A scoping review investigating the use of exposure for the treatment and targeted prevention of anxiety and related disorders in young people

Abstract

BackgroundCognitive Behavioural Therapy (CBT) is the gold standard intervention for anxiety and related mental health disorders among young people; however, the efficacy of individual elements of CBT (e.g., exposure to feared stimuli) have received little scrutiny.AimsThis scoping review, informed by three stakeholder groups and a scientific advisory group, aimed to identify the nature and extent of the available research literature on the efficacy of exposure to feared stimuli, moderators of effectiveness in young people aged 14–24 years.MethodThree international stakeholder groups composed of clinicians (N = 8), parents/carers (N = 5) and youth with lived experience of anxiety (N = 7) provided input into study design and results. Using the PRISMA extension for scoping reviews, a search of MEDLINE/Ovid, PsycINFO, PubMed, CINAHL, SCOPUS, EMBASE, ERIC, and Health Collection (informit) was conducted using terms related to anxiety, ages 14–24, and exposure.ResultsFrom 3508 unique abstracts, 64 papers were included for the review. While there was evidence for the efficacy of exposure as a treatment for youth anxiety disorders, fundamental gaps in knowledge of exposure in this age group were identified. Most studies examined post‐traumatic stress disorder, obsessive–compulsive disorder, and specific phobias with no randomised clinical trials uniquely evaluating exposure for the treatment of DSM‐5 anxiety disorders. Exposure was typically delivered accompanied by other anxiety management techniques. A multitude of optimisation strategies have been tested, yet only one of these effects (timing relative to sleep) showed preliminary evidence of replication.ConclusionsA systematic and theoretically driven program of research investigating the efficacy of exposure in young people and factors that moderate its efficacy, along with methods to overcome barriers for delivery, is urgently needed.

Gamification in the classroom: Kahoot! As a tool for university teaching innovation

“…The game presents a wide range of situations that require adaptation to changing environments, and generation of effective answers in contexts where time is limited (Vlachopoulos and Makri, 2017). In addition, other researchers have reported that prolonged exposure facilitates experimentation with multiple strategies when solving problems, which also strengthens this skill (Donkin and Rasmussen, 2021;Teunisse et al, 2022).…”

Transparent and complete reporting of confounding in observational research

“…JCPP Advances also requires authors to adhere to the PRISMA guideline in the reporting of systematic reviews. The June issue of JCPP Advances have included three high quality systematic reviews covering important research questions related to (i) structural and functional brain changes associated with peer‐victimisation, bullying, and cyberbullying (Ke et al., 2022 ), (ii) the associations between adverse experiences and mental health outcomes in individuals with minority identities related to sexual orientation, gender expression, or gender identity (Jonas et al., 2022 ), and (iii) the use of exposure in the management of anxiety‐related disorders among young people (Teunisse et al., 2022 ). As expected from publications in JCPP Advances, the above mentioned systematic reviews all followed PRISMA guidelines.…”