Perceived health among individuals with panic disorder: associations with affective vulnerability and psychiatric disability

Anxiety sensitivity and COVID-19 mental health, fatigue, and well-being: a longitudinal examination among adults from the United States during March-October 2020

There is widespread empirical evidence that the COVID-19 pandemic contributed to elevated risk of mental and physical health symptoms and decreased quality of life. The present investigation sought to examine if individual differences in anxiety sensitivity was associated with mental health, psychosomatic, and well-being among a sample of US adults during a 6-month period early in the COVID-19 pandemic. Employing longitudinal research methodology, we tested the hypothesis that the anxiety sensitivity global factor would be related to increased risk of anxiety, depression, fatigue, and lower well-being. Secondary analyses evaluated the lower order anxiety sensitivity factors for the same criterion variables. The sample consisted of 778 participants with an average age of 37.96 (SD = 11.81; range 18-73). Results indicated that, as hypothesized, anxiety sensitivity was associated with increased risk for more severe anxiety, depression, fatigue, and lesser well-being; the observed effects of anxiety sensitivity were relatively robust and evident in adjusted models that controlled for numerous theoretically and clinically relevant factors (e.g. perceived health status). Overall, these results suggest that pandemic functioning could likely be improved via interventions that target elevated anxiety sensitivity as a vulnerability factor for a broad range of aversive psychosomatic symptoms and personal well-being.

Fatigue severity and fatigue sensitivity: relations to anxiety, depression, pain catastrophizing, and pain severity among adults with severe fatigue and chronic low back pain

Chronic low back pain is the second leading cause of disability in the United States, and it is often associated with severe fatigue. However, little is known about individual differences that may be related to poorer mental health and pain among individuals with severe fatigue and chronic low back pain. The aim of the current investigation was to explore the role of fatigue severity and fatigue sensitivity in terms of anxiety and depressive symptoms, pain catastrophizing, pain interference, and pain severity among 783 adults with severe fatigue and chronic low back pain. Results suggest that fatigue severity and fatigue sensitivity were statistically significant predictors for anxiety, depression, pain interference, and pain catastrophizing. However, only fatigue sensitivity significantly predicted pain severity. Overall, the current study provides initial support for the role of fatigue severity and fatigue sensitivity in the presence of mental and physical health complaints among individuals with severe fatigue and chronic low back pain.

Ghost Encounters Among Traumatized Cambodian Refugees: Severity, Relationship to PTSD, and Phenomenology

Ghost encounters were found to be a key part of the trauma ontology among Cambodian refugees at a psychiatric clinic, a key idiom of distress. Fifty-four percent of patients had been bothered by ghost encounters in the last month. The severity of being bothered by ghosts in the last month was highly correlated to PTSD severity (r = .8), and among patients bothered by ghosts in the last month, 85.2% had PTSD, versus among those not so bothered, 15.4%, odds ratio of 31.8 (95% confidence level 11.3-89.3), Chi square = 55.0, p < .001. Ghost visitations occurred in multiple experiential modalities that could be classified into three states of consciousness: full sleep (viz., in dream), hypnagogia, that is, upon falling asleep or awakening (viz., in sleep paralysis [SP] and in non-SP hallucinations), and full waking (viz., in hallucinations, visual aura, somatic sensations [chills or goosebumps], and leg cramps). These ghost visitations gave rise to multiple concerns-for example, of being frightened to death or of having the soul called away-as part of an elaborate cosmology. Several heuristic models are presented including a biocultural model of the interaction of trauma and ghost visitation. An extended case illustrates the article's findings.

Searching for self: the layers and labels of panic disorder: a New Zealand study

The diagnosis and management of panic symptoms are relatively neglected. If not treated, people can develop a panic disorder, a condition that has an adverse effect on the client's quality of life and psychological well-being. The aim of this New Zealand research is to understand the clients' perspective of panic disorder and how it impacts on their quality of life. Ten participants were interviewed and the data were analyzed using thematic analysis. The research findings indicate that recovery from panic disorder occurs in a process of the search for self that is made up of self-understanding and the reclaiming the self. The findings provide a psychosocial perspective of panic disorder that will assist nurses who work with these clients. Nurses are pivotal in teaching clients about their body's response to stress and health anxiety, the giving of supplementary health information, and timely referral for specialist treatment. The recommendations for nurse specialist input and biopsychosocial assessments are discussed.

Negative affectivity as a moderator of the association between smoking status and anxiety sensitivity, anxiety symptoms, and perceived health among young adults

The present investigation evaluated the moderational role of negative affectivity in the relation between smoking status and panic-relevant symptoms in a young adult sample (n = 222; 123 females; mean age = 22.45 years, SD = 8.08). Consistent with the prediction, negative affectivity moderated the association of smoking status with anxious arousal symptoms, anxiety sensitivity, and perceived health. Specifically, greater negative affectivity was associated with higher levels of anxious arousal and anxiety sensitivity and lower levels of perceived health among smokers compared to nonsmokers. The effects were evident after controlling for the variance accounted for by alcohol use problems and gender. Findings are discussed with regard to the role of negative affectivity in the relation between smoking and panic-related processes.

Perceptions of health and health service utilization among homeless and housed psychiatric consumer/survivors

Homelessness has a direct impact on health. Homeless individuals report several barriers to accessing health care. Although research exists regarding the utilization of health services for homeless and housed psychiatric consumer/survivors, few studies have compared the perceived health and service utilization of these two groups. The objective of this study was to determine whether or not differences exist between the utilization of health services and the perceptions of health of homeless and housed psychiatric consumer/survivors in London, Ontario, Canada. It was hypothesized that differences would exist between homeless and housed psychiatric consumer/survivors on all health-related variables examined. A secondary analysis of quantitative data was conducted in a Community-University Research Alliance on Mental Health and Housing project funded by the Social Sciences and Humanities Research Council of Canada. Key findings include significant differences in the characteristics of each population, the use of health services and their perceptions of health. Implications for practice and policy are discussed.

Panic attacks and physical health problems in a representative sample: singular and interactive associations with psychological problems, and interpersonal and physical disability

BACKGROUND

Panic attacks may be a risk marker for a variety of psychological problems and are associated with increased impairment in a host of domains. However, previous studies have not investigated the role of physical illness in the panic attack-disability relations, which is striking due to findings that physical illness is linked to both panic attacks and disability. The present investigation examined the singular and interactive effects of panic attacks and physical illness in relation to psychological, interpersonal, and physical types of impairment.

METHOD

Adult participants (4,745) recruited from the statewide Colorado Social Health Survey were administered the diagnostic interview schedule.

RESULTS

As predicted, main effects of panic attacks and physical illness were significantly related to psychiatric comorbidity, depressive symptoms, interpersonal functioning, physical functioning, and perceived general health (p<.05 for all associations). Also as predicted, interaction of panic attacks and physical illness was significantly related to all of the outcome variables (p<.05 for all associations).

CONCLUSIONS

These findings suggest that individuals with both panic attacks and physical illness experience elevated disability across a variety of dimensions.

Concurrent associations between anxiety sensitivity and perceived health and health disability among young adult daily smokers

The aim of this investigation was to evaluate the incremental validity of anxiety sensitivity (fear of arousal-related physical and psychological sensations) relative to health factors (smoking variables, alcohol use and exercise level), in predicting perceived health and disability among a sample of 225 young adult daily smokers (102 females; M(age) = 23.9 years, SD = 8.8). Consistent with prediction, anxiety sensitivity, relative to smoking-relevant variables, alcohol consumption (a single frequency by quantity composite) and exercise activity, predicted lower perceived general health and impairments in mental health and social functioning; no incremental effects were evident for anxiety sensitivity for predicting impairments in physical functioning, role functioning, or increased healthcare usage. These findings are discussed with respect to better understanding cognitive factors that affect perceptions of health status and functioning among daily smokers.

Gastrointestinal-focused panic attacks among Cambodian refugees: associated psychopathology, flashbacks, and catastrophic cognitions

Among Cambodian refugees attending a psychiatric clinic, we assessed psychopathology associated with gastrointestinal panic (GIP), and investigated possible causal mechanisms, including "fear of fear" and GIP-associated flashbacks and catastrophic cognitions. GIP (n=46) patients had greater psychopathology (Clinician-Administered PTSD Scale [CAPS] and Symptom Checklist-90-R [SCL]) and "fear of fear" (Anxiety Sensitivity Index [ASI]) than did non-GIP patients (n=84). Logistic regression revealed that general psychopathology (SCL; odds ratio=4.1) and fear of anxiety-related sensations (ASI; odds ratio=2.4) predicted the presence of GIP. Among GIP patients, a hierarchical regression revealed that GIP-associated trauma recall and catastrophic cognitions explained variance in GIP severity beyond a measure of general psychopathology (SCL). A mediational analysis indicated that SCL's effect on GIP severity was mediated by GIP-associated flashbacks and catastrophic cognitions.

Incremental validity of mindfulness-based attention in relation to the concurrent prediction of anxiety and depressive symptomatology and perceptions of health

This investigation evaluated the role of mindfulness-based attention in concurrently predicting anxiety and depressive symptomatology and perceived health functioning in a community sample of 170 young adults (95 females; mean age (Mage) = 22.2 years, SD = 7.6). Partially consistent with prediction, results indicated that, relative to negative and positive affectivity and emotional expression and processing associated with approach-oriented coping, mindfulness-based attention incrementally predicted anhedonic depressive, but not anxious arousal, symptoms. Additionally, consistent with prediction, mindfulness-based attention demonstrated incremental validity in relation to perceived health, and the degree of impairment of health in terms of physical and mental functioning. Results are discussed in relation to the construct development of mindfulness-based attention, and specifically, the role(s) of this factor in emotional and physical health processes.