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Studies have found older adults report fewer anxiety symptoms than younger adults. As behavioral avoidance is theoretically associated with maintaining anxiety, this study sought to examine age-related differences in avoidance and anxiety in a cross-cultural sample of older (n = 60, 60–92 years) and younger adults (n = 70; 17–24 years). Community dwelling participants from Australia and the United States of America completed self-report measures of anxiety, worry, and depression. Participants also self-rated levels of avoidance to 133 common fearful situations using a card sort task. Older adults reported significantly less avoidance of age-adjusted social and medical scenarios, more avoidance of aggressive scenarios, with no significant difference for animal or agoraphobic scenarios when compared to younger adults. Age-related effects were no longer significant in full models, in which the main effect of anxiety explained variance in avoidance for social, medical, animal, agoraphobic, but not aggression scenarios. Age differences in avoidance behavior were accounted for by differences in anxiety symptoms, except for avoidance of aggressive scenarios, which was not associated with anxiety. CLINICAL IMPLICATIONS: Age differences in levels of avoidance of common fearful situations were found, and may be associated with differences in anxiety symptom severity. [ABSTRACT FROM AUTHOR]

This study examined the impact of COVID-19 lockdowns and physical distancing requirements on engagement with and sense of connectedness to social activities among older adults. Community-dwelling cognitively healthy older adults (N = 126) completed self-report questionnaires post-lock down (November 2020 to February 2021) assessing participation format (face-to-face with restrictions, online), frequency of attendance, and connectedness with a range of existing social groups. Thirty-two percent of participants stopped and had not re-engaged with social activities post lockdown. These participants reported the lowest connectedness ratings and quality of life related to psychological health than compared to those who continued to engage with social groups, albeit in a controlled format. Adapted face-to-face formats were associated with significantly greater connectedness than engagement via online methods for hobbies, cultural activities, meal entertainment, and other social activities, but not for sporting, community, religious, or volunteering activities. Qualitative data suggested online social participation was not as enjoyable as adapted face-to-face formats. For older adults who attended social activities via online formats, sense of connectedness was reduced for some activities. Given the importance of social connectedness for well-being in late life, interventions may be needed to help older adults re-engage in face-to-face formats without restrictions. What is already known about this topic: Poor social connection is associated with reduced mental well-being and physical health in older adults. Local lockdown orders in response to the 2020 wave of the COVID-19 pandemic led to temporary closure of community activities groups, suspension of religious, sporting, and social activities. and restrictions on face-to-face contact with family. Many community organisations, social groups, and families adapted activities to online formats. What this topic adds: Older adult who stopped attending and did not re-engage in social groups had the lowest connectedness ratings and quality of life related to psychological health, compared to those who continued to engage with social groups in some format. Face-to-face engagement, even with restrictions, was associated with significantly greater connectedness in older adults than engagement online for hobby, cultural activities, meal entertainment and other social activities besides sporting, community, religious, or volunteering activities. Qualitative data suggested that online social participation was not as enjoyable as adapted face-to-face formats. [ABSTRACT FROM AUTHOR]

This systematic review and meta-analysis examined the efficacy of low intensity psychological interventions for older adults (60+ years) with clinical anxiety and/or depressive disorders. Systematic review and meta-analysis of randomised control trials of low-intensity psychological interventions for anxiety and/or depression with an active or passive control condition (e.g., waitlist, treatment-as-usual or active control) in any setting. Low intensity psychological interventions (e.g., cognitive behaviour therapy [CBT]) targeted anxiety and/or depression as primary outcomes, were primarily self-help, and included support from trained practitioners/facilitators with <6 h total contact time (typically <30 min p/contact). Seven studies consisting of 304 older adults (65–78 years, M age = 70, SD = 4) were identified and six included in the meta-analysis of depression outcomes and three for anxiety. A random effects meta-analysis of group differences in symptom change from pre-post treatment found evidence favouring low intensity psychological interventions over passive control groups for the treatment of depressive and anxiety symptoms, with moderate effect sizes for depression (Cohen's d = −0.62) and large effect sizes for anxiety (Cohen's d = −0.84) at post-treatment. Results are limited by study design of included studies such that the efficacy of interventions compared to treatment-as-usual, non-CBT approaches, in adults >80 years and long-term effects are unknown. There is some evidence supporting the clinical benefits of low intensity psychological interventions for depressive and anxiety symptoms in older adults compared to passive controls. More research is needed to examine efficacy compared to active control conditions, and among those over 80 years. • Low intensity psychological interventions hold great promise. • Their efficacy for treating depression and anxiety in older adults in unknown • This systematic review and meta-analysis examined their efficacy against controls. • Results indicated some efficacy against passive controls in adults <80 years old. • Comparisons against active controls and older age groups were lacking. [ABSTRACT FROM AUTHOR]

This systematic review and meta-analysis aimed to examine the effectiveness of psychological interventions for internalising disorders in youth when delivered in routine settings. Secondary aims were to examine the effectiveness of cognitive behavioural therapy and determine moderators of treatment response. The study was pre-registered (PROSPERO 2020 CRD42020202776). Databases were systematically searched (PsycINFO, Medline, Embase, PubMed, ERIC) in December 2022 and screened according to the PRISMA 2020 statement. Inclusion: School aged participants (4–18 years) with a primary internalising disorder; psychotherapy delivered in a routine setting (e.g. outpatient clinic, school) by setting staff; compared psychotherapy to any control in a randomised controlled trial; reported pre-to-post or pre-to-follow-up comparisons on the primary disorder according to child, parent or independent evaluator report; and was published in English. Risk of bias was assessed using the ROB 2.0 Cochrane tool. Results were synthesised using random effects to pool estimates. Risk ratios were used to analyse dichotomous data and standardised mean differences (SMD) for continuous data. Forty-five studies were included (N = 4901 participants; M = 13 years; range 8–16; SD = 2.5). Nine used waitlist control, 17 treatment as usual, 4 placebo; 15 compared psychotherapy to active control. Psychotherapy was associated with small significant effects pre- to post-treatment compared to non-active controls for anxiety (SMD = − 0.24 to 0.50) and depression (SMD = − 0.19 to 0.34) with effects differing by informant. Psychotherapy led to small significant pre-to-post-benefits in youth internalising disorders in routine settings. Results are limited by reporter type and follow-up. [ABSTRACT FROM AUTHOR]

Initial research suggests stepped-care approaches to therapy for youth anxiety is associated with reduced therapy time with similar therapeutic outcomes to treatment-as-usual in real-world settings. Research on the acceptability and feasibility of stepped-care approaches in routine practice is very limited. In a secondary analysis of a pilot randomised controlled trial that compared stepped-care to treatment-as-usual in adolescent mental health services, we examine acceptability and feasibility from consumer and clinician perspectives. Fifteen adolescents and ten clinicians provided brief quantitative and qualitative feedback. Some benefits were noted and these related to improved access to treatment; however, major barriers were also noted. Concerns related to the lack of consumer and clinician choice and flexibility in delivery of stepped interventions, challenges engaging adolescents with internet interventions and associated guided telephone calls, and workplace issues. Systemic changes to facilitate consumer preferences, clinician flexibility and staffing are needed for stepped-care to be feasible in routine care. [ABSTRACT FROM AUTHOR]

Despite the empirical support for exposure therapy, it is unclear how many community-dwelling older adults with anxiety disorders receive this intervention. This study examined the use of exposure therapy compared to other treatment techniques among clinicians who treat older adults with anxiety disorders. 60 registered mental health treatment providers (e.g., psychologists, clinical psychologists) (M = 44 years, 83.3% female) completed self-report questionnaires assessing the frequency of use of exposure therapy and other treatment techniques for older clients with anxiety disorders, as well as beliefs about the safety and tolerability of exposure for older adults. Compared to younger anxious clients, clinicians endorsed significantly less frequent use of exposure therapy than other treatment techniques in older anxious adults. Negative therapist beliefs about the safety and tolerability of exposure therapy were significantly associated with infrequent use of exposure therapy in older adult clients. Clinical qualification was also associated with therapist beliefs about the exposure therapy, with clinicians who hold postgraduate qualifications reporting less negative therapist beliefs about exposure. Current findings indicate there may be a need to address negative clinician attitudes towards the use of exposure therapy when working with anxious older clients. What is already known about this topic: Anxiety disorders are common mental disorders in older adults. Exposure-based cognitive behavioural therapy is highly effective in anxiety treatment. Clinicians trained in exposure therapy rarely deliver exposure therapy or they deliver this therapy in a less effective manner. What this topic adds: Exposure therapy is under-delivered in older adults with anxiety Negative beliefs about exposure therapy are associated with underuse of exposure therapy in older adults. Clinical training should address negative clinician attitudes towards the use of exposure therapy when working with anxious older clients. [ABSTRACT FROM AUTHOR]

Background: Increasing both the frequency and quality of social interactions within treatments for anxiety and depressive disorders in older adults may improve their mental health outcomes and quality of life. This study aims to evaluate the clinical efficacy and cost utility of an enhanced cognitive behavioural therapy (CBT) plus social participation program in a sample of older adults with depression and/or anxiety. Methods: A total of 172 community-dwelling adults aged 65 years or older with an anxiety and/or depressive disorder will be randomly allocated to either an enhanced CBT plus social participation program (n = 86) or standard CBT (n = 86). Both treatments will be delivered during 12 weekly individual sessions utilising structured manuals and workbooks. Participants will be assessed at pre-treatment, post-treatment, and 12-month follow-up. The primary outcome evaluates mean change in clinician-rated diagnostic severity of anxiety and depressive disorders from baseline to post-treatment (primary endpoint) based on a semi-structured diagnostic interview. Secondary outcomes evaluate changes in symptomatology on self-report anxiety and depression measures, as well as changes in social/community participation, social network, and perceived social support, loneliness, quality of life, and use of health services. Economic benefits will be evaluated using a cost-utility analysis to derive the incremental cost utility ratios for the enhanced CBT program. Discussion: Outcomes from this study will provide support for the establishment of improved psychosocial treatment for older adults with anxiety and/or depression. Study outcomes will also provide health systems with a clear means to reduce the impact of poor emotional health in older age and its associated economic burden. In addition to the empirical validation of a novel treatment, the current study will contribute to the current understanding of the role of social participation in older adult wellbeing. Trial registration: Prospectively registered on the Australian New Zealand Clinical Trials Registry (ID: ACTRN12619000242123; registered 19th February 2019) and the ISRCTN registry (ID: ISRCTN78951376; registered 10th July 2019). [ABSTRACT FROM AUTHOR]

Background: Fear appeals are discourses commonly used by teachers to motivate students especially when academic outcomes are paramount. Fear appeals have been associated with better and worse academic performance by the student recipients, with some evidence that fear appeals are detrimental for students who are anxious and have lower self‐efficacy. Little is known about the factors that drive teachers' use of fear appeals beyond a desire to increase motivation to excel. Aims: This study examined the relationship between the use of fear appeals, psychological distress, and self‐efficacy in both teachers and students. Sample: Participants were 377 students (81% female, age range 15 to 18, M = 16.68, SD = 0.49) and 96 teachers (73% female, Mean years teaching = 18.04, SD = 12.39). Methods: Participants completed surveys mid‐way through the first school term of their final year of high school. Student surveys examined student anxiety, depression, stress, self‐efficacy, and experience of teacher fear appeals. Teacher surveys examined teacher anxiety, depression, stress, emotional burnout, self‐efficacy, years of teaching, and use of fear appeals. Results: Teachers use of fear appeals was associated with student distress which was heightened for students with lower academic self‐efficacy. Similarly, teachers' use of fear appeals was associated with higher anxiety and lower self‐efficacy in teachers themselves. Conclusions: Therefore, the use and consequence of fear appeals is strongly linked to both student and teacher self‐efficacy and distress. Given the detrimental impacts of fear appeals on academic performance in vulnerable students, more research is needed on the consequences of fear appeals. [ABSTRACT FROM AUTHOR]

The final year of secondary school has been shown to be associated with heightened student stress. Psychological interventions have been shown to be effective in reducing and preventing distress in students during this school period, although the widespread adoption of these interventions into school settings is limited. There have been recent calls for research to examine the implementation success of evidence‐based programmes when used by schools in school settings. The present study aimed to evaluate the implementation success of an evidence‐based cognitive‐behavioural therapy programme (Study without Stress) using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE‐AIM) framework. At one Australian high school, all tutor group teachers were trained by the school counsellor to deliver the programme in standard school classes to students in the lead up to their final year of secondary school. Students (n = 80) and teachers (n = 11) reported on programme success against the RE‐AIM framework at pre‐intervention, post‐intervention, and three‐month follow‐up. The findings indicated that SWOS was implemented successfully by the school. SWOS was associated with maintaining student stress levels at normal levels over time, as well as reducing the severity of stress for initially highly distressed students. The findings provide evidence from implementation science that SWOS can be adapted and delivered effectively by school staff to manage stress in final year secondary school students. [ABSTRACT FROM AUTHOR]

Purpose: The importance of both frequent and high-quality social connections is widely recognised. Previous reviews of interventions for promoting social connections found mixed results due to the inclusion of uncontrolled studies and merging of objective and subjective dimensions of social connections. This study aimed to compare the effectiveness of interventions designed to promote 'objective social contact' and the 'quality of social connections'; and compare the effectiveness of interventions from different theoretical orientations on these social dimensions through a systematic review and meta-analysis of controlled trials. Methods: A systematic search of electronic databases Medline, Embase, PsycINFO and PubMed was conducted to identify randomised controlled trials of interventions for social isolation, loneliness, social participation and/or social connectedness in adults. Data were analysed using Stata V.16.0. Results: Fifty-eight studies met inclusion criteria (mean age = 62 years). Overall, interventions led to significant improvements in objective social contact (Hedges' g = 0.43) and perceived quality of social connections (Hedges' g = − 0.33). Increasing access to other people was the most effective strategy for promoting objective social contact (Hedges' g = 0.67). Providing adults with skills to manage maladaptive attributional biases, fear-related avoidance of social situations, and barriers to social contact, was the most effective strategy for addressing deficits in perceived quality of social connections (Hedges' g = − 0.53). Conclusion: In summary, different interventions had differential effects on the frequency and quality of social relationships and associated emotional distress. Psychological interventions hold the most promise for increasing meaningful social connections and reducing distress. [ABSTRACT FROM AUTHOR]

Levels of distress, which include stress, depression, and anxiety, are often heightened during the final year of secondary school and have been linked to major examinations that occur during this time period. However, relatively little is known about how these symptoms change over the course of the year or what moderates symptom severity. Using a longitudinal survey design, we tracked student outcomes and potential moderators (i.e., gender, test anxiety, self-efficacy, connectedness with peers, school and family, perceived use of fear appeals by teachers) associated with stress, depression, and anxiety once per term (i.e., 4 times total) over the final year of high school in seven Australian high schools. We hypothesised that student symptoms would increase over time and that symptom severity would be moderated by individual and environmental factors. Six hundred and thirty-eight unique students (M age = 16.95 years, SD = 0.56, range = 15–18 years, female = 474 [74.29%]) participated in at least one of the four surveys administered during each term of the final year of high school. Linear mixed models indicated that stress (d = 0.2) and anxiety (d = 1.7) increased over time. When all potential moderators of distress were entered into the full model, gender, test anxiety, emotional self-efficacy, and peer connectedness were all significant unique predictors of stress. Similar patterns were found for symptoms of depression and anxiety. Time 3 stress was predicted by unique variance in baseline stress, higher test anxiety, and academic self-efficacy. Overall distress increased over time and was moderated by gender, as well as by test anxiety, self-efficacy, and peer connectedness, which are areas that can then be targeted by interventions designed to maintain distress at optimum levels for wellbeing and academic performance. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the authors discuss various topics within the issue, including the social participation of older adults, the benefits of maintaining social support in elderly, and the reintegration of older people into the community after leaving nursing homes.

Research suggests a link between loneliness, depression, and anxiety. Multiple studies have examined treatment programs for loneliness; however, none have examined the efficacy of Cognitive Behavioral Therapy (CBT) for depression and anxiety in reducing loneliness. Change in loneliness in sixty-two older adults (≥60 yrs; 65% female) who took part in a previously reported randomized controlled trial for the treatment of comorbid depression and anxiety was examined. Older adults were randomized to a 12-week group CBT or waitlist control condition. Participants who took part in CBT were followed-up three months later. Linear Mixed Model analyses indicated that after controlling for baseline cognition, depression, and anxiety, participants who completed CBT experienced a significant decrease in loneliness while the control group did not. This reduction was maintained at follow-up. CBT programs for depression and anxiety are likely to be effective at reducing loneliness. This may be due to shared underlying cognitive and behavioral mechanisms between loneliness, depression, and anxiety such as sensitivity to perceived threat and social withdrawal. Further research is needed to understand if specific loneliness interventions are more effective. CBT may be effective at reducing loneliness among older adults with depression and anxiety. [ABSTRACT FROM AUTHOR]

Objectives: Co‐occurring mood and anxiety disorders are common in older adult populations and are associated with worse long‐term outcomes and poorer treatment response than either disorder alone. This systematic review and meta‐analysis aimed to examine the efficacy and effectiveness of psychological interventions for treating co‐occurring mood and anxiety disorders in older adults. Method: The study was registered (PROSPERO CRD4201603834), databases systematically searched (MEDLINE, PSYCINFO, PubMed and Cochrane Reviews) and articles screened according to PRISMA guidelines. Inclusion: Participants aged ≥60 years with clinically significant anxiety and depression, psychological intervention evaluated against control in randomised controlled trial, changes in both anxiety and depression reported at post‐treatment. ResultsFour studies were included (total n = 255, mean age range 67–71 years). Overall, psychological interventions (cognitive behavioural therapy, mindfulness) resulted in significant benefits over control conditions (active, waitlist) for treating depression in the presence of co‐occurring anxiety (Hedges' g = −0.44), and treating anxiety in the presence of depression (Hedges' g = −0.55). However, conclusions are limited; the meta‐analysis was non‐significant, few studies were included, several were low quality and there was high heterogeneity between studies. Benefits at follow‐up were not established. Conclusion: Co‐occurring anxiety and mood disorders can probably be treated simultaneously with psychological interventions in older adults with moderate effect sizes, however, more research is needed. Given comorbidity is common and associated with worse clinical outcomes, more high‐quality clinical trials are needed that target the treatment of co‐occurring anxiety and mood disorders, and report changes in diagnostic remission for both anxiety and mood disorders independently. Key Points: Comorbid anxiety and mood disorders are common in older adults and are associated with worse outcomes than anxiety or mood disorders aloneFew psychological interventions have examined the efficacy of treating co‐occurring mood and anxiety disorders in older adults, and the quality of these studies is mixedLimited evidence suggests that psychological therapy can simultaneously target anxiety and mood disorders with moderate effect sizesSignificantly more research is needed to understand the efficacy of psychological interventions to target comorbid mood and anxiety disorders in older adults [ABSTRACT FROM AUTHOR]

Gynaecological conditions (e.g., endometriosis, PCOS) result in bodily changes that negatively impact body image. Psychological interventions (e.g., CBT, psychoeducation) have shown promise in reviews with the general population for alleviating body image concerns. This systematic review and meta-analysis aims to provide asynthesis of the impact of psychological interventions for reducing body image concerns for individuals with gynaecological conditions. Electronic databases were searched for relevant psychological intervention studies with body image outcomes. Twenty-one eligible studies were included in the systematic review (ten were included in a random-effects meta-analysis). Studies included participants (N = 1483, M = 71.85, SD = 52.79) with a range of gynaecological conditions, ages (Mage = 35.08, SD = 12.17) and cultural backgrounds. Most included studies reported at least one positive effect with the meta-analysis indicating psychological interventions were moderately superior to control conditions for reducing body image concerns (SMD -.41, 95% CI [−0.20 −0.62]). However, there was a high risk of bias and moderate heterogeneity. Results suggest psychological interventions may hold promise for reducing body image concerns among individuals gynaecological conditions in the short term. Further, preliminary support was found for the use of theory-guided psychological interventions delivered in group settings in particular, with further research needed on optimal intervention length and particular psychotherapeutic approach. [ABSTRACT FROM AUTHOR]

Typically students in their final year of school report high levels of anxiety, depression and stress. This study evaluated Study without Stress, a group cognitive behavioural program to reduce student stress. Fifty-six final year students (77% female) from four Australian secondary schools were randomly allocated to Study without Stress delivered by school staff, or to an 8-week usual care condition. Changes in self-reported stress, anxiety, depression, self-efficacy, and teacher reported emotional problems were assessed pre to post-treatment using intent-to-treat analyses. Maintenance of changes were examined 3-months later. Compared to usual care, Study without Stress led to significant reductions in self-reported stress and distress, and increases in self-efficacy that were maintained over time, with no significant changes in anxiety, depression or teacher reported emotional problems. Study without Stress is beneficial for reducing academic stress and improving self-efficacy in final year students when delivered in a school setting. [ABSTRACT FROM AUTHOR]

Heightened academic stress in the final years of schooling is a common concern, yet little is known about how stress changes over time and what individual, school and family factors are associated with distress. We conducted a systematic review to examine the nature of distress in students in their final two years of secondary school. Sixty studies were eligible for inclusion. The main findings indicated severity of distress differed across the 17 countries sampled and measures used. There was some consistencies suggesting about 1 in 6 students experienced excessive distress. Female gender and anxiety proneness were consistently associated with increased distress, and freedom from negative cognitions with reduced distress. There was some evidence that individual characteristics (perfectionism, avoidance, coping, self-efficacy, resilience), lifestyle (sleep, homework), school, family and peer connectedness were associated with distress. Overall at-risk students can be predicted by theoretical models of anxiety and distress targeted with psychological interventions. [ABSTRACT FROM AUTHOR]

Objective: Stepped care models are a possible solution to address service gaps in the provision of psychological therapies for anxiety and/or depression. The benefits may be particularly relevant for people in rural and remote areas and other under‐serviced and/or hard to reach populations, such as older adults. Design: Narrative literature review. Participants: Narrative literature review of the PubMed, Medline, and Psycinfo databases for studies reporting on the results of stepped care psychological interventions for older adults with anxiety and/or depressive symptoms. Main outcomes: Seventy‐seven papers were identified for evaluation of which nine papers met the study criteria (reporting on four individual trials). Results: We identified four controlled studies. Three of the four studies found stepped care intervention to be associated with significantly better clinical outcomes and cost‐effectiveness compared to treatment as usual. Studies primarily targeted subthreshold symptoms, mostly in primary care. Various interventions and stepping models were used. Conclusion: Stepped care has been associated with improved clinical outcomes and costs in older adults, particularly in primary care. There have been no rigorous studies of stepped delivery of psychological interventions to older depressed and anxious adults in alternative settings such as in specialist older adult mental health services or in private clinics. Although the evidence‐base for stepped care interventions is growing, it is not clear what evidence‐based treatment model should be adopted and in what services it could apply. More research is needed. However, the evidence to date is promising and suggests that stepped care approaches are feasible in older adults, and are likely to increase access to high quality interventions for older adults living in rural communities. [ABSTRACT FROM AUTHOR]

Objectives: To determine the feasibility, acceptability and initial efficacy of telephone-delivered cognitive behavioral therapy (CBT) for the treatment of anxiety and depressive symptoms in people with Parkinson's disease. Methods: A small randomized controlled trial compared telephone-based CBT to waitlist control. Eleven participants aged >50 years with Parkinson's disease and anxiety and/or depressive symptoms above recommended clinical cut-offs, were randomized to one of two conditions. Participants completed self-report measures of symptom severity and quality of life. Their carers were invited to participate and completed self-reported measures of symptoms and carer burden. At the end of the 10-week intervention period, participants and carers were reassessed on baseline measures, and again one month later. Results: The CBT program was associated with significantly reduced depressive symptoms (Cohen's d =.90) at post-treatment with gains maintained at one-month follow-up. Anxiety symptom decreases (Cohen's d = 0.36) were not statistically different. Waitlist was associated with significantly worsened anxiety. Carer symptoms also reduced with CBT. No changes on quality of life were found. Good acceptability and feedback was received. Conclusions: Telephone-based CBT reduced symptoms of depression in participants with Parkinson's disease but not anxiety. Clinical Implications: Telephone-based CBT is a promising treatment option. [ABSTRACT FROM AUTHOR]

There is limited research investigating the mechanisms underlying the lower rate of posttraumatic stress disorder (PTSD) in older compared to younger adults. This study examined age differences in peritraumatic and posttraumatic reactions, and the use of two emotion regulation strategies (rumination and positive reappraisal) using a trauma film induction paradigm. Participants (45 older adults and 45 younger adults) watched a trauma film. Eye gaze, Galvanic Skin Response, peritraumatic distress, and emotion regulation were assessed during the film. Participants completed an intrusive memory diary over the next 7 days and follow-up measures of posttraumatic symptoms and emotion regulation. Findings showed no age differences in peritraumatic distress or use of rumination or positive reappraisal during film viewing. Older adults reported lower posttraumatic stress and distress from intrusive memories than younger adults at the 1-week follow-up, despite experiencing a comparable number of intrusions. Rumination was a unique predictor of intrusive and hyperarousal symptoms, after accounting for age. There were no age differences in the use of positive appraisal, and positive reappraisal was not associated with posttraumatic stress. Lower rates of latelife PTSD may relate to decreased use of maladaptive emotion regulation (i.e., rumination), rather than increased use of adaptive emotion regulation strategies (i.e., positive reappraisal). [ABSTRACT FROM AUTHOR]

This article discusses potential adaptations to cognitive behavioral therapy (CBT) needed when working with older adults. Although CBT has been demonstrated to be efficacious in older anxious populations in meta-analyses, more research is needed to better understand the efficacy of CBT for the individual anxiety disorders, for older adults aged 80 years and older, and the efficacy of individual CBT elements. Despite normal age-related reductions in cognitive and physical abilities, most research suggests that only minor adaptations to CBT, if any, are needed for older adults. More significant adaptations relate to therapist attitudes and beliefs rather than the pragmatic CBT delivery, for example, negative attitudes related to aging and the likely benefit of CBT. Despite normal age-related declines in some cognitive domains, research to date suggests that normal cognitive changes do not significantly impact on treatment outcomes over the course of CBT; a case example is presented. [ABSTRACT FROM AUTHOR]

This study compared a single-session intervention of positive reappraisal to cognitive restructuring and supportive counselling to examine whether a brief positive reappraisal intervention could significantly increase positive reappraisal coping and positive emotion and lead to reductions in anxiety and depression. Inclusion criteria were: aged 60 years or older, diagnosed with type 2 diabetes, cognitively intact, and English language proficiency. 81 participants were randomly allocated to a condition and self-report measures of positive reappraisal, emotion, anxiety and depression were compared pre-intervention and at 1-week follow-up. The positive reappraisal intervention led to significantly increased positive reappraisal coping compared to the other two conditions, and significantly higher positive but not negative emotion compared to the control condition. No group differences in anxiety and depression were found. The results indicate that the single-session intervention may be effective for increasing older adults' positive reappraisal coping and specifically their positive emotion when compared to supportive counselling. [ABSTRACT FROM AUTHOR]

Background: Studies examining treatment moderators and mediators in late-life anxiety and depression are sparse. Executive functioning skills decrease with age, and are poorer in the context of anxiety and depression. One of the key cognitive behavioral therapy techniques for anxiety and depression is cognitive restructuring (CR), which teaches people to identify and dispute maladaptive thoughts. There is evidence that cognitive flexibility (CF), one aspect of executive functioning, has a negative impact on CR skill acquisition in nonclinical older adults, and this warrants extension in a clinical sample.Method: This study assessed CR skill acquisition in a clinical sample of 47 older adults with anxiety and depression and 53 nonclinical controls during an experimental paradigm, and investigated the influence of CF on this relationship. A battery of neuropsychological tests assessing CF were administered and CR was learned during a brief intervention.Results: The clinical sample showed poorer CF on some measures, as well as poorer CR quality and efficacy (reduction in subjective distress). CF partially mediated the relationship between clinical status and CR quality, and between clinical status and CR efficacy.Conclusion: These results provide preliminary evidence that older adults with anxiety and depression are worse at learning and benefiting from CR with a brief intervention and this is partially due to having poorer CF skills. These findings warrant further examination in a treatment context to assess whether CR skill acquisition improves over treatment. [ABSTRACT FROM AUTHOR]

Positive reappraisal, a cognitive emotion regulation strategy of identifying personally relevant positive meaning following a stressor, has been demonstrated to be particularly relevant for older adults. However, research has not examined whether this strategy can be taught to older adults to facilitate coping. We examined whether we could increase chronically ill older adults’ use of positive reappraisal and whether it was associated with increased positive emotion and reduced distress. Twenty-six community-dwelling older adults with a current medically diagnosed chronic physical illness perceived to be at least moderately stressful were taught to use positive reappraisal. Participants reported increased positive reappraisal use and emotional well-being, indicating that positive reappraisal can be taught to chronically ill older adults to facilitate coping. [ABSTRACT FROM AUTHOR]

Negative interpretation biases have been associated with clinical depression and anxiety. However, ageing is associated with a positivity effect, in which older adults have a positive interpretation bias compared to younger adults. Few studies have compared interpretation biases in younger and older adults and fewer have made this comparison in clinical samples with anxiety and depression. This study conducted a signal detection analysis to assess differences in interpretation biases to ambiguous sentences in a control and a depressed and anxious sample of younger (18-30 years) and older (60+ years) adults. Participants completed an interpretation bias task in which they were presented with unambiguous neutral sentences and ambiguous sentences related to threat. In addition, participants completed a recognition memory task to assess sensitivity and response biases to threat. Clinical anxiety and depression was associated with a negative interpretation bias; however, there were no significant differences in sensitivity or response bias on the recognition memory task. Older age was associated with a positive interpretation bias. Compared to younger adults, older adults showed a positive interpretation bias for ambiguous sentences, and greater sensitivity towards neutral sentences. In contrast, younger adults showed a negative interpretation bias, as well as a response bias towards threatening sentences. [ABSTRACT FROM AUTHOR]

Loneliness and social isolation are known to be associated with depression, general anxiety, and social anxiety. However, knowledge on the overlapping and unique features of these relationships, while differentiating between social loneliness (perceived absence of an acceptable social network) and emotional loneliness (perceived absence of close connections), is lacking. We constructed a network analysis to examine the relationships between self-reported social loneliness, emotional loneliness, social isolation, depression, general anxiety and social anxiety in a large sample of university students (N = 7314, 67.4 % female, range 16.3–75.8 years, M age = 23.9, SD age = 5.7). Hierarchical regression analyses were used to examine whether depression, general anxiety and social anxiety moderated the relationship between social isolation and loneliness types. As comorbidity between anxiety and depression is high, the role of anxiety as a moderator in the relationship between depression and loneliness types was also examined. The network analysis showed that social loneliness was most strongly explained by social isolation, whereas emotional loneliness was most strongly explained by social anxiety and depression. General anxiety was solely related to loneliness through depression. The regression analyses showed that general and social anxiety and depression did not moderate the relationship between social isolation and loneliness types. Differences found between loneliness types may be influenced by a methodological artifact of the DJGLS. These findings highlight the importance of social anxiety over general anxiety in relation to loneliness. Also, it showed unique relationships for social- and emotional loneliness with psycho-social variables, which has important implications for research- and clinical settings. • Emotional and social loneliness are strongly related. • The network shows the impact of social anxiety over general anxiety on loneliness. • Mental health does not moderate relation between social isolation and loneliness. • Unique relationships for loneliness types may be relevant for clinical practice. [ABSTRACT FROM AUTHOR]

Positive reappraisal is a meaning-based cognitive emotion regulation strategy of identifying positive meaning within negative experiences and is particularly relevant to older adults. There is currently no single accepted self-report measure. We conducted a systematic literature review of existing positive reappraisal self-report measures. Reliability and validity information were reported for all eight measures, with most internal consistency values exceeding .60. However, there were some concerns with factor structure and content validity. After careful review, the Cognitive Emotion Regulation Questionnaire, COPE Inventory and Illness Cognition Questionnaire appear to be the most useful and robust measures of positive reappraisal generally, and are also suitable for older adult samples. A more consistent use of measures in the literature will further positive reappraisal research. [ABSTRACT FROM PUBLISHER]

Objectives:Positive reappraisal is a meaning-based cognitive emotion regulation strategy that is frequently used by older adults to deal with stressors. The strategy involves finding personally relevant positive meaning from an experience in the face of its negative reality. As positive reappraisal has not been previously systematically examined and appears to be particularly relevant to older adults, this paper reviews the research on positive reappraisal in older adult populations. Method:Database searches identified 302 studies, of which 22 addressed positive reappraisal in older adult samples. The findings were categorised into four core themes: use and value for older adults, effects on mental health, benefit for physical illness, and influence of cognitive functioning and gender. Results:The literature indicates that positive reappraisal is an adaptive coping strategy for older adults with wide-ranging benefits. Specifically, positive reappraisal appears to be related to improved mental health for older adults, and particularly in the context of physical illness. Conclusion:Helping older adults find meaning in their negative experiences appears to be a worthwhile research area to pursue. Questions for future research on positive reappraisal in older adulthood are proposed. [ABSTRACT FROM AUTHOR]

Neuropsychological testing currently represents the gold standard in assessing cognitive flexibility. However, this format presents some challenges in terms of time and skills required for administration, scoring, and interpretation. Two self-report measures of cognitive flexibility have been developed to measure aspects of cognitive flexibility in everyday settings, although neither has been validated in an older sample. In this study, we investigated the psychometric properties of 2 self-report measures of cognitive flexibility, the Cognitive Flexibility Inventory (CFI; Dennis & Vander Wal, 2010) and the Cognitive Flexibility Scale (CFS; Martin & Rubin, 1995), against neuropsychological measures of cognitive flexibility in a clinical sample of 47 older adults with comorbid anxiety and depression and a nonclinical sample of 53 community-dwelling older adults. Internal consistency was good for the CFS and CFI in all samples. The clinical sample reported poorer cognitive flexibility than did the nonclinical sample on self-report measures and performed more poorly on some neuropsychological measures. There was evidence of convergent validity between the 2 self-report measures but little relationship between the self-report and neuropsychological measures of cognitive flexibility, suggesting that self-report measures assess a different aspect of cognitive flexibility than does neuropsychological testing. Divergent validity was weak from measures of anxiety and depression in the combined and nonclinical samples but acceptable in the clinical sample. Results suggest that these measures are suitable for use with an older adult sample but do not assess the same aspects of cognitive flexibility as are assessed by neuropsychological assessment. [ABSTRACT FROM AUTHOR]

Objective: This study examined whether differences in habitual negative self-thinking and coping strategies might contribute to the age differences in worry and depression. Method: 60 undergraduate students (age range: 18–24 years, M = 19.10, SD = 1.3) and 45 community-dwelling older adults (age range: 60–89 years, M = 73.5, SD = 7.5) participated. Participants completed self-report measures of worry, depression, negative self-thinking, and coping styles. Results: We replicated previous findings that older adults were less worried and less depressed than younger adults. Older adults also reported engaging in less habitual negative thinking and using more problem solving as a coping strategy than younger adults. Furthermore, negative self-thinking and problem-solving skills were found to partially mediate age differences in worry and fully mediate depression scores. Conclusions: These results suggest that habitual negative thinking and problem-solving skills play a role in explaining the lower rates of worry and depression in older populations. [ABSTRACT FROM AUTHOR]

The Penn State Worry Questionnaire (PSWQ) is a widely used measure of worry severity. An 8-item abbreviated version (PSWQ-A) has been developed as a brief screening measure, although there are limited studies assessing the psychometric properties of this measure in a large geriatric population. The aim of this study was to assess the utility of the PSWQ-A compared to the full PSWQ, to identify pathological worry in an older adult sample ( N = 108) of clinically anxious and depressed older adults, compared to a non-clinical sample ( N = 53). The PSWQ and PSWQ-A were found to have similarly adequate reliability and validity. The factor structure of the PSWQ-A was replicated, but not for the PSWQ. Both measures accurately distinguished between clinical and non-clinical status with similar sensitivity and specificity. These findings indicate the PSWQ-A is a useful measure for screening or epidemiological studies assessing worry in geriatric populations. [ABSTRACT FROM AUTHOR]

Abstract: Anxiety and depression are commonly comorbid in older adults and are associated with worse physical and mental health outcomes and poorer response to psychological and pharmacological treatments. However, little research has examined the effectiveness of psychological programs to treat comorbid anxiety and depression in older adults. Sixty-two community dwelling adults aged over 60 years with comorbid anxiety and depression were randomly allocated to group cognitive behavioural therapy or a waitlist condition and were assessed immediately following and three months after treatment. After controlling for cognitive ability at pre-treatment, cognitive behaviour therapy resulted in significantly greater reductions, than waitlist, on symptoms of anxiety and depression based on a semi-structured diagnostic interview rated by clinicians unaware of treatment condition. Significant time by treatment interactions were also found for self-report measures of anxiety and depression and these gains were maintained at the three month follow up period. In contrast no significant differences were found between groups on measures of worry and well-being. In conclusion, group cognitive behavioural therapy is efficacious in reducing comorbid anxiety and depression in geriatric populations and gains maintain for at least three months. [Copyright &y& Elsevier]

Two case studies by Lundkvist-Houndoumadi and Thastum (2013a, 2013b) describe the use of the Cool Kids cognitive behavioral therapy program for anxious children and their parents, which was conducted at their Clinic at the University of Aarhus in Denmark. In providing our reactions to these two fascinating and illuminating articles, we first familiarize readers with the Cool Kids program, including both its nature, range, and evidence base. This is followed by a discussion of some relevant issues and complications in doing therapy with anxious children that are illustrated by these case studies, including the motivation of both anxious children and their parents; the therapeutic role of exposure to anxious situations; a modular approach to accommodate individual variation; group versus individual format; directly addressing parental anxiety problems; and the cost-effectiveness of treatment. [ABSTRACT FROM AUTHOR]

The article presents a case study which examines potential obstacles to treatment of anxiety disorders in adolescents and user preferences of computer technology. Adolescents that took part in the randomized controlled trial of the Cool Teens anxiety control program engaged in a computerized cognitive-behavioral therapy program for anxiety management. Results suggest that adolescents that took part in the program noticed reductions in the severity of anxiety disorders.

Stress literacy is a term that refers to knowledge about stress and stress management techniques. Levels of stress literacy were examined in more than nine hundred Australian adolescents by providing a short stress-management education session and assessing stress literacy using a pre-post survey design. It was found that while adolescents had a reasonable knowledge of the symptoms of stress and effective stress management techniques, the likelihood of adolescents seeking help for stress or using these stress management techniques was low. The implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

• Stepped-care has been shown to have clinical and cost efficacy in anxiety disorders. • Stepped-care has not been evaluated in anxious youth in real world settings. • Stepped-care was associated with benefits but also significant challenges. Stepped-care (SC) interventions for treating adolescent anxiety have been shown to reduce therapy time and societal costs with similar therapeutic outcomes to best practice when applied in university clinics. This pilot study examined clinical- and cost-effectiveness of SC in two community mental health services. Fifty-three anxious adolescents (aged 12-18 years) were randomly allocated to SC or treatment as usual (TAU). Adolescent- and clinician-rated symptom severity and quality of life collected over time indicated SC used significantly less therapy time, with similar benefits in clinical effectiveness, waiting time and quality adjusted life years. Significant barriers limited engagement with early therapy steps. [ABSTRACT FROM AUTHOR]

The article reviews the software package "The Cool Teens CD-ROM: An Anxiety Management Program for Young People."

Abstract: Two alternative formats of the Schizotypal Personality Questionnaire (SPQ: Raine, 1991) were compared to examine if a Likert format in which SPQ items could be interleaved with other personality measures would promote reporting of symptoms. The Likert versions correlated highly with the standard SPQ (0.88–0.94) and showed better internal reliability compared to the standard version in which three subscales had Cronbach α<0.70. The Likert versions also identified additional high scorers missed by the standard version and so may be desirable when testing relatives of patients with schizophrenia. Norms for the new version administered to 834 subjects are provided. [Copyright &y& Elsevier]

With expected increases in the number of older adults worldwide, the delivery of stepped psychological care for depression and anxiety in older populations may improve both treatment and allocative efficiency for individual patients and the health system. A multisite pragmatic randomised controlled trial evaluating the clinical and cost-effectiveness of a stepped care model of care for treating depression and anxiety among older adults compared to treatment as usual (TAU) will be conducted. Eligible participants (n = 666) with clinically interfering anxiety and/or depression symptoms will be recruited from and treated within six Australian mental health services. The intervention group will complete a low intensity cognitive behavioural therapy (CBT) program: Internet-delivered or using a work-at-home book with brief therapist calls (STEP 1). Following STEP 1 a higher intensity face-to-face CBT (STEP 2) will then be offered if needed. Intention-to-treat analyses will be used to examine changes in primary outcomes (e.g. clinician-rated symptom severity changes) and secondary outcomes (e.g. self-reported symptoms severity, health related quality of life and service utilisation costs). An economic evaluation will be conducted using a cost-utility analysis to derive the incremental cost-effectiveness ratio for the stepped care intervention. This study will demonstrate the relative clinical and economic benefits of stepped care model of psychological care for older adults experiencing anxiety and/or depression compared to TAU. The evaluation of the intervention within existing mental health services means that results will have significant implications for the translation of evidence-based interventions in older adult services across urban and rural settings. Prospectively registered on anzctr.org.au (ACTRN12619000219189) and isrctn.com (ISRCTN37503850). [ABSTRACT FROM AUTHOR]

Background: Current models of loneliness emphasise the role of maladaptive cognitions in causing and/or maintaining loneliness. However, standardised paradigms to experimentally examine the role of maladaptive cognition in loneliness are lacking, making it difficult to establish causality. This paper tested a mock online chat paradigm designed to induce changes in negative affect (loneliness, depression, and anxiety), and strength of belief in lonely thoughts, by manipulating comparative and normative fit.Participants (N = 59) were randomised into either the loneliness arm (i.e., loneliness induction chat followed by a social connectedness induction chat), or the social connectedness arm (i.e., two separate social connectedness induction chats), and subsequently completed outcome measures.The experimental paradigm significantly and specifically increased lonely affect; however, this was associated with non-significant changes in strength of belief in lonely thoughts. The social connectedness induction chat led to significant reductions in broad negative affect for both groups, with these effects accruing across chats for participants in the social connectedness arm.Experimentally manipulating comparative and normative fit to either emphasise differences or similarities between an individual and group members is an effective paradigm for increasing lonely affect or decreasing general negative affect, respectively.Methods: Current models of loneliness emphasise the role of maladaptive cognitions in causing and/or maintaining loneliness. However, standardised paradigms to experimentally examine the role of maladaptive cognition in loneliness are lacking, making it difficult to establish causality. This paper tested a mock online chat paradigm designed to induce changes in negative affect (loneliness, depression, and anxiety), and strength of belief in lonely thoughts, by manipulating comparative and normative fit.Participants (N = 59) were randomised into either the loneliness arm (i.e., loneliness induction chat followed by a social connectedness induction chat), or the social connectedness arm (i.e., two separate social connectedness induction chats), and subsequently completed outcome measures.The experimental paradigm significantly and specifically increased lonely affect; however, this was associated with non-significant changes in strength of belief in lonely thoughts. The social connectedness induction chat led to significant reductions in broad negative affect for both groups, with these effects accruing across chats for participants in the social connectedness arm.Experimentally manipulating comparative and normative fit to either emphasise differences or similarities between an individual and group members is an effective paradigm for increasing lonely affect or decreasing general negative affect, respectively.Results: Current models of loneliness emphasise the role of maladaptive cognitions in causing and/or maintaining loneliness. However, standardised paradigms to experimentally examine the role of maladaptive cognition in loneliness are lacking, making it difficult to establish causality. This paper tested a mock online chat paradigm designed to induce changes in negative affect (loneliness, depression, and anxiety), and strength of belief in lonely thoughts, by manipulating comparative and normative fit.Participants (N = 59) were randomised into either the loneliness arm (i.e., loneliness induction chat followed by a social connectedness induction chat), or the social connectedness arm (i.e., two separate social connectedness induction chats), and subsequently completed outcome measures.The experimental paradigm significantly and specifically increased lonely affect; however, this was associated with non-significant changes in strength of belief in lonely thoughts. The social connectedness induction chat led to significant reductions in broad negative affect for both groups, with these effects accruing across chats for participants in the social connectedness arm.Experimentally manipulating comparative and normative fit to either emphasise differences or similarities between an individual and group members is an effective paradigm for increasing lonely affect or decreasing general negative affect, respectively.Conclusion: Current models of loneliness emphasise the role of maladaptive cognitions in causing and/or maintaining loneliness. However, standardised paradigms to experimentally examine the role of maladaptive cognition in loneliness are lacking, making it difficult to establish causality. This paper tested a mock online chat paradigm designed to induce changes in negative affect (loneliness, depression, and anxiety), and strength of belief in lonely thoughts, by manipulating comparative and normative fit.Participants (N = 59) were randomised into either the loneliness arm (i.e., loneliness induction chat followed by a social connectedness induction chat), or the social connectedness arm (i.e., two separate social connectedness induction chats), and subsequently completed outcome measures.The experimental paradigm significantly and specifically increased lonely affect; however, this was associated with non-significant changes in strength of belief in lonely thoughts. The social connectedness induction chat led to significant reductions in broad negative affect for both groups, with these effects accruing across chats for participants in the social connectedness arm.Experimentally manipulating comparative and normative fit to either emphasise differences or similarities between an individual and group members is an effective paradigm for increasing lonely affect or decreasing general negative affect, respectively. [ABSTRACT FROM AUTHOR]

This paper describes the development and psychometric evaluation of a brief self‐report measure (BEACON) to inform universal mental health screening in schools. Items assess symptoms and impairment associated with anxiety and attention/hyperactivity problems (grades 4–11) as well as depression and eating difficulties (grades 6–11), with optional items for suicidality and self‐harm (grades 7–11). Initial item examination based on Item Response Theory (IRT) and classical test theory involved 3844 students in grades 4 through 11 (Study 1) and identified 18 items for grades 4–5 and 31 items for grades 6–11 that fulfilled pre‐set criteria. Study 2 extended testing with 10,479 students in grades 4–11 and added an additional four items assessing impairment associated with eating difficulties for older students (grades 6–11) creating a total of 35 items for grades 6–11. All items, for both grade‐level versions, met the pre‐set criteria for IRT and classical test theory analysis supporting their strength in the measurement of the dimensions of concern. The measure showed good reliability (subscale alphas.87 to.95). Validity was also demonstrated against standard symptom measures, school grades, school absenteeism, and help‐seeking. The BEACON appears to be a psychometrically sound measure to use in the first stage of school‐based screening for mental health problems. [ABSTRACT FROM AUTHOR]

This study examined the long-term durability of cognitive behaviour therapy (CBT) for older adults with comorbid anxiety and depression 10 years after treatment, in comparison to an active control group. Participants from a randomised controlled trial for older adults with comorbid anxiety and depression (Wuthrich et al., 2016) were re-contacted. Participants had received either group CBT or an active control treatment (Discussion Group). The final sample (N = 54; Aged 70–84, M age = 76.07, SD = 3.83; 59 % of the eligible original sample) completed a diagnostic interview, cognitive assessment and self-report measures of symptoms and quality of life. CBT was associated with significantly improved long-term (10-year) efficacy for reducing anxiety and depression in older adults compared to the Discussion group. Effects included higher rates of remission (58 % remission of all diagnoses vs 27 %, 88 % of all depressive diagnoses vs 54 %, 63 % of all anxiety diagnoses vs 35 %, 67 % of primary diagnosis vs 42 %), lower rates of relapse (25–31 % vs 50–78 %) and lower rates of chronic treatment-resistance (8 % primary disorder vs 39 %, 21 % any disorder vs 58 %). Participants who showed an acute treatment response at post-treatment were 7–9 times more likely to be in remission after 10 years than those with residual symptoms. Results may not generalise to those who do not complete CBT, and the time trajectory of symptom change is unclear. Long-term improvements in symptoms are specific to CBT. Results provide compelling evidence for CBT as an effective and durable treatment for late-life anxiety and depression. • Assessed the durability of CBT among older adults 10 years after treatment • Compared effects to an active control group • CBT was associated with higher remission, lower relapse and chronic non-response. • CBT has long-lasting benefits for anxiety and depression in older adults. [ABSTRACT FROM AUTHOR]

Anxiety disorders are the most prevalent mental disorders experienced by adolescents. As students spend a significant amount of time within a school environment, it is not surprising that factors in the school environment have been linked to student mental health. Positive teacher-student relationships (TSRs) in children have been found to improve student mental health outcomes, with supportive TSRs associated with reduced student anxiety, and in turn, student anxiety has also been associated with reduced poorer TSR quality. The findings in adolescents are less clear. This review aimed to systematically evaluate the impact of TSRs on anxiety in secondary school students, and vice-versa using PRISMA guidelines. Searches were conducted in five databases and studies screened against inclusion and exclusion criteria, and rated for study quality by two independent researchers. Twenty-six studies across 12 countries were included. Most studies reported higher quality TSRs (e.g., those that are perceived as more supportive, caring, and warm) was associated with decreased anxiety. Conversely, TSRs that were characterised by dependence, motivational support, conflict, or harassment, were associated with increased anxiety. Most studies used a cross-sectional design and as such conclusions regarding causality as well as the direction of the effects cannot be made. However, early evidence from a limited number of longitudinal studies indicated that positive TSRs reduced anxiety over time. Future research is warranted to investigate whether anxiety affects TSRs, as well as exploring specific strategies and approaches teachers can use to establish positive relationships with their students. [ABSTRACT FROM AUTHOR]

This qualitative study aimed to identify common stress beliefs. Undergraduate psychology students (N = 35) completed semi-structured interviews discussing the sensations, causes, purpose, valence, consequences, control, and timeline of stress. Interviews were analysed via double-coded thematic analysis employing a latent, inductive, and realist framework. Five themes (cognition, emotion, physical health, interpersonal relations, and behaviour) and 17 subthemes were identified. Themes and subthemes were validated in a Delphi study of experts in stress research (N = 14). Many of these identified beliefs have not been incorporated into current measures of stress beliefs, suggesting the need for new approaches to measuring this construct. [ABSTRACT FROM AUTHOR]

Methods to deliver empirically validated treatments for anxious youth that require fewer therapist resources (low intensity) are beginning to emerge. However, the relative efficacy of low-intensity treatment for youth anxiety against standard face-to-face delivery has not been comprehensively evaluated. Young people aged 6–16 years with a primary anxiety disorder (N = 281) were randomly allocated to treatment delivered either face-to-face or in a low-intensity format. Face-to-face treatment comprised ten, 60-min sessions delivered by a qualified therapist. Low intensity comprised information delivered in either printed (to parents of children under 13) or electronic (to adolescents aged 13 +) format and was supported by up to four telephone sessions with a minimally qualified therapist. Youth receiving face-to-face treatment were significantly more likely to remit from all anxiety disorders (66%) than youth receiving low intensity (49%). This difference was reflected in parents' (but not child) reports of child's anxiety symptoms and life interference. No significant moderators were identified. Low intensity delivery utilised significantly less total therapist time (175 min) than face-to-face delivery (897 min) and this was reflected in a large mean difference in therapy costs ($A735). Standard, face-to-face treatment for anxious youth is associated with significantly better outcomes than delivery of similar content using low-intensity methods. However, the size of this difference was relatively small. In contrast, low-intensity delivery requires markedly less time from therapists and subsequently lower treatment cost. Data provide valuable information for youth anxiety services. Clinical trial registration information: A randomised controlled trial of standard care versus stepped care for children and adolescents with anxiety disorders; https://anzctr.org.au/; ACTRN12612000351819. [ABSTRACT FROM AUTHOR]

Objectives: Social participation has been shown to improve health, well-being, and quality of life in older adults. Previous reviews on social participation have been limited to identifying logistical barriers. The current review sought to examine barriers of social participation more broadly, as well as potential facilitators.Methods: We conducted a systematic review to collate identified barriers and facilitators to social participation in older adults. Seventy-six studies were eligible for inclusion.Results: Four main themes of barriers and facilitators to social participation associated with aging emerged: Demographic factors (such as age and socioeconomic status), Individual/Internal factors (such as motivations and health), Environmental/Infrastructure (such as accessibility, transport, and neighborhood cohesion), and Social Networks (particularly preexisting network size).Conclusions: These findings extended previous reviews to show that personal motivations, preexisting social networks, and neighborhood cohesion play vital roles in improving and maintaining quality social participation. The ability to facilitate this can occur at the individual therapeutic level and at the community level. Clinical implications: The findings highlight the need to consider barriers beyond logistical issues. In particular, healthy aging initiatives may benefit from matching social activities with individual motivations, and preventive measures to establish social networks early in the aging process are important. [ABSTRACT FROM AUTHOR]

Background Individual stress beliefs are associated with stress-related behavioral responses and health consequences. The Common-Sense Model of Self-Regulation may help in understanding the role of stress beliefs in these behavioral responses and consequences. Purpose To synthesize empirical studies exploring the relationship between stress beliefs and stress-related behavioral responses and health consequences using the Common-Sense Model as a guiding framework. Methods Peer-reviewed journal articles on stress beliefs in PsycArticles, PsycINFO, PubMed, Scopus, and Sociological Abstracts were included if they were in English, reported on adult humans. Nineteen of the 1,972 unique articles reporting on 24 studies met inclusion criteria. Study quality was assessed with existing reporting criteria. Results Four of the five Common-Sense Model representations were included across the review studies, namely Identity, Cause, Consequences, and Control. Consequences and Control-related stress beliefs are associated with stress-based health and behavioral outcomes. One study explored Identity-related stress beliefs with health outcomes, reporting no relationship. No study assessed the relationship between Cause-related stress beliefs and behaviors or health outcomes. No study has explored any aspect of Timeline-related stress beliefs. Study quality ranged from very low to very high. Conclusions There is limited evidence exploring stressrelated beliefs and behaviors and health outcomes. According to the Common-Sense Model, the Timeline representations remains to be investigated in the stress context, and Identity and Cause are under-researched. This review highlights future directions for stress beliefs research. [ABSTRACT FROM AUTHOR]

Objectives: One major obstacle to the diagnosis and treatment of specific phobias in later life is the lack of assessment tools that are relevant to the fears of older adults. This study investigated the utility of five reliable subscales (Blood/Injury, Agoraphobia, Aggression, Animal/Insect, Social Fears) derived from the Fear Survey Schedule-III, a popular measure of phobic fear, in discriminating older from younger participants. Method: The sample was comprised of 81 younger and 61 older adults who completed self-report measures of anxiety and depression and neuropsychological tests. Results: Older adults scored significantly higher than their younger counterparts only on the Aggression subscale of the FSS-III; whereas younger adults scored significantly higher than the older group only on the Social Fears subscale. These subscales showed slightly different associations with other measures of anxiety, depression, and intelligence across age groups. Within the older sample, scores on the Aggression subscale were significantly higher than all other subscales except for Social Fears. Conclusions: It is recommended that clinicians and researchers use subscale scores derived from the FSS-III, rather than total scores, when treating and studying fears of later life. Clinical Implications: Use of FSS-III subscales in assessment could result in improved detection and treatment of phobias in later life, and thus raise quality of life among the elderly. Older adults' fears of victimization should be prioritized as a possible treatment target in clinical settings. [ABSTRACT FROM AUTHOR]

Abstract Objective This paper aims to systematically review and synthesize existing empirical evidence examining the factors related to interindividual differences in stressor appraisals (i.e., perceived challenge and threat). Method Studies were identified in PsycINFO, Scopus, Psychological and Behavioral Sciences Collection, and Medline databases (1980-March 2017). Only empirical studies assessing constructs theorized to influence stressor appraisals were included. Results Of the 1956 identified articles, 11 studies reported in 12 articles assessing six constructs met inclusion criteria: Emotional intelligence, Big Five personality traits, anxiety, stress mindset, just world beliefs, and perfectionism. Stronger challenge appraisals were associated with higher emotional intelligence, lower neuroticism, higher extraversion, and more positive beliefs about the consequences of feeling stressed. Weaker threat appraisals were associated with lower neuroticism, and higher emotional intelligence, agreeableness, extraversion, and openness, stronger beliefs that the world is a just and fair place, and lower perfectionistic concerns and greater perfectionistic striving. Anxiety was unrelated to appraisals. Conclusion This review identified factors associated with interindividual differences in stressor appraisals, with some factors related to challenge appraisal but not threat appraisal, and vice versa. This suggests a potentially complex interplay between personality and appraisals. Highlights • There are interindividual differences in the way stressful events are appraised. • This review collates factors related to these interindividual differences. • Eleven studies reporting on six different factors met inclusion criteria. • Very few of the identified factors have been replicated or confirmed. • Some factors related to challenge appraisal but not threat, and vice versa. [ABSTRACT FROM AUTHOR]