Anxiety Research Today is a free monthly online journal that collates and summarizes the latest research about Anxiety, including details on anxiety disorder, panic attacks, medication, counselling, therapy.

Effectiveness of a web-based self-help intervention for symptoms of depression, anxiety, and stress: randomized controlled trial.

van Straten A, Cuijpers P, Smits N

FPP, Department of Clinical Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands. a.van.straten@psy.vu.nl

BACKGROUND: Self-help therapies are often effective in reducing mental health problems. We developed a new Web-based self-help intervention based on problem-solving therapy, which may be used for people with different types of comorbid problems: depression, anxiety, and work-related stress. OBJECTIVE: The aim was to study whether a Web-based self-help intervention is effective in reducing depression, anxiety, and work-related stress (burnout). METHODS: A total of 213 participants were recruited through mass media and randomized to the intervention (n = 107) or a waiting list control group (n = 106). The Web-based course took 4 weeks. Every week an automated email was sent to the participants to explain the contents and exercises for the coming week. In addition, participants were supported by trained psychology students who offered feedback by email on the completed exercises. The core element of the intervention is a procedure in which the participants learn to approach solvable problems in a structured way. At pre-test and post-test, we measured the following primary outcomes: depression (CES-D and MDI), anxiety (SCL-A and HADS), and work-related stress (MBI). Quality of life (EQ-5D) was measured as a secondary outcome. Intention-to-treat analyses were performed. RESULTS: Of the 213 participants, 177 (83.1%) completed the baseline and follow-up questionnaires; missing data were statistically imputed. Of all 107 participants in the intervention group, 9% (n = 10) dropped out before the course started and 55% (n = 59) completed the whole course. Among all participants, the intervention was effective in reducing symptoms of depression (CES-D: Cohen's d = 0.50, 95% confidence interval (CI) 0.22-0.79; MDI: d = 0.33, 95% CI 0.03-0.63) and anxiety (SCL-A: d = 0.42, 95% CI 0.14-0.70; HADS: d = 0.33, 95% CI 0.04-0.61) as well as in enhancing quality of life (d = 0.31, 95% CI 0.03-0.60). Moreover, a higher percentage of patients in the intervention group experienced a significant improvement in symptoms (CES-D: odds ratio [OR] = 3.5, 95% CI 1.9-6.7; MDI: OR = 3.7, 95% CI 1.4-10.0; SCL-A: OR = 2.1, 95% CI 1.0-4.6; HADS: OR = 3.1, 95% CI 1.6-6.0). Patients in the intervention group also recovered more often (MDI: OR = 2.2; SCL-A: OR = 2.0; HADS < 8), although these results were not statistically significant. The course was less effective for work-related stress, but participants in the intervention group recovered more often from burnout than those in the control group (OR = 4.0, 95% CI 1.2-13.5). CONCLUSIONS: We demonstrated statistically and clinically significant effects on symptoms of depression and anxiety. These effects were even more pronounced among participants with more severe baseline problems and for participants who fully completed the course. The effects on work-related stress and quality of life were less clear. To our knowledge, this is the first trial of a Web-based, problem-solving intervention for people with different types of (comorbid) emotional problems. The results are promising, especially for symptoms of depression and anxiety. Further research is needed to enhance the effectiveness for work-related stress. TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number (ISRCTN) 14881571.

Published 26 March 2008 in J Med Internet Res, 10(1): e7.
Full-text of this article is available online (may require subscription).

Articles on Anxiety published 19 March 2008:

Big fish in big ponds: a multilevel analysis of test anxiety and achievement in special gifted classes.   Anxiety Stress Coping, 21(2): 185-98.

This study analyzes the effects of individual achievement and achievement level of student reference group on test anxiety in a national sample of 769 gifted Israeli students (grade levels 4-9), which was previously investigated by Zeidner and Schleyer (1999a). We hypothesized that when controlling for individual achievement, students' experiences of test anxiety should increase with the increasing ability level of their peer reference group. It was assumed that this effect was largely mediated ... [Abstract] [Full-text]

Evaluation of a brief aerobic exercise intervention for high anxiety sensitivity.   Anxiety Stress Coping, 21(2): 117-28.

Anxiety sensitivity, or the belief that anxiety-related sensations can have negative consequences, has been shown to play an important role in the etiology and maintenance of panic disorder and other anxiety-related pathology. Aerobic exercise involves exposure to physiological cues similar to those experienced during anxiety reactions. The present study sought to investigate the efficacy of a brief aerobic exercise intervention for high anxiety sensitivity. Accordingly, 24 participants with ... [Abstract] [Full-text]

Articles on Anxiety published 17 March 2008:

Marked for life? Effects of early cage-cleaning frequency, delivery batch, and identification tail-marking on rat anxiety profiles.   Dev Psychobiol, 50(3): 266-77.

Daily handling of preweanling rats reduces their adult anxiety. Even routine cage-cleaning, involving handling, reduces adult anxiety compared with controls. Cage-cleaning regimes differ between animal breeders, potentially affecting rodent anxiety and experimental results. Here, 92 adult male rats given different cage-cleaning rates as pups, were compared on plus-maze, hyponeophagia, corticosterone, and handling tests. They were pair-housed and half were tail-marked for identification. ... [Abstract] [Full-text]

Articles on Anxiety published 12 March 2008:

A preliminary investigation of the relationship of dental fear to other specific fears, general fearfulness, disgust sensitivity and harm sensitivity.   Community Dent Oral Epidemiol, 36(2): 128-36.

OBJECTIVES: People with dental fear often suffer from other psychological disorders, as well as from a number of other specific fears. Fear of going to the dentist may be associated not only with general fearfulness, but also with underlying personality dispositions. This exploratory study, therefore, investigated the associations between dental fear and 67 other specific fears, general fearfulness, disgust sensitivity and harm sensitivity. METHODS: Participants were 88 Australian adults who ... [Abstract] [Full-text]

Articles on Anxiety published 10 March 2008:

Anxiety and salivary cortisol levels in patients with burning mouth syndrome: case-control study.   Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 105(4): 460-5.

OBJECTIVE: The objective of this study was to evaluate the anxiety and salivary cortisol levels in patients with burning mouth syndrome. STUDY DESIGN: A case-control ed into 2 groups: BMS, with diagnosis of the syndrome, and control, without any complaint of burning mouth. Anamnesis, oral examination, sialometry, the application anxiety inventory, and 3 saliva samples for cortisol analysis were done in every patient. RESULTS: Statistical difference for subjective xerostomia was found on the BMS ... [Abstract] [Full-text]

Articles on Anxiety published 7 March 2008:

Factor structure of the Hospital Anxiety and Depression Scale in coronary heart disease patients in three countries.   J Eval Clin Pract, 14(2): 281-7.

BACKGROUND: Depression and anxiety in patients with coronary heart disease (CHD) is associated with a poorer prognosis. Therefore, the screening for psychological distress is strongly recommended in cardiac care and rehabilitation. The Hospital Anxiety and Depression Scale (HADS) is a widely used screening tool that has demonstrated good sensitivity and specificity for mental disorders. The factor structure of the HADS was investigated in CHD populations across three countries (Germany, Hong ... [Abstract] [Full-text]

Articles on Anxiety published 3 March 2008:

Duloxetine for premenstrual dysphoric disorder: a pilot study.   Expert Opin Pharmacother, 9(4): 517-21.

OBJECTIVE: Premenstrual dysphoric disorder (PMDD) is a complex clinical syndrome that is notoriously difficult to treat. The purpose of the present study was to provide preliminary data on the effectiveness of duloxetine in PMDD. RESEARCH DESIGN AND METHODS: Fifty-five women with PMDD were treated with a 60 mg/day dosage of duloxetine for two menstrual cycles. Responses were assessed at first and second treatment cycle. MAIN OUTCOME MEASURES: Outcome measures included a visual analogue scale, ... [Abstract] [Full-text]

Articles on Anxiety published 29 February 2008:

Suspicious findings in antenatal care and their implications from the mothers' perspective: a prospective study in Germany.   Birth, 35(1): 41-9.

BACKGROUND: Antenatal care services are well established in Germany, with at least 10 routine antenatal consultations per pregnancy. Although many individual antenatal screening procedures and tests have been assessed in clinical trials, little is known about the overall prevalence of suspicious findings in routine antenatal surveillance and about related effects on psychological maternal well-being. The objectives of this study were to evaluate the views of pregnant women on prevalence, type, ... [Abstract] [Full-text]

© 2004-2008 Anxiety Research Today. All Rights Reserved.