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Robinson MD, Irvin RL, Asad MR. Threat sensitivity in emotion dynamics: Negativity effects and sex differences. Behav Res Ther 2024; 178:104542. [PMID: 38648683 DOI: 10.1016/j.brat.2024.104542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/03/2024] [Accepted: 04/14/2024] [Indexed: 04/25/2024]
Abstract
Evolutionary theorizing has given rise to the idea that responding to any particular threat may be more mandatory than responding to any particular reward. The present three experiments (total N = 375) sought to provide support for this perspective in an emotion dynamics task in which participants continuously rated their affective state in response to appetitive (reward-related) versus aversive (threat-related) images. Even when equating images for arousal and extremity, several negativity effects (e.g., steeper reactivity slopes in response to aversive images) were found. These negativity effects can serve as an experimental model of threat sensitivity, which should predispose some individuals, more than others, to symptoms related to fear and anxiety. This point was made with respect to sex differences, given that women (relative to men) are diagnosed with anxiety disorders at higher rates. Sex differences were pronounced and extensions of this work, both basic and applied, are proposed.
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Gamne R, Misar S, Rai M. Evaluation of comparative efficacy of Celastrus paniculatus (Jyotishmati) capsule versus sertraline capsule in the management of Chittodvega (generalized anxiety disorder): protocol for a randomized controlled trial. F1000Res 2024; 12:1577. [PMID: 39114320 PMCID: PMC11305454 DOI: 10.12688/f1000research.139473.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/12/2024] [Indexed: 08/10/2024] Open
Abstract
Background Generalized anxiety disorder (GAD) (Chittodvega) is one among many types of mental disorders explained in Ayurveda. It can be defined as a Chitta (mind) + Udvega (anxiety)= Chittodvega- Anxious status of a mind. Celastrus paniculatus also known as Jyotishmati. stimulates and improves the digestive fire and metabolism at a cellular level ( Jatharagni and Majja dhatwagni). It can be correlated to GAD. GAD is characterized by feelings of threat, restlessness, irritability, sleep disturbance, and tension, and symptoms such as palpitations, dry mouth, and sweating. It affects women more frequently than men and prevalence rates are high in midlife (prevalence in females over age 35: 10%) and older subjects. In modern medicine the first-line psychological and pharmaceutical treatments are selective serotonin reuptake inhibitors (SSRIs) like sertraline (SNRIs). Aim and objectives To evaluate the comparative efficacy of Jyotishmati versus sertraline in the management of Chittodvega. Methods In this randomized active controlled double blind equivalence trial a total of 70 patients will be enrolled and divided into two equal groups. Patients between 20-50 years age of either gender having symptoms of Chittodvega and a Hamilton anxiety rating (HAM-A) scale score less than 24 (i.e., mild to moderate) will be selected for the study. In Group A, sertraline capsules 25 mg for first 7 days and then dose increased to 50 mg at bedtime for next 53 days and in Group B Jyotishmati Capsules 500 mg will be given twice a day after food with water for 60 days. Result and observation The patients will be assessed on the HAM-A scale, serum cortisol and WHO Quality of Life on day 0, 30, 60 and 90 and data will be analyzed using paired and unpaired t-tests for continuous variables and chi-square tests for categorical variables to evaluate whether treatments are equivalent. Trial registration CTRI No. REF/2023/07/069880 Date - 15/09/2023.
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Affiliation(s)
- Reeya Gamne
- Department Kayachikitsa, Mahatma Gandhi Ayurved College Hospital and Research Centre, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India
| | - Sadhana Misar
- Department Kayachikitsa, Mahatma Gandhi Ayurved College Hospital and Research Centre, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India
| | - Mayank Rai
- Department Kayachikitsa, Mahatma Gandhi Ayurved College Hospital and Research Centre, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India
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Westas M, Mourad G, Andersson G, Lundgren J, Johansson P. The effects of internet-based cognitive behaviour therapy for depression in cardiovascular disease on symptoms of anxiety: a secondary analysis of a randomized trial. Eur J Cardiovasc Nurs 2024; 23:382-390. [PMID: 37740442 DOI: 10.1093/eurjcn/zvad097] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 09/24/2023]
Abstract
AIMS The aims of this study were to evaluate: (i) the short- and long-term effects of the internet-based cognitive behaviour (iCBT) programme on symptoms of distress and fear disorder in cardiovascular disease (CVD) patients, and (ii) the association between changes in depression and changes in symptoms of distress and fear disorder from baseline to 12-month follow-up. METHODS AND RESULTS Secondary analysis of data collected in a randomized controlled study evaluating the effects on depression of an iCBT programme compared to an online discussion forum (ODF) in CVD patients (n = 144). Data were collected at baseline, at post-intervention (9 weeks), and at 6- and 12-month follow-ups.The results showed that symptoms of distress disorder were statistically significantly more reduced in the iCBT group than in the ODF group. For symptoms of the fear disorder, no differences were found except for avoidance, which showed a statistically significant reduction in the iCBT group. The long-term analysis in the iCBT group showed that CAQ total score and fear decreased from baseline to 6- and 12-month follow-ups, respectively. Avoidance and attention both decreased statistically significantly from baseline to post-intervention, but not between post-intervention and 12-month follow-up. CONCLUSION The results suggest that the iCBT programme targeted depression in CVD patients successfully reduced symptoms of distress disorder and to a lesser extent symptoms of fear disorder. Change in depression was more strongly associated with a change in distress than a change in fear disorder. REGISTRATION ClinicalTrials.gov: NCT02778074.
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Affiliation(s)
- Mats Westas
- Department of Health, Medicine and Caring Sciences, Linköping University, 601 74 Norrköping, Linköping, Sweden
| | - Ghassan Mourad
- Department of Health, Medicine and Caring Sciences, Linköping University, 601 74 Norrköping, Linköping, Sweden
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Johan Lundgren
- Department of Health, Medicine and Caring Sciences, Linköping University, 601 74 Norrköping, Linköping, Sweden
| | - Peter Johansson
- Department of Health, Medicine and Caring Sciences and Department of Internal Medicine, Linköping University, Linköping, Sweden
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Wang T, Butterworth P, Cooklin A, Strazdins L, Leach L. Investigating the association between work family conflict (WFC) and generalized anxiety disorder (GAD) in an Australian community-based cohort study. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02672-8. [PMID: 38780779 DOI: 10.1007/s00127-024-02672-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 04/17/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE Difficulties managing work and family demands are common and have been found to be associated with stress and poor mental health. However, very few studies have examined Work Family Conflict (WFC) in connection with diagnosable anxiety disorders (and none with Australian representative data). The current study investigated whether high WFC was significantly associated with a diagnosis of Generalised Anxiety Disorder (GAD) after controlling for a broad range of socio-demographic contextual factors, related psychosocial job, family and individual characteristics, and prior anxiety symptom history. METHODS Data was analysed from an Australian population-based community cohort - the Personality and Total Health (PATH) Through Life project. Eligible participants (N = 1159) were employed full-time or part-time, with data collected by both online questionnaire and face-to-face interview. Presence of Generalised Anxiety Disorder (GAD) in the past 12-months was diagnosed by the GAD module in the Composite International Diagnostic Interview (CIDI) (based on DSM-IV criteria) and severe anxiety symptoms were measured using the Patient Health Questionnaire (PHQ) 7-item 'other anxiety' model. RESULTS The findings consistently showed that those experiencing high WFC had higher odds of a GAD diagnosis (final adjusted model: CIDI: OR: 2.55, CI: 1.38-4.70) as well as clinical levels of anxiety symptoms (PHQ: OR:2.61, CI:1.44,4.72). This was the case after controlling for an extensive range of covariates. CONCLUSIONS This is one of the first studies to show that WFC is associated with greater likelihood of GAD. The challenge of juggling both work and family can have far-reaching impacts - not just increasing distress broadly, but also potentially increasing the likelihood of clinically diagnosable anxiety.
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Affiliation(s)
- Tianying Wang
- National Centre for Epidemiology and Population Health (NCEPH), The Australian National University, Canberra, 2601, Australia.
| | - Peter Butterworth
- National Centre for Epidemiology and Population Health (NCEPH), The Australian National University, Canberra, 2601, Australia
| | - Amanda Cooklin
- Judith Lumley Centre, La Trobe University, Melbourne, Australia
| | - Lyndall Strazdins
- National Centre for Epidemiology and Population Health (NCEPH), The Australian National University, Canberra, 2601, Australia
| | - Liana Leach
- National Centre for Epidemiology and Population Health (NCEPH), The Australian National University, Canberra, 2601, Australia
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5
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Kowalczyk M, Kornacka M, Kostrzewa Z, Krejtz I. Differences in anxiety, worry, and perceived stress among naturally cycling women and oral contraceptives users: a cross-sectional study investigating the role of contraceptive types. Arch Womens Ment Health 2024; 27:241-247. [PMID: 38017240 PMCID: PMC10933156 DOI: 10.1007/s00737-023-01405-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 11/19/2023] [Indexed: 11/30/2023]
Abstract
The goal of our study was to test whether the types of OC affect the link between anxiety and its main maintenance factors: worry and perceived stress. Women are particularly at risk of being affected by excessive worrying, a core component of generalized anxiety disorder (GAD), and they are twice as likely as men to suffer from GAD. The literature suggests that gonadal hormones and types of oral contraceptives (OC) should be taken into account when exploring anxiety disorders in women, but the precise mechanism of this link remains understudied. We performed an observational cross-sectional study on a sample of 908 women, including 499 women naturally cycling (NC) and 409 taking OC (277 in the anti-androgenic group, 132 in the androgenic group). The participants filled in a battery of online questionnaires. Anxiety positively correlated with worry and perceived stress in the whole sample and in the three groups: androgenic OC, anti-androgenic OC, and NC. There was no significant difference between the groups on all the variables apart from the age of the participants. However, we found that women taking anti-androgenic OC had significantly higher levels of worry than NC women (after controlling for stress and age). The differences in OC types should be taken into account in future studies which might also lead to a better choice of OC based on women's individual needs.
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Affiliation(s)
| | | | | | - Izabela Krejtz
- SWPS University, Institute of Psychology, Warsaw, Poland
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6
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Inness BE, McCabe RE, Streiner DL, Barrett E, Green SM. The Worry Behaviors Inventory-Perinatal Revised: Adaptation and Initial Validation for Use in Perinatal Samples. Assessment 2024; 31:350-362. [PMID: 37005700 PMCID: PMC10822066 DOI: 10.1177/10731911231165071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
Generalized anxiety disorder (GAD) is a leading mental health concern during pregnancy and the postpartum (perinatal) period. People with GAD engage in problematic behaviors to manage their distress. However, the extent of GAD behaviors during the perinatal period may not be adequately captured by the Worry Behaviors Inventory (WBI), the most comprehensive measure of GAD behaviors to date. We evaluated the structure of the initial WBI item-pool and then evaluated the internal consistency, construct validity, and predictive utility of the Perinatal Revised WBI (WBI-PR) in a sample of 214 perinatal women with and without GAD. A two-factor, 10-item scale was supported, and some of the retained items differed from the original WBI. Internal consistency of the WBI-PR was acceptable, and evidence of construct validity was demonstrated. The WBI-PR predicted GAD diagnostic status both alone and beyond existing generalized anxiety and depression symptoms. Implications of these findings are discussed.
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Affiliation(s)
| | - Randi E. McCabe
- McMaster University, Hamilton, Ontario, Canada
- St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
| | | | | | - Sheryl M. Green
- McMaster University, Hamilton, Ontario, Canada
- St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
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Dobbertin M, Blair KS, Aloi J, Bajaj S, Bashford-Largo J, Mathur A, Zhang R, Carollo E, Schwartz A, Elowsky J, Ringle JL, Tyler P, Blair RJ. Neural correlates of automatic emotion regulation and their association with suicidal ideation in adolescents during the first 90-days of residential care. Transl Psychiatry 2024; 14:54. [PMID: 38263400 PMCID: PMC10806086 DOI: 10.1038/s41398-023-02723-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/09/2023] [Accepted: 12/15/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Suicide is the second leading cause of death for adolescents in the United States. However, relatively little is known about the forms of atypical neuro-cognitive function that are correlates of suicidal ideation (SI). One form of cognitive/affective function that, when dysfunctional, is associated with SI is emotion regulation. However, very little work has investigated the neural correlates of emotion dysregulation in adolescents with SI. METHODS Participants (N = 111 aged 12-18, 32 females, 31 [27.9%] reporting SI) were recruited shortly after their arrival at a residential care facility where they had been referred for behavioral and mental health problems. Daily reports of SI were collected during the participants' first 90-days in residential care. Participants were presented with a task-fMRI measure of emotion regulation - the Affective Number Stroop task shortly after recruitment. Participants were divided into two groups matched for age, sex and IQ based on whether they demonstrated SI. RESULTS Participants who demonstrated SI showed increased recruitment of regions including dorsomedial prefrontal cortex/supplemental motor area and parietal cortex during task (congruent and incongruent) relative to view trials in the context of emotional relative to neutral distracters. CONCLUSIONS Participants with SI showed increased recruitment of regions implicated in executive control during the performance of a task indexing automatic emotion regulation. Such data might suggest a relative inefficiency in the recruitment of these regions in individuals with SI.
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Affiliation(s)
- Matthew Dobbertin
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA.
| | - Karina S Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Joseph Aloi
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sahil Bajaj
- Department of Cancer Systems Imaging, MD Anderson Cancer Center, Houston, TX, USA
| | - Johannah Bashford-Largo
- Multimodal Clinical Neuroimaging Laboratory, Institute for Human Neuroscience, Boys Town, NE, USA
| | - Avantika Mathur
- Department of Psychology and Human Development, Peabody College, Vanderbilt University, Nashville, TN, USA
| | - Ru Zhang
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Erin Carollo
- Stritch School of Medicine, Loyola University Medical Center, Maywood, IL, USA
| | | | - Jaimie Elowsky
- University of Nebraska Department of Psychology, Lincoln, NE, USA
| | - J L Ringle
- Child and Family Translational Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Patrick Tyler
- Child and Family Translational Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - R James Blair
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
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8
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Zeidan RK, Shukla A, Hussein A, AlZubaidi H, Temsah MH, AlHajjaj MS, Al-Bluwi N, Awad M, Alsayed HAH, Saheb Sharif-Askari N, AlHano Z, Agha R, Hamid Q, Halwani R, Saddik B. Assessment of Knowledge, Perceptions, and Attitudes During the Global Mpox Outbreak in June 2022: A Cross-Sectional Study From the United Arab Emirates. Int J Public Health 2023; 68:1606080. [PMID: 38024212 PMCID: PMC10657881 DOI: 10.3389/ijph.2023.1606080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives: To examine knowledge, worry, anxiety, and vaccine acceptance for mpox among UAE adults. Methods: An online survey, advertised on academic and social media platform in June 2022 collected data from 959 participants (aged 18 and above) on mpox beliefs, risks, knowledge, worry, anxiety, COVID-19 infection, vaccination, and willingness to receive the mpox vaccine. Bivariate and logistic regression analysis identified associations and predictors between variables. Results: 56% had optimal knowledge of mpox transmission and symptoms. 54% were worried, and 27% experienced anxiety related to the outbreak. Knowledge scores were higher among women, healthcare workers, and those with reliable information sources. High perceived infection risk, changes in precautionary measures, and belief in difficult treatment predicted more worry and anxiety. Higher worry and two or more doses of the COVID-19 vaccine predicted higher likelihood of taking the mpox vaccine. Conclusion: The UAE population showed low knowledge and high worry and anxiety during the global mpox outbreak. Increasing public awareness through targeted educational campaigns is vital. Promoting better understanding of infectious diseases, addressing concerns, and encouraging vaccine uptake can prepare for future outbreaks.
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Affiliation(s)
- Rouba Karen Zeidan
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Ankita Shukla
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Amal Hussein
- Department of Family and Community Medicine and Behavioural Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Hamzah AlZubaidi
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
- School of Medicine, Deakin Rural Health, Deakin University Faculty of Health, Warrnambool, VIC, Australia
| | - Mohamad-Hani Temsah
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohamed S. AlHajjaj
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Najlaa Al-Bluwi
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Manal Awad
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | | | - Narjes Saheb Sharif-Askari
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Department of Family and Community Medicine and Behavioural Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Zahraa AlHano
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Razan Agha
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Qutayba Hamid
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Meakins-Christie Laboratories, Research Institute, McGill University Health Center, Montréal, QC, Canada
| | - Rabih Halwani
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Basema Saddik
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Department of Family and Community Medicine and Behavioural Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
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9
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Freeston MH. What if we have too many models of worry and GAD? Behav Cogn Psychother 2023; 51:559-578. [PMID: 37183586 DOI: 10.1017/s1352465822000649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Affiliation(s)
- Mark H Freeston
- School of Psychology, Newcastle University, Newcastle upon Tyne, UK
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10
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Mishra AK, Varma AR. A Comprehensive Review of the Generalized Anxiety Disorder. Cureus 2023; 15:e46115. [PMID: 37900518 PMCID: PMC10612137 DOI: 10.7759/cureus.46115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 09/28/2023] [Indexed: 10/31/2023] Open
Abstract
Excessive, uncontrollable, and usually unjustified worry about certain things is a sign of the mental and behavioral disease known as generalized anxiety disorder (GAD). Genetic research suggests that numerous genes are likely implicated in the development of GAD, even if much is yet unclear about this. As a result, if someone in a family has GAD, there is a high likelihood that someone else will also suffer from the illness, as well as another anxiety disorder. Individuals with GAD are frequently overly bothered about workaday affairs like health, assets, demise, family, accord issues, or effort challenges. Worry frequently interferes with daily functioning. Excessive concern, restlessness, difficulty sleeping, tiredness, irritability, sweating, and trembling are a few symptoms that may be present. For a formal diagnosis of GAD, symptoms must be persistent for at least six months and consistent. Conversion in the amygdala's utilitarian congruence and how it processes fear and anxiety have been linked to generalized anxiety disorder. Neurotransmitters, and particularly the gamma-aminobutyric acid (GABA) variant, have long been known to cause GAD through dysregulating amygdala activity in the brain. Anxiety, concern, or physical symptoms must significantly hinder social, academic, or occupational functioning in order to qualify for a GAD diagnosis. The Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V) provides explicit ethos to aid doctors in identifying this disorder. Psychological therapy based on cognitive behavioral therapy (CBT) principles is effective in reducing anxiety symptoms for short-term treatment of GAD. In this, the patient's thinking ability and methods are focused. The main principle behind CBT is that your thought patterns affect your feelings, which in turn can affect your behavior. Drugs like antidepressants, buspirone, benzodiazepines, and can all be worn to goody GAD. Outside of therapy, patients with anxiety can learn to manage it by practicing relaxation methods, reframing unfavorable ideas, and adopting stress-relieving adjustments. Being socially active and setting aside time for proper self-care are crucial components of managing generalized anxiety disorder.
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Affiliation(s)
- Aneesh K Mishra
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anuj R Varma
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Kosasih FR, Yee VTS, Toh SHY, Sündermann O. Efficacy of Intellect's self-guided anxiety and worry mobile health programme: A randomized controlled trial with an active control and a 2-week follow-up. PLOS DIGITAL HEALTH 2023; 2:e0000095. [PMID: 37224139 DOI: 10.1371/journal.pdig.0000095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 03/24/2023] [Indexed: 05/26/2023]
Abstract
Digital self-guided mobile health [mHealth] applications are cost-effective, accessible, and well-suited to improve mental health at scale. This randomized controlled trial [RCT] evaluated the efficacy of a recently developed mHealth programme based on cognitive-behavioral therapy [CBT] principles in improving worry and anxiety. We also examined psychological mindedness [PM] as a mediator by which app engagement is thought to improve outcomes. The Intervention group completed a 2-week "Anxiety and Worry" programme with daily CBT-informed activities, while the active waitlist-control completed a matched 2-week mHealth programme on procrastination. Participants filled out the Generalized Anxiety Disorder [GAD-7], Patient Health Questionnaire [PHQ-9], and Psychological Mindedness Scale [PMS] at baseline, post-intervention, and 2-week follow-up. App engagement was measured at post-intervention only. Contrary to prediction, the Intervention group did not perform better than the Active Control group; both groups showed significant improvements on anxiety and depressive symptoms from baseline to follow-up. From post-intervention to follow-up, only the Intervention group showed further improvements for anxiety symptoms. Higher engagement with the mHealth app predicted lower anxiety and depressive symptoms at follow-up, and this relationship was fully mediated by psychological mindedness. This study provides evidence that [a] engaging in a CBT mHealth programme can reduce anxiety and worry, and [b] Psychological mindedness is a potential pathway by which engaging with a mHealth app improves anxiety and depressive symptoms. While overall effect sizes were small, at the population level, these can make significant contributions to public mental health.
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Affiliation(s)
| | | | | | - Oliver Sündermann
- Research Department, Intellect Co Pte Ltd, Singapore
- Department of Psychology, National University of Singapore
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12
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Husain W, Wasif S, Fatima I. Profanity as a Self-Defense Mechanism and an Outlet for Emotional Catharsis in Stress, Anxiety, and Depression. DEPRESSION RESEARCH AND TREATMENT 2023; 2023:8821517. [PMID: 37181488 PMCID: PMC10171984 DOI: 10.1155/2023/8821517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/14/2023] [Accepted: 04/18/2023] [Indexed: 05/16/2023]
Abstract
Background Swearing is an increasing trend among men and women worldwide. Earlier studies on the positive aspects of profanity mostly relate to pain management and the release of negative emotions. The uniqueness of the current study is its analysis for a possible constructive role of profanity in stress, anxiety, and depression. Method The current survey involved 253 conveniently selected participants from Pakistan. The study analyzed the role of profanity in connection to stress, anxiety, and depression. Profanity Scale and the Urdu version of Depression, Anxiety, and Stress Scale were used along with a structured interview schedule. Descriptive statistics, Pearson's correlation coefficient, and t-test were implied to obtain results. Results The study revealed that the usage of profane language had significantly inverse correlations with stress (r = -0.250; p < 0.01), anxiety (r = -0.161; p < 0.05), and depression (r = -0.182; p < 0.01). Higher profaners also revealed significantly lower levels of depression (M = 29.91, SD = 10.80 vs. M = 33.48, SD = 10.40; p = 0.009; Cohen's d = 0.338) and stress (M = 30.83, SD = 11.41 vs. M = 35.16, SD = 11.31; p = 0.003; Cohen's d = 0.381) as compared to lower profaners. Profanity had no significant correlations with age (r = 0.031; p > 0.05) and education (r = 0.016; p > 0.05). Men projected significantly higher levels of profanity as compared to women. Conclusion The current study viewed profanity similar to the self-defense mechanisms and emphasized on its cathartic role in stress, anxiety, and depression.
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Affiliation(s)
- Waqar Husain
- Department of Humanities, COMSATS University, Park Road, Islamabad, Pakistan
| | - Samia Wasif
- Department of Humanities, COMSATS University, Park Road, Islamabad, Pakistan
| | - Insha Fatima
- Department of Humanities, COMSATS University, Park Road, Islamabad, Pakistan
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13
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Cheng YC, Su MI, Liu CW, Huang YC, Huang WL. Heart rate variability in patients with anxiety disorders: A systematic review and meta-analysis. Psychiatry Clin Neurosci 2022; 76:292-302. [PMID: 35340102 DOI: 10.1111/pcn.13356] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 03/10/2022] [Accepted: 03/21/2022] [Indexed: 11/28/2022]
Abstract
AIMS Patients with anxiety disorders (AD) have been found to have lower heart rate variability (HRV) than healthy individuals in some studies, but this was inconsistent. Furthermore, the influence of distinct diagnoses, study design, and demographic factors on the results was not comprehensively examined. METHODS We gathered studies comparing HRV in patients with AD and in healthy controls. The parasympathetic activity in the hierarchical order principle was adopted in the main analysis. We adopted the random effects model to calculate the standardized mean difference. RESULTS Of the 7805 screened studies, 99 were included in the quantitative analysis, with a total of 4897 AD patients and 5559 controls finally entered the meta-analysis. AD patients had a significantly lower resting-state HRV for parasympathetic activity compared to control (Hedges' g = -0.3897). For the diagnostic subgroup analysis relative to the controls, resting-state HRV was significantly lower in post-traumatic stress disorder, panic disorder, generalized anxiety disorder, and social anxiety disorder patients. HRV reactivity (all reactivity data, data on physiological challenge, and psychological challenge) did not show significant inter-group differences between AD patients and healthy subjects. CONCLUSIONS The results supported that patients with AD had significantly lower resting-state HRV than the healthy population, but no alterations were found for HRV reactivity.
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Affiliation(s)
- Ying-Chih Cheng
- Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan.,Department of Public Health and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Research Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Min-I Su
- Division of Cardiology, Department of Internal Medicine, Taitung MacKay Memorial Hospital, Taitung, Taiwan.,Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Cheng-Wei Liu
- Department of Internal Medicine, Tri-Service General Hospital Songshan Branch, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yu-Chen Huang
- Research Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Dermatology, School of Medicine and College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wei-Lieh Huang
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan.,Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan.,Cerebellar Research Center, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
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14
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Rook L, Mazza MC, Lefter I, Brazier F. Toward Linguistic Recognition of Generalized Anxiety Disorder. Front Digit Health 2022; 4:779039. [PMID: 35493530 PMCID: PMC9051024 DOI: 10.3389/fdgth.2022.779039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 03/21/2022] [Indexed: 11/21/2022] Open
Abstract
Background Generalized anxiety disorder (GAD) refers to extreme, uncontrollable, and persistent worry and anxiety. The disorder is known to affect the social functioning and well-being of millions of people, but despite its prevalence and burden to society, it has proven difficult to identify unique behavioral markers. Interestingly, the worrying behavior observed in GAD is argued to stem from a verbal linguistic process. Therefore, the aim of the present study was to investigate if GAD can be predicted from the language people use to put their anxious worries into words. Given the importance of avoidance sensitivity (a higher likelihood to respond anxiously to novel or unexpected triggers) in GAD, this study also explored if prediction accuracy increases when individual differences in behavioral avoidance and approach sensitivity are taken into account. Method An expressive writing exercise was used to explore whether GAD can be predicted from linguistic characteristics of written narratives. Specifically, 144 undergraduate student participants were asked to recall an anxious experience during their university life, and describe this experience in written form. Clinically validated behavioral measures for GAD and self-reported sensitivity in behavioral avoidance/inhibition (BIS) and behavioral approach (BAS), were collected. A set of classification experiments was performed to evaluate GAD predictability based on linguistic features, BIS/BAS scores, and a concatenation of the two. Results The classification results show that GAD can, indeed, be successfully predicted from anxiety-focused written narratives. Prediction accuracy increased when differences in BIS and BAS were included, which suggests that, under those conditions, negatively valenced emotion words and words relating to social processes could be sufficient for recognition of GAD. Conclusions Undergraduate students with a high GAD score can be identified based on their written recollection of an anxious experience during university life. This insight is an important first step toward development of text-based digital health applications and technologies aimed at remote screening for GAD. Future work should investigate the extent to which these results uniquely apply to university campus populations or generalize to other demographics.
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15
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Stahl-Pehe A, Selinski S, Bächle C, Castillo K, Lange K, Holl RW, Rosenbauer J. Screening for generalized anxiety disorder (GAD) and associated factors in adolescents and young adults with type 1 diabetes: Cross-sectional results of a Germany-wide population-based study. Diabetes Res Clin Pract 2022; 184:109197. [PMID: 35065100 DOI: 10.1016/j.diabres.2022.109197] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/29/2021] [Accepted: 01/13/2022] [Indexed: 01/09/2023]
Abstract
AIMS The aims of this study were to screen 14- to 30-year-olds with early-onset type 1 diabetes for generalized anxiety disorder (GAD) and to compare the characteristics of the study participants who had a positive result for GAD with those who had a negative result. METHODS This study used data from a questionnaire survey conducted from 2018 to 2019. The GAD-7 questionnaire was used to screen for GAD (positive: GAD-7 score ≥ 10). All regression analyses were adjusted for age, sex, depression diagnosis and considered multiple testing. RESULTS The 713 participants had a mean GAD-7 score of 4.32 (SD 4.18). A total of 12% of the study population (10% of adolescents, 13% of adults) was screened positive for GAD. Positive screening results were associated with impairments in various domains, such as self-assessed physical performance (RR poor versus good 3.03 [95% CI 1.85-4.96]), difficulty falling asleep (RR ≥3 times/week versus not during the last 4 weeks 5.36 [2.86-10.07]), glycemic control (RR HbA1c per 1% 1.16 [1.03-1.31]), and diabetes treatment satisfaction (RR poor versus good 2.67 [1.43-5.00]). CONCLUSIONS Diabetologists should be aware that adolescents and young adults with GAD symptoms might experience extensive impairments in their daily lives.
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Affiliation(s)
- Anna Stahl-Pehe
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Germany; German Centre for Diabetes Research (DZD), Munich-Neuherberg, Germany.
| | - Silvia Selinski
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Germany; German Centre for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Christina Bächle
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Germany; German Centre for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Katty Castillo
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Germany; German Centre for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Karin Lange
- Medical Psychology Unit, Hannover Medical School, Hannover, Germany
| | - Reinhard W Holl
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Germany; Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Germany
| | - Joachim Rosenbauer
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Germany; German Centre for Diabetes Research (DZD), Munich-Neuherberg, Germany
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16
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Marciano H, Eshel Y, Kimhi S, Adini B. Hope and Fear of Threats as Predictors of Coping with Two Major Adversities, the COVID-19 Pandemic and an Armed Conflict. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031123. [PMID: 35162144 PMCID: PMC8834741 DOI: 10.3390/ijerph19031123] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/12/2022] [Accepted: 01/17/2022] [Indexed: 02/04/2023]
Abstract
Coping with adversities has been explained by two major theories: the fear appeal theory and the hope theory. The predictability of hope with that of fear of threats as variables explaining coping with two major adversities, the COVID-19 pandemic and an armed conflict, was compared. Participants were approached via an internet panel company in two different times: (1) January 2021 (N = 699; age range: 18–82; 330 women), during the third wave of the COVID-19 pandemic in Israel and (2) May 2021 (N = 647; age range: 19–83; 297 women), during an armed conflict between Israel and Hamas. Participants self-reported on hope, four perceived threats (health, economics, security, and political), well-being, individual resilience, societal resilience, and distress symptoms (anxiety and depression symptoms) were collected. Hope was found as a more consistent and stronger predictor of the following expressions of coping: well-being, individual and societal resilience, depression, and anxiety. It can be concluded that hope is a better and more consistent predictor of coping, as well as coping suppressing expressions, compared with fear of threats, in the face of the current adversities. The innovative nature of these findings, the importance of hope as a coping supporter, and the need for replicating these innovative results are discussed and elaborated.
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Affiliation(s)
- Hadas Marciano
- Stress and Resilience Research Center, Tel-Hai College, Tel Hai 1220800, Israel; (Y.E.); (S.K.)
- The Institute of Information Processing and Decision Making (IIPDM), University of Haifa, Haifa 3498838, Israel
- Correspondence:
| | - Yohanan Eshel
- Stress and Resilience Research Center, Tel-Hai College, Tel Hai 1220800, Israel; (Y.E.); (S.K.)
- Department of Psychology, University of Haifa, Haifa 3498838, Israel
| | - Shaul Kimhi
- Stress and Resilience Research Center, Tel-Hai College, Tel Hai 1220800, Israel; (Y.E.); (S.K.)
| | - Bruria Adini
- Department of Emergency and Disaster Management, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6139001, Israel;
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17
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Therriault D, Houle AA, Lane J, Smith J, Gosselin P, Roberge P, Dupuis A. Portrait des symptômes d’anxiété généralisée chez les élèves du secondaire : l’importance de la prévention, du dépistage et de l’intervention. SANTÉ MENTALE AU QUÉBEC 2022. [DOI: 10.7202/1094154ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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18
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Zhu S, Zhang X, Zhou M, Kendrick KM, Zhao W. Therapeutic applications of transcutaneous auricular vagus nerve stimulation with potential for application in neurodevelopmental or other pediatric disorders. Front Endocrinol (Lausanne) 2022; 13:1000758. [PMID: 36313768 PMCID: PMC9596914 DOI: 10.3389/fendo.2022.1000758] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 09/27/2022] [Indexed: 11/13/2022] Open
Abstract
Non-invasive transcutaneous auricular vagus nerve stimulation (taVNS) as a newly developed technique involves stimulating the cutaneous receptive field formed by the auricular branch of the vagus nerve in the outer ear, with resulting activation of vagal connections to central and peripheral nervous systems. Increasing evidence indicates that maladaptive neural plasticity may underlie the pathology of several pediatric neurodevelopmental and psychiatric disorders, such as autism spectrum disorder, attention deficit hyperactivity disorder, disruptive behavioral disorder and stress-related disorder. Vagal stimulation may therefore provide a useful intervention for treating maladaptive neural plasticity. In the current review we summarize the current literature primarily on therapeutic use in adults and discuss the prospects of applying taVNS as a therapeutic intervention in specific pediatric neurodevelopmental and other psychiatric disorders. Furthermore, we also briefly discuss factors that would help optimize taVNS protocols in future clinical applications. We conclude from these initial findings that taVNS may be a promising alternative treatment for pediatric disorders which do not respond to other interventions.
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Affiliation(s)
- Siyu Zhu
- The Clinical Hospital of Chengdu Brain Science Institute, Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiaolu Zhang
- The Clinical Hospital of Chengdu Brain Science Institute, Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Menghan Zhou
- The Clinical Hospital of Chengdu Brain Science Institute, Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Keith M. Kendrick
- The Clinical Hospital of Chengdu Brain Science Institute, Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Weihua Zhao
- The Clinical Hospital of Chengdu Brain Science Institute, Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
- Institute of Electronic and Information Engineering of University of Electronic Science and Technology of China (UESTC) in Guangdong, Dongguan, China
- *Correspondence: Weihua Zhao,
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19
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Bounoua N, Goodling S, Sadeh N. Cross-Lagged Analysis of COVID-19-Related Worry and Media Consumption in a Socioeconomically Disadvantaged Sample of Community Adults. Front Psychol 2021; 12:728629. [PMID: 34955958 PMCID: PMC8692940 DOI: 10.3389/fpsyg.2021.728629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 11/12/2021] [Indexed: 11/15/2022] Open
Abstract
The COVID-19 pandemic has led to an increase in an array of mental health problems. Previous research has shown that media exposure to stressful situations is often related to anxiety and stress. However, given that most existing work has used cross-sectional designs, less is known about the interplay of media exposure and worry as they unfold during sustained exposure to a collective stressor. The current study examined bidirectional associations between COVID-related worry and media consumption over a three-month period. Participants were 87 community adults, the majority of whom were recruited from communities heavily impacted by the COVID-19 pandemic. For three consecutive months, participants asked to indicate how much time they spent worrying and consuming news about the COVID-19 pandemic on a scale from 1 ("never") to 5 ("most of the day"). Cross-lagged analyses revealed that Pandemic Worry at Month 1 predicted increases in Pandemic Media Consumption at Month 2, which in turn predicted increases in Pandemic Worry at Month 3. Findings suggest that media consumption may be a maladaptive coping strategy that has the iatrogenic effect of increasing worry. Clarifying the causal associations between anxiety-perpetuating processes and media consumption may have important clinical implications for understanding and treating mental health during health pandemics.
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Affiliation(s)
- Nadia Bounoua
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, United States
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20
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The Role of Overt and Covert Avoidance Strategies in Generalized Anxiety Disorder Symptoms and Fear of Emotion. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2021. [DOI: 10.1007/s10862-021-09929-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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21
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Wright L, Steptoe A, Fancourt D. Does thinking make it so? Differential associations between adversity worries and experiences and mental health during the COVID-19 pandemic. J Epidemiol Community Health 2021; 75:817-823. [PMID: 33483341 PMCID: PMC7830321 DOI: 10.1136/jech-2020-215598] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 01/06/2021] [Accepted: 01/17/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND There is evidence that the COVID-19 pandemic is having adverse effects on mental health. It is vital to understand what is causing this: worries over potential adversities due to the pandemic, or the toll of experiencing adverse events. METHODS We used panel data from 41 909 UK adults in the COVID-19 Social Study assessed weekly from 1 April 2020 to 12 May 2020 to study the association between adversities and anxiety and depressive symptoms. We studied six categories of adversity including both worries and experiences of: illness with COVID-19, financial difficulty, loss of paid work, difficulties acquiring medication, difficulties accessing food, and threats to personal safety. Anxiety and depression were measured using the 7-item Generalised Anxiety Disorder Assessment and the 9-item Patient Health Questionnaire. We used fixed-effect regression models to account for time-invariant confounders. RESULTS Cumulative number of worries and experience of adversities were both related to higher levels of anxiety and depression. A number of worries were associated more with anxiety than depression, but number of experiences were equally related to anxiety and depression. There were clear associations between specific worries and poorer mental health. There was weak evidence that individuals of lower socio-economic position were more negatively affected psychologically by the adverse experiences. CONCLUSION Measures over the first few weeks of lockdown in the UK appear to have been insufficient at reassuring people given that we see clear associations with mental health and cumulative worries. Interventions are required that seek to prevent adverse events (eg, redundancies) and reassure individuals and support adaptive coping strategies.
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Affiliation(s)
- Liam Wright
- Department of Behavioural Science and Health, University College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London, UK
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22
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He Y, Li A, Li K, Xiao J. Neuroticism vulnerability factors of anxiety symptoms in adolescents and early adults: an analysis using the bi-factor model and multi-wave longitudinal model. PeerJ 2021; 9:e11379. [PMID: 34221704 PMCID: PMC8231313 DOI: 10.7717/peerj.11379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 04/09/2021] [Indexed: 11/23/2022] Open
Abstract
Background Neuroticism and stress are important vulnerability factors in the development and outcome of anxiety symptoms. However, as neuroticism is a heterogeneity trait, it is still unclear how different neuroticism factors contribute to anxiety symptoms independently or in conjunction with stress. Thus, different factors of neuroticism were extracted in the present longitudinal study using the bi-factor model. The prediction effect of these different factors on anxiety symptoms and their combined effects with stress in both adolescent and adult samples were examined. Method Participants (592 adolescents and 638 young adults) in Hunan China were included. In the initial assessment in our longitudinal study, participants were asked to complete measurements that assessed neuroticism, stress, and anxiety symptoms. Next, a monthly assessment of stress and anxiety symptoms was completed for the subsequent 6 months. The bi-factor model was used to extract different factors of neuroticism. The hierarchical linear model was used to analyze longitudinal multi-wave data. Result Several model fit indices were used to evaluate the bi-factor model fit for neuroticism (adolescent: Tucker-Lewis index (TLI) = 0.957, comparative fit index (CFI) = 0.973, RMSEA = 0.040, Chi-Square = 80.471; early adults: TLI = 0.957, CFI = 0.973, RMSEA = 0.042, Chi-Square = 88.465). The results of hierarchical linear modeling analyses indicated that the general factor of neuroticism possessed a predictive effect on anxiety symptoms (adolescents: F = 36.77, p < 0.0001, early adults: F = 30.44, p < 0.0001); The negative effect factor only had the prediction effect on anxiety symptoms in early adults (adolescents: F = 0.65, p > 0.05; early adults: F = 4.84, p < 0.05); No prediction of self-reproach factor was found on anxiety symptoms (adolescents: F = 3.79, p > 0.05; early adults: F = 0.02, p > 0.05); the interactive effects of the general factor and stress on anxiety symptoms were only found in early adulthood (adolescents: F = 0.13, p > 0.05; early adults: F = 11.55, p < 0.01). Conclusion Our results suggested that the bi-factor model achieved a satisfactory fit for neuroticism measurement and supported that the anxiety symptoms were induced by the main effects of the general factor in both age samples and the negative factor only in adults. The general factor of neuroticism, but not the negative factor could make an additive effect for anxiety symptoms in face of stress, which meant that the homogeneity of neuroticism played a more significant role in further anxiety symptoms than heterogeneity when coping with stress.
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Affiliation(s)
- Yini He
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Ang Li
- State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| | - Kaixin Li
- School of Mechanical and Power Engineering, Harbin University of Science and Technology, Harbin, China
| | - Jing Xiao
- Beijing Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, China
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23
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Herbert C, El Bolock A, Abdennadher S. How do you feel during the COVID-19 pandemic? A survey using psychological and linguistic self-report measures, and machine learning to investigate mental health, subjective experience, personality, and behaviour during the COVID-19 pandemic among university students. BMC Psychol 2021; 9:90. [PMID: 34078469 PMCID: PMC8170461 DOI: 10.1186/s40359-021-00574-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 04/26/2021] [Indexed: 12/12/2022] Open
Abstract
Background The WHO has raised concerns about the psychological consequences of the current COVID-19 pandemic, negatively affecting health across societies, cultures and age-groups. Methods This online survey study investigated mental health, subjective experience, and behaviour (health, learning/teaching) among university students studying in Egypt or Germany shortly after the first pandemic lockdown in May 2020. Psychological assessment included stable personality traits, self-concept and state-like psychological variables related to (a) mental health (depression, anxiety), (b) pandemic threat perception (feelings during the pandemic, perceived difficulties in describing, identifying, expressing emotions), (c) health (e.g., worries about health, bodily symptoms) and behaviour including perceived difficulties in learning. Assessment methods comprised self-report questions, standardized psychological scales, psychological questionnaires, and linguistic self-report measures. Data analysis comprised descriptive analysis of mental health, linguistic analysis of self-concept, personality and feelings, as well as correlational analysis and machine learning. N = 220 (107 women, 112 men, 1 = other) studying in Egypt or Germany provided answers to all psychological questionnaires and survey items. Results Mean state and trait anxiety scores were significantly above the cut off scores that distinguish between high versus low anxious subjects. Depressive symptoms were reported by 51.82% of the student sample, the mean score was significantly above the screening cut off score for risk of depression. Worries about health (mental and physical health) and perceived difficulties in identifying feelings, and difficulties in learning behaviour relative to before the pandemic were also significant. No negative self-concept was found in the linguistic descriptions of the participants, whereas linguistic descriptions of feelings during the pandemic revealed a negativity bias in emotion perception. Machine learning (exploratory) predicted personality from the self-report data suggesting relations between personality and subjective experience that were not captured by descriptive or correlative data analytics alone. Conclusion Despite small sample sizes, this multimethod survey provides important insight into mental health of university students studying in Egypt or Germany and how they perceived the first COVID-19 pandemic lockdown in May 2020. The results should be continued with larger samples to help develop psychological interventions that support university students across countries and cultures to stay psychologically resilient during the pandemic. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-021-00574-x.
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Affiliation(s)
- Cornelia Herbert
- Applied Emotion and Motivation Psychology, Institute of Psychology and Education, Faculty of Engineering, Computer Science and Psychology, Ulm University, Albert Einstein Allee 47, 89081, Ulm, Germany.
| | - Alia El Bolock
- Applied Emotion and Motivation Psychology, Institute of Psychology and Education, Faculty of Engineering, Computer Science and Psychology, Ulm University, Albert Einstein Allee 47, 89081, Ulm, Germany.,Computer Science Department, Faculty of Media Engineering and Technology, German University in Cairo - GUC, New Cairo City, Egypt
| | - Slim Abdennadher
- Computer Science Department, Faculty of Media Engineering and Technology, German University in Cairo - GUC, New Cairo City, Egypt
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24
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Sharma P, Rosário MC, Ferrão YA, Albertella L, Miguel EC, Fontenelle LF. The impact of generalized anxiety disorder in obsessive-compulsive disorder patients. Psychiatry Res 2021; 300:113898. [PMID: 33812219 DOI: 10.1016/j.psychres.2021.113898] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 03/20/2021] [Indexed: 01/09/2023]
Abstract
Despite generalized anxiety disorder (GAD) being one of the most prevalent comorbidities in obsessive-compulsive disorder (OCD), few studies have researched its impact on the OCD phenotype. The present study investigated how the sociodemographic and clinical profile of people with OCD with comorbid GAD differs from people with OCD without comorbid GAD. We hypothesised that the phenotype of the comorbid group would be closely related to GAD, in that it would more likely be female, have an earlier age at onset of OCD, and show an increased severity of fear-related OCD symptoms (aggressive, sexual/religious, and contamination dimensions), more avoidant behaviours, greater suicidality, more severe anxiety symptoms, and increased rates of comorbid anxiety and mood disorders. The study included 867 participants with OCD, with GAD being comorbid in 33.56%. Mann-Whitney U tests, chi-square tests with continuity correction, and logistic regressions were performed. Results showed that comorbid GAD was uniquely associated with an increased number of avoidant behaviours, greater anxiety severity, panic disorder without agoraphobia, social phobia, specific phobia, and type II bipolar disorder. These results illustrate the clinical severity associated with this comorbidity and highlight markers that can aid diagnosis of GAD in OCD. Future studies should investigate whether this comorbidity has an impact on the treatment of OCD.
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Affiliation(s)
- Prerika Sharma
- Turner Institute for Brain and Mental Health, Monash University, Victoria, Australia
| | - Maria C Rosário
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), Brazil
| | - Ygor A Ferrão
- Department of Psychiatry, Federal University of Health Sciences of Porto Alegre (UFCSPA)
| | - Lucy Albertella
- Turner Institute for Brain and Mental Health, Monash University, Victoria, Australia
| | - Euripedes C Miguel
- Obsessive-Compulsive Spectrum Disorders Program (PROTOC), Department and Institute of Psychiatry, University of São Paulo (USP), Brazil
| | - Leonardo F Fontenelle
- Turner Institute for Brain and Mental Health, Monash University, Victoria, Australia; Obsessive, Compulsive, and Anxiety Spectrum Research Program. Institute of Psychiatry, Federal University of Rio de Janeiro & D'Or Institute for Research and Education, Rio de Janeiro, Brazil.
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25
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Küpeli Akkol E, Tatlı Çankaya I, Şeker Karatoprak G, Carpar E, Sobarzo-Sánchez E, Capasso R. Natural Compounds as Medical Strategies in the Prevention and Treatment of Psychiatric Disorders Seen in Neurological Diseases. Front Pharmacol 2021; 12:669638. [PMID: 34054540 PMCID: PMC8155682 DOI: 10.3389/fphar.2021.669638] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 04/16/2021] [Indexed: 12/14/2022] Open
Abstract
Psychiatric disorders are frequently encountered in many neurological disorders, such as Alzheimer’s and Parkinson diseases along with epilepsy, migraine, essential tremors, and stroke. The most common comorbid diagnoses in neurological diseases are depression and anxiety disorders along with cognitive impairment. Whether the underlying reason is due to common neurochemical mechanisms or loss of previous functioning level, comorbidities are often overlooked. Various treatment options are available, such as pharmacological treatments, cognitive-behavioral therapy, somatic interventions, or electroconvulsive therapy. However oral antidepressant therapy may have some disadvantages, such as interaction with other medications, low tolerability due to side effects, and low efficiency. Natural compounds of plant origin are extensively researched to find a better and safer alternative treatment. Experimental studies have shown that phytochemicals such as alkaloids, terpenes, flavonoids, phenolic acids as well as lipids have significant potential in in vitro and in vivo models of psychiatric disorders. In this review, various efficacy of natural products in in vitro and in vivo studies on neuroprotective and their roles in psychiatric disorders are examined and their neuro-therapeutic potentials are shed light.
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Affiliation(s)
- Esra Küpeli Akkol
- Department of Pharmacognosy, Faculty of Pharmacy, Gazi University, Ankara, Turkey
| | - Irem Tatlı Çankaya
- Department of Pharmaceutical Botany, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey
| | | | - Elif Carpar
- Department of Psychiatry, Private French La Paix Hospital, Istanbul, Turkey
| | - Eduardo Sobarzo-Sánchez
- Instituto de Investigación y Postgrado, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago, Chile.,Department of Organic Chemistry, Faculty of Pharmacy, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Raffaele Capasso
- Department of Agricultural Sciences, University of Naples Federico II, Potici, Italy
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Franklin AR, Mathersul DC, Raine A, Ruscio AM. Restlessness in Generalized Anxiety Disorder: Using Actigraphy to Measure Physiological Reactions to Threat. Behav Ther 2021; 52:734-744. [PMID: 33990246 DOI: 10.1016/j.beth.2020.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 08/28/2020] [Accepted: 09/08/2020] [Indexed: 01/22/2023]
Abstract
Generalized anxiety disorder (GAD) is characterized by excessive, uncontrollable worry accompanied by symptoms of physiological arousal. Although individuals with GAD report greater subjective arousal than healthy individuals, they show equivalent or even attenuated physiological reactions to threat. This may result from using physiological measures better suited to fear than anxiety. To test this possibility, 102 adults with and without GAD were assessed for restlessness, a core physiological symptom of GAD. They were exposed to an in vivo threat task designed to elicit anxiety in the laboratory. Throughout the task, restlessness was measured physiologically with actigraphy sensors on both ankles and both wrists, and subjectively with self-report ratings. The GAD group reported higher subjective restlessness than the no-GAD group, and in the subset of cases who had restlessness as a clinically significant symptom, actigraphy scores were reliably elevated as well. However, although actigraphy scores increased with proximity to the threat, the increases did not differ by group. These findings provide initial validation for actigraphy as a novel measure of motor restlessness in GAD. In addition, they underscore the value of measuring restlessness using multiple assessment methods. These methods suggest that, in GAD, restlessness reflects a chronic state of arousal rather than a heightened physiological reaction to threat.
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A Preliminary Exploration of Behaviours Associated with Negative Urgency in Individuals High and Low in Chronic Worry. BEHAVIOUR CHANGE 2021. [DOI: 10.1017/bec.2021.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractWhile chronic worry is typically associated with cautious and harm-avoidant behaviours, there is evidence that people high in chronic worry are characterised by negative urgency (NU), that is, the propensity to act rashly when experiencing negative affect. The present study was a preliminary examination of how rash action and impulsive decision-making manifest for chronic worriers compared to individuals low in worry. In total, 93 participants who endorsed high and low worry and NU responded to open-ended questions about their experience of NU on Amazon Mechanical Turk. Themes were identified using a data-driven approach. Participants high in chronic worry endorsed significantly greater NU compared to those low in worry. However, the types of NU behaviours were similar across participants, with a majority of responses involving initiating interpersonal conflict. Other themes included spending money, excessive eating, alcohol use, and aggressive behaviours. The manifestations of NU were largely consistent with those described in the model of NU. Although individuals higher in chronic worry engaged in NU behaviours to a greater extent, the types of behaviours were similar to those reported by people lower in worry. More research is needed to understand the characteristics of NU-motivated behaviour in individuals high in chronic worry.
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Freeston M, Tiplady A, Mawn L, Bottesi G, Thwaites S. Towards a model of uncertainty distress in the context of Coronavirus (COVID-19). COGNITIVE BEHAVIOUR THERAPIST 2020; 13:e31. [PMID: 34191941 PMCID: PMC7426588 DOI: 10.1017/s1754470x2000029x] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 06/19/2020] [Accepted: 06/27/2020] [Indexed: 12/11/2022]
Abstract
The paper forms part of a series of papers outlining the theoretical framework for a new model of uncertainty distress (this paper), treatment implications arising from the model, and empirical tests of the model. We define uncertainty distress as the subjective negative emotions experienced in response to the as yet unknown aspects of a given situation. In the first paper we draw on a robust body of research on distinct areas including: threat models of anxiety, perceived illness uncertainty and intolerance of uncertainty. We explore how threat and uncertainty are separable in anxiety and how we can understand behaviours in response to uncertainty. Finally, we propose a clinically, theoretically and empirically informed model for uncertainty distress, and outline how this model can be tested. Caveats, clinical applications and practitioner key points are briefly included, although these are more fully outlined in the treatment implications article. While we outline this model in the context of novel coronavirus (COVID-19), the model has broader applications to both mental and physical health care settings. KEY LEARNING AIMS (1)To define the concept of uncertainty distress.(2)To understand the role of threat, over-estimation of threat, perceived uncertainty, actual uncertainty, and intolerance of uncertainty in distress maintenance.(3)To understand how people may behave in response to uncertainty distress.(4)To describe a model of uncertainty distress.
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Affiliation(s)
- Mark Freeston
- School of Psychology, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - Ashley Tiplady
- Newcastle Hospitals Occupational Health Service, Regent Point, Regent Farm Road, GosforthNE3 3HD, UK
| | - Lauren Mawn
- School of Psychology, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
- Psychology in Healthcare, Royal Victoria Infirmary, Queen Victoria Road, Newcastle Upon TyneNE1 4LP, UK
| | - Gioia Bottesi
- Department of General Psychology, University of Padova, via Venezia 8, 35131Padova, Italy
| | - Sarah Thwaites
- School of Psychology, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
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Lee EJ, Park J, Chun J, Pi S. State Vocational Rehabilitation Services and Employment Outcomes for Asian Americans with Psychiatric Disabilities. Community Ment Health J 2020; 56:854-866. [PMID: 31925654 DOI: 10.1007/s10597-020-00547-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 01/02/2020] [Indexed: 11/25/2022]
Abstract
One major concern of Asian Americans with psychiatric disabilities is underutilization of services, furthermore their service needs and accessibility have been significantly understudied. This study examined the effects of the public vocational rehabilitation (VR) services on employment outcomes for Asian Americans with psychiatric disabilities in the United States. This study investigated which individual characteristics, work disincentives, and VR service types were related to competitive employment outcomes among Asian Americans with psychiatric disabilities and compared the findings to other racial/ethnic groups. Logistic regression analyses were used to analyze a sample of RSA-911 data from fiscal year 2013. The results provided empirical support regarding VR services and employment outcomes for Asian Americans with psychiatric disabilities. Specifically, level of education, work experiences, and receipt of health insurance benefits were significantly related to employment outcomes among the Asian American group. Regarding VR services, job placement assistance, on-the-job supports, maintenance, miscellaneous training, and other services also predicted employment outcomes. Future research needs to address the impact of specific cultural factors on access to VR services, service utilization, and employment outcomes.
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Affiliation(s)
- Eun-Jeong Lee
- Department of Psychology, Illinois Institute of Technology, 3424 S. State St, Chicago, IL, 60616, USA.
| | - Jinhee Park
- Department of Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, AL, USA
| | - Jina Chun
- Department of Counseling, Educational Psychology and Special Education, Michigan State University, East Lansing, MI, USA
| | - Sukyeong Pi
- Department of Counseling, Educational Psychology and Special Education, Michigan State University, East Lansing, MI, USA
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30
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Menta C, Bisol LW, Nogueira EL, Engroff P, Cataldo Neto A. Prevalence and correlates of generalized anxiety disorder among elderly people in primary health care. JORNAL BRASILEIRO DE PSIQUIATRIA 2020. [DOI: 10.1590/0047-2085000000267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective To examine the prevalence of generalized anxiety disorder (GAD) and its associations with sociodemographic and health factors. Methods A cross-sectional study with a population-based sample of 578 individuals aged 60 years or older from the Family Health Strategy (FHS) program of Porto Alegre, RS, Brazil. Home visit screening and general data collection were made by trained Community Health Workers (CHWs). Diagnoses of psychiatric disorders were made by board-certified psychiatrists using the Mini International Neuropsychiatric Interview plus (MINIplus) in the Hospital São Lucas of the Pontifical University of Rio Grande do Sul (PUCRS). Results GAD was found in 9% of the sample (n = 52; CI 95% = 6.9-11.6). The main results of the multivariate analysis show associations between GAD and retirement (PR: 0.43, CI: 0.25-0.76), history of falls (PR: 2.52, CI: 1.42-4.49), cohabitation with four or more people (PR: 1.80, CI: 1.04-3.13), having more than one hospitalization in the last year (PR: 2.53, CI: 1.17-5.48) and self-perception of health as regular (PR: 2.75, CI: 1.02-7.47). Retirement in the elderly shows 2.32x less risk of GAD, although confounding factors may have overestimated this finding and underestimated the association with female gender (PR: 1.61, CI: 0.83-3.10). Conclusions We estimate a high prevalence of GAD in this population. Associations were found between GAD and health self-perceived as regular, cohabitation with four or more people, history of falls and more than one hospitalization in the last year. These epidemiological data from the Family Health Strategy are important to develop further strategies for this age group that could improve the health care practice.
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Affiliation(s)
- Caroline Menta
- Pontifical Catholic University of Rio Grande do Sul, Brazil; Pontifical Catholic University of Rio Grande do Sul, Brazil
| | | | - Eduardo Lopes Nogueira
- Pontifical Catholic University of Rio Grande do Sul, Brazil; Pontifical Catholic University of Rio Grande do Sul, Brazil
| | - Paula Engroff
- Pontifical Catholic University of Rio Grande do Sul, Brazil; Pontifical Catholic University of Rio Grande do Sul, Brazil
| | - Alfredo Cataldo Neto
- Pontifical Catholic University of Rio Grande do Sul, Brazil; Pontifical Catholic University of Rio Grande do Sul, Brazil
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Asselmann E, Kunas SL, Wittchen HU, Martini J. Changes in psychopathological symptoms during pregnancy and after delivery: A prospective-longitudinal study in women with and without anxiety and depressive disorders prior to pregnancy. J Affect Disord 2020; 263:480-490. [PMID: 31969281 DOI: 10.1016/j.jad.2019.11.112] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/15/2019] [Accepted: 11/22/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND The role of anxiety and depressive disorders prior to pregnancy for changes in peripartum psychopathological symptoms has not been resolved yet. METHODS A regional-epidemiological sample of 306 women was prospectively followed in seven waves from early pregnancy until 16 months postpartum. Lifetime DSM-IV anxiety and depressive disorders were assessed at baseline with the CIDI-V. Psychopathological symptoms (somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism) were measured with the BSI three times during pregnancy and three times after delivery. RESULTS Multilevel analyses revealed that women with versus without lifetime anxiety (β=0.22 to β=0.32) and depressive (β=0.24 to β=0.34) disorders prior to pregnancy experienced higher peripartum psychopathological symptoms. All symptoms linearly decreased during pregnancy (β=-0.02 to β=-0.07 per month). Somatization (β=-0.46) was lower, whereas paranoid ideation (β=0.26) and obsession-compulsion (β=0.21) were higher after delivery than during pregnancy. Though, obsession-compulsion linearly decreased after delivery (β=-0.02). Lifetime anxiety disorders prior to pregnancy interacted with linear changes in anxiety (β=-0.04) and phobic anxiety (β=-0.05) during pregnancy. That is, only women with, but not without anxiety disorders prior to pregnancy experienced a linear decline in anxiety and phobic anxiety during pregnancy. LIMITATIONS Lifetime anxiety and depressive disorders were assessed in early pregnancy and might be biased. CONCLUSIONS Peripartum psychopathological symptoms are higher in women with versus without lifetime anxiety and depressive disorders prior to pregnancy, but symptom changes only slightly vary by lifetime diagnostic status.
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Affiliation(s)
- E Asselmann
- Department of Psychology, Faculty of Life Sciences, Humboldt University of Berlin, Unter den Linden 6, 10099, Berlin, Germany.
| | - S L Kunas
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - H-U Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - J Martini
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Department of Psychiatry & Psychotherapy, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
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Shrestha S, Ramos K, Fletcher TL, Kraus-Schuman C, Stanley MA, Ramsey D, Amspoker AB. Psychometric properties of worry and anxiety measures in a sample of african american and caucasian older adults. Aging Ment Health 2020; 24:315-321. [PMID: 30810345 DOI: 10.1080/13607863.2018.1544217] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: The aim of our study was to examine the psychometric properties of commonly used anxiety and worry assessment measures in a community-based, low-income sample of African American and Caucasian older adults.Method: African American and Caucasian participants from three community-based clinical trials testing treatments for late-life worry/anxiety were pooled to examine the factor structure, internal consistency reliability, and convergent, discriminant, and predictive validity of the Penn State Worry Questionnaire-Abbreviated (PSWQ-A), Generalized Anxiety Disorder-7 (GAD-7) and Geriatric Anxiety Inventory-short form (GAI-SF).Results: All three measures demonstrated an adequate fit to a one-factor structure. Internal consistency reliability was adequate for the PSWQ-A and GAD-7 in the total sample and racial subgroups but was acceptable for the GAI-SF only in the African American subgroup. The PSWQ-A and GAD-7 demonstrated good convergent, discriminant, and predictive validity. The GAI-SF has adequate convergent and divergent validity in the African American subgroup.Conclusion: Our study offers preliminary evidence for use of the PSWQ-A and GAD-7 for assessment of anxiety in a sample of low-income, predominantly African American participants. These measures may facilitate identification of anxiety symptoms, which are often overlooked in this population. More research is needed to examine the accuracy of these measures in other racial/ethnic groups.
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Affiliation(s)
- Srijana Shrestha
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX.,Department of Psychology, Wheaton College, Wheaton, IL
| | - Katherine Ramos
- Geriatric Education, Research, and Clinical Center, Veterans Affairs Medical Center, Durham, NC.,Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina
| | - Terri L Fletcher
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX.,Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX.,VA South Central Mental Illness Research Education and Clinical Center
| | - Cynthia Kraus-Schuman
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX.,Mental Health Care Line, Michael E. DeBakey VA Medical Center, Houston, TX
| | - Melinda A Stanley
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX.,Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX.,VA South Central Mental Illness Research Education and Clinical Center
| | - David Ramsey
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX.,Department of Medicine, Baylor College of Medicine, Houston, TX
| | - Amber B Amspoker
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX.,Department of Medicine, Baylor College of Medicine, Houston, TX
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Correa JK, Brown TA. Expression of Generalized Anxiety Disorder Across the Lifespan. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2020; 41:53-59. [PMID: 31938010 DOI: 10.1007/s10862-018-9697-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
In generalized anxiety disorder (GAD), both the associated symptoms and worry content have been shown to vary as a function of age (Jeste et al., 2005; Portman et al., 2011). However, few studies have conducted analyses beyond mean comparisons and no studies have examined whether the observed differences in worry content and the associated symptoms are due to the lack of measurement invariance across age groups. The current study evaluated whether the measurement and expression of GAD in adults varied as a function of age, using a clinical sample of 375 participants and dimensional measures of GAD. The sample was divided into three age groups (OLDER = 60+, MID = 40-59, YOUNG = 20-39), matched by sex and GAD status. Two associated symptoms were found to exhibit differential item functioning, overall distress/interference as well as fatigue, with higher levels distress/interference and lower levels of fatigue found in the OLDER age group despite equivalent GAD severity levels across groups. When examining the content of reported worries, differential item functioning was found in four worry domains. Holding the latent dimension of worry severity constant: (a) the YOUNG age group was found to have higher reported rate of social worries, and (b) the OLDER age group was found to have higher levels of reported worries about community/world affairs and health of self. The OLDER age group also exhibited lower levels of worry about work and school. These results are discussed with regard to the assessment of GAD across the lifespan.
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34
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Relationships between dispositional and experimentally elicited emotional reactivity, intensity, and perseveration. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020. [DOI: 10.1016/j.paid.2019.109573] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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35
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Ranney RM, Cox CM, Behar E. Relationships Between Emotion Regulation and Depression in High and Low Worriers. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2019. [DOI: 10.1007/s10862-019-09783-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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36
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Content-specific interpretation biases in clinically anxious children. Behav Res Ther 2019; 121:103452. [DOI: 10.1016/j.brat.2019.103452] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 07/26/2019] [Accepted: 08/09/2019] [Indexed: 11/19/2022]
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LaFreniere LS, Newman MG. The impact of uncontrollability beliefs and thought-related distress on ecological momentary interventions for generalized anxiety disorder: A moderated mediation model. J Anxiety Disord 2019; 66:102113. [PMID: 31362145 PMCID: PMC6692212 DOI: 10.1016/j.janxdis.2019.102113] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 06/25/2019] [Accepted: 07/08/2019] [Indexed: 11/17/2022]
Abstract
This study was a secondary analysis of LaFreniere and Newman (2016), a randomized controlled trial comparing two ecological momentary interventions (EMIs) for generalized anxiety disorder (GAD): The worry outcome journal (WOJ) and thought log (TL). We predicted that higher thought-related distress would be a mediator by which higher uncontrollability beliefs (UB) would hinder the efficacy of the WOJ, but not the TL. Fifty-one undergraduates who met GAD criteria underwent one of the EMIs for 10 days. WOJ users tracked worries, associated distress, interference, expected outcome probabilities, and whether their worries came true four times/day. TL users tracked general thoughts, associated distress, and interference four times/day. Bootstrapping path analysis was used to analyze moderated mediation models. Higher UB predicted higher thought-related distress for both EMIs. Higher UB also predicted reduced efficacy of the WOJ at post-trial and of both EMIs at 30-day follow-up. However, for WOJ users, when higher initial UB levels predicted higher thought-related distress early in treatment, participants reported greater levels of worry at post-trial and follow-up. In contrast, UB's effect on the TL group at post-trial and follow-up was not mediated by early distress. Thought-related distress appears to be a mechanism by which UB impedes the WOJ intervention.
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Orgilés M, Fernández-Martínez I, Espada JP, Morales A. Spanish version ofSuper Skills for Life: short- and long-term impact of a transdiagnostic prevention protocol targeting childhood anxiety and depression. ANXIETY STRESS AND COPING 2019; 32:694-710. [DOI: 10.1080/10615806.2019.1645836] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Mireia Orgilés
- Department of Health Psychology, Miguel Hernández University, Alicante, Spain
| | | | - José P. Espada
- Department of Health Psychology, Miguel Hernández University, Alicante, Spain
| | - Alexandra Morales
- Department of Health Psychology, Miguel Hernández University, Alicante, Spain
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Newman MG, Jacobson NC, Zainal NH, Shin KE, Szkodny LE, Sliwinski MJ. The Effects of Worry in Daily Life: An Ecological Momentary Assessment Study Supporting the Tenets of the Contrast Avoidance Model. Clin Psychol Sci 2019; 7:794-810. [PMID: 31372313 PMCID: PMC6675025 DOI: 10.1177/2167702619827019] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The contrast avoidance model (CAM) suggests that worry increases and sustains negative emotion to prevent a negative emotional contrast (sharp upward shift in negative emotion) and increase the probability of a positive contrast (shift toward positive emotion). In Study 1, we experimentally validated momentary assessment items (N = 25). In Study 2, participants with generalized anxiety disorder (N = 31) and controls (N = 37) were prompted once per hour regarding their worry, thought valence, and arousal 10 times a day for 8 days. Higher worry duration, negative thought valence, and uncontrollable train of thoughts predicted feeling more keyed up concurrently and sustained anxious activation 1 hr later. More worry, feeling keyed up, and uncontrollable train of thoughts predicted lower likelihood of a negative emotional contrast in thought valence and higher likelihood of a positive emotional contrast in thought valence 1 hr later. Findings support the prospective ecological validity of CAM. Our findings suggest that naturalistic worry reduces the likelihood of a sharp increase in negative affect and does so by increasing and sustaining anxious activation.
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Affiliation(s)
| | - Nicholas C. Jacobson
- Department of Psychology, The Pennsylvania State University
- Massachusetts General Hospital, Boston, Massachusetts
| | | | - Ki Eun Shin
- Department of Psychology, The Pennsylvania State University
| | - Lauren E. Szkodny
- Department of Psychology, The Pennsylvania State University
- Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire
| | - Martin J. Sliwinski
- Department of Psychology, The Pennsylvania State University
- Department of Human Development and Family Studies, The Pennsylvania State University
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40
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The Contribution of Worry Behaviors to the Diagnosis of Generalized Anxiety Disorder. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2019; 40:636-644. [PMID: 30739985 DOI: 10.1007/s10862-018-9683-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Worry behaviors (i.e., overt acts to avoid or cope with worry-induced distress) have been recognized as being important in the psychopathology and treatment of generalized anxiety disorder (GAD). This study evaluated the worry behaviors criterion proposed for DSM-5 GAD, but was ultimately not adopted due to insufficient evidence. In 800 outpatients with emotional disorders (366 with GAD), most patients with GAD (92.6%) met the proposed worry behaviors criterion, which was at a rate significantly higher than other patient groups (e.g., patients with mood disorders). Patients who met the worry behaviors criterion had more severe GAD than patients who did not. The worry behaviors criterion, and 3 of its 4 constituent behaviors, were associated with no better than "fair" interrater reliability. Diagnostic reliability of GAD was not improved in cases where both interviewers agreed the worry behaviors criterion was met. The worry behaviors criterion significantly predicted DSM-5 GAD holding core GAD features constant (e.g., excessive worry), but this contribution was weak and did not appreciably improve the classification accuracy of GAD diagnostic status. Mixed support was obtained for the discriminant validity of the worry behaviors criterion in relation to mood disorders. Raising the proposed threshold of the criterion (requiring 2 instead of 1 behaviors) did not result in a substantial improvement in reliability, prediction, and classification accuracy. Although additional research is warranted (e.g., importance of worry behaviors in the treatment and natural course of GAD), the results raise questions about the role of worry behaviors in the diagnostic classification of GAD.
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Klein AM, Bakens R, van Niekerk RE, Ouwens MA, Rapee RM, Bögels SM, Becker ES, Rinck M. The relation between generalized anxiety disorder symptoms and content-specific interpretation biases for auditory stimuli in children. J Behav Ther Exp Psychiatry 2018; 61:121-127. [PMID: 29990681 DOI: 10.1016/j.jbtep.2018.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 06/22/2018] [Accepted: 06/29/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Cognitive theories of fear suggest that biases in interpretation are content-specific: Fearful children should only interpret materials negatively if they are specifically related to the content of their fear. So far, there are only a few studies available that report on this postulated content-specificity of interpretation processes in childhood fear. The goal of this study was to examine interpretation bias and its content-specificity in children with varying levels of Generalized Anxiety Disorder (GAD) symptoms. METHODS In an Auditory Interpretation Task (AIT), two words that differ by one phoneme are acoustically blended so that one can hear only one of the words. In the current AIT, we included GAD-related blends, negatively-valenced fear-related blends and positive blends. Multiple-choice (n = 371) or open-ended (n = 295) responses were collected from 666 nonclinical children between 7 and 13 years of age. RESULTS Children with higher levels of self-reported GAD showed significantly more negative interpretations of ambiguous GAD-related blends in the multiple-choice version than children with lower levels of GAD. There were no differences when interpreting the other ambiguous blends. This result was not found with the open-ended version. LIMITATIONS Effects were relatively small, some GAD-stimuli were sub-optimal, and the task was administered in a classroom setting. Even though we ensured that all children were able to hear all words clearly, this may have impacted the results. CONCLUSIONS The findings only partly support the idea that fearful children display cognitive biases specific for fear-relevant stimuli, and more research is needed to replicate the results and test the usability of the AIT.
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Affiliation(s)
- Anke M Klein
- Behavioural Science Institute, Radboud University Nijmegen, the Netherlands; University of Amsterdam, the Netherlands.
| | - Rian Bakens
- Behavioural Science Institute, Radboud University Nijmegen, the Netherlands
| | | | | | - Ronald M Rapee
- Centre for Emotional Health, Macquarie University, Sydney, Australia
| | | | - Eni S Becker
- Behavioural Science Institute, Radboud University Nijmegen, the Netherlands
| | - Mike Rinck
- Behavioural Science Institute, Radboud University Nijmegen, the Netherlands
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Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of panic disorder, social anxiety disorder and generalised anxiety disorder. Aust N Z J Psychiatry 2018. [DOI: 10.1177/0004867418799453] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Objective: To provide practical clinical guidance for the treatment of adults with panic disorder, social anxiety disorder and generalised anxiety disorder in Australia and New Zealand. Method: Relevant systematic reviews and meta-analyses of clinical trials were identified by searching PsycINFO, Medline, Embase and Cochrane databases. Additional relevant studies were identified from reference lists of identified articles, grey literature and literature known to the working group. Evidence-based and consensus-based recommendations were formulated by synthesising the evidence from efficacy studies, considering effectiveness in routine practice, accessibility and availability of treatment options in Australia and New Zealand, fidelity, acceptability to patients, safety and costs. The draft guidelines were reviewed by expert and clinical advisors, key stakeholders, professional bodies, and specialist groups with interest and expertise in anxiety disorders. Results: The guidelines recommend a pragmatic approach beginning with psychoeducation and advice on lifestyle factors, followed by initial treatment selected in collaboration with the patient from evidence-based options, taking into account symptom severity, patient preference, accessibility and cost. Recommended initial treatment options for all three anxiety disorders are cognitive–behavioural therapy (face-to-face or delivered by computer, tablet or smartphone application), pharmacotherapy (a selective serotonin reuptake inhibitor or serotonin and noradrenaline reuptake inhibitor together with advice about graded exposure to anxiety triggers), or the combination of cognitive–behavioural therapy and pharmacotherapy. Conclusion: The Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of panic disorder, social anxiety disorder and generalised anxiety disorder provide up-to-date guidance and advice on the management of these disorders for use by health professionals in Australia and New Zealand.
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The Mediating Relationship Between Maladaptive Behaviours, Cognitive Factors, and Generalised Anxiety Disorder Symptoms. BEHAVIOUR CHANGE 2018. [DOI: 10.1017/bec.2018.13] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cognitive theories of generalised anxiety disorder (GAD) posit that cognitive and behavioural factors maintain the disorder. This study examined whether avoidance and safety behaviours mediated the relationship between cognitive factors and GAD symptoms. We also examined the reverse mediation model; that is, whether cognitive factors mediated the relationship between maladaptive behaviours and GAD symptoms. Undergraduate psychology students (N = 125 and N = 292) completed the Worry Behaviours Inventory (a recently developed measure of maladaptive behaviours associated with GAD), in addition to measures of intolerance of uncertainty, cognitive avoidance, metacognitive beliefs, and symptoms of GAD and depression. Analyses supported the reliability and validity of the WBI. We consistently found that engagement in maladaptive behaviours significantly mediated the relationship between cognitive factors and symptoms of GAD. The reverse mediation model was also supported. Our results are consistent with the contention that cognitive and behavioural factors contribute to GAD symptom severity.
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Jones SMW, Salem R, Amtmann D. Somatic Symptoms of Depression and Anxiety in People with Multiple Sclerosis. Int J MS Care 2018; 20:145-152. [PMID: 29896052 DOI: 10.7224/1537-2073.2017-069] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background People with multiple sclerosis (MS) are at increased risk for depression and anxiety. The symptoms of MS are often similar to the somatic or physical symptoms of depression and anxiety (fatigue, trouble concentrating). This study examined whether MS symptoms and effects biased the assessment of somatic symptoms of anxiety and depression. Methods People with MS (n = 513) completed a survey about MS symptoms, treatments, and distress. The Patient Health Questionnaire-9 assessed depression, and the patient-report version of the Primary Care Evaluation of Mental Disorders assessed anxiety. Participants were grouped into low versus high MS symptoms based on self-reported symptoms and as high versus low disability by the Expanded Disability Status Scale (EDSS). Groups were compared using differential item functioning analysis. Results No bias was found on somatic symptoms of depression comparing high versus low MS symptom groups (P > .15) or comparing groups based on EDSS scores (P > .29). Two anxiety symptoms (fatigue and muscle tension) showed bias comparing high versus low MS symptom groups (P < .01) and comparing high versus low groups based on EDSS scores (P ≤ .01). Intraclass correlations suggested a small effect due to bias in the somatic symptoms of anxiety. Conclusions Somatic symptoms of depression are unlikely to be biased by MS symptoms. However, the use of certain somatic symptoms to assess anxiety may be biased for those with high MS symptoms.
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Newman MG, Przeworski A. The increase in interest in GAD: Commentary on Asmundson & Asmundson. J Anxiety Disord 2018; 56:11-13. [PMID: 29859657 PMCID: PMC7340183 DOI: 10.1016/j.janxdis.2018.04.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 04/24/2018] [Indexed: 11/25/2022]
Abstract
Generalized Anxiety Disorder (GAD) is one of the most common anxiety disorders. It is associated with functional impairment and is unlikely to spontaneously remit. As identified by Asmundson and Asmundson (2018), published research studies on GAD have increased in number over the last decade. We propose that this is due to the high prevalence of the diagnosis and symptoms, interest in transdiagnostic processes, such as worry, increased interest in emotion dysregulation as a principle underlying diagnoses, and new methods of treating and disseminating treatment that may be particularly well suited to GAD. Despite the increase in research articles on GAD, GAD still remains one of the least studied anxiety disorders. We propose that this is due to the misconception that GAD does not lead to severe impairment, despite data showing otherwise. Future research should continue to examine the phenomenology, mechanisms, and treatment of GAD in order to better understand this common anxiety disorder.
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Affiliation(s)
- Michelle G. Newman
- Department of Psychology, The Pennsylvania State University, United States,Corresponding author. (M.G. Newman)
| | - Amy Przeworski
- Department of Psychological Sciences, Case Western Reserve University, United States
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Maladaptive Behaviours Associated with Generalized Anxiety Disorder: An Item Response Theory Analysis. Behav Cogn Psychother 2018; 46:479-496. [DOI: 10.1017/s1352465818000127] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background: Cognitive models of generalized anxiety disorder (GAD) suggest that maladaptive behaviours may contribute to the maintenance of the disorder; however, little research has concentrated on identifying and measuring these behaviours. To address this gap, the Worry Behaviors Inventory (WBI) was developed and has been evaluated within a classical test theory (CTT) approach. Aims: As CTT is limited in several important respects, this study examined the psychometric properties of the WBI using an Item Response Theory approach. Method: A large sample of adults commencing treatment for their symptoms of GAD (n = 537) completed the WBI in addition to measures of GAD and depression symptom severity. Results: Patients with a probable diagnosis of GAD typically engaged in four or five maladaptive behaviours most or all of the time in an attempt to prevent, control or avoid worrying about everyday concerns. The two-factor structure of the WBI was confirmed, and the WBI scales demonstrated good reliability across a broad range of the respective scales. Together with previous findings, our results suggested that hypervigilance and checking behaviours, as well as avoidance of saying or doing things that are worrisome, were the most relevant maladaptive behaviours associated with GAD, and discriminated well between adults with low, moderate and high degrees of the respective WBI scales. Conclusions: Our results support the importance of maladaptive behaviours to GAD and the utility of the WBI to index these behaviours. Ramifications for the classification, theoretical conceptualization and treatment of GAD are discussed.
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Procrastination and anxiety: Exploring the contributions of multiple anxiety-related disorders. CURRENT ISSUES IN PERSONALITY PSYCHOLOGY 2018. [DOI: 10.5114/cipp.2018.73054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BackgroundProcrastination is the unnecessary delay of a task that subsequently creates anxiety (Rothblum, Solomon, & Maurakami, 1986). Research suggests that procrastination is linked with poorer mental health, but questions remain regarding its association with anxiety disorders. Studies exploring obsessive-compulsive disorder (OCD) and procrastination have found high levels of procrastination in OCD (Ferrari & McCown, 1994), but have also found no association between obsessive thoughts and procrastination (Kağan, Çakır, İlhan, & Kandemir, 2010). Scher and Osterman (2002) found that procrastination correlated with physiological anxiety and social anxiety, but not worry. No previous research has examined the connection between procrastination and health anxiety.Participants and procedureA non-clinical university sample (N = 300) completed online self-report questionnaires in order to examine the relationships between procrastination and symptoms of OCD, generalised anxiety disorder, social anxiety disorder, health anxiety, and panic disorder.ResultsSymptoms of panic disorder, social anxiety disorder, and health anxiety correlated with levels of procrastination. However, using a multiple regression analysis, only panic disorder symptoms uniquely predicted procrastination.ConclusionsIt is proposed that people with panic disorder may procrastinate to avoid anxiety inducing situations, or that individuals who frequently procrastinate may become sensitive to the anxiety caused by procrastination, thereby potentially triggering panic disorder. The full implications of these findings are further discussed.
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Jones SM, Walker R, Fujii M, Nekhlyudov L, Rabin BA, Chubak J. Financial difficulty, worry about affording care, and benefit finding in long-term survivors of cancer. Psychooncology 2018; 27:1320-1326. [DOI: 10.1002/pon.4677] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 02/08/2018] [Accepted: 02/11/2018] [Indexed: 11/12/2022]
Affiliation(s)
| | - Rod Walker
- Kaiser Permanente Washington Health Research Institute; Seattle WA USA
| | - Monica Fujii
- Kaiser Permanente Washington Health Research Institute; Seattle WA USA
| | | | - Borsika A. Rabin
- Department of Family Medicine and Public Health, School of Medicine; University of California San Diego; La Jolla CA USA
| | - Jessica Chubak
- Kaiser Permanente Washington Health Research Institute; Seattle WA USA
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Asselmann E, Wittchen HU, Lieb R, Perkonigg A, Beesdo-Baum K. Incident mental disorders in the aftermath of traumatic events: A prospective-longitudinal community study. J Affect Disord 2018; 227:82-89. [PMID: 29053980 DOI: 10.1016/j.jad.2017.10.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 09/11/2017] [Accepted: 10/01/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Few strictly prospective-longitudinal community studies examined the role of traumatic events for risk of developing a broad range of incident mental disorders over several years. METHOD A representative community sample of adolescents and young adults (n = 2797, baseline age 14-24) was prospectively examined in up to three assessment waves over up to 10 years. Traumatic events and DSM-IV mental disorders were assessed at each wave using the DIA-X/M-CIDI. Associations between traumatic events (meeting the DSM-IV A1-criterion for posttraumatic stress disorder, PTSD) or qualifying traumatic events (meeting the DSM-IV A2-criterion) at baseline and incident disorders at follow-up were tested with logistic regressions adjusted for gender and age. RESULTS While traumatic and qualifying traumatic events at baseline were related to various baseline disorders, considerably fewer associations were found in strictly prospective analyses with incident disorders at follow-up as outcomes. After adjustment for baseline disorders, only (a) the association of traumatic events with incident specific phobias (Odds Ratio, OR = 1.6) and (b) the associations of qualifying traumatic events with incident specific phobias (OR = 1.6), PTSD (OR = 2.5) and major depressive episodes (OR = 1.4) remained significant. CONCLUSION Targeted prevention and early intervention among traumatized individuals may be particularly beneficial to lower the incidence of specific phobias and MDE besides PTSD. LIMITATIONS Associations between traumatic events and incident mental disorders might be underestimated, as cases developing psychopathology immediately after trauma exposure prior to baseline were excluded in our strictly prospective analyses.
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Affiliation(s)
- Eva Asselmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany.
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Germany
| | - Roselind Lieb
- Max Planck Institute of Psychiatry, Munich, Germany; Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Axel Perkonigg
- Division of Psychopathology and Clinical Intervention, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
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Altunoz U, Kokurcan A, Kirici S, Bastug G, Ozel-Kizil ET. Clinical characteristics of generalized anxiety disorder: older vs. young adults. Nord J Psychiatry 2018; 72:97-102. [PMID: 29065768 DOI: 10.1080/08039488.2017.1390607] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Generalized anxiety disorder (GAD) is one of the most common anxiety disorders in older people. Although GAD in older adults seems to differ in many aspects like clinical presentation, severity and treatment response, there is a paucity of comparative research. AIMS The aim of the study is to compare the clinical presentation of GAD between older and young adults. METHODS One hundred and two non-demented older patients (age ≥65) and 64 young patients (age <45) who were diagnosed with GAD according to the DSM-IV-TR criteria were included to the study. Socio-demographic Data Form, the Structured Clinical Interview for DSM Disorders-1 (SCID-1), the Questionnaire for the Suggested Behavioral Criteria of GAD for DSM-5, the Hamilton Depression Scale (HAM-D), the Generalized Anxiety Disorder Severity Scale (GADSS) and the Sheehan Disability Scale (SDS) were applied to both groups. RESULTS AND CONCLUSIONS Older GAD patients had more disturbances of sleep, less reassurance seeking behaviors, higher rates of depression and higher depression severity when compared to the young patients. Although older people seemed to have a lower severity of GAD, they had higher disability due to worries. Older patients worried more about their own health and family well-being, whereas young patients worried more about future and other's health.
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Affiliation(s)
- Umut Altunoz
- a Department of Transcultural Psychiatry & Psychotherapy , Wahrendorff Clinic , Hannover , Germany
| | - Ahmet Kokurcan
- b Psychiatry Clinic , Corum Sungurlu State Hospital , Corum , Turkey
| | - Sevinc Kirici
- c Department of Psychiatry, Geriatric Psychiatry Unit , Ankara University School of Medicine , Ankara , Turkey
| | - Gulbahar Bastug
- d Vocational School of Health , Ankara University , Ankara , Turkey
| | - Erguvan Tugba Ozel-Kizil
- c Department of Psychiatry, Geriatric Psychiatry Unit , Ankara University School of Medicine , Ankara , Turkey
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