional analysis of the African American Health study data." Thesis, Proquest, 2013. http://hdl.handle.net/1805/4840.
Full textAbstract:
Indiana University-Purdue University Indianapolis (IUPUI)Research indicates that negative affective traits (e.g., depression) are predictors and consequences of excess adiposity. Given that racial minorities and positive affective traits have been underrepresented in past investigations, more prospective studies are needed which examine multiple affective traits in relation to obesity in these populations. The objective of the current study was to investigate the prospective, bidirectional associations between multiple affective traits and multiple adiposity indicators in African Americans using data from the African American Health (AAH) study. The AAH study is a prospective cohort study of African Americans aged 49-65 years at baseline (N = 998). The longest follow-up period in the current study was 9 years (N = 579). Self-reported and measured body mass index (BMI; kg/m2) and body fat percent (BF%) were used as adiposity indicators. Depressive symptoms were assessed with the 11-item Center for Epidemiologic Studies-Depression Scale (CES-D), and anxiety was assessed using the Generalized Anxiety Disorder-2 (GAD-2) scale. Positive affective traits were assessed with the Vitality subscale of the Short Form-36 and Positive Affect subscale from the CES-D. Latent variable path analysis, a structural equation modeling technique, was conducted. Although fit statistics indicated that the models fit the data (RMSEA < .06), examination of the structural paths revealed that the CES-D and GAD-2 were not predictors or consequences of self-reported BMI, measured BMI, or BF% (ps > .05). Likewise, Vitality and CES-D Positive Affect were not related to any adiposity indicator (ps > .05). The results of this prospective cohort study suggest that affective traits are not predictors or consequences of adiposity in middle-aged African Americans and that this group may require obesity prevention or intervention programs with little to no emphasis on affective traits. Possible explanations for the current results include ethnic differences in the mechanistic pathways between affective traits and adiposity.
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Moustié, Jean-Baptiste. "Droit et risques psychosociaux au travail." Thesis, Bordeaux, 2014. http://www.theses.fr/2014BORD0266/document.
Full textAbstract:
Le concept de « risques psychosociaux au travail » rassemble plusieurs phénomènes de souffrance liés au travail. Ces risques se réfèrent à la fois aux actes porteurs de souffrance et aux expressions de cette souffrance sur la santé des salariés. Malgré sa formulation, ce concept renvoie à des événements qui portent atteinte tant à la santé psychique que physique des travailleurs. Ces atteintes d’origine professionnelle ont pour trait commun leur caractère avant tout social. En effet, les risques psychosociaux sont principalement causés par des organisations du travail, des méthodes de management ou des relations interpersonnelles néfastes. Si l’expression de risques psychosociaux a émergé hors du champ juridique, elle est désormais communément utilisée en droit pour traiter des questions de santé et de sécurité au travail. L’appréhension juridique de ces risques n’est pourtant pas évidente. Ceux-ci sont difficiles à délimiter, teintés de subjectivité et peu enclins à être appréhendés au vu de l’histoire du droit social. Toutefois, le droit est de plus en plus sensible à l’appréhension des différentes dimensions de la personne du salarié. En outre, si la consécration des risques psychosociaux en tant que catégorie juridique est marginale, les événements auxquels renvoie ce concept sont saisis par les textes de droit nationaux et extranationaux ainsi que par la jurisprudence. Dès lors, les dispositifs et solutions juridiques applicables aux relations de travail de droit privé sont en capacité de prévenir ces risques, de les sanctionner ou de les réparer. À ce titre, une multitude d’acteurs internes ou externes à l’entreprise sont en capacité d’agir face à ces risquesThe concept of "psychosocial risks at work" gathers several work-related suffering risks. These risks are, at the same time, related to the generating acts of pain and to the expressions of suchpain on employees’ health. Despite its formulation, this concept refers to events affecting both mental and physical health of workers. Such affecting events share the same social ground. Indeed, psychosocial risks are mainly caused by the companies’ organization themselves, management methods or harmful relationships. Even though the expression of psychosocial risks was formerly developed out of the legal environment, it is now generally used in law to deal with issues of health and safety at work. However, the comprehensive understanding of such risks is not yet obvious from a legal perspective. These are complicated to define and delimit, tinged with subjectivity and unlikely to be understood in light of the employment law history. However, law is increasingly taking into account the different dimensions of the workers’ individuality. Also, if the psychosocial risks fail to be recognized, so far, as an independent and entire legal concept, both laws (domestic and international) and case law are more and more referring to it. Therefore, measures and legal solutions applicable to the working relationships in private companies enable to prevent such risks, punish or compensate them. As such, a wide range of people, whether related or not to the company, are able to duly face these factors
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"Feasibility and effectiveness of stepped care programme for depression and anxiety." 2013. http://library.cuhk.edu.hk/record=b5884408.
Full textAbstract:
Zhang, Dexing = 階梯式治預防焦慮癥和抑鬱癥的效果和可性的研究 / 張德杏.Thesis (Ph.D.)--Chinese University of Hong Kong, 2013.
Includes bibliographical references (leaves 181-205).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Abstracts also in Chinese; appendixes includes Chinese.
Zhang, Dexing = Jie ti shi zhi yu fang jiao lü zheng he yi yu zheng de xiao guo he ke xing de yan jiu / Zhang Dexing.
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Gallegos, Guajardo Julia 1979. "Preventing childhood anxiety and depression : testing the effectiveness of a school-based program in México." 2008. http://hdl.handle.net/2152/18005.
Full textAbstract:
A growing number of school-aged children experience or are at risk for myriad psychological and behavioral problems such as anxiety and depression that interfere with their interpersonal relationships, school performance, and potential to become productive citizens--hence, the critical nature of early prevention and intervention in schools. The purpose of this study was to assess the effectiveness of AMISTAD, a social and emotional program focusing on the prevention of anxiety and depression of four groups of students. Eight schools from a northern city in México were randomly selected and assigned to either an intervention or monitoring condition. Sixteen teachers implemented the intervention, and 16 served as control. Participants were 1,030 fourth- and fifth-grade students (ages 9-11), including 131 children with learning disabilities (LD). Children in the intervention group received the program and learned about relaxation techniques, coping with difficulties, positive thinking, and interpersonal skills, among others. For analysis, the sample was divided into four nonoverlapping groups: children diagnosis-free for anxiety and non-LD, children at risk for anxiety and non-LD, children at risk for anxiety with LD, and children diagnosis-free for anxiety with LD. The impact of the program was evaluated immediately after the intervention and after 6 months. Results showed statistically significant improvements of small impact for the overall sample and for children diagnosis-free for anxiety and non-LD, in that those receiving the program decreased the severity of their depressive symptoms, the number of children at risk for depression decreased, and these children increased their proactive coping skills. For children already showing risk for anxiety and/or LD, the program in the current format did not produce meaningful changes. Therefore, adaptations regarding culture, mode of delivery, and content should be incorporated in order to better meet these children’s needs. Finally, this study confirms the importance of prevention, as in the current study, almost 1 out of 5 children reported clinical depression, and it appears that without intervention, these symptoms will escalate over time.text
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Cukrowicz, Kelly C. Berler Ellen S. "Prevention of anxiety and depression." Diss., 2005. http://etd.lib.fsu.edu/theses/available/etd-07082005-165534.
Full textAbstract:
Thesis (Ph. D.)--Florida State University, 2005.Advisor: Dr. Ellen S. Berler, Florida State University, College of Arts and Sciences, Dept. of Psychology. Title and description from dissertation home page (viewed Sept. 19, 2005). Document formatted into pages; contains viii, 48 pages. Includes bibliographical references.
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Williams, Jennifer Gail. "The Body image of middle adolescent girls." Diss., 2002. http://hdl.handle.net/10500/861.
Full textAbstract:
The prevalence of dieting is alarmingly high amongst adolescents in South Africa. Dieting behaviour, influenced by the promotion of the thin ideal, poses one of the main risks for eating disorders, which have serious physical, psychological and social consequences, including death.
Treatment of eating disorders is a costly, difficult and long-term process, therefore preventative measures have been advocated. One of the shortcomings of existing school-based primary intervention programmes has been the failure to bring about significant changes in body image, a key defining feature of eating disorders.
This study evaluates the effectiveness of a modified version of Rosen's body image programme with adolescents, with the view to exploring the idea of adding a body image component to existing preventative programmes. The modified version of Rosen's programme proved to be effective in improving the body image of mid-adolescents.Educational Studies
M. Ed. (Psychology of Education, with specialisation in Guidance and Counselling)
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Cooper, Jonathan A. "Canadian social validity evaluation of the FRIENDS school-based universal anxiety prevention program." 2007. http://hdl.handle.net/1993/20451.
Full text
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"Evaluation of the Maternal Mental Health Program." Thesis, 2012. http://hdl.handle.net/10388/ETD-2012-12-860.
Full textAbstract:
According to the World Health Organization, mental health problems, particularly depression and anxiety, are increasing worldwide; this places a huge burden on individuals, families, and society. Maternal depression has drawn a lot of attention during the last two decades because maternal depression affects not only the women, but also their unborn children and/or newborns. However, the majority of women who suffer from maternal depression do not seek help. When the women seek help, they are often under-diagnosed or under-treated by their family physicians.
The shared care model has been implemented in a variety of health care settings including mental health. Shared care enhances collaboration between family physicians and specialists in delivering patient care. The Maternal Mental Health Program (MMHP) is a shared care program, and was developed to improve the mental health of pregnant and postpartum women in the Saskatoon Health Region. In comparison to other shared care programs reported in the literature, the MMHP is focused exclusively on maternal mental health.
To evaluate the MMHP, a quantitative evaluation was conducted to examine the implementation and maintenance of the program. Based on the findings, there was a significant reduction of depression and anxiety symptoms among women who completed the program. This study revealed that social determinants of health are associated with the level of symptoms. Overall, the program met women’s and physician’s expectations, with 75 women (75.8%) and 75 physicians (76.5%) being satisfied or very satisfied with the program. This evaluation study suggests that implementation and maintenance of a shared care maternal mental health program are possible and effective in a local setting, and, in order to improve maternal mental health, social determinants of health have to be addressed.
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Short, Christina. "A universal prevention program for anxiety symptoms in school aged children : taming worry dragons." Thesis, 2005. http://hdl.handle.net/2429/16697.
Full textAbstract:
A growing literature has investigated the efficacy of cognitive-behavioral therapy for
treating children with anxiety disorders; however, there remains scant research to discover if
cognitive-behavior therapy programs can be used as a preventative approach for anxiety.
This study adds to the limited available research on the prevention of anxiety by
implementing and evaluation a locally developed cognitive-behavioral intervention program,
Taming Worry Dragons.
This study examined the effectiveness of a school based cognitive-behavioral
intervention for reducing rates of anxiety symptoms in children aged 7 to 12 years. Using a
universal prevention approach, 162 children were randomly assigned (school as unit of
randomization) to either an 8-week cognitive-behavioral intervention group or to a wait list
control group. Children's anxiety levels were assessed before and immediately after the
intervention by child self-report (Multidimensional Anxiety Screen for Children, March,
1997) and by parent reports (Behavioral Assessment Schedule for Children, Kamphaus,
1992). Results of the statistical analysis (ANCOVA) indicate that the manualized CBT
intervention, which included relaxation training, cognitive restructuring, and behavioural
components, was not successful in reducing symptoms of anxiety within the general
population of school aged children. The children in the wait-list condition, however, did
report significantly lower mean scores on the self-report measure. A separate wi thin-group
analysis was performed, examining those children with elevated self-report scores only (T
score of 55+ in treatment and WL groups). Those in the treatment condition significantly
improved following the intervention (effect size of .8) while those in the waitlist condition
remained unchanged.Education, Faculty of
Educational and Counselling Psychology, and Special Education (ECPS), Department of
Graduate
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"Predictors of Program Response to a Child Anxiety Indicated Prevention and Early Intervention Protocol." Doctoral diss., 2017. http://hdl.handle.net/2286/R.I.45594.
Full textAbstract:
abstract: The purpose of this study was to examine if certain child demographics and risk modifiers of the child (i.e., anxiety sensitivity, depressive symptoms, anxiety control, and social competence) predict program response to a Child Anxiety Indicated Prevention and Early Intervention protocol (Pina, Zerr, Villalta, & Gonzales, 2012). This anxiety protocol focused on cognitive behavioral techniques (e.g., systematic and gradual exposure) that used culturally responsive implementation strategies (Pina, Villalta, & Zerr, 2009). The current study aims to investigate specific predictors of program response to this anxiety protocol. First, it was of interest to determine if child demographics and risk modifiers of the child at baseline would predict program response to the early anxiety intervention protocol. Second, it was of interest to see if an interaction with one of the four risk modifiers at baseline and sex or protocol condition would predict program response to the early anxiety intervention protocol. This study included 88 youth (59.14% Hispanic/Latino and 40.9% Caucasian) who were recruited through referrals from public schools and randomized to one of two protocol conditions (i.e., child-only or the child-plus-parent protocol), which had varying levels of mothers’ participation within the Child Anxiety Indicated Prevention and Early Intervention protocol (Pina et al., 2012). Participants ranged from 6 to 17 years of age (M = 10.36, SD = 2.73), and 48.9% were boys. The four risk modifiers were assessed using the Childhood Anxiety Sensitivity Index (CASI; Silverman, Fleisig, Rabian, & Peterson, 1991), Children's Depression Inventory (CDI; Kovacs, 1981), Anxiety Control Questionnaire for Children-Short Form (ACQ-C-S; Weems, 2005), and Social Competence scale from the Child Behavior Checklist (CBCL; Achenbach & Resorla, 2001). Program response was measured by pre-to-posttest changes in anxiety outcomes. Regarding the first aim, each of the four risk modifiers was related to pre-to-posttest changes in program response outcomes. Regarding the second aim for interactions between each of the four focal predictors, sex and protocol condition emerged as moderators. These results have potential implications for clinicians and researchers interested in understanding why some children might experience more or less change when participating in an early intervention protocol for anxiety.Dissertation/Thesis
Doctoral Dissertation Psychology 2017
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"Identifying Mediators of Youth Anxiety and Depression Intervention Outcomes: A Meta-Analytic Path Analysis." Master's thesis, 2015. http://hdl.handle.net/2286/R.I.36008.
Full textAbstract:
abstract: Anxiety and depression are among the most prevalent disorders in youth, with prevalence rates ranging from 15% to 25% for anxiety and 5% to 14% for depression. Anxiety and depressive disorders cause significant impairment, fail to spontaneously remit, and have been prospectively linked to problematic substance use and legal problems in adulthood. These disorders often share a high-degree of comorbidity in both clinical and community samples, with anxiety disorders typically preceding the onset of depression. Given the nature and consequences of anxiety and depressive disorders, a plethora of treatment and preventative interventions have been developed and tested with data showing significant pre to post to follow-up reductions in anxiety and depressive symptoms. However, little is known about the mediators by which these interventions achieve their effects. To address this gap in the literature, the present thesis study combined meta-analytic methods and path analysis to evaluate the effects of youth anxiety and depression interventions on outcomes and four theory-driven mediators using data from 55 randomized controlled trials (N = 11,413). The mediators included: (1) information-processing biases, (2) coping strategies, (3) social competence, and (4) physiological hyperarousal. Meta-analytic results showed that treatment and preventative interventions reliably produced moderate effect sizes on outcomes and three of the four mediators (information-processing biases, coping strategies, social competence). Most importantly, findings from the path analysis showed that changes in information-processing biases and coping strategies consistently mediated changes in outcomes for anxiety and depression at both levels of intervention, whereas gains in social competence and reductions in physiological hyperarousal did not emerge as significant mediators. Knowledge of the mediators underlying intervention effects is important because they can refine testable models of treatment and prevention efforts and identify which anxiety and depression components need to be packaged or strengthened to maximize intervention effects. Allocating additional resources to significant mediators has the potential to reduce costs associated with adopting and implementing evidence-based interventions and improve dissemination and sustainability in real-world settings, thus setting the stage to be more readily integrated into clinical and non-clinical settings on a large scale.Dissertation/Thesis
Masters Thesis Psychology 2015