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Kaelber K, Seifert LS, Nguyen ATH, McWhirter K. Anxiety on the internet: Describing person, provider, and organization online posts. THE JOURNAL OF GENERAL PSYCHOLOGY 2024:1-26. [PMID: 38801396 DOI: 10.1080/00221309.2024.2349765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 02/27/2024] [Indexed: 05/29/2024]
Abstract
Anxiety is a pervasive phenomenon in contemporary society. With increased internet use in recent years, more people in the general population are seeking and providing help and participating in community online. The goal of our study was to evaluate the content of internet narratives among those who post about anxiety and determine what stakeholder groups are saying online. We used the bifurcated method; it is a multi-method (qualitative) approach with inductive, thematic analyses, and with quantification of content-related words via a computer program that crawls websites and counts the occurrences of specified terms (for cross-checking purposes). Themes of posts and webpages about anxiety were: using/reporting treatment strategies (83.3% saturation), providing help (77.8% saturation), telling personal stories (72.2% saturation), seeking help (61.1% saturation), and illustrating interpersonal impact (50% saturation). We argue that anxiety stakeholders may take part in health co-inquiry online (i.e., cooperating with others) in many of the same ways that they might collaborate in person. We recommend that clinicians query their clients about use of the internet in ways related to their anxiety (e.g., seeking information/treatment strategies, offering help to others, telling their personal stories, etc.) so that they might help them process what they experience online.
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Rickelt J, Viechtbauer W, Marcelis M, van den Heuvel OA, van Oppen P, Eikelenboom M, Schruers K. Anxiety during the long-term course of obsessive-compulsive disorder. J Affect Disord 2024; 345:311-319. [PMID: 37838266 DOI: 10.1016/j.jad.2023.10.078] [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: 03/06/2023] [Revised: 09/22/2023] [Accepted: 10/09/2023] [Indexed: 10/16/2023]
Abstract
OBJECTIVE The study aimed to investigate anxiety and its relation with obsessive-compulsive symptoms during the long-term course of obsessive-compulsive disorder (OCD). METHODS We used data from the Netherlands OCD Association (NOCDA) study, which included 419 participants with OCD (aged 18-79 years). Severity of obsessive-compulsive symptoms and anxiety at baseline and after two, four, and six years were entered into three models, which were analyzed using structural equation modeling: 1) the cross-lagged model, which assumes that anxiety and obsessive-compulsive symptoms are two distinct groups of symptoms interacting directly on the long-term; 2) the stable traits model, which assumes that anxiety and obsessive-compulsive symptoms result from two distinct latent factors, which are stable over the time and interact with each other; and 3) the common factor model, which assumes that anxiety and obsessive-compulsive symptoms are presentations of the same latent factor. RESULTS The cross-lagged model and the stable traits model both were valid models with a good model fit. The common factor model had a poor model fit and was rejected. LIMITATIONS The duration of OCD varied widely between the participants (0-64 years). The majority experienced obsessive-compulsive symptoms since several years, which may have affected results on the course of anxiety and the interaction between anxiety and obsessive-compulsive symptoms. CONCLUSIONS Anxiety and obsessive-compulsive symptoms in OCD patients do not result from a shared underlying factor but are distinct, interacting symptom groups, probably interacting by distinct latent factors.
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Affiliation(s)
- J Rickelt
- Maastricht University, Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Vijverdalseweg 1, 6226NB Maastricht, the Netherlands; Institute for Mental Health Eindhoven (GGzE), Dr. Poletlaan 39, 5626ND Eindhoven, the Netherlands.
| | - W Viechtbauer
- Maastricht University, Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Vijverdalseweg 1, 6226NB Maastricht, the Netherlands
| | - M Marcelis
- Maastricht University, Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Vijverdalseweg 1, 6226NB Maastricht, the Netherlands; Institute for Mental Health Eindhoven (GGzE), Dr. Poletlaan 39, 5626ND Eindhoven, the Netherlands
| | - O A van den Heuvel
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Department of Anatomy and Neuroscience, Amsterdam Neuroscience, de Boelelaan 1117, 1007MB Amsterdam, the Netherlands
| | - P van Oppen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Department of Anatomy and Neuroscience, Amsterdam Neuroscience, de Boelelaan 1117, 1007MB Amsterdam, the Netherlands; GGZ inGeest, Research & Innovation, Oldenaller 1, 1081 HL Amsterdam, the Netherlands
| | - M Eikelenboom
- GGZ inGeest, Research & Innovation, Oldenaller 1, 1081 HL Amsterdam, the Netherlands
| | - K Schruers
- Maastricht University, Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Vijverdalseweg 1, 6226NB Maastricht, the Netherlands; Mondriaan Mental Health Center, Vijverdalseweg 1, 6226NB Maastricht, the Netherlands
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Brattmyr M, Lindberg MS, Lundqvist J, Solem S, Hjemdal O, Anyan F, Havnen A. Symptoms and prevalence of common mental disorders in a heterogenous outpatient sample: an investigation of clinical characteristics and latent subgroups. BMC Psychiatry 2023; 23:804. [PMID: 37924053 PMCID: PMC10623879 DOI: 10.1186/s12888-023-05314-6] [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: 05/08/2023] [Accepted: 10/27/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Patient-reported outcome measures (PROM) provide clinicians with information about patients' perceptions of distress. When linked with treatment and diagnostic registers, new information on common mental health disorders (CMHD) and service use, may be obtained, which might be useful clinically and for policy decision-making. This study reports the prevalence of CMHD and their association with PROM severity. Further, subgroups of self-reported symptoms of depression and anxiety were examined, and their association with clinician-assessed mental disorders, functional impairment, and service use. METHODS In a cohort study of 2473 (63% female) outpatients, CMHD was examined with pre-treatment scores of self-reported depression and anxiety, and the number of assessments and psychotherapy appointments one year after treatment start. Factor mixture modelling (FMM) of anxiety and depression was used to examine latent subgroups. RESULTS Overall, 22% of patients with a CMHD had an additional comorbid mood/anxiety disorder, making the prevalence lower than expected. This comorbid group reported higher symptoms of anxiety and depression compared to patients with non-comorbid disorders. FMM revealed three classes: "anxiety and somatic depression" (33%), "mixed depression and anxiety" (40%), and "cognitive depression" (27%). The anxiety and somatic depression class was associated with older age, being single and on sick leave, higher probability of depressive-, anxiety-, and comorbid disorders, having more appointments and higher functional impairment. Although the cognitive depression class had less somatic distress than the mixed depression and anxiety class, they reported more functional impairment and had higher service use. CONCLUSION The results show that higher levels of somatic symptoms of depression could both indicate higher and lower levels of functional impairment and service use. A group of patients with high somatic depression and anxiety was identified, with severe impairment and high service needs. By gaining insights into CMHD factors' relation with clinical covariates, self-reported risk factors of depression and anxiety could be identified for groups with different levels of aggravating life circumstances, with corresponding service needs. These could be important symptom targets in different groups of patients.
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Affiliation(s)
- Martin Brattmyr
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, NO-7491, Norway.
| | - Martin Schevik Lindberg
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, NO-7491, Norway
- Mental Health Care Services, Trondheim Municipality, Norway
| | - Jakob Lundqvist
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, NO-7491, Norway
| | - Stian Solem
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, NO-7491, Norway
| | - Odin Hjemdal
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, NO-7491, Norway
| | - Frederick Anyan
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, NO-7491, Norway
| | - Audun Havnen
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, NO-7491, Norway
- Division of Psychiatry, Nidaros Community Mental Health Centre, St. Olavs University Hospital, Trondheim, Norway
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Kroener J, Hack L, Mayer B, Sosic-Vasic Z. Imagery rescripting as a short intervention for symptoms associated with mental images in clinical disorders: A systematic review and meta-analysis. J Psychiatr Res 2023; 166:49-60. [PMID: 37738780 DOI: 10.1016/j.jpsychires.2023.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/11/2023] [Accepted: 09/15/2023] [Indexed: 09/24/2023]
Abstract
There is an unmet need for effective short-term therapeutic techniques to reduce clinical symptoms associated with prospective-, as well as retrospective aversive mental images across mental disorders. We investigated the efficacy of imagery rescripting (IR) as a short-term intervention across clinical disorders, as the literature suggests that this technique could be a promising intervention to reduce psychopathology by altering intrusive mental images. A systematic literature review identified 23 trials including 805 adult patients, out of which 15 trials were designed as randomized controlled trials (RCT) including patients with the following diagnoses: Social anxiety disorder (SAD), Posttraumatic-Stress-Disorder (PTSD), Bulimia Nervosa, Borderline Personality Disorder, Obsessive-Compulsive Disorder, nightmare disorder, test anxiety, health anxiety, and Generalized Anxiety Disorder. Most studies (14) comprised of one treatment session. Effect size estimates indicate that IR is highly effective in reducing clinical symptoms associated with mental images from pre-, to post-treatment (g = 1.09, 95% CI = [0.64; 1.53]), as well as from pre-treatment to follow-up (g = 1.90, 95% CI = [1.02; 2.77]). Comparing the IR intervention to a passive control group showed large effect sizes at post-treatment (g = -0.99; 95% CI = [-1.79; -0.20]), however, comparing IR to an active control group resulted in a small effect (g = -0.05; 95% CI = [-0.43; 0.33]). Lastly, large effects of IR were found for the SAD and PTSD subgroups, for comorbid symptoms of depression. In summary, our results indicate that IR is a promising short-term therapeutic technique for clinical symptoms associated with aversive prospective-, and retrospective mental images.
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Affiliation(s)
- Julia Kroener
- Department of Applied Psychotherapy and Psychiatry, Christophsbad Goeppingen, Jahnstraße 30, 73037, Goeppingen, Germany; Medical Department, University of Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany.
| | - Lisa Hack
- Department of Applied Psychotherapy and Psychiatry, Christophsbad Goeppingen, Jahnstraße 30, 73037, Goeppingen, Germany; Medical Department, University of Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany
| | - Benjamin Mayer
- Institute for Epidemiology and Medical Biometry, University of Ulm, Schwabstraße 13, 89075, Ulm, Germany
| | - Zrinka Sosic-Vasic
- Department of Applied Psychotherapy and Psychiatry, Christophsbad Goeppingen, Jahnstraße 30, 73037, Goeppingen, Germany; Medical Department, University of Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany
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Flatot-Blin D, Rey A, Derynck F, Fossard O, Khalfa S. Clinical Efficiency and Acceptability of EMDR and MOSAIC Therapy for PTSD. Healthcare (Basel) 2023; 11:2226. [PMID: 37570464 PMCID: PMC10418657 DOI: 10.3390/healthcare11152226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 08/13/2023] Open
Abstract
Eye movement desensitization and reprocessing (EMDR) therapy is one of the therapies recommended by the World Health Organization (2013) to treat posttraumatic stress disorder (PTSD). Although efficient, repeated exposure to the traumatic memory may reduce its acceptability to patients. The therapy "eye movement and alternate stimulation for brain integration" (MOSAIC in French) was developed to improve acceptability and reduce pain by drawing on the patient's internal resources. MOSAIC therapy focuses on the body sensations that the patient wants to experience and avoids having to relive the traumatic memories. This observational study aimed to compare the clinical efficiency of EMDR and MOSAIC therapy for PTSD and to measure the well-being generated by both therapies. Twenty-six PTSD patients (17 females and 9 males, mean age 37.01 years, SD = 13.06) received treatment by psychiatrists and/or psychologists trained with EMDR or MOSAIC therapy. Both patient groups achieved a significant decrease in PTSD symptoms as measured with the PCL-5. However, fewer sessions were required with the MOSAIC therapy than with EMDR therapy. As expected, the level of well-being experienced by the patient during the therapy, assessed using the Lickert scale, was higher with MOSAIC than with EMDR therapy from the first session. These findings provide the first evidence of the efficacy of MOSAIC therapy treatment, which now needs to be corroborated in a larger randomized clinical trial.
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Affiliation(s)
- Deborah Flatot-Blin
- Laboratoire de Psychologie Cognitive, CNRS, Aix Marseille University, 13003 Marseille, France
- Laboratoire de Neurosciences Cognitives, CNRS, Aix Marseille University, 13003 Marseille, France
- Assistance Publique des Hôpitaux de Marseille, 13005 Marseille, France
| | - Arnaud Rey
- Laboratoire de Psychologie Cognitive, CNRS, Aix Marseille University, 13003 Marseille, France
- Institute of Language and Communication and the Brain, CNRS, Aix Marseille University, 13604 Aix-en-Provence, France
| | - Flavie Derynck
- Assistance Publique des Hôpitaux de Marseille, 13005 Marseille, France
| | | | - Stephanie Khalfa
- Laboratoire de Neurosciences Cognitives, CNRS, Aix Marseille University, 13003 Marseille, France
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Rajkumar RP. Comorbid depression and anxiety: Integration of insights from attachment theory and cognitive neuroscience, and their implications for research and treatment. Front Behav Neurosci 2022; 16:1104928. [PMID: 36620859 PMCID: PMC9811005 DOI: 10.3389/fnbeh.2022.1104928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
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