Simon Byrne

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Do parents enhance cognitive behavior therapy for youth anxiety? Protocol for an overview of systematic reviews over time (Preprint)

BACKGROUND Cognitive behavioral therapy (CBT) has shown to be highly effective for treating youth... more BACKGROUND Cognitive behavioral therapy (CBT) has shown to be highly effective for treating youth anxiety; yet, there is ongoing debate as to whether involving parents improves outcomes. For example, parents who attend may learn CBT skills to help their child in an ongoing way; yet, they could also distract their child from treatment depending on how they interact. As evidence has accumulated, reviews and meta-analyses have attempted to examine the most effective treatment format. These reviews often have high impact in the field; however, they use varied methodologies and draw on different primary studies. Different formats of CBT for youth anxiety have been developed in relation to parental involvement, including youth-only CBT (Y-CBT; where the youth alone attends treatment), youth and parent or family CBT (F-CBT; where youths and their parents attend together), and, most recently, parent-only CBT (P-CBT; where the parent alone attends). OBJECTIVE This protocol describes an overview of systematic reviews comparing the relative efficacy of different formats of CBT for youth anxiety (Y-CBT, F-CBT, and P-CBT) over the study period. The protocol will also examine the moderating effects of variables on the efficacy of different formats; for example, youths’ age and long-term outcomes. METHODS We will analyze the results of systematic reviews that compare different levels and types of parental involvement in CBT for youth anxiety over the study period. A systematic review of medical and psychological databases (PsycINFO, PubMed, SCOPUS, Web of Science, Cochrane Library, and Embase) will identify reviews comparing the efficacy of different formats of parent involvement in CBT for youth anxiety. Data extraction will include (1) author names (and year of publication), (2) review design, (3) age range, (4) analysis type, (5) conclusions, and (6) moderators. This overview will present the relative efficacy of formats chronologically in a table and then describe the main results longitudinally in a narrative summary. A Measurement Tool to Assess Systematic Reviews, 2nd Edition (AMSTAR 2), quality rating will be given to each review, and the amount of primary study overlap across reviews will be quantified. RESULTS The last search was conducted on July 1, 2022. The reviews were published between 2005 and 2022. We found a total of 3529 articles, of which we identified 25 for the final analysis. CONCLUSIONS This overview will compare and report the relative efficacy of Y-CBT, P-CBT, and F-CBT for youth anxiety over the study period, describe the heterogeneity across reviews and primary studies, and consider the moderating effect of relevant variables. It will describe the limitations of an overview, including the potential for nuance in the data to be lost, and provide conclusions and recommendations for conducting systematic reviews regarding parental involvement for CBT for youth anxiety. INTERNATIONAL REGISTERED REPORT RR1-10.2196/48077

Disaster Medical Assistance Teams: What Psychosocial Support is Needed?

Prehospital and Disaster Medicine, 2008

Objective:The objective of this preliminary study was to evaluate the perceptions of internationa... more Objective:The objective of this preliminary study was to evaluate the perceptions of internationally deployed Disaster Medical Assistance Team (DMAT) personnel regarding the psychosocial support needs of these teams.Methods:The DMAT questionnaire was sent to 34 members of Australian medical teams involved in deployments to the 2004 Southeast Asian tsunami and the 2006 Java earthquake. Twenty personnel (59%) completed this survey, which reviewed key deployment stressors, specific support strategies, and the support needs of team members, their families, and team leaders. A key aspect of the survey was to determine whether the perceived psychosocial needs would be supported best within with existing provisions and structures, or if they would be enhanced by further provisions, including the deployment of mental health specialists.Results:There was strong support for brief reviews of stress management strategies as part of the pre-deployment briefing, and access to written stress manag...

Comparing the Roles of Ambiguity and Unpredictability in Intolerance of Uncertainty

Behaviour Change, Mar 4, 2015

One means by which Intolerance of Uncertainty (IU) purports to contribute to anxiety is by increa... more One means by which Intolerance of Uncertainty (IU) purports to contribute to anxiety is by increasing Threat Perception (TP). This process was examined by comparing two different definitions of uncertainty: ambiguity versus unpredictability. N = 104 participants were measured for IU and then made worry and TP estimates for four different scenario types: Ambiguous Scenarios (where an outcome could be interpreted as threatening), Unpredictable Positive Scenarios (where a surprising and positive outcome was anticipated), as well as Positive and Negative Scenarios (with certain outcome). Both Ambiguous and Unpredictable Positive Scenarios more strongly predicted the relationship between IU and worry scores than (certain) Positive or Negative Scenarios. The relationship between IU and 'ambiguous worry' was largely explained by TP estimates, whereas the relationship between IU and 'Unpredictable Positive Worry' was largely independent of TP. Results suggest ambiguity and unpredictability are differentially explained by TP such that they produce different types of response. The authors argue ambiguity and unpredictability are explanatory components within IU.

format_quoteParticipants with high IU rated concern higher for ambiguous scenarios than for certain positive or negative ones.format_quote

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Systematic Reviews of Mindfulness and Acceptance and Commitment Therapy for Alcohol Use Disorder: Should we be using Third Wave Therapies?

Alcohol and Alcoholism, 2018

Aims: Third wave therapies have shown efficacy for treating emotional disorders and potential for... more Aims: Third wave therapies have shown efficacy for treating emotional disorders and potential for treating substance use disorders. There is developing interest in whether they can more specifically be used for treating alcohol use disorders (AUDs). We were interested in whether third wave therapies have value alongside current evidence-based psychosocial treatments for AUDs. Method: We conducted systematic reviews of third wave therapies for AUDs. We searched PsycINFO, Embase and Medline for peer reviewed journal articles where mindfulness or Acceptance and Commitment Therapy (ACT) were used to treat adults with AUDs or alcohol use that caused impairment. Results: We identified 11 studies where mindfulness was used for treating AUDs and 6 where ACT was used for AUDs. The studies identified included RCTs, non-randomized controlled studies and uncontrolled studies. We found preliminary support that both third wave therapies are better than no treatment, treatments of minimal efficacy, as well as some evidence they are comparable to effective psychosocial treatments for AUDs. Conclusions: We conclude ACT and mindfulness provide an alternative to existing treatments, particularly for patients who have not responded to, or have disengaged from, standard treatments. We also found some evidence ACT and mindfulness are useful for comorbid mental health conditions. Yet while these results are promising, further research is needed to determine their utility, ideally employing randomized-controlled designs, larger clinical samples and longer follow-ups. Furthermore, few studies in this review directly compared third wave therapies to first line treatments, making it difficult to determine their relative efficacy.

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Comparing the Roles of Ambiguity and Unpredictability in Intolerance of Uncertainty

Behaviour Change, 2015

One means by which Intolerance of Uncertainty (IU) purports to contribute to anxiety is by increa... more One means by which Intolerance of Uncertainty (IU) purports to contribute to anxiety is by increasing Threat Perception (TP). This process was examined by comparing two different definitions of uncertainty: ambiguity versus unpredictability. N = 104 participants were measured for IU and then made worry and TP estimates for four different scenario types: Ambiguous Scenarios (where an outcome could be interpreted as threatening), Unpredictable Positive Scenarios (where a surprising and positive outcome was anticipated), as well as Positive and Negative Scenarios (with certain outcome). Both Ambiguous and Unpredictable Positive Scenarios more strongly predicted the relationship between IU and worry scores than (certain) Positive or Negative Scenarios. The relationship between IU and ‘ambiguous worry’ was largely explained by TP estimates, whereas the relationship between IU and ‘Unpredictable Positive Worry’ was largely independent of TP. Results suggest ambiguity and unpredictability ...

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An Examination of Harm Beliefs in Dog Fearful Children

Journal of Experimental Psychopathology, 2016

This study examined the harm beliefs of dog fearful children and the effect of exposure therapy o... more This study examined the harm beliefs of dog fearful children and the effect of exposure therapy on harm beliefs. The harm beliefs of 27 dog fearful children were examined before and after exposure therapy to a dog. Children were shown a live dog and asked to rate the extent to which they believed the dog would harm them (for example, the dog would bite or attack). The children were asked to complete Behaviour Approach Tests (BATs) to the dog before and after the exposure therapy. The children partially endorsed all harm beliefs regarding the dog prior to exposure. Harm beliefs predicted distress during a BAT before exposure therapy and avoidance after exposure. There was a significant reduction in all harm beliefs after exposure therapy with large effect sizes. Results also indicate the effectiveness of a single session of exposure in reducing a child's harm beliefs.

format_quoteLarge effect sizes indicate a significant reduction in harm beliefs after exposure therapy, enhancing understanding of effectiveness in treating dog phobia.format_quote

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D-Cycloserine Augmented Treatment of Anxiety Disorders in Children and Adolescents: A Review of Preliminary Research

Psychopathology Review, 2014

This paper reviews evidence for using the "cognitive enhancer" D-Cycloserine (DCS) to treat anxio... more This paper reviews evidence for using the "cognitive enhancer" D-Cycloserine (DCS) to treat anxious young people. Adult studies indicate DCS consolidates fear extinction learning into memory during exposure therapy, thereby increasing the speed of remission. This paper examines basic research indicating both fear extinction and DCS may work differently in younger animals compared to adults. It reviews trials using DCS to enhance treatment of obsessive compulsive disorder in youths. Given there is often ambivalence about using medication to treat young people, this paper also reviews current research examining parental attitudes to DCS. It considers specific challenges facing DCS research, particularly with regard to maintaining experimental control and managing negative perceptions associated with using medication. Finally, this paper considers current research underway, particularly with regard to using DCS to treat young people with specific phobias. Overall, findings indicate that DCS shows promise for enhancing the treatment of anxiety in young people, but further investigation is needed to determine whether it provides significant benefits over and above current therapies.

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Can young people reliably rate side effects of low-dose antipsychotic medication using a self-report survey?

Acta Neuropsychiatrica, 2010

Walter G, Byrne S, Griffiths O, Hunt G, Soh N, Cleary M, Duffy P, Crawford G, Krabman P, Concanno... more

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Self-reported side effects in children and adolescents taking risperidone

Australasian …

Results: Young persons, overall, seemed to tolerate risperidone well, but longer exposure to the ... more

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