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Zainal NH, Newman MG. Treatment condition as a moderator and change in trait mindfulness as a mediator of a brief mindfulness ecological momentary intervention for generalized anxiety disorder. Eur Psychiatry 2024; 67:e40. [PMID: 38711385 DOI: 10.1192/j.eurpsy.2024.1750] [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] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Theories propose that judgment of and reactivity to inner experiences are mediators of the effect of mindfulness-based interventions on generalized anxiety disorder (GAD). However, no study has tested such theories using brief, mindfulness ecological momentary intervention (MEMI). We thus tested these theories using a 14-day MEMI versus self-monitoring app (SM) control for GAD. METHODS Participants (N = 110) completed self-reports of trait mindfulness (Five Facet Mindfulness Questionnaire), GAD severity (GAD-Questionnaire-IV), and trait perseverative cognitions (Perseverative Cognitions Questionnaire) at prerandomization, posttreatment, and 1-month follow-up (1MFU). Counterfactual mediation analyses with temporal precedence were conducted. RESULTS Improvement in pre-post mindfulness domains (acceptance of emotions, describing feelings accurately, acting with awareness, judgment of inner experience, and reactivity to inner experience) predicted pre-1MFU reduction in GAD severity and pre-1MFU reduction in trait perseverative cognitions from MEMI but not SM. MEMI reduced pre-post reactivity to inner experiences (but not other mindfulness domains) significantly more than SM. Only reduced pre-post reactivity significantly mediated stronger efficacy of MEMI over SM on pre-1MFU reductions in GAD severity (indirect effect: β = -2.970 [-5.034, -0.904], p = .008; b path: β = -3.313 [-6.350, -0.276], p = .033; percentage mediated: 30.5%) and trait perseverative cognitions (indirect effect: β = -0.153 [-0.254, -0.044], p = .008; b path: β = -0.145 [-0.260, -0.030], p = .014; percentage mediated: 42.7%). Other trait mindfulness domains were non-significant mediators. CONCLUSIONS Reactivity to inner experience might be a mindfulness-based intervention change mechanism and should be targeted to optimize brief MEMIs for GAD.
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Affiliation(s)
- Nur Hani Zainal
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
- Department of Psychology, National University of Singapore, Kent Ridge, Singapore
| | - Michelle G Newman
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
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Peng J, Yuan S, Wei Z, Liu C, Li K, Wei X, Yuan S, Guo Z, Wu L, Feng T, Zhou Y, Li J, Yang Q, Liu X, Wu S, Ren L. Temporal network of experience sampling methodology identifies sleep disturbance as a central symptom in generalized anxiety disorder. BMC Psychiatry 2024; 24:241. [PMID: 38553683 PMCID: PMC10981297 DOI: 10.1186/s12888-024-05698-z] [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: 07/30/2023] [Accepted: 03/18/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND A temporal network of generalized anxiety disorder (GAD) symptoms could provide valuable understanding of the occurrence and maintenance of GAD. We aim to obtain an exploratory conceptualization of temporal GAD network and identify the central symptom. METHODS A sample of participants (n = 115) with elevated GAD-7 scores (Generalized Anxiety Disorder 7-Item Questionnaire [GAD-7] ≥ 10) participated in an online daily diary study in which they reported their GAD symptoms based on DSM-5 diagnostic criteria (eight symptoms in total) for 50 consecutive days. We used a multilevel VAR model to obtain the temporal network. RESULTS In temporal network, a lot of lagged relationships exist among GAD symptoms and these lagged relationships are all positive. All symptoms have autocorrelations and there are also some interesting feedback loops in temporal network. Sleep disturbance has the highest Out-strength centrality. CONCLUSIONS This study indicates how GAD symptoms interact with each other and strengthen themselves over time, and particularly highlights the relationships between sleep disturbance and other GAD symptoms. Sleep disturbance may play an important role in the dynamic development and maintenance process of GAD. The present study may develop the knowledge of the theoretical model, diagnosis, prevention and intervention of GAD from a temporal symptoms network perspective.
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Affiliation(s)
- Jiaxi Peng
- Mental Health Education Center, Chengdu University, 610106, Chengdu, China
| | - Shuai Yuan
- University of Amsterdam, 1018WB, Amsterdam, the Netherlands
| | - Zihan Wei
- Xijing Hospital, Air Force Medical University, 710032, Xi'an, China
| | - Chang Liu
- Brain Park, School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, 3800, Clayton, VIC, Australia
| | - Kuiliang Li
- Department of Psychology, Army Medical University, 400038, Chongqing, China
| | - Xinyi Wei
- Department of Psychology, Renmin University of China, 100000, Beijing, China
| | - Shangqing Yuan
- School of Psychology, Capital Normal University, 100089, Beijing, China
| | - Zhihua Guo
- Department of Military Medical Psychology, Air Force Medical University, 710032, Xi'an, China
| | - Lin Wu
- Department of Military Medical Psychology, Air Force Medical University, 710032, Xi'an, China
| | - Tingwei Feng
- Department of Military Medical Psychology, Air Force Medical University, 710032, Xi'an, China
| | - Yu Zhou
- Military Psychology Section, Logistics University of PAP, 300309, Tianjin, China
- Military Mental Health Services & Research Center, 300309, Tianjin, China
| | - Jiayi Li
- Military Psychology Section, Logistics University of PAP, 300309, Tianjin, China
- Military Mental Health Services & Research Center, 300309, Tianjin, China
| | - Qun Yang
- Department of Military Medical Psychology, Air Force Medical University, 710032, Xi'an, China
| | - Xufeng Liu
- Department of Military Medical Psychology, Air Force Medical University, 710032, Xi'an, China
| | - Shengjun Wu
- Department of Military Medical Psychology, Air Force Medical University, 710032, Xi'an, China.
| | - Lei Ren
- Military Psychology Section, Logistics University of PAP, 300309, Tianjin, China.
- Military Mental Health Services & Research Center, 300309, Tianjin, China.
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Freeston MH. What if we have too many models of worry and GAD? Behav Cogn Psychother 2023; 51:559-578. [PMID: 37183586 DOI: 10.1017/s1352465822000649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Affiliation(s)
- Mark H Freeston
- School of Psychology, Newcastle University, Newcastle upon Tyne, UK
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Wu L, Ren L, Li F, Shi K, Fang P, Wang X, Feng T, Wu S, Liu X. Network Analysis of Anxiety Symptoms in Front-Line Medical Staff during the COVID-19 Pandemic. Brain Sci 2023; 13:1155. [PMID: 37626510 PMCID: PMC10452648 DOI: 10.3390/brainsci13081155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND This research analyses the relations between anxiety symptoms from the network perspective to deepen the understanding of anxiety in front-line medical staff during the COVID-19 pandemic and can also provide a reference for determining potential goals of clinical interventions. METHODS A convenience sampling was adopted, and the Generalized Anxiety Disorder 7-item scale (GAD-7) was administered to front-line medical staff through online platforms. A regularized partial correlation network of anxiety was constructed and then we evaluated its accuracy and stability. The expected influence and predictability were used to describe the relative importance and the controllability, using community detection to explore community structure. The gender-based differences and the directed acyclic graph were implemented. RESULTS The connections between A1 "Feeling nervous, anxious or on edge" and A2 "Not being able to stop or control worrying", A6 "Becoming easily annoyed or irritable" and A7 "Feeling afraid as if something awful might happen", etc., were relatively strong; A2 "Not being able to stop or control worrying" and A3 "Worrying too much about different things" had the highest expected influence, and A2 "Not being able to stop or control worrying" had the highest predictability. The community detection identified two communities. The results of the gender network comparison showed the overall intensity of the anxiety network in women was higher than that in men; DAG indicated that A2 "Not being able to stop or control worrying" had the highest probabilistic priority; the lines from A2 "Not being able to stop or control worrying" to A1 "Feeling nervous, anxious or on edge" and A2 "Not being able to stop or control worrying" to A7 "Feeling afraid as if something awful might happen" represented the most important arrows. CONCLUSION There exist broad interconnections among anxiety symptoms of front-line medical staff on the GAD-7. A2 "Not being able to stop or control worrying" might be the core symptom and a potential effective intervention target. It was possible to bring an optimal result for the entire GAD symptom network by interfering with A2 "Not being able to stop or control worrying". GAD may have two "subsystems". The modes of interconnection among anxiety may be consistent between genders.
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Affiliation(s)
- Lin Wu
- Department of Military Medical Psychology, Air Force Medical University, Xi’an 710032, China; (L.W.)
| | - Lei Ren
- Military Psychology Section, Logistics University of PAP, Tianjin 300309, China
- Military Mental Health Services & Research Center, Tianjin 300309, China
| | - Fengzhan Li
- Department of Military Medical Psychology, Air Force Medical University, Xi’an 710032, China; (L.W.)
| | - Kang Shi
- Department of Military Medical Psychology, Air Force Medical University, Xi’an 710032, China; (L.W.)
| | - Peng Fang
- Department of Military Medical Psychology, Air Force Medical University, Xi’an 710032, China; (L.W.)
| | - Xiuchao Wang
- Department of Military Medical Psychology, Air Force Medical University, Xi’an 710032, China; (L.W.)
| | - Tingwei Feng
- Department of Military Medical Psychology, Air Force Medical University, Xi’an 710032, China; (L.W.)
| | - Shengjun Wu
- Department of Military Medical Psychology, Air Force Medical University, Xi’an 710032, China; (L.W.)
| | - Xufeng Liu
- Department of Military Medical Psychology, Air Force Medical University, Xi’an 710032, China; (L.W.)
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Christian C, Cusack CE, Ralph-Nearman C, Spoor SP, Hunt RA, Levinson CA. A Pilot, Time-Series Investigation of Depression, Anxiety, and Eating Disorder Symptoms in Adults Experiencing Major Depressive Symptoms: The Need for Eating Disorder Assessment and Research in Depression. Behav Ther 2023; 54:214-229. [PMID: 36858755 DOI: 10.1016/j.beth.2022.08.003] [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: 08/04/2021] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 11/27/2022]
Abstract
Major Depressive Disorder (MDD) is a prevalent psychiatric disorder impacting 10-16% of Americans in their lifetime. Approximately 60% of individuals with MDD have comorbid anxiety disorders. Additionally, although scarce research has examined eating disorders (EDs) in depression, a bidirectional association exists between ED and MDD symptoms. The current pilot study (N = 31 individuals with moderate to severe depression) modeled networks of depressive, anxiety, and ED symptoms using intensive time-series data. This study also tested if temporal central symptoms predicted six-month clinical outcomes. The most central symptoms were guilt, self-dislike, lack of energy, and difficulty concentrating. Several anxiety and ED symptoms were also central, including physical anxiety, social anxiety, body dissatisfaction, and desire for thinness. The central symptom crying predicted six-month depression with a medium effect size. These findings suggest anxiety and ED symptoms may influence the day-to-day course of depression in some individuals with comorbid diagnoses, but predictors of symptoms across hours may differ from predictors across longer time scales (i.e., months). Time scale should be considered when conducting and interpreting research on MDD. Research, assessment, and treatment for MDD should continue to explore transdiagnostic approaches including anxiety and ED symptoms to optimize care for individuals with complex presentations.
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Li J, Liu C, Wulandari T, Wang P, Li K, Ren L, Liu X. The relationship between dimensions of empathy and symptoms of depression among university students during the COVID-19 pandemic: A network analysis. Front Public Health 2022; 10:1034119. [PMID: 36620303 PMCID: PMC9813512 DOI: 10.3389/fpubh.2022.1034119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
Background The relationship between different dimensions of empathy and individual symptoms of depression during the COVID-19 pandemic remains unclear, despite the established link between empathy and depression. The network analysis offers a novel framework for visualizing the association between empathy and depression as a complex system consisting of interacting nodes. In this study, we investigated the nuanced associations between different dimensions of empathy and individual symptoms of depression using a network model during the pandemic. Methods 1,177 students completed the Chinese version of the Interpersonal Reactivity Index (IRI), measuring dimensions of empathy, and the Chinese version of the Patient Health Questionnaire-9 (PHQ-9), measuring symptoms of depression. First, we investigated the nuanced associations between different dimensions of empathy and individual depressive symptoms. Then, we calculated the bridge expected influence to examine how different dimensions of empathy may activate or deactivate the symptoms of depression cluster. Finally, we conducted a network comparison test to explore whether network characteristics such as empathy-depression edges and bridge nodes differed between genders. Results First, our findings showed that personal distress was positively linked to symptoms of depression. These symptoms involved psychomotor agitation or retardation (edge weight = 0.18), sad mood (edge weight = 0.12), trouble with concentrating (edge weight = 0.11), and guilt (edge weight = 0.10). Perspective-taking was found to be negatively correlated with trouble with concentrating (edge weight = -0.11). Empathic concern was negatively associated with suicidal thoughts (edge weight = -0.10) and psychomotor agitation or retardation (edge weight = -0.08). Fantasy was not connected with any symptoms of depression. Second, personal distress and empathic concern were the most positive and negative influential nodes that bridged empathy and depression (values of bridge expected influence were 0.51 and -0.19 and values of predictability were 0.24 and 0.24, respectively). The estimates of the bridge expected influence on the nodes were adequately stable (correlation stability coefficient = 0.75). Finally, no sex differences in the studied network characteristics were observed. Conclusions This study applied network analysis to reveal potential pathways between different dimensions of empathy and individual symptoms of depression. The findings supported the existing theoretical system and contribute to the theoretical mechanism. We have also made efforts to suggest interventions and preventions based on personal distress and empathic concern, the two most important dimensions of empathy for depressive symptoms. These efforts may help Chinese university students to adopt better practical methods to overcome symptoms of depression during the COVID-19 pandemic.
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Affiliation(s)
- Jiayi Li
- Military Medical Psychology School, Fourth Military Medical University, Xi'an, China
| | - Chang Liu
- BrainPark, Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VI, Australia
| | - Teresa Wulandari
- BrainPark, Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VI, Australia
| | - Panhui Wang
- Military Medical Psychology School, Fourth Military Medical University, Xi'an, China
| | - Kuiliang Li
- Department of Developmental Psychology for Armyman, School of Medical Psychology, Army Medical University, Chongqing, China
| | - Lei Ren
- Military Medical Psychology School, Fourth Military Medical University, Xi'an, China,*Correspondence: Lei Ren
| | - Xufeng Liu
- Military Medical Psychology School, Fourth Military Medical University, Xi'an, China,Xufeng Liu
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Shahamabadi MG, Farajkhoda T, Mahmoodabadi HZ. Online versus face-to-face metacognitive educational counseling program on anxiety and meta-worry in women with a history of miscarriage: A randomized clinical trial. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:264. [PMID: 36325205 PMCID: PMC9621353 DOI: 10.4103/jehp.jehp_1292_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/27/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND In the COVID-19 outbreak, women with a history of miscarriage need more mental health. Anxiety and meta-worry as consequences of miscarriage, besides concerns due to pregnancy during coronavirus, show the necessity of appropriate online and face-to-face educational counseling. This study aimed to evaluate the effectiveness of online metacognitive educational counseling versus face-to-face method on anxiety and meta-worry in these women. MATERIALS AND METHODS In this randomized clinical trial, 80 women with a history of miscarriage, anxiety, and meta-worry referred to Imam Jafar Sadegh hospital (labor, women ward and women clinic), Meybod, Iran, were selected conveniently and randomly assigned into two groups (n = 20/each). The participants received 8-session metacognitive educational counseling package online or face-to-face. Data were collected by Beck Anxiety Inventory, Wellz meta-worry questionnaire at baseline, week eight, and follow up as primary outcomes and analyzed via SPSS software (Anova and Repeated measure statistic tests). RESULTS Anxiety in the 12th week (online group 13.75 ± 3.59 vs. face to face 18.25 ± 5.91, P = 0.04) was statistical significantly less than baseline (respectively 22.15 ± 5.67 vs. 22.35 ± 4.93, P = 0.56); with fewer anxiety scores in the online group. Meta-worry in the 12th week (online group 11.90 ± 2.59 vs. face to face 15.70 ± 4.06, P = 0.03) was statistically significant compared to baseline (respectively 17.15 ± 2.70 vs. 18.50 ± 3.47, P = 0.36); with fewer meta-worry scores in the online group. Belief about worry in 12th week (online group 66.50 ± 14.60 vs. face to face 78.45 ± 9.27, P = 0.01) was statistical significantly less than baseline (respectively 85.50 ± 8.87 vs. 86.05 ± 8.85, P = 0.96); with less score of belief about worry in the online group. CONCLUSION Online and face-to-face metacognitive educational counseling methods decreased anxiety, meta-worry, and belief about worry in women with miscarriage. But online educational counseling was more effective. Distance online counseling in COVID-19 can help the mental health of women with miscarriage.
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Affiliation(s)
- Mina Ghiasi Shahamabadi
- Counseling in Midwifery (MSc), Student Research Committee, Midwifery Department, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Tahmineh Farajkhoda
- Reproductive Health (Ph.D.) and Clinical Psycologist, Research Center for Nursing and Midwifery Care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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GÜNDÜZ A, GÜNDOĞMUŞ İ, ENGİN B, BAĞLAR G, GÜNDÜZ EBU. The Validity and Reliability of the Turkish Version of the Meta-Worry Questionnaire. Noro Psikiyatr Ars 2022; 59:218-225. [PMID: 36160071 PMCID: PMC9466641 DOI: 10.29399/npa.27926] [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: 05/26/2021] [Accepted: 11/30/2021] [Indexed: 06/16/2023] Open
Abstract
INTRODUCTION This study aims to investigate the validity and reliability of the Meta-Worry Questionnaire in the Turkish version as a contribution to clinical practice. METHOD The research sample consisted of two groups. Cases were people who have General Anxiety Disorder (n=165) and controls were age and sex-matched healthy volunteers (n=158). To evaluate the psychometric properties of the scale, Meta-Worry Questionnaire, Metacognition Questionnaire-30, Beck Depression Inventory, Beck Anxiety Inventory, Penn State Worry Questionnaire and Generalized Anxiety Disorder-7 Questionnaire were used. RESULTS In this study, Cronbach's alpha coefficient values of frequency and belief components were found 0.92 and 0.94, respectively. At the same time, excluding each item, Cronbach's alpha coefficient values of these two components also remained above 0.90, regardless of which item was chosen. While the frequency component accounted for 69.07% of the total variance, the belief component accounted for 72.95%. The area under the ROC curve is 0.948 for the frequency component and 0.944 for the belief component. The construct validity of the scale was tested with Exploratory and Confirmatory Factor Analysis and the one-dimensional structure of the scale was shown. To evaluate the psychometric properties of the scale, other scales which are related to metacognition were used. CONCLUSION All items in the tool displayed a high correlation with the overall questionnaire. High total variance of the scale indicates its high validity. These results suggest high reliability of the tool as well as consistency of every item it includes.
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Affiliation(s)
- Anıl GÜNDÜZ
- Department of Clinical Psychology, İstanbul Kent University, İstanbul, Turkey
| | - İbrahim GÜNDOĞMUŞ
- ²Department of Psychiatry, Kırıkkale Yüksek İhtisas Hospital, Kırıkkale, Turkey
| | - Betül ENGİN
- Department of Clinical Psychology, İstanbul Kent University, İstanbul, Turkey
| | - Gonca BAĞLAR
- Department of Clinical Psychology, İstanbul Kent University, İstanbul, Turkey
| | - Elvan Başak Usta GÜNDÜZ
- Department of Child and Adolescent Psychiatry, Medeniyet University Göztepe Training and Research Hospital, İstanbul, Turkey
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Wang Y, Tang Z, Zhang X, Yang L. Auditory and cross-modal attentional bias toward positive natural sounds: Behavioral and ERP evidence. Front Hum Neurosci 2022; 16:949655. [PMID: 35967006 PMCID: PMC9372282 DOI: 10.3389/fnhum.2022.949655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 06/28/2022] [Indexed: 11/13/2022] Open
Abstract
Recently, researchers have expanded the investigation into attentional biases toward positive stimuli; however, few studies have examined attentional biases toward positive auditory information. In three experiments, the present study employed an emotional spatial cueing task using emotional sounds as cues and auditory stimuli (Experiment 1) or visual stimuli (Experiment 2 and Experiment 3) as targets to explore whether auditory or visual spatial attention could be modulated by positive auditory cues. Experiment 3 also examined the temporal dynamics of cross-modal auditory bias toward positive natural sounds using event-related potentials (ERPs). The behavioral results of the three experiments consistently demonstrated that response times to targets were faster after positive auditory cues than they were after neutral auditory cues in the valid condition, indicating that healthy participants showed a selective auditory attentional bias (Experiment 1) and cross-modal attentional bias (Experiment 2 and Experiment 3) toward positive natural sounds. The results of Experiment 3 showed that N1 amplitudes were more negative after positive sounds than they were after neutral sounds, which further provided electrophysiological evidence that positive auditory information enhances attention at early stages in healthy adults. The results of the experiments performed in the present study suggest that humans exhibit an attentional bias toward positive natural sounds.
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Affiliation(s)
- Yanmei Wang
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
- Shanghai Changning Mental Health Center, Shanghai, China
| | - Zhenwei Tang
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Xiaoxuan Zhang
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
- Shanghai Changning Mental Health Center, Shanghai, China
| | - Libing Yang
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
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Executive Functioning Constructs in Anxiety, Obsessive-Compulsive, Post-Traumatic Stress, and Related Disorders. Curr Psychiatry Rep 2022; 24:871-880. [PMID: 36401677 PMCID: PMC9676877 DOI: 10.1007/s11920-022-01390-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/23/2022] [Indexed: 11/20/2022]
Abstract
PURPOSE OF REVIEW We synthesize theories proposing complex relations between cognitive functioning and anxiety-related concepts. We evaluate vulnerability theories suggesting that deficits in various cognitive functioning domains predict future anxiety-associated concepts. We examine scar theories asserting the opposite direction of effects (i.e., anxiety predicting cognitive dysfunction). Furthermore, we examine more novel frameworks on this topic. RECENT FINDINGS Reliable evidence exists for the scar and vulnerability theories. This includes mounting data on diverse anxiety symptoms predicting cognitive dysfunction (and conversely) unfolding at between- and within-person levels (dynamic mutualism theory). It also includes data on the stronger effects or central influence of anxiety (versus non-anxiety) symptoms on executive functioning (EF; i.e., higher-order cognitive control governing myriad thinking and action repertoires) versus non-EF domains and vice versa (network theory). In addition, it reviews emerging evidence that enhanced cognitive control can correlate with higher anxiety among children (overgeneralized control theory). The generally inverse relations between anxiety symptoms and cognitive dysfunction are bidirectional and complex within and between persons. Plausible mediators and moderators merit more attention, including immune, metabolism, and neural markers and the social determinants of health.
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Fisher K, Seidler ZE, King K, Oliffe JL, Rice SM. Men's anxiety: A systematic review. J Affect Disord 2021; 295:688-702. [PMID: 34517242 DOI: 10.1016/j.jad.2021.08.136] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 07/27/2021] [Accepted: 08/27/2021] [Indexed: 11/27/2022]
Abstract
AIM Anxiety disorders are amongst the most commonly diagnosed mental illnesses amongst men; however male-specific anxiety research is lacking. This review explores men's anxiety symptoms and disorders including help-seeking, coping and the role of masculinity. METHOD Four electronic database searches identified 8,333 citations, with 25 studies meeting inclusion criteria. Nineteen studies employed quantitative methods, five studies reported qualitative research, and one utilised mixed methods. RESULTS Unique profiles of anxiety, including psychosomatic symptoms, were identified and persisted over extended periods of time. Men commonly reported self-reliance over formal help-seeking, and typically managed anxiety symptoms through problem-based coping. Masculinity was related to anxiety in complex ways; adherence to norms of toughness could be protective against anxiety onset, while adherence to emotional restrictiveness and heterosexual presentation norms were positively associated with anxiety. The experience of, and help-seeking for anxiety transgressed many men's adherence to masculinity norms resulting in significant social and self-stigmas. LIMITATIONS The anxiety measurement scales utilised were inconsistent across included studies and there was limited scope of research into panic disorders, phobias and agoraphobia. CONCLUSION Findings demonstrate the enduring nature of anxiety for men and a potential under-reporting of symptoms, especially amongst younger men. To better tailor clinical care and public health resources to the needs of men with anxiety disorders, targeted research examining men's lived experiences of (and coping strategies for) anxiety is essential.
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Affiliation(s)
- Krista Fisher
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia.
| | - Zac E Seidler
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia.
| | - Kylie King
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia.
| | - John L Oliffe
- University of British Columbia, Vancouver, British Columbia, Canada; Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
| | - Simon M Rice
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia.
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Mohammadkhani S, Akbari M, West A, Mazloom M, Gezloo F. The Relationship of Metacognition with Worry: The Mediating Role of Emotional Flexibility and Affective Style. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2021. [DOI: 10.1007/s10942-021-00422-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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13
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Ren L, Wei Z, Li Y, Cui LB, Wang Y, Wu L, Wei X, Peng J, Li K, Jin Y, Li F, Yang Q, Liu X. The relations between different components of intolerance of uncertainty and symptoms of generalized anxiety disorder: a network analysis. BMC Psychiatry 2021; 21:448. [PMID: 34507563 PMCID: PMC8431915 DOI: 10.1186/s12888-021-03455-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 08/25/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Intolerance of uncertainty (IU) is considered as a specific risk factor in the development and maintenance of generalized anxiety disorder (GAD). Yet, researches have investigated the relations between IU and GAD (or worry) using total scores on self-report measures. This ignores that there are different components exist in IU and the heterogeneity of GAD symptoms. In the present study, we explored the relations among different components of IU and symptoms of GAD. METHODS A dimensional approach which take individual differences into consideration in different components of IU along a full range of normal to abnormal symptom severity levels of GAD were used in this study. Components of IU were measured by 12-item Intolerance of Uncertainty Scale and symptoms of GAD were measured by Generalized Anxiety Disorder 7-Item Questionnaire. Regularized partial-correlation network was estimated using cross-sectional data from 624 university students. RESULTS Four strongest edges are between components of IU, like "Unforeseen events upset me greatly" and "It frustrates me not having all the information I need". Two strongest edges are between symptoms of GAD, like "Being so restless that it is hard to sit still" and "Feeling afraid as if something awful might happen". Symptom "Worrying too much about different things" and component "It frustrates me not having all the information I need" have the highest expected influences in the present network. In the community of IU, component "It frustrates me not having all the information I need" has the highest bridge expected influence. And in the community of GAD, symptoms "Worrying too much about different things" and "Not being able to stop or control worrying" have the highest bridge expected influence. CONCLUSIONS This study reveals potential pathways between different components of IU and various symptoms of GAD. Understanding how putative risk factors such as different components of IU are related to symptoms of GAD may provide some references for related preventions and interventions, such as targeting component "It frustrates me not having all the information I need" may be more effective at reducing symptoms of GAD than targeting other components of IU.
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Affiliation(s)
- Lei Ren
- grid.233520.50000 0004 1761 4404Department of Military Medical Psychology, Air Force Medical University, Xi’an, 710032 China
| | - Zihan Wei
- grid.233520.50000 0004 1761 4404Department of Neurology, Xijing Hospital, Air Force Medical University, Xi’an, 710032 China
| | - Ye Li
- grid.460132.20000 0004 1758 0275Psychological counseling center, Xijing University, Xi’an, 710100 China
| | - Long-Biao Cui
- grid.233520.50000 0004 1761 4404Department of Military Medical Psychology, Air Force Medical University, Xi’an, 710032 China
| | - Yifei Wang
- grid.233520.50000 0004 1761 4404Department of Military Medical Psychology, Air Force Medical University, Xi’an, 710032 China
| | - Lin Wu
- grid.233520.50000 0004 1761 4404Department of Military Medical Psychology, Air Force Medical University, Xi’an, 710032 China
| | - Xinyi Wei
- grid.24539.390000 0004 0368 8103Department of Psychology, Renmin University of China, Beijing, 100000 China
| | - Jiaxi Peng
- grid.411292.d0000 0004 1798 8975College of Teachers, Chengdu University, Chengdu, 610106 China
| | - Kuiliang Li
- grid.410570.70000 0004 1760 6682Department of Psychology, Army Medical University, Chongqing, 400038 China
| | - Yinchuan Jin
- grid.233520.50000 0004 1761 4404Department of Military Medical Psychology, Air Force Medical University, Xi’an, 710032 China
| | - Fengzhan Li
- grid.233520.50000 0004 1761 4404Department of Military Medical Psychology, Air Force Medical University, Xi’an, 710032 China
| | - Qun Yang
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, 710032, China.
| | - Xufeng Liu
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, 710032, China.
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