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Ghaffar RSA, Sheikh M, Kidwai M, Sanaullah A, Salman M, Ilyas A, Ahmed N, Lal A. Impact of high-speed handpiece noise-induced dental anxiety on heart rate: analyzing experienced and non-experienced patients - a comparative study. BMC Oral Health 2024; 24:265. [PMID: 38389070 PMCID: PMC10885409 DOI: 10.1186/s12903-024-04017-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 02/12/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Dental anxiety is very much common among the patients and could be due to different factors like the behavior of the dentist, past experiences, Needle phobia, or word of mouth from other patients. According to recent studies, a strong association between sound and anxiety has been found, so this observational study has been conducted to find out the link between the activation of anxiety with the sound of a handpiece between experienced patients, who have already gone through the dental treatments and non-experienced patients. METHODS Total of 297 participants were part of this study. These participants were divided into 2 groups according to the experienced and non-experienced dental patients. The researcher first filled out the CORAH Dental Anxiety Scale (DAS) form to mark the anxiety level of the patients, and then noted the readings of the heart rate in 3 intervals which were before during, and after the treatment with the pulse oximeter. Later the data was analysed using the SPSS independent t-test. RESULTS Results show that patients in group 1 who have gone through the dental treatment before were less anxious and had a lesser effect on their heart rate than the patient who were having the treatment for the first time who were in group 2. Another interesting factor was noticed that in both the groups female were found to be more anxious than male participants. Participants with younger age were found to be more anxious than older age patient in both groups CONCLUSIONS: The sound of the handpiece can provoke anxiety in the patient, affecting the heart and increasing the heart rate. Participants who were experienced were found to be less anxious than the participants who were inexperienced.
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Affiliation(s)
| | - Mahnoor Sheikh
- Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Muneeza Kidwai
- Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Anas Sanaullah
- Altamash Institute of Dental Medicine, Karachi, Pakistan
| | | | - Anum Ilyas
- Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Naseer Ahmed
- Department of Prosthodontics, Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Abhishek Lal
- Department of Medicine, The Aga Khan University, Karachi, Pakistan
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Goryunov AV, Nikiforova IY. [Teraligen in the complex treatment of anxiety-phobic, behavioral and depressive syndromes in children and adolescents with schizotypal disorder]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:77-82. [PMID: 37942976 DOI: 10.17116/jnevro202312309277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
ABSTRUCT OBJECTIVE To determine the frequency of prescribing and the main therapeutic targets of Teraligen in the treatment of Schizotypal disorder (STD) in childhood and adolescence. MATERIAL AND METHODS The sample consisted of 151 patients aged 7 to 16 years with a diagnosis of STD (F 21), of which 31.1% (n=47) of female patients and 68.9% (n=104) of male patients who received inpatient or outpatient treatment at the FSBI NCPZ from 2008 to 2020. The study was conducted by clinical-psychopathological, clinical-catamnestic, and statistical methods. RESULTS Teraligen was prescribed by psychiatrists to patients with STD in 74.2% of cases, of which in 46.4% of cases patients received Teraligen even before the diagnosis of STD in connection with complaints of neurotic disorders (anxiety, fears and sleep disorders) (n=30), as well as in connection with autistic-like behavior (n=22). At the time of follow-up, 55% (n=83) of patients received Teraligen, of which 63.9% (n=53) of patients were prescribed it for the first time. The applied schemes of prescribing Teraligen for the treatment of anxiety-phobic, depressive and behavioral syndromes within the framework of the STD in a relatively age-related aspect are presented. CONCLUSION The high frequency of prescribing Teraligen by psychiatrists and neurologists to children and adolescents with STD at different stages of observation is shown, which reflects the confidence of specialists in this drug. Teraligen has demonstrated a multidimensional pharmacological effect, including a mild antipsychotic effect, providing reduction of a wide range of psychopathological symptoms, with good tolerability and drug interaction. The study of the possibilities of Teraligen, both for monotherapy and for augmentation of the treatment of mental pathology in childhood, remains relevant.
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Deniz G, Bilek F, Esmez O, Gulkesen A. How does kinesiophobia affect short- and long-term gait parameters in individuals with total knee arthroplasty surgery? Acta Orthop Belg 2022; 88:788-796. [PMID: 36800665 DOI: 10.52628/88.4.10057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Delays in weight transfer due to various fears after Total knee arthroplasty (TKA) surgery negatively affect recovery. Therefore, the presence of kinesiophobia is essential for the success of the treatment. This study was planned to investigate the effects of kinesiophobia on Spatio-temporal parameters in patients who underwent unilateral TKA surgery. This study was a prospective and cross-sectional study. Seventy patients with TKA were assessed preoperatively in the 1st week (Pre1W) and post- operatively in the 3rd month (Post3M) and 12th month (Post12M). Spatiotemporal parameters were assessed using the Win-Track platform (Medicapteurs Technology, France). The Tampa kinesiophobia scale and Lequesne index were evaluated in all individuals. A significant relationship was found between the Pre1W, Post3M, and Post12M periods and Lequesne Index scores (p<0.01), and this relationship was in favor of improvement. In the Post3M period, kinesiophobia increased compared to the Pre1W period, and kinesiophobia decreased effectively in the Post12M period (p<0.01). The effect of kine-siophobia was evident in the first postoperative period. In the correlation analyses between spatiotemporal para- meters and kinesiophobia, significant negative correlations were observed (p<0.01) in the early postoperative period (Post3M). Evaluating the effectiveness of kinesiophobia on Spatio-temporal parameters at different time intervals before and after TKA surgery may be necessary for the treatment process.
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Alsbrooks K, Hoerauf K. Prevalence, causes, impacts, and management of needle phobia: An international survey of a general adult population. PLoS One 2022; 17:e0276814. [PMID: 36409734 PMCID: PMC9678288 DOI: 10.1371/journal.pone.0276814] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 10/14/2022] [Indexed: 11/22/2022] Open
Abstract
Needle phobia is an overlooked condition that affects virtually all medical procedures. Our study aimed to identify how commonly needle phobia is experienced, its underlying reasons, impacts, and potential mitigation strategies. A global survey was conducted in a general adult population using a questionnaire based on a targeted literature review that identified under-researched areas. The 21-item questionnaire was completed on a secure, web-based survey platform. Statistical analyses and models were utilized to identify relationships between participant characteristics and needle phobia. Of the 2,098 participants enrolled in the study, 63.2% (n = 1,325) reported experiencing needle phobia, and rated the intensity of their fear as 5.7 (±2.6) on average on a scale from 0 (no fear) to 10 (very strong/unreasonable fear or avoidance). According to the logistic regression model, other medical fears (odds coefficient = 2.14) and family history (1.67) were the most important factors associated with needle phobia. General anxiety (96.1%) and pain (95.5%) were the most common reasons for needle fear. Of the participants experiencing needle phobia, 52.2% stated avoiding blood draws, followed by 49.0% for blood donations, and 33.1% for vaccinations. While 24.3% of participants have seen a therapist, most have never sought help. The majority have shared their fear with nurses (61.1%) or physicians (44.4%); however, the provider helpfulness was rated as 4.9 (±3.1) on average on a scale from 0 (unhelpful) to 10 (extremely helpful). Utilizing non-invasive alternatives (94.1%) and smaller needles (91.1%) were most commonly identified as potential device-related solutions to alleviate fear; distractions (92.1%) and relaxation techniques (91.7%) were the top non-device-related approaches. Our findings highlight the prevalent nature of needle phobia and provide insights into its etiology and effects on patient care. Clinician responses were not perceived as helpful, emphasizing the need to address needle phobia, and improve patient experience.
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Affiliation(s)
- Kimberly Alsbrooks
- Becton, Dickinson, and Company, Franklin Lakes, NJ, United States of America
- * E-mail:
| | - Klaus Hoerauf
- Becton, Dickinson, and Company, Franklin Lakes, NJ, United States of America
- Medical University of Vienna, Vienna, Austria
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Rentmeester C, Bake M, Dall C. Claustrophobia-Related Anxiety During MR Imaging Examinations. Radiol Technol 2022; 94:53-57. [PMID: 36347608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Casey Rentmeester
- Casey Rentmeester, PhD, is director of academic success and associate professor of philosophy for Bellin College in Green Bay, Wisconsin. He has written and edited books and peer-reviewed articles on phenomenology, and he teaches courses in medical ethics
| | - Mark Bake
- Mark Bake, DBA, R.T.(R), CT, is dean of students and allied health sciences and associate professor of radiologic sciences for Bellin College. He has written peer-reviewed articles in health sciences, lectured at national conferences, and he teaches courses in medical imaging
| | - Chad Dall
- Chad Dall, MBA, R.T.(R), MR, is director of outreach and engagement and assistant professor of radiologic sciences for Bellin College. He has lectured at national conferences, and he teaches courses in medical imaging
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Keane N, Farrell A, Hallahan B. Pregnancy-related claustrophobia. BMJ Case Rep 2022; 15:e246568. [PMID: 35027381 PMCID: PMC8762120 DOI: 10.1136/bcr-2021-246568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 11/03/2022] Open
Abstract
A 35-year-old primigravida presented with significant anxiety symptoms at 26 weeks' gestation. Symptoms were preceded by a nightmare about her upcoming labour. She developed repetitive intrusive thoughts of being trapped emotionally and physically in her pregnancy. Her symptoms were suggestive of new-onset claustrophobia associated with pregnancy, which has not been previously reported on. Her symptoms ameliorated with a combination of cognitive-behavioural therapy and pharmacotherapy (sertraline and low dose quetiapine). The later stages of pregnancy were associated with minimal symptoms and the resolution of her subjective 'entrapment'. A subsequent pregnancy resulted in similar although less severe symptomatology. No postpartum anxiety symptoms were demonstrated on both occasions. Anxiety symptoms can adversely impact both the mother and fetus, and thus correct identification and management of pregnancy-related claustrophobia improved symptomatology and functioning and allowed for earlier detection and reduced symptomatology in a subsequent pregnancy.
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Affiliation(s)
- Nessa Keane
- Department of Psychiatry, Galway University Hospitals, Galway, Ireland
| | - Amy Farrell
- Department of Psychiatry, Galway University Hospitals, Galway, Ireland
| | - Brian Hallahan
- Department of Psychiatry, Galway University Hospitals, Galway, Ireland
- Psychiatry, National University of Ireland Galway, Galway, Ireland
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Kamonseki DH, Haik MN, Ribeiro LP, de Almeida RF, de Almeida LA, Fonseca CL, Camargo PR. Measurement properties of the Brazilian versions of Fear-Avoidance Beliefs Questionnaire and Tampa Scale of Kinesiophobia in individuals with shoulder pain. PLoS One 2021; 16:e0260452. [PMID: 34852000 PMCID: PMC8635377 DOI: 10.1371/journal.pone.0260452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 11/09/2021] [Indexed: 01/26/2023] Open
Abstract
PURPOSE To verify the measurement properties of the Brazilian versions of Fear-avoidance Beliefs Questionnaire (FABQ) and Tampa Scale of Kinesiophobia (TSK) in individuals with shoulder pain. METHODS Individuals with shoulder pain (>18 years) were included in this study. Structural validity was verified by exploratory factor analysis, which was used to identify dimensionality of the FABQ and TSK. Test-retest reliability was assessed with intraclass correlation coefficient(3,1) and internal consistency with Cronbach's alpha. Floor or ceiling effects were also investigated. Responsiveness was verified by effect sizes and area under the receiver operating characteristic curve (AUC). RESULTS Exploratory factor analysis identified two and one factor in the FABQ and TSK, respectively. FABQ and TSK presented moderate to good reliability and adequate internal consistency (Cronbach's alpha > 0.70). The floor effect was present in one factor of the FABQ. The FABQ and TSK showed small to moderate effect sizes and did not show adequate AUC. CONCLUSION FABQ and TSK are multidimensional and unidimensional instruments, respectively. Those instruments presented moderate to good reliability and the responsiveness was considered to be suboptimal in individuals with shoulder pain.
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Affiliation(s)
- Danilo Harudy Kamonseki
- Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos, (SP), Brazil
| | - Melina Nevoeiro Haik
- Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos, (SP), Brazil
| | - Larissa Pechincha Ribeiro
- Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos, (SP), Brazil
| | - Rafaela Firmino de Almeida
- Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos, (SP), Brazil
| | - Lucas Araújo de Almeida
- Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos, (SP), Brazil
| | | | - Paula Rezende Camargo
- Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos (UFSCar), São Carlos, (SP), Brazil
- * E-mail:
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Frynta D, Janovcová M, Štolhoferová I, Peléšková Š, Vobrubová B, Frýdlová P, Skalíková H, Šípek P, Landová E. Emotions triggered by live arthropods shed light on spider phobia. Sci Rep 2021; 11:22268. [PMID: 34782659 PMCID: PMC8593055 DOI: 10.1038/s41598-021-01325-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 10/21/2021] [Indexed: 01/03/2023] Open
Abstract
Spiders are mostly harmless, yet they often trigger high levels of both fear and disgust, and arachnophobia (the phobia of spiders) ranks among the most common specific animal phobias. To investigate this apparent paradox, we turned to the only close relatives of spiders that pose a real danger to humans: scorpions. We adopted a unique methodology in order to assess authentic emotions elicited by arthropods. Over 300 respondents were asked to rate live specimens of 62 arthropod species (including spiders, scorpions, cockroaches, and other insects) based on perceived fear, disgust, and beauty. We found that species' scores on all three scales depended on the higher taxon as well as on body size. Spiders, scorpions, and other arachnids scored the highest in fear and disgust, while beetles and crabs scored the highest in beauty. Moreover, all chelicerates were perceived as one cohesive group, distinct from other arthropods, such as insects or crabs. Based on these results, we hypothesize that the fear of spiders might be triggered by a generalized fear of chelicerates, with scorpions being the original stimulus that signals danger.
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Affiliation(s)
- Daniel Frynta
- Department of Zoology, Faculty of Science, Charles University, Viničná 7, 128 43, Prague 2, Czech Republic
| | - Markéta Janovcová
- Department of Zoology, Faculty of Science, Charles University, Viničná 7, 128 43, Prague 2, Czech Republic
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
| | - Iveta Štolhoferová
- Department of Zoology, Faculty of Science, Charles University, Viničná 7, 128 43, Prague 2, Czech Republic
| | - Šárka Peléšková
- Department of Zoology, Faculty of Science, Charles University, Viničná 7, 128 43, Prague 2, Czech Republic
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
| | - Barbora Vobrubová
- Department of Zoology, Faculty of Science, Charles University, Viničná 7, 128 43, Prague 2, Czech Republic
| | - Petra Frýdlová
- Department of Zoology, Faculty of Science, Charles University, Viničná 7, 128 43, Prague 2, Czech Republic
| | - Hana Skalíková
- Department of Zoology, Faculty of Science, Charles University, Viničná 7, 128 43, Prague 2, Czech Republic
| | - Petr Šípek
- Department of Zoology, Faculty of Science, Charles University, Viničná 7, 128 43, Prague 2, Czech Republic
| | - Eva Landová
- Department of Zoology, Faculty of Science, Charles University, Viničná 7, 128 43, Prague 2, Czech Republic.
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.
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Ratner C, Shin JH, Dwibedi C, Tremaroli V, Bjerregaard A, Hartmann B, Bäckhed F, Leinninger G, Seeley RJ, Holst B. Anorexia and Fat Aversion Induced by Vertical Sleeve Gastrectomy Is Attenuated in Neurotensin Receptor 1-Deficient Mice. Endocrinology 2021; 162:6311588. [PMID: 34190328 PMCID: PMC8294690 DOI: 10.1210/endocr/bqab130] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Indexed: 12/25/2022]
Abstract
Neurotensin (NT) is an anorexic gut hormone and neuropeptide that increases in circulation following bariatric surgery in humans and rodents. We sought to determine the contribution of NT to the metabolic efficacy of vertical sleeve gastrectomy (VSG). To explore a potential mechanistic role of NT in VSG, we performed sham or VSG surgeries in diet-induced obese NT receptor 1 (NTSR1) wild-type and knockout (ko) mice and compared their weight and fat mass loss, glucose tolerance, food intake, and food preference after surgery. NTSR1 ko mice had reduced initial anorexia and body fat loss. Additionally, NTSR1 ko mice had an attenuated reduction in fat preference following VSG. Results from this study suggest that NTSR1 signaling contributes to the potent effect of VSG to initially reduce food intake following VSG surgeries and potentially also on the effects on macronutrient selection induced by VSG. However, maintenance of long-term weight loss after VSG requires signals in addition to NT.
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Affiliation(s)
- Cecilia Ratner
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Correspondence: Cecilia Ratner, University of Copenhagen: Kobenhavns Universitet, Blegdamsvej 3B, 2200, Copenhagen N, Denmark. E-mail:
| | - Jae Hoon Shin
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Chinmay Dwibedi
- Wallenberg Laboratory, University of Gothenburg, Gothenburg, Sweden
- Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | | | - Anette Bjerregaard
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bolette Hartmann
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Fredrik Bäckhed
- Wallenberg Laboratory, University of Gothenburg, Gothenburg, Sweden
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
- Region Västra Götaland, Sahlgrenska University Hospital, Department of Clinical Physiology, Gothenburg, Sweden
| | - Gina Leinninger
- Department of Physiology, Michigan State University, East Lansing, MI, USA
| | - Randy J Seeley
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Birgitte Holst
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Correspondence: Birgitte Holst, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark.
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Rosenberg Danziger C, Krause I, Scheuerman O, Luder A, Yulevich A, Dalal I, Grisaru-Soen G, Bilavsky E. Pediatrician, watch out for corona-phobia. Eur J Pediatr 2021; 180:201-206. [PMID: 32661937 PMCID: PMC7357258 DOI: 10.1007/s00431-020-03736-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/02/2020] [Accepted: 07/07/2020] [Indexed: 01/17/2023]
Abstract
The current outbreak of COVID-19 raging globally is taking a heavy toll on the adult population, with a rapidly growing number of newly infected and critically ill patients. However, to date, mortality rate among children is low as they mostly suffer from a mild disease. Yet, other more routinely encountered childhood diseases do not stand still and continue to be the main share of pediatricians' everyday challenges. Here we describe a case series of routinely seen pediatric diseases with delayed diagnosis due to different aspects of what we call "Corona-phobia". These cases were easily collected within a 1-week period which implies that this is a more widespread phenomenon.In conclusion, this raises the possibility that measures taken to mitigate this pandemic may be more damaging to children overall than the virus itself. We believe that pediatricians as well as policy makers should take this important aspect into consideration. What is Known: • COVID-19 manifests as a mild disease in most children; however, children are an important reservoir and may become spreaders of the disease. • Social distancing and isolation are important tools in mitigating COVID-19 transmission. What is New: • This case series describes 7 cases with delayed diagnosis of every-day pediatric diseases that were not caused by COVID-19 but were highly influenced by different aspects of "Corona-phobia". • Our objective is to highlight the possibility that measures taken to mitigate this pandemic may lead to a substantial delay in the diagnosis of other non-COVID-19 related diseases.
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Affiliation(s)
- Chen Rosenberg Danziger
- Department of Pediatrics C, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel
| | - Irit Krause
- Department of Pediatrics C, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Oded Scheuerman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Pediatrics B, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel
| | - Anthony Luder
- Department of Pediatrics, Ziv Medical Center, Safed, Israel
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Alon Yulevich
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
- Department of Pediatric Surgery, Ziv Medical Center, Safed, Israel
| | - Ilan Dalal
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Paediatrics, Edith Wolfson Medical Center, Holon, Israel
| | - Galia Grisaru-Soen
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Infectious Disease Unit, Tel Aviv Sourasky Medical Center, Dana- Dwek Children’s Hospital, Tel Aviv, Israel
| | - Efraim Bilavsky
- Department of Pediatrics C, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Bağlan Yentür S, Karatay S, Oskay D, Tufan A, Küçük H, Haznedaroğlu Ş. Kinesiophobia and related factors in systemic lupus erythematosus patients. Turk J Med Sci 2019; 49:1324-1331. [PMID: 31648437 PMCID: PMC7018320 DOI: 10.3906/sag-1804-152] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 05/29/2019] [Indexed: 01/01/2023] Open
Abstract
Background/aim This study was designed to investigate the relationship between kinesiophobia and the level of physical activity, depression, disease activity, fatigue, pain, and quality of life in female patients with systemic lupus erythematosus (SLE). Materials and methods Seventy volunteer female patients were included in the study. Kinesiophobia, physical activity level, disease activity, fatigue, depression, pain, and quality of life were assessed using the Tampa Scale for Kinesiophobia (TSK), International Physical Activity Questionnaire- Short Form (IPAQ), Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), Fatigue Severity Scale (FSS), Beck Depression Inventory (BDI), McGill Pain Questionnaire- Short Form (MPQ-SF) and Nottingham Health Profile (NHP), respectively. Results Two-thirds of the patients in the study had a high degree of kinesiophobia. Although there was a significant correlation between kinesiophobia and depression and some subscales of quality of life (sleep, social isolation, emotional reactions) (P < 0.05), no significant correlation with other parameters was found. Conclusion As a result of this study, the majority of SLE patients included in the study were identified as having high levels of kinesiophobia. Patients’ fear and avoidance reaction from movement can be influenced by psychosocial factors. Treatments focusing on kinesiophobia of SLE patients could be beneficial in increasing the success of rehabilitation.
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Affiliation(s)
- Songül Bağlan Yentür
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Saliha Karatay
- Department of Physical Medicine and Rehabilitation, A Life Park Hospital, Ankara, Turkey
| | - Deran Oskay
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Abdurrahman Tufan
- Division of Rheumatology, Faculty of Medical Sciences, Gazi University
| | - Hamit Küçük
- Erzurum Regional Education Hospital, Erzurum, Turkey
| | - Şeminur Haznedaroğlu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
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Scheurich JA, Beidel DC, Vanryckeghem M. Exposure therapy for social anxiety disorder in people who stutter: An exploratory multiple baseline design. J Fluency Disord 2019; 59:21-32. [PMID: 30578977 DOI: 10.1016/j.jfludis.2018.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 11/21/2018] [Accepted: 12/11/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND & OBJECTIVES Social anxiety disorder (SAD) is a debilitating condition, and approximately half of adults who stutter have SAD. Cognitive-behavioral therapy (CBT) has shown promise in decreasing social anxiety symptoms among adults who stutter, but exposure, arguably the essential component for successful CBT for SAD, has been understudied and underemphasized. Aims of this study were to develop an exposure therapy protocol designed specifically for people who stutter and have SAD and evaluate its potential efficacy in reducing social anxiety and stuttering severity using a multiple baseline design. METHODS Six participants received ten sessions of exposure therapy. Participants reported daily social anxiety, and social distress and stuttering severity were evaluated at major assessment points. RESULTS There were substantial reductions in social anxiety and considerable improvements in affective, behavioral, and cognitive experiences of stuttering. No consistent change was observed for stuttering frequency. Gains were mostly maintained after six-months. CONCLUSIONS Results suggest that the novel exposure approach may decrease social distress, but not necessarily influence speech fluency. These findings underscore the importance of the assessment and treatment of SAD among adults who stutter and suggest that the integration of care between clinical psychologists and speech-language pathologists may prove beneficial for this population.
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Affiliation(s)
- Jennifer A Scheurich
- Department of Psychology, University of Central Florida, 4111 Pictor Lane, Orlando, FL 32816-1390, United States.
| | - Deborah C Beidel
- Department of Psychology, University of Central Florida, 4111 Pictor Lane, Orlando, FL 32816-1390, United States
| | - Martine Vanryckeghem
- School of Communication Sciences and Disorders, University of Central Florida, 4111 Pictor Lane, Orlando, FL 32816-1390, United States
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Hall DL, Luberto CM, Philpotts LL, Song R, Park ER, Yeh GY. Mind-body interventions for fear of cancer recurrence: A systematic review and meta-analysis. Psychooncology 2018; 27:2546-2558. [PMID: 29744965 PMCID: PMC6488231 DOI: 10.1002/pon.4757] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 03/21/2018] [Accepted: 04/19/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Fear of cancer recurrence (FCR) is a common existential concern and source of distress among adults with a cancer history. Multiple randomized controlled trials (RCTs) have examined mind-body approaches to mitigating FCR. We summarized characteristics of these trials and calculated their pooled effects on decreasing FCR. METHODS Six electronic databases were systematically searched from inception to May 2017, using a strategy that included multiple terms for RCTs, cancer, mind-body medicine, and FCR. Data extraction and reporting followed Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Pooled effect sizes on self-report measures of FCR were computed by using random-effects models. RESULTS Nineteen RCTs (pooled N = 2806) were included. Most studies (53%) were published since 2015 and targeted a single cancer type (84%; mostly breast). Intervention sessions (median = 6, mode = 4) tended to last 120 minutes and occur across 1.5 months. Delivery was predominantly in-person (63%) to either groups (42%) or individuals (42%). Most interventions incorporated multiple mind-body components (53%), commonly cognitive-behavioral skills (58%), or meditative practices (53%). Small-to-medium pooled effect sizes were observed postintervention (Hedges' g = -0.36, 95% CI = -0.49, -0.23, P < .001) and at follow-up assessments (median = 8 months, P < .001). Potential modifiers (control group design, group/individual delivery, use of cognitive-behavioral or mindfulness skills, number of mind-body components, cancer treatment status, and number of sessions) did not reach statistical significance. CONCLUSIONS Mind-body interventions are efficacious for reducing FCR, with small-to-medium effect sizes that persist after intervention delivery ends. Recommendations include testing effects among survivors of various cancers and exploring the optimal integration of mind-body practices for managing fundamental uncertainties and fears during cancer survivorship.
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Affiliation(s)
- Daniel L. Hall
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | | | | | - Rhayun Song
- College of Nursing, Chungnam National University, South Korea
| | - Elyse R. Park
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Massachusetts General Hospital Cancer Center, Boston, MA, USA
- Mongan Institute Health Policy Center, Massachusetts General Hospital, Boston, MA, USA
| | - Gloria Y. Yeh
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Galera O, Bajon D, Maoz Z, Lussagnet C, Tadiotto A, Babin T. [Effectiveness of therapeutic education against "nicotinophobia" in smokers hospitalized for cardiovascular and pulmonary rehabilitation]. Rev Pneumol Clin 2018; 74:221-225. [PMID: 29502895 DOI: 10.1016/j.pneumo.2017.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 10/20/2017] [Accepted: 11/21/2017] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Nicotine replacement therapies remain the main validated treatment to stop smoking. Nevertheless, treatment acceptance deals with patients negative representations. This "nicotinophobia" could be the main barrier to treatment acceptance and as a consequence would be at the origin of numerous failures of smoking cessation. MATERIALS AND METHODS We estimated the efficiency of an educational collective workshop to fight against nicotinophobia in patients smokers hospitalized for cardiovascular and pulmonary rehabilitation. RESULTS Smoking cessation was significantly improved in patients who participated at the workshop (81 vs. 48 %), associated with a significant decrease of anxiety-depression scores, and without significant weight gain (average loss of 2.8kg). CONCLUSION Educational approaches seem to help a majority of patient smokers to stop smoking, without anxiety and without weight gain. These results encourage the creation of a real therapeutic educational program dedicated to smoking cessation.
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Affiliation(s)
- O Galera
- Clinique de rééducation cardiovasculaire et pulmonaire de Saint-Orens, 12, avenue de Revel, 31650 Saint-Orens-de-Gameville, France; Réseau régional de santé respiratoire Partn'Air, 12, avenue de Revel, 31650 Saint-Orens-de-Gameville, France.
| | - D Bajon
- Clinique de rééducation cardiovasculaire et pulmonaire de Saint-Orens, 12, avenue de Revel, 31650 Saint-Orens-de-Gameville, France; Réseau régional de santé respiratoire Partn'Air, 12, avenue de Revel, 31650 Saint-Orens-de-Gameville, France
| | - Z Maoz
- Clinique de rééducation cardiovasculaire et pulmonaire de Saint-Orens, 12, avenue de Revel, 31650 Saint-Orens-de-Gameville, France; Laboratoire CERPPS, université Jean-Jaurès Toulouse- Jean Jaurès, maison de la recherche, 5, allées Antonio-Machado, 31058 Toulouse cedex 9, France
| | - C Lussagnet
- Clinique de rééducation cardiovasculaire et pulmonaire de Saint-Orens, 12, avenue de Revel, 31650 Saint-Orens-de-Gameville, France
| | - A Tadiotto
- Clinique de rééducation cardiovasculaire et pulmonaire de Saint-Orens, 12, avenue de Revel, 31650 Saint-Orens-de-Gameville, France
| | - T Babin
- Clinique de rééducation cardiovasculaire et pulmonaire de Saint-Orens, 12, avenue de Revel, 31650 Saint-Orens-de-Gameville, France
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Gómez-Arnau J, Martín-Larrégola M, Rabito-Alcón MF, Dolengevich-Segal H, Gutiérrez-Velasco L, Correas-Lauffer J. Effectiveness of a non-sedative intervention to prevent anxious and claustrophobic reactions in magnetic resonance imaging. Actas Esp Psiquiatr 2018; 46:200-204. [PMID: 30338778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 09/01/2018] [Indexed: 06/08/2023]
Affiliation(s)
- Jorge Gómez-Arnau
- Servicio de Psiquiatría. Hospital Universitario del Henares, Coslada (Madrid)
| | | | - María F Rabito-Alcón
- Facultad de Ciencias de la Salud. Universidad a Distancia de Madrid (UDIMA), Collado-Villalba (Madrid)
| | | | | | - Javier Correas-Lauffer
- Servicio de Psiquiatría. Hospital Universitario del Henares, Coslada (Madrid) Facultad de Medicina. Universidad Francisco de Vitoria, Pozuelo de Alarcón (Madrid)
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Buyukturan O, Buyukturan B, Sas S, Karartı C, Ceylan İ. The Effect of Mulligan Mobilization Technique in Older Adults with Neck Pain: A Randomized Controlled, Double-Blind Study. Pain Res Manag 2018; 2018:2856375. [PMID: 29861800 PMCID: PMC5976899 DOI: 10.1155/2018/2856375] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 03/16/2018] [Accepted: 04/10/2018] [Indexed: 11/17/2022]
Abstract
Background The purpose of this study was to examine the effect of Mulligan mobilization technique (MMT) on pain, range of motion (ROM), functional level, kinesiophobia, depression, and quality of life (QoL) in older adults with neck pain (NP). Methods Forty-two older adults with NP were included in the study, and they were randomly divided into two groups: traditional physiotherapy (TP) group and traditional physiotherapy-Mulligan mobilization (TPMM) group. Treatment program was scheduled for 10 sessions. Participants were assessed in terms of pain, ROM, functional level, kinesiophobia, depression, and QoL both pre- and posttreatment. Results Pain, ROM, functional level, kinesiophobia, depression, and QoL improved in both groups following treatment (p < 0.05). When comparing effects of these two treatment programs, it was observed that the TPMM group had a better outcome (p < 0.05) in terms of ROM, kinesiophobia, depression, and QoL. Conclusion In older adults with NP, MMT has been found to have significant effects on pain, ROM, functional level, kinesiophobia, depression, and QoL as long as it is performed by a specialist. "This trial is registered with NCT03507907".
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Affiliation(s)
- Oznur Buyukturan
- School of Physical Therapy and Rehabilitation, Ahi Evran University, Kırşehir, Turkey
| | - Buket Buyukturan
- School of Physical Therapy and Rehabilitation, Ahi Evran University, Kırşehir, Turkey
| | - Senem Sas
- Department of Physical Medicine and Rehabilitation, Ahi Evran University Training and Research Hospital, Kırşehir, Turkey
| | - Caner Karartı
- School of Physical Therapy and Rehabilitation, Ahi Evran University, Kırşehir, Turkey
| | - İsmail Ceylan
- School of Physical Therapy and Rehabilitation, Ahi Evran University, Kırşehir, Turkey
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Azoum M, Clark GI, Rock AJ. The impact of affect labelling on responses to aversive flying-cues. PLoS One 2018; 13:e0194519. [PMID: 29672519 PMCID: PMC5908089 DOI: 10.1371/journal.pone.0194519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 03/05/2018] [Indexed: 11/19/2022] Open
Abstract
Individuals with flying phobia experience increases in subjective anxiety in response to flying-related cues. However, the cognitive processes that contribute to cue-reactive anxiety in individuals with flying-related anxiety remain poorly understood. Preliminary research suggests that changes in visual imagery and volitional control may contribute to this cue-reactive anxiety. Engaging in affect labelling during exposure therapy has been shown to reduce cue-reactive anxiety in individuals with fears relating to a variety of stimuli but has not been investigated in the fear of flying. The present study recruited 110 participants with a range of flying-related anxiety scores to complete an online cue-reactivity experiment. The study sought to evaluate whether an aversive flying cue triggered changes in imagery, volitional control and anxiety, and whether changes in imagery and volitional control predicted level of cue-reactive anxiety. Participants were randomly allocated to an affect labelling or non-affect labelling condition to additionally assess whether engaging in labelling one's emotion following exposure to an aversive flying cue would attenuate cue-reactive changes in anxiety relative to a group who did not. Significant cue-reactive changes in anxiety, and volitional control were observed from neutral to aversive flying cue were observed. After accounting for the effects of flying anxiety severity, only volitional control significantly improved the prediction of cue-reactive anxiety. Participants in the affect labelling condition reported significantly smaller increases in anxiety than the non-affect labelling group following exposure to the aversive flight cue. This is the first study to indicate affect labelling may help to regulate aspects of cue-reactive anxiety in response to aversive flying stimuli.
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Affiliation(s)
- Michelle Azoum
- School of Behavioural, Cognitive and Social Sciences, University of New England, Armidale, NSW, Australia
| | - Gavin I. Clark
- School of Behavioural, Cognitive and Social Sciences, University of New England, Armidale, NSW, Australia
| | - Adam J. Rock
- School of Behavioural, Cognitive and Social Sciences, University of New England, Armidale, NSW, Australia
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Michałowski JM, Matuszewski J, Droździel D, Koziejowski W, Rynkiewicz A, Jednoróg K, Marchewka A. Neural response patterns in spider, blood-injection-injury and social fearful individuals: new insights from a simultaneous EEG/ECG-fMRI study. Brain Imaging Behav 2018; 11:829-845. [PMID: 27194564 DOI: 10.1007/s11682-016-9557-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In the present simultaneous EEG/ECG-fMRI study we compared the temporal and spatial characteristics of the brain responses and the cardiac activity during fear picture processing between spider, blood-injection-injury (BII) and social fearful as well as healthy (non-fearful) volunteers. All participants were presented with two neutral and six fear-related blocks of pictures: two social, two spider and two blood/injection fear blocks. In a social fear block neutral images were occasionally interspersed with photographs of angry faces and social exposure scenes. In spider and blood/injection fear blocks neutral pictures were interspersed with spider fear-relevant and blood/injection pictures, respectively. When compared to healthy controls the social fear group responded with increased activations in the anterior orbital, middle/anterior cingulate and middle/superior temporal areas for pictures depicting angry faces and with a few elevated superior frontal activations for social exposure scenes. In the blood/injection fear group, heart rate was decreased and the activity in the middle/inferior frontal and visual processing regions was increased for blood/injection pictures. The HR decrease for blood/injection pictures correlated with increased frontal responses. In the spider fear group, spider fear-relevant pictures triggered increased activations within a broad subcortical and cortical neural fear network. The HR response for spider fear-relevant stimuli was increased and correlated with an increased insula and hippocampus activity. When compared to healthy controls, all fear groups showed higher LPP amplitudes for their feared cues and an overall greater P1 hypervigilance effect. Contrasts against the fear control groups showed that the increased responses for fear-specific stimuli are mostly related to specific fears and not to general anxiety proneness. The results suggest different engagement of cognitive evaluation and down-regulation strategies and an overall increased sensitization of the fear system in the three fear groups.
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Affiliation(s)
- Jarosław M Michałowski
- Department of Differential Psychology, Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183, Warsaw, Poland.
| | - Jacek Matuszewski
- Department of Differential Psychology, Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183, Warsaw, Poland
- Laboratory of Brain Imaging, Neurobiology Centre, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland
| | - Dawid Droździel
- Department of Differential Psychology, Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183, Warsaw, Poland
- Laboratory of Brain Imaging, Neurobiology Centre, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland
| | - Wojciech Koziejowski
- Department of Differential Psychology, Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183, Warsaw, Poland
| | - Andrzej Rynkiewicz
- Department of Differential Psychology, Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183, Warsaw, Poland
| | - Katarzyna Jednoróg
- Laboratory of Psychophysiology, Department of Neurophysiology, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland
| | - Artur Marchewka
- Laboratory of Brain Imaging, Neurobiology Centre, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland
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da Costa RT, de Carvalho MR, Ribeiro P, Nardi AE. Virtual reality exposure therapy for fear of driving: analysis of clinical characteristics, physiological response, and sense of presence. Braz J Psychiatry 2018; 40:192-199. [PMID: 29451586 PMCID: PMC6900765 DOI: 10.1590/1516-4446-2017-2270] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 06/13/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the reactions of women with driving phobia to a therapeutic program of scheduled virtual reality exposure treatment (VRET) sessions. METHODS The study intervention consisted of a computer game with car-driving scenarios that included several traffic situations. We investigated the participants' sense of presence, subjective distress, and physiological responses during eight virtual-reality exposures. We also evaluated clinical characteristics, driving cognitions, and quality of life in the participants. RESULTS Thirteen women were selected. Eight were able to complete the protocol. After VRET, there was a decrease in the frequency of distorted thoughts and state anxiety scores, as well as a slight improvement in quality of life. Subjective discomfort scores, heart rate variation, and sense of presence scores confirmed that there was sense of presence in the virtual reality environment. CONCLUSION All patients showed some degree of improvement and demonstrated different levels of anxiety in subsequent in vivo driving experiences. Our findings suggest that VRET could be used to facilitate in vivo exposure, because it can induce presence/immersion and reduce anxiety in patients with specific phobia. Furthermore, VRET is not associated with any type of risk.
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Affiliation(s)
- Rafael T. da Costa
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
- Instituto Nacional de Ciência e Tecnologia (INCT), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Rio de Janeiro, RJ, Brazil
- Laboratório de Pânico e Respiração (LabPR), Rio de Janeiro, RJ, Brazil
- Núcleo Integrado de Pesquisas em Psicoterapia nas Abordagens Cognitivas e Comportamentais (NIPPACC), Instituto de Psiquiatria (IPUB), UFRJ, Rio de Janeiro, RJ, Brazil
| | - Marcele R. de Carvalho
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
- Instituto Nacional de Ciência e Tecnologia (INCT), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Rio de Janeiro, RJ, Brazil
- Laboratório de Pânico e Respiração (LabPR), Rio de Janeiro, RJ, Brazil
- Núcleo Integrado de Pesquisas em Psicoterapia nas Abordagens Cognitivas e Comportamentais (NIPPACC), Instituto de Psiquiatria (IPUB), UFRJ, Rio de Janeiro, RJ, Brazil
| | - Pedro Ribeiro
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
- Escola de Educação Física e Desportos, UFRJ, Rio de Janeiro, RJ, Brazil
| | - Antonio E. Nardi
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
- Instituto Nacional de Ciência e Tecnologia (INCT), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Rio de Janeiro, RJ, Brazil
- Laboratório de Pânico e Respiração (LabPR), Rio de Janeiro, RJ, Brazil
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21
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Abramovits W, Babaniji D, Vincent KD. Needlephilia versus Needlephobia. Skinmed 2017; 15:413-414. [PMID: 29282176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- William Abramovits
- Department of Dermatology, Baylor University Medical Center and the University of Texas Southwestern Medical School, Dallas, TX;
| | - Damilola Babaniji
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX
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Thewes B, Kaal SEJ, Custers JAE, Manten-Horst E, Jansen R, Servaes P, van der Graaf WTA, Prins JB, Husson O. Prevalence and correlates of high fear of cancer recurrence in late adolescents and young adults consulting a specialist adolescent and young adult (AYA) cancer service. Support Care Cancer 2017; 26:1479-1487. [PMID: 29168035 PMCID: PMC5876258 DOI: 10.1007/s00520-017-3975-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 11/13/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVE High fear of cancer recurrence (FCR) is a frequently reported problem among cancer patients. Previous research has shown that younger age is associated with higher levels of FCR. However, little attention has been given to date about how FCR manifests itself among adolescent and young adult (AYA) cancer patients. This study explores the prevalence, correlates of high FCR, and its association with HRQoL in cancer patients in their late adolescence or young adulthood. METHODS Seventy-three AYA cancer patients, aged 18-35 years at diagnosis, consulted the AYA team of the Radboud University Medical Center completed questionnaires including the Cancer Worry Scale (CWS), Quality of Life-Cancer Survivors (QOL-CS), and Hospital Anxiety and Depression Scale (HADS). Sociodemographic and medical data was collected by self-reported questionnaire. RESULTS Forty-five participants experienced high FCR (62%), which was higher than the 31-52% reported in previous studies among mixed adult cancer patient samples. Sociodemographic and medical variables were not associated with levels of FCR. High FCR was significantly associated with lower levels of social and psychological functioning and overall HRQoL and higher levels of anxiety and psychological distress. CONCLUSION Results illustrate that FCR is a significant problem among AYA cancer patients consulting an AYA team, with participants reporting higher levels of FCR than cancer patients of mixed ages. Health care providers should pay specific attention to this problem by screening and the provision of appropriate psychosocial care when needed.
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Affiliation(s)
- Belinda Thewes
- Department of Medical Psychology, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands.
| | - Suzanne E J Kaal
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jose A E Custers
- Department of Medical Psychology, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Eveliene Manten-Horst
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Rosemarie Jansen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Petra Servaes
- Department of Medical Psychology, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Winette T A van der Graaf
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
- Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | - Judith B Prins
- Department of Medical Psychology, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Olga Husson
- Department of Medical Psychology, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands
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Rotunda TJ. Reducing Occurrences of MR-related Claustrophobia in Patients With PTSD. Radiol Technol 2017; 89:97-99. [PMID: 28904166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Khundadze M, Geladze N, Kapanadze N. IMPACT OF INTERNET GAMBLING ON MENTAL AND PSYCHOLOGICAL HEALTH OF CHILDREN OF VARIOUS AGES. Georgian Med News 2017:50-53. [PMID: 28480849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The aim of the study was to assess the impact of internet gambling on children's mental and physical health and find correlation between the age, duration of internet use and type of comorbidity associated with internet gambling. The study assessed 50 patients with internet gambling (35 boys, 15 girls) from 2013-2016 y. The age range was 3-15 years. 15 patients were from 3-7 y of age, 20 patients from 7-12 y and 15 - from 12-15 y of age. The core problem common for all patients were internet overuse by computer games, mobile device and other gadgets. The main problem occurring in these children were insomnia, language delay, stuttering, behavioral disturbances, aggressive behavior phobias. These complaints were correlated with age of patients. The group of patients from 3-7 years of age exhibited sleep disturbances and language impairment, mainly presented with stuttering. The complaints occurring in children from 7-12 y of age are: tics, insomnia, phobias, emotional disturbances, daily fatigue, and attention-deficit. The group of children aged 12-15 years mainly revealed poor academic performance, refuse to play sport games, refuse to play music, insomnia, aggressive behavior, attention deficit, conflict with parents, coprolalia. Thus internet overuse affects physical and psychological aspects of child development which has to be managed by parental and psychologist's joint effort.
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Affiliation(s)
- M Khundadze
- Tbilisi State Medical University, Department of Child Neurology, Georgia
| | - N Geladze
- Tbilisi State Medical University, Department of Child Neurology, Georgia
| | - N Kapanadze
- Tbilisi State Medical University, Department of Child Neurology, Georgia
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Abstract
This study is conducted to investigate efficacy of an insulin jet injector and an insulin pen in treatment of type 2 diabetic patients. Sixty patients with type 2 diabetes were treated with rapid-acting insulin (regular insulin) and insulin analog (insulin aspart) using the jet injector and the pen in 4 successive test cycles. Postprandial glucose and insulin concentrations in blood were measured over time. Areas under curves of glucose and the insulin were calculated, and efficacy of 2 injection methods in treatment of the diabetes was compared. Regular insulin and insulin aspart administration by the jet injector showed significant decreases in plasma glucose levels as compared to the pen injection (P < 0.05). Postprandial plasma glucose excursions at the time points of 0.5 to 3 hours were obviously lower in the jet-treated patients than the pen-treated ones (P < 0.05). Postprandial plasma insulin levels were markedly higher in the jet-treated patients than the pen-treated ones (P < 0.05). Area under the glucose curve in the pen-treated patients was significantly increased as compared to the jet-treated ones (P < 0.01). Efficacy of the insulin jet injector in treatment of type 2 diabetic patients is obviously superior to the insulin pen in regulating plasma glucose and insulin levels.
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Affiliation(s)
- Lixin Guo
- Department of Endocrinology, Beijing Hospital
| | - Xinhua Xiao
- Department of Endocrinology, Peking Union Medical College Hospital, Beijing, China
| | - Xue Sun
- Department of Endocrinology, Beijing Hospital
| | - Cuijuan Qi
- Department of Endocrinology, Peking Union Medical College Hospital, Beijing, China
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LaGuardia K. Claustrophobia in Radiology Departments. Radiol Technol 2017; 88:346-348. [PMID: 28298588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Thomas JS, France CR, Applegate ME, Leitkam ST, Walkowski S. Feasibility and Safety of a Virtual Reality Dodgeball Intervention for Chronic Low Back Pain: A Randomized Clinical Trial. J Pain 2016; 17:1302-1317. [PMID: 27616607 PMCID: PMC5125833 DOI: 10.1016/j.jpain.2016.08.011] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 08/29/2016] [Accepted: 08/30/2016] [Indexed: 10/21/2022]
Abstract
Whereas the fear-avoidance model of chronic low back pain (CLBP) posits a generic avoidance of movement that is perceived as threatening, we have repeatedly shown that individuals with high fear and CLBP specifically avoid flexion of the lumbar spine. Accordingly, we developed a virtual dodgeball intervention designed to elicit graded increases in lumbar spine flexion while reducing expectations of fear and harm by engaging participants in a competitive game that is entertaining and distracting. We recruited 52 participants (48% female) with CLBP and high fear of movement and randomized them to either a game group (n = 26) or a control group (n = 26). All participants completed a pregame baseline and a follow-up assessment (4-6 days later) of lumbar spine motion and expectations of pain and harm during standardized reaches to high (easier), middle, and low (hardest to reach) targets. For 3 consecutive days, participants in the game group completed 15 minutes of virtual dodgeball between baseline and follow-up. For the standardized reaching tests, there were no significant effects of group on changes in lumbar spine flexion, expected pain, or expected harm. However, virtual dodgeball was effective at increasing lumbar flexion within and across gameplay sessions. Participants reported strong positive endorsement of the game, no increases in medication use, pain, or disability, and no adverse events. Although these findings indicate that very brief exposure to this game did not translate to significant changes outside the game environment, this was not surprising because graded exposure therapy for fear of movement among individuals with low back pain typically last 8 to 12 sessions. Because of the demonstration of safety, feasibility, and ability to encourage lumbar flexion within gameplay, these findings provide support for a clinical trial wherein the treatment dose is more consistent with traditional graded exposure approaches to CLBP. PERSPECTIVE This study of a virtual reality dodgeball intervention provides evidence of feasibility, safety, and utility to encourage lumbar spine flexion among individuals with CLBP and high fear of movement.
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Affiliation(s)
- James S Thomas
- School of Rehabilitation and Communication Studies, Division of Physical Therapy, Ohio University, Athens, Ohio.
| | | | - Megan E Applegate
- School of Rehabilitation and Communication Studies, Division of Physical Therapy, Ohio University, Athens, Ohio
| | - Samuel T Leitkam
- School of Rehabilitation and Communication Studies, Division of Physical Therapy, Ohio University, Athens, Ohio
| | - Stevan Walkowski
- Department of Osteopathic Manipulative Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio
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Abstract
2006 marks the 40th year of publication for The Annals. Over that time, The Annals has been an important contributor to the development of clinical pharmacy. Throughout 2006, we are publishing articles reflecting on the history of clinical pharmacy through the eyes of practitioners, including those pioneering clinical pharmacy, as well as those who have more recently entered the profession and a well-established specialty. In addition, we are also presenting articles and editorials from the early history of The Annals that have given direction and shape to the practice of clinical pharmacy (see page 2240).
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Affiliation(s)
- Timothy E Welty
- Department of Pharmacy Practice, McWhorter School of Pharmacy, Samford University, Birmingham, AL 35229-7027, USA.
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Abstract
Motion sickness is believed to be caused by conflicting sensory signals, a situation that mimics the effects of ingesting certain toxins. Thus, one might suspect that individuals who have experienced a relatively high frequency of motion sickness may be particularly vigilant about avoiding anything that produces nausea, including potentially nauseating toxins. Consequently, they may be more resistant to trying new foods, i.e., be more food neophobic, since unfamiliar foods can have unexpected adverse effects due to toxins or allergens. Likewise, many highly stimulating experiences can trigger motion sickness, so individuals who are more susceptible may be more prone to avoid such experiences, i.e., be less sensation seeking. Finally, it was expected that food neophobia would be more frequent in individuals low on sensation seeking tendencies. Self-reported motion sickness history in 308 adults ( M=18.8 yr.; SD=1.6) was correlated with scores on the Arnett Inventory of Sensation Seeking and the Food Neophobia Scale. As predicted, greater history of motion sickness was associated with lower Sensation Seeking scores. Food Neophobia was not correlated with motion sickness history but, as expected, was negatively correlated ( r = –.42) with scores on Sensation Seeking. Further research is recommended that measures actual sensitivity to motion sickness.
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Affiliation(s)
- Thomas R Alley
- Department of Psychology, Clemson University, SC 29634-1355, USA.
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Overmeer T, Peterson G, Landén Ludvigsson M, Peolsson A. The effect of neck-specific exercise with or without a behavioral approach on psychological factors in chronic whiplash-associated disorders: A randomized controlled trial with a 2-year follow-up. Medicine (Baltimore) 2016; 95:e4430. [PMID: 27559950 PMCID: PMC5400316 DOI: 10.1097/md.0000000000004430] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND To investigate the effect of neck-specific exercise with (NSEB) or without (NSE) a behavioural approach and prescribed physical activity (PPA) on general pain disability and psychological factors in chronic whiplash-associated disorders (WAD), grade 2 and 3, with a 2-year follow-up. METHODS A randomized controlled multi-centre study of 3 exercise interventions (NSE, NSEB or PPA) including a 2-year follow-up. A total of 216 volunteers with chronic WAD were recruited and 194 were analyzed, mean age 40.4 (Standard Deviation [SD] 11.4). Measures of general pain disability, pain catastrophizing, anxiety and depression, and kinesiophobia were evaluated at baseline, and 3, 6, 12 and 24 months with linear mixed models. RESULTS General pain disability decreased by 28% in the NSEB group from baseline to 3 months (P < 0.001) and the improvements in disability were maintained over time (6, 12 and 24 months P < 0.01) compared to the NSE (P > 0.42) and PPA groups (P > 0.43). Pain catastrophizing decreased in the NSE group from baseline to 6 and 12 months (P < 0.01) and in the NSEB group from baseline to 3 and 24 months (P < 0.01) compared to the PPA group (P > 0.82) that showed no change over time. The NSE group improved in kinesiophobia over time from baseline to12 months (P < 0.01) compared to the NSEB (P = 0.052) and the PPA groups (P > 0.74). Anxiety decreased over time from baseline to 12 and 24 months in the NSE group (P > 0.02), but not in the NSEB (P > 0.25) or the PPA (P > 0.50) groups. The PPA had no effect on general disability or any of the measured psychological factors. CONCLUSION This randomised controlled trial with a 2-year follow-up shows that physiotherapist-led neck-specific exercise with or without the addition of a behavioural approach had superior outcome on general disability and most psychological factors compared to the mere prescription of physical activity.
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Affiliation(s)
- Thomas Overmeer
- Physiotherapy Department, School of Health, Care and Social Welfare, Mälardalen University, Västerås
- Centre for Health and Medical Psychology, Örebro University, Örebro
- Correspondence: Thomas Overmeer, Physiotherapy Department, School of Health, Care and Social Welfare, Mälardalen University, Västerås, Västmanland, Sweden (e-mail: )
| | - Gunnel Peterson
- Department of Medical and Health Sciences, Division of Physiotherapy, Linköping University, Linköping
- Centre for Clinical Research Sörmland, Uppsala University, Uppsala
| | - Maria Landén Ludvigsson
- Department of Medical and Health Sciences, Division of Physiotherapy, Linköping University, Linköping
- Rehab Väst, County Council of Östergötland, Department of Rehabilitation and Department of Medical and Health Sciences, Linköping University, Sweden
| | - Anneli Peolsson
- Department of Medical and Health Sciences, Division of Physiotherapy, Linköping University, Linköping
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Abstract
This study evaluated the effect of claustrophobia, an abnormal dread or fear of closed spaces, on adherence to continuous positive airway pressure (CPAP) therapy. The design was a secondary analysis of data from a prospective study of participants (N = 153) that completed 3 months of CPAP therapy from seven sleep disorders centers in the United States and Canada. A 15-item subscale adapted from the Fear and Avoidance Scale measured claustrophobic tendencies pre-CPAP treatment and again after 3 months. An overt monitor attached to the CPAP machines recorded mask-on CPAP adherence. There was a statistically significant difference in claustrophobia scores by adherence group (< 2 hours, 2 to < 5 hours, ≥ 5 hours) and time period (pre-CPAP and after 3 months CPAP). Poor CPAP adherence (< 2 hours per night)was more than two times higher in participants with a claustrophobia score ≥ 25. Identification of persons with increased claustrophobia tendencies and targeted interventions may increase adherence.
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Waszczuk MA, Zavos HMS, Gregory AM, Eley TC. The stability and change of etiological influences on depression, anxiety symptoms and their co-occurrence across adolescence and young adulthood. Psychol Med 2016; 46:161-75. [PMID: 26310536 PMCID: PMC4673666 DOI: 10.1017/s0033291715001634] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 07/29/2015] [Accepted: 08/03/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND Depression and anxiety persist within and across diagnostic boundaries. The manner in which common v. disorder-specific genetic and environmental influences operate across development to maintain internalizing disorders and their co-morbidity is unclear. This paper investigates the stability and change of etiological influences on depression, panic, generalized, separation and social anxiety symptoms, and their co-occurrence, across adolescence and young adulthood. METHOD A total of 2619 twins/siblings prospectively reported symptoms of depression and anxiety at mean ages 15, 17 and 20 years. RESULTS Each symptom scale showed a similar pattern of moderate continuity across development, largely underpinned by genetic stability. New genetic influences contributing to change in the developmental course of the symptoms emerged at each time point. All symptom scales correlated moderately with one another over time. Genetic influences, both stable and time-specific, overlapped considerably between the scales. Non-shared environmental influences were largely time- and symptom-specific, but some contributed moderately to the stability of depression and anxiety symptom scales. These stable, longitudinal environmental influences were highly correlated between the symptoms. CONCLUSIONS The results highlight both stable and dynamic etiology of depression and anxiety symptom scales. They provide preliminary evidence that stable as well as newly emerging genes contribute to the co-morbidity between depression and anxiety across adolescence and young adulthood. Conversely, environmental influences are largely time-specific and contribute to change in symptoms over time. The results inform molecular genetics research and transdiagnostic treatment and prevention approaches.
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Affiliation(s)
- M. A. Waszczuk
- King's College London, MRC
Social, Genetic and Developmental Psychiatry Centre, Institute of
Psychiatry, Psychology and Neuroscience, London,
UK
| | - H. M. S. Zavos
- King's College London, MRC
Social, Genetic and Developmental Psychiatry Centre, Institute of
Psychiatry, Psychology and Neuroscience, London,
UK
| | - A. M. Gregory
- Department of Psychology,
Goldsmiths, University of London,
London, UK
| | - T. C. Eley
- King's College London, MRC
Social, Genetic and Developmental Psychiatry Centre, Institute of
Psychiatry, Psychology and Neuroscience, London,
UK
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Tabak I, Mazur J. Social support and family communication as factors protecting adolescents against multiple recurrent health complaints related to school stress. Dev Period Med 2016; 20:27-39. [PMID: 27416623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION One reason of increased psychological and somatic health problems in adolescence is intensification of stress in school and everyday life. There is little evidence to what extent the level of school achievements shapes this relationship. AIM The aim of the study was to investigate determinants of subjective health complaints in schoolaged children, taking into account the interaction effects. METHODS Anonymous survey was conducted in Poland in 2013/2014 on the sample of 4,545 students, as a part of the HBSC (Health Behaviour in School-aged Children) study. On the basis of prevalence of eight symptoms in the past 6 months, a standardized index of health complaints (SCL - Subjective Complaints Checklist) was calculated (0-100). To predict its variability three hierarchical linear models (five blocks) were estimated, separately for three levels of school achievements. Support from family, classmates and teachers as well as family communication were considered as protective factors, which can reduce the negative impact of stress. All analyses were adjusted for age, gender and family affluence. RESULTS The standardized SCL index was equal to 23.2 in boys and 32.5 in girls. The high level of school stress was reported by 28.5% boys and 35.6% girls, respectively. Regarding these two measures, similar patterns of change were observed, increase with age and with deterioration of academic achievement. Final multivariate models explained 22-25% variability of SCL, slightly more among worst students. Accumulation of low family support and high level of school stress caused the highest increase in the SCL index in very good students. CONCLUSIONS School performance is an important determinant of subjective health complaints in adolescence, also modifying the impact of other risk and protective factors.
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Affiliation(s)
- Izabela Tabak
- Department of Child and Adolescent Health, Institute of Mother and Child, Warsaw, Poland, e-mail:
| | - Joanna Mazur
- Department of Child and Adolescent Health, Institute of Mother and Child, Warsaw, Poland
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Messenger M, Packman A, Onslow M, Menzies R, O'Brian S. Children and adolescents who stutter: Further investigation of anxiety. J Fluency Disord 2015; 46:15-23. [PMID: 26292910 DOI: 10.1016/j.jfludis.2015.07.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 07/27/2015] [Accepted: 07/27/2015] [Indexed: 06/04/2023]
Abstract
PURPOSE Despite the greatly increased risk of social anxiety disorder in adults who stutter, there is no clear indication of the time of onset of this disorder in childhood and adolescence. The purpose of this study was to explore this issue further using the Revised Children's Manifest Anxiety Scale (RCMAS), so that appropriate interventions can be developed prior to adulthood. This is the first time the RCMAS has been completed by children younger than 11 years. Using the same test for both school-age children and adolescents can potentially identify when anxiety starts to develop from age 6 years through to adulthood. METHODS The RCMAS was administered to 18 school-age boys, five school-age girls, 41 adolescent boys and nine adolescent girls who were seeking treatment for their stuttering. Participants also rated the severity of their own stuttering. RESULTS All mean scaled scores on the four RCMAS subscales and Total Anxiety scores were within normal limits. However, for both groups of boys, scores on the Lie Scale were significantly higher than scores on the other three subscales. CONCLUSIONS Experts suggest high scores on the RCMAS Lie Scale are indicative of participants attempting to present themselves in a positive light and so cast doubt on the veracity of their other responses on the test. One interpretation, then, is that the boys were concealing true levels of anxiety about their stuttering. The results suggest why findings of anxiety studies in children and adolescents to date are equivocal. Clinical implications are discussed. EDUCATIONAL OBJECTIVES The reader will be able to: (a) discuss why understanding when anxiety starts in people who stutter is important, (b) describe the function of the RCMAS Lie sub scale and (c) summarize the possible implications of the RCMAS findings in this study.
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Affiliation(s)
- Michelle Messenger
- Australian Stuttering Research Centre, The University of Sydney, Australia.
| | - Ann Packman
- Australian Stuttering Research Centre, The University of Sydney, Australia.
| | - Mark Onslow
- Australian Stuttering Research Centre, The University of Sydney, Australia.
| | - Ross Menzies
- Australian Stuttering Research Centre, The University of Sydney, Australia.
| | - Sue O'Brian
- Australian Stuttering Research Centre, The University of Sydney, Australia.
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McMurtry CM, Noel M, Taddio A, Antony MM, Asmundson GJ, Riddell RP, Chambers CT, Shah V. Interventions for Individuals With High Levels of Needle Fear: Systematic Review of Randomized Controlled Trials and Quasi-Randomized Controlled Trials. Clin J Pain 2015; 31:S109-23. [PMID: 26352916 PMCID: PMC4900415 DOI: 10.1097/ajp.0000000000000273] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Accepted: 06/18/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND This systematic review evaluated the effectiveness of exposure-based psychological and physical interventions for the management of high levels of needle fear and/or phobia and fainting in children and adults. DESIGN/METHODS A systematic review identified relevant randomized and quasi-randomized controlled trials of children, adults, or both with high levels of needle fear, including phobia (if not available, then populations with other specific phobias were included). Critically important outcomes were self-reported fear specific to the feared situation and stimulus (psychological interventions) or fainting (applied muscle tension). Data were pooled using standardized mean difference (SMD) or relative risk with 95% confidence intervals. RESULTS The systematic review included 11 trials. In vivo exposure-based therapy for children 7 years and above showed benefit on specific fear (n=234; SMD: -1.71 [95% CI: -2.72, -0.7]). In vivo exposure-based therapy with adults reduced fear of needles posttreatment (n=20; SMD: -1.09 [-2.04, -0.14]) but not at 1-year follow-up (n=20; SMD: -0.28 [-1.16, 0.6]). Compared with single session, a benefit was observed for multiple sessions of exposure-based therapy posttreatment (n=93; SMD: -0.66 [-1.08, -0.24]) but not after 1 year (n=83; SMD: -0.37 [-0.87, 0.13]). Non in vivo e.g., imaginal exposure-based therapy in children reduced specific fear posttreatment (n=41; SMD: -0.88 [-1.7, -0.05]) and at 3 months (n=24; SMD: -0.89 [-1.73, -0.04]). Non in vivo exposure-based therapy for adults showed benefit on specific fear (n=68; SMD: -0.62 [-1.11, -0.14]) but not procedural fear (n=17; SMD: 0.18 [-0.87, 1.23]). Applied tension showed benefit on fainting posttreatment (n=20; SMD: -1.16 [-2.12, -0.19]) and after 1 year (n=20; SMD: -0.97 [-1.91, -0.03]) compared with exposure alone. CONCLUSIONS Exposure-based psychological interventions and applied muscle tension show evidence of benefit in the reduction of fear in pediatric and adult populations.
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Affiliation(s)
- C. Meghan McMurtry
- Department of Psychology, University of Guelph, Guelph
- Children’s Health Research Institute
- Department of Paediatrics, Western University, London
| | - Melanie Noel
- Department of Psychology, University of Calgary, AB, Canada
| | - Anna Taddio
- Leslie Dan Faculty of Pharmacy
- The Hospital for Sick Children
| | | | | | - Rebecca Pillai Riddell
- Department of Psychiatry
- The Hospital for Sick Children
- Department of Psychology, York University
| | - Christine T. Chambers
- Departments of Pediatrics, Psychology & Neuroscience, Dalhousie University
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS, Canada
| | - Vibhuti Shah
- Health Policy Management and Evaluation, Faculty of Medicine, University of Toronto
- Mount Sinai Hospital, Toronto, ON
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Abstract
Models of social anxiety suggest that negative social experiences contribute to the development of social anxiety, and this is supported by self-report research. However, there is relatively little experimental evidence for the effects of learning experiences on social cognitions. The current study examined the effect of observing a social performance situation with a negative outcome on children's (8 to 11 years old) fear-related beliefs and cognitive processing. Two groups of children were each shown 1 of 2 animated films of a person trying to score in basketball while being observed by others; in 1 film, the outcome was negative, and in the other, it was neutral. Children's fear-related beliefs about performing in front of others were measured before and after the film and children were asked to complete an emotional Stroop task. Results showed that social fear beliefs increased for children who saw the negative social performance film. In addition, these children showed an emotional Stroop bias for social-anxiety-related words compared to children who saw the neutral film. The findings have implications for our understanding of social anxiety disorder and suggest that vicarious learning experiences in childhood may contribute to the development of social anxiety.
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Affiliation(s)
| | | | - Julie Morgan
- School of Applied Social Science, University of Brighton
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Lu JC, Nielsen JC, Morowitz L, Musani M, Ghadimi Mahani M, Agarwal PP, Ibrahim ESH, Dorfman AL. Use of a 1.0 Tesla open scanner for evaluation of pediatric and congenital heart disease: a retrospective cohort study. J Cardiovasc Magn Reson 2015; 17:39. [PMID: 26004027 PMCID: PMC4490663 DOI: 10.1186/s12968-015-0144-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 05/04/2015] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Open cardiovascular magnetic resonance (CMR) scanners offer the potential for imaging patients with claustrophobia or large body size, but at a lower 1.0 Tesla magnetic field. This study aimed to evaluate the efficacy of open CMR for evaluation of pediatric and congenital heart disease. METHODS This retrospective, cross-sectional study included all patients ≤18 years old or with congenital heart disease who underwent CMR on an open 1.0 Tesla scanner at two centers from 2012-2014. Indications for CMR and clinical questions were extracted from the medical record. Studies were qualitatively graded for image quality and diagnostic utility. In a subset of 25 patients, signal-to-noise (SNR) and contrast-to-noise (CNR) ratios were compared to size- and diagnosis-matched patients with CMR on a 1.5 Tesla scanner. RESULTS A total of 65 patients (median 17.3 years old, 60% male) were included. Congenital heart disease was present in 32 (50%), with tetralogy of Fallot and bicuspid aortic valve the most common diagnoses. Open CMR was used due to scheduling/equipment issues in 51 (80%), claustrophobia in 7 (11%), and patient size in 3 (5%); 4 patients with claustrophobia had failed CMR on a different scanner, but completed the study on open CMR without sedation. All patients had good or excellent image quality on black blood, phase contrast, magnetic resonance angiography, and late gadolinium enhancement imaging. There was below average image quality in 3/63 (5%) patients with cine images, and 4/15 (27%) patients with coronary artery imaging. SNR and CNR were decreased in cine and magnetic resonance angiography images compared to 1.5 Tesla. The clinical question was answered adequately in all but 2 patients; 1 patient with a Fontan had artifact from an embolization coil limiting RV volume analysis, and in 1 patient the right coronary artery origin was not well seen. CONCLUSIONS Open 1.0 Tesla scanners can effectively evaluate pediatric and congenital heart disease, including patients with claustrophobia and larger body size. Despite minor artifacts and differences in SNR and CNR, the majority of clinical questions can be answered adequately, with some limitations with coronary artery imaging. Further evaluation is necessary to optimize protocols and image quality.
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Affiliation(s)
- Jimmy C Lu
- Department of Pediatrics and Communicable Diseases, Division of Pediatric Cardiology, University of Michigan, Ann Arbor, MI, USA.
- Department of Radiology, Section of Pediatric Radiology, University of Michigan, Ann Arbor, MI, USA.
| | - James C Nielsen
- Departments of Pediatrics and Radiology, Stony Brook University, Stony Brook, NY, USA.
| | - Layne Morowitz
- Departments of Pediatrics and Radiology, Stony Brook University, Stony Brook, NY, USA.
| | - Muzammil Musani
- Department of Medicine, Division of Cardiology, Stony Brook University, Stony Brook, NY, USA.
| | - Maryam Ghadimi Mahani
- Department of Radiology, Section of Pediatric Radiology, University of Michigan, Ann Arbor, MI, USA.
| | - Prachi P Agarwal
- Department of Radiology, Division of Cardiothoracic Radiology, University of Michigan, Ann Arbor, MI, USA.
| | - El-Sayed H Ibrahim
- Department of Radiology, Division of Cardiothoracic Radiology, University of Michigan, Ann Arbor, MI, USA.
| | - Adam L Dorfman
- Department of Pediatrics and Communicable Diseases, Division of Pediatric Cardiology, University of Michigan, Ann Arbor, MI, USA.
- Department of Radiology, Section of Pediatric Radiology, University of Michigan, Ann Arbor, MI, USA.
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Eikenaes I, Egeland J, Hummelen B, Wilberg T. Avoidant personality disorder versus social phobia: the significance of childhood neglect. PLoS One 2015; 10:e0122846. [PMID: 25815817 PMCID: PMC4376891 DOI: 10.1371/journal.pone.0122846] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 02/19/2015] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Avoidant personality disorder (AvPD) and social phobia (SP) are common disorders both in the community and in clinical settings. Whether the two disorders represent different severity levels of social anxiety disorder is currently in dispute. The relationship between AvPD and SP is probably more complex than previously assumed. Several environmental, temperamental, and constitutional factors may play a role in the etiology of AvPD and SP. Better knowledge about childhood experiences may shed light on similarities and differences between the two disorders. The aim of this study was to compare self-reported childhood experiences in AvPD and SP patients. DESIGN This is a cross-sectional multi-site study of 91 adult patients with AvPD and/ or SP. We compared patients with AvPD with and without SP (AvPD group) to patients with SP without AvPD (SP group). METHODS The patients were examined using structured diagnostic interviews and self-report measures, including Child Trauma Questionnaire, Parental Bonding Instrument, and Adult Temperament Questionnaire. RESULTS Both AvPD and SP were associated with negative childhood experiences. AvPD patients reported more severe childhood neglect than patients with SP, most pronounced for physical neglect. The difference between the disorders in neglect remained significant after controlling for temperamental factors and concurrent abuse. CONCLUSIONS The study indicates that childhood neglect is a risk factor for AvPD and may be one contributing factor to phenomenological differences between AvPD and SP.
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Affiliation(s)
- Ingeborg Eikenaes
- Department of Group Psychotherapy, Division of Mental Health and Addiction, Vestfold Hospital Trust, Tønsberg, Norway
- * E-mail:
| | - Jens Egeland
- Department of Research, Division of Mental Health and Addiction, Vestfold Hospital Trust, Tønsberg, Norway
| | - Benjamin Hummelen
- Department of Research and Development, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Theresa Wilberg
- Department for Research and Development, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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Medvecky MJ, Nelson S. Kinesiophobia and Return to Sports After Anterior Cruciate Ligament Reconstruction. Conn Med 2015; 79:155-157. [PMID: 26244221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Anterior cruciate ligament (ACL) reconstruction is typically recommended for patients who wish to return to aggressive athletic activity. Unfortunately, reconstructive knee surgery is not a guarantee that all patients will return to their preinjury level of function. A recent meta-analysis including 48 studies showed that after a mean follow-up of 41 months, 82% of participants had returned to some kind of athletic activity but only 63% returned to their preinjury level of participation and a disappointing 44% returned to competitive sports. The reasons why some athletes have been unsuccessful in returning to previous levels of activity are vast and our understanding of these factors is limited. The importance of psychological factors has recently been emphasized. One such factor, kinesiophobia, or fear of reinjury, may play a significant role in some patients' inability to successfully return to their previous level of sports participation. In the meta-analysis, kinesiophobia was the most common reason cited for postoperative reduction in, or cessation of, sports participation.
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Poeschl S, Doering N. Measuring Co-Presence and Social Presence in Virtual Environments - Psychometric Construction of a German Scale for a Fear of Public Speaking Scenario. Stud Health Technol Inform 2015; 219:58-63. [PMID: 26799880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Virtual reality exposure therapy (VRET) applications use high levels of fidelity in order to produce high levels of presence and thereby elicit an emotional response for the user (like fear for phobia treatment). State of research shows mixed results for the correlation between anxiety and presence in virtual reality exposure, with differing results depending on specific anxiety disorders. A positive correlation for anxiety and presence for social anxiety disorder is not proven up to now. One reason might be that plausibility of the simulation, namely including key triggers for social anxiety (for example verbal and non-verbal behavior of virtual agents that reflects potentially negative human evaluation) might not be acknowledged in current presence questionnaires. A German scale for measuring co-presence and social presence for virtual reality (VR) fear of public speaking scenarios was developed based on a translation and adaption of existing co-presence and social presence questionnaires. A sample of N = 151 students rated co-presence and social presence after using a fear of public speaking application. Four correlated factors were derived by item- and principle axis factor analysis (Promax rotation), representing the presenter's reaction to virtual agents, the reactions of the virtual agents as perceived by the presenter, impression of interaction possibilities, and (co-)presence of other people in the virtual environment. The scale developed can be used as a starting point for future research and test construction for VR applications with a social context.
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Henderson HA, Pine DS, Fox NA. Behavioral inhibition and developmental risk: a dual-processing perspective. Neuropsychopharmacology 2015; 40:207-24. [PMID: 25065499 PMCID: PMC4262899 DOI: 10.1038/npp.2014.189] [Citation(s) in RCA: 111] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 06/12/2014] [Accepted: 07/24/2014] [Indexed: 01/13/2023]
Abstract
Behavioral inhibition (BI) is an early-appearing temperament characterized by strong reactions to novelty. BI shows a good deal of stability over childhood and significantly increases the risk for later diagnosis of social anxiety disorder (SAD). Despite these general patterns, many children with high BI do not go on to develop clinical, or even subclinical, anxiety problems. Therefore, understanding the cognitive and neural bases of individual differences in developmental risk and resilience is of great importance. The present review is focused on the relation of BI to two types of information processing: automatic (novelty detection, attention biases to threat, and incentive processing) and controlled (attention shifting and inhibitory control). We propose three hypothetical models (Top-Down Model of Control; Risk Potentiation Model of Control; and Overgeneralized Control Model) linking these processes to variability in developmental outcomes for BI children. We argue that early BI is associated with an early bias to quickly and preferentially process information associated with motivationally salient cues. When this bias is strong and stable across development, the risk for SAD is increased. Later in development, children with a history of BI tend to display normative levels of performance on controlled attention tasks, but they demonstrate exaggerated neural responses in order to do so, which may further potentiate risk for anxiety-related problems. We conclude by discussing the reviewed studies with reference to the hypothetical models and make suggestions regarding future research and implications for treatment.
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Affiliation(s)
| | - Daniel S Pine
- Mood and Anxiety Disorders Program, Intramural Research Program, The National Institute of Mental Health, Bethesda, MD, USA
| | - Nathan A Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA
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Chou IJ, Tench CR, Gowland P, Jaspan T, Dineen RA, Evangelou N, Abdel-Fahim R, Whitehouse WP, Constantinescu CS. Subjective discomfort in children receiving 3 T MRI and experienced adults' perspective on children's tolerability of 7 T: a cross-sectional questionnaire survey. BMJ Open 2014; 4:e006094. [PMID: 25320001 PMCID: PMC4201995 DOI: 10.1136/bmjopen-2014-006094] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES To explore the possible discomfort perceived by children participating in 7 T MRI research, and the age range in which children are most likely to tolerate it well. DESIGN A cross-sectional survey using age-appropriate questionnaires containing six measures of subjective discomfort (general discomfort, dizziness, noisiness, claustrophobia and feeling of cold or warm). SETTING For children, 3 T clinical scanner in a tertiary referral teaching hospital; for adults, 3 and 7 T scanner in a university research building. PARTICIPANTS Non-sedated children and young people under 18 years of age who underwent 3 T clinical MRI for brain or musculoskeletal scans and adult volunteers attending 7 T with or without 3 T for brain scans. RESULTS 83% (89/107) of involved individuals returned questionnaires. The most common discomfort among 31 children receiving 3 T MRI was noisiness (39%), followed by cold (19%), general discomfort (16%), dizziness (13%) and claustrophobia (10%). The noise was reported more frequently in children younger than 12 years than those older (p=0.021). The most common discomfort for 58 adults receiving 7 T MRI was noisiness (43%). In adults, there was a higher frequency of general discomfort during 7 than 3 T scans (p=0.031). More than 85% of adult respondents thought children aged 12-17 years would tolerate 7 T scans well, but only 35% and 15% thought children aged 10-11 and 8-9 years, respectively, would. CONCLUSIONS Noisiness was the most common discomfort across all ages in 3 and 7 T scanners. Although general discomfort was more common during 7 than 3 T scans in adults, most adults thought children aged 12 years or more would tolerate 7 T MRI well. Cautious enrolment of children in 7 T MRI study is warranted, but until there is more evidence of how well those aged 12 years or more tolerate 7 T MRI, we would caution against enrolling younger children.
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Affiliation(s)
- I-Jun Chou
- Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
- Division of Child Health, Obstetrics and Gynaecology, School of Medicine, University of Nottingham, Nottingham, UK
- Division of Paediatric Neurology and Paediatric General Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Christopher R Tench
- Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Penny Gowland
- Sir Peter Mansfield Magnetic Resonance Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Tim Jaspan
- Department of Radiology, Nottingham University Hospitals Trust, Nottingham, UK
| | - Rob A Dineen
- Department of Radiology, Nottingham University Hospitals Trust, Nottingham, UK
- Division of Radiological and Imaging Sciences, University of Nottingham, Nottingham, UK
| | - Nikos Evangelou
- Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Rasha Abdel-Fahim
- Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - William P Whitehouse
- Division of Child Health, Obstetrics and Gynaecology, School of Medicine, University of Nottingham, Nottingham, UK
- Department of Paediatric Neurology, Nottingham Children's Hospital, Nottingham University Hospitals Trust, Nottingham, UK
| | - Cris S Constantinescu
- Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
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Savage GH. Fear of syphilis and suicide. 1914. Practitioner 2014; 258:37. [PMID: 25591287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Bailer J, Witthöft M, Wagner H, Mier D, Diener C, Rist F. Childhood maltreatment is associated with depression but not with hypochondriasis in later life. J Psychosom Res 2014; 77:104-8. [PMID: 25077850 DOI: 10.1016/j.jpsychores.2014.06.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 06/10/2014] [Accepted: 06/13/2014] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Previous studies demonstrated that a history of childhood trauma is linked to mental disorders in adulthood, particularly to depression. Adverse childhood experiences are also considered to contribute to the risk of hypochondriasis, but the results of previous studies have not been conclusive with respect to the strength and specificity of this association. Therefore, we compared the association of adverse childhood experiences with both hypochondriasis and depression. METHODS Fifty-eight patients with hypochondriasis, 52 patients with depression, and 52 healthy control participants completed the Childhood Trauma Questionnaire (CTQ) which assesses 5 varieties of abuse and neglect. A clinical interview (SCID-I) was used to establish DSM-IV diagnoses. Associations between childhood maltreatment, hypochondriasis and depression were estimated by means of analyses of variance and multiple linear regression analyses. RESULTS In comparison to hypochondriacal and healthy participants, patients with a current depressive disorder reported more emotional abuse as well as more emotional and physical neglect during childhood. Patients with hypochondriasis reported more emotional neglect than healthy individuals. However, when predicting the CTQ trauma types by diagnostic category adjusting for sex and comorbid DSM-IV diagnoses, emotional abuse, emotional neglect, physical abuse, physical neglect, as well as the CTQ total score were significantly associated with depression, but none of the CTQ scores was significantly related to hypochondriasis. CONCLUSIONS The findings suggest a robust association of childhood maltreatment with depression but not with hypochondriasis. This result does not support etiological models of hypochondriasis which rely on childhood maltreatment as a risk factor for the development of this disorder.
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Affiliation(s)
- Josef Bailer
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, University Heidelberg, Germany.
| | - Michael Witthöft
- Department of Health Psychology, University of Mannheim, Germany
| | - Henriette Wagner
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, University Heidelberg, Germany
| | - Daniela Mier
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, University Heidelberg, Germany
| | - Carsten Diener
- School of Applied Psychology, SRH University of Applied Sciences, Heidelberg, Germany
| | - Fred Rist
- Department of Clinical Psychology, University of Münster, Germany
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Abstract
BACKGROUND Although prior genetic studies of interview-assessed fears and phobias have shown that genetic factors predispose individuals to fears and phobias, they have been restricted to the DSM-III to DSM-IV aggregated subtypes of phobias rather than to individual fearful and phobic stimuli. METHOD We examined the lifetime history of fears and/or phobias in response to 21 individual phobic stimuli in 4067 personally interviewed twins from same-sex pairs from the Virginia Adult Twin Study of Psychiatric and Substance Abuse Disorders (VATSPSUD). We performed multivariate statistical analyses using Mx and Mplus. RESULTS The best-fitting model for the 21 phobic stimuli included four genetic factors (agora-social-acrophobia, animal phobia, blood-injection-illness phobia and claustrophobia) and three environmental factors (agora-social-hospital phobia, animal phobia, and situational phobia). CONCLUSIONS This study provides the first view of the architecture of genetic and environmental risk factors for phobic disorders and their subtypes. The genetic factors of the phobias support the DSM-IV and DSM-5 constructs of animal and blood-injection-injury phobias but do not support the separation of agoraphobia from social phobia. The results also do not show a coherent genetic factor for the DSM-IV and DSM-5 situational phobia. Finally, the patterns of co-morbidity across individual fears and phobias produced by genetic and environmental influences differ appreciably.
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Affiliation(s)
- E. K. Loken
- Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - J.M. Hettema
- Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - S.H. Aggen
- Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - K. S. Kendler
- Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
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Smith KA, Iverach L, O'Brian S, Kefalianos E, Reilly S. Anxiety of children and adolescents who stutter: a review. J Fluency Disord 2014; 40:22-34. [PMID: 24929464 DOI: 10.1016/j.jfludis.2014.01.003] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 01/22/2014] [Accepted: 01/30/2014] [Indexed: 06/03/2023]
Abstract
PURPOSE Adults who stutter have heightened rates of anxiety disorders, particularly social anxiety disorder, compared with non-stuttering controls. However, the timing of anxiety onset and its development in relation to stuttering is poorly understood. Identifying the typical age of anxiety onset in stuttering has significant clinical implications and is crucial for the management of both disorders across the lifespan. The present review aims to determine the scope of the research pertaining to this topic, identify trends in findings, and delineate timing of anxiety onset in stuttering. METHODS We examine putative risk factors of anxiety present for children and adolescents who stutter, and provide a review of the research evidence relating to anxiety for this population. RESULTS Young people who stutter can experience negative social consequences and negative attitudes towards communication, which is hypothesised to place them at increased risk of developing anxiety. The prevalence of anxiety of young people who stutter, and the timing of anxiety onset in stuttering could not be determined. This was due to methodological limitations in the reviewed research such as small participant numbers, and the use of measures that lack sensitivity to identify anxiety in the targeted population. CONCLUSIONS In sum, the evidence suggests that anxiety in stuttering might increase over time until it exceeds normal limits in adolescence and adulthood. The clinical implications of these findings, and recommendations for future research, are discussed. EDUCATIONAL OBJECTIVES The reader will be able to: (a) discuss contemporary thinking on the role of anxiety in stuttering and reasons for this view; (b) describe risk factors for the development of anxiety in stuttering, experienced by children and adolescents who stutter (c) outline trends in current research on anxiety and children and adolescents with stuttering; and (d) summarise rationales behind recommendations for future research in this area.
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Affiliation(s)
- Kylie A Smith
- Murdoch Childrens Research Institute, Royal Childrens Research Institute, Flemington Road, Parkville, Victoria 3052, Australia; Department of Paediatrics, University of Melbourne, Victoria 3010, Australia.
| | - Lisa Iverach
- Centre for Emotional Health, Department of Psychology, Macquarie University, Balaclava Road, North Ryde, NSW 2109, Australia
| | - Susan O'Brian
- Australian Stuttering Research Centre, University of Sydney, PO Box 170, Lidcombe, NSW 1825, Australia
| | - Elaina Kefalianos
- Murdoch Childrens Research Institute, Royal Childrens Research Institute, Flemington Road, Parkville, Victoria 3052, Australia; Department of Audiology and Speech Pathology, University of Melbourne, Victoria 3010, Australia
| | - Sheena Reilly
- Murdoch Childrens Research Institute, Royal Childrens Research Institute, Flemington Road, Parkville, Victoria 3052, Australia; Department of Paediatrics, University of Melbourne, Victoria 3010, Australia
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Craig A, Tran Y. Trait and social anxiety in adults with chronic stuttering: conclusions following meta-analysis. J Fluency Disord 2014; 40:35-43. [PMID: 24929465 DOI: 10.1016/j.jfludis.2014.01.001] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 01/04/2014] [Accepted: 01/04/2014] [Indexed: 06/03/2023]
Abstract
PURPOSE The relationship between chronic stuttering and anxiety has been a matter of some debate over the past two decades, with a major emphasis of research focused on examining whether people who stutter have abnormally elevated levels of trait or social anxiety. The major goal of this paper was to perform a systematic literature review and perform meta-analyses on research that has assessed (i) trait anxiety and (ii) social anxiety, in adults who stutter. METHOD Only studies that met strict inclusion criteria were selected for the meta-analyses. Two meta-analyses were conducted, the first for trait anxiety, and the second for social anxiety. Meta-analysis combines statistically the results of selected studies that meet strict design criteria, thereby clarifying the size of differences in trait and social anxiety between adults who stutter and adults who do not stutter. RESULTS Meta-analytic results confirmed that adults with chronic stuttering do have substantially elevated trait and social anxiety. The overall effect size for trait and social anxiety was calculated to be .57 and .82, respectively. CONCLUSIONS Trait and social anxiety are definite problems for many adults who stutter. Clinical implications of these findings for the diagnosis and treatment of adult who stutter are discussed. EDUCATIONAL OBJECTIVES The reader will be able to: (a) describe the process of conducting a systematic review and meta-analysis; (b) describe the possible impact of publication bias on meta-analysis results; (c) explain the impact of a chronic disorder like stuttering on levels of trait anxiety; (d) explain the impact of stuttering on levels of social anxiety; (e) interpret the results of meta-analysis when applied to differences in anxiety between adult people who stutter and those who do not stutter; and (f) describe implications for fluency enhancing treatments.
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Affiliation(s)
- Ashley Craig
- Rehabilitation Studies Unit, Sydney Medical School, The University of Sydney, Level 12 Kolling Building, RNSH, St Leonards, NSW 2065, Australia.
| | - Yvonne Tran
- Rehabilitation Studies Unit, Sydney Medical School, The University of Sydney, Level 12 Kolling Building, RNSH, St Leonards, NSW 2065, Australia
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Iverach L, Rapee RM. Social anxiety disorder and stuttering: current status and future directions. J Fluency Disord 2014; 40:69-82. [PMID: 24929468 DOI: 10.1016/j.jfludis.2013.08.003] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Revised: 08/11/2013] [Accepted: 08/20/2013] [Indexed: 06/03/2023]
Abstract
UNLABELLED Anxiety is one of the most widely observed and extensively studied psychological concomitants of stuttering. Research conducted prior to the turn of the century produced evidence of heightened anxiety in people who stutter, yet findings were inconsistent and ambiguous. Failure to detect a clear and systematic relationship between anxiety and stuttering was attributed to methodological flaws, including use of small sample sizes and unidimensional measures of anxiety. More recent research, however, has generated far less equivocal findings when using social anxiety questionnaires and psychiatric diagnostic assessments in larger samples of people who stutter. In particular, a growing body of research has demonstrated an alarmingly high rate of social anxiety disorder among adults who stutter. Social anxiety disorder is a prevalent and chronic anxiety disorder characterised by significant fear of humiliation, embarrassment, and negative evaluation in social or performance-based situations. In light of the debilitating nature of social anxiety disorder, and the impact of stuttering on quality of life and personal functioning, collaboration between speech pathologists and psychologists is required to develop and implement comprehensive assessment and treatment programmes for social anxiety among people who stutter. This comprehensive approach has the potential to improve quality of life and engagement in everyday activities for people who stutter. Determining the prevalence of social anxiety disorder among children and adolescents who stutter is a critical line of future research. Further studies are also required to confirm the efficacy of Cognitive Behaviour Therapy in treating social anxiety disorder in stuttering. EDUCATIONAL OBJECTIVES The reader will be able to: (a) describe the nature and course of social anxiety disorder; (b) outline previous research regarding anxiety and stuttering, including features of social anxiety disorder; (c) summarise research findings regarding the diagnostic assessment of social anxiety disorder among people who stutter; (d) describe approaches for the assessment and treatment of social anxiety in stuttering, including the efficacy of Cognitive Behaviour Therapy; and (e) outline clinical implications and future directions associated with heightened social anxiety in stuttering.
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Affiliation(s)
- Lisa Iverach
- Centre for Emotional Health, Department of Psychology, Macquarie University, Australia.
| | - Ronald M Rapee
- Centre for Emotional Health, Department of Psychology, Macquarie University, Australia.
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Camporesi EM. Side effects of hyperbaric oxygen therapy. Undersea Hyperb Med 2014; 41:253-257. [PMID: 24984321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Several side effects and complications from hyperbaric oxygen (HBO2) therapy have been described, with varying degrees of seriousness. By far, the two most frequent and benign side effects comprise middle ear barotrauma, which has been noted in up to 2% of treated patients, and can be prevented or minimized by teaching autoinflation techniques, or by inserting tympanostomy tubes. Another frequent complaint is claustrophobia, both during multiplace and monoplace chamber compression, requiring reassurance, coaching and, at times, sedation. Other more rare, but more severe side effects derive from oxygen (O2) toxicity, from the multiple exposures required for chronic treatments, especially progressive myopia, usually transient and reversible after stopping HBO2 sessions, or pulmonary dyspnea, with cough and inspiratory pain. More serious O2-induced seizures happen rarely, at higher O2 pressures, and often during acute treatments in acidotic patients (carbon monoxide poisoning).
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