Exploring research into anxiety disorders this Mental Health Awareness Week

Individualised interventions to prevent anxiety disorders

We know that many anxiety disorders begin in childhood and adolescence, but how do we know which interventions work for which child? Dr Josefien Breedvelt has began new research investigating how we can use individualised approaches to prevent anxiety disorders in children and young people.

Watch the video below to hear from Dr Breedvelt about her research.

When bad experiences trigger anxiety

Up to 80% of children are exposed to trauma by the age of 18 in the UK. After experiencing trauma, it’s not unusual for children to develop emotional and behavioural symptoms. This is a normal psychological response and not a psychiatric disorder. However, by age 18, around one in four children exposed to trauma will have developed Post-Traumatic Stress Disorder (PTSD).

Professor Andrea Danese leads the Stress & Development Lab at the IoPPN, where his team aims to understand how traumatic experiences in childhood affect mental and physical health, how to identify those children at greatest risk of developing PTSD, and how to support children who have experienced trauma.

Professor Danese also co-leads the National & Specialist CAMHS Clinic for Trauma, Anxiety, and Depression at South London and Maudsley NHS Foundation Trust, where his team delivers assessment and treatment to children and adolescents who experience severe and/or treatment-resistant PTSD, anxiety disorders and depression.

In his Mental Health Awareness Week blog, Professor Andrea Danese unpacks how childhood trauma can lead to anxiety – and in some of the more serious cases, PTSD.

Intrusive images in generalised anxiety disorder

Distressing intrusive images commonly occur in anxiety disorders. Research led by Dr Victoria Pile found that when adolescents experience symptoms of generalised anxiety disorder, intrusive images about the future have a greater impact on them.

To reduce the impact of intrusive images, it's important to process them, rather than avoid or suppress them. One approach that Dr Pile and her team are investigating is called 'imagery rescripting' which aims to change the meaning of intrusive images to reduce the distress they cause. They are developing a protocol in collaboration with young people to effectively use imagery rescripting in schools to reduce symptoms of anxiety and depression.

Watch the video below to hear from Dr Victoria Pile about intrusive imagery in anxiety and what she is working on to combat it.

Supporting autistic children with co-occurring anxiety disorders

Around 40% of autistic young people have at least one anxiety condition, with social anxiety and generalised anxiety disorder being the most common. But do autistic children experience anxiety differently to neurotypical children?

Dr Matthew Hollocks, a clinical academic at the IoPPN and South London and Maudsley NHS Foundation Trust, explains some of the mental health difficulties that commonly co-occur with autism, how they might differ to those experienced by neurotypical children, and what the King's Maudsley Partnership are doing to support young people.

Read the King's Maudsley Partnership Q&A with Dr Matthew Hollocks here.

Genetic factors in anxiety

Professor Thalia Eley co-leads the Genetic Links to Anxiety and Depression (GLAD) study, where she and her team are investigating the genetic and environmental factors underlying anxiety and depression. The GLAD study aims to better understand depression and anxiety in order to find effective treatments and improve the lives of people experiencing these disorders. In her research, Professor Eley is exploring how genetics could explain why people respond differently to anxiety treatments and how this insight could help develop a more personalised approach.

Watch the video below to hear from Professor Eley about some of the genetic factors that can influence anxiety and how they are just one of many influences in the development of the condition.

Helping pregnant women with worry and anxiety

The RELAX study, led by Professor Colette Hirsch and funded by the NIHR, will be starting a series of clinical trials to evaluate the effectiveness of a new digital therapy to support pregnant women with feelings of worry and anxiety. The digital therapy will encourage pregnant women to interpret ambiguous situations more positively as a way to help manage their worry and anxiety.

Patient and public involvement (PPI) has been at the heart of the design of the training and the study: watch the video below to hear from Abi, a member of the PPI advisory group, about why she decided to get involved.

Evidence-based tips for young people to manage anxiety

KeepCool has developed five evidence-based tips for young people to manage anxiety, developed by IoPPN researchers in collaboration with young people and psychologists and psychiatrists at South London and Maudsley NHS Trust.

Tip 1. Breathing and grounding techniques can distract you from feeling anxious. Help break the anxious thinking cycle by focusing on your breath and what is going on around you: what you can see, hear, smell, taste & feel.

Tip 2. Take care of your body: Movement can reduce anxiety by getting rid of stress hormones. Eat enough and regularly throughout the day. Try to wind down with a good sleep routine.

Tip 3. To strip worries of their power, accept that worrying is normal and that you can learn to manage it. For example, you can write down your worries before going to bed to see if this helps your mind to let go of them.

Tip 4. Fears can make us avoid important activities or situations. Try to face your fears one step at a time: start with something that makes you a bit uncomfortable, then take bigger steps as you build up confidence.

Tip 5. Finding what works for you to reduce anxiety can take time. The first step is learning to recognise symptoms, then you can choose how you want to respond - maybe by using some of the strategies above.

KeepCool is funded by UK Research and Innovation and led by Andrea Danese, Professor of Child & Adolescent Psychiatry at the IoPPN and South London and Maudsley NHS Foundation Trust, in collaboration with the McPin Foundation, TOAD, and Passion Digital.

You can find all the tips here.

Transforming children and young people's mental health through the King's Maudsley Partnership

Professor Andrea Danese, Dr Josefien Breedvelt and Dr Matthew Hollocks are some of the many experts who are transforming our understanding and treatment of young people’s mental health as part of the King's Maudsley Partnership for Children and Young People. The Partnership, which will have its home in the Pears Maudsley Centre for Children and Young People, is a unique collaboration between specialist clinicians from the South London and Maudsley NHS Foundation Trust and leading academics at King’s College London.