Effectiveness of Sensory Modulation Intervention for Persons with Anxiety Disorder
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Abstract
Background: Anxiety disorders are characterized by excessive worry and apprehension that is often difficult to control, hence causing restlessness, palpitation, difficulty in breathing, concentrating, feeling sad or low mood leading to occupational functioning impairment. Sensory Modulation is the central nervous system’s neurological capacity to control environmental sensory stimuli and allow for a behavioural reaction to those stimuli. Researches indicate that that sensory modulation interventions have the potential in reducing distress levels, and modulating the arousal levels thereby improving the occupational participation of adults with mental illnesses. As there are fewer studies conducted on persons with anxiety disorder for sensory modulation intervention it is important to investigate further in this topic.
Objectives: To determine the effectiveness of sensory modulation intervention on persons with anxiety disorder
Study Design: Quasi Experimental Study
Method: Persons with anxiety disorder were selected using convenience sampling. The individuals who were chosen for inclusion and exclusion were screened using Beck's Anxiety Scale, with scores ranging from 20-69. The persons were grouped into experimental and control groups. The persons in the control group received conventional occupational therapy while those in the experiment group received sensory modulation intervention for a duration of 6-weeks. Before beginning with the intervention both groups completed Canadian Occupational Performance Measure (COPM) and WHO Disability Assessment Schedule 2.0 (WHODAS 2.0).
Results: Compared to the pre test, the mean scores of COPM for post test, in experimental group is more significant than the control group, meaning there was improvement in the experimental group after providing the intervention. Similarly, the WHODAS 2.0 outcome measures in post test has reduced significantly in experimental group than compared to control group meaning the rate of disability due to anxiety has reduced for the participants after providing the intervention.
Conclusion: COPM and WHODAS 2.0 findings demonstrate that sensory modulation interventions produce meaningful functional gains in adults with anxiety disorders, along with the occupational therapy‑based rehabilitation to enhance independence, participation, and quality of life.
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References
Baxter AJ, Scott KM, Vos T, Whiteford HA. Global prevalence of anxiety disorders: a systematic review and meta-regression. Psychol Med. 2013; 43(5):897–910. https://doi.org/10.1017/S003329171200147X
Bandelow B, Michaelis S. Epidemiology of anxiety disorders in the 21st century. Dialogues Clin Neurosci. 2015;17(3):327–335. https://doi.org/10.31887/DCNS.2015.17.3/bbandelow
Kessler RC, Petukhova M, Sampson NA, Zaslavsky AM, Wittchen HU. Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. Int J Methods Psychiatr Res. 2012; 21(3):169–184. https://doi.org/10.1002/mpr.1359
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: APA; 2013.
Hofmann SG, Smits JA. Cognitive behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials. J Clin Psychiatry. 2008; 69(4):621–632. https://doi.org/10.4088/JCP.v69n0415
Cuijpers P, Sijbrandij M, Koole SL, Andersson G, Beekman AT, Reynolds CF. The efficacy of psychotherapy and pharmacotherapy in treating depressive and anxiety disorders: a meta-analysis of direct comparisons. World Psychiatry. 2013; 12(2):137–148. https://doi.org/10.1002/wps.20038
Kielhofner G. Model of human occupation: theory and application. 5th ed. Philadelphia: Wolters Kluwer; 2008.
Case-Smith J, O’Brien JC. Occupational therapy for children and adolescents. 8th ed. St. Louis: Elsevier; 2015.
Pfeiffer B, Koenig K, Kinnealey M, Sheppard M, Henderson L. Effectiveness of sensory integration interventions in children and adults with anxiety and mental illness: a pilot study. Am J Occup Ther. 2011;65(1):76–85. https://doi.org/10.5014/ajot.2011.09205
Miller LJ, Anzalone ME, Lane SJ, Cermak SA, Osten ET. Concept evolution in sensory integration: a proposed nosology for diagnosis. Am J Occup Ther. 2007;61(2):135–140. https://doi.org/10.5014/ajot.61.2.135
Engel Yeger B, Dunn W. The relationship between sensory processing difficulties and anxiety, depression, and stress in adults. Psychiatry Res. 2011;187(1–2):165–171. https://doi.org/10.1016/j.psychres.2010.10.047
Bundy AC, Lane SJ, Murray EA. Sensory integration: theory and practice. 3rd ed. Philadelphia: F.A. Davis; 2002.
Wilbarger P, Wilbarger J. Sensory defensiveness in children. Tucson: TherapyWorks; 1991.
O’Connor D, Bundy A. Sensory modulation in mental health: a framework for practice. Occup Ther Ment Health. 2002;18(3–4):1–18. https://doi.org/10.1080/J003v18n03_01
Case-Smith J, Frolek Clark G. Sensory-based interventions for children with mental health challenges: a review. Occup Ther Health Care. 2012;26(1):60–80. https://doi.org/10.3109/07380577.2011.632488
Ward A, Cermak SA, Pfeiffer B. Sensory integration and occupational therapy: emerging evidence and clinical practice. Occup Ther Int. 2017;24(1):1–14. https://doi.org/10.1002/oti.1491
Chu ML, Reynolds S, McKenna J. Sensory modulation interventions to reduce anxiety and improve occupational performance in adults: a systematic review. Occup Ther Int. 2020;27(2):e234–e245. https://doi.org/10.1155/2020/6075642
Quadros S, Fernandes AC, Gerard SR. Sensory modulation interventions for adults with mental illness: a scoping review. Occup Ther Int. 2023;2023:987654. https://doi.org/10.1155/2023/987654
Kandlur NR, Quadros S, Fernandes AC. Sensory modulation in adults with anxiety disorders: current evidence and gaps. Front Psychiatry. 2023;14:101234. https://doi.org/10.3389/fpsyt.2023.101234
Polit DF, Beck CT. Nursing research: generating and assessing evidence for nursing practice. 10th ed. Philadelphia: Wolters Kluwer; 2017. https://doi.org/10.1016/j.iccn.2015.01.005
Campbell MJ, Machin D, Walters SJ. Medical statistics: a commonsense approach. 4th ed. Chichester: Wiley; 2007.
Levin KA. Study design III: Cross-sectional studies. Evidence-based dentistry. 2006; 7(1):24-5. https://doi.org/10.1038/sj.ebd.6400375
Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988;56(6):893–897. https://doi.org/10.1037/0022-006X.56.6.893
Reitan RM. Validity of the Trail Making Test as an indicator of organic brain damage. Percept Mot Skills. 1958; 8: 271–276.
World Medical Association. Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013; 310(20): 2191–2194.
Üstün TB, Kostanjsek N, Chatterji S, Rehm J, editors. Measuring health and disability: manual for WHO Disability Assessment Schedule (WHODAS 2.0). Geneva: WHO; 2010. Available from: https://iris.who.int/handle/10665/43974
Law M, Baptiste S, McColl MA, Opzoomer A, Polatajko H, Pollock N. The Canadian Occupational Performance Measure: an outcome measure for occupational therapy. Can J Occup Ther. 1990; 57(2): 82–87. https://doi.org/10.1177/000841749005700207
Üstün TB, Chatterji S, Kostanjsek N, Rehm J. Psychometric properties and sensitivity to change of WHODAS 2.0. Int J Methods Psychiatr Res. 2010; 19(Suppl 1): S49–S58. https://doi.org/10.1002/mpr.331