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Shalom JG, Shaul-Tsoran I, Strauss AY, Huppert JD, Andersson G, Aderka IM. Mediation of social anxiety and depression during internet-delivered treatment for social anxiety disorder. Cogn Behav Ther 2024; 53:436-453. [PMID: 38502174 DOI: 10.1080/16506073.2024.2331188] [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: 11/07/2023] [Accepted: 03/07/2024] [Indexed: 03/20/2024]
Abstract
Many individuals with social anxiety disorder (SAD) have depressive symptoms that meet criteria for major depressive disorder (MDD). In our study, we examined the temporal relationship between symptoms of social anxiety and symptoms of depression during the course of an 11-week internet-delivered cognitive behavioral treatment (ICBT) for SAD (n = 170). Specifically, we investigated whether weekly changes in social anxiety mediated changes in depression, changes in depression mediated changes in anxiety, both or neither. In addition, we compared individuals with SAD and MDD (n = 50) and individuals with SAD and no MDD (n = 120) to examine the role of MDD as a moderator of the social anxiety-depression relationship. Lower-level mediational modeling revealed that changes in social anxiety symptoms mediated changes in depression symptoms to a greater extent than vice versa. In addition, mediation among individuals with SAD and MDD was significantly greater compared to individuals with SAD and no MDD. Our findings suggest that ICBT is effective in treating individuals with SAD regardless of comorbid depression, and that focusing ICBT interventions on social anxiety can lead to significant reductions in depression among individuals with SAD.
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Affiliation(s)
- Jonathan G Shalom
- School of Psychological Sciences, University of Haifa, 199 Aba Khoushy Ave., Mount Carmel, Haifa 3498838, Israel
| | - Inbar Shaul-Tsoran
- School of Psychological Sciences, University of Haifa, 199 Aba Khoushy Ave., Mount Carmel, Haifa 3498838, Israel
| | - Asher Y Strauss
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Jonathan D Huppert
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institute, Stockholm, Sweden
| | - Idan M Aderka
- School of Psychological Sciences, University of Haifa, 199 Aba Khoushy Ave., Mount Carmel, Haifa 3498838, Israel
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2
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Ebling S, Ebrahimi OV, Johnson SU, Skjerdingstad N, Hoffart A. Psychological well-being in times of COVID-19: Associated factors and levels in the general population. Front Public Health 2022; 10:860863. [PMID: 36262228 PMCID: PMC9574009 DOI: 10.3389/fpubh.2022.860863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 08/31/2022] [Indexed: 01/21/2023] Open
Abstract
The COVID-19 pandemic and living under social distancing restrictions have been hypothesized to impact well-being and mental health in the general population. This study investigated the general Norwegian adult population's well-being after implementing and lifting strict social distancing restrictions. The study was conducted through digital surveys; during the implementation of strict social distancing restrictions in March 2020 (T1) and 3 months later, when the preponderance of strict distancing restrictions was discontinued (T2). Well-being was measured at T2. Four thousand nine hundred twenty-one individuals participated, and a sensitivity analysis was conducted to ensure that the sample reflects the true Norwegian adult population. Hierarchical regression analyses show that contemporaneous employment status and positive metacognitions at T2 were associated with higher well-being. Negative metacognitions and the use of unhelpful coping strategies at T2 had a contemporaneous association with lower mental well-being. Negative metacognitions at T1 were associated with lower well-being scores, while positive metacognitions at T1 were positively associated with higher well-being. An indirect association between social distancing and lower well-being was found through heightened depressive symptoms. These results contribute to understanding how social distancing restrictions relate to general well-being, which may further contribute to designing proper strategies to strengthen mental health and well-being during challenging and unavoidable societal conditions.
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Affiliation(s)
- Sara Ebling
- Department of Psychology, University of Bergen, Bergen, Norway,*Correspondence: Sara Ebling
| | - Omid V. Ebrahimi
- Department of Psychology, University of Oslo, Oslo, Norway,Modum Bad Psychiatric Hospital, Vikersund, Norway
| | - Sverre Urnes Johnson
- Department of Psychology, University of Oslo, Oslo, Norway,Modum Bad Psychiatric Hospital, Vikersund, Norway
| | | | - Asle Hoffart
- Department of Psychology, University of Oslo, Oslo, Norway,Modum Bad Psychiatric Hospital, Vikersund, Norway
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3
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Kenntemich L, von Hülsen L, Schäfer I, Böttche M, Lotzin A. Coping profiles and differences in well‐being during the COVID‐19 pandemic: A latent profile analysis. Stress Health 2022; 39:460-473. [PMID: 36083785 PMCID: PMC9539043 DOI: 10.1002/smi.3196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/13/2022] [Accepted: 09/04/2022] [Indexed: 11/11/2022]
Abstract
During the current COVID-19 pandemic, people need to cope with multiple stressors which may affect their well-being. This study aimed (1) to identify latent coping profiles in the German general population, and (2) to investigate differences between these profiles in well-being. In total, N = 2326 German participants were recruited as part of the European Society of Traumatic Stress Studies (ESTSS) ADJUST study from June to September 2020 using an online survey. Coping strategies were assessed using the Brief-COPE and the Pandemic Coping Scale; well-being was assessed using the WHO-5 Well-Being Index. Coping profiles were identified using latent profile analysis; differences between profiles were examined using the automatic BCH method and multiple group analyses. Five coping profiles were identified that included different types and numbers of coping strategies: (1) High functional coping (17.84%), (2) Moderate functional coping (40.63%), (3) High functional and religious coping (9.07%), (4) Low functional coping (22.06%), (5) Moderate functional and dysfunctional coping (10.40%). The identified profiles significantly differed in well-being (χ2 = 503.68, p <0.001). Coping profiles indicating high functional coping were associated with greater well-being compared to coping profiles indicating low (χ2 = 82.21, p <0.001) or primarily dysfunctional (χ2 = 354.33, p <0.001) coping. These results provide insight into how people differ in their coping strategies when dealing with stressors in an early phase of the COVID-19 pandemic. The study indicates higher levels of well-being in coping profiles with more frequent use of functional strategies. To promote well-being in the general population, it might be beneficial to train functional coping strategies in appropriate interventions that are associated with increased well-being.
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Affiliation(s)
- Laura Kenntemich
- Department of Psychiatry and PsychotherapyUniversity Medical Center Hamburg EppendorfHamburgGermany,Department of PsychologyMSH Medical School HamburgHamburgGermany
| | - Leonie von Hülsen
- Department of Psychiatry and PsychotherapyUniversity Medical Center Hamburg EppendorfHamburgGermany
| | - Ingo Schäfer
- Department of Psychiatry and PsychotherapyUniversity Medical Center Hamburg EppendorfHamburgGermany
| | - Maria Böttche
- ForschungsabteilungZentrum ÜBERLEBENBerlinGermany,Division of Clinical Psychological InterventionFreie Universität BerlinBerlinGermany
| | - Annett Lotzin
- Department of Psychiatry and PsychotherapyUniversity Medical Center Hamburg EppendorfHamburgGermany,Department of PsychologyMSH Medical School HamburgHamburgGermany
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Sunkara C, Thakkar R, Ong T, Bunnell BE. Characterizing Consumer Smartphone Apps for Virtual Reality-Based Exposure Therapy: Content Analysis (Preprint). J Med Internet Res 2022; 25:e41807. [PMID: 37058343 PMCID: PMC10148210 DOI: 10.2196/41807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 11/18/2022] [Accepted: 03/15/2023] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND In vivo exposure therapy is the most effective treatment for phobias but is often impractical. Virtual reality exposure therapy (VRET) can help overcome critical barriers to in vivo exposure therapy. However, accessible mobile software related to VRET is not well understood. OBJECTIVE The purpose of our study is to describe the landscape of accessible smartphone apps with potential utility for clinical VRET. METHODS We conducted a content analysis of publicly available smartphone apps related to virtual reality on the Google Play Store and the Apple App Store as of March 2020. RESULTS The initial search yielded 525 apps, with 84 apps (52 on the Google Play Store and 32 on the Apple App Store) included for analysis. The most common phobic stimulus depicted was bodies of water or weather events (25/84, 29.8%), followed by heights (24/84, 28.6%), and animals (23/84, 27.4%). More than half of the apps were visually abstract (39/84, 53.5%). Most apps were free to use (48/84, 57.1%), while the rest were free to try (22/84, 26.2%) or required payment for use (14/84, 16.7%), with the highest cost for use being US $6. The average overall app rating was 2.9 stars out of 5, but the number of ratings ranged from 0 to 49,233. None of the 84 apps advertised compliance with the Health Insurance Portability and Accountability Act, offered the ability to monitor data, provided clinician control over variables in the app experiences, or explicitly stated use by or development with clinicians. CONCLUSIONS None of the smartphone apps reviewed were explicitly developed for phobia therapy. However, 16 of the 84 included apps were considered ideal candidates to investigate further as part of treatment due to their accessibility, depiction of phobia-relevant stimuli, low or no cost, and high user scores. Most of these apps were visually abstract and free to use, making them accessible and potentially flexible as part of clinical exposure hierarchies. However, none of the apps were designed for clinical use, nor did they provide tools for clinician workflows. Formal evaluation of these accessible smartphone apps is needed to understand the clinical potential of accessible VRET solutions.
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Affiliation(s)
- Charvi Sunkara
- Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - Rajvi Thakkar
- Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - Triton Ong
- Doxy.me Research, Doxy.me Inc, Rochester, NY, United States
| | - Brian E Bunnell
- Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
- Doxy.me Research, Doxy.me Inc, Rochester, NY, United States
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Stocker K, Hartmann M, Reissmann S, Kist A, Liechti ME. Buddhist-like opposite diminishing and non-judging during ketamine infusion are associated with antidepressant response: an open-label personalized-dosing study. Front Pharmacol 2022; 13:916641. [PMID: 35959442 PMCID: PMC9358215 DOI: 10.3389/fphar.2022.916641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 06/30/2022] [Indexed: 11/18/2022] Open
Abstract
Background: Cognition that is not dominated by thinking in terms of opposites (opposite diminishing) or by making judgments (non-judging) can be found both in Buddhist/mindfulness contexts and in mental states that are fostered by dissociative psychedelics (N-methyl-D-aspartate antagonists) such as ketamine. Especially for the Buddhist/mindfulness case, both opposite diminishing and non-judging have been proposed to relate to mental well-being. Whether ketamine-occasioned opposite diminishing and/or non-judging relate to increased mental well-being in the form of antidepressant response is unknown, and was investigated in the present study. Methods: In this open-label outpatient study, the dose level and frequency for the ketamine infusions were adjusted individually in close consultation with the patients suffering from depression with the overall goal to maximize antidepressant benefits—a novel dose regimen that we term personalized antidepressant dosing. In general, treatment started with an initial series of ketamine infusions with a dosage of 0.5 mg/kg body weight and was then adjusted (usually increased). A possible relationship between ketamine-induced antidepressant benefits and retrospectively reported peri-infusion experiences of opposite diminishing and non-judging was assessed based on a total of 45 ketamine-infusion treatment sessions from 11 different patients suffering from depression. Opposite diminishing and non-judging were measured with the two items from the Altered States of Consciousness Inventory (ASCI) that measure these concepts. Depression was measured with the Beck Depression Inventory (BDI-II). Results: Peri-infusion experiences of both opposite diminishing and non-judging were associated with antidepressant responses confirming our hypothesis. Furthermore, opposite diminishing and non-judging were closely related to one another while relating to antidepressant response in distinguishable ways. Conclusion: Future controlled randomized trials with dissociative and other psychedelics and with a larger number of participants are needed to establish the possible link of psychedelically induced opposite diminishing and non-judging with an antidepressant response more firmly.
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Affiliation(s)
- Kurt Stocker
- Psychopharmacology Research, Division of Clinical Pharmacology and Toxicology, Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland
- Chair of Cognitive Science, Department of Humanities, Social and Political Sciences, ETH Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
- Department of Psychology, University of Zurich, Zurich, Switzerland
- Faculty of Psychology, UniDistance Suisse, Brig, Switzerland
- *Correspondence: Kurt Stocker,
| | | | | | - Andreas Kist
- Medical Office for Anesthesiology Zelenka and Colleagues, Villingen-Schwenningen, Germany
| | - Matthias E. Liechti
- Psychopharmacology Research, Division of Clinical Pharmacology and Toxicology, Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland
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Kim H, Duval ER. Social interaction anxiety and depression symptoms are differentially related in men and women. CURRENT PSYCHOLOGY 2022; 42:1-12. [PMID: 35789632 PMCID: PMC9243700 DOI: 10.1007/s12144-022-03245-1] [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] [Accepted: 05/16/2022] [Indexed: 11/11/2022]
Abstract
Social anxiety disorder (SAD) and major depressive disorder (MDD) are highly comorbid with each other, and comorbidity exacerbates distress and impairment. The prevalence of comorbid depression is higher in women with SAD than in men with SAD, but this is based on global depression scores and cannot speak to heterogeneous individual depression symptoms. The current study bridges this gap by examining gender differences in the relationship between social interaction anxiety and individual depression symptoms. 165 community adults (113 women, 52 men) were included in a series of bootstrapped moderation analyses to examine the main and interaction effects of social interaction anxiety and gender on total depression and individual depressive symptom scores while controlling for age and racial/ethnic background. Social interaction anxiety positively predicted total and individual depression scores. Greater social interaction anxiety predicted greater self-dislike and worthlessness in men than in women. Our findings replicate the finding that social anxiety and depression are highly comorbid with respect to total scores and extend this finding to individual symptoms. Our findings also demonstrate that the relationship between social interaction anxiety and depressive symptoms can be modulated by gender identities. Men with social interaction anxiety may be more prone to distress associated with self/identity. These findings elucidate the specific ways in which social interaction anxiety relates to the constellation of depression symptoms in men and women and highlights the need for more tailored assessment and intervention for socially anxious men and women to target individual dimensions of symptom presentations.
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Affiliation(s)
- Hanjoo Kim
- Department of Psychiatry, Michigan Medicine, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48109 USA
| | - Elizabeth R. Duval
- Department of Psychiatry, Michigan Medicine, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48109 USA
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7
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Ye B, Chen X, Zhang Y, Yang Q. Psychological flexibility and COVID-19 burnout in Chinese college students: A moderated mediation model. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022; 24:126-133. [PMID: 35465104 PMCID: PMC9013698 DOI: 10.1016/j.jcbs.2022.04.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 03/10/2022] [Accepted: 04/14/2022] [Indexed: 12/26/2022]
Abstract
Few studies have examined factors that might explain or affect the relationship between psychological flexibility and university students’ COVID-19 burnout. The present study tested a moderated mediation model with perceived COVID-19 stress as the mediator and social support, a moderator, among 2377 Chinese college students. After controlling for gender, age, family location, and year of study (freshmen, sophomores, juniors, seniors), psychological flexibility was significantly associated with COVID-19 burnout, and this link was mediated by perceived COVID-19 stress. Social support buffered the adverse effects of perceived COVID-19 stress on psychological flexibility, as well as the correlation between perceived COVID-19 stress and burnout.
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Affiliation(s)
- Baojuan Ye
- Center of Mental Health Education and Research, School of Psychology, Jiangxi Normal University, 99 Ziyang Avenue, Nanchang, 330022, China
| | - Xun Chen
- Center of Mental Health Education and Research, School of Psychology, Jiangxi Normal University, 99 Ziyang Avenue, Nanchang, 330022, China
| | - Yanzhen Zhang
- Department of Psychology, University of California, 900 University Ave, Riverside, CA, 92521, USA
| | - Qiang Yang
- School of Education, Jiangxi Normal University, 99 Ziyang Avenue, Nanchang, 330022, China
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8
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Social anxiety disorder with comorbid major depression - why fearful attachment style is relevant. J Psychiatr Res 2022; 147:283-290. [PMID: 35114512 DOI: 10.1016/j.jpsychires.2022.01.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 12/17/2021] [Accepted: 01/09/2022] [Indexed: 11/22/2022]
Abstract
Individuals with social anxiety disorder (SAD) often suffer from comorbid major depressive disorder (MDD), which goes along with increased clinical and functional impairment. There has been little research on underlying differences regarding childhood adversities and attachment styles between individuals with SAD with and without comorbid MDD. In the present study, the consecutive sample comprised 612 SCID-diagnosed participants. Of these, n = 472 (62.3% women, 40.7 ± 13.8 years) showed SAD and comorbid MDD (SAD-MDD group) and n = 140 (47.9% women, 43.7 ± 14.7 years) showed just SAD (SAD group). The two groups were compared regarding SAD symptom severity (Social Phobia Inventory; SPIN), childhood adversities (Adverse Childhood Experience Questionnaire; ACE) and attachment styles (Attachment Style Questionnaire, ASQ). The SAD-MDD group reported significantly more severe SAD symptoms (p = .002, d = 0.30), more childhood adversities (p < .001, d = 0.35) and a higher level of fearful attachment style (p < .001, d = 0.30). Group significantly moderated the association between fearful attachment style and SAD symptom severity (β = .292, p < .05) but not between preoccupied attachment style and SAD symptom severity (β = -.184, p = .124; R2adj = .168, p < .05). Fearful attachment style mediated the association between childhood adversities and SAD symptom severity in the SAD-MDD group. Our study could identify a specific significance of fearful attachment style for the association between negative childhood experiences and social anxiety symptoms in SAD-MDD. Findings have specific implications for the therapeutic relationship.
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Ong T, Wilczewski H, Soni H, Nisbet Q, Paige SR, Barrera JF, Welch BM, Bunnell BE. The Symbiosis of Virtual Reality Exposure Therapy and Telemental Health: A Review. FRONTIERS IN VIRTUAL REALITY 2022; 3:848066. [PMID: 37483657 PMCID: PMC10361704 DOI: 10.3389/frvir.2022.848066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Phobias and related anxiety are common and costly mental health disorders. Experts anticipate the prevalence of phobias will increase due to the COVID-19 pandemic. Exposure therapies have been established as effective and reliable treatments for anxiety, including recent innovations in virtual reality-based exposure therapy (VRET). With the recent advent of telemental health (TMH), VRET is poised to become mainstream. The combination of VRET and TMH has the potential to extend provider treatment options and improve patient care experiences. In this narrative review, we describe how recent events have accelerated VRET + TMH, identify barriers to VRET + TMH implementation, and discuss strategies to navigate those barriers.
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Affiliation(s)
- Triton Ong
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States
| | | | - Hiral Soni
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States
| | - Quinn Nisbet
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States
| | | | - Janelle F. Barrera
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States
- Biomedical Informatics Center, Public Health and Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Brandon M. Welch
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States
- Innovation in Mental Health Lab, Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, United States
| | - Brian E. Bunnell
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States
- Biomedical Informatics Center, Public Health and Sciences, Medical University of South Carolina, Charleston, SC, United States
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Nakie G, Melkam M, Desalegn GT, Zeleke TA. Prevalence and associated factors of social phobia among high school adolescents in Northwest Ethiopia, 2021. Front Psychiatry 2022; 13:949124. [PMID: 36387008 PMCID: PMC9640733 DOI: 10.3389/fpsyt.2022.949124] [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: 05/20/2022] [Accepted: 10/06/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Social phobia is the third most common mental illness in the world. It harms educational achievement by increasing school absentees and prevents students to participate in class, and this leads to a significant impairment of the emotional, psychological, social, and physical wellbeing of students. The research done regarding social phobia and associated factors among high school students in low- and middle-income countries is limited. Therefore, this study aims to assess the prevalence and associated factors of social phobia among adolescents and have a pivotal role in further investigation. OBJECTIVES To assess the prevalence and associated factors of social phobia among high school adolescents in Northwest Ethiopia, 2021. MATERIALS AND METHODS An institutional-based cross-sectional study was conducted from 15 April to 14 May 2021, by using a simple random sampling technique to select a sample of 936 participants after proportional allocation to the six high schools. Social phobia was assessed by using the social phobia inventory (SPIN), independent variables like social support were assessed by Oslo social support scale, substance-related factors by ASSIST, and the rest of the other factors were assessed by structured questionnaires. Binary and multivariate analyses were done to identify factors associated with social phobia. Statistical significance was declared at a 95% confidence interval (CI) of p-value less than or equal to 0.05. RESULT The prevalence of social phobia among adolescents was found to be 40.2% (95% CI 37.0 to 43.4%). In the multivariable analysis, female sex (AOR = 1.374, 95% CI = 1.016, 1.858), poor social support (AOR = 2.408, 95% CI = 1.660, 3.493), having known chronic medical illness (AOR = 2.131, 95% CI = 1.173, 3.870), having a history of mental illness in the family (AOR = 1.723, 95% CI = 1.071, 2.773), and is highly risky alcohol user (AOR = 1.992 95% CI 1.034, 3.838) were factors significantly associated with social phobia symptoms. CONCLUSION The overall prevalence of SP among adolescents was high. Therefore, early detection and adequate intervention are crucial to reducing the overall burden of social phobia among adolescents.
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Affiliation(s)
- Girum Nakie
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mamaru Melkam
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Getachew Tesfaw Desalegn
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Tadele Amare Zeleke
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Radetzki PA, Wrath AJ, Le T, Adams GC. Alexithymia is a mediating factor in the relationship between adult attachment and severity of depression and social anxiety. J Affect Disord 2021; 295:846-855. [PMID: 34706455 DOI: 10.1016/j.jad.2021.08.057] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 07/20/2021] [Accepted: 08/24/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) and social anxiety disorder (SAD) are commonly occurring conditions, either alone or together (MDD-SAD). Recent research linked insecure attachment and alexithymia to MDD and/or SAD, indicating that the way affected individuals relate interpersonally and their ability to identify and communicate emotions are pertinent issues. The current study investigated the mediating role of alexithymia in the relationship between insecure attachment and severity of MDD and SAD symptoms. METHOD Using the SCID-I, participants (N=159) were identified as MDD-only (n=43), MDD-SAD (n=56), or a healthy control (n=60). Participants completed measures of adult attachment, depression, social anxiety and alexithymia (defined as difficulty identifying and describing feelings). A two-step mediation analysis approach recommended by Shrout and Bolger determined if alexithymia mediates the relationship between attachment-depression and attachment-social anxiety. RESULTS While alexithymia was high in MDD-only and MDD-SAD groups, individuals with MDD-SAD had significantly greater difficulty describing feelings. Alexithymia was a full mediator between attachment avoidance and depression, but only a partial mediator between attachment anxiety and depression. Meanwhile, alexithymia was a partial mediator for both attachment dimensions and social anxiety. LIMITATIONS Causal inferences regarding insecure attachment, alexithymia, and MDD and SAD cannot be assumed given the cross-sectional data. The 'externally oriented thinking' component in alexithymia was also excluded from analyses due to low reliability. CONCLUSION The results suggest emotional awareness and expression play a role in the illness severity for MDD and SAD-particularly in those with high attachment avoidance, offering a possible target for treatment and prevention strategies.
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Affiliation(s)
| | - Andrew J Wrath
- Department of Psychiatry, University of Saskatchewan, Canada
| | - Thuy Le
- Department of Psychiatry, University of Saskatchewan, Canada
| | - G Camelia Adams
- Department of Psychiatry, University of Saskatchewan, Canada.
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12
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The Medium is the Message: Effects of Mediums of Communication on Perceptions and Emotions in Social Anxiety Disorder. J Anxiety Disord 2021; 83:102458. [PMID: 34343785 DOI: 10.1016/j.janxdis.2021.102458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/04/2021] [Accepted: 07/26/2021] [Indexed: 11/22/2022]
Abstract
We examined the use of voice/text and visual mediums and their effects on perceptions and emotions in social anxiety disorder (SAD). Our sample included 88 individuals: 44 individuals with SAD and 44 non-socially-anxious (NSA) individuals. We used an experience sampling methodology (ESM) in which participants received daily links to online measures at random times during the day, for 21 days and reported on social interactions, emotions and perceptions. Results indicated that individuals with SAD used voice/text mediums to a greater extent and used visual mediums to a lesser extent compared to NSA individuals. However, despite preferring voice/text mediums, use of visual mediums resulted in immediate increases in positive perceptions and emotions for individuals with SAD. These findings were above and beyond the effect of depressive symptoms and remained when social anxiety was represented as a continuum of severity. This has important implications for exposure interventions in the treatment of SAD.
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13
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Gilbert L, Rossel JB, Quansah DY, Puder JJ, Horsch A. Mental health and its associations with weight in women with gestational diabetes mellitus. A prospective clinical cohort study. J Psychosom Res 2021; 146:110489. [PMID: 33895430 DOI: 10.1016/j.jpsychores.2021.110489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 04/06/2021] [Accepted: 04/09/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Despite the prevalence of depression in women with gestational diabetes mellitus (GDM) and the relationship between mental health (depression and well-being) and metabolic health, little is known about mental health or its metabolic impact in GDM pregnancy. This prospective clinical cohort study aimed to investigate associations between 1) well-being and depression, and 2) mental health and weight/weight gain in women with GDM. METHODS We included 334 pregnant women with GDM treated at a Swiss University Hospital between January 2016 and December 2018. They completed two self-report questionnaires: The World Health Organization well-being index (WHO-5) at the first (29 weeks of gestation) and last (36 weeks of gestation) GDM visits during pregnancy and the Edinburgh Postnatal Depression Scale (EPDS) at the first GDM visit. A cut-off of ≥11 was selected for this questionnaire to indicate the presence of elevated depression scores. RESULTS There was an inverse association between the well-being and depression total scores at the first GDM visit during pregnancy (r = -0.55; p < 0.0001). Elevated depression scores at the first GDM visit were associated with subsequent weight gain in GDM pregnancy (β = 1.249; p = 0.019). CONCLUSION In women with GDM, elevated depression scores during pregnancy are prospectively associated with weight gain. Depression symptoms should therefore be screened for and treated in women with GDM to reduce the risks associated with excessive weight gain during pregnancy.
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Affiliation(s)
- Leah Gilbert
- Obstetric service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
| | - Jean-Benoît Rossel
- Obstetric service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland; Clinical Trials Unit, University of Bern, Bern, Switzerland
| | - Dan Yedu Quansah
- Obstetric service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Jardena J Puder
- Obstetric service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland; Neonatology Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
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Gilbert L, Nikolaou A, Quansah DY, Rossel JB, Horsch A, Puder JJ. Mental health and its associations with glucose-lowering medication in women with gestational diabetes mellitus. A prospective clinical cohort study. Psychoneuroendocrinology 2021; 124:105095. [PMID: 33321330 DOI: 10.1016/j.psyneuen.2020.105095] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 11/09/2020] [Accepted: 11/26/2020] [Indexed: 01/23/2023]
Abstract
AIMS Mental health symptoms are frequent in women with gestational diabetes mellitus (GDM) and may influence glycemic control. We therefore investigated if mental health symptoms (high depression and low well-being scores) predicted a need for glucose-lowering medication and if this use of medication influenced the trajectory of mental health during pregnancy and in the postpartum period. METHODS We included 341 pregnant women from a cohort of GDM women in a Swiss University Hospital. The World Health Organization Well-being Index-Five was collected at the first and last GDM and at the postpartum clinical visits and the Edinburgh Postnatal Depression Scale at the first GDM and the postpartum clinical visits. Medication intake was extracted from participants' medical records. We conducted linear and logistic regressions with depression as an interaction factor. RESULTS Mental health symptoms did not predict a need for medication (all p ≥ 0.29). Mental health improved over time (both p ≤ 0.001) and use of medication did not predict this change (all p ≥ 0.40). In women with symptoms of depression, medication was associated with less improvement in well-being at the postpartum clinical visit (p for interaction=0.013). CONCLUSIONS Mental health and glucose-lowering medication did not influence each other in an unfavourable way in this cohort of women with GDM.
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Affiliation(s)
- Leah Gilbert
- Obstetric Service, Woman-Mother-Child Department, Lausanne University Hospital, Avenue Pierre-Decker 2, 1011 Lausanne, Switzerland.
| | - Argyro Nikolaou
- Clinical Pharmacology and Toxicology Division, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, Geneva, Switzerland.
| | - Dan Yedu Quansah
- Obstetric Service, Woman-Mother-Child Department, Lausanne University Hospital, Avenue Pierre-Decker 2, 1011 Lausanne, Switzerland.
| | - Jean-Benoît Rossel
- Clinical Trials Unit, University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland.
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Route de la Corniche 10, 1010 Lausanne, Switzerland; Neonatology Service, Woman-Mother-Child Department, Lausanne University Hospital, Avenue Pierre-Decker 2, 1011 Lausanne, Switzerland.
| | - Jardena J Puder
- Obstetric Service, Woman-Mother-Child Department, Lausanne University Hospital, Avenue Pierre-Decker 2, 1011 Lausanne, Switzerland.
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Rozen N, Aderka IM. Do depressive symptoms affect the outcome of treatments for SAD? A meta analysis of randomized controlled trials. Clin Psychol Rev 2020; 80:101874. [PMID: 32653699 DOI: 10.1016/j.cpr.2020.101874] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/17/2020] [Accepted: 05/30/2020] [Indexed: 01/05/2023]
Abstract
Individuals with social anxiety disorder (SAD) typically have elevated depressive symptoms. In the present meta-analysis, we reviewed the treatment outcome literature in SAD and examined whether depressive symptoms predict treatment outcome. We focused on randomized controlled trials of cognitive behavior therapy (individual face-to-face, group format, and internet-delivered format) and randomized controlled trials of pharmacotherapy. After implementing exclusion criteria, 108 studies with 133 treatment conditions (n = 12,913 participants) were included in the meta-analysis. Our findings indicated that treatments for SAD were efficacious and significantly reduced social anxiety symptoms across all treatment modalities. Exclusion of individuals with MDD or high levels of depression did not affect outcome at post-treatment or at follow-up. However, we found that elevated depressive symptoms were associated with greater reductions in social anxiety symptoms from pre-treatment to post-treatment. Importantly, this effect was above and beyond pre-treatment levels of social anxiety. Finally, analyzing treatment modalities separately, we found that depressive symptoms were associated with better post-treatment outcomes in individual face-to-face CBT but not in other modalities. Clinical and research implications of these findings are discussed.
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Affiliation(s)
- Naama Rozen
- School of Psychological Sciences, University of Haifa, Israel
| | - Idan M Aderka
- School of Psychological Sciences, University of Haifa, Israel.
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16
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Geng Y, Gu J, Zhu X, Yang M, Shi D, Shang J, Zhao F. Negative emotions and quality of life among adolescents: A moderated mediation model. Int J Clin Health Psychol 2020; 20:118-125. [PMID: 32550851 PMCID: PMC7296238 DOI: 10.1016/j.ijchp.2020.02.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 02/05/2020] [Indexed: 02/06/2023] Open
Abstract
Background/Objective Depression, anxiety and stress are known as negative emotions. Previous studies have shown that negative emotions were associated with quality of life. There are a lot of researches on quality of life. However, previous studies mainly focused on health-related quality of life among patients. This study aims to examine the relationship between negative emotions and quality of life as well as the underlying psychological mechanism among community-based samples. Method We surveyed 6,401 adolescents (age: 9-15 years old). Participants were assessed using the Depression Anxiety Stress Scale, Resilience Scale for Chinese Adolescent, Perceived Social Support Scale and the Pediatric Quality of Life Inventory 4.0 Generic Scale for Negative Emotions, Resilience, Social Support and Quality of Life. Results Results revealed that negative emotions were negatively associated with quality of life, and resilience mediated the relationship between negative emotions and quality of life. Social support moderated all the paths among negative emotions, resilience and quality of life. Conclusions Adolescents’ quality of life was indirectly affected by negative emotions via resilience, and less affected by negative emotions and more affected by resilience with the improvement of social support. The theoretical and practical implications of these results are discussed.
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Affiliation(s)
- Yaoguo Geng
- School of Education, Zhengzhou University, China
| | - Jingjing Gu
- School of Education, Zhengzhou University, China
| | - Xueli Zhu
- School of Education, Zhengzhou University, China
| | - Minqi Yang
- School of Education, Zhengzhou University, China.,School of Marxism, Zhengzhou University, China
| | - Dan Shi
- School of Education, Zhengzhou University, China
| | - Jing Shang
- School of Marxism, Zhengzhou University, China
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Mindfulness for Preventing Psychosocial Risks in the Workplace: A Systematic Review and Meta-Analysis. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10051851] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Organizations today are implementing psychological interventions to promote the job performance and wellbeing of their employees. Mindfulness-based interventions (MBIs) can contribute to providing workers with competencies and skills and develop their strengths. MBIs are therefore becoming more and more present in the workplace, sometimes using online intervention programs, which offer a promising direction in prevention and intervention for health. The objective of this study is to analyze the efficacy of MBIs on psychological variables in the workplace. For this purpose, a search for scientific articles published from 2009 to 2019 was made in the Psicodoc, PsycINFO, and Web of Science databases, where a total of 468 articles were found. After filtering with preestablished inclusion criteria, 24 studies were included in the systematic review and meta-analysis. The results of the meta-analysis suggest that intervention in mindfulness positively influences psychological variables related to employee health and wellbeing. However, it is recommended to continue performing new studies to confirm this finding.
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18
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Rosa-Alcázar Á, Olivares-Olivares PJ, Martínez-Esparza IC, Parada-Navas JL, Rosa-Alcázar AI, Olivares-Rodríguez J. Cognitive flexibility and response inhibition in patients with Obsessive-Compulsive Disorder and Generalized Anxiety Disorder. Int J Clin Health Psychol 2020; 20:20-28. [PMID: 32021615 PMCID: PMC6994753 DOI: 10.1016/j.ijchp.2019.07.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 07/25/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND/OBJECTIVE The main aim of this study was to analyze differences in inhibition and cognitive flexibility, taking into account some variables that may influence results (non verbal reasoning, depression, anxiety, intolerance of uncertainty, comorbidity, medication consumption). METHOD The participants were 95 adults aged 17-61 years old (M = 33.48, SD = 11.13), primary (most severe) Generalized Anxiety Disorder or Obsessive-Compulsive Disorder and a healthy control group. Neuropsychological neasures were completed using computerized Wisconsin Card Sorting Test, Stroop Color Word Test and Go/NoGo Task. RESULTS Clinical groups presented worse results in cognitive flexibility to the control group. The obsessive-compulsive group showed worse scores in flexibility than the generalized anxiety group, once non-verbal reasoning and tolerance to uncertainty were controlled. Comorbidity and medication use did not affect results in the obsessive compulsive group but did however influence the generalized anxiety group. CONCLUSIONS Cognitive flexibility could be included treatment in the treatment of obsessive-compulsive disorder and generalized anxiety disorder.
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Affiliation(s)
| | | | | | | | - Ana I. Rosa-Alcázar
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Universidad de Murcia, Spain
| | - José Olivares-Rodríguez
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Universidad de Murcia, Spain
- Facultad de Educación, Universidad de Murcia, Spain
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Neufeld CB, Palma PC, Caetano KA, Brust-Renck PG, Curtiss J, Hofmann SG. A randomized clinical trial of group and individual Cognitive-Behavioral Therapy approaches for Social Anxiety Disorder. Int J Clin Health Psychol 2019; 20:29-37. [PMID: 32021616 PMCID: PMC6994736 DOI: 10.1016/j.ijchp.2019.11.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 11/29/2019] [Indexed: 12/27/2022] Open
Abstract
To compare the effectiveness of two Cognitive-Behavioral Therapy (CBT) interventions-an individual and a group intervention-in Social Anxiety Disorder therapy. We compared the two treatment groups against a waitlist condition in a randomized clinical trial with 86 young adults. The individual CBT intervention was Trial-Based Cognitive Therapy (TBCT) developed by De-Oliveira, a novel technique in which the therapist engages the patient in a simulated judicial trial with the goal of identifying and changing core dysfunctional beliefs. The group intervention consisted of exposition therapy based on the Hofmann and Otto protocol (Group CBT) to restructure negative and dysfunctional cognitions regarding social situations. Both interventions reduced psychiatric symptoms from pre- to post-test and primary social anxiety and depression symptoms relative to waitlist controls. The interventions were recently introduced in Brazil, and this is the first randomized control trial to compare TBCT and this Group CBT, which were effective in assessing changes in social anxiety symptoms as well as co-occurring psychiatric symptoms.
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Affiliation(s)
- Carmem Beatriz Neufeld
- Universidade de São Paulo, Brazil
- Corresponding author. Departamento de Psicologia, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Av. Bandeirantes, 3900, 14040-901, Ribeirão Preto, SP, Brazil.
| | | | - Kátia A.S. Caetano
- Universidade de São Paulo, Brazil
- Boston University, United States of America
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Carneiro-Barrera A, Amaro-Gahete FJ, Sáez-Roca G, Martín-Carrasco C, R. Ruiz J, Buela-Casal G. Anxiety and Depression in Patients with Obstructive Sleep Apnoea before and after Continuous Positive Airway Pressure: The ADIPOSA Study. J Clin Med 2019; 8:jcm8122099. [PMID: 31805748 PMCID: PMC6947599 DOI: 10.3390/jcm8122099] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 11/19/2019] [Accepted: 11/27/2019] [Indexed: 12/11/2022] Open
Abstract
The prevalence and treatment response of depression and anxiety symptoms in obstructive sleep apnoea (OSA), although widely addressed in research and clinical settings, still remain unclear due to overlapping symptoms. The ADIPOSA study sought to elucidate the presence of non-overlapping symptoms of depression and anxiety in patients with moderate to severe OSA before and after continuous positive airway pressure (CPAP) treatment. Forty-eight adults aged 18-80 (68.75% men) with moderate to severe OSA were enrolled in this twelve-week longitudinal single-arm trial and completed a full-night ambulatory sleep diagnostic test and an assessment of cognitive-affective depression and anxiety symptoms using the Beck-Depression Inventory-Fast Screen (BDI-FS), the State-Trait Depression Inventory (IDER) and the State-Trait Anxiety Inventory (STAI). We found no cognitive-affective depression or anxiety symptoms of clinical relevance at baseline. The amelioration of depression and anxiety symptoms after CPAP use was only statistically significant when considering anxiety-trait (p < 0.01; d = 0.296) and euthymia (p < 0.05; d = 0.402), the distinctive component of depression. Although dysthymia or high negative affect remained unchanged, CPAP may be effective at reducing the lack of positive affect, a well-established health-protective factor. However, not until depression and anxiety disorders related to OSA are accurately measured in clinical and research settings will it be possible to obtain robust conclusions on the occurrence and amelioration of these symptoms after treatment.
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Affiliation(s)
- Almudena Carneiro-Barrera
- Sleep and Health Promotion Laboratory, Mind, Brain and Behaviour Research Centre (CIMCYC), University of Granada, 18011 Granada, Spain;
- Correspondence:
| | - Francisco J. Amaro-Gahete
- EFFECTS-262 Research group, Department of Medical Physiology, School of Medicine, University of Granada, 18071 Granada, Spain;
- PROmoting FITness and Health through physical activity research group (PROFITH), Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain;
| | - Germán Sáez-Roca
- Unidad de Trastornos Respiratorios del Sueño, Servicio de Neumología, “Virgen de las Nieves” University Hospital, 18014 Granada, Spain; (G.S.-R.); (C.M.-C.)
| | - Carlos Martín-Carrasco
- Unidad de Trastornos Respiratorios del Sueño, Servicio de Neumología, “Virgen de las Nieves” University Hospital, 18014 Granada, Spain; (G.S.-R.); (C.M.-C.)
| | - Jonatan R. Ruiz
- PROmoting FITness and Health through physical activity research group (PROFITH), Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain;
| | - Gualberto Buela-Casal
- Sleep and Health Promotion Laboratory, Mind, Brain and Behaviour Research Centre (CIMCYC), University of Granada, 18011 Granada, Spain;
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Interdisciplinary Weight Loss and Lifestyle Intervention for Obstructive Sleep Apnoea in Adults: Rationale, Design and Methodology of the INTERAPNEA Study. Nutrients 2019; 11:nu11092227. [PMID: 31540168 PMCID: PMC6770131 DOI: 10.3390/nu11092227] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/09/2019] [Accepted: 09/11/2019] [Indexed: 12/12/2022] Open
Abstract
Obesity is a major risk factor for obstructive sleep apnoea (OSA), the most common sleep-disordered breathing related to neurocognitive and metabolic syndromes, type II diabetes, and cardiovascular diseases. Although strongly recommended for this condition, there are no studies on the effectiveness of an interdisciplinary weight loss and lifestyle intervention including nutrition, exercise, sleep hygiene, and smoking and alcohol cessation. INTERAPNEA is a randomised controlled trial with a two-arm parallel design aimed at determining the effects of an interdisciplinary tailored weight loss and lifestyle intervention on OSA outcomes. The study will include 84 males aged 18–65 with a body mass index of ≥25 kg/m2 and severe to moderate OSA randomly assigned to usual care (i.e., continuous positive airway pressure), or interdisciplinary weight loss and lifestyle intervention combined with usual care. Outcomes will be measured at baseline, intervention end-point, and six-month post-intervention, including apnoea-hypopnoea index (primary outcome), other neurophysical and cardiorespiratory polysomnographic outcomes, sleep quality, daily functioning and mood, body weight and composition, physical fitness, blood biomarkers, health-related quality of life, and cost-effectiveness. INTERAPNEA may serve to establish a cost-effective treatment not only for the improvement of OSA and its vast and severe comorbidities, but also for a potential remission of this condition.
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Improving Adolescents' Subjective Well-Being, Trait Emotional Intelligence and Social Anxiety through a Programme Based on the Sport Education Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101821. [PMID: 31126004 PMCID: PMC6571931 DOI: 10.3390/ijerph16101821] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 05/20/2019] [Accepted: 05/21/2019] [Indexed: 11/17/2022]
Abstract
This study aimed to evaluate the impact of a physical-sport education pilot programme on adolescents' subjective well-being (health-related quality of life, positive affect and negative affect), trait emotional intelligence and social anxiety. The programme was based on the pedagogical sport education model within a quality physical education framework, and approached from the perspective of social and emotional learning. Participants were 113 compulsory secondary education students aged 12-15 years that were assigned to a control group (n = 44) and an experimental group (n = 69). A quasi-experimental design with repeated pre-test and post-test measures was used. Bonferroni correction was applied for multiple comparisons. The preliminary results obtained in this investigation revealed that the physical-sport education pilot programme promoted significant improvements in a specific indicator of subjective well-being and trait emotional intelligence in the experimental group. These encouraging findings support the pedagogical efficiency of the programme with regard to the programme aim. The findings also highlight the feasibility and appropriateness of the programme in terms of an innovative teaching proposal.
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Olivares-Olivares PJ, Ortiz-González PF, Olivares J. Role of social skills training in adolescents with social anxiety disorder. Int J Clin Health Psychol 2018; 19:41-48. [PMID: 30619496 PMCID: PMC6300857 DOI: 10.1016/j.ijchp.2018.11.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 11/16/2018] [Indexed: 12/18/2022] Open
Abstract
Background/Objective: Social skills training (SST) is frequently included in the treatment of social anxiety disorder (SAD) in both children and adolescents, although there is no empirical evidence to support it. Consequently, our objective is to study the role and effects of SST in the treatment of a sample of adolescents with SAD. Method: A total of 108 adolescents diagnosed with generalized social phobia were randomly assigned to two treatment conditions (with and without SST) and a control group waiting list (WLCG). The evaluation included self-report measures, observational tests and blind evaluators. Results: Both interventions significantly reduced the number of social situations feared/avoided with respect to the WLCG, which worsened. Likewise, both interventions were effective but the group with SST obtained better results in the post-test and follow-ups, as well as a lower dropout rate (6:1). Conclusions: The use of SST reduces the dropout rate of treated adolescents and increases the effectiveness of the Intervention Program for Adolescents with Social Phobia.
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