Generalized Anxiety Disorder 1
Running Head: Generalized Anxiety Disorder
Literature Review on Generalized Anxiety Anxiety Disorder Arianne (J’Nae) Broadnax a!e "orest #niversity
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, Abstract
Anxiety disorders -ave .e/o0e 0ore 1revalent2 /onsidering t-e /-anges wit-in so/iety over t-e years3 -e i01a/t o4 so/iety on /-ildren and adoles/ents -as instigated t-e rise in anxiety disorders .eing diagnosed a0ong t-is 1o1ulation3 -e /lassi4i/ation o4 Anxiety disorders /urrently listed in t-e D*567 (A8A2 (A8A2 ,9;) are Generalized Anxiety disorder GAD)2 *e1aration Anxiety Anxiety Disorder (*AD)2 ( *AD)2 *ele/tive 5utis0 (*5)2 *o/ial Anxiety Disorder (also identi4ied as
uently diagnosed disorders in /-ildren and adoles/ents (5i/-ael2 8ayne2 ? Al.rig-t2 ,9,)3 -is review will atte01t to in/rease !nowledge o4 e44e/tive interventions 1arti/ularly geared toward redu/ing t-e *N* (sy01at-eti/ nervous syste0) res1onse3 +ne intervention o4 1arti/ular interests is relaxation t-era1y (guided=visual i0agery=0editation2 i0agery=0editation2 1rogressive relaxation) use4ul in redu/ing sy01to0s in /-ildren and adoles/ents3 adoles/ents3 -e overall goal o4 t-is literature review is to note t-e eviden/e eviden/e to su11ort t-e use o4 relaxation .ased interventions wit- /-ildren=adoles/ents2 /-ildren=adoles/ents2 1rovide diagnosti/ /riteria 4or GAD s1e/i4i/ally 4or 4or -ow GAD 0ani4ests in /-ildren3 /-ildren3 -is do/u0ent also also in/ludes detailed 0et-ods used 4or resear/-ing t-e literature on t-is to1i/2 results indi/ating t-e e44e/ts o4 relaxation .ased t-era1ies on /-ildren wit- Generalized Anxiety Disorder3
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; Introduction
oday’s so/iety -as .roug-t a.out nu0erous /-anges in t-e way o4 -u0an li4e3 $xa01les o4 t-e so/ietal /-anges o//urring wit-in t-e 1ast 9 years= sin/e t-e 0illenniu0 are t-e advan/es in te/-nology2 environ0ental /-anges su/- as glo.al war0ing2 4o/us on energy /onservation2 to 0ore 1ersonal 0eans o4 ta!ing res1onsi.ility res1onsi.ility 4or one’s -ealt- wit- t-e rise o4 organi/ 1rodu/tion 1rodu/tion o4 4oods3 Alt-ougAlt-oug- our so/iety -as its s-are o4 /onstru/tive out/o0es2 un/onstru/tive /-anges -ave and /ontinue to o//ur3 -ere -as .een a signi4i/ant in/reases in t-e a 0ount o4 so/ietal stressors su/- as t-e rise in natural disasters2 t-reats o4 terroris02 in/reased violen/e=/ri0e2 /onstant rising divor/e rates leading to dys4un/tional 4a0ilies2 4inan/ial de4i/its leading to an e/ono0y in a re/ession w-i/- all i01a/t -ow individuals live and 0ost o4 all /o1e3 Glaring t-roug- t-e t-e s/o1e o4 0ental -ealt-2 -ealt-2 t-ese stressors -ave i01a/ted i01a/ted not only adults adults .ut yout- as well to a su.stantial a0ount3 @-ild-ood is t-e new 4a/e o4 anxiety3 *tatisti/s s-ow t-at anxiety disord disorders ers o//ur o//ur in a11rox a11roxi0a i0ately tely 9 o4 /-ildr /-ildren en (e>ual (e>ually ly in .oys .oys and girls) girls) .e4ore .e4ore t-e stage stage o4 1u.es/en/e (5anassis2 ,99)2 0eaning onset o//urs in /-ild-ood3 7iewing 7iewing t-e /ourse o4 /-ild develo10ent into adoles/en/e2 additional so/ietal stressors are a//u0ulate2 -owever t-e 4o/us s-i4ts to in/reased a/ade0i/=so/ietal 1ressure6 relations-i1=gender stressors2 /-anges in 1-ysi/al a11earan/e2 and 1er4or0an/e 1ressures3 C%4 le4t untreated2 anxiety anxiety /an /ause ongoing di44i/ulties di44i/ulties into adult-ood 1otentially 1otentially in/r in/rea easi sing ng t-e t-e ris! ris!ss 4or 4or de1r de1res essi sion on22 su.s su.sta tan/ n/ee a.us a.use2 e2 and and li0i li0ita tati tion onss in rea/ rea/-i -ing ng edu/ edu/at atio iona nall 1otential2(5i/-ael2 1otential2(5i/-ael2 et3al3 ,9,)3
-e 4a/tors 1reviously listed -ave all /ontri.uted to t-e in/rease
/-ildren ex1erien/ing anxiety sy01to0s3 Generalized Anxiety Disorder is one o4 t-e 0ental -ealt- disorders 0ost /o00only diagnosed in /-ildren /-ildren a44e/ting a44e/ting ; o4 /-ildren /-ildren and 93E o4 adoles/ents adoles/ents (5i/-ael (5i/-ael et3al2 ,9,)3 ,9,)3 Due to t-e rise in diagnosis2 a su00ons -as .een 1la/ed on t-e needs 4or early intervention w-i/- usually .egins wit- t-e 4a0ily noting /-allenges 4ollowed .y a visit to t-eir 1ediatri/ 1ri0ary /are o44i/e (Brewer ? *arvet2 ,9)3 Based on an arti/le in t-e 8ediatri/ Annals2 Annals2 e01-asis -as .een 1la/ed on Anxiety Disorders .eing
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treated in an out1atient setting (Brewer ? *arvet2 ,9)3 +t-er 4a/tors t-at i01a/t diagnosis in/lude t-e 4a/t t-at Generalized Anxiety Disorder is o4ten /o60or.id2 0eaning in order to deter0ine an a//urate diagnosis diagnosis22 rule outs 4or /on/urrent /on/urrent illnesses illnesses and ot-er ot-er /onsider /onsideration ationss (i3e32 environ0 environ0ental ental stressors2 stressors2 ex1osure ex1osure to trau0a2 trau0a2 1-ysi/al 1-ysi/al illnesses illnesses22 grie4 related issues2 issues2 de1ressio de1ression2 n2 sti0ulant sti0ulant 0edi/ations) 0edi/ations) 0ust trans1ire2 (5anasiss2 ,99)3 -ese 4a/tors also 0a!e it 0u/- 0ore di44i/ult to assess2 diagnose and treat generalize generalized d anxiety disorder disorder in /-ildren3 /-ildren3 $01-asis $01-asis is now s-i4ting s-i4ting 4ro0 diagnosis diagnosis to treat0ent treat0ent wit 1ro4essionals dee0ing to learn e44e/tive te/-ni>ues or interventions to .e used wit- /-ildren diagnosed wit- Generalized Anxiety Disorder3 -e signi4i/an/e o4 t-e rise in GAD and /ontri.uting 4a/tors t-at i01a/t a//ura/y in diagnosing 0a!es e44e/tive treat0ents or interventions a 0ust 4or 1ro4essionals wor!ing in t-e 4ield o4 0ental -ealt-3 -e /-allenge is to un/over t-e interventions to address so0e o4 t-e 1-ysi/al and /ognitive sy01to0s o4 Generalized Anxiety Anxiety resulting in -eig-tened *N* 1-ysiologi/al res1onses2 (5anasiss2 ,99)3 +ne intervention t-at /ould 1rove 1ro0ise in t-e treat0ent o4 GAD in/ludes relaxation .ased t-era1y in/luding guided i0agery2 i0agery2 0editation and 0ind4ulness .ased a11roa/-es3 Are relaxation .ased interventions e44e/tive e44e/tive in t-e redu/tion o4 s y01to0s o4 Generalized Anxiety DisorderF Reviewing t-e /urrent literature will .e su.stantial in deter0ining t-e answers to t-is >uestion3
Methods
-e initial 1ro/ess o4 /ondu/ting t-e literature review involved learning a.out 4oundational ele0ents o4 literature reviews 4ro0 @reswell’s $du/ational $du/ational Resear/- ext.oo!2 ext.oo!2 /-a1ter ;3 %nitial resear/was /ondu/ted on Generalized Anxiety Disorder in relation to /-ildren2 ? adoles/ents wit- regards to t-e e44e/tiveness o4 relaxation t-era1y3 Resear/- on GAD and Relaxation t-era1ies originated wit- a!e "orest &3 *0it- Reynolds Li.rary3 *1e/i4i/ 1ara0eters were instituted as 1art o4 t-e 0et-od to /ondu/ting resear/- o4 t-e literature3
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"irst 1riorities were to /onsider re4eren/e sour/es su/- as various data.ases to lo/ate ournal arti/les2 1eer reviews2 e6.oo!s et/3 *1e/i4i/ data.ases identi4ied and utilized to resear/- literature in/luded2 PsychInfo, ERIC, PubMed & ProQuest. ProQuest. Next ste1s in/luded identi4ying !ey words words to 4a/ilitate t-e sear/sear/- o4 arti/les2 1eer reviews or e6.oo!s related related to t-e to1i/ o4 Generalized Generalized Anxiety Anxiety Disorder in/luding in/luding using !ey /on/e1ts /on/e1ts 4ro0 t-e resear/- to1i/3 Iey words in/luded: /-ildren ? anxiety 1sy/-o6t-era1y 1sy/-o6t-era1y relaxation guided=visual i0agery /-ild-ood anxiety generalized anxiety disorder and alternative t-era1ies3 o /ondu/t 4urt-er resear/- on t-is to1i/2 ex1ansions to .roader sear/-es using !ey words o42 eviden/e .ased treat0ents relaxation 0ind4ulness a11roa/-es 0ental -ealt- stress 0anage0ent relaxation res1onse 1rogressive 0us/le relaxation relaxation 0ind .ody t-era1ies and i0agination i0agination were also in/luded3 in/luded3 @o0.inations o4 t-ese words were also in/or1orated to 0axi0ize sear/- 1otential3 Restri/tions Restri/tions were also /onsidered 4or arti/les or .oo!s wit-in t-e ti0e 1eriods o4 ,9996,9; and re>uire0ents 4or 4ull6text versions o4 t-e arti/le were instituted in order to -ave 4ull a//ess to t-e in4or0ation3 *trategies t-at were noted to .e use4ul in t-e sear/- o4 arti/les in/luded ex1anding t-e s/o1e to in/lude /urrent e44e/tive treat0ents su/- as @ognitive Be-avioral -era1y on/e a /o00on t-e0e was noted a0ong t-e t-e literature arti/les arti/les reviewed3 Notation o4 any re4eren/es to t-e use or in/or1oration in/or1oration o4 !ey ter0s su/- as relaxation2 guided i0agery2 0editation were /onsidered wit-in t-e literature2 due to t-e /-allenges wit- lo/ating /urrent s1e/i4i/ in4or0ation using s1e/i4i/ !ey words6 /-ild-ood anxiety disorder and relaxation t-era1y3 t-era1y3 5ost in4or0ation was gained t-rougt-roug- reviewing Pro-Quest Pro-Quest and ERIC. +t-er strategies in/luded reviewing t-e arti/les 4or 4urt-er 1otential in4or0ation related to t-e resear/>uestion3 Arti/les were saved 4or evaluation evaluation in de1t- reading over t-e /ourse o4 /o01leting t-e review to deter0ine t-eir /redi.ility as relia.le relia.le sour/e using t-e strategies o4 @RAA8 0et-od3 0et-od3 Arti/les were grou1ed into /ategories 1ertaining to t-eir relations-i1 to t-e resear/- to1i/ o4 relaxation t-era1y
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interventions .eing use4ul in redu/ing sy01to0s in /-ildren and adoles/ents3 Literature 0a11ing was also e44e/tive in grou1ing arti/les .ased on t-eir to1i/s3 *o0e arti/les 1reviously in/luded wit-in t-e /ontext o4 t-e literature review were dis/arded due to li0ited in4or0ation 1ointing to t-e resear/- to1i/3 -e .rea!down o4 t-e arti/les into /ategories /on/luded t-ree arti/les 4o/using on relaxation and 0edi/ation te/-ni>ues used wit- /-ildren=adoles/ents3 -ree arti/les reviewed revealed i01li/ations 4or relaxation=0editation relaxation=0editation .eing used wit-in t-e a/ade0i/=s/-ool settings as a 0eans to redu/e=stress and anxiety a0ong students wit- so0e e01-asis on 0inorities3 -ree arti/les 4o/used on s1e/i4i/s 4or use o4 0editation=0ind4ulness 0editation=0ind4ulness .ased a11roa/-es to redu/e anxiety levels3 levels3 -ree arti/les 4o/used on s1e/i4i/ s1e/i4i/ @B 8rogra06 @o1ing @at w-i/- revealed also i01li/ations 4or t-e use o4 relaxation .ased a11roa/-es to treat Generalized Anxiety Disorder3
Results:
Background Information on Generalized Anxiety Disorder-DM-! Disorder-DM-!
-e 4irst sour/e utilized wit-in t-e review in/luded gaining insig-t on Generalized Anxiety Anxiety Disorder3 -e -e D*567 states t-e diagnosti/ /riteria 4or Generalized Anxiety Disorder as2 Cex/essive anxiety and worry a.out a nu0.er o4 events and a/tivities 0ore days 4or a 0ini0u0 o4 K 0ont-s3 orry orry is di44i/ult to /ontrol and is asso/iated wit- /lini/ally signi4i/ant distress or i01air0ent wit- ; or 0ore o4 t-e 4ollowing K sy01to0s .eing 1resent 4or a 0ini0u0 o4 K 0ont-s 3 Restlessness or 4eeling !eyed u1 or on edge ,3 Being easily 4atigued ;3 Di44i/ulty /on/entrating or 0ind going .lan! 3 %rrita.ility 3 5us/le ension ension ?K3 *lee1 distur.an/e (4alling or staying aslee1)3 -e anxiety2 worry or or 1-ysi/al sy01to0s /ause /lini/ally signi4i/ant distress or i01air0ents in so/ial2 o//u1ational or ot-er i01ortant areas o4 4un/tioning) and 0ust .e a//o01anied .y at least 1-ysiologi/al sy01to0 o4 anxiety in /-ildren and ; 1-ysiologi/al sy01to0s in adults and /annot .e a//ounted 4or .y anot-er Axis % disorder2 0edi/al /ondition or su.stan/e (i3e3 0ood disorder2 1sy/-oti/ disorder or 1ervasive develo10ental disorder3 disorder3
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A /o01arison o4 t-e in4or0ation 4ro0 t-e D*56%7 to t-e D*567 (A8A2 (A8A2 ,999) noted no variations in t-e diagnosti/ /riteria alt-oug- /ategories in/luded wit-in t-e /lassi4i/ation o4 Anxiety Disorders revealed so0e alterations3
"ey #eatures of GAD
Iey 4eatures o4 t-e disorder noted in /-ildren are t-e0es o4 worrying a.out eit-er t-eir /a1a.ilities or >uality o4 t-eir 1er4or0an/e2 (A8A2 (A8A2 ,9;)3 -ese extended duration o4 worries o4ten i01ede 1sy/-oso/ial 4un/tioning2 4un/tioning2 are a//o01anied .y 1-ysi/al sy01to0s and are in/reased .ased on t-e range o4 t-e li4e /ir/u0stan/es2 (A8A2 (A8A2 ,9;)3 A /o00on t-read revealed t-at 4e 0ales (6K9) are 0ore 1revalent t-an 0ales in a/>uiring GAD (A8A2 (A8A2 ,9;)3 -e overall /ontent /ontent o4 worries 4or /-ildren2 /-ildren2 are age a11ro1riate and s-i4t wit- age over t-e li4es1an3 li4es1an3 -e0ati/ally2 -e0ati/ally2 /-ildren are /onsu0ed wit- worries o4 1er4or0an/e2 so/ially 6.eing 6.eing evaluated .y ot-ers2 ot-ers2 intelle/tually 6a/ade0i/ 6a/ade0i/ /a1a.ility2 /a1a.ility2 and 1-ysi/ally6i3e32 1-ysi/ally6i3e32 s1orts2 (A8A2 (A8A2 ,9;)3 @-ildren and adoles/ents 0ay over /on4or0 to rules and re>uire re>uire /onstant reassuran/e 4ro0 1arents2 tea/-ers2 1eers (A8A2 (A8A2 ,9;)3 %t is also i01ortant t-at in adoles/ents adoles/ents t-e severities o4 sy01to0s are greater as /o01ared to adults (A8A2 (A8A2 ,9;)3 @o 0or.idity exists a0ong ot-er /lassi4i/ations o4 0ental -ealt- diagnosis in /-ildren=adoles/ents i3e3 (ADHD2 Autis02 +@D2 De1ressive2 1sy/-oti/ disorders) disorders) and w-en a /-ild=adoles/ent /-ild=adoles/ent is diagnosed diagnosed wit- GAD2 sy01to0s sy01to0s o4 ot-er /lassi4i/ations o4 anxiety disorders (i3e3 *AD2 *o/ial 8-o.ia2 su.stan/e indu/ed anxiety) 0ust .e ruled out2 (A8A2 ,9;)3
$ffecti%e &reatments
$44e/tive treat0ents /urrently 4or Generalized Anxiety Anxiety Disorder in/lude @B and 1-ar0a/ologi/al 0anage0ent3 "or anxiety disorders in /-ildren2 sele/tive serotonin reu1ta!e in-i.itors (**R%s) are /urrently /onsidered 4irst6line 4irst6line 0edi/ations2 0edi/ations2 (5anassis2 ,9;)3 All **R%s -ave .een used 4or 4or /-ildren2 and no /lear eviden/e eviden/e indi/ates one one is su1erior to anot-er (5anassis2 (5anassis2 ,9;)3 C@-ildren s-ow a slig-tly -ig-er
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in/iden/es o4 .e-avioral a/tivation on t-ese 0edi/ations2 /o01ared to adults2 so 0any /lini/ians start /-ildren on 0edi/ations wit- redu/ed a/tivation agents2 su/- as 4luvoxa0ine2 sertraline2 or /italo1ra02 (5anassis2 ,9;)3
'iterature Analysis
A generalized review o4 t-e literature -as indi/ated t-e /o0.ination o4 @ognitive Be-avioral -era1y in /onun/tion wit- 1-ar0a/ology were t-e two 0ost e44e/tive interventions utilized today3 today3 All o4 t-e arti/les ex-i.ited /o00on t-reads noting t-e in/or1oration o4 t-e use o4 relaxation wit-in t-e s/o1e o4 ot-er interventions su/- as @B=5ind4ulness a11roa/-es 4o/using 0ore on 0editation3 Rarely was relaxation t-era1y utilized inde1endently t-ere4ore indi/ating t-e need 4or 4urt-er resear/- s1e/i4i/ to relaxation .ased interventions3 interventions3
Relaxation(Meditation Relaxation(Meditation )ractices- General *se in )sychothera+y
-ree arti/les were /ategorized wit-in t-is se/tion3 -e 4irst -ig-lig-ted t-e use o4 *yste0ati/ Relaxation raining raining wit- /-ildren and adoles/ents and t-e last two arti/les ta!ing a loo! at alternative 4or0s o4 relaxation6 0editation 1ra/ti/es3 -e 4irst arti/le w-i/- 4urt-er su11orted t-e resear/- to1i/ des/ri.ed an ex1eri0ental study o4 /-ildren’s2 /-ildren’s2 Cres1onse to extended and intensi4ied relaxation training to note 1rolonged e44e/ts o4 redu/tions in stress2 (Ilein6He.ling2 ? Lo-aus2 ,99,)3 C* yste0ati/ relaxation training te/-ni>ues (85R6 8rogressive 5us/le Relaxation and Autogeni/ Autogeni/ raining=use o4 visual i0agery or i0agination) were o4ten 0et-ods used to en-an/e sel4 regulation s!ills2 (Ilein6He.ling2 (Ilein6He.ling2 et3al2 ,99,)3 %n4or0ation regarding t-e use o4 t-ese ty1es o4 relaxation suggested s-ort ter0 e44e/ts 4ro0 its use wit/-ildren3 -e out/o0e o4 t-is study noted 0ini0al di44eren/es .etween extended relaxation training or intensi4ied training .ut rat-er rein4or/ed its i 00edia/y in indu/ing /al0ness in /-ildren2 (Ilein6He.ling2 (Ilein6He.ling2 et3al2 ,99,)3
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-e se/ond arti/le in/luded wit-in t-is /ategory was 0ore s1e/i4i/ to relaxation training or 0editation te/-ni>ues .eing used wit- /-ildren and adoles/ents wit- .e-avioral disorders (i3e3 Anxiety2 Anxiety2 @ondu/t disorders2 and ADHD3 A//ording A//ording to one o4 t-e arti/les2 Cea/-ing Cea/-ing 5editation to @-ildren as 8art o4 8sy/-ot-era1y2 8sy/-ot-era1y2 in/luded wit-in t-e Journal o4 %ntegrative 5edi/ine des/ri.ed 0editation2 a 4or0 o4 relaxation2 as an integral 1ie/e in t-e 1s y/-ot-era1euti/ y/-ot-era1euti/ 1ro/ess 4or /-ildren 4a/ed wit- disorders o4 ADHD2 8*D2 Anxiety Anxiety and de1ression2 (illia0s6+rlando2 (illia0s6+rlando2 ,9;)3 -e arti/le 1rovided a /lear ex1lanation o4 0editation and eviden/e to su11ort its e44e/tiveness 4ro0 .ot- t-e 1-ysi/al2 /ognitive real0s3 -e arti/le engaged in !ey 4a/tors 4or i01le0entation o4 0editation 0editation in 1sy/-ot-era1y 4ro0 t-e as1e/ts o4 environ0ent2 routine2 age a11ro1riate 4a/tors2 duration2 use o4 /-ild64riendly language2 in/or1oration o4 o4 visuals and 4or0 o4 0editations3 0editations3 -e arti/le also also 1resented a11arent in4or0ation in4or0ation regarding t-e various ty1es o4 0editation2 t-e i01ortan/e o4 t-e t-era1euti/ relations-i1 and eli/iting 4a0ily 1arti/i1ation or involve0ent as well as a su11ortive .rie4 /ase study3 -e arti/le alluded to t-e need 4or 4urt-er resear/- 4or interventions wit- t-e younger 1o1ulation2 -owever resear/-ers would learn t-roug- t-e >ualitative data 1rovided in t-is arti/le 4oundational in4or0ation on -ow to e01loy 0editation in 1sy/-ot-era1y3 1sy/-ot-era1y3 -e arti/le s1e/i4i/ally details 1ossi.le out/o0es related to 0editation i3e3 stated in t-e arti/le (illia0s6+rlando2 (illia0s6+rlando2 ,9;)2 .uilding .uilding resilien/e2 in/rease 1ositive outloo!s2 outloo!s2 in/rease sel46estee0 and sel4 /on4iden/e as well as in/rease /ons/iousness2 awareness o4 sel4=surroundings and .uild /o01assion /o01assion o4 sel4 and ot-ers3 -e aut-or ex1ounds ex1ounds on t-e !ey ele0ents to /reating t-ese 1ossi.le 1ossi.le out/o0es t-roug- -ow 0editation is 1resented2 in ot-er words -ow it is C1a/!aged3 Rein4or/e0ent is noted t-at t-e in>uirer would learn -ow to deliver a 0editation session in 1sy/-ot-era1y2 1sy/-ot-era1y2 t-e ty1es o4 0editation 4or0s or te/-ni>ues t-at ar e /ategorized as "o/used attention2 silent 0editations2 0ind4ulness 0editation and i0agery3 i0agery3 -e t-ird arti/le wit-in 8ediatri/s in Review2 C@o01li0entary2 C@o01li0entary2 -olisti/ and integrative 0edi/ine: 5editation 1ra/ti/es 4or 1ediatri/ -ealt-2 1rovided t-e 0ost use4ul in4or0ation /on/erning t-e use o4
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C0editation2 and ot-er 0et-ods o4 relaxation2 wit- t-e 1ediatri/ 1o1ulation2 (*i.inga2 ? Ie01er2 ,99)3 -is arti/le was /o01ilation o4 studies on 0ediation dating .a/! 4ro0 M, and extensive lists o4 resour/es (.oo!s2 arti/les et/3) to su11ort ot-er 4or0s o4 relaxation su/- as oga2 oga2 ai@-i2 ai@-i2 and 5ind4ulness3 -ree /ase 1resentations were also in/or1orated in t-e study (5aria2 Antwan and 5aggie) to e01-asize t-e 1otential use o4 relaxation ty1e interventions to address ea/- /-ild’s s1e/i4i/ issues2 one o4 w-i/- was anxiety (*i.inga2 ? Ie01er2 ,99)3
Relaxation Based inter%entions in $ducational settings
-ree arti/les a//entuated 1ers1e/tives o4 relaxation .ased interventions .eing utilized wit-in an edu/ational setting3 setting3 5ost o4 t-ese arti/les in 1arti/ular wit-in t-is t-is /ategory were ex1eri0ental studies3 wo wo studies gave e 01-asis to t-e use o4 relaxation=0edi/ation .ased interventions wit- -ig- s/-ool students and one study 4o/used on its use wit- ele0entary s/-ool students3 -e Journal o4 Adoles/en/e 1resented a study o42 C%ntegrating a relaxation res1onse .ased /urri/ulu0 into a 1u.li/ -ig- s/-ool in 5assa/-usetts2 ("oret2 */ult2 il/-er2 @-udno4s!y2 @-udno4s!y2 5alloy2 Has-e0inead2 ? 8ar!2 8ar!2 ,9,)3 -e 1ur1ose o4 t-e study reviewed t-e atte01ts atte01ts to deter0ine deter0ine t-e e44e/tiveness o4 eli/iting a relaxation res1onse .ased /urri/ulu02 in redu/ing anxiety=stress2 ("oret2 et3al2 ,9,)3 8arti/i1ants=students 8arti/i1ants=students learned di44erent te/-ni>ues2 te/-ni>ues2 w-i/- in/or1orated t-e use o42 C0editation2 .reat- 4o/us2 0ind4ulness2 0ind4ulness2 1rogressive 0us/le 0us/le relaxation2 i0agery=visualization i0agery=visualization and yoga2 yoga2 ("oret2 et3al2 ,9,)3 8re and 1ost testing was initiated wit- t-e 1arti/i1ant’s during t-e study3 study3 Results revealed redu/ed levels o4 1er/eived stress and anxiety wit- 0ost e44e/tiveness .eing a0ong 4e0ales2 ("oret2 et3al2 ,9,)3 wo wo ot-er studies wit-in t-is /ategory s1otlig-ted 0inorities o4 A4ri/an A0eri/ans2 A0eri/ans2 /ondu/ted ex1eri0ental resear/-3 -e 4irst arti/le (Gins.urg2 ? Dra!e2 ,99,) 4ro0 t-e Journal o4 t-e A0eri/an A/ade0y o4 @-ild and Adoles/ent Adoles/ent 8sy/-iatry 1resented a 1ilot study /o01aring @B wit- an attention su11ort /ontrol /ondition3 -e study was /ondu/ted in t-e edu/ational setting to redu/e Anxiety
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Disorders in A4ri/an A4ri/an A0eri/ans3 Alt-oug- t-is arti/le -ig-lig-ts @ognitive Be-avioral Be-avi oral -era1y2 it was in/or1orated into t-e literature due to one o4 t-e !e y ingredients in @B2 Crelaxation Crelaxation exer/ises (i3e3 1rogressive 0us/le relaxation relaxation and dia1-rag0ati/ dia1-rag0ati/ .reat-ing)2 (Gins.urg2 (Gins.urg2 et3al2 ,99,)3 -is arti/le 1rovided slig-t slig-t e01iri/al eviden/e to t-e t-e 1otential o4 t-e e44e/t e44e/t o4 relaxation exer/ises exer/ises integrated into @B .eing used to redu/e anxiety sy01to0s in t-e A4ri/an A0eri/an 1o1ulation3 1o1ulation3 -e study revealed2 C*/-ool .ased @B intervention 4or anxiety redu/tion was 4easi.le3 Anot-er 1ie/e o4 literature 4o/used on redu/ing 8sy/-ologi/al distress in 0inority students t-roug- i01le0enting t-e 1ra/ti/e o4 a rans/endental rans/endental 5editation 8rogra02 ($lder2 *3 Nidi/-2 @ol.ert2 Hagelin2 Grays-ield2 +viedo6Li02 R3 Nidi/-2 Rain4ort-2 Jones2 Jones2 ? Gera/e2 ,9)3 ,9)3 -e arti/le revealed signi4i/ant signi4i/ant i01rove0ent in out/o0es o4 redu/ing anxiety using 0easures o4 t-e *D=*trengt-s and Di44i/ulties uestionnaire e0otional sy01to0s s/ale2 ($lder2 et3al2 ,9)3
Relaxation(Meditation Relaxation(Meditation Incor+orated into ,ogniti%e Beha%ioral &hera+y
Arti/les reviewed wit-in t-is /ategory in/lude two 1ie/es o4 literature (one /lini/al /ase study and one extra/ted arti/le 4ro0 a .oo! on @B) e01-asizing t-e use o4 t-e @B2 C@o1ing C@o1ing @at32 in t-e treat0ent o4 Anxiety3 Anxiety3 Anot-er arti/le des/ri.ing e44e/tive treat0ents 4or /-ild-ood Anxiety Disorders w-i/- en/o01asses t-e t-e use o4 @B as an e44e/tive e44e/tive treat0ent a11roa/-3 -e 4irst two literature literature sour/es dis/ussed i01li/ations i01li/ations 4or t-e use o4 relaxation3 -e /ase study2 CAn A Ada1tation da1tation o4 t-e @o1ing @at 8rogra0: -e su//ess4ul treat0ent o4 a K year old .oy wit- GAD2 dis/ussed t-e /lient Ja!e’s treat0ent using t-e @o1ing @at 1roto/ol2 (5i/-ael2 8ayne2 ? Al.rig-t2 Al.rig-t2 ,9,)3 C -e study e01-asized an i01ortant i01ortant /o01onent o4 Ja!e’s treat0ent treat0ent was learning to relax2 in w-i/- t-e /lini/ian o44ered exa01les o4 -ow to relax su/- as 1retending to .e a ro.ot (tense) or a rag doll (relaxed)2 5i/-ael2 et3al32 ,9,)3 -is rein4or/ed t-e use o4 85R w-i/- was in/or1orated into @B3 @B3 -e study also re4eren/ed t-e use o4 visualization o4 a 4avored /-ara/ter6 CBat0an2 and /ontrolled .reat-ing te/-ni>ues used wit- Ja!e in
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,
atte01ts to redu/e 4eelings o4 distress or anxiety2 (5i/-ael2 et3al32 ,9,)3 -e out/o0e o4 t-is study indi/ated t-at2 CJa!e 1arti/i1ated 1arti/i1ated in t-era1y a total o4 ti0es over a 1eriod o4 0ont-s and 1ost treat0ent evaluations /ondu/ted at ; and year 0ar!s revealed Ja!e was no longer ex1erien/ing /lini/ally elevated sy01to0s on t-e BA*@2 (5i/-ael2 et3al32 ,9,)3 -e next literature sour/e wit-in t-is /ategory allows 1er/e1tions to .e drawn 4a0ily 1-ysi/ians in treating /-ildren wit- anxiety sy01to0s3 sy01to0s3 -e arti/le dis/usses treating treating 0ild /ases o4 Generalized Anxiety Disorder Disorder and e44e/tive e44e/tive a11roa/-es to /onsult3 C@ounseling 1arents2 1arents2 relaxation te/-ni>ues2 te/-ni>ues2 and in/entives 4or C.rave .e-avior /an o4ten return /-ildren wit- 0ild disorders to age6a11ro1riate 4un/tioning2 5anassis2 ,99)3 R@’s -ave .een /ondu/ted on t-e use o4 @B to 4urt-er validate its e44e/tiveness (5anassis2 (5anassis2 ,99)3 -e arti/le 0ade !ey re4eren/es to t-e use o4 relaxation as a /o01onent o4 @B or inde1endently2 inde1endently2 due to t-e noted 1otential di44i/ulties wit- a//ess to a 1sy/-ologist trained in /ondu/ting @B (5anassis2 (5anassis2 ,99)3
Des/ri1tions were given as to -ow -ow to rein4or/e rein4or/e relaxation te/-ni>ues
wit- t-e /-ild using /-ild64riendly /-ild64riendly language su/- as C slow .alloon .reat-ing2 .reat-ing2 in 1la/e o4 t-e ter0 dia1-rag0ati/ .reat-ing used wit- adults or ter0ing Cs1ag-etti legs2 as a 0eta1-or to e01-asize t-e use o4 1rogressive 0us/le relaxation3 Literature /ontinues to /onsistently su11ort t-e in/or1oration o4 relaxation training=t-era1y into @B 0et-ods3
Mindfulness A++roaches(Relaxation A++roaches(Relaxation
-e last two arti/les were an extension o4 t-e literature3 -e in/or1oration o4 t-ese two arti/les was to investigate 5ind4ulness a11roa/-es and t-eir si0ilarities wit- relaxation in t-eir use wit- /-ildren to treat stress related disorders=anxiety disorders=anxiety33 +4ten during resear/- /orrelations /orrelations were noted in t-e !eywords .etween relaxation=0edi/ation=and relaxation=0edi/ation=and 0ind4ulness 0ind4ulness .ased a11roa/-es3 a11roa/-es3 -e eviden/e o4 5ind4ulness 5ind4ulness a11roa/-es wit- /-ildren is a growing area 4or resear/-3 -e arti/le ex1lored 0ind=.ody 0ind=.ody t-era1ies as a w-ole in/luding resear/-ing2 C-y1not-era1y2 guided i0agery2 0editation2 0editation2 0usi/ t-era1y and yoga2
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;
(Hart0ann2 ? 7lieger2 ,9,)3 -e arti/le2 C5ind4ulness wit- @-ildren and Adoles/ents: Adoles/ents: $44e/tive @lini/al A11li/ation2 A11li/ation2 revealed /o01arisons .etween relaxation2 0editation and /ognitive t-era1y de4ining t-e 1ur1oses o4 ea/-3 -is arti/le was a transitional 1ie/e 1ie/e o4 literature /onsidering t-e 1er/eived si0ilarities .etween 5ind4ulness2 Relaxation and @ognitive -era1y3 -era1y3 C-e 1ur1ose o4 relaxation exer/ise is to indu/e a state o4 relaxation2 ? t-e 1ur1ose o4 0ind4ulness is to /ultivate non6udg0ental awareness in t-e 1resent 0o0ent2 (-o01son2 ? Gauntlett6Gil.ert2 Gauntlett6Gil.ert2 ,99E)3 C@ognitive a11roa/-es assu0es assu0es evaluation and 0odi4i/ations o4 t-in!ing2 t-in!ing2 (-o01son2 et3al2 ,99E)3 $xtra/tions /an .e 0ade 4ro0 t-ese de4initions t-at C5ind4ulness a11roa/-es 4o/us on awareness o4 tension and agitation (Cnoti/ing2) w-ereas relaxation 0et-ods wor! on distra/ting distra/ting onesel4 4ro0 t-e02 (-o01son2 et3al2 ,99E)3 Botarti/les indi/ated t-e2 Cneed 4or 4uture resear/- to 1rovide trans1aren/y t-e e44e/tiveness o4 0ind4ulness a11roa/-es .eing used wit- /-ildren and adoles/ents3
Discussion
-e overall literature suggested 1ositive results 4or t-e use o4 relaxation .ased interventions in t-e treat0ent o4 Generalized Anxiety Anxiety Disorders3 Alt-oug Alt-oug- t-e literature indi/ated /o00on t-reads o4 e44e/tive treat0ents toward @B a11roa/-es w-i/- en/o01ass t-e use o4 relaxation 0et-ods2 it is 4air to /on/lude t-at resear/- -as su11ortive grounds 4or dee0ing relaxation .ased a11roa/-es i01a/ting /-ildren wit- Generalized Anxiety Disorder3 Disorder3 "urt-er resear/- /ould .e /ondu/ted loo!ing s1e/i4i/ally at Relaxation .ased a11roa/-es inde1endently to ex1ound on t-e /urrent literature2 1roviding e01iri/al data 4or t-e s-ort ter0 e44e/tiveness o4 its use wit- /-ildren and adoles/ents 4or t-e /lassi4i/ation o4 Anxiety Disorders in/luding Generalized Anxiety Disorder3 $44e/tive treat0ents 4or Generalized Anxiety=Anxiety Anxiety=Anxiety Disorders2 noted wit-in t-e sour/es o4 literature were also i01ortant i01ortant 4a/tors 1ortrayed 1ortrayed t-roug-out t-e review3 review3 %ndi/ations were 0ade to t-e /o0.ination o4 1-ar0a/ologi/al 0anage0ent (use o4 **R%’s) and @ognitive Be-avioral -era1y as e44e/tive 0eans o4 treat0ent2 (5anassis2 ,9;)3 ,9;)3 #se o4 t-e @ognitive Be-avioral -era1y .ased .ased 1rogra02
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t-e C@o1ing @at2 was also a /o00on re4eren/ed sour/e to .e used wit- /-ildren and adoles/ents2 w-i/is instru0ental to 1ro4essionals wor!ing in t-e 4ield3
-e last additional i01ortant as1e/t a/>uired t-roug- t-is review was t-e revelation o4 nu0erous assess0ents=evaluations assess0ents=evaluations t-at /ould .e 1rove /onstru/tive in 4uture resear/- su/- as AD%*6%7 @=Anxiety Disorders %nterview */-edule 4or D*56%7 @-ild 7ersion 7ersion *@AR$D= */reen 4or @-ild Anxiety Related $0otional disorders *A*6A=*o/ial Anxiety */ale 4or Adoles/ents 8**=8er/eived *tress */ale *A%6= *tate trait anxiety inventory 4or0 ? H8L86%%=Healt-61ro0oting li4e style 1ro4ile %%3
Reference 'ist A0eri/an 8sy/-iatri/ Asso/iation Asso/iation (,999)3 Diagnosti/ and *tatisti/al 5anual o4 5ental
Disorders (t- ed32 ext Revision)3 as-ington2 D@: Aut-or3 A0eri/an 8sy/-iatri/ Asso/iation Asso/iation (,9;)3 Diagnosti/ and *tatisti/al 5anual o4 5ental Disorders (t- ed32 ext Revision)3 Arlington2 7irginia: Aut-or3 Brewer2 *32 53D32 ? *arvet2 B32 53D3 (,9)3 5anage0ent o4 anxiety disorders in t-e 1ediatri/ 1ri0ary /are setting3 Pediatric setting3 Pediatric Annals, 40 ()2 63 doi:-tt1:==dx3doi3org=93;M,E=99M9E6,99969 @reswell2 J32 (,9,)3 $du/ational Resear/-3 Plannin conductin conductin and e!aluatin e!aluatin "uantitati!e "uantitati!e and "ualitati!e research. (t- ed3)3 5assa/-usetts: 8earson $du/ation2 %n/. %n/ . 113 ;6,3 $lder2 @32 Nidi/-2 *32 @ol.ert2 R32 Hagelin2 J32 Grays-ield2 L32 +viedo6Li02 D32 ? 333 Gera/e2 D3 (,9)3 Redu/ed 8sy/-ologi/al Distress in Ra/ial and $t-ni/ 5inority *tudents 8ra/ti/ing t-e rans/endental 5editation 8rogra03 #ournal of Instructional Instructional Psycholoy Psycholoy 2 $%(,)2 $% (,)2 9M6 9M6K3 K3
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"oret2 532 */ult2 532 il/-er2 532 @-udno4s!y2 R32 5alloy2 L32 Has-e0inead2 N32 8ar!2 $3 (,9,)3 %ntegrating a relaxation res1onse6.ased /urri/ulu0 into a 1u.li/ -ig- s/-ool in 5assa/-usetts3 #ournal of Adolescence, Adolescence, $(,)2 $ (,)2 ;,6;;,3 doi3org=939 doi3org=939K=3adoles/en/e3,9 K=3adoles/en/e3,939E399E 39E399E Gins.urg2 G3 *32 ? Dra!e2 I3 L3 (,99,)3 */-ool6.ased treat0ent 4or anxious A4ri/an6A0eri/an adoles/ents: A /ontrolled 1ilot study3 #ournal of the A'erican A'erican Acade'y Acade'y of Child & Adolescent Psychiatry Psychiatry22 4( 4(()2 ()2 KE63 doi: 939M=9999E;6,99,999969999 939M=9999E;6,99,999969999 Hart0an2 "32 7lieger2 7lieger2 A3 53 (,9,)3 $44e/ts o4 0ind6.ody t-era1ies in /-ildren3 )ocus on Alternati!e Alternati!e and Co'*le'entary +hera*ies. ( (,)2 ( (,)2 M6MK3 doi: 93=3,9,6KK3,9,39K3x Ilein6He.ling2 Ilein6He.ling2 J Lo-aus2 A3 (,99,)3 Bene4its and interindividual interindividual di44eren/es in /-ildren’s /-ildren’s res1onses to extended and intensi4ied relaxation training3 Aniety tress and Co*in, ((;)2 ((;)2 ,6,EE3 D+%: 939E9=9KE99,999 939E9=9KE99,9999,9; 9,9; 5anassis2 I3 (,99)3 @-ild-ood anxiety disorders: A11roa/- to intervention3 Canadian )a'ily Physician, 0, $/-$%4. 85%D:;EK $/-$%4. 85%D:;EK 5i/-ael2 I32 8a yne2 L32 Al.rig-t2 A3 A3 (,9,)3 An ada1tation o4 t-e @o1ing @at 8rogra0: -e su//ess4ul treat0ent o4 a K6year old .oy wit- Generalized Anxiety Anxiety Disorder3 *age 8u.lis-ing3 D+%: 93=;K9,K9M,3 *i.inga2 $353*32 Ie01er2 I3J32 (,99)3 @o01li0entary2 @o01li0entary2 -olisti/ and integrative 0edi/ine: 5editation 1ra/ti/es 4or 1ediatri/ -ealt-3 Pediatrics in Re!ie, Re!ie, $( $( (,)2 $M6$9;3 doi:93,=1ir3;6,6eM -o01son2 53 Gauntlett6Gil.ert2 J3 (,99E)3 5ind4ulness wit- /-ildren and adoles/ents: $44e/tive @lini/al a11li/ation3 *age 8u.lis-ing3 D+%: 93=;M99E9M9K9;3 93=;M99E9M9K9;3 illia0s6+rlando2 illia0s6+rlando2 @3 (,9;)3 ea/-ing ea/-ing 0editation to /-ildren as 1art o4 1sy/-ot-era1y3 Interati!e Medicine, Medicine, (1()2 (1 ()2 ,6;,3
