1. Developing Categories for the Literature Review and 2. Applying the Spider Diagram

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Critical Annotated Bibliography

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Stress Management and the Clinical Interventions in Psychology

Boucher, E., Ward, H., Miles, C., Henry, R. D., & Stoeckl, S. E. (2024). Effects of a digital mental health intervention on perceived stress and rumination in adolescents aged 13 to 17: A randomized controlled trial (Preprint). JMIR. Journal of Medical Internet Research/Journal of Medical Internet Research, 26. https://doi.org/10.2196/54282

This study sought to evaluate the efficacy of an online mental health intervention, Happify for Teens, for stress management and reducing rumination among adolescents. The intervention showed a significant reduction in perceived stress and rumination in the treatment group compared to the waitlist group over 12 weeks. The program, which is based on CBT, mindfulness, and positive psychology, was well-received and suggests that digital interventions could be a convenient and scalable mental health solution for adolescents. Despite these positive results, the study indicates that it is still unclear how the program impacts long-term mental health and that further investigation is warranted. The intervention's digital characteristics constitute one avenue by which adolescent mental health services could be expanded. This article largely contains my research. It offers insights into how digital tools can intervene in transdiagnostic risk factors, such as stress and rumination, which are key areas in clinical psychology for adolescent mental health outcomes.

Cuijpers, P., Pineda, B. S., Quero, S., Karyotaki, E., Struijs, S. Y., Figueroa, C. A., ... & Muñoz, R. F. (2021). Psychological interventions to prevent the onset of depressive disorders: a meta-analysis of randomized controlled trials. Clinical Psychology Review, 83. https://doi.org/10.1016/j.cpr.2020.101955

The current meta-analytic study explores the effectiveness of psychological intervention in the onset of depressive disorders, offering analyses for persons with no diagnosis of depression at baseline. The synthesis was drawn from 50 random controlled trials which in total draw over 14,000 subjects. The study inferred that psychological preventive interventions, indicated chiefly cognitive-behavioral therapy, would prevent 19% of the development of depression. As such, psychological interventions appear to be useful in preventing disorders such as depression, especially in well-defined risk groups such as persons with a family history of depression or persons currently putting a lot of stress on themselves. The study presumes these interventions as being effective for short-term prevention, whereas their long-term effect is yet to be established. While the study is quite large and employs good methodology, they note the effect might differ, based on the patient’s initial risk and the intervention provided. The article will hold great importance in my research into the prevention of mental disorders, especially in parallel with understanding how early intervention reduces the burden of depression, in my research into the prevention of mental disorders, especially in parallel with understanding how early intervention reduces the burden of depression and will provide feedback into the future practice of clinicians in mental health prevention.

Duagi, D., Carter, B., Farrelly, M., Lisk, S., Shearer, J., Byford, S., James, K., & Brown, J. (2024). Long-term effects of psychosocial interventions for adolescents on depression and anxiety: a systematic review and meta-analysis. EClinicalMedicine, 68. https://doi.org/10.1016/j.eclinm.2023.102382

The systematic review and meta-analysis aim to investigate how psychosocial interventions influence the long-term management of adolescent depression and anxiety. A sum of 57 studies with a combined sample size of 46,678 was introduced into the analysis. According to the findings, psychosocial interventions generated slight but sustained decreases in depressive symptoms up to two years after follow-up. The changes in anxiety symptoms were negligible, however. The study emphasized that interventions with more potent effects were provided by trained mental health professionals, particularly when the intervention was targeted. While presenting promising prevention effects for adolescent depression, this study also emphasized the need to improve access to such services, primarily through schools. This study is of immense importance given its broad scope: both universal and targeted interventions, which thus provide a panoramic perspective on how adolescent mental health may be affected by different approaches. However, due to the nonsignificant findings for anxiety, its implementations for handling broader adolescent mental health problems are limited. The article will shed light on incorporating psychosocial interventions into mental health prevention strategies for children and adolescents in clinical and school-based domains.

Fazia, T., Bubbico, F., Nova, A., Chiara Buizza, Cela, H., Iozzi, D., Beril Calgan, Maggi, F., Floris, V., Sutti, I., Bruno, S., Ghilardi, A., & Bernardinelli, L. (2023). Improving stress management, anxiety, and mental well-being in medical students through an online Mindfulness-Based Intervention: a randomized study. Scientific Reports, 13(1). https://doi.org/10.1038/s41598-023-35483-z

This randomized trial examines the efficacy of an online Mindfulness-Based Intervention to reduce stress and anxiety among medical students. The intervention combined mindfulness exercises, yoga, and dietary advice. There were significant improvements in mental well-being, emotional regulation, and stress management in the intervention group compared to the control subjects. The results thus suggest that interventions to develop mindfulness skills in individuals, mainly through an online user-friendly program, can effectively reduce stress and build emotional resilience in high-stress academic settings like medical school. The study fills a gap in the literature by studying issues unique to medical students, among whom high stress levels are nearly constant. While the research was intense in its well-defined methods and meaningful results, its limitations were the relatively short follow-up period and bias in the self-reported measurement sources. This study is germane to research in clinical psychology, especially in stressing online-based interventions as accessible means for managing stress and emotional well-being among students and practitioners in high-pressure environments.

Rogerson, O., Wilding, S., Prudenzi, A., & O’Connor, D. B. (2023). Effectiveness of stress management interventions to change cortisol levels: a systematic review and meta-analysis. Psychoneuroendocrinology, 159(159). https://doi.org/10.1016/j.psyneuen.2023.106415

The authors conducted a systematic review and meta-analysis of psychological interventions on salivary cortisol (primary stress hormone) by considering 58 trials and 3,508 participants. Mindfulness and relaxation exercises showed a medium positive effect size favoring a decrease in cortisol, with mind-body and talking therapies showing a lesser effect. The interventions with active control groups showed larger effects than those with passive controls as well. As previously mentioned, mindfulness, most notably psychological interventions, helps reduce the physiological stress response, which further emphasizes the data's role in cortisol as a biological marker of stress. The authors noted the citations of the article might reflect the impact of methodological differences in non-pharmaceutical forms of cortisol measurement due to differences in the sample types (blood, saliva, hair, etc.). This article is pertinent to my purview on stress management in clinical environments as it aids in understanding the physiological grounding through which certain interventions deliver their impact. Therefore, how cortisol is regulated will be critical to understanding evidence-based clinical psychology approaches to managing stress