72 results on '"Wuthrich, Viviana"'
Search Results
52. Comparison of Transdiagnostic Treatment and Specialized Social Anxiety Treatment for Children and Adolescents With Social Anxiety Disorder: A Randomized Controlled Trial.
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Rapee, Ronald M., McLellan, Lauren F., Carl, Talia, Trompeter, Nora, Hudson, Jennifer L., Jones, Michael P., and Wuthrich, Viviana M.
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SOCIAL anxiety , *ANXIETY disorders , *ANXIETY treatment , *RANDOMIZED controlled trials , *COGNITIVE therapy , *PEDIATRIC therapy , *TEENAGERS - Abstract
Pediatric social anxiety disorder consistently shows the poorest treatment response of all anxiety disorders. The current study compared a generic cognitive−behavioral therapy (CBT) treatment for pediatric anxiety against a modified (social anxiety) treatment that incorporated specific components to target theoretically important maintaining processes. A total of 200 children and adolescents (mean age = 9.5 years, SD = 2.2 years; 47% boys) diagnosed with social anxiety disorder as either their principal or additional disorder were randomly allocated to either the generic or the modified treatment. Both treatments were based on a manualized, empirically validated program (Cool Kids) and comprised 10 sessions over 12 weeks. Assessments comprised structured diagnostic interview and parent and youth reports, and covered diagnoses, symptoms, life impairment, and assessment of maintaining processes at posttreatment and 6-month follow-up. The treatments did not differ significantly on the primary outcome (remission of social anxiety disorder) at either posttreatment (remission in generic = 41%; modified = 44%) or follow-up (remission in generic = 51%; modified = 69%), although the latter approached significance (p =.08). They also did not differ at either time point on most secondary measures of outcome. The only maintaining process that changed more under modified treatment was attention to the current task. Despite some positive hints in the data, there was little evidence that the modified intervention significantly improved treatment of pediatric social anxiety disorder, despite incorporating strategies to address putative maintaining mechanisms. The similar improvement between treatments on most maintaining processes suggests that new and innovative strategies may be needed to better target these processes. Efficacy of Cognitive Behavioural Treatment for Socially Anxious Youth; https://www.anzctr.org.au/ ; 12616001065482. [ABSTRACT FROM AUTHOR]
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- 2023
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53. Comparison of Stepped Care Delivery Against a Single, Empirically Validated Cognitive-Behavioral Therapy Program for Youth With Anxiety: A Randomized Clinical Trial.
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Rapee, Ronald M., Lyneham, Heidi J., Wuthrich, Viviana, Chatterton, Mary Lou, Hudson, Jennifer L., Kangas, Maria, and Mihalopoulos, Cathrine
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COGNITIVE therapy , *MENTAL health of youth , *ANXIETY , *CLINICAL trials , *DRUG efficacy , *ANXIETY treatment , *ANXIETY disorders treatment , *ANXIETY disorders , *COMPARATIVE studies , *RESEARCH methodology , *MEDICAL care , *MEDICAL cooperation , *RESEARCH , *EVALUATION research , *RANDOMIZED controlled trials , *TREATMENT effectiveness , *PSYCHOLOGY - Abstract
Objective: Stepped care is embraced as an ideal model of service delivery but is minimally evaluated. The aim of this study was to evaluate the efficacy of cognitive-behavioral therapy (CBT) for child anxiety delivered via a stepped-care framework compared against a single, empirically validated program.Method: A total of 281 youth with anxiety disorders (6-17 years of age) were randomly allocated to receive either empirically validated treatment or stepped care involving the following: (1) low intensity; (2) standard CBT; and (3) individually tailored treatment. Therapist qualifications increased at each step.Results: Interventions did not differ significantly on any outcome measures. Total therapist time per child was significantly shorter to deliver stepped care (774 minutes) compared with best practice (897 minutes). Within stepped care, the first 2 steps returned the strongest treatment gains.Conclusion: Stepped care and a single empirically validated program for youth with anxiety produced similar efficacy, but stepped care required slightly less therapist time. Restricting stepped care to only steps 1 and 2 would have led to considerable time saving with modest loss in efficacy. Clinical trial registration information-A Randomised Controlled Trial of Standard Care Versus Stepped Care for Children and Adolescents With Anxiety Disorders; http://anzctr.org.au/; ACTRN12612000351819. [ABSTRACT FROM AUTHOR]- Published
- 2017
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54. Assessing Functional Impairment in Youth: Development of the Adolescent Life Interference Scale for Internalizing Symptoms (ALIS-I).
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Schniering, Carolyn A., Forbes, Miriam K., Rapee, Ronald M., Wuthrich, Viviana M., Queen, Alexander H., and Ehrenreich-May, Jill
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YOUTH development , *INTERNALIZING behavior , *ADOLESCENT development , *STATISTICAL reliability , *EXPLORATORY factor analysis , *PSYCHOMETRICS - Abstract
This study described the psychometric properties of a self-report measure of functional impairment related to anxiety and depression in adolescents, the Adolescent Life Interference Scale for Internalizing symptoms (ALIS-I). A clinical sample of 266 adolescents and a community sample of 63 adolescents, aged 11 to 18 years (Mean = 14.7, SD = 1.71) completed the ALIS-I and additional measures assessing internalizing problems. Exploratory factor analyses indicated four distinct but correlated factors of life interference related to personal withdrawal/avoidance, peer problems, problems with study/work, and somatic symptoms. Reliability and retest reliability (8–12 weeks) of the total score were high and psychometric properties of the subscales were acceptable. The ALIS-I effectively discriminated between clinical and community control groups, and expected correlations were shown between ALIS-I subscales and other related symptom measures. The ALIS-I is a promising instrument for the assessment of functional impairment related to internalizing disorders in youth. [ABSTRACT FROM AUTHOR]
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- 2023
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55. Combining CBT and sertraline does not enhance outcomes for anxious youth: a double-blind randomised controlled trial.
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Hudson, Jennifer L., McLellan, Lauren F., Eapen, Valsamma, Rapee, Ronald M., Wuthrich, Viviana, and Lyneham, Heidi J.
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ANXIETY disorders treatment , *DRUG efficacy , *PARENT attitudes , *HEALTH outcome assessment , *RANDOMIZED controlled trials , *TREATMENT effectiveness , *PLACEBOS , *SEVERITY of illness index , *BLIND experiment , *RESEARCH funding , *COMBINED modality therapy , *STATISTICAL sampling , *COGNITIVE therapy , *SERTRALINE , *PHARMACODYNAMICS , *CHILDREN , *ADOLESCENCE - Abstract
Background: Anxiety disorders are the most prevalent mental disorder in children and young people. Developing effective therapy for these children is critical to reduce mental disorders across the lifespan. The study aimed to evaluate the efficacy of combining cognitive behavioural therapy (CBT) and sertraline (SERT) in the treatment of anxiety in youth, using a double-blind randomised control trial design. Methods: Ninety-nine youth (ages 7–15 years) with an anxiety disorder were randomly allocated to either individual (CBT) and SERT or individual CBT and pill placebo and assessed again immediately and 6 months after treatment. Results: There were no significant differences between conditions in remission of primary anxiety disorder or all anxiety disorders. Furthermore, there were no significant differences in rates of change in diagnostic severity, parent-reported anxiety symptoms, child-reported anxiety symptoms or life interference due to anxiety. Conclusions: The efficacy of CBT for children and adolescents with anxiety disorders is not significantly enhanced by combination with a short-term course of anti-depressants over and above the combined effects of pill placebo. [ABSTRACT FROM AUTHOR]
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- 2023
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56. A protocol for the Hearing impairment in Adults: A Longitudinal Outcomes Study (HALOS).
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Tang, Diana, Tran, Yvonne, McMahon, Catherine, Turner, Jessica, Amin, Janaki, Sinha, Kompal, Alam, Mohammad Nure, Wuthrich, Viviana, Sherman, Kerry A., Garcia, Patrick, Mitchell, Rebecca, Braithwaite, Jeffrey, Leigh, Greg, Lim, Shermin, Shekhawat, Giriraj Singh, Rapport, Frances, Ferguson, Melanie, and Gopinath, Bamini
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HEARING disorders , *DEAF children , *HEARING aids , *COCHLEAR implants , *LONGITUDINAL method , *SOCIAL belonging - Abstract
Background: Often considered an "invisible disability", hearing loss is one of the most prevalent chronic diseases and the third leading cause for years lived with disability worldwide. Hearing loss has substantial impacts on communication, psychological wellbeing, social connectedness, cognition, quality of life, and economic independence. The Hearing impairment in Adults: a Longitudinal Outcomes Study (HALOS) aims to evaluate the: (1) impacts of hearing devices (hearing aids and/or cochlear implants), (2) differences in timing of these interventions and in long-term outcomes between hearing aid and cochlear implant users, and (3) cost-effectiveness of early intervention for adult-onset hearing loss among hearing device users. Materials and methods: HALOS is a mixed-methods study collecting cross-sectional and longitudinal data on health and social outcomes from 908 hearing aid and/or cochlear implant users aged ≥40 years, recruited from hearing service providers across Australia. The quantitative component will involve an online survey at baseline (time of recruitment), 24-months, and 48-months and will collect audiological, health, psychosocial, functional and employment outcomes using validated instruments. The qualitative component will be conducted in a subset of participants at baseline and involve semi-structured interviews to understand the patient journey and perspectives on the Australian hearing service model. Ethics: This study has been approved by the Macquarie University Human Research Ethics Committee (ID: 11262) and Southern Adelaide Local Health Network (ID: LNR/22/SAC/88). Dissemination of results: Study findings will be disseminated to participants via a one-page summary, and to the public through publications in peer-reviewed journals and presentations at conferences. Trial registration: Australia New Zealand Clinical Trial Registry (ANZCTR) registration number: ACTRN12622000752763. [ABSTRACT FROM AUTHOR]
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- 2023
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57. Protocol for a pre-post, mixed-methods feasibility study of the Brain Bootcamp behaviour change intervention to promote healthy brain ageing in older adults.
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Siette, Joyce, Dodds, Laura, Dawes, Piers, Richards, Deborah, Savage, Greg, Strutt, Paul, Ijaz, Kiran, Johnco, Carly, Wuthrich, Viviana, Heger, Irene, Deckers, Kay, Köhler, Sebastian, and Armitage, Christopher J.
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OLDER people , *HEALTH behavior , *DISEASE risk factors , *OLD age , *FOOD habits , *FEASIBILITY studies , *MIDDLE-aged persons - Abstract
Introduction: Behaviour change interventions represent key means for supporting healthy ageing and reducing dementia risk yet brief, scalable behaviour change interventions targeting dementia risk reduction in older adults is currently lacking. Here we describe the aims and design of the three-month Brain Bootcamp initiative that seeks to target multiple dementia risk and protective factors (healthy eating, physical, social and cognitive inactivity), through the use of multiple behaviour change techniques, including goal-setting for behaviour, information about health consequences and physical prompts to change behaviours that reduce dementia risk among older adults. Our secondary aim is to understand participants' views of dementia prevention and explore the acceptability and integration of this campaign into daily life. Methods: Brain Bootcamp is a pre-post feasibility trial conducted in Sydney, Australia beginning in January 2021 until late August. Participants aged ≥65 years living independently in the community (n = 252), recruited through social media and flyers, will provide information about their demographics, medical history, alcohol consumption, smoking habits, mental health, physical activity, cognitive activity, and diet to generate a dementia risk profile at baseline and assess change therein at three-month follow-up. During the intervention, participants will receive a resource pack containing their individual risk profile, educational booklet on dementia risk factors and four physical items designed to prompt physical, social and mental activity, and better nutrition. Outcome measures include change in dementia risk scores, dementia awareness and motivation. A qualitative process evaluation will interview a sample of participants on the acceptability and feasibility of the intervention. Discussion: This will be the first short-term multi-domain intervention targeting dementia risk reduction in older adults. Findings will generate a new evidence base on how to best support efforts targeting lifestyle changes and to identify ways to optimise acceptability and effectiveness towards brain health for older adults. Trial registration number: ACTRN 381046 (registered 17/02/2021); Pre-results. [ABSTRACT FROM AUTHOR]
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- 2022
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58. A Systematic Review and Meta-Analysis of Impairment and Quality of Life in Children and Adolescents with Anxiety Disorders.
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Dickson, Sophie J., Oar, Ella L., Kangas, Maria, Johnco, Carly J., Lavell, Cassie H., Seaton, Ashleigh H., McLellan, Lauren F., Wuthrich, Viviana M., and Rapee, Ronald M.
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Anxiety disorders are common, emerge during childhood, and pose a significant burden to society and individuals. Research evaluating the impact of anxiety on functional impairment and quality of life (QoL) is increasing; however, there is yet to be a systematic review and meta-analysis of these relationships in pediatric samples. This systematic review and meta-analysis were conducted to determine the extent of impairments in functioning and QoL that young people with anxiety disorders experience relative to their healthy peers, as well as sociodemographic and clinical moderators of these relationships. Studies were included when they compared young people (mean age range within studies 7–17 years) with a primary clinical anxiety disorder to a healthy comparison group and measured impairment and/or QoL via a validated instrument. A total of 12 studies met criteria for this review (
N = 3,129 participants). A majority of studies (K = 9) assessed impairment as an outcome measure, and three assessed QoL outcomes. Meta-analysis of nine studies (N = 1,457 children) showed large relationships between clinical anxiety and life impairment (g = 3.23) with the strongest effects seen for clinician report (g = 5.00), followed by caregiver (g = 2.15) and child (g = 1.58) report. The small number of studies and diversity in methodology prevented quantitative investigation of moderating factors. In the systematic review of QoL outcomes, all three studies reported significantly poorer QoL for youth with anxiety disorders relative to unaffected peers. Findings support the importance of measuring functioning and QoL as outcomes in clinical research and practice among anxious young people.This study is registered with PROSPERO under the identification number CRD42023439040. [ABSTRACT FROM AUTHOR]- Published
- 2024
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59. Believing is seeing: Development and validation of the STRESS (Subjective Thoughts REgarding Stress Scale) for measuring stress beliefs.
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Kilby, Christopher J., Sherman, Kerry A., and Wuthrich, Viviana M.
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EXPLORATORY factor analysis , *CONFIRMATORY factor analysis , *STATISTICAL reliability , *PSYCHOMETRICS , *PSYCHOLOGICAL stress - Abstract
The association between stress beliefs and stressor appraisals has been limited by the absence of a comprehensive stress belief scale. This paper aimed to develop a new stress belief scale (the Subjective Thoughts REgarding Stress Scale; STRESS) and to assess the association between stress beliefs and stressor appraisals. Study 1: A pool of 75 Likert-type items assessing beliefs about stress and cognition, emotion, social factors, and behavior, was piloted on an international sample (N = 107); all items were found to reflect commonly held beliefs. Study 2: Exploratory factor analysis (N = 419), reduced the scale to 19 items over three factors (Consequences, Social Factors, and Coping Efficacy), demonstrating acceptable construct validity and internal reliability. Study 3: Confirmatory factor analysis (N = 300) replicated the factor structure in a new sample and demonstrated acceptable convergent and divergent validity. Study 4: Predictive validity (N = 137) was demonstrated with stressor appraisals and acceptable test-retest reliability over two weeks. This study provides evidence for both good psychometric properties of the new STRESS measure and predictive validity in terms of an association between stress beliefs and stressor appraisals. • Current stress belief measures do not correlate with stressor appraisals. • Current stress belief measures may have flaws in their development. • This four-study paper reports the development of a new measure, the STRESS. • The STRESS demonstrated satisfactory psychometric requirements. • The STRESS predicted five types of stressor appraisals of a stress induction. [ABSTRACT FROM AUTHOR]
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- 2022
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60. Academic Stress Interventions in High Schools: A Systematic Literature Review.
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Jagiello, Tess, Belcher, Jessica, Neelakandan, Aswathi, Boyd, Kaylee, and Wuthrich, Viviana M.
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The experience of academic stress is common during high school and can have significant negative consequences for students’ educational achievement and wellbeing. High school students frequently report heightened levels of school-related distress, particularly as they approach high-stakes assessments. Programs designed to reduce or prevent academic stress are needed, and their delivery in school settings is ideal to improve treatment access. The current review aimed to examine the effectiveness of high school-based programs in reducing or preventing academic stress. A systematic search returned 31 eligible studies across 13 countries. Programs were categorised according to intervention type, format, and facilitator. Results showed that the methodological quality of most studies was poor, and many used an inactive control group. As predicted by theories of academic stress, the strongest evidence was for programs grounded in cognitive-behavioural therapy (CBT). There was evidence that both universal and targeted approaches can be beneficial. The unique implementation issues for these two formats are discussed. Most programs were delivered by psychologists and were generally effective, but almost all of these were CBT programs. A smaller proportion of programs delivered by teachers were effective. Therefore, future studies should evaluate the implementation success of programs to improve the rate of effective delivery by school staff. Overall, the field will benefit from more randomised controlled trials with comparisons to active control groups, larger sample sizes and longer-term follow-ups. [ABSTRACT FROM AUTHOR]
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- 2024
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61. National Survey on the Impact of COVID-19 on the Mental Health of Australian Residential Aged Care Residents and Staff.
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Brydon, Aida, Bhar, Sunil, Doyle, Colleen, Batchelor, Frances, Lovelock, Harry, Almond, Helen, Mitchell, Leander, Nedeljkovic, Maja, Savvas, Steven, and Wuthrich, Viviana
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COVID-19 , *NURSING home patients , *ATTITUDE (Psychology) , *MEDICAL personnel , *SURVEYS , *PSYCHOSOCIAL factors , *RESIDENTIAL care , *DESCRIPTIVE statistics , *DATA analysis software , *COVID-19 pandemic , *ELDER care - Abstract
This study is the first to obtain data on the prevalence of, contributors to, and supports required for, pandemic-related distress within the residential aged care sector in Australia. A nested mixed-methods approach was used to examine aged care leaders' opinions about the impact of COVID-19 on the mental health of aged care residents and staff. A total of 288 senior staff of Australian residential aged care facilities (care managers, clinical care coordinators, and lifestyle team leaders; mean age = 52.7 years, SD = 10.3) completed an online survey between 10th September and 31st October 2020. On average, nearly half of their residents experienced loneliness (41%) and a third experienced anxiety in response to COVID-19 (33%). The most frequently noted contributors to poor mental health among residents were restrictions to recreational outings and watching news coverage relating to COVID-19. Participants emphasized the need for increased access to counseling services and improved mental health training amongst staff. Residential care staff were similarly impacted by the pandemic. More than a third of staff were reported as anxious (36%) and 20% depressed, in response to COVID-19. Staff were worried about introducing COVID-19 into their facility and were impacted by news coverage of COVID-19. Staff would feel supported by financial assistance and by increased staff-resident ratios. Senior staff perceive that the mental health of Australian aged care residents and staff was negatively impacted by the COVID-19 pandemic. The most noted contributors were identified, as was the mental health support for aged care communities. This study provides government and policymakers with clear intervention targets for supporting the sector. Clinicians can support residential aged care communities by providing on-site or telehealth counseling, and upskill and train residential aged care staff on how to respond to the emotional needs of residents in response to COVID-19. [ABSTRACT FROM AUTHOR]
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- 2022
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62. Stress and Coping in Older Australians During COVID-19: Health, Service Utilization, Grandparenting, and Technology Use.
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Strutt, Paul A., Johnco, Carly J., Chen, Jessamine, Muir, Courtney, Maurice, Olivia, Dawes, Piers, Siette, Joyce, Botelho Dias, Cintia, Hillebrandt, Heidi, and Wuthrich, Viviana M.
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SOCIALIZATION , *ADAPTABILITY (Personality) , *SELF-control , *MENTAL health , *MEDICAL care use , *FAMILY roles , *PHYSICAL activity , *LONELINESS , *QUALITY of life , *MENTAL depression , *PSYCHOLOGICAL adaptation , *STAY-at-home orders , *ANXIETY , *EMOTION regulation , *COVID-19 pandemic , *PSYCHOLOGICAL stress , *INFORMATION technology , *PSYCHOLOGICAL distress , *PSYCHOLOGICAL resilience - Abstract
This study examined the impacts of COVID-19 lockdown on health and lifestyle factors for older adults in Sydney, Australia. The study examined demographic differences, social engagement, loneliness, physical activity, emotion regulation, technology use, and grandparenting experiences and their contribution to emotional health and quality of life during lockdown. Participants were 201 community-dwelling older adults (60–87 years, M = 70.55, SD = 6.50; 67.8% female) who completed self-report scales measuring physical and emotional health outcomes, quality of life, health service utilization, changes in diet and physical activity, impacts on grandparenting roles, and uptake of new technology. One-third of older adults experienced depression, and 1 in 5 experienced elevated anxiety and/or psychological distress during lockdown. Specific emotion regulation strategies, better social and family engagement, and new technology use were associated with better emotional health and quality of life; 63% of older adults used new technologies to connect with others. Older adults were adaptable and resilient during lockdown, demonstrating high uptake of new technologies to remain connected to others, while negative emotional health outcomes were linked to loneliness and unhelpful emotion regulation. Further diversifying use of video technologies may facilitate improved physical and emotional health outcomes. [ABSTRACT FROM AUTHOR]
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- 2022
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63. Acceptance and commitment therapy for late-life treatment-resistant generalised anxiety disorder: a feasibility study.
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Gould, Rebecca L, Wetherell, Julie Loebach, Kimona, Kate, Serfaty, Marc A, Jones, Rebecca, Graham, Christopher D, Lawrence, Vanessa, Livingston, Gill, Wilkinson, Philip, Walters, Kate, Novere, Marie Le, Leroi, Iracema, Barber, Robert, Lee, Ellen, Cook, Jo, Wuthrich, Viviana M, and Howard, Robert J
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PILOT projects , *ADAPTABILITY (Personality) , *PATIENT satisfaction , *TREATMENT failure , *ACCEPTANCE & commitment therapy , *MENTAL depression , *GENERALIZED anxiety disorder , *ANXIETY , *WORRY , *OLD age - Abstract
Background Generalised anxiety disorder (GAD) is the most common anxiety disorder in older people. First-line management includes pharmacological and psychological therapies, but many do not find these effective or acceptable. Little is known about how to manage treatment-resistant generalised anxiety disorder (TR-GAD) in older people. Objectives To examine the acceptability, feasibility and preliminary estimates of the effectiveness of acceptance and commitment therapy (ACT) for older people with TR-GAD. Participants People aged ≥65 years with TR-GAD (defined as not responding to GAD treatment, tolerate it or refused treatment) recruited from primary and secondary care services and the community. Intervention Participants received up to 16 one-to-one sessions of ACT, developed specifically for older people with TR-GAD, in addition to usual care. Measurements Co-primary outcomes were feasibility (defined as recruitment of ≥32 participants and retention of ≥60% at follow-up) and acceptability (defined as participants attending ≥10 sessions and scoring ≥21/30 on the satisfaction with therapy subscale). Secondary outcomes included measures of anxiety, worry, depression and psychological flexibility (assessed at 0 and 20 weeks). Results Thirty-seven participants were recruited, 30 (81%) were retained and 26 (70%) attended ≥10 sessions. A total of 18/30 (60%) participants scored ≥21/30 on the satisfaction with therapy subscale. There was preliminary evidence suggesting that ACT may improve anxiety, depression and psychological flexibility. Conclusions There was evidence of good feasibility and acceptability, although satisfaction with therapy scores suggested that further refinement of the intervention may be necessary. Results indicate that a larger-scale randomised controlled trial of ACT for TR-GAD is feasible and warranted. [ABSTRACT FROM AUTHOR]
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- 2021
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64. The Youth Online Diagnostic Assessment (YODA): Validity of a New Tool to Assess Anxiety Disorders in Youth.
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McLellan, Lauren F., Kangas, Maria, Rapee, Ronald M., Iverach, Lisa, Wuthrich, Viviana M., Hudson, Jennifer L., and Lyneham, Heidi J.
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ANXIETY disorders , *SEPARATION anxiety , *MEDICAL personnel , *SYMPTOMS - Abstract
This study developed an online diagnostic tool for anxiety disorders in youth, and evaluated its reliability and validity amongst 297 children aged 6–16 years (Mage = 9.34, 46% male). Parents completed the online tool, the Youth Online Diagnostic Assessment (YODA), which is scored either using a fully-automated algorithm, or combined with clinician review. In addition, parents and children completed a clinician-administered diagnostic interview and self-report measures of internalizing and externalizing symptoms and wellbeing. The fully-automated YODA demonstrated relatively weak agreement with the diagnostic interview for identifying the presence of any anxiety disorder and specific anxiety disorders, apart from separation anxiety (which had moderate agreement). The clinician-reviewed YODA showed better agreement than fully-automated scoring, particularly for identifying the presence of any anxiety disorder. The YODA demonstrated good agreement with parent-reported measures of symptoms/interference. The YODA offers a fully or largely automated method to determine the presence of anxiety disorders in youth, with particular value in situations where low-resource assessments are needed. While it currently requires further research and improvement, the YODA provides a promising start to the development of such a tool. [ABSTRACT FROM AUTHOR]
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- 2021
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65. Characteristics and effectiveness of cognitive behavioral therapy for older adults living in residential care: a systematic review.
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Chan, Phoebe, Bhar, Sunil, Davison, Tanya E., Doyle, Colleen, Knight, Bob G., Koder, Deborah, Laidlaw, Ken, Pachana, Nancy A., Wells, Yvonne, and Wuthrich, Viviana M.
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ANXIETY treatment , *ELDER care , *ATTITUDE (Psychology) , *COGNITIVE therapy , *MENTAL depression , *MEDICAL care , *MEDICAL personnel , *NEEDS assessment , *PATIENT satisfaction , *SYSTEMATIC reviews , *RESIDENTIAL care , *TREATMENT effectiveness , *PATIENTS' attitudes , *DESCRIPTIVE statistics , *EVALUATION - Abstract
Cognitive behavioral therapy (CBT) for depression and anxiety for older adults living in residential aged care facilities (RACFs) needs to accommodate the care needs of residents and the circumstances of RACFs. This systematic review examines the delivery and content characteristics of these interventions, in relation to participant satisfaction, staff appraisal, uptake rate, attrition rate, and treatment effectiveness. Such a review could provide important information for the development of future CBT-based interventions. Studies that examined the application of CBT for depression or anxiety in RACFs were identified by systematically searching a number of relevant databases. Reference lists of all included studies were examined, and citation searches on the Web of Science were conducted. Two independent reviewers were involved in screening articles and in extracting data and assessing methodological quality of the selected studies. Across the 18 studies included in this review, the most common therapeutic strategy was pleasant activities scheduling. Studies varied on treatment duration (2–24 weeks), number of sessions (6–24), and length of sessions (10–120 min). Residents and staff members were satisfied with the CBT interventions. The average uptake rate was 72.9%. The average attrition rate was 19.9%. Statistically significant results were reported in 8 of the 12 randomized controlled trials (RCTs). In these eight RCTs, CBT was characterized by psychoeducation, behavioral activation, and problem-solving techniques; further, the therapists in six of these studies had training in psychology. CBT interventions for depression and anxiety are acceptable to RACF residents and judged positively by staff members. Effective studies differed from non-effective studies on content and training characteristics, but not on other delivery features. [ABSTRACT FROM AUTHOR]
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- 2021
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66. Optimising the acceptability and feasibility of acceptance and commitment therapy for treatment-resistant generalised anxiety disorder in older adults.
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Lawrence, Vanessa, Kimona, Kate, Howard, Robert J, Serfaty, Marc A, Wetherell, Julie Loebach, Livingston, Gill, Wilkinson, Philip, Walters, Kate, Jones, Rebecca, Wuthrich, Viviana M, and Gould, Rebecca L
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ADAPTABILITY (Personality) , *PSYCHOLOGICAL adaptation , *ELDER care , *ATTITUDE (Psychology) , *INTERPROFESSIONAL relations , *INTERVIEWING , *MEDICAL needs assessment , *MEDICAL personnel , *MEDICAL referrals , *PATIENT compliance , *QUALITATIVE research , *SOCIAL support , *ACCEPTANCE & commitment therapy , *TREATMENT effectiveness , *HEALTH literacy , *GENERALIZED anxiety disorder - Abstract
Background generalised anxiety disorder (GAD) is common in later life with a prevalence of 3–12%. Many only partially respond to cognitive behavioural therapy or pharmacotherapy and can be classified as treatment resistant. These patients experience poor quality of life, and are at increased risk of comorbid depression, falls and loneliness. Acceptance and commitment therapy (ACT) is an emerging therapy, which may be particularly suited to this population, but has not been tailored to their needs. Objectives to optimise the acceptability and feasibility of ACT for older adults with treatment-resistant GAD. Design a person-based approach to ground the adapted ACT intervention in the perspectives and lives of those who will use it. Methods first, we conducted qualitative interviews with 15 older adults with GAD and 36 healthcare professionals to develop guiding principles to inform the intervention. Second, we consulted service users and clinical experts and interviewed the same 15 older adults using 'think aloud' techniques to enhance its acceptability and feasibility. Results in Stage 1, older adults' concerns and needs were categorised in four themes: 'Expert in one's own condition', 'Deep seated coping strategies', 'Expert in therapy' and 'Support with implementation'. In Stage 2, implications for therapy were identified that included an early focus on values and ACT as a collaborative partnership, examining beliefs around 'self as worrier' and the role of avoidance, validating and accommodating individuals' knowledge and experience and compensating for age-related cognitive changes. Discussion Our systematic approach combined rigour and transparency to develop a therapeutic intervention tailored to the specific needs of older adults with treatment-resistant GAD. [ABSTRACT FROM AUTHOR]
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- 2019
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67. Economic evaluation of stepped care for the management of childhood anxiety disorders: Results from a randomised trial.
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Chatterton, Mary Lou, Rapee, Ronald M, Catchpool, Max, Lyneham, Heidi J, Wuthrich, Viviana, Hudson, Jennifer L, Kangas, Maria, and Mihalopoulos, Cathrine
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CHILD psychology , *COST effectiveness , *ANXIETY disorders treatment , *ECONOMIC aspects of diseases , *MEDICAL care costs , *QUALITY of life , *PARENT attitudes , *EVALUATION of human services programs - Abstract
Background: Stepped care has been promoted for the management of mental disorders; however, there is no empirical evidence to support the cost-effectiveness of this approach for the treatment of anxiety disorders in youth. Method: This economic evaluation was conducted within a randomised controlled trial comparing stepped care to a validated, manualised treatment in 281 young people, aged 7–17, with a diagnosed anxiety disorder. Intervention costs were determined from therapist records. Administrative data on medication and medical service use were used to determine additional health care costs during the study period. Parents also completed a resource use questionnaire to collect medications, services not captured in administrative data and parental lost productivity. Outcomes included participant-completed quality of life, Child Health Utility – nine-dimension and parent-completed Assessment of Quality of Life – eight-dimension to calculate quality-adjusted life years. Mean costs and quality-adjusted life years were compared between groups at 12-month follow-up. Results: Intervention delivery costs were significantly less for stepped care from the societal perspective (mean difference −$198, 95% confidence interval −$353 to −$19). Total combined costs were less for stepped care from both societal (−$1334, 95% confidence interval −$2386 to $510) and health sector (−$563, 95% confidence interval −$1353 to $643) perspectives but did not differ significantly from the manualised treatment. Youth and parental quality-adjusted life years were not significantly different between groups. Sensitivity analysis indicated that the results were robust. Conclusion: For youth with anxiety, this three-step model provided comparable outcomes and total health sector costs to a validated face-to-face programme. However, it was less costly to deliver from a societal perspective, making it an attractive option for some parents. Future economic evaluations comparing various models of stepped care to treatment as usual are recommended. [ABSTRACT FROM AUTHOR]
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- 2019
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68. Age differences in negative and positive expectancy bias in comorbid depression and anxiety.
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Tadic, Dusanka, MacLeod, Colin, Cabeleira, Cindy M., Wuthrich, Viviana M., Rapee, Ronald M., and Bucks, Romola S.
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AGE differences , *MENTAL depression , *ANXIETY , *COGNITIVE bias , *AGING - Abstract
Anxious individuals report disproportionately negative expectations concerning the future, termed the negative expectancy bias. In contrast, ageing is associated with an inflated expectancy for positive future events. A recent study [Steinman, S. A., Smyth, F. L., Bucks, R. S., MacLeod, C., & Teachman, B. A. (2013). Anxiety-linked expectancy bias across the adult lifespan. Cognition and Emotion, 27, 345-355. doi:10.1080/02699931.2012.711743] found using an interpretation bias task, a negative expectancy bias in young adults and positive expectancy bias in older adults with high trait anxiety. Extending this, the current study examined expectancy bias for positive, negative and ambiguously emotionally toned information in younger and older adults with clinical levels of depression and anxiety to community control groups, thus allowing examination of both disorder status and age on biases. Clinical participants reported a pervasive tendency to expect negative events relative to positive regardless of whether the current scenarios were positive, negative or ambiguous. Older adults showed greater expectancy for future positive scenarios when the initial scenario was negative or ambiguous. Age moderated the negative expectancy bias shown by clinical participants for ambiguous scenarios. Clinical disorders in older adults attenuated the positive expectancy bias that was otherwise strong in community participants. These findings provide further evidence for age differences in processing of emotionally toned information, with older adults showing a greater expectancy for positive future events. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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- View/download PDF
69. Interpretation modification training reduces social anxiety in clinically anxious children.
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Klein, Anke M., Rapee, Ronald M., Hudson, Jennifer L., Schniering, Carolyn A., Wuthrich, Viviana M., Kangas, Maria, Lyneham, Heidi J., Souren, Pierre M., and Rinck, Mike
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SOCIAL anxiety , *SOCIAL phobia in children , *SEPARATION anxiety , *COGNITIVE bias , *STIMULUS & response (Psychology) - Abstract
The present study was designed to examine the effects of training in positive interpretations in clinically anxious children. A total of 87 children between 7 and 12 years of age were randomly assigned to either a positive cognitive bias modification training for interpretation (CMB-I) or a neutral training. Training included 15 sessions in a two-week period. Children with an interpretation bias prior to training in the positive training group showed a significant reduction in interpretation bias on the social threat scenarios after training, but not children in the neutral training group. No effects on interpretation biases were found for the general threat scenarios or the non-threat scenarios. Furthermore, children in the positive training did not self-report lower anxiety than children in the neutral training group. However, mothers and fathers reported a significant reduction in social anxiety in their children after positive training, but not after neutral training. This study demonstrated that clinically anxious children with a prior interpretation bias can be trained away from negative social interpretation biases and there is some evidence that this corresponds to reductions in social anxiety. This study also highlights the importance of using specific training stimuli. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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- View/download PDF
70. Comparing outcomes for children with different anxiety disorders following cognitive behavioural therapy.
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Hudson, Jennifer L., Rapee, Ronald M., Lyneham, Heidi J., McLellan, Lauren F., Wuthrich, Viviana M., and Schniering, Carolyn A.
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ANXIETY in children , *COGNITIVE therapy , *OBSESSIVE-compulsive disorder in children , *FOLLOW-up studies (Medicine) , *HEALTH outcome assessment , *THERAPEUTICS - Abstract
Objective The purpose of this study was to compare treatment outcomes following a group family-based cognitive behavioural therapy for children with different anxiety disorders (social anxiety disorder, separation anxiety disorder, generalised anxiety disorder, specific phobia and obsessive compulsive disorder). Method This study utilised a clinical sample of 842 children and adolescents (aged between 6 and 18 years) and assessed outcome using diagnostic interview, parent-report and child-report. Results Based on diagnostic data and parent-reported symptoms, results revealed that children with a diagnosis of social anxiety disorder experienced a slower rate of change and poorer diagnostic outcomes at post treatment and follow-up than children with other anxiety disorders. Children with GAD showed better response to this broad-based intervention and children with OCD showed better response on one measure. Conclusions This study provides evidence for differential response to broad-based CBT for children, based on type of anxiety diagnoses. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
71. Effect of Comorbidity on Treatment of Anxious Children and Adolescents: Results From a Large, Combined Sample.
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Rapee, Ronald M., Lyneham, Heidi J., Hudson, Jennifer L., Kangas, Maria, Wuthrich, Viviana M., and Schniering, Carolyn A.
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CHILD anxiety testing , *COMORBIDITY , *COGNITIVE therapy , *EXTERNALIZING behavior , *AFFECTIVE disorders in children - Abstract
The article presents a study on the influence of comorbid disorders in the treatment of young people suffering from anxiety. Research featured children with primary anxiety disorders who participated in a cognitive-behavioral treatment program, the results of which were categorized based on the prevalence of comorbidity. Other topics covered include externalizing disorders, negative thinking, and mood disorders.
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- 2013
- Full Text
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72. Aggression management training for youth in behaviour schools.
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Wheatley, Anna, Murrihy, Rachael, van Kessel, Jacobine, Wuthrich, Viviana, Rémond, Louise, Tuqiri, Rebekka, Dadds, Mark, and Kidman, Antony
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BEHAVIOR therapy , *PARENT-teacher relationships , *YOUTH , *PEER relations , *TRAINING - Abstract
A 16-week, bi-weekly, cognitive behavioural therapy (CBT)-based aggression management training course was conducted with a limited sample of behavioural school students in New South Wales. Attendance, withdrawal and suspension rates over the training period were compared to those of a control period. Parent and teacher feedback, assessed at pre- and post-training, delivered preliminary information on disruptive behaviours and peer relations. Results revealed mixed findings with some improvements in disruptive behaviours, suspensions and withdrawals over the training period. Further research is needed to replicate these findings with a larger group of students. [ABSTRACT FROM AUTHOR]
- Published
- 2009
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