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- All Subjects: treatment
- Creators: Adams, James
- Creators: MacKinnon, David
Description
Anxiety and depression are among the most prevalent disorders in youth, with prevalence rates ranging from 15% to 25% for anxiety and 5% to 14% for depression. Anxiety and depressive disorders cause significant impairment, fail to spontaneously remit, and have been prospectively linked to problematic substance use and legal problems in adulthood. These disorders often share a high-degree of comorbidity in both clinical and community samples, with anxiety disorders typically preceding the onset of depression. Given the nature and consequences of anxiety and depressive disorders, a plethora of treatment and preventative interventions have been developed and tested with data showing significant pre to post to follow-up reductions in anxiety and depressive symptoms. However, little is known about the mediators by which these interventions achieve their effects. To address this gap in the literature, the present thesis study combined meta-analytic methods and path analysis to evaluate the effects of youth anxiety and depression interventions on outcomes and four theory-driven mediators using data from 55 randomized controlled trials (N = 11,413). The mediators included: (1) information-processing biases, (2) coping strategies, (3) social competence, and (4) physiological hyperarousal. Meta-analytic results showed that treatment and preventative interventions reliably produced moderate effect sizes on outcomes and three of the four mediators (information-processing biases, coping strategies, social competence). Most importantly, findings from the path analysis showed that changes in information-processing biases and coping strategies consistently mediated changes in outcomes for anxiety and depression at both levels of intervention, whereas gains in social competence and reductions in physiological hyperarousal did not emerge as significant mediators. Knowledge of the mediators underlying intervention effects is important because they can refine testable models of treatment and prevention efforts and identify which anxiety and depression components need to be packaged or strengthened to maximize intervention effects. Allocating additional resources to significant mediators has the potential to reduce costs associated with adopting and implementing evidence-based interventions and improve dissemination and sustainability in real-world settings, thus setting the stage to be more readily integrated into clinical and non-clinical settings on a large scale.
ContributorsStoll, Ryan (Author) / Pina, Armando A (Thesis advisor) / MacKinnon, David (Committee member) / Knight, George (Committee member) / Arizona State University (Publisher)
Created2015
Description
As the prevalence and awareness of Autism Spectrum Disorder (ASD) increases, so does the variety of treatment options for primary symptoms (social interaction, communication, behavior) and secondary symptoms (anxiety, hyperactivity, GI problems, and insomnia). Various treatments, from Adderall to Citalopram to Flax Seed Oil promise relief for these symptoms. However, very little research has actually been done on some of these treatments. Additionally, the research that has been done fails to compare these treatments against one another in terms of symptom relief. The Autism Treatment Effectiveness Survey, written by Dr. James Adams, director of the Autism/Asperger's Research Program at ASU, and graduate student/program coordinator Devon Coleman, aims to fill this gap. The survey numerically rates medications based on benefit and adverse effects, in addition to naming specific symptoms that are impacted by the treatments. However, the survey itself was retrospective in nature and requires further evidence to support its claims. Therefore, the purpose of this research paper is to evaluate evidence related to the results of the survey. After the performing an extensive literature review of over 70 different treatments, it appears that the findings of the Autism Treatment Effectiveness Survey are generally well supported. There were a few minor discrepancies regarding the primary benefitted symptom, but there was not enough of a conflict to discount the information from the survey. As research is still ongoing, conclusions cannot yet be drawn for Nutritional Supplements, although the current data looks promising.
ContributorsAnderson, Amy Lynn (Author) / Adams, James (Thesis director) / Coleman, Devon (Committee member) / School of Nutrition and Health Promotion (Contributor) / W.P. Carey School of Business (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
Autism Spectrum Disorder is a disorder that makes learning, socializing and daily living much more challenging for affected children and adults because of their atypical behaviors. A few examples of these behaviors are repetitive movements, impulsive actions, inability to communicate in a social setting, and many more. There is a stigma behind autism that is caused by those who are not well informed on the disorder. These people lack information, and in the past, it was assumed that the disorder is caused by "bad parenting." The parents are then afraid of social shame brought upon them by their child and neglect or avoid a diagnosis for their child's disorder. This becomes a vicious cycle that has negative effects on the affected individuals and their loved ones. Neglect of a diagnosis may also be caused by misinformation interpreted by the parents as their child develops. The parents do not realize this child developing outside of normal behavioral patterns. Years of research have been done to attempt to alleviate the symptoms of autism and cure the disorder. The Autism and Asperger's Program at ASU has developed a year-long dietary plan that increases supplementation to alleviate nutritional deficiencies in participants with autism. These deficiencies include vitamins, minerals, essential fatty acids, sulfate, carnitine, and digestive enzymes such as sucrase, maltase, and lactase. The participants were also put on a gluten-free casein-free diet toward the end of the study. To test the effectiveness of the treatment, the Severity of Autism Scale (SAS) and Social Responsiveness Scales (SRS) were used. The SAS tested the overall severity of ASD participants by rating them from one to ten, ten being "very severe" in terms of ASD symptoms. The results of this scale were compared at the beginning of the study (day 0) and at the end of the study (day 365). The SRS tested the social responsiveness of participants in the form of overall SRS and five subscales that included awareness, cognition, communication, motivation, and mannerisms. These results were also compared at the beginning and end of the study. After analysis of the data, there seemed to be no correlation between age and severity of autism/social responsiveness of participants. There was also no statistically significant data to suggest that there was a correlation between gender and severity of autism/social responsiveness of participants. However, there was statistically significant evidence that the treatment group did improve over the non-treatment/delayed treatment group in both the SAS and SRS. Neither age nor gender had a significant effect on the effectiveness of the treatment. These positive findings suggest that the integrated dietary
utritional therapy was beneficial, and future research on dietary treatments for autism and other disorders is recommended. This may also further discoveries of affected epigenomes with regards to nutritional treatments in disorders like ASD. The epigenome is the methylation and demethylation of the genome that mediates gene expression.
utritional therapy was beneficial, and future research on dietary treatments for autism and other disorders is recommended. This may also further discoveries of affected epigenomes with regards to nutritional treatments in disorders like ASD. The epigenome is the methylation and demethylation of the genome that mediates gene expression.
ContributorsGutgsell, Crystal Megan (Author) / Adams, James (Thesis director) / Pollard, Elena (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
There is a need to reinvent evidence-based interventions (EBIs) for pediatric anxiety problems to better address the demands of real-word service delivery settings and achieve public health impact. The time- and resource-intensive nature of most EBIs for youth anxiety has frequently been noted as a barrier to the utilization of EBIs in community settings, leading to increased attention towards exploring the viability of briefer, more accessible protocols. Principally, this research reports between-group effect sizes from brief-interventions targeting pediatric anxiety and classifies each as well-established, probably efficacious, possibly efficacious, experimental, or questionable. brief interventions yielded an overall mean effect size of 0.19 on pediatric anxiety outcomes from pre to post. Effect sizes varied significantly by level of intervention: Pre to post-intervention effects were strongest for brief-treatments (0.35), followed by brief-targeted prevention (0.22), and weakest for brief-universal prevention (0.09). No participant or other intervention characteristic emerged as significant moderators of effect sizes. In terms of standard of evidence, one brief intervention is well-established, and five are probably efficacious, with most drawing on cognitive and behavioral change procedures and/or family systems models. At this juncture, the minimal intervention needed for clinical change in pediatric anxiety points to in-vivo exposures for specific phobias (~3 hours), cognitive-behavioral therapy (CBT) with social skills training (~3 hours), and CBT based parent training (~6 hours, eight digital modules with clinician support). This research concludes with a discussion on limitations to available brief EBIs, practice guidelines, and future research needed to capitalize on the viability of briefer protocols in enhancing access to, and impact of, evidence-based care in the real-world.
ContributorsStoll, Ryan (Author) / Pina, Armando A. (Thesis advisor) / Gonzales, Nancy (Committee member) / MacKinnon, David (Committee member) / Perez, Marisol (Committee member) / Arizona State University (Publisher)
Created2019