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Ernst J, Rückert F, Ollmann TM, Voss C, Kische H, Knappe S, Beesdo-Baum K. Social Interactions in Everyday Life of Socially Anxious Adolescents: Effects on Mental State, Anxiety, and Depression. Res Child Adolesc Psychopathol 2024; 52:207-222. [PMID: 37768440 PMCID: PMC10834615 DOI: 10.1007/s10802-023-01121-5] [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] [Accepted: 08/28/2023] [Indexed: 09/29/2023]
Abstract
Unfavorable interpersonal behavior in social anxiety disorder (SAD) contributes to the maintenance of the disorder and may also be related to the development of secondary depression. Since there is limited research on daily life behavior in SAD, this study aimed to describe social interaction behavior and analyze the effect of positive interactions on depression, anxiety, and mental state. Data were obtained from the Behavior and Mind Health study (11/2015-12/2016), an epidemiological cohort study of adolescents and young adults (n = 1,180, aged 14-21 years) from Dresden, Germany. Interpersonal behavior, current mental state, anxiety, and depression were assessed eight times per day over four days using smartphone-based ecological momentary assessments. The analyzed subsample consisted of n = 723 participants, comparing 12-month SAD (n = 60) and healthy controls (HC; n = 663). The interaction behavior of participants with SAD did not differ substantially from that of HC in terms of frequency of social interactions, type of interaction partner, and time spent communicating, although they reported fewer real-life interaction partners (SAD: M = 2.49, SD = 4.78; HC: M = 3.18, SD = 6.43; F(17,044) = 23.92, p < 0.001). When comparing mental state, anxiety, and depression after interactions with familiar people to no interaction, no differences were found between SAD and HC. However, interactions with unfamiliar people negatively affected depressive symptoms in individuals with SAD (b = 0.53; SE = 0.25; 95%CI: 0.04-1.03; p = 0.036). In adolescents with SAD, social situations with unfamiliar people seem to be processed in a dysfunctional way, contributing to increased depressive mood in everyday life. This is particularly interesting given the high rate of secondary depression in SAD.
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Affiliation(s)
- Julia Ernst
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany.
| | - Frank Rückert
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany
| | - Theresa Magdalena Ollmann
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany
| | - Catharina Voss
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany
| | - Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany
| | - Susanne Knappe
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany
- Evangelische Hochschule Dresden (ehs), University of Applied Sciences for Social Work, Education and Nursing, Dresden, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Chemnitzer Straße 46, 01187, Dresden, Germany
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Glück VM, Boschet-Lange JM, Pittig R, Pittig A. Persistence of extensively trained avoidance is not elevated in anxiety disorders in an outcome devaluation paradigm. Behav Res Ther 2023; 170:104417. [PMID: 37879245 DOI: 10.1016/j.brat.2023.104417] [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: 03/15/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND A habitual avoidance component may enforce the persistence of maladaptive avoidance behavior in anxiety disorders. Whether habitual avoidance is acquired more strongly in anxiety disorders is unclear. METHODS Individuals with current social anxiety disorder, panic disorder and/or agoraphobia (n = 62) and healthy individuals (n = 62) completed a devaluation paradigm with extensive avoidance training, followed by the devaluation of the aversive outcome. In the subsequent test phase, habitual response tendencies were inferred from compatibility effects. Neutral control trials were added to assess general approach learning in the absence of previous extensive avoidance training. RESULTS The compatibility effects indicating habitual control did not differ between patients with anxiety disorders and healthy controls. Patients showed lower overall approach accuracy, but this effect was unrelated to the compatibility effects. CONCLUSIONS In this study, anxiety disorders were characterized by reduced approach but not stronger habitual avoidance. These results do not indicate a direct association between anxiety disorders and the acquisition of pervasive habitual avoidance in this devaluation paradigm.
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Affiliation(s)
- Valentina M Glück
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany
| | - Juliane M Boschet-Lange
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany
| | - Roxana Pittig
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany
| | - Andre Pittig
- Translational Psychotherapy, Institute of Psychology, University of Goettingen, Göttingen, Germany.
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3
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Williams ZJ, Cascio CJ, Woynaroski TG. Psychometric validation of a brief self-report measure of misophonia symptoms and functional impairment: The duke-vanderbilt misophonia screening questionnaire. Front Psychol 2022; 13:897901. [PMID: 35936331 PMCID: PMC9355318 DOI: 10.3389/fpsyg.2022.897901] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/27/2022] [Indexed: 11/24/2022] Open
Abstract
Misophonia is a newly described disorder of sound tolerance characterized by strong negative emotional reactions to specific "trigger" sounds, resulting in significant distress, pathological avoidance, and impairment in daily life. Research on misophonia is still in its infancy, and most existing psychometric tools for assessing misophonia symptoms have not been extensively validated. The purpose of the current study was to introduce and psychometrically validate the duke-vanderbilt Misophonia Screening Questionnaire (DVMSQ), a novel self-report measure of misophonia symptoms that can be used to determine misophonia "caseness" in clinical and research settings. Employing large online samples of general population adults (n = 1403) and adults on the autism spectrum (n = 936), we rigorously evaluated the internal structure, reliability, validity, and measurement invariance of the DVMSQ. Results indicated that 17 of the 20 original DVMSQ items fit well to a bifactor structure with one "general misophonia" factor and four specific factors (anger/aggression, distress/avoidance, impairment, and global impact). DVMSQ total and subscale scores were highly reliable in both general population and autistic adult samples, and the measure was found to be approximately invariant across age, sex, education level, and autism status. DVMSQ total scores also correlated strongly with another measure of misophonia symptoms (Duke Misophonia Questionnaire-Symptom Scale), with correlations between these two measures being significantly stronger than correlations between the DVMSQ and scales measuring other types of sound intolerance (Inventory of Hyperacusis Symptoms [General Loudness subscale] and DSM-5 Severity Measure for Specific Phobia [modified for phonophobia]). Additionally, DVMSQ items were used to operationalize diagnostic criteria for misophonia derived from the Revised Amsterdam Criteria, which were further updated to reflect a recent consensus definition of misophonia (published after the development of the DVMSQ). Using the new DVMSQ algorithm, 7.3% of general population adults and 35.5% of autistic adults met criteria for clinically significant misophonia. Although additional work is needed to further investigate the psychometric properties of the DVMSQ and validate its theory-based screening algorithm using best-estimate clinical diagnoses, this novel measure represents a potentially useful tool to screen for misophonia and quantify symptom severity and impairment in both autistic adults and the general population.
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Affiliation(s)
- Zachary J. Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN, United States
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, United States
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, United States
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Carissa J. Cascio
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, United States
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, United States
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, United States
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Tiffany G. Woynaroski
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, United States
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, United States
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, United States
- Department of Communication Sciences and Disorders, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, United States
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4
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Investigating the Psychometric Properties of the Severity Measure for Specific Phobia. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2022. [DOI: 10.1007/s10862-022-09976-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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5
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Developing a novel assessment of interpretation flexibility: Reliability, validity and clinical implications. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022. [DOI: 10.1016/j.paid.2022.111548] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Binasis T, Groves D, Wootton BM, Moses K. Psychometric properties of the DSM-5 social anxiety disorder dimensional scale in an Australian community sample. J Clin Psychol 2021; 78:938-950. [PMID: 34704259 DOI: 10.1002/jclp.23262] [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: 05/19/2021] [Revised: 09/01/2021] [Accepted: 10/06/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The Social Anxiety Disorder Dimensional Scale (SAD-D) is a 10-item scale developed by the Diagnostic and Statistical Manual (Fifth Edition) Anxiety, Obsessive-Compulsive Spectrum, Posttraumatic, and Dissociative Disorder work group to supplement current dichotomous approaches to assessment of Social Anxiety Disorder (SAD). The aim of the present study was to evaluate the psychometric properties of the SAD-D in an Australian community sample. METHODS Two-hundred and ninety-one participants (72.9% female) aged 18-76 years (M =28.46; SD = 12.30) completed the study. RESULTS Confirmatory factor analysis indicated support for the unidimensional structure of the SAD-D (root mean square error of approximation [RMSE] = 0.08; comparative fit index [CFI] = 0.97). The measure demonstrated strong internal consistency (α = 0.94), as well as good divergent validity. The SAD-D showed excellent test-retest reliability (intraclass correlation coefficient [ICC] = 0.93). CONCLUSIONS Overall, the SAD-D appears to be a brief and reliable measure of SAD symptomatology. Limitations, including the use of a predominantly female convenience sample, and failure to include the mental health and background of the sample, are discussed.
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Affiliation(s)
- Theodora Binasis
- School of Psychology, Western Sydney University, Penrith, New South Wales, Australia
| | - David Groves
- School of Psychology, Western Sydney University, Penrith, New South Wales, Australia
| | - Bethany M Wootton
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Karen Moses
- School of Psychology, Western Sydney University, Penrith, New South Wales, Australia
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Konjusha A, Hopwood CJ, Price AL, Masuhr O, Zimmermann J. Investigating the Transdiagnostic Value of Subjective Emptiness. J Pers Disord 2021; 35:788-800. [PMID: 33661017 DOI: 10.1521/pedi_2021_35_510] [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] [Indexed: 11/20/2022]
Abstract
It is common for people with mental health problems to report feelings of emptiness. However, the association of subjective emptiness with specific disorders and its unique role within dimensional taxonomies of personality pathology is not well understood. The present study assesses the transdiagnostic value of subjective emptiness using a recently developed self-report measure in a mixed sample of 157 participants. The authors investigated the associations of emptiness with clinically relevant variables, including borderline personality disorder symptoms, depression, anxiety, suicidal ideation, and suicide attempts. Subjective emptiness showed strong positive relationships with all criteria. Regression models controlling for impairments of personality functioning, maladaptive personality traits, and current symptom distress supported the incremental validity of emptiness for specific disorder constructs and suicidality. These findings indicate that emptiness represents a facet of psychopathology that can be particularly useful for the classification of mental disorders, and in particular internalizing disorders involving self-dysfunction and detachment.
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Affiliation(s)
| | | | | | - Oliver Masuhr
- Asklepios Fachklinikum Tiefenbrunn, Rosdorf, Germany
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8
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Stein DJ, Craske MG, Rothbaum BO, Chamberlain SR, Fineberg NA, Choi KW, de Jonge P, Baldwin DS, Maj M. The clinical characterization of the adult patient with an anxiety or related disorder aimed at personalization of management. World Psychiatry 2021; 20:336-356. [PMID: 34505377 PMCID: PMC8429350 DOI: 10.1002/wps.20919] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The clinical construct of "anxiety neurosis" was broad and poorly defined, so that the delineation of specific anxiety disorders in the DSM-III was an important advance. However, anxiety and related disorders are not only frequently comorbid, but each is also quite heterogeneous; thus diagnostic manuals provide only a first step towards formulating a management plan, and the development of additional decision support tools for the treatment of anxiety conditions is needed. This paper aims to describe systematically important domains that are relevant to the personalization of management of anxiety and related disorders in adults. For each domain, we summarize the available research evidence and review the relevant assessment instruments, paying special attention to their suitability for use in routine clinical practice. We emphasize areas where the available evidence allows the clinician to personalize the management of anxiety conditions, and we point out key unmet needs. Overall, the evidence suggests that we are becoming able to move from simply recommending that anxiety and related disorders be treated with selective serotonin reuptake inhibitors, cognitive-behavioral therapy, or their combination, to a more complex approach which emphasizes that the clinician has a broadening array of management modalities available, and that the treatment of anxiety and related disorders can already be personalized in a number of important respects.
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Affiliation(s)
- Dan J Stein
- South African Medical Research Council Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Michelle G Craske
- Department of Psychology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, (UCLA), Los Angeles, CA, USA
| | | | - Samuel R Chamberlain
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, and Southern Health NHS Foundation Trust, Southampton, UK
| | - Naomi A Fineberg
- School of Life and Medical Sciences, University of Hertfordshire, and Hertfordshire Partnership University NHS Foundation Trust, Hatfield, UK
- University of Cambridge Clinical Medical School, Cambridge, UK
| | - Karmel W Choi
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Peter de Jonge
- Developmental Psychology, Department of Psychology, Rijksuniversiteit Groningen, Groningen, The Netherlands
| | - David S Baldwin
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, and Southern Health NHS Foundation Trust, Southampton, UK
| | - Mario Maj
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
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9
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Sunderland M, Batterham PJ, Calear AL, Carragher N, Slade T. The psychometric properties of 30-day versions of the DSM-5 dimensional severity scales for social anxiety disorder and panic disorder. Psychiatry Res 2020; 291:113229. [PMID: 32580090 DOI: 10.1016/j.psychres.2020.113229] [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: 03/09/2020] [Revised: 06/11/2020] [Accepted: 06/13/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The current study aimed to investigate the psychometric properties of the DSM-5 dimensional severity scales for social anxiety disorder (SAD) and panic disorder (PD) using a past 30 day timeframe. METHODS Data were from a sample of 1,052 Australian community dwelling adults (aged 18 years or older) recruited using online advertisements. Respondents completed the DSM-5 severity scales for SAD and PD as well as a range of additional widely used self-administered scales for SAD and PD in the past 30 days prior to the survey. RESULTS Both scales exhibited high internal consistency (alpha>=0.94) and a strong general factor that justified unidimensional item response analysis (OmegaH=0.96). There was no evidence of significant local dependence amongst item pairs after accounting for the single factor. Similarly, there was no evidence for meaningful differential item functioning of the scales across sex, age, education level, and residential location. There was high convergent validity (0.71 - 0.85) amongst conceptually related scale and moderate to high correlations (0.54 - 0.80) between conceptually unrelated scales. CONCLUSIONS These findings provide support for the use of past month versions of the DSM-5 severity scales for SAD and PD by researchers and clinicians to inform and supplement diagnostic decisions.
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Affiliation(s)
- Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia.
| | - Philip J Batterham
- Centre for Mental Health Research, Australian National University, Canberra, Australia
| | - Alison L Calear
- Centre for Mental Health Research, Australian National University, Canberra, Australia
| | | | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
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10
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Kaiser T, Laireiter AR. Process-symptom-bridges in psychotherapy: An idiographic network approach. J Pers Oriented Res 2018; 4:49-62. [PMID: 33569133 PMCID: PMC7842641 DOI: 10.17505/jpor.2018.06] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
AIM real-time monitoring of psychotherapeutic processes was recently described as a promising, new way of tracking periods of change in ongoing treatments. This approach generates complex, multivariate datasets that have to be presented in an intuitive way for clinicians to aid their clinical decision-making. Using network modeling and new approaches in centrality analyses, we examine "bridge nodes" between symptom stress and aspects of the psychotherapeutic process between therapy session (intersession processes, ISP). Method:we recorded intersession processes as well as depressive and anxiety symptoms using daily questionnaires in ten cases. Regularized, thresholded intraindividual dynamic networks were estimated. We applied bridge centrality analysis to identify individual bridges between psychotherapeutic processes and symptoms in the resulting models. Case-wise interpretations of bridge centrality values are offered. RESULTS bridge centrality analysis revealed individual bridge nodes between intersession processes and symptom severity. Strength and direction of bridges varied substantially across individuals. CONCLUSION given current methodological challenges, idiographic network studies are feasible and offer important insights for psychotherapy process research. In this case, we demonstrated how patients deal with periods of increased symptom stress. In this case we have described how patients deal with their therapy under increased symptom load. Bridges between psychotherapeutic processes and symptom stress are a promising target for monitoring systems based on ISP. Future studies should examine the clinical utility of network-based monitoring and feedback in ongoing therapies. In the near future, process feedback systems based on idiographic models could serve clinicians to improve treatments.
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Affiliation(s)
- Tim Kaiser
- University of Salzburg, Psychotherapy Research Group, Hellbrunnerstrasse 34, 5020 Salzburg, Austria
| | - Anton-Rupert Laireiter
- University of Salzburg, Psychotherapy Research Group, Hellbrunnerstrasse 34, 5020 Salzburg, Austria
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Fuentes-Rodriguez G, Garcia-Lopez LJ, Garcia-Trujillo V. Exploring the role of the DSM-5 performance-only specifier in adolescents with social anxiety disorder. Psychiatry Res 2018; 270:1033-1038. [PMID: 29609991 DOI: 10.1016/j.psychres.2018.03.052] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 03/20/2018] [Accepted: 03/21/2018] [Indexed: 11/18/2022]
Abstract
The DSM-5 social anxiety disorder section has recently added the performance-only specifier for individuals whose anxiety is limited to speaking or performing in public. The impact of the DSM-5 performance-only specifier remains a neglected area. The sample comprised 44 healthy controls and 50 adolescents with a clinical diagnosis of SAD (20% met criteria for the performance-only specifier). Findings revealed that adolescents with the specifier had a later age of onset; lower levels of depression, social anxiety symptomatology and clinical severity; and a lesser degree of comorbidity relative to adolescents with SAD but excluding the performance-only specifier. Specifiers only evidenced higher (cognitive) social anxiety symptomatology compared to healthy controls. Results of this study also suggested that the performance-only specifier may correspond to a mild form of social anxiety disorder. Data also revealed that SAD exists on a continuum of severity among healthy controls, specifier participants, and those with both interactional and performance fears, which is consistent with a dimensional structure for SAD. Finally, findings suggested a unique comorbid pattern for specifiers and those adolescents with SAD but excluding the performance-only specifier. The implications of these findings for the etiology, assessment, classification, and treatment of social anxiety in youth are discussed.
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Affiliation(s)
- Gema Fuentes-Rodriguez
- Department of Psychology, Division of Clinical Psychology, Universidad de Jaen, Jaen, Spain
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12
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Stacey TL, Froude EH, Trollor J, Foley KR. Leisure participation and satisfaction in autistic adults and neurotypical adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 23:993-1004. [PMID: 30132680 DOI: 10.1177/1362361318791275] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Leisure participation is important for well-being and has been attributed to improved quality of life for autistic individuals. Rigorous studies exploring the leisure participation of autistic adults are sparse. This study aimed to compare the type of leisure activity and frequency of participation between autistic adults and neurotypical adults as well as compare and identify factors associated with their leisure satisfaction. Data for 145 autistic and 104 neurotypical adults were obtained from time point one of the Australian Longitudinal Study of Adults with Autism. The primary outcome measure used was the Leisure Satisfaction Scale. Autistic adults were less satisfied with their leisure overall (mean = 3.29, standard deviation = 0.75) compared with neurotypical adults (mean = 3.69, standard deviation = 0.55). Multiple linear regression revealed being younger and reporting less depressive symptoms were significantly associated with higher leisure satisfaction in autistic but not neurotypical adults. Engagement in solitary leisure activities was comparable across participants, but socialising in person was predominated by neurotypical adults. Leisure activity preferences of autistic adults' and the frequency of their leisure participation are important factors for clinicians to understand when working with this population and tailoring well-being interventions.
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Affiliation(s)
| | | | - Julian Trollor
- 2 UNSW, Australia.,3 Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Kitty-Rose Foley
- 2 UNSW, Australia.,3 Cooperative Research Centre for Living with Autism (Autism CRC), Australia.,4 Southern Cross University, Australia
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13
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Zhu J, Li J, Li X, Rao J, Hao Y, Ding Z, Wang G. Neural Basis of the Emotional Conflict Processing in Major Depression: ERPs and Source Localization Analysis on the N450 and P300 Components. Front Hum Neurosci 2018; 12:214. [PMID: 29896094 PMCID: PMC5986884 DOI: 10.3389/fnhum.2018.00214] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 05/08/2018] [Indexed: 11/13/2022] Open
Abstract
Objects: Effective psychological function requires that cognition is not affected by task-irrelevant emotional stimuli in emotional conflict. Depression is mainly characterized as an emotional disorder. The object of this study is to reveal the behavioral and electrophysiological signature of emotional conflict processing in major depressive disorder (MDD) using event-related potentials (ERPs) and standardized low-resolution brain electromagnetic tomography (sLORETA) analysis. Method: We used a face–word Stroop task involving emotional faces while recording EEG (electroencephalography) in 20 patients with MDD and 20 healthy controls (HCs). And then ERPs were extracted and the corresponding brain sources were reconstructed using sLORETA. Results: Behaviorally, subjects with MDDs manifested significantly increased Stroop effect when examining the RT difference between happy incongruent trials and happy congruent trials, compared with HC subjects. ERP results exhibited that MDDs were characterized by the attenuated difference between P300 amplitude to sad congruent stimuli and sad incongruent stimuli, as electrophysiological evidence of impaired conflict processing in subjects with MDD. The sLORETA results showed that MDD patients had a higher current density in rostral anterior cingulate cortex (rostral ACC) within N450 time window in response to happy incongruent trials than happy congruent stimuli. Moreover, HC subjects had stronger activity in right inferior frontal gyrus (rIFG) region in response to incongruent stimuli than congruent stimuli, revealing successful inhibition of emotional distraction in HCs, which was absent in MDDs. Conclusion: Our results indicated that rostral ACC was implicated in the processing of negative emotional distraction in MDDs, as well as impaired inhibition of task-irrelevant emotional stimuli, relative to HCs. This work furnishes novel behavioral and neurophysiological evidence that are closely related to emotional conflict among MDD patients.
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Affiliation(s)
- Jing Zhu
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, China
| | - Jianxiu Li
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, China
| | - Xiaowei Li
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, China
| | - Juan Rao
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, China
| | - Yanrong Hao
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, China
| | - Zhijie Ding
- The Third People's Hospital of Tianshui City, Tianshui, China
| | - Gangping Wang
- The Third People's Hospital of Tianshui City, Tianshui, China
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14
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DeSousa DA, Moreno AL, Osório FL, Crippa JAS, LeBeau R, Manfro GG, Salum GA, Koller SH. Psychometric properties of the dimensional anxiety scales for DSM-5 in a Brazilian community sample. Int J Methods Psychiatr Res 2017; 26:e1531. [PMID: 27748002 PMCID: PMC6877262 DOI: 10.1002/mpr.1531] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 06/12/2016] [Accepted: 06/28/2016] [Indexed: 11/11/2022] Open
Abstract
The DSM-5 highlights the use of dimensional assessments of mental health as a supplement to categorical diagnoses. This study investigated the psychometric properties of the DSM-5 Dimensional Anxiety Scales in a Brazilian community sample. Dimensional scales for generalized anxiety disorder, social anxiety disorder, panic disorder, agoraphobia, and specific phobia were administered to 930 adults aged 18 to 70, 64.2% female. Psychometric properties investigated were: unidimensionality; measurement invariance; internal consistency; composite reliability; test-retest reliability; convergent and divergent validity; category thresholds and item performance analyses. Analyses revealed unidimensionality for all scales except for specific phobia. Measurement invariance, high internal consistency and composite reliability, and convergent and divergent validity were demonstrated. Test-retest reliability was high for all scales but generalized anxiety disorder. Item-based analyses evidenced that none of the items were very easy to endorse and that the scales offered more information about subjects with high severity estimates of anxiety. The DSM-5 Dimensional Anxiety Scales are a valid and reliable alternative to assess anxiety symptomatology in community settings, although further evaluation is needed, especially for specific phobia. The scales seem to be more useful for characterizing dimensionality of symptoms for subclinical or clinical cases than for slight or mildly anxious subjects.
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Affiliation(s)
- Diogo A DeSousa
- Anxiety Disorders Outpatient Program (PROTAN), Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.,Center for Psychological Studies on At-Risk Populations (CEP-Rua), Institute of Psychology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.,Department of Psychology, Tiradentes University, Aracaju, SE, Brazil
| | - André L Moreno
- Neurosciences and Behavioral Sciences Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Flávia L Osório
- Neurosciences and Behavioral Sciences Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - José Alexandre S Crippa
- Neurosciences and Behavioral Sciences Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Richard LeBeau
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Gisele G Manfro
- Anxiety Disorders Outpatient Program (PROTAN), Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Giovanni A Salum
- Anxiety Disorders Outpatient Program (PROTAN), Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Silvia H Koller
- Center for Psychological Studies on At-Risk Populations (CEP-Rua), Institute of Psychology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
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15
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LeBeau RT, Mesri B, Craske MG. The DSM-5 social anxiety disorder severity scale: Evidence of validity and reliability in a clinical sample. Psychiatry Res 2016; 244:94-6. [PMID: 27479097 DOI: 10.1016/j.psychres.2016.07.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 06/28/2016] [Accepted: 07/12/2016] [Indexed: 11/30/2022]
Abstract
With DSM-5, the APA began providing guidelines for anxiety disorder severity assessment that incorporates newly developed self-report scales. The scales share a common template, are brief, and are free of copyright restrictions. Initial validation studies have been promising, but the English-language versions of the scales have not been formally validated in clinical samples. Forty-seven individuals with a principal diagnosis of Social Anxiety Disorder (SAD) completed a diagnostic assessment, as well as the DSM-5 SAD severity scale and several previously validated measures. The scale demonstrated internal consistency, convergent validity, and discriminant validity. The next steps in the validation process are outlined.
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Affiliation(s)
- Richard T LeBeau
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, United States.
| | - Bita Mesri
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, United States
| | - Michelle G Craske
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, United States
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16
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Möller EL, Bögels SM. The DSM-5 Dimensional Anxiety Scales in a Dutch non-clinical sample: psychometric properties including the adult separation anxiety disorder scale. Int J Methods Psychiatr Res 2016; 25:232-9. [PMID: 27378317 PMCID: PMC5129553 DOI: 10.1002/mpr.1515] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 03/24/2016] [Accepted: 05/17/2016] [Indexed: 11/21/2022] Open
Abstract
With DSM-5, the American Psychiatric Association encourages complementing categorical diagnoses with dimensional severity ratings. We therefore examined the psychometric properties of the DSM-5 Dimensional Anxiety Scales, a set of brief dimensional scales that are consistent in content and structure and assess DSM-5-based core features of anxiety disorders. Participants (285 males, 255 females) completed the DSM-5 Dimensional Anxiety Scales for social anxiety disorder, generalized anxiety disorder, specific phobia, agoraphobia, and panic disorder that were included in previous studies on the scales, and also for separation anxiety disorder, which is included in the DSM-5 chapter on anxiety disorders. Moreover, they completed the Screen for Child Anxiety Related Emotional Disorders Adult version (SCARED-A). The DSM-5 Dimensional Anxiety Scales demonstrated high internal consistency, and the scales correlated significantly and substantially with corresponding SCARED-A subscales, supporting convergent validity. Separation anxiety appeared present among adults, supporting the DSM-5 recognition of separation anxiety as an anxiety disorder across the life span. To conclude, the DSM-5 Dimensional Anxiety Scales are a valuable tool to screen for specific adult anxiety disorders, including separation anxiety. Research in more diverse and clinical samples with anxiety disorders is needed. © 2016 The Authors International Journal of Methods in Psychiatric Research Published by John Wiley & Sons Ltd.
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Affiliation(s)
- Eline L Möller
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands. .,Research Priority Area Yield, University of Amsterdam, Amsterdam, The Netherlands.
| | - Susan M Bögels
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands.,Research Priority Area Yield, University of Amsterdam, Amsterdam, The Netherlands
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17
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Makovac E, Watson DR, Meeten F, Garfinkel SN, Cercignani M, Critchley HD, Ottaviani C. Amygdala functional connectivity as a longitudinal biomarker of symptom changes in generalized anxiety. Soc Cogn Affect Neurosci 2016; 11:1719-1728. [PMID: 27369066 PMCID: PMC5091683 DOI: 10.1093/scan/nsw091] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 06/20/2016] [Indexed: 11/22/2022] Open
Abstract
Generalized anxiety disorder (GAD) is characterized by excessive worry, autonomic dysregulation and functional amygdala dysconnectivity, yet these illness markers have rarely been considered together, nor their interrelationship tested longitudinally. We hypothesized that an individual’s capacity for emotion regulation predicts longer-term changes in amygdala functional connectivity, supporting the modification of GAD core symptoms. Sixteen patients with GAD (14 women) and individually matched controls were studied at two time points separated by 1 year. Resting-state fMRI data and concurrent measurement of vagally mediated heart rate variability were obtained before and after the induction of perseverative cognition. A greater rise in levels of worry following the induction predicted a stronger reduction in connectivity between right amygdala and ventromedial prefrontal cortex, and enhanced coupling between left amygdala and ventral tegmental area at follow-up. Similarly, amplified physiological responses to the induction predicted increased connectivity between right amygdala and thalamus. Longitudinal shifts in a distinct set of functional connectivity scores were associated with concomitant changes in GAD symptomatology over the course of the year. Results highlight the prognostic value of indices of emotional dysregulation and emphasize the integral role of the amygdala as a critical hub in functional neural circuitry underlying the progression of GAD symptomatology.
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Affiliation(s)
- Elena Makovac
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy.,Psychiatry, Division of Medicine, Brighton and Sussex Medical School, Brighton, UK
| | - David R Watson
- Psychiatry, Division of Medicine, Brighton and Sussex Medical School, Brighton, UK
| | - Frances Meeten
- Psychiatry, Division of Medicine, Brighton and Sussex Medical School, Brighton, UK.,Kings College London, London, UK.,Sussex Partnership NHS Foundation Trust Sussex, Sussex UK
| | - Sarah N Garfinkel
- Psychiatry, Division of Medicine, Brighton and Sussex Medical School, Brighton, UK.,Sackler Centre for Consciousness Science, University of Sussex, Sussex, UK
| | - Mara Cercignani
- Psychiatry, Division of Medicine, Brighton and Sussex Medical School, Brighton, UK
| | - Hugo D Critchley
- Psychiatry, Division of Medicine, Brighton and Sussex Medical School, Brighton, UK.,Sussex Partnership NHS Foundation Trust Sussex, Sussex UK.,Sackler Centre for Consciousness Science, University of Sussex, Sussex, UK
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18
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[Reliability and external validity of a questionnaire to assess the knowledge about risk and cardiovascular disease and in patients attending Spanish community pharmacies]. Aten Primaria 2016; 48:586-595. [PMID: 27142591 PMCID: PMC6875968 DOI: 10.1016/j.aprim.2016.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 12/23/2015] [Accepted: 01/21/2016] [Indexed: 12/04/2022] Open
Abstract
Objetivos Determinar la fiabilidad test-retest de un cuestionario, con validación preliminar, para valorar el conocimiento sobre riesgo cardiovascular (RCV) y enfermedad cardiovascular, en pacientes atendidos en farmacias comunitarias de España. Complementar la validez externa, estableciendo la relación entre una actividad educativa y el aumento del conocimiento sobre RCV y enfermedad cardiovascular. Diseño Subanálisis del estudio clínico controlado EMDADER-CV, en el que se aplicó un cuestionario de conocimiento sobre RCV en 4 momentos. Emplazamiento Farmacia comunitaria española. Participantes Trescientos veintitrés pacientes del grupo control, de los 640 que finalizaron el estudio. Mediciones principales Coeficiente de correlación intraclase para evaluar la fiabilidad en 3 comparaciones (postactividad educativa con semana 16, postactividad educativa con semana 32, y semana 16 con semana 32); y prueba no paramétrica de Friedman para establecer la relación entre una actividad educativa oral y escrita con el aumento del conocimiento. Resultados Para los 323 pacientes, en las 3 comparaciones, los valores del coeficiente de correlación intraclase fueron 0,624; 0,608 y 0,801 (fiabilidad aceptable-buena a excelente). Por su parte, la prueba de Friedman mostró relación entre la actividad educativa y el aumento del conocimiento, estadísticamente significativa (p < 0,0001). Conclusiones Acorde con el coeficiente de correlación intraclase, el cuestionario orientado a valorar el conocimiento sobre el RCV y enfermedad cardiovascular tiene una fiabilidad entre aceptable y excelente, lo cual, sumado a la validación previa, indica que dicho instrumento cumple los criterios de validez y fiabilidad. Además, el cuestionario evidencia capacidad de relacionar un aumento en el conocimiento con una intervención educativa, característica que complementa su validez externa.
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19
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Wong QJJ, Gregory B, McLellan LF. A Review of Scales to Measure Social Anxiety Disorder in Clinical and Epidemiological Studies. Curr Psychiatry Rep 2016; 18:38. [PMID: 26893236 DOI: 10.1007/s11920-016-0677-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
To advance research into social anxiety disorder (SAD) and provide efficacious treatments for individuals with SAD, researchers and clinicians must have effective assessment instruments for identifying the disorder in terms of its diagnostic criteria, symptoms, and the presence of specific maintaining factors. This review highlights the main lines of existing adult and youth research on scales that form part of diagnostic instruments that assess SAD, scales that measure social anxiety symptoms, and scales that measure theory-based psychological maintaining factors associated with SAD. The review also highlights methodological issues that impact on the use of the aforementioned scales. The continued refinement and comparative evaluation of measures for SAD, culminating in the ascertainment of optimal measures, will improve the assessment and identification of the disorder. Improved identification of the disorder will contribute to the advancement of SAD research and treatment.
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Affiliation(s)
- Quincy J J Wong
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW 2109, Australia.
| | - Bree Gregory
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW 2109, Australia
| | - Lauren F McLellan
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW 2109, Australia
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