Main Findings

Pharmacological agents used in the treatment of anxiety have been reported to decrease threat relevant processing in patients and healthy controls, suggesting a potentially relevant mechanism of action. However, the effects of the anxiolytic diazepam have typically been examined at sedative doses, which do not allow the direct actions on emotional processing to be fully separated from global effects of the drug on cognition and alertness. 2

Anxiety sensitivity (AS), or a fear of anxiety-related sensations, has become one of the most well researched risk factors for the development of psychopathology and comprises three subfactors: physical, cognitive, and social concerns. Fortunately, research has demonstrated brief protocols can successfully reduce AS, and in turn improve psychopathological symptoms. Computerized AS reduction protocols have combined psychoeducation with interoceptive exposure (IE), but they have not been dismantled to evaluate the effects of psychoeducation alone. 7

A pilot study on high-anxious young adults did not find compelling evidence for an anxiolytic effect of bright light exposure. While it resulted in marginally greater reductions in psychic symptoms of the Hamilton Anxiety Scale (HAM-A) and other measures, the effect was not statistically significant. 3

Attentional control (AC), the ability to regulate attentional processes by focusing and shifting attention as needed, has been linked to AS, anxiety, and depression, suggesting it may moderate the effectiveness of brief interventions focused on reducing AS. This suggests that individuals with better AC may benefit more from these interventions. 8

A study comparing a cognitive behavioral therapy (CBT) group to a recreational group found negative effects in patients with anxiety disorders within the CBT group. This suggests that group settings, content, or interactions between participants in the group may trigger adverse reactions in those with anxiety disorders. 9

A comparison of placebo effects in patients with social phobia, panic disorder, and obsessive-compulsive disorder (OCD) revealed that patients with OCD were less likely to respond to placebo compared to those with generalized social phobia or panic disorder. This suggests that OCD may be more resistant to placebo effects than other anxiety disorders. 1

Methylphenidate and propranolol have been shown to influence the interplay between induced anxiety and working memory (WM). Propranolol, by blocking the physiological effects of anxiety, might also block anxiety interference on WM. Conversely, methylphenidate, by improving task-directed attention, might reduce anxiety or improve cognitive efficiency, freeing up processing resources to compute anxiety. 6

The effectiveness of reappraisal, acceptance, and distraction strategies in dealing with anticipatory anxiety in social anxiety disorder (SAD) was examined. While these strategies led to an initial decrease in anxiety, there was a rebound of anxiety prior to the social event, suggesting that these strategies might not be effective in the long term for regulating anticipatory anxiety. 5

While some studies suggest initial anxiety may have equivocal or negative effects in depression treatment, others report that anxiety predicts greater or more rapid change in depression during cognitive behavioral therapy (CBT). This highlights the need for further investigation to clarify the relationship between initial anxiety and the course of depression treatment, particularly in the context of CBT. 4

Benefits and Risks

Benefits Summary

Pharmacological agents used in the treatment of anxiety have been reported to decrease threat relevant processing in patients and healthy controls, suggesting a potentially relevant mechanism of action. 2

Brief protocols can successfully reduce AS, and in turn improve psychopathological symptoms. 7

Individuals with better AC may benefit more from brief AS-focused interventions. 8

Risks Summary

Group interventions can have negative effects for patients with anxiety disorders. 9

OCD may be more resistant to placebo effects than other anxiety disorders. 1

Comparison Across Studies

Commonalities

These studies used a variety of methods to understand anxiety and the effectiveness of treatments for anxiety-related symptoms. Many studies evaluated anxiety treatments, such as cognitive behavioral therapy or medication. The studies also examined factors that might influence anxiety, including anxiety sensitivity, attentional control, and placebo effects.

Differences

The studies differed in their participants, the treatments used, and the outcomes measured. Some studies focused on specific anxiety disorders (e.g. social anxiety disorder, panic disorder), while others looked at more general anxiety symptoms. The treatments used in the studies also varied, including medication, cognitive behavioral therapy, or other interventions.

Consistency and Contradictions in Results

These studies suggest various approaches that could potentially be effective in treating anxiety. However, there are contradictions between some of the findings. For instance, while one study found that cognitive behavioral therapy is effective for anxiety, another found that it can have negative effects for some patients. These inconsistencies could be attributed to methodological differences between the studies, variations in the populations studied, or the complex nature of anxiety.

Implications for Real-Life Application

While these research findings provide insights into potential approaches for managing anxiety, it's essential to exercise caution when directly applying them to real-life situations. The impact of anxiety varies from person to person, and a particular intervention may not be effective for everyone. It's crucial to consult with a qualified healthcare professional if you're experiencing anxiety symptoms.

Limitations of Current Research

There are limitations to these studies. For instance, some studies involved relatively small sample sizes, which could limit the generalizability of the findings. Additionally, some studies focused on specific anxiety disorders, meaning the findings might not apply to other anxiety disorders.

Future Research Directions

Future research should employ larger sample sizes, encompass a broader range of anxiety disorders, and utilize diverse treatment approaches to obtain further insights into the effectiveness of anxiety treatments. Furthermore, research should delve deeper into the role of factors that might influence anxiety, including anxiety sensitivity, attentional control, and placebo effects.

Conclusion

These studies have deepened our understanding of anxiety and its treatment. They suggest that various approaches hold potential for treating anxiety, but inconsistencies in the findings highlight the complexity of the condition. It's essential to consult with a qualified healthcare professional if you're experiencing anxiety symptoms.