Sample records for anxiety disorder diagnosis

  1. Current Diagnosis and Treatment of Anxiety Disorders

    PubMed Central

    Bystritsky, Alexander; Khalsa, Sahib S.; Cameron, Michael E.; Schiffman, Jason

    2013-01-01

    Anxiety disorders are the most prevalent mental health conditions. Although they are less visible than schizophrenia, depression, and bipolar disorder, they can be just as disabling. The diagnoses of anxiety disorders are being continuously revised. Both dimensional and structural diagnoses have been used in clinical treatment and research, and both methods have been proposed for the new classification in the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-5). However, each of these approaches has limitations. More recently, the emphasis in diagnosis has focused on neuroimaging and genetic research. This approach is based partly on the need for a more comprehensive understanding of how biology, stress, and genetics interact to shape the symptoms of anxiety. Anxiety disorders can be effectively treated with psychopharmacological and cognitive–behavioral interventions. These inter ventions have different symptom targets; thus, logical combinations of these strategies need to be further studied in order to improve future outcomes. New developments are forthcoming in the field of alternative strategies for managing anxiety and for treatment-resistant cases. Additional treatment enhancements should include the development of algorithms that can be easily used in primary care and with greater focus on managing functional impairment in patients with anxiety. PMID:23599668

  2. [The pathophysiology and diagnosis of anxiety disorder].

    PubMed

    Akiyoshi, Jotaro

    2012-01-01

    In addition to genetic factors, the role of epigenetic and other environmental factors in the promotion of anxiety disorder has attracted much attention in psychiatric research. When stress is encountered in the environment, the hypothalamus-pituitary adrenal system (HPA system) is activated and cortisol is secreted. CRHR gene function is closely related to this response. As a result of haplotype analysis of CRHR genes in depression and panic disorder patients, it was found that genetic polymorphism of CRHR1 and CRHR2 was related to both disorders. It is reported that abused children are more susceptible to developing depression and anxiety disorder upon reaching adulthood, but there also exist genetic polymorphisms that may moderate this relationship. Direct methylation of DNA (typically repressing gene expression) and modification of chromatin structure (complexes of histone proteins and DNA) via acetylation (typically facilitating gene expression) represent epigenetic modifications that are thought to influence behavioral phenotypes. For example, it is rare that schizophrenia develops in identical twins brought up together in the same environment, and thus phenotypic differences cannot be explained simply by genetic polymorphism. We also evaluated salivary cortisol and amylase reactivity (indices of the HPA system and sympathoadrenal medullary system, respectfully) after electrical stimulation stress and Trier Social Stress Test (TSST) administration. Here we found differences in the cortisol stress response between electrical stimulation and TSST stressors, in contrast to the theory of Selye. In addition, we found alterations in activity patterns and difficulties integrating sensorimotor information in panic disorder patients, suggesting links between sensorimotor integration and stress in panic disorder. Moreover, state and trait anxiety may be associated with stabilograph factors. PMID:23198596

  3. Anxiety Disorders

    MedlinePLUS

    ... Anxiety Disorders About Anxiety Disorders Anxiety Disorders in Older Adults If you have an anxiety disorder, worry or ... of better as time goes on. Doctors and older adults tend to view anxiety and fear as normal ...

  4. Validity of prototype diagnosis for mood and anxiety disorders.

    PubMed

    DeFife, Jared A; Peart, Joanne; Bradley, Bekh; Ressler, Kerry; Drill, Rebecca; Westen, Drew

    2013-02-01

    CONTEXT With growing recognition that most forms of psychopathology are best represented as dimensions or spectra, a central question becomes how to implement dimensional diagnosis in a way that is empirically sound and clinically useful. Prototype matching, which involves comparing a patient's clinical presentation with a prototypical description of the disorder, is an approach to diagnosis that has gained increasing attention with forthcoming revisions to both the DSM and the International Classification of Diseases. OBJECTIVE To examine prototype diagnosis for mood and anxiety disorders. DESIGN, SETTING, AND PATIENTS In the first study, we examined clinicians' DSM-IV and prototype diagnoses with their ratings of the patients' adaptive functioning and patients' self-reported symptoms. In the second study, independent interviewers made prototype diagnoses following either a systematic clinical interview or a structured diagnostic interview. A third interviewer provided independent ratings of global adaptive functioning. Patients were recruited as outpatients (study 1; N = 84) and from primary care clinics (study 2; N = 143). MAIN OUTCOME MEASURES Patients' self-reported mood, anxiety, and externalizing symptoms along with independent clinical ratings of adaptive functioning. RESULTS Clinicians' prototype diagnoses showed small to moderate correlations with patient-reported psychopathology and performed as well as or better than DSM-IV diagnoses. Prototype diagnoses from independent interviewers correlated on average r = .50 and showed substantial incremental validity over DSM-IV diagnoses in predicting adaptive functioning. CONCLUSIONS Prototype matching is a viable alternative for psychiatric diagnosis. As in research on personality disorders, mood and anxiety disorder prototypes outperformed DSM-IV decision rules in predicting psychopathology and global functioning. Prototype matching has multiple advantages, including ease of use in clinical practice, reduced artifactual comorbidity, compatibility with naturally occurring cognitive processes in diagnosticians, and ready translation into both categorical and dimensional diagnosis. PMID:23403467

  5. Diagnosis and Treatment of Child and Adolescent Anxiety Disorders

    Microsoft Academic Search

    Bruce A. Thyer

    1991-01-01

    The criteria from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental' Disorders (DSM-III-R) for anxiety disorders relevant to children and adolescents are reviewed. Empirically supported behavioral and pharmacological therapies specific to separation anxiety disorder, avoidant disorder, overanxious disorder, simple phobia, obsessive compulsive disorder, and sleep terror disorder are discussed. Exposure-based treatments are indicated in most cases in which

  6. Separation anxiety disorder across the lifespan: DSM-5 lifts age restriction on diagnosis.

    PubMed

    Silove, Derrick; Rees, Susan

    2014-10-01

    DSM-5 has lifted the age criterion in the definition of separation anxiety disorder thereby overturning the long-standing convention of restricting the diagnosis to childhood. Previously, adults with separation anxiety symptoms were assigned to other conventional categories such as panic disorder, agoraphobia or generalized anxiety disorder. Over the past two decades, an evolving body of research has identified separation anxiety disorder in adulthood, with 20-40% of adult psychiatric outpatients being assigned that diagnosis. In the US, the lifetime prevalence of the disorder in adulthood is 6.6%. The removal of the age restriction on diagnosis has important implications for clinical practice. Whereas parents (particularly mothers) of children with separation anxiety disorder commonly attracted the diagnosis of agoraphobia, the latter are more likely now to be diagnosed with the adult form of separation anxiety disorder, focusing attention on the importance of intervening with both members of the dyad to overcome mutual reinforcement of symptoms. In addition, adults with separation anxiety disorder have been found to manifest high levels of disability and they tend to show a poor response to conventional psychological and pharmacological treatments. There is an urgent need therefore to devise novel psychological and pharmacological interventions for the adult form of the disorder. The reformulation of separation anxiety disorder in DSM-5 therefore requires a paradigm shift in which clinicians are alerted to identifying and treating the condition in all age groups. Research across countries is needed to examine the new formulation of separation anxiety disorder amongst populations of diverse ethnic and cultural backgrounds. PMID:25453710

  7. Anxiety Disorders

    Microsoft Academic Search

    Rose C. Smith; Lisa S. Elwood; Matthew T. Feldner; Bunmi O. Olatunji

    \\u000a Anxiety disorders are among the most common psychological disorders, with a lifetime prevalence of 31.2% and a 12-month prevalence\\u000a of 19.1% in the United States (Kessler et al., 2005; Kessler, Chiu, Demler, Merikangas, & Walters, 2005). Individuals with\\u000a an anxiety disorder present with a variety of physical and psychological symptoms. Particularly unique to anxiety are the\\u000a symptoms of physical tension

  8. [Anxiety disorder].

    PubMed

    Hayashida, Maiko; Horiguchi, Jun

    2013-10-01

    Anxiety disorder (AD) often is under diagnosed and under treated in older adults, especially when the clinical presentation of anxiety. Symptoms often overlap with medical conditions. Of all the anxiety disorders in later life, generalized anxiety disorder (GAD) is one of the most frequently diagnosed. AD is often comorbid with depression. AD is associated with excess disability. Anxiety in older adults has traditionally been treated pharmacology, often with benzodiazepine. However, the clinical recommendations for pharmacologic treatment actually have been much broader, including suggestions to consider serotonergic antidepressants. Selective serotonin reuptake inhibitors (SSRIs) and serotonin nor epinephrine reuptake inhibitors (SNRIs) generally are safe and procedure fewer side effects compared with tricyclic antidepressants (TCAs), in older patients. Effective treatment includes pharmacotherapy and psychotherapy, and complementary and alternative therapies. Late life AD is associated with substantial impairments in quality of life. Effective treatment for AD may be one of the most predictors of improvement of QOL. PMID:24261208

  9. Anxiety Disorders

    MedlinePLUS

    ... be related to genes that can affect brain chemistry and the regulation of chemicals called neurotransmitters. But ... should: Tell a parent or other adult about physical sensations, worries, or fears. Because anxiety disorders don' ...

  10. Conditional Probabilities in the Diagnosis of Depressive and Anxiety Disorders in Children.

    ERIC Educational Resources Information Center

    Laurent, Jeff; And Others

    1993-01-01

    Determined most efficient inclusion and exclusion criteria for differential diagnosis of depression and anxiety in children. Results from fourth through seventh graders indicated that four symptoms served as efficient inclusion and exclusion criteria for depressive disorders: feeling unloved, anhedonia, excessive guilt, and depressed mood.…

  11. Anxiety Disorders in Persons with Developmental Disabilities: Empirically Informed Diagnosis and Treatment

    Microsoft Academic Search

    Ervin Davis; Sy Atezaz Saeed; Diana J. Antonacci

    2008-01-01

    Anxiety disorders are common in individuals with developmental disabilities (DDs), although they may not be diagnosed and\\u000a treated as often as they are in patients without DDs. Patients with mental retardation, autism, and other pervasive developmental\\u000a disorders may exhibit comorbid anxiety disorders, such as generalized anxiety disorder (GAD), obsessive-compulsive disorder\\u000a (OCD), phobias, and other anxiety symptoms at much higher rates

  12. Transdiagnostic versus Diagnosis-Specific CBT for Anxiety Disorders: A Preliminary Randomized Controlled Non-inferiority Trial

    PubMed Central

    Norton, Peter J.; Barrera, Terri L.

    2012-01-01

    BACKGROUND Transdiagnostic cognitive-behavioral treatments for anxiety disorders have been gaining increased attention and empirical study in recent years. Despite this, research on transdiagnostic anxiety treatments has, to date, relied on open trials, or comparisons to waitlist conditions, published benchmarks, or relaxation-based interventions. METHODS The current study was a randomized clinical trial examining the efficacy of a 12-week transdiagnostic cognitive-behavioral group treatment in comparison to 12-week diagnosis-specific group CBT protocols for panic disorder, social anxiety disorder and generalized anxiety disorder. RESULTS Results from 46 treatment initiators suggested significant improvement during treatment, strong evidence for treatment equivalence across transdiagnostic and diagnosis-specific CBT conditions, and no differences in treatment credibility. CONCLUSIONS This study provides evidence supporting the efficacy of transdiagnostic CBT by comparison to current gold-standard diagnosis-specific CBT for social anxiety disorder, generalized anxiety disorder, and panic disorder. Transdiagnostic group CBT has the benefit of potentially easing dissemination and increasing access to evidence based treatments for anxiety without sacrificing efficacy. PMID:22767410

  13. Epidemiology of anxiety disorders

    Microsoft Academic Search

    Jürgen Margraf; U ZETSCHE

    2007-01-01

    This contribution provides an overview of the most important recent epidemiological studies examining anxiety disorders in the general population. Results demonstrate that anxiety disorders are widespread, with lifetime prevalence rates ranging between 13.6% and 28.8% in Western countries. Comorbidity among individuals with an anxiety disorder is high: three out of four people with a lifetime anxiety disorder experience at least

  14. Separation Anxiety Disorder

    Microsoft Academic Search

    Andreas Dick-Niederhauser; Wendy K. Silverman

    ?Separation anxiety disorder (SAD) is a common psychiatric disorder of childhood and early adolescence and is characterized by an unrealistic and excessive fear of separation from an attachment figure, usually the mother. Separation anxiety can be a characteristic of normal development or a symptom of an anxiety disorder. Anxieties about separation are regarded as clinically significant if they are excessive,

  15. School Functioning in Youth with and without Anxiety Disorders: Comparisons by Diagnosis and Comorbidity

    ERIC Educational Resources Information Center

    Mychailyszyn, Matthew P.; Mendez, Julia L.; Kendall, Philip C.

    2010-01-01

    This article reports on school functioning for 227 youth ages 7-14 (M = 10.3) with principal diagnoses of separation anxiety disorder (n = 40), social phobia (n = 58), generalized anxiety disorder (n = 76), or no diagnoses (n = 53). School functioning data were gathered via parent and teacher report. Youth with no diagnoses demonstrated…

  16. Childhood Anxiety Disorders

    Microsoft Academic Search

    Gail A. Bernstein; Andrea M. Victor

    Anxiety disorders is one of the most prevalent diagnostic categories identified in children and adolescents. This chapter\\u000a provides an overview of the epidemiology of childhood anxiety disorders. Several pathways of etiology are presented, specifically\\u000a genetics, parent–child attachment, parental anxiety and parenting style, and life experiences. Six of the common childhood\\u000a anxiety disorders, separation anxiety disorder, specific phobia, social phobia, generalized

  17. Diagnosis and management of bipolar disorder with comorbid anxiety in the elderly.

    PubMed

    Sajatovic, Martha; Kales, Helen C

    2006-01-01

    Currently, in individuals over 65 year of age, prevalence rates of bipolar disorder range from 0.1% to 0.4%. As is the case for bipolar disorder in younger individuals, bipolar disorder may be unrecognized or underrecognized among older adults. While anxiety disorders are frequently comorbid among younger individuals with bipolar illness, the prevalence and impact of comorbid anxiety is far less understood among geriatric individuals with bipolar disorder, in whom anxiety disorders may be underreported. This comorbidity may have serious consequences, since in older adult populations with depression, the presence of comorbid anxiety is associated with more severe depressive symptoms, more chronic medical illness, greater functional impairment, and lower quality of life; the same associations may prove to be true in older patients with bipolar disorder. As with younger individuals with bipolar disorder, effective treatment of the underlying mood disorder is critically important before treating comorbid symptoms. Unfortunately, few evidence-based studies are available to guide the treating clinician in the management of these vulnerable patients, many of whom have additional psychiatric or medical comorbidity. PMID:16426113

  18. Separation Anxiety Disorder

    Microsoft Academic Search

    Andrew R. Eisen; Joshua M. Sussman; Talya Schmidt; Luke Mason; Lee Ann Hausler; Rebecca Hashim

    \\u000a According to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR; American Psychiatric Association [APA], 2000), the central feature of separation\\u000a anxiety disorder (SAD) is unrealistic and excessive anxiety upon separation or anticipation of separation from major attachment\\u000a figures. SAD is the only anxiety disorder based on specific child criteria as well as having a childhood

  19. Rating scales for anxiety\\/anxiety disorders

    Microsoft Academic Search

    Richard Balon; UPC Jefferson

    2007-01-01

    This article reviews new developments in rating scales for anxiety\\/anxiety disorders. Several new rating instruments have\\u000a been developed. These instruments could be useful in various areas, such as research of anxiety disorders or in assessment\\u000a of anxiety in patients with various somatic diseases (dyspnea, pain, chronic illnesses such as diabetes or cancer). Some of\\u000a the existing instruments have been modified,

  20. Memory and anxiety disorders.

    PubMed Central

    Mcnally, R J

    1997-01-01

    Experimental psychopathologists have identified varying patterns in memory bias in people with depressive and anxiety disorders. Individuals suffering from depression tend to exhibit explicit memory deficits for positively-valanced material, and sometimes exhibit biases for retrieving negative self-relevant information as well. Most studies, however, provide scant evidence for implicit memory biases in depression. In contrast to depression, anxiety disorders are rarely associated with enhanced explicit memory for threat-related information (with the exception of panic disorder). Evidence for implicit memory biases for threat in these syndromes is mixed. After providing an overview of findings on memory abnormalities in depressive and anxiety disorders, data from several new studies bearing on posttraumatic stress disorder (PTSD) in Vietnam combat veterans and in women with histories of childhood sexual abuse are presented. Involving directed forgetting, implicit memory and autobiographical cueing paradigms, these experiments point to a pattern of abnormalities linked to PTSD rather than to trauma per se. PMID:9415928

  1. Glutamate and anxiety disorders

    Microsoft Academic Search

    Jonathan M. Amiel; Sanjay J. Mathew

    2007-01-01

    Anxiety disorders are among the most prevalent psychiatric disorders, but they represent a particular challenge for treatment.\\u000a The standard first-line treatments, including antidepressants, benzodiazepines, and buspirone, result in significant response\\u000a rates for a majority of patients; however, unfavorable side effect profiles or risk for dependency for particular agents might\\u000a limit their use by anxious patients, who often have low thresholds

  2. Gender as a Moderator between Having an Anxiety Disorder Diagnosis and Coronary Artery Bypass Grafting Surgery (CABG) Outcomes in Rural Patients

    ERIC Educational Resources Information Center

    Dao, Tam K.; Voelkel, Emily; Presley, Sherine; Doss, Brendel; Huddleston, Cashuna; Gopaldas, Raja

    2012-01-01

    Purpose: This paper examines gender as a moderating variable between having an anxiety disorder diagnosis and coronary artery bypass grafting surgery (CABG) outcomes in rural patients. Methods: Using the 2008 Nationwide Inpatient Sample (NIS) database, 17,885 discharge records of patients who underwent a primary CABG surgery were identified.…

  3. Anxiety disorders in neurologic illness

    Microsoft Academic Search

    Robert D. Davies; Sherri L. Gabbert; Paula D. Riggs

    2001-01-01

    Opinion statement  \\u000a \\u000a \\u000a \\u000a \\u000a – \\u000a \\u000a Anxiety disorders frequently occur in individuals with neurologic illness. Anxiety may be a symptom of or a reaction to the\\u000a neurologic disorder, a medication side effect, or a comorbid condition. The most common anxiety disorders seen in neurologic\\u000a patients are panic disorder, generalized anxiety disorder, social phobia, and obsessive-compulsive disorder (OCD). Very often,\\u000a these conditions go unrecognized

  4. Anxiety disorders in late life.

    PubMed Central

    Flint, A. J.

    1999-01-01

    OBJECTIVE: To review the epidemiology, clinical characteristics, and treatment of anxiety disorders in late life. QUALITY OF EVIDENCE: Epidemiologic and comorbidity data are derived from well designed random-sample community surveys. There are virtually no controlled data specific to treatment of anxiety in the elderly. Guidelines for treating anxiety disorders in late life, therefore, must be extrapolated from results of randomized controlled trials conducted in younger patients. MAIN MESSAGE: Generalized anxiety disorder and agoraphobia account for most cases of anxiety disorder in late life. Late-onset generalized anxiety is usually associated with depressive illness and, in this situation, the primary pharmacologic treatment is antidepressant medication. Most elderly people with agoraphobia do not give a history of panic attacks; exposure therapy is the preferred treatment for agoraphobia without panic. CONCLUSIONS: Physicians need to make more use of antidepressant medication and behavioural therapy and less use of benzodiazepines in treating anxiety disorders in late life. PMID:10587775

  5. Clinical characteristics of anxiety disordered youth

    PubMed Central

    Kendall, Philip C.; Compton, Scott N.; Walkup, John T.; Birmaher, Boris; Albano, Anne Marie; Sherrill, Joel; Ginsburg, Golda; Rynn, Moira; McCracken, James; Gosch, Elizabeth; Keeton, Courtney; Bergman, Lindsey; Sakolsky, Dara; Suveg, Cindy; Iyengar, Satish; March, John; Piacentini, John

    2010-01-01

    Reports the characteristics of a large, representative sample of treatment seeking anxious youth (N =488). Participants, aged 7–17 years (mean 10.7 yrs), had a principal DSM-IV diagnosis of separation anxiety disorder (SAD), generalized anxiety disorder (GAD), or social phobia (SP). Although youth with a co-primary diagnosis for which a different disorder-specific treatment would be indicated (e.g., major depressive disorder, substance abuse) were not included, there were few other exclusion criteria. Participants and their parent/guardian underwent an extensive baseline assessment using a broad array of measures capturing diagnostic status, anxiety symptoms and severity, and areas of functional impairment. Means and standard deviations of the measures of psychopathology and data on diagnostic status are provided. The sample had moderate to severe anxiety disorder and was highly comorbid, with 55.3% of participants meeting criteria for at least one non-targeted DSM-IV disorder. Anxiety disorders in youth often do not present as a single/focused disorder: such disorders in youth overlap in symptoms and are highly comorbid among themselves. PMID:20206470

  6. Sleep-Related Problems in Children and Adolescents With Anxiety Disorders

    Microsoft Academic Search

    Rhea M. Chase; Donna B. Pincus

    2011-01-01

    This study examined the prevalence and patterns of sleep problems in a sample of children with anxiety disorders. Participants were 175 children, aged 6 to 18 years, with a primary diagnosis of generalized anxiety disorder, separation anxiety disorder, social phobia, or obsessive–compulsive disorder, presenting for assessment at an anxiety specialty clinic. Ninety percent of the sample demonstrated at least one

  7. [Anxiety disorder due to epilepsy: a case report].

    PubMed

    Özyurt, Gonca; Öztura, ?brahim; Alk?n, Tunç; Özerdem, Ay?egül

    2015-01-01

    Epileptic patients present with psychiatric disorders more frequently than the general population and patients with other chronic medical conditions. Psychiatric disorders can co-occur with epilepsy and can be caused by epilepsy. Personality changes, as well as psychosis, and mood or anxiety disorders can occur in association with epilepsy. Anxiety disorders due to epilepsy can manifest as generalized anxiety disorder, panic disorder, phobias, or obsessive-compulsive disorder. The risk of an anxiety disorder is higher in patients with focal epilepsy, especially those with temporal lobe epilepsy, but an anxiety disorder can also occur in patients with frontal lobe epilepsy or generalized tonic-clonic epilepsy. Herein we present a 41-year-old female patient with comorbid anxiety disorder and epilepsy that improved following initiation of antiepileptic medication. The patient's EEG showed abnormalities, particularly in the frontal lobe. Epileptic activation-associated anxiety disorder presented as phobia of swallowing and the patient exhibited features of generalized anxiety disorder. Following initiation of antiepileptic medication, the seizures stopped and the symptoms of anxiety disappeared in two weeks. The patient was receiving psychotherapy once every 2 weeks. The patient remained asymptomatic during 2-years of follow-up. This case highlights the importance of differential diagnosis of underlying epilepsy in patients with acute severe anxiety and the efficacy of proper medical treatment, which was given in the presented case for the underling pathology of anxiety. PMID:25742040

  8. Alcohol Use and Anxiety Disorders

    Microsoft Academic Search

    Brigitte C. Sabourin; Sherry H. Stewart

    The relationship between anxiety and alcohol use is a topic of great theoretical and practical interest for both scientists interested in the nature and causes of psychopathology and practitioners working with anxious and\\/or alcohol abusing clients. Although it has been clearly established that anxiety disorders and alcohol use disorders are highly ‘‘comorbid’’ or co-occurring conditions (e.g., see Kushner, Abrams &

  9. What Do Childhood Anxiety Disorders Predict?

    ERIC Educational Resources Information Center

    Bittner, Antje; Egger, Helen L.; Erkanli, Alaattin; Costello, E. Jane; Foley, Debra L.; Angold, Adrian

    2007-01-01

    Background: Few longitudinal studies of child and adolescent psychopathology have examined the links between specific childhood anxiety disorders and adolescent psychiatric disorder. In this paper we test the predictive specificity of separation anxiety disorder (SAD), overanxious disorder (OAD), generalized anxiety disorder (GAD), and social…

  10. Mental imagery in anxiety disorders

    Microsoft Academic Search

    Emily A. Holmes

    2007-01-01

    Distressing mental images are common in anxiety disorders and have recently been found to have an important role in the maintenance of anxious problems. For example, in post-traumatic stress disorder (PTSD) the hallmark feature is the presence of recurrent sensory images of a past trauma, known as ‘flashbacks’. These flashbacks comprise the key information that needs to be addressed in

  11. Studying Anxiety Disorders | NIH MedlinePlus the Magazine

    MedlinePLUS

    ... Health (NIMH) supports research into the causes, diagnosis, prevention, and treatment of anxiety disorders. Researchers are investigating the impact of environmental factors, such as pollution, physical and psychological stress, and diet. 5 Major ...

  12. Childhood anxiety disorders and developmental issues in anxiety

    Microsoft Academic Search

    Paul Arnold; S. Preeya Banerjee; Rashmi Bhandari; Jennifer Ivey; Michelle Rose; David R. Rosenberg

    2003-01-01

    Anxiety disorders are common disorders in childhood, and developmental differences must be considered when diagnosing and\\u000a treating patients in this age group. Recent research has illuminated the course of childhood anxiety disorders, including\\u000a how they can be precursors to continued anxiety and mood problems in adulthood. Recent studies of cognitive-behavioral therapy,\\u000a the first-line psychosocial treatment for childhood anxiety, have focused

  13. Comorbid anxiety and mood disorders among persons with social anxiety disorder

    Microsoft Academic Search

    Brigette A Erwin; Richard G Heimberg; Harlan Juster; Melissa Mindlin

    2002-01-01

    Axis I comorbidity is associated with greater severity of social anxiety disorder. However, the differential effects of comorbid mood and anxiety disorders on symptom severity or treatment outcome have not been investigated. We evaluated 69 persons with uncomplicated social anxiety disorder, 39 persons with an additional anxiety disorder, and 33 persons with an additional mood disorder (with or without additional

  14. Anxiety, Mood, and Substance Use Disorders in Parents of Children with Anxiety Disorders

    ERIC Educational Resources Information Center

    Hughes, Alicia A.; Furr, Jami M.; Sood, Erica D.; Barmish, Andrea J.; Kendall, Philip C.

    2009-01-01

    Examined the prevalence of anxiety, mood, and substance use disorders in the parents of anxiety disordered (AD) children relative to children with no psychological disorder (NPD). The specificity of relationships between child and parent anxiety disorders was also investigated. Results revealed higher prevalence rates of anxiety disorders in…

  15. Cognitions in Generalized Anxiety Disorder and Panic Disorder Patients

    Microsoft Academic Search

    Elisabeth Breitholtz; Bengt E. Westling

    1998-01-01

    Forty-three patients with generalized anxiety disorder (GAD) and 44 patients with panic disorder (PD) were given a standardized interview about thoughts and images during times of anxiety. The two groups differed significantly regarding the ideational content of anxiety. GAD patients experienced more thoughts focusing on themes of mental catastrophes and other catastrophes when suffering from anxiety or anxiety attacks, while

  16. Pharmacotherapy of anxiety disorders: a critical review.

    PubMed

    Koen, Nastassja; Stein, Dan J

    2011-01-01

    Given the enormous contribution of anxiety disorders to the burden of disease, it is key to optimize their prevention and treatment. In this critical review we assess advances in the pharmacotherapy of anxiety disorders, as well as remaining challenges, in recent decades, the field has seen rigorous clinical trial methods to quantify the efficacy and safety of serendipitously discovered agents, more focused development of medications with selective mechanisms of action, and the gradual translation of insights from laboratory research into proof-of-principle clinical trials. On the positive side, a considerable database of studies shows efficacy and relative tolerability of the selective serotonin reuptake inhibitors in the major anxiety disorders, and secondary analyses of such datasets have informed questions such as optimal definition of response and remission, optimal dose and duration, and comparative efficacy of different agents. Significant challenges in the field include barriers to appropriate diagnosis and treatment of anxiety disorders, failure of a significant proportion of patients to respond to first-line pharmacotherapy agents, and a limited database of efficacy or effectiveness studies to guide treatment in such cases. PMID:22275848

  17. Pharmacological Treatment for Phobias and Anxiety Disorders

    Microsoft Academic Search

    Michael H. Bloch; Joseph F. McGuire

    \\u000a Anxiety disorders in childhood are quite ­common, affecting between 6 and 20% of all children (Costello, Mustillo, Erkanli,\\u000a Keeler, & Angold, 2003). Anxiety disorders can adversely impact social and academic functioning as well as self-esteem (Mendlowicz\\u000a & Stein, 2000). Children with anxiety disorders grow up to having greater rates of depression, new anxiety disorders, substance\\u000a abuse, educational underachievement, and suicide

  18. Anxiety Disorders: Recognizing the Symptoms of Six of the Most Common Anxiety Disorders

    ERIC Educational Resources Information Center

    Cancro, Robert

    2007-01-01

    This article describes six common types of anxiety disorders: (1) generalized anxiety disorder; (2) panic disorder; (3) obsessive-compulsive disorder; (4) post-traumatic stress disorder; (5) specific phobias; and (6) social phobia. Treatment of anxiety disorders have two components that can be offered separately or in combination. They are…

  19. Emotion Regulation and Anxiety Disorders

    PubMed Central

    Amstadter, Ananda B.

    2009-01-01

    Recent attention has been given to the role of emotion regulation in the development and maintenance of psychopathology. Gross (1998) provided a framework from which to understand emotion regulation processes, and it is within this framework that the literature on emotion regulation/dysregulation in the anxiety disorder population is reviewed, with a focus on possible deficiencies that lead to or maintain the disorders. The present paper aims to (1) briefly introduce emotion regulation strategies of suppression and reappraisal; (2) summarize the empirical studies of emotion regulation within anxiety disorders; (3) discuss the neurobiological markers of emotion regulation within these disorders; (4) provide future directions for research; and (5) summarize possible treatment implications resulting from this important area of research. PMID:17349775

  20. Psychotherapy for Anxiety in Children With Autism Spectrum Disorder

    ClinicalTrials.gov

    2015-07-07

    Autism Spectrum Disorders; Autism; Asperger's Syndrome; Pervasive Developmental Disability - Not Otherwise Specified; Obsessive-compulsive Disorder; Social Phobia; Generalized Anxiety Disorder; Specific Phobia; Separation Anxiety Disorder

  1. Psychotherapy for Anxiety in Children With Autism Spectrum Disorder

    ClinicalTrials.gov

    2015-02-03

    Autism Spectrum Disorders; Autism; Asperger's Syndrome; Pervasive Developmental Disability - Not Otherwise Specified; Obsessive-compulsive Disorder; Social Phobia; Generalized Anxiety Disorder; Specific Phobia; Separation Anxiety Disorder

  2. Social communication deficits: Specific associations with Social Anxiety Disorder

    PubMed Central

    Halls, Georgia; Cooper, Peter J.; Creswell, Cathy

    2015-01-01

    Background Social communication deficits are prevalent amongst children with anxiety disorders; however whether they are over-represented specifically among children with Social Anxiety Disorder has not been examined. This study set out to examine social communication deficits among children with Social Anxiety Disorder in comparison to children with other forms of anxiety disorder. Methods Parents of 404 children with a diagnosed anxiety disorder completed the Social Communication Questionnaire (SCQ; Rutter, M., Bailey, A., Lord, C., 2003. The Social Communication Questionnaire – Manual. Western Psychological Services, Los Angeles, CA). Children with a diagnosis of Social Anxiety Disorder (n=262) and anxious children without Social Anxiety Disorder (n=142) were compared on SCQ total and subscale scores and the frequency of participants scoring above clinical cut-offs. Results Children with Social Anxiety Disorder scored significantly higher than anxious children without Social Anxiety Disorder on the SCQ total (t(352)=4.85, p<.001, d=.55, r=.27), Reciprocal Social Interaction (t(351)=4.73, p<.001, d=.55, r=.27), communication (t(344)=3.62, p<.001, d=.43, r=.21) and repetitive, restrictive and stereotyped behaviors subscales (t(353)=3.15, p=.002, d=.37, r=.18). Furthermore, children with Social Anxiety Disorder were three times more likely to score above clinical cut-offs. Limitations The participants were a relatively affluent group of predominantly non-minority status. The social communication difficulties measure relied on parental report which could be influenced by extraneous factors. Conclusions Treatments for Social Anxiety Disorder may benefit from a specific focus on developing social communication skills. Future research using objective assessments of underlying social communication skills is required. PMID:25451393

  3. Treatment for illegal drug use disorders: the role of comorbid mood and anxiety disorders

    PubMed Central

    2014-01-01

    Background Our aim was to examine whether comorbid mood and anxiety disorders influence patterns of treatment or the perceived unmet need for treatment among those not receiving treatment for illegal drug use disorders. Methods Data came from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, 2001–2002 and 2004–2005, n?=?34,653). Lifetime DSM-IV illegal drug use disorder (abuse and dependence), as well as comorbid mood (major depression, dysthymia, manic disorder, hypomanic disorder) and anxiety disorders (panic disorder, agoraphobia, social phobia, specific phobia, generalized anxiety) were ascertained by a standardized psychiatric interview. Treatment for illegal drug use disorders and perceived unmet need for treatment were assessed among individuals with illegal drug use disorder. Odds of treatment and odds of perceived unmet need for treatment were assessed using logistic regression, adjusting for socio-demographic characteristics, treatment for mood and anxiety disorders, and comorbid alcohol use disorder. Results Out of 34,653 participants, 1114 (3.2%) had a diagnosis of lifetime illegal drug use disorder: 21.2% had a comorbid mood disorder only, 11.8% a comorbid anxiety disorder only, and 45.9% comorbid mood and anxiety disorders. Comorbid mood and anxiety disorders were not related to treatment for illegal drug use disorders but were associated with an elevated likelihood of unmet need for treatment: compared to participants with no comorbidities, multivariate ORs were 2.21 (95% CI: 1.23- 4.10) for mood disorder only, 2.38 (95% CI: 1.27-4.45) for anxiety disorder only, and 2.90 (95% CI: 1.71-4.94) for both mood and anxiety disorders. Conclusions Individuals with an illegal drug use disorder and comorbid mood or anxiety disorders are disproportionately likely to report unmet need for treatment. Integrated mental health and substance use programs could prove effective in addressing their treatment needs. PMID:24670230

  4. Treating Anxiety Disorders | NIH MedlinePlus the Magazine

    MedlinePLUS

    ... anxiety disorders—panic disorder, generalized anxiety disorder, social anxiety disorder, or post-traumatic stress disorder. An NIMH-funded study has revealed that female rat brain cells are more sensitive to a ...

  5. Evolutionary aspects of anxiety disorders

    PubMed Central

    Price, John S.

    2003-01-01

    Danger and harm are avoided by strategic decisions made at all three levels of the triune forebrain: rational (neomammalian), emotional (paleomammalian), and instinctive (reptilian). This applies also to potential harm from conspecifics, which leads to a choice between escalating and de-escalating strategies. Anxiety is a component of de-escalating strategies mediated by the paleomammalian and reptilian forebrains. When the neomammalian (rational) brain fails to deal with the threat of conspecific danger, these more primitive de-escalating strategies may be activated and may present as anxiety disorders. The capacity for concealment of anxiety and other forms of negative affect has also evolved, and excessive concealment may lead to psychopaihology by breaking the negative feedback loop of excessive motivation, leading to impaired performance, leading to signals of distress, and leading to reduced exhortation to succeed on the part of parents and teachers; this situation is illustrated by a model based on the Yerkes-Dodson law. PMID:22033473

  6. Anxiety Sensitivity and Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Calamari, John E.; Rector, Neil A.; Woodard, John L.; Cohen, Robyn J.; Chik, Heather M.

    2008-01-01

    Anxiety sensitivity (AS), a cognitive risk factor for anxiety disorders, was evaluated in a homogeneous obsessive-compulsive disorder (OCD) sample. A total of 280 individuals with OCD completed measures. Evaluation of the Anxiety Sensitivity Index revealed a latent structure that was congruent with previous studies showing a single higher order…

  7. Generalized anxiety disorder: neurobiological and pharmacotherapeutic perspectives

    Microsoft Academic Search

    Kathryn M Connor; Jonathan R. T Davidson

    1998-01-01

    The concept of generalized anxiety has evolved over many years, from initial descriptions of “anxiety neurosis” to recognition of generalized anxiety disorder (GAD) as a clinical entity included in the 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980. Since 1980, the definition of GAD has undergone further change, with modifications in the salience of

  8. Temperament and Anxiety Disorders

    Microsoft Academic Search

    Elizabeth C. Winter; O. Joseph Bienvenu

    \\u000a Psychiatric illness is highly prevalent among children and adolescents. For example, Costello, Mustillo, Erkanli, Keeler,\\u000a and Angold (2003) psychiatrically evaluated over one thousand children aged 9 to 13 years yearly until age 16 years. The 3-month\\u000a prevalence of any disorder was 13%. However, over the course of the study, 31% of girls and 42% of boys had at least one

  9. Antidepressant Treatment in Anxiety Disorders

    Microsoft Academic Search

    Anton Y. Bespalov; Marcel M. van Gaalen; Gerhard Gross

    \\u000a Antidepressant drug treatment is the clinical standard of care for all types of anxiety disorders. Broad efficacy of selective\\u000a serotonin reuptake inhibitors suggests the importance of enhanced serotonergic function of the anxiolytic properties of current\\u000a antidepressants. However, analysis of the preclinical evidence indicates that most conventional “anxiolytic” drug tests are\\u000a not sensitive to antidepressants. Such dissociation is not surprising because

  10. Psychopharmacologic treatment for pediatric anxiety disorders.

    PubMed

    Peters, Todd E; Connolly, Sucheta

    2012-10-01

    Anxiety is an innate emotion that all humans experience, especially during early childhood in periods of significant growth and development. Treatment strategies exist for anxiety disorders that cause significant dysfunction and impairment in youth. This article provides a current overview of the literature on psychopharmacologic management of pediatric anxiety disorders. Potential side effects and complications of psychotropic medications are reviewed. The treatment of anxiety disorders in patients with comorbid conditions is explored, addressing the impact on treatment course and pharmacologic recommendations. A clinical vignette describing a 10-year-old boy with increasing anxiety is presented describing in-hospital and outpatient treatment and therapies. PMID:23040902

  11. [Differential diagnosis of anxiety with ICD 10].

    PubMed

    Schneider, W; Janssen, P L

    1995-05-01

    The principles of operational psychiatric diagnostic systems like DSM-III-R, DSM-IV and ACD-10 are shown at the beginning of the paper. On this background, the classification of the anxiety disorders in ICD-10 and the most important diagnostic guidelines and criteria are explained. The "diagnostic criteria for research" study in Germany in the field of psychosomatics and psychotherapy has shown good interrater reliability which is an important characteristic of the quality of the diagnosis. At last, essential shortcomings of ICD-10 from the perspective of psychosomatics/psychotherapy are discussed. For example, the disease conceptualization and the low treatment validity are missing because important diagnostic characteristics like personality structure, the specific conflicts of the patient, characteristics of learning and the coping mechanism are missing in ICD-10 and DSM. PMID:7610675

  12. Comorbid Anxiety Disorders in Depressed Elderly Patients

    Microsoft Academic Search

    Eric J. Lenze; Benoit H. Mulsant; Herbert C. Schulberg; D. Mary Amanda Dew; Amy E. Begley; Bruce G. Pollock; Charles F. Reynolds III

    2000-01-01

    Method: History of anxiety disorders was assessed by using a structured diag- nostic instrument in 182 depressed sub- jects aged 60 and older seen in primary care and psychiatric settings. Associa- tions between comorbid anxiety disor- ders and baseline characteristics were measured. The modified structured in- strument allowed detection of symp- toms that met inclusion criteria for gen- eralized anxiety

  13. Health anxiety disorders: a cognitive construal.

    PubMed

    Rachman, S

    2012-08-01

    The features of severe health anxiety, intense and persistent anxiety about one's present and future health, are described. In common with other anxiety disorders such as GAD, PTSD and OCD, the core of HAD is distressing, uncontrollable anxiety, and is classifiable as an Anxiety Disorder, Health Anxiety Disorder (HAD). The cognitive construal of HAD proposes that health anxiety is caused by catastrophic misinterpretations of the significance of sensations and/or changes in bodily functions and appearance (such as swellings, pain, loss of energy, dizzy spells). The nature, causes, triggers, persistence, assessment and treatment of HAD are reviewed, and the present status of the cognitive model is appraised. Suggestions are made for future research and clinical applications, and the need for incisive evaluations of the main premises of the model is emphasized. PMID:22659160

  14. Anxiety, Anxiety Disorders, Tobacco Use, and Nicotine: A Critical Review of Interrelationships

    ERIC Educational Resources Information Center

    Morissette, Sandra Baker; Tull, Matthew T.; Gulliver, Suzy Bird; Kamholz, Barbara Wolfsdorf; Zimering, Rose T.

    2007-01-01

    Smoking is highly prevalent across most anxiety disorders. Tobacco use increases risk for the later development of certain anxiety disorders, and smokers with anxiety disorders have more severe withdrawal symptoms during smoking cessation than smokers without anxiety disorders. The authors critically examined the relationships among anxiety,…

  15. Transdiagnostic Treatment of Bipolar Disorder and Comorbid Anxiety with the Unified Protocol: A Clinical Replication Series

    ERIC Educational Resources Information Center

    Ellard, Kristen K.; Deckersbach, Thilo; Sylvia, Louisa G.; Nierenberg, Andrew A.; Barlow, David H.

    2012-01-01

    Bipolar disorder (BD) is a chronic, debilitating disorder with recurrent manic and depressive episodes. More than 75% of bipolar patients have a current or lifetime diagnosis of a comorbid anxiety disorder. Comorbid anxiety in BD is associated with greater illness severity, greater functional impairment, and poorer illness-related outcomes.…

  16. Development of Anxiety Disorders in a Traumatized Pediatric Population: A Preliminary Longitudinal Evaluation

    ERIC Educational Resources Information Center

    Cortes, Adriana M.; Saltzman, Kassey M.; Weems, Carl F.; Regnault, Heather P.; Reiss, Allan L.; Carrion, Victor G.

    2005-01-01

    Objective: The current study was conducted to determine if post-traumatic stress disorder (PTSD) symptomatology predicted later development of non-PTSD anxiety disorders in children and adolescents victimized by interpersonal trauma. Methods: Thirty-four children with a history of interpersonal trauma and no initial diagnosis of anxiety disorder

  17. Dysfunctional Cognitions in Children with Social Phobia, Separation Anxiety Disorder, and Generalized Anxiety Disorder

    Microsoft Academic Search

    Susan M. Bögels; Denise Zigterman

    2000-01-01

    According to cognitive theories of anxiety, anxious adults interpret ambiguous situations in a negative way: They overestimate danger and underestimate their abilities to cope with danger. The present study investigated whether children with social phobia, separation anxiety disorder, and generalized anxiety disorder have such a bias, compared to a clinical and a normal control group. Children were exposed to stories

  18. Depersonalization disorder and anxiety: a special relationship?

    PubMed

    Sierra, Mauricio; Medford, Nick; Wyatt, Geddes; David, Anthony S

    2012-05-15

    A significant association between anxiety and depersonalization has been found in healthy controls and psychiatric patients irrespective of underlying conditions. Although patients with depersonalization disorder (DPD) often have a history of severe anxiety symptoms, clinical observations suggest that the relation between anxiety and depersonalization is complex and poorly understood. Using relevant rating scales, levels of anxiety and depersonalization were assessed in 291 consecutive DPD cases. 'High' and 'low' depersonalization groups, were compared according to anxiety severity. Correlation and multivariate regression analyses were also used to assessed the contribution of anxiety to the phenomenology and natural course of depersonalization. A low but significant association between depersonalization and anxiety (as measured by Beck's Anxiety Inventory) was only apparent in those patients with low intensity depersonalization, but not in those with severe depersonalization. Levels of anxiety did not seem to make specific contributions to the clinical features of depersonalization itself, although DPD patients with high anxiety seem characterised by additional non-specific perceptual symptoms. The presence of a 'statistical dissociation' between depersonalization and anxiety adds further evidence in favour of depersonalization disorder being an independent condition and suggests that its association with anxiety has been overemphasized. PMID:22414660

  19. Cultural Aspects in Social Anxiety and Social Anxiety Disorder

    PubMed Central

    Hofmann, Stefan G.; Asnaani, Anu; Hinton, Devon E.

    2010-01-01

    To examine cultural aspects in social anxiety and social anxiety disorder (SAD), we reviewed the literature on the prevalence rates, expressions, and treatments of social anxiety/SAD as they relate to culture, race, and ethnicity. We further reviewed factors that contribute to the differences in social anxiety/SAD between different cultures, including individualism/collectivism, perception of social norms, self-construal, gender roles, and gender role identification. Our review suggests that the prevalence and expression of social anxiety/SAD depends on the particular culture. Asian cultures typically show the lowest rates, whereas Russian and US samples show the highest rates, of SAD. Taijin kyofusho is discussed as a possible culture-specific expression of social anxiety, although the empirical evidence concerning the validity of this syndrome has been mixed. It is concluded that the individual's social concerns need to be examined in the context of the person's cultural, racial, and ethnic background in order to adequately assess the degree and expression of social anxiety and social anxiety disorder. This has direct relevance for the upcoming DSM-V. PMID:21132847

  20. Depression and Anxiety Disorders among Hospitalized Women with Breast Cancer

    PubMed Central

    Vin-Raviv, Neomi; Akinyemiju, Tomi F.; Galea, Sandro; Bovbjerg, Dana H.

    2015-01-01

    Purpose To document the prevalence of depression and anxiety disorders, and their associations with mortality among hospitalized breast cancer patients. Methods We examined the associations between breast cancer diagnosis and the diagnoses of anxiety or depression among 4,164 hospitalized breast cancer cases matched with 4,164 non-breast cancer controls using 2006-2009 inpatient data obtained from the Nationwide Inpatient Sample database. Conditional logistic regression models were used to compute odds ratios (ORs) and 95% confidence intervals (CI) for the associations between breast cancer diagnosis and diagnoses of anxiety or depression. We also used binary logistic regression models to examine the association between diagnoses of depression or anxiety, and in-hospital mortality among breast cancer patients. Results We observed that breast cancer cases were less likely to have a diagnosis of depression (OR=0.63, 95% CI: 0.52-0.77), and less likely to have a diagnosis of anxiety (OR=0.68, 95% CI: 0.52-0.90) compared with controls. This association remained after controlling for race/ethnicity, residential income, insurance and residential region. Breast cancer patients with a depression diagnosis also had lower mortality (OR=0.69, 95% CI: 0.52-0.89) compared with those without a depression diagnosis, but there was no significant difference in mortality among those with and without anxiety diagnoses. Conclusion Diagnoses of depression and anxiety in breast cancer patients were less prevalent than expected based on our analysis of hospitalized breast cancer patients and matched non-breast cancer controls identified in the NIS dataset using ICD-9 diagnostic codes. Results suggest that under-diagnosis of mental health problems may be common among hospitalized women with a primary diagnosis of breast cancer. Future work may fruitfully explore reasons for, and consequences of, inappropriate identification of the mental health needs of breast cancer patients. PMID:26035180

  1. Peer Perceptions and Liking of Children with Anxiety Disorders

    Microsoft Academic Search

    Timothy L. Verduin; Philip C. Kendall

    2008-01-01

    Examined three aspects of childhood anxiety and peer liking: (1) whether or not children can detect anxiety in age-mates,\\u000a (2) the degree to which peer-reported anxiety, self-reported anxiety, and presence of anxiety disorders are associated with\\u000a peer liking, and (3) whether or not self-reported anxiety and presence of anxiety disorders are associated with peer liking\\u000a after controlling for peer-reported anxiety.

  2. Anxiety in adolescents: Update on its diagnosis and treatment for primary care providers

    PubMed Central

    Siegel, Rebecca S; Dickstein, Daniel P

    2012-01-01

    Anxiety disorders are the most prevalent mental health concern facing adolescents today, yet they are largely undertreated. This is especially concerning given that there are fairly good data to support an evidence-based approach to the diagnosis and treatment of anxiety, and also that untreated, these problems can continue into adulthood, growing in severity. Thus, knowing how to recognize and respond to anxiety in adolescents is of the utmost importance in primary care settings. To that end, this article provides an up-to-date review of the diagnosis and treatment of anxiety disorders geared towards professionals in primary care settings. Topics covered include subtypes, clinical presentation, the etiology and biology, effective screening instruments, evidence-based treatments (both medication and therapy), and the long-term prognosis for adolescents with anxiety. Importantly, we focus on the most common types of anxiety disorders, often known as phobias, which include generalized anxiety disorder, social anxiety/social phobia, separation anxiety disorder, panic disorder, and specific phobias. In summary, anxiety is a common psychiatric problem for adolescents, but armed with the right tools, primary care providers can make a major impact. PMID:24600282

  3. Update on managing generalized anxiety disorder in older adults.

    PubMed

    Clifford, Kalin M; Duncan, Nakia A; Heinrich, Krista; Shaw, Jennifer

    2015-04-01

    With the recent updates to the Diagnostic and Statistical Manual of Mental Disorders (5th edition; DSM-5), there are many questions on how to care for older adults with generalized anxiety disorder (GAD) and other psychiatric conditions. The current article reviews the new changes to the DSM-5 for diagnosis of GAD, discusses new anxiety assessment scales that are validated in older adults, evaluates pharmacological agents that have been studied in older adults for GAD treatment, and provides monitoring recommendations to help those who provide care to older adults experiencing GAD. PMID:25848826

  4. Anxiety Sensitivity and the Anxiety Disorders: A Meta-Analytic Review and Synthesis

    Microsoft Academic Search

    Bunmi O. Olatunji; Kate B. Wolitzky-Taylor

    2009-01-01

    There has been significant interest in the role of anxiety sensitivity (AS) in the anxiety disorders. In this meta-analysis, we empirically evaluate differences in AS between anxiety disorders, mood disorders, and nonclinical controls. A total of 38 published studies (N = 20,146) were included in the analysis. The results yielded a large effect size indicating greater AS among anxiety disorder

  5. Threat perception abnormalities in children: the role of anxiety disorders symptoms, chronic anxiety, and state anxiety

    Microsoft Academic Search

    Peter Muris; Ron Rapee; Cor Meesters; Erik Schouten; Marijn Geers

    2003-01-01

    This study investigated the relative contribution of general (trait) anxiety and state anxiety to threat perception abnormalities in nonreferred children aged 8–13 years (N=299). Children were first asked to complete self-report measures of anxiety disorders symptoms and chronic anxiety. Next, they were individually interviewed using an ambiguous story paradigm from which a number of threat perception indexes were derived. Just

  6. Personality dimensions in panic disorder and generalized anxiety disorder

    Microsoft Academic Search

    Vladan Starcevic; E. H. Uhlenhuth; Stephanie Fallon; Dorothy Pathak

    1996-01-01

    To make a dimensional assessment of personality in individuals with pathological anxiety, the Tridimensional Personality Questionnaire (TPQ) was administered to 32 patients with panic disorder (PD) and 49 patients with generalized anxiety disorder (GAD). The most striking findings were a substantially increased score on the harm avoidance dimension in both groups of patients, and a lack of significant differences between

  7. MANAGEMENT GUIDELINES FOR ANXIETY DISORDERS IN CHILDREN AND ADOLESCENTS

    Microsoft Academic Search

    Prabhat Sitholey; Anil Nischal

    Anxiety disorders represent one of the most common categories of psychopathology in children and adolescents. Apart from separation anxiety disorder, a well recognized problem of childhood, it is now widely accepted that generalized anxiety disorder, social phobia, specific phobia, posttraumatic stress disorder, obsessive compulsive disorder and panic disorder all occur during the childhood and adolescent years. Numerous studies examining the

  8. [Anxiety disorders in DSM-5: an overview on changes in structure and content].

    PubMed

    Wittchen, H-U; Heinig, I; Beesdo-Baum, K

    2014-05-01

    The Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) "anxiety, obsessive-compulsive spectrum, posttraumatic, and dissociative disorders" work group addressed reconceptualization issues regarding all anxiety-related disorders. Based on systematic literature reviews, reanalyses of available data and evaluation of results following the DSM-5 principles it was decided to rearrange the disorder spectrum into separate groupings for the classical anxiety disorders, trauma- and stressor-related disorders, obsessive-compulsive and related disorders, and dissociative disorders. Among the classical anxiety disorders DSM-5 now also includes selective mutism and separation anxiety disorder. A major change from DSM-IV is a drastically simplified classification of panic disorder and agoraphobia. Both conditions can be separately coded in DSM-5 and the overlap is disclosed by a comorbid double diagnosis. The anxiety disorder criteria have been generally harmonized regarding content and order. It was assured that criteria are applicable to all age, gender and cultural groups. Furthermore, diagnosis-specific and cross-cutting dimensional anxiety scales have been developed to supplement categorical diagnosis which appears to facilitate assessment of severity and course of treatment. PMID:24737036

  9. Recognizing and managing anxiety disorders in primary health care in Turkey

    Microsoft Academic Search

    Mehtap Kartal; Ozlem Coskun; Nesrin Dilbaz

    2010-01-01

    BACKGROUND: Anxiety disorders are common and are frequently not diagnosed accurately in primary care. Our aim was to determine the knowledge gaps of general practitioners (GPs) in the diagnosis and treatment of anxiety disorders by using vignettes. METHODS: A cross-sectional survey was completed with 255 primary care physicians (response rate 59.4%) in Manisa, a city in western Turkey. From the

  10. Late-life Anxiety Disorders: A Review

    Microsoft Academic Search

    Josien Schuurmans; Anton van Balkom

    2011-01-01

    Anxiety disorders are a major clinical problem in late life; estimated prevalence rates vary from 6% to 10%, and the disease\\u000a impact is considerable and equal to that of depression. However, anxiety disorders often remain undetected and untreated in\\u000a older adults. This discrepancy may be accounted for by a combination of patient variables (eg, a lack of help-seeking behavior\\u000a and

  11. COMPLICATED GRIEF SYMPTOMS IN ANXIETY DISORDERS: PREVALENCE AND ASSOCIATED IMPAIRMENT

    PubMed Central

    Marques, Luana; Bui, Eric; LeBlanc, Nicole; Porter, Eliora; Robinaugh, Donald; Dryman, Taylor; Nadal-Vicens, Mireya; Worthington, John; Simon, Naomi

    2014-01-01

    Background Previous research has identified high rates of comorbid anxiety disorders among individuals presenting with primary CG. In the present study, we examined the prevalence of comorbid CG in bereaved primary anxiety disorder (AD) patients compared to bereaved healthy controls. We also examined the impairment associated with comorbid CG in AD. Methods Participants were 242 bereaved adults (mean (SD) age = 41.5 (13.1), 44.2% women) with a primary AD diagnosis, including generalized anxiety disorder (GAD; n = 57), panic disorder (PD; n = 49), posttraumatic stress disorder (PTSD; n = 29), and generalized social anxiety disorder (GSAD; n = 107), as well as 155 bereaved healthy controls with no current DSM-IV Axis I diagnosis (mean (SD) age = 43.0 (13.6), 51.0% women). CG symptoms were measured using the 19-item inventory of complicated grief (ICG), with threshold CG defined as an ICG score of ?30. Quality of life and functional impairment were assessed with the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) and the Range of Impaired Functioning Tool (LIFE-RIFT), respectively. Results Participants with primary ADs had significantly higher rates of threshold CG symptoms than bereaved controls (12.0% vs. 0.65%; Fisher’s Exact P < 0.001). Rates of threshold CG were significantly elevated for each AD when compared to bereaved controls. After adjustment for age, sex, education, and comorbid major depressive disorder, threshold CG was associated with lower quality of life (? = ?0.140, P = 0.023) and greater impairment (? = 0.141, P = 0.035) among individuals with AD. Conclusions Our findings suggest that threshold CG is of clinical relevance in bereaved individuals with a primary anxiety disorder. Screening for CG in patients with ADs may be warranted. PMID:23495105

  12. Combined Psychological and Pharmacological Treatment of Pediatric Anxiety Disorders

    Microsoft Academic Search

    Hunna J. Watson

    \\u000a The identification of efficacious psychological and psychiatric therapies is arguably one of the most significant achievements\\u000a in the pediatric anxiety disorders field. Controlled trials have supported the usefulness of psychological and pharmacological\\u000a monotherapies for pediatric obsessive–compulsive disorder, social anxiety disorder, panic disorder, agoraphobia, generalized\\u000a anxiety disorder, specific phobia, posttraumatic stress disorder, and separation anxiety disorder (Compton et al., 2004; Feeney,

  13. Comorbidity of substance use disorders with mood and anxiety disorders

    Microsoft Academic Search

    Kathleen R. Merikangas; Rajni L. Mehta; Beth E. Molnar; Ellen E. Walters; Joel D. Swendsen; Sergio Aguilar-Gaziola; Rob Bijl; Guilherme Borges; Jorge J. Caraveo-Anduaga; David J. Dewit; Bohdan Kolody; William A. Vega; Hans-Ulrich Wittchen; Ronald C. Kessler

    1998-01-01

    This article reports the results of a cross-national investigation of patterns of comorbidity between substance use and psychiatric disorders in six studies participating in the International Consortium in Psychiatric Epidemiology. In general, there was a strong association between mood and anxiety disorders as well as conduct and antisocial personality disorder with substance disorders at all sites. The results also suggest

  14. Cross-Cultural Aspects of Anxiety Disorders

    PubMed Central

    Hofmann, Stefan G.; Hinton, Devon E.

    2014-01-01

    A person’s cultural background influences the experience and expression of emotions. In reviewing the recent literature on cross-cultural aspects of anxiety disorders, we identified some culturally related ethnopsychology/ethnophysiology factors (the culture’s conceptualizations of how the mind and body function) and contextual factors that influence anxiety disorders. Ethnopsychology/ethnophysiology factors include the person’s ideas about the mental and bodily processes (and their interaction), whereas contextual factors are associated with the social norms and rules that may contribute to anxiety, including individualism vs. collectivism and self-construals. From the perspective of ethnopsychology/ethnophysiology and contextual factors, we will discuss “khyâl cap” (“wind attacks”), taijin kyofusho, and ataques de nervios, three prominent examples of culture-specific expressions of anxiety disorders that have all been included in the DSM-5 list of cultural concepts of distress, PMID:24744049

  15. Patterns of anxiety and personality disorder comorbidity

    Microsoft Academic Search

    Andrew E. Skodol; John M. Oldham; Steven E. Hyler; Dan J. Stein; Eric Hollander; Peggy E. Gallaher; Anne E. Lopez

    1995-01-01

    The purpose of this study was to examine patterns of comorbidity of DSM-III-R anxiety disorders and personality disorders (PD). Two-hundred subjects were independently interviewed with the Structured Clinical Interview for DSM-III-R (SCID) and the Personality Disorder Examination (PDE) face-to-face by two experienced clinicians. One-hundred and forty-six also completed the Personality Diagnostic Questionnaire—Revised (PDQ-R). Rates of personality disorder among patients with

  16. Pain-related anxiety and anxiety sensitivity across anxiety and depressive disorders.

    PubMed

    Carleton, R Nicholas; Abrams, Murray P; Asmundson, Gordon J G; Antony, Martin M; McCabe, Randi E

    2009-08-01

    Fear-anxiety-avoidance models posit pain-related anxiety and anxiety sensitivity as important contributing variables in the development and maintenance of chronic musculoskeletal pain [Asmundson, G. J. G, Vlaeyen, J. W. S., & Crombez, G. (Eds.). (2004). Understanding and treating fear of pain. New York: Oxford University Press]. Emerging evidence also suggests that pain-related anxiety may be a diathesis for many other emotional disorders [Asmundson, G. J. G., & Carleton, R. N. (2005). Fear of pain is elevated in adults with co-occurring trauma-related stress and social anxiety symptoms. Cognitive Behaviour Therapy, 34, 248-255; Asmundson, G. J. G., & Carleton, R. N. (2008). Fear of pain. In: M. M. Antony & M. B. Stein (Eds.), Handbook of anxiety and the anxiety disorders (pp. 551-561). New York: Oxford University Press] and appears to share several elements in common with other fears (e.g., anxiety sensitivity, illness/injury sensitivity, fear of negative evaluation) as described by Reiss [Reiss, S. (1991). Expectancy model of fear, anxiety, and panic. Clinical Psychology Review, 11, 141-153] and Taylor [Taylor, S. (1993). The structure of fundamental fears. Journal of Behavior Therapy and Experimental Psychiatry, 24, 289-299]. The purpose of the present investigation was to assess self-reported levels of pain-related anxiety [Pain Anxiety Symptoms Scale-Short Form; PASS-20; McCracken, L. M., & Dhingra, L. (2002). A short version of the Pain Anxiety Symptoms Scale (PASS-20): preliminary development and validity. Pain Research and Management, 7, 45-50] across several anxiety and depressive disorders and to compare those levels to non-clinical and chronic pain samples. Participants consisted of a clinical sample (n=418; 63% women) with principal diagnoses of a depressive disorder (DD; n=22), panic disorder (PD; n=114), social anxiety disorder (SAD; n=136), obsessive-compulsive disorder (OCD; n=86), generalized anxiety disorder (GAD; n=46), or specific phobia (n=14). Secondary group comparisons were made with a community sample as well as with published data from a treatment-seeking chronic pain sample [McCracken, L. M., & Dhingra, L. (2002). A short version of the Pain Anxiety Symptoms Scale (PASS-20): preliminary development and validity. Pain Research and Management, 7, 45-50]. Results suggest that pain-related anxiety is generally comparable across anxiety and depressive disorders; however, pain-related anxiety was typically higher (p<.01) in individuals with anxiety and depressive disorders relative to a community sample, but comparable to or lower than a chronic pain sample. Results imply that pain-related anxiety may indeed be a construct independent of other fundamental fears, warranting subsequent hierarchical investigations and consideration for inclusion in treatments of anxiety disorders. Additional implications and directions for future research are discussed. PMID:19362446

  17. [Diagnosis of olfactory disorders].

    PubMed

    Schriever, V A; Abolmaali, N; Welge-Lüssen, A

    2014-12-01

    Alongside a structured case history, the measurement of olfactory function and diagnosis of olfactory dysfunction is of great clinical importance. Validated and established methods have been developed to this aim. The "Sniffin' Sticks" test battery is an easy-to-use tool for assessing olfactory function. Recording of olfactory event-related potentials is a more objective approach, which is particularly important in medicolegal cases. Imaging techniques such as MRI and CT provide additional information in the diagnosis of olfactory disorders. The latter techniques enable the anatomical structures of the skull and brain with the areas relevant to olfactory function to be evaluated. PMID:25465077

  18. Toddler Anxiety Disorders: A Pilot Study

    ERIC Educational Resources Information Center

    Warren, Susan L.; Umylny, Polina; Aron, Emily; Simmens, Samuel J.

    2006-01-01

    Objective: This research examined the validity of criteria for diagnosing social phobia (SOC) and generalized anxiety disorder (GAD), where the "DSM-IV" criteria were modified to better identify toddlers who could have these disorders. Method: Diagnoses were made with a semistructured clinical interview that included child observations. Parents…

  19. Perfectionism in pediatric anxiety and depressive disorders.

    PubMed

    Affrunti, Nicholas W; Woodruff-Borden, Janet

    2014-09-01

    Although perfectionism has been identified as a factor in many psychiatric disorders across the life span, it is relatively understudied in pediatric anxiety and depressive disorders. Furthermore, there exists little cohesion among previous research, restricting the conclusions that can be made across studies. In this review, research associating perfectionism with pediatric anxiety and depression is examined and a framework is presented synthesizing research to date. We focus on detailing the current understanding of how perfectionism develops and interacts with other developmental features characteristic of anxiety and depression in children and potential pathways that result in anxiety and depressive disorders. This includes: how perfectionism is measured in children, comparisons with relevant adult literature, the development of perfectionism in children and adolescents, mediators and moderators of the link between perfectionism and anxiety and depression, and the role of perfectionism in treatment and prevention of these disorders. We also present research detailing perfectionism across cultures. Findings from these studies are beginning to implicate perfectionism as an underlying process that may contribute broadly to the development of anxiety and depression in a pediatric population. Throughout the review, difficulties, limitations, and gaps in the current understanding are presented while offering suggestions for future research. PMID:24481881

  20. New Psychotherapies for Mood and Anxiety Disorders

    PubMed Central

    Stirman, Shannon Wiltsey; Toder, Katherine; Crits-Christoph, Paul

    2010-01-01

    Objective To discuss psychotherapies for depression and anxiety that have emerged in recent years and to evaluate their current level of empirical support. Method An electronic and a manual literature search of psychotherapies for mood and anxiety disorders were conducted. Results Five new therapies for mood disorders and 3 interventions for posttraumatic stress disorder with co-occurring substance abuse met criteria for inclusion in this review. Fewer psychotherapies have been developed for other anxiety disorders. Although research for some of the psychotherapies has demonstrated superiority to usual care, none have firmly established efficacy or specific benefits over other established psychotherapies. Conclusions A plurality of the new psychotherapies introduced and established in the past 5 years have been different assimilations of previously established cognitive-behavioural, interpersonal, or psychodynamic models. While initial results are promising for some, more rigorous efficacy trials and replications are necessary before conclusions can be drawn regarding their relative benefits. PMID:20416142

  1. Toward an application to psychological disorders diagnosis.

    PubMed

    Nunes, Luciano Comin; Pinheiro, Plácido Rogério; Pequeno, Tarcísio Cavalcante; Pinheiro, Mirian Calíope Dantas

    2011-01-01

    Psychological disorders have kept away and incapacitated professionals in different sectors of activities. The most serious problems may be associated with various types of pathologies; however, it appears, more often, as psychotic disorders, mood disorders, anxiety disorders, antisocial personality, multiple personality and addiction, causing a micro level damage to the individual and his/her family and in a macro level to the production system and the country welfare. The lack of early diagnosis has provided reactive measures, and sometimes very late, when the professional is already showing psychological signs of incapacity to work. This study aims to help the early diagnosis of psychological disorders with a hybrid proposal of an expert system that is integrated to structured methodologies in decision support (Multi-Criteria Decision Analysis - MCDA) and knowledge structured representations into production rules and probabilities (Artificial Intelligence - AI). PMID:21431598

  2. Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders

    PubMed Central

    2014-01-01

    Background Anxiety and related disorders are among the most common mental disorders, with lifetime prevalence reportedly as high as 31%. Unfortunately, anxiety disorders are under-diagnosed and under-treated. Methods These guidelines were developed by Canadian experts in anxiety and related disorders through a consensus process. Data on the epidemiology, diagnosis, and treatment (psychological and pharmacological) were obtained through MEDLINE, PsycINFO, and manual searches (1980–2012). Treatment strategies were rated on strength of evidence, and a clinical recommendation for each intervention was made, based on global impression of efficacy, effectiveness, and side effects, using a modified version of the periodic health examination guidelines. Results These guidelines are presented in 10 sections, including an introduction, principles of diagnosis and management, six sections (Sections 3 through 8) on the specific anxiety-related disorders (panic disorder, agoraphobia, specific phobia, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder), and two additional sections on special populations (children/adolescents, pregnant/lactating women, and the elderly) and clinical issues in patients with comorbid conditions. Conclusions Anxiety and related disorders are very common in clinical practice, and frequently comorbid with other psychiatric and medical conditions. Optimal management requires a good understanding of the efficacy and side effect profiles of pharmacological and psychological treatments. PMID:25081580

  3. Physiologic instability in panic disorder and generalized anxiety disorder

    Microsoft Academic Search

    Frank H. Wilhelm; Werner Trabert; Walton T. Roth

    2001-01-01

    Background: Because panic attacks can be accompanied by surges in physiologic activation, we tested the hypothesis that panic disorder is characterized by fluctuations of physiologic variables in the absence of external triggers.Methods: Sixteen patients with panic disorder, 15 with generalized anxiety disorder, and 19 normal control subjects were asked to sit quietly for 30 min. Electrodermal, cardiovascular, and respiratory measures

  4. Nonorganic Insomnia in Generalized Anxiety Disorder

    Microsoft Academic Search

    Gerda Saletu-Zyhlarz; Bernd Saletu; Peter Anderer; Nadja Brandstätter; Richard Frey; Georg Gruber; Gerhard Klösch; Magdalene Mandl; Josef Grünberger; Leopold Linzmayer

    1997-01-01

    Objective and subjective sleep and awakening quality as well as daytime vigilance of insomniac patients with generalized anxiety disorder (GAD) were investigated, as compared with normal controls. Forty-four outpatients (25 females, 19 males), aged 24–65 (mean 43) years, diagnosed with non-organic insomnia (ICD-10: F 51.0), related to mild GAD (F 41.1), with a Hamilton anxiety (HAMA) score of 22 ±

  5. An overview of generalized anxiety disorder: disease state—appropriate therapy

    Microsoft Academic Search

    R. Bruce Lydiard

    2000-01-01

    Objective: This article reviews the prevalence, diagnosis, and treatment of generalized anxiety disorder (GAD).Background: Patients with GAD often present to primary care physicians; frequently the disorder manifests with somatic symptoms that have no identifiable physiologic foundation. Accurate diagnosis and treatment often prove elusive, and health care resources are inappropriately consumed in the management of a wide array of complaints, including

  6. Transdiagnostic Treatment of Bipolar Disorder and Comorbid Anxiety with the Unified Protocol: A Clinical Replication Series

    PubMed Central

    Ellard, Kristen K.; Deckersbach, Thilo; Sylvia, Louisa G.; Nierenberg, Andrew A.; Barlow, David H.

    2013-01-01

    Bipolar disorder (BD) is a chronic, debilitating disorder with recurrent manic and depressive episodes. Over 75% of bipolar patients have a current or lifetime diagnosis of a comorbid anxiety disorder. Comorbid anxiety in BD is associated with greater illness severity, greater functional impairment, and poorer illness-related outcomes. Effectively treating comorbid anxiety in individuals with BD has been recognized as one of the biggest unmet needs in the field of bipolar disorder. Recently, the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) was developed to be applicable to the full range of anxiety and mood disorders, based upon converging evidence from genetics, cognitive and affective neuroscience, and behavioral research suggesting common, core emotion-related pathology. Here, we present a preliminary evaluation of the efficacy of the UP for the treatment of BD with comorbid anxiety, in a clinical replication series consisting of three cases. PMID:22822175

  7. Early and late perceived pubertal timing as risk factors for anxiety disorders in adult women.

    PubMed

    Weingarden, Hilary; Renshaw, Keith D

    2012-11-01

    Anxiety disorders generally have an early age of onset and can contribute to the development of comorbid disorders later in life. Thus, it is important to identify adolescent risk factors for anxiety. Past research has identified early pubertal timing as a risk factor for anxiety, typically measured as a general construct through self-report. The current study used data from the National Comorbidity Survey-Replication (NCS-R) to examine recollection of early and late menarche as a predictor of posttraumatic stress disorder (PTSD), specific phobias (SP), social anxiety disorder (SAD), generalized anxiety disorder (GAD), and panic disorder (PD) among women. Findings showed that early timing predicted increased risk of a lifetime diagnosis of PTSD, SP, and SAD, whereas late pubertal timing only predicted increased rates of SAD. Examination of race as a potential moderator of these relationships did not yield significant findings, but these analyses were limited by low power. Other limitations and future directions are discussed. PMID:22901773

  8. Mental health service use among Canadian older adults with anxiety disorders and clinically significant anxiety symptoms

    Microsoft Academic Search

    Tiffany Scott; Corey S. Mackenzie; Judith G. Chipperfield; Jitender Sareen

    2010-01-01

    Objectives: Despite evidence of disproportionate underutilization of mental health services by older adults and by individuals with anxiety disorders, little is known specifically about service use by older adults with anxiety. This study examines the prevalence of mental health service use among older adults with anxiety disorders and clinically significant anxiety symptoms, as well as factors associated with service use.Method:

  9. Generalized Anxiety Disorder in Referred Children and Adolescents

    Microsoft Academic Search

    Gabriele Masi; Stefania Millepiedi; Maria Mucci; Paola Poli; Nicoletta Bertini; Luca Milantoni

    2004-01-01

    ObjectiveThere are insufficient data on generalized anxiety disorder in children and adolescents. Symptoms and comorbidity of generalized anxiety disorder are described as a function of age, gender, and comorbidity in a consecutive series of referred children and adolescents.

  10. Over 4 Million Working Americans Suffer from Anxiety Disorders

    MedlinePLUS

    ... html Over 4 Million Working Americans Suffer From Anxiety Disorders Illness can be debilitating, but treatment is ... million Americans with full-time jobs had an anxiety disorder in the past year. That number represents ...

  11. Anxiety and Somatic Complaints in Children with Recurrent Abdominal Pain and Anxiety Disorders

    PubMed Central

    Dunn, Madeleine J.; Compas, Bruce E.

    2009-01-01

    Objective?To compare anxiety symptoms and disorders in children and adolescents with recurrent abdominal pain (RAP), anxiety disorders, and healthy control children.?Methods?Twenty-one children with RAP (nine males, mean age = 11.05) were compared to 21 children with anxiety disorders (11 males, mean age = 12.29), and 21 children without pain or anxiety (nine males, mean age = 11.57) using diagnostic interviews and continuous measures of anxiety and other internalizing symptoms.?Results?Sixty-seven percent of children with RAP met criteria for an anxiety disorder. Children with RAP were higher than well children but not significantly different from children with anxiety on total internalizing and anxiety symptoms.?Conclusions?RAP and anxiety are closely related. Further understanding between these disorders is essential to understanding the development and progression of RAP, and to inform the prevention and treatment of the disorder. PMID:18577541

  12. Anxiety Sensitivity and the Anxiety Disorders: A Meta-Analytic Review and Synthesis

    ERIC Educational Resources Information Center

    Olatunji, Bunmi O.; Wolitzky-Taylor, Kate B.

    2009-01-01

    There has been significant interest in the role of anxiety sensitivity (AS) in the anxiety disorders. In this meta-analysis, we empirically evaluate differences in AS between anxiety disorders, mood disorders, and nonclinical controls. A total of 38 published studies (N = 20,146) were included in the analysis. The results yielded a large effect…

  13. Metacognitive therapy for generalized anxiety disorder: An open trial

    Microsoft Academic Search

    Adrian Wells; Paul King

    2006-01-01

    Generalized anxiety disorder (GAD) responds only modestly to existing cognitive-behavioural treatments. This study investigated a new treatment based on an empirically supported metacognitive model [Wells, (1995). Metacognition and worry: A cognitive model of generalized anxiety disorder. Behavioural and Cognitive Psychotherapy, 23, 301–320; Wells, (1997). Cognitive therapy of anxiety disorders: A practice manual and conceptual guide. Chichester, UK: Wiley]. Ten consecutive

  14. Attentional Bias in Generalized Anxiety Disorder Versus Depressive Disorder

    Microsoft Academic Search

    Karin Mogg; Brendan P. Bradley

    2005-01-01

    This review evaluates evidence of attentional biases in generalized anxiety disorder (GAD) and depressive disorder from studies using modified Stroop and visual probe tasks. There appears to be fairly consistent evidence for an attentional bias for external negative cues in GAD, and for the involvement of non-conscious processes in this bias. By contrast, in clinical depression, the evidence for an

  15. Assessment of anxiety in subclinical thyroid disorders.

    PubMed

    Sait Gönen, Mustafa; Kisakol, Gurcan; Savas Cilli, Ali; Dikbas, Oguz; Gungor, Kagan; Inal, Ali; Kaya, Ahmet

    2004-06-01

    It is well known that manifest thyroid dysfunction causes mood disorders. In the literature there are few studies related with subclinical thyroid dysfunction and anxiety. We aimed to determine if there exists a relation between the anxiety and subclinical thyroid dysfunction. This study was carried out in the Meram Medical Faculty of Selçuk University, Department of Endocrinology and Metabolism. Eighty-five outpatients were enrolled into the study. In the presence of normal fT(3) and fT(4), patients were grouped as subclinical hyperthyroid with TSH lower than 0.1 mU/L (n = 24), subclinical hypothyroid with TSH higher than 4.5 mU/L (n = 32) and euthyroid subjects (n = 29). Beck's Anxiety Inventory (BAI) was administered to all patients. There was no any statistically significant difference between euthyroid and study groups in terms of age, gender, weight and height (p<0.05). One-way ANOVA showed that both of the subclinical hypothyroid and subclinical hyperthyroid groups had significantly higher anxiety scores than euthyroid group (F: 11.4, p<0.001). Manifest hypothyroidism and hyperthyroidism, as causes of mental and neurological dysfunction have been known for a long time, but the relation between subclinical thyroid dysfunction and anxiety is less well studied. We have found that subclinical thyroid dysfunction increases the anxiety of patients whether hyperthyroid or hypothyroid. Overlap of symptoms common to both thyroid dysfunction and anxiety is an important limitation in this study. Mood changes especially anxiety due to subclinical thyroid dysfunction may have an important impact on the patient's quality of life. Negative effect on quality of life may be an indication of treatment in these patients. It is the first study evaluating anxiety in subclinical hypothyroidism in the literature. PMID:15256776

  16. Screening for depression and anxiety disorder in children with headache

    PubMed Central

    Lee, Sang Mi; Yoon, Jung-Rim; Yi, Yoon Young; Eom, Soyong; Lee, Joon Soo; Kim, Heung Dong; Cheon, Keun-Ah

    2015-01-01

    Purpose The purpose of this study was to investigate the importance of initial screening tests for depression and anxiety disorders in children with headache. In addition, this study evaluated whether the Children's Depression Inventory (CDI) and Revised Children's Manifest Anxiety Scale (RCMAS) are suitable for screening symptoms of depression and anxiety. Methods A retrospective chart review was conducted of 720 children aged 7-17 years who had visited a pediatric neurology clinic for headaches and were referred to a pediatric psychiatric clinic for psychiatric symptoms from January 2010 to December 2011. All patients completed the CDI and RCMAS. Among them, charts of patients with clinically significant total scores (cutoff>15) for psychiatric symptoms, as defined by the CDI and RCMAS scoring scales, were reviewed. Results Nineteen patients had headaches and clinically significant total scores for psychiatric symptoms. The mean age at headache diagnosis was 11.7 years, and 57% were male. Mean duration of headache was 11.5 months. Two point eight percent of the patients were diagnosed with psychiatric disorders including major depression (1.7%), generalized anxiety disorder (1.1%), and bipolar disorder (0.1%). Four patients (0.6%) were diagnosed with attention deficit/hyperactivity disorder (ADHD). Total mean CDI and RCMAS scores of patients referred to the psychiatric clinic were 18.8 and 22.2, respectively. There was no correlation between CDI or RCMAS total scores and headache frequency, duration, or severity. Conclusion We recommend that all patients with headache should be screened for depression and anxiety by CDI and RCMAS scores. PMID:25774198

  17. Fluvoxamine in the treatment of anxiety disorders

    PubMed Central

    Irons, Jane

    2005-01-01

    Fluvoxamine is a selective-serotonin reuptake inhibitor (SSRI) that has proved effective in large double-blind, randomized, controlled trials involving patients with social anxiety disorder (SAD), obsessive-compulsive disorder (OCD), and panic disorder. Improvements have also been demonstrated in patients with post-traumatic stress disorder, as well as those with a range of obsessive-compulsive spectrum disorders including binge eating disorder, bulimia nervosa, pathological gambling, and body dysmorphic disorder. Several well controlled studies have confirmed the efficacy of fluvoxamine in children and adolescents with OCD, SAD, and other anxiety disorders, and it was the first SSRI to be registered for the treatment of OCD in children. Fluvoxamine is well tolerated. In common with other SSRIs, the most frequently reported adverse event is nausea. Fluvoxamine does not cause sedation or cognitive impairment and is associated with a low risk of sexual dysfunction, suicidality, and withdrawal reactions. It is safe in overdose and has no significant effect on body weight or cardiovascular parameters. PMID:18568110

  18. The prevalence and correlates of adult separation anxiety disorder in an anxiety clinic

    Microsoft Academic Search

    Derrick M Silove; Claire L Marnane; Renate Wagner; Vijaya L Manicavasagar; Susan Rees

    2010-01-01

    BACKGROUND: Adult separation anxiety disorder (ASAD) has been identified recently, but there is a paucity of data about its prevalence and associated characteristics amongst anxiety patients. This study assessed the prevalence and risk factor profile associated with ASAD in an anxiety clinic. METHODS: Clinical psychologists assigned 520 consecutive patients to DSM-IV adult anxiety subcategories using the SCID. We also measured

  19. Test Anxiety and College Students with Attention Deficit Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Nelson, Jason M.; Lindstrom, Will; Foels, Patricia A.

    2014-01-01

    Test anxiety was examined in college students with and without attention deficit hyperactivity disorder (ADHD). Results indicated that, relative to college students without ADHD, college students with ADHD reported higher total test anxiety as well as specific aspects of test anxiety, including worry (i.e., cognitive aspects of test anxiety) and…

  20. Emotional Intelligence and Clinical Symptoms in Outpatients with Generalized Anxiety Disorder (GAD)

    Microsoft Academic Search

    Nathalie P. Lizeretti; Natalio Extremera

    Generalized anxiety disorder (GAD) is the anxiety disorder with the highest prevalence rate in mental health centers. Empirical\\u000a researches concerning its diagnosis and treatment have not yet explored the potential implications of deficits in emotional\\u000a intelligence (EI) as a vulnerability factor in its development. The present study aimed to investigate the relationship between\\u000a EI and clinical symptoms in a group

  1. Screening for anxiety disorders in patients with coronary artery disease

    PubMed Central

    2013-01-01

    Background Anxiety disorders are prevalent and associated with poor prognosis in patients with coronary artery disease (CAD). However, studies examining screening of anxiety disorders in CAD patients are lacking. In the present study we evaluated the prevalence of anxiety disorders in patients with CAD and diagnostic utility of self-rating scales for screening of anxiety disorders. Methods Five-hundred and twenty-three CAD patients not receiving psychotropic treatments at initiation of rehabilitation program completed self-rating scales (Hospital Anxiety and Depression Scale or HADS; Spielberger State-Anxiety Inventory or SSAI; and Spielberger Trait-Anxiety Inventory or STAI) and were interviewed for generalized anxiety disorder (GAD), social phobia, panic disorder and agoraphobia (Mini-International Neuropsychiatric Interview or MINI). Results Thirty-eight (7%) patients were diagnosed with anxiety disorder(s), including GAD (5%), social phobia (2%), agoraphobia (1%) and panic disorder (1%). Areas under the ROC curve of the HADS Anxiety subscale (HADS-A), STAI and SSAI for screening of any anxiety disorder were .81, .80 and .72, respectively. Optimal cut-off values for screening of any anxiety disorders were ?8 for the HADS-A (sensitivity?=?82%; specificity?=?76%; and positive predictive value (PPV)?=?21%); ?45 for the STAI (sensitivity?=?89%; specificity?=?56%; and PPV?=?14%); and ?40 for the SSAI (sensitivity?=?84%; specificity?=?55%; PPV?=?13%). In a subgroup of patients (n?=?340) scoring below the optimal major depressive disorder screening cut-off value of HADS-Depression subscale (score <5), the HADS-A, STAI and SSAI had moderate-high sensitivity (range from 69% to 89%) and low PPVs (?22%) for GAD and any anxiety disorders. Conclusions Anxiety disorders are prevalent in CAD patients but can be reliably identified using self-rating scales. Anxiety self-rating scales had comparable sensitivities but the HADS-A had greater specificity and PPV when compared to the STAI and SSAI for screening of anxiety disorders. However, false positive rates were high, suggesting that patients with positive screening results should undergo psychiatric interview prior to initiating treatment for anxiety disorders and that routine use of anxiety self-rating scales for screening purposes can increase healthcare costs. Anxiety screening has incremental value to depression screening for identifying anxiety disorders. PMID:23497087

  2. 6 Benzodiazepines in anxiety disorders: managing therapeutics and dependence

    Microsoft Academic Search

    Trevor R Norman; Steven R Ellen; Graham D Burrows

    nxiety is a normal emotion experienced at some time by vir- tually all humans. Pathological anxiety is less commonly expe- rienced and may arise from an anxiety disorder in the context of a depressive or psychotic illness or from one of a number of somatic illnesses, such as hyperthyroidism. The range of anxiety disorders and appropriate choice of therapies is

  3. Child and Adolescent Anxiety Disorders and Early Attachment

    Microsoft Academic Search

    SUSAN L. WARREN; LISA HUSTON; BYRON EGELAND; L. ALAN SROUFE

    1997-01-01

    ObjectiveThe major aim of this research is to determine whether infants who were anxiously\\/resistantly attached in infancy develop more anxiety disorders during childhood and adolescence than infants who were securely attached. To test different theories of anxiety disorders, newborn temperament and maternal anxiety were included in multiple regression analyses.

  4. Treatment of Childhood and Adolescent Anxiety Disorders with Tricyclic Antidepressants

    Microsoft Academic Search

    Eliezer Schnall

    Children and adolescents suffering from anxiety disorders may require pharmacotherapy. Tricyclic antidepressants are often prescribed in these instances. Unfortunately, most clinical research analyzing the effectiveness of tricyclic antidepressants on anxiety disorders has focused exclusively on adult patients. This critical review exam- ines those studies that have investigated the effects of tricyclic antidepressants on childhood and adolescent anxiety. Double-blind placebo-controlled trials

  5. A functionalist perspective on social anxiety and avoidant personality disorder.

    PubMed

    Lafreniere, Peter

    2009-01-01

    A developmental-evolutionary perspective is used to synthesize basic research from the neurosciences, ethology, genetics, and developmental psychology into a unified framework for understanding the nature and origins of social anxiety and avoidant personality disorder. Evidence is presented that social anxiety disorder (social phobia) and avoidant personality disorder may be alternate conceptualizations of the same disorder because they have virtually the same symptoms and genetic basis, and respond to the same pharmacologic and psychotherapeutic interventions. A functionalist perspective on social anxiety is formulated to (a) explain the origins of normative states of anxiety, (b) outline developmental pathways in the transition from normative anxiety to social anxiety and avoidant personality disorders, and (c) account for the processes leading to gender-differentiated patterns of anxiety-related disorders after puberty. PMID:19825257

  6. Self-compassion and social anxiety disorder

    Microsoft Academic Search

    Kelly H. Werner; Hooria Jazaieri; Philippe R. Goldin; Michal Ziv; Richard G. Heimberg; James J. Gross

    2011-01-01

    Self-compassion refers to having an accepting and caring orientation towards oneself. Although self-compassion has been studied primarily in healthy populations, one particularly compelling clinical context in which to examine self-compassion is social anxiety disorder (SAD). SAD is characterized by high levels of negative self-criticism as well as an abiding concern about others' evaluation of one's performance. In the present study,

  7. Self-compassion and social anxiety disorder

    Microsoft Academic Search

    Kelly H. Werner; Hooria Jazaieri; Philippe R. Goldin; Michal Ziv; Richard G. Heimberg; James J. Gross

    2012-01-01

    Self-compassion refers to having an accepting and caring orientation towards oneself. Although self-compassion has been studied primarily in healthy populations, one particularly compelling clinical context in which to examine self-compassion is social anxiety disorder (SAD). SAD is characterized by high levels of negative self-criticism as well as an abiding concern about others’ evaluation of one's performance. In the present study,

  8. [Comorbid depressive and anxiety disorders in patients with cancer].

    PubMed

    Kapfhammer, H-P

    2015-03-01

    Patients with cancer face a high risk of comorbid depressive and anxiety disorders that have to be paradigmatically considered within a complex biopsychosocial context. Several conceptual challenges have to be mastered in arriving at a correct clinical diagnosis. Coexistent affective and anxiety disorders in cancer patients include a more dramatic subjective suffering, reduced psychological coping, possible negative interference with somatic treatment and rehabilitation, impaired quality of life and higher grades of psychosocial disability. They may also lead to an overall increased risk of somatic morbidity, a more rapid progression of cancer and a higher cancer-related mortality in the course of the disease. Manifold psychological, psychosocial and existential, cancer and treatment-related stressors have to be considered with respect to common neurobiological, especially neuroendocrine and neuroinflammatory mechanisms. Complex psychosomatic, somatopsychic and somato-somatic effects must always be considered. Evidence-based approaches in psychotherapy and pharmacotherapy exist for the integrative treatment of comorbid depressive and anxiety disorders in cancer. PMID:25737493

  9. The Screen for Child Anxiety Related Emotional Disorders (SCARED) and traditional childhood anxiety measures

    Microsoft Academic Search

    Peter Muris; Harald Merckelbach; Birgit Mayer; Anneke van Brakel; Sandra Thissen; Véronique Moulaert; Björn Gadet

    1998-01-01

    The Screen for Child Anxiety Related Emotional Disorders (SCARED) is a self-report questionnaire that measures symptoms of DSM-IV linked anxiety disorders in children. This article presents two studies that investigated the relationship between the SCARED, on the one hand, and two other widely used anxiety measures for children, namely the Revised Children’s Manifest Anxiety Scale (RCMAS) and the Fear Survey

  10. Bayesian Analysis of Current and Lifetime Comorbidity Rates of Mood and Anxiety Disorders In Individuals with Posttraumatic Stress Disorder

    PubMed Central

    Gallagher, Matthew W.; Brown, Timothy A.

    2014-01-01

    Although posttraumatic stress disorder (PTSD) is no longer considered an anxiety disorder in DSM-5, previous research has indicated high rates of comorbid anxiety and mood disorders in individuals with PTSD. The goal of the present study was to build upon previous examinations of diagnostic comorbidity by using Bayesian methods of estimating current and lifetime comorbidity rates to determine more precise estimates of the proportion of individuals in a clinical sample with PTSD that also meet criteria for various emotional disorders. Two hundred and fifty three individuals with a current or lifetime diagnosis of PTSD underwent a comprehensive assessment of current and lifetime emotional disorders. Bayesian statistical techniques were then used to calculate credibility intervals for the current and lifetime comorbidity rates of emotional disorders. The Bayesian analyses used informative priors based on previous comorbidity findings. The median number of current emotional disorders was two and the median number of lifetime comorbid emotional disorders was three. Credibility intervals indicated that social phobia and major depressive disorder were the most common current and lifetime comorbid emotional disorders. The proportion of individuals with lifetime comorbidity rates were very high for both any lifetime anxiety disorder (.91, 95% CI .88: .94) and any lifetime depressive disorder (.90, 95% CI .86: .93). Together these results indicate that despite the separation from the anxiety disorders in DSM-5, the vast majority of individuals with PTSD will present with one or more emotional disorders. Implications for the assessment and treatment of PTSD are discussed.

  11. Eating disorder symptoms among female anxiety disorder patients in clinical practice: the importance of anxiety comorbidity assessment.

    PubMed

    Becker, Carolyn Black; DeViva, Jason C; Zayfert, Claudia

    2004-01-01

    This exploratory study investigated the relationship between anxiety disorders, anxiety comorbidity, and eating disorder (ED) symptoms in clinical practice, and examined the naturalistic detection of ED when diagnoses were based on the Anxiety Disorders Interview Schedule (ADIS). Two hundred and fifty-seven female patients completed an ED questionnaire and were assessed with the ADIS. Although ED frequency did not differ among anxiety disorder diagnoses, regression analyses revealed that social phobia (SP) and posttraumatic stress disorder (PTSD) accounted for unique variance in eating pathology. Questionnaire results indicated that almost 12% of patients met criteria for a possible ED. Clinicians using the ADIS evidenced good specificity but were not sensitive to detecting ED, missing 80% of possible cases. Results support possible links between ED, social phobia and PTSD and highlight the importance of assessing anxiety comorbidity when examining the relationship between ED and anxiety disorders. Results also suggest that formal screening for ED among female anxiety patients may be warranted. PMID:15125976

  12. Correlates of comorbid anxiety and externalizing disorders in childhood obsessive compulsive disorder.

    PubMed

    Langley, Audra K; Lewin, Adam B; Bergman, R Lindsey; Lee, Joyce C; Piacentini, John

    2010-08-01

    The present study examines the influence of diagnostic comorbidity on the demographic, psychiatric, and functional status of youth with a primary diagnosis of obsessive compulsive disorder (OCD). Two hundred and fifteen children (ages 5-17) referred to a university-based OCD specialty clinic were compared based on DSM-IV diagnostic profile: OCD without comorbid anxiety or externalizing disorder, OCD plus anxiety disorder, and OCD plus externalizing disorder. No age or gender differences were found across groups. Higher OCD severity was found for the OCD + ANX group, while the OCD + EXT group reported greater functional impairment than the other two groups. Lower family cohesion was reported by the OCD + EXT group compared to the OCD group and the OCD + ANX group reported higher family conflict compared to the OCD + EXT group. The OCD + ANX group had significantly lower rates of tic disorders while rates of depressive disorders did not differ among the three groups. The presence of comorbid anxiety and externalizing psychopathology are associated with greater symptom severity and functional and family impairment and underscores the importance of a better understanding of the relationship of OCD characteristics and associated disorders. Results and clinical implications are further discussed. PMID:20349255

  13. Anxiety Disorders Among Methamphetamine Dependent Adults: Association With Posttreatment Functioning

    PubMed Central

    Glasner-Edwards, Suzette; Mooney, Larissa J.; Marinelli-Casey, Patricia; Hillhouse, Maureen; Ang, Alfonso; Rawson, Richard

    2011-01-01

    Although anxiety is one of the most prominent psychiatric complaints of methamphetamine (MA) users, little is known about the association between anxiety disorders and treatment outcomes in this population. Using data from 526 adults in the largest psychosocial clinical trial of MA users conducted to date, this study examined psychiatric, substance use, and functional outcomes of MA users with concomitant anxiety disorders 3 years after treatment. Anxiety disorders were associated with poorer alcohol and drug use outcomes, increased health service utilization, and higher levels of psychiatric symptomatology, including suicidality. Addressing anxiety symptoms and syndromes in MA users may be helpful as a means of optimizing treatment outcomes. PMID:20716300

  14. Escitalopram in the treatment of generalized anxiety disorder

    Microsoft Academic Search

    David S Baldwin; Rajesh V Nair

    2005-01-01

    The selective serotonin reuptake inhibitor escitalopram is the active enantiomer of citalopram and has proven efficacy in the treatment of major depression, panic disorder and social phobia. Accumulating data indicate that it is also efficacious in the treatment of patients with generalized anxiety disorder. This drug profile summarizes the current evidence-base for the treatment of generalized anxiety disorder, describes the

  15. Recognition of Depressive and Anxiety Disorders in Dermatological Outpatients

    Microsoft Academic Search

    Angelo Picardi; Paolo Amerio; Giannandrea Baliva; Claudio Barbieri; Patrizia Teofoli; Simone Bolli; Valentina Salvatori; Eva Mazzotti; Paolo Pasquini; Damiano Abeni

    2004-01-01

    Although mental disorders are frequent among dermato- logical patients, little is known about their recognition by dermatologists. This study aimed to assess dermato- logists' ability to recognize depressive and anxiety disorders. All adult outpatients who visited four dermatologists on predetermined days (n~317) com- pleted the 12-item General Health Questionnaire (GHQ- 12) and the section on depressive and anxiety disorders of

  16. Hoarding among patients seeking treatment for anxiety disorders

    Microsoft Academic Search

    David F. Tolin; Suzanne A. Meunier; Randy O. Frost; Gail Steketee

    2011-01-01

    The aim of the present study was to examine the prevalence of hoarding symptoms among individuals presenting for treatment of anxiety symptoms. Participants included 130 adults who were seeking treatment at an outpatient anxiety disorders clinic between January 2004 and February 2006. During their initial assessment, participants (31 with panic disorder, 15 specific phobia, 27 social phobia, 36 obsessive-compulsive disorder,

  17. Anxiety of young female athletes with disordered eating behaviors

    Microsoft Academic Search

    Erdal Vardar; Selma Arzu Vardar; Cem Kurt

    2007-01-01

    The aim of this study was to investigate the prevalence rate of disordered eating behaviors in young female athletes and to compare the anxiety levels of the athletes with or without disordered eating behaviors. Female athletes (n=243) of 15 to 25 years old from the city, Edirne, in Turkey participated our study. Disordered eating behaviors and anxiety levels of participants were

  18. Obsessive-Compulsive Spectrum Disorders in Obsessive-Compulsive Disorder and Other Anxiety Disorders

    Microsoft Academic Search

    Christine Lochner; Dan J. Stein

    2010-01-01

    Background: There has been debate about whether obsessive-compulsive disorder (OCD) should be classified as one of the anxiety disorders, or should rather be categorized with obsessive-compulsive spectrum conditions. Sampling and Methods: The question of where OCD should be located in the diagnostic system was addressed by investigating the relationship of OCD, obsessive-compulsive spectrum disorders (OCSDs), and anxiety disorders. We administered

  19. Differential attentional bias in generalized anxiety disorder and panic disorder

    PubMed Central

    Chen, Jing; Wang, Zhiyan; Wu, Yan; Cai, Yiyun; Shen, Yifeng; Wang, Liwei; Shi, Shenxun

    2013-01-01

    Background Cognitive theorists relate anxiety disorders to the way in which emotional information is processed. The existing research suggests that patients with anxiety disorders tend to allocate their attention toward threat-related information selectively, and this may differ among different types of anxious subjects. The aim of this study was to explore attentional bias in patients with generalized anxiety disorder (GAD) and panic disorder (PD) using the emotional Stroop task and compare the differences between them. Methods Forty-two patients with GAD, 34 patients with PD, and 46 healthy controls performed the emotional Stroop task with four word types, ie, GAD-related words, PD-related words, neutral words, and positive words. Results Patients with GAD and those with PD were slower than healthy controls to respond to all stimuli. Patients with GAD had longer response latencies in color-naming both PD-relevant words and GAD relevant words. Patients with PD had longer response latencies only in color-naming PD-related words, similar to healthy controls. Conclusion Patients with GAD and those with PD had a different pattern of attentional bias, and there was insufficient evidence to support the existence of specific attentional bias in patients with PD. PMID:23326197

  20. Assessment and management of anxiety disorders in children and adolescents.

    PubMed

    Creswell, Cathy; Waite, Polly; Cooper, Peter J

    2014-07-01

    Anxiety disorders in childhood and adolescence are extremely common and are often associated with lifelong psychiatric disturbance. Consistent with DSM-5 and the extant literature, this review concerns the assessment and treatment of specific phobias, separation anxiety disorder, generalised anxiety disorder, social anxiety disorder, panic disorder and agoraphobia. Evidence-based psychological treatments (cognitive behaviour therapy; CBT) for these disorders have been developed and investigated, and in recent years promising low-intensity versions of CBT interventions have been proposed that offer a means to increase access to evidence-based treatments. There is some evidence of effectiveness of pharmacological treatments for anxiety disorders in children and young people, however, routine prescription is not recommended due to concerns about potential harm. PMID:24636957

  1. Anxiety and mood disorder in young males with mitral valve prolapse

    PubMed Central

    Lung, For-Wey; Cheng, Chih-Tao; Chang, Wei-To; Shu, Bih-Ching

    2008-01-01

    Objective This study explored the prevalence of panic disorder and other psychiatric disorders in young Han Chinese males with mitral valve prolapse (MVP). With the factors of age, sex, and ethnicity controlled, the specific role of MVP in panic disorder was analyzed. Methods Subjects with chest pain aged between 18 and 25 years were assessed with the echocardiograph for MVP and the Chinese version of the Mini-International Neuropsychiatric Interview for panic disorder (n = 39). Results Of the 39 participants, 35.9% met the diagnosis of anxiety disorder, 46.2% met at least one criterion of anxiety disorder, and 23.1% met the diagnostic criteria of major depressive disorder. There was no statistically significant difference in the prevalence of panic disorder between one of the (8.3%) MVP patients, and two (7.4%) control participants. Conclusions There is a high prevalence of psychiatric disorder, including anxiety disorder and major depressive disorder, in those who report pain symptoms, so that diagnosis and treatment of these patients is of great importance. In addition, individuals with MVP did not have an increased risk for panic disorder. Whether MVP may be a modifier or mediating factor for panic disorder needs to be further assessed in a larger scale study. PMID:21197339

  2. Emotion Dysregulation in Generalized Anxiety Disorder: A Comparison with Social Anxiety Disorder

    Microsoft Academic Search

    Cynthia L. Turk; Richard G. Heimberg; Jane A. Luterek; Douglas S. Mennin; David M. Fresco

    2005-01-01

    From an emotion regulation framework, generalized anxiety disorder (GAD) can be conceptualized as a syndrome involving heightened intensity of subjective emotional experience, poor understanding of emotion, negative reactivity to emotional experience, and the use of maladaptive emotion management strategies (including over-reliance on cognitive control strategies such as worry). The current study sought to replicate previous findings of emotion dysregulation among

  3. Eating disorder symptoms among female anxiety disorder patients in clinical practice

    Microsoft Academic Search

    Carolyn Black Becker; Jason C DeViva; Claudia Zayfert

    2004-01-01

    This exploratory study investigated the relationship between anxiety disorders, anxiety comorbidity, and eating disorder (ED) symptoms in clinical practice, and examined the naturalistic detection of ED when diagnoses were based on the Anxiety Disorders Interview Schedule (ADIS). Two hundred and fifty-seven female patients completed an ED questionnaire and were assessed with the ADIS. Although ED frequency did not differ among

  4. Does generalized anxiety disorder predict coronary heart disease risk factors independently of major depressive disorder?

    Microsoft Academic Search

    Steven D. Barger; Sumner J. Sydeman

    2005-01-01

    BackgroundAnxiety symptoms are associated with elevated coronary heart disease (CHD) risk, but it is not known whether such associations extend to anxiety disorders or if they are independent of depression. We sought to determine if generalized anxiety disorder is associated with elevated CHD risk, and whether this association is independent of or interacts with major depressive disorder.

  5. Anxiety Disorders in Children and Adolescents with Autistic Spectrum Disorders: A Meta-Analysis

    ERIC Educational Resources Information Center

    van Steensel, Francisca J. A.; Bogels, Susan M.; Perrin, Sean

    2011-01-01

    There is considerable evidence that children and adolescents with autistic spectrum disorders (ASD) are at increased risk of anxiety and anxiety disorders. However, it is less clear which of the specific DSM-IV anxiety disorders occur most in this population. The present study used meta-analytic techniques to help clarify this issue. A systematic…

  6. Attention Modification Program in Individuals With Generalized Anxiety Disorder

    Microsoft Academic Search

    Nader Amir; Courtney Beard; Michelle Burns; Jessica Bomyea

    2009-01-01

    Research suggests that individuals with generalized anxiety disorder (GAD) show an attention bias for threat-relevant information. However, few studies have examined the causal role of attention bias in the maintenance of anxiety and whether modification of such biases may reduce pathological anxiety symptoms. In the present article, the authors tested the hypothesis that an 8-session attention modification program would (a)

  7. Anxiety is associated with impulsivity in bipolar disorder

    Microsoft Academic Search

    Charles T. Taylor; Dina R. Hirshfeld-Becker; Michael J. Ostacher; Candice W. Chow; Richard T. LeBeau; Mark H. Pollack; Andrew A. Nierenberg; Naomi M. Simon

    2008-01-01

    Impulsivity and anxiety, common features of bipolar disorder (BD), are each associated with a number of negative outcomes in BD. The relationship between anxiety and impulsivity, however, has not been a focus of study in BD. In this paper, we present data regarding the association between anxiety and impulsivity as measured by the Barratt impulsiveness scale (BIS-11) in 114 outpatients

  8. Adult Separation Anxiety Disorder: A Disorder Comes of Age

    Microsoft Academic Search

    Vijaya Manicavasagar; Claire Marnane; Stefano Pini; Marianna Abelli; Susan Rees; Valsa Eapen; Derrick Silove

    2010-01-01

    This article explores accruing evidence supporting the occurrence of an adult form of separation anxiety disorder (ASAD),\\u000a a category yet to be recognized by international classification systems. ASAD can have its first onset in adulthood, although\\u000a in a portion of cases, it represents a persistence or recurrence of the childhood-onset type. Recent large-scale clinic studies\\u000a have suggested that ASAD is

  9. Are there specific metacognitive processes associated with anxiety disorders in youth?

    PubMed Central

    Bacow, Terri Landon; May, Jill Ehrenreich; Brody, Leslie R; Pincus, Donna B

    2010-01-01

    While Wells’ metacognitive model of generalized anxiety disorder (GAD) posits that certain metacognitive processes, such as negative meta-worry (negative beliefs about worry), are more strongly associated with symptoms of GAD than other anxiety disorders in adults, research has yet to determine whether the same pattern is true for younger individuals. We examined the relationship between several metacognitive processes and anxiety disorder diagnostic status in a sample of 98 youth aged 7–17 years. Twenty youth with GAD were compared with similarly sized groups of youth with obsessive-compulsive disorder (OCD, n = 18), social phobia (SOC, n = 20), separation anxiety disorder (SAD, n = 20), and healthy controls who were not patients (NONP, n = 20) using a self-report measure of metacognition adapted for use with young people in this age range (Metacognitions Questionnaire for Children). Contrary to expectations, only one specific metacognitive process was significantly associated with an anxiety disorder diagnosis, in that the controls endorsed a greater degree of cognitive monitoring (self-reported awareness of one’s thoughts) than those with SAD. In addition, there was a trend indicating that nonpatients scored higher than youth with GAD on this scale. These surprising results suggest potentially differing patterns in the relationships between symptoms and metacognitive awareness in anxious youth, depending on the type of anxiety disorder presentation. PMID:22110332

  10. Anxiety Disorders in Primary Care: Prevalence, Impairment, Comorbidity, and Detection

    Microsoft Academic Search

    Kurt Kroenke; Robert L. Spitzer; Janet B. W. Williams; Patrick O. Monahan; Bernd Lowe

    2007-01-01

    Results: Of the 965 patients, 19.5% (95% CI, 17.0% to 22.1%) had at least 1 anxiety disorder, 8.6% (CI, 6.9% to 10.6%) had posttraumatic stress disorder, 7.6% (CI, 5.9% to 9.4%) had a generalized anxiety disorder, 6.8% (CI, 5.3% to 8.6%) had a panic disorder, and 6.2% (CI, 4.7% to 7.9%) had a social anxiety dis- order. Each disorder was

  11. Journal of Anxiety Disorders 27 (2013) 619626 Contents lists available at ScienceDirect

    E-print Network

    Barrett, Lisa Feldman

    2013-01-01

    of Anxiety Disorders Smiles may go unseen in generalized social anxiety disorder: Evidence from binocular to negative social cues and reduced attention to positive social cues in generalized social anxiety disorder People with generalized social anxiety disorder (GSAD) expe- rience pervasive anxiety in social

  12. Cost of anxiety disorders in Japan in 2008: a prevalence-based approach

    PubMed Central

    2013-01-01

    Background The societal burden caused by anxiety disorders has likely been underestimated, while those for schizophrenia and depression have received more attention. Anxiety disorders represent a significant illness category that occurs at a high prevalence and poses a considerable burden. However, the cost of anxiety disorders in Japan has not yet been well researched. The goal of the present study was to estimate the total cost of anxiety disorders in Japan and to clarify the characteristics of this burden. Method A prevalence-based approach was adopted to measure the total cost of anxiety disorders. Anxiety disorders were defined as diagnosis code F40.0-F41.9 according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision. The cost was comprised of the following components: medical treatment costs and social service costs as direct costs, and morbidity and mortality costs as indirect costs. Data were collected from publicly available statistics. Results The total cost of anxiety disorders in Japan in 2008 was JPY 2.4 trillion (US$ 20.5 billion at the current exchange rate of US$1?=?JPY 116.8). The direct cost was JPY 50 billion. The morbidity cost was JPY 2.1 trillion, while the mortality cost was JPY 0.24 trillion. Conclusions The social burden caused by anxiety disorders in Japan is tremendous and is similar to that of other mental disorders. Productivity loss in the workplace represents the largest portion of all the cost components. Because the medical examination rate is quite low, the improvement of healthcare access might contribute to cost mitigation. PMID:24350841

  13. Preliminary Investigation of Intolerance of Uncertainty Treatment for Anxiety Disorders

    ERIC Educational Resources Information Center

    Hewitt, Sarah N.; Egan, Sarah; Rees, Clare

    2009-01-01

    Intolerance of uncertainty (IU) is the tendency to react negatively to uncertain situations or events, and it has been found to be an important maintaining factor in a number of different anxiety disorders. It is often included as a part of cognitive behavioural interventions for anxiety disorders but its specific contribution to treatment outcome…

  14. Cognitive Bias in Adolescents With Social Anxiety Disorder

    Microsoft Academic Search

    Alyssa A. Rheingold; James D. Herbert; Martin E. Franklin

    2003-01-01

    Judgmental biases for threat-relevant stimuli are thought to be important mechanisms underlying the etiology and maintenance of anxiety disorders. Previous research has shown that adults with social anxiety disorder rate negative social events as more likely (probability) to occur as well as more distressing (cost) than do nonanxious controls. However, no empirical research has examined whether this is also the

  15. Conceptual Relations between Anxiety Disorder and Fearful Temperament

    ERIC Educational Resources Information Center

    Rapee, Ronald M.; Coplan, Robert J.

    2010-01-01

    Fearful temperaments have been identified as a major risk factor for anxiety disorders. However, descriptions of fearful temperament and several forms of anxiety disorder show strong similarities. This raises the question whether these terms may simply refer to different aspects of the same underlying construct. The current review examines…

  16. Anxiety Disorders in Childhood: Casting a Nomological Net

    ERIC Educational Resources Information Center

    Weems, Carl F.; Stickle, Timothy R.

    2005-01-01

    Empirical research highlights the need for improving the childhood anxiety disorder diagnostic classification system. In particular, inconsistencies in the stability estimates of childhood anxiety disorders and high rates of comorbidity call into the question the utility of the current "DSM" criteria. This paper makes a case for utilizing a…

  17. Generalized Anxiety Disorder in Referred Children and Adolescents.

    ERIC Educational Resources Information Center

    Masi, Gabriele; Millepiedi, Stefania; Mucci, Maria; Poli, Paola; Bertini, Nicoletta; Milantoni, Luca

    2004-01-01

    Objective: There are insufficient data on generalized anxiety disorder in children and adolescents. Symptoms and comorbidity of generalized anxiety disorder are described as a function of age, gender, and comorbidity in a consecutive series of referred children and adolescents. Method: One hundred fifty-seven outpatients (97 males and 60 females,…

  18. Effect of juggling therapy on anxiety disorders in female patients

    Microsoft Academic Search

    Toshihiro Nakahara; Kazuhiko Nakahara; Miho Uehara; Ken-ichiro Koyama; Kouha Li; Toshiro Harada; Daisuke Yasuhara; Hikaru Taguchi; Sinya Kojima; Ken-ichiro Sagiyama; Akio Inui

    2007-01-01

    AIMS: The aim of this study was to investigate the effect of juggling therapy for anxiety disorder patients. DESIGN AND METHOD: Subjects were 17 female outpatients who met the DSM-IV diagnostic criteria for anxiety disorders. Subjects were treated with standard psychotherapy, medication and counseling for 6 months. For the last 3 months of treatment, subjects were randomized into either a

  19. Hemispheric Laterality and Memory Bias for Threat in Anxiety Disorders

    Microsoft Academic Search

    2000-01-01

    The authors examined auditory perceptual asymmetries and explicit memory biases for threat in patients with panic disorder and generalized anxiety disorder relative to healthy control subjects. They did not find a greater explicit memory bias for threat in the anxiety patients. However, explicit memory biases for threat were associated with perceptual asymmetry scores; patients with a greater right-ear (left hemisphere)

  20. The Neurocircuitry of Fear, Stress, and Anxiety Disorders

    Microsoft Academic Search

    Lisa M Shin; Israel Liberzon

    2010-01-01

    Anxiety disorders are a significant problem in the community, and recent neuroimaging research has focused on determining the brain circuits that underlie them. Research on the neurocircuitry of anxiety disorders has its roots in the study of fear circuits in animal models and the study of brain responses to emotional stimuli in healthy humans. We review this research, as well

  1. Anxiety and Panic Disorders in Older Adults Sharon

    Microsoft Academic Search

    M. Valente

    1999-01-01

    Despite the growing numbers of older adults in the home health care system, those who suffer from anxiety disorders often are not detected or effectively treated. Untreated anxiety disorders reduce the patient's quality of life, activities of daily living, and compliance with treatment. In worse cases, the patient may decide that life is not worth living and may contemplate suicide.

  2. Friendship quality predicts treatment outcome in children with anxiety disorders.

    PubMed

    Baker, J R; Hudson, J L

    2013-01-01

    It was examined whether friendship quality (FQ) and friends' anxiety predicted treatment outcome in 116 children with anxiety disorders (72.3% Australian) receiving cognitive behavioural therapy (CBT). Target children and an identified close friend aged between 7 and 13 years (50% female) completed the Friendship Quality Questionnaire (Parker & Asher, 1993) before treatment, and child diagnoses were based on the Anxiety Disorders Interview Schedule for DSM-IV-Child/Parent Version (Silverman & Albano, 1996). Children who reported higher FQ were significantly more likely to be free of their initial primary anxiety disorder and of any anxiety disorder at posttreatment and 6-month follow-up; friend report of FQ and friend's anxiety as measured by the Spence Child Anxiety Scale (Spence, 1998) did not predict treatment outcome. Children with anxiety disorders reporting higher FQ responded better to CBT than children with anxiety disorders reporting lower FQ. FQ measures could help identify anxious children at heightened risk of poor treatment response. Further, good quality friendships may be an important aid in anxious children's treatment response. PMID:23178676

  3. Increased activity of frontal and limbic regions to emotional stimuli in children at-risk for anxiety disorders.

    PubMed

    Christensen, Rhandi; Van Ameringen, Michael; Hall, Geoffrey

    2015-07-30

    Neuroimaging studies of children with anxiety disorders are limited, and no study has examined children who are at increased risk for developing anxiety disorders based on parental anxiety. The objective of this study was to examine the function of frontal and limbic brain regions using functional magnetic resonance imaging (fMRI) in children at risk for anxiety disorders. Study participants included high-risk children (n=20) who had at least one parent with a primary diagnosis of social anxiety disorder and normal-risk control children (n=19). Using fMRI, we measured the blood oxygenation level dependent response while high-risk and normal-risk children were exposed to different emotional facial stimuli. We found greater activation of frontal, temporal and limbic regions in high-risk children relative to normal-risk children during the presentation of emotional stimuli (angry and happy). These regions included the prefrontal cortex, anterior cingulate, hippocampus and insula. Our within-group analysis revealed similar patterns of hyperactivity in high-risk children with and without current anxiety symptoms. To our knowledge, this is the first study to demonstrate functional alterations in emotion-processing brain regions in children who are at risk for anxiety disorders based on parental anxiety. These findings are consistent with previous fMRI studies of pediatric anxiety and behaviorally inhibited children, and they contribute to our understanding of the neural correlates of risk for anxiety disorders. PMID:25978933

  4. The Risk for Early-Adulthood Anxiety and Depressive Disorders in Adolescents With Anxiety and Depressive Disorders

    Microsoft Academic Search

    Daniel S. Pine; Patricia Cohen; Diana Gurley; Judith Brook; Yuju Ma

    1998-01-01

    Background: Various studies find relationships among anxiety and depressive disorders of adoles- cence and adulthood. This study prospectively exam- ines the magnitude of longitudinal associations between adolescent and adult anxiety or depressive disorders. Methods: An epidemiologically selected sample of 776 young people living in upstate New York received DSM- based psychiatric assessments in 1983, 1985, and 1992 using structured interviews.

  5. Broadening the definition of generalized anxiety disorder: Effects on prevalence and associations with other disorders in the National Comorbidity Survey Replication

    Microsoft Academic Search

    Ayelet Meron Ruscio; Wai Tat Chiu; Peter Roy-Byrne; Paul E. Stang; Dan J. Stein; Hans-Ulrich Wittchen; Ronald C. Kessler

    2007-01-01

    Concerns have been raised that the DSM-IV requirements of 6-month duration, excessive worry, and three associated symptoms exclude a substantial number of people with clinically significant anxiety from a diagnosis of generalized anxiety disorder (GAD). We examined the implications of relaxing these three criteria for the estimated prevalence and predictive validity of GAD using nationally representative data from the US

  6. Generalized anxiety disorder and major depressive disorder comorbidity: an example of genetic pleiotropy?

    Microsoft Academic Search

    P. Gorwood

    2004-01-01

    Generalized anxiety disorder (GAD) and major depressive disorder (MDD) are the most common type of anxiety-mood comorbidity. Up to 80% of subjects with lifetime GAD also have a comorbid mood disorder during their lifetime. Many hypotheses have been raised to explain such high comorbidity. Pleiotropy, i.e. a single genetic mutation explains (apparently) different disorders, is one of them and is

  7. [Borderline personality disorders: diagnosis and treatment].

    PubMed

    Allilaire, Jean-François

    2012-10-01

    Borderline personality disorders are complex clinical states with highly polymorphic symptoms and signs, leading to delays in their diagnosis and treatment. All international classifications emphasize certain clinical criteria such as unstable identity and interpersonal relationships, feelings of emptiness or boredom, and pathological impulsiveness. The prevalence is about 2%, with a female-male sex ratio of 2 or 3 to 1. Both adolescents and adults may be affected There is a high risk of suicide, addictive behaviors, eating disorders, and criminality. These individuals frequently have a history of trauma in early childhood, such as separation, loss, physical or sexual abuse, or affective privation. Subjective signs and symptoms are particularly important in the diagnostic and therapeutic evaluation, and this requires an empathic and subtle approach. Standardized and semi-structured interviews may help to identify comorbidities such as thymic disorders, anxiety, addiction, eating disorders, and, in some cases, psychotic symptoms. The psychiatric bio-psycho-social model takes into account multiple pathogenic factors, such as trauma during early development, temperamental instability and other emotional disorders, as well as psychosocial, neurobiological (5HT etc.) and genetic vulnerabilities. Treatment requires optimal integration of psychotherapeutic and pharmacotherapeutic approaches. Emergency intervention must be available in case of delirious or suicidal behavior The clinical course is often lengthy and complex, but outcome may be favorable, provided the principal risk--suicide--is correctly managed, PMID:23815019

  8. Mood & Anxiety Disorders Huys et al. Biology of Mood & Anxiety Disorders 2013, 3:12

    E-print Network

    Dayan, Peter

    to disentangle these factors with respect to anhedonia in the context of stress, Major Depressive Disorder (MDD diagnosis of major depressive disorder (MDD; [1-3]) and refers to an inability to experience pleasure-based reinforcement learning meta-analysis for dissecting anhedonic behavior. Keywords: Anhedonia, Major depressive

  9. Comorbid Depressive Disorders in Anxiety-Disordered Youth: Demographic, Clinical, and Family Characteristics

    ERIC Educational Resources Information Center

    O'Neil, Kelly A.; Podell, Jennifer L.; Benjamin, Courtney L.; Kendall, Philip C.

    2010-01-01

    Research indicates that depression and anxiety are highly comorbid in youth. Little is known, however, about the clinical and family characteristics of youth with principal anxiety disorders and comorbid depressive diagnoses. The present study examined the demographic, clinical, and family characteristics of 200 anxiety-disordered children and…

  10. Pediatric anxiety disorders: from neuroscience to evidence-based clinical practice.

    PubMed

    Salum, Giovanni Abrahão; Desousa, Diogo Araújo; do Rosário, Maria Conceição; Pine, Daniel Samuel; Manfro, Gisele Gus

    2013-01-01

    The objective of this narrative review of the literature is to describe the epidemiology, etiology, pathophysiology, diagnosis, and treatment of pediatric anxiety disorders. We aim to guide clinicians in understanding the biology of anxiety disorders and to provide general guidelines for the proper diagnoses and treatment of these conditions early in life. Anxiety disorders are prevalent, associated with a number of negative life outcomes, and currently under-recognized and under-treated. The etiology involves both genes and environmental influences modifying the neural substrate in a complex interplay. Research on pathophysiology is still in its infancy, but some brain regions, such as the amygdala and the prefrontal cortex, have been implicated in fear and anxiety. Current practice is to establish diagnosis based purely on clinical features, derived from clinical interviews with the child, parents, and teachers. Treatment is effective using medication, cognitive behavioral therapy, or a combination of both. An introduction to the neuroscience behind anxiety disorders combined with an evidence-based approach may help clinicians to understand these disorders and treat them properly in childhood. PMID:24142122

  11. Dimensions of perfectionism across the anxiety disorders.

    PubMed

    Antony, M M; Purdon, C L; Huta, V; Swinson, R P

    1998-12-01

    To explore the role of perfectionism across anxiety disorders, 175 patients with either panic disorder (PD), obsessive compulsive disorder (OCD), social phobia, or specific phobia, as well as 49 nonclinical volunteers, completed two measures [Frost, R. O., Marten, P., Lahart, C., & Rosenblate, R., (1990). The dimensions of perfectionism. Cognitive Therapy and Research, 14, 449-468; Hewitt, P. L., & Flett, G. L., (1991). Perfectionism in the self and social contexts: Conceptualization, assessment and association with psychopathology. Journal of Personality and Social Psychology, 60, 456-470.] that assess a total of nine different dimensions of perfectionism. Relative to the other groups, social phobia was associated with greater concern about mistakes (CM), doubts about actions (DA), and parental criticism (PC) on one measure and more socially prescribed perfectionism (SP) on the other measure. OCD was associated with elevated DA scores relative to the other groups. PD was associated with moderate elevations on the CM and DA subscales. The remaining dimensions of perfectionism failed to differentiate among groups. The clinical implications of these findings are discussed. PMID:9745799

  12. The Screen for Child Anxiety Related Emotional Disorders (SCARED) and traditional childhood anxiety measures.

    PubMed

    Muris, P; Merckelbach, H; Mayer, B; van Brakel, A; Thissen, S; Moulaert, V; Gadet, B

    1998-12-01

    The Screen for Child Anxiety Related Emotional Disorders (SCARED) is a self-report questionnaire that measures symptoms of DSM-IV linked anxiety disorders in children. This article presents two studies that investigated the relationship between the SCARED, on the one hand, and two other widely used anxiety measures for children, namely the Revised Children's Manifest Anxiety Scale (RCMAS) and the Fear Survey Schedule for Children-Revised (FSSC-R), on the other hand. Results indicate that SCARED scores are positively and in a theoretically meaningful way related to RCMAS and FSSC-R scores, and thus provide evidence for the concurrent validity of the SCARED. PMID:10037229

  13. The Screen for Child Anxiety Related Emotional Disorders (SCARED): Relationship with anxiety and depression in normal children

    Microsoft Academic Search

    Peter Muris; Harald Merckelbach; Anneke van Brakel; Birgit Mayer; Lieke van Dongen

    1998-01-01

    The current article presents two studies that investigated the concurrent validity of the Screen for Child Anxiety Related Emotional Disorders (SCARED), a self-report questionnaire that measures symptoms of DSM-IV linked anxiety disorders in children. Study 1 (N = 68) addressed the connection between the SCARED, on the one hand, and state anxiety and trait anxiety as indexed by the Spielberger

  14. Anxiety disorders and inflammation in a large adult cohort

    PubMed Central

    Vogelzangs, N; Beekman, A T F; de Jonge, P; Penninx, B W J H

    2013-01-01

    Although anxiety disorders, like depression, are increasingly being associated with metabolic and cardiovascular burden, in contrast with depression, the role of inflammation in anxiety has sparsely been examined. This large cohort study examines the association between anxiety disorders and anxiety characteristics with several inflammatory markers. For this purpose, persons (18–65 years) with a current (N=1273) or remitted (N=459) anxiety disorder (generalized anxiety disorder, social phobia, panic disorder, agoraphobia) according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria and healthy controls (N=556) were selected from the Netherlands Study of Depression and Anxiety. In addition, severity, duration, age of onset, anxiety subtype and co-morbid depression were assessed. Inflammatory markers included C-reactive protein (CRP), interleukin (IL)-6 and tumor-necrosis factor (TNF)-?. Results show that after adjustment for sociodemographics, lifestyle and disease, elevated levels of CRP were found in men, but not in women, with a current anxiety disorder compared with controls (1.18 (s.e.=1.05) versus 0.98 (s.e.=1.07) mg?l?1, P=0.04, Cohen's d=0.18). No associations were found with IL-6 or TNF-?. Among persons with a current anxiety disorder, those with social phobia, in particular women, had lower levels of CRP and IL-6, whereas highest CRP levels were found in those with an older age of anxiety disorder onset. Especially in persons with an age of onset after 50 years, CRP levels were increased compared with controls (1.95 (s.e.=1.18) versus 1.27 (s.e.=1.05) mg?l?1, P=0.01, Cohen's d=0.37). In conclusion, elevated inflammation is present in men with current anxiety disorders. Immune dysregulation is especially found in persons with a late-onset anxiety disorder, suggesting the existence of a specific late-onset anxiety subtype with a distinct etiology, which could possibly benefit from alternative treatments. PMID:23612048

  15. Cardiovascular disease in persons with depressive and anxiety disorders

    PubMed Central

    Vogelzangs, Nicole; Seldenrijk, Adrie; Beekman, Aartjan TF; van Hout, Hein PJ; de Jonge, Peter; Penninx, Brenda WJH

    2010-01-01

    Background Associations between depression, and possibly anxiety, with cardiovascular disease have been established in the general population and among heart patients. This study examined whether cardiovascular disease was more prevalent among a large cohort of depressed and/or anxious persons. In addition, the role of specific clinical characteristics of depressive and anxiety disorders in the association with cardiovascular disease was explored. Methods Baseline data from the Netherlands Study of Depression and Anxiety were used, including persons with a current (i.e. past year) or remitted DSM-IV depressive or anxiety disorder (N=2315) and healthy controls (N=492). Additional clinical characteristics (subtype, duration, severity, psychoactive medication) were assessed. Cardiovascular disease (stroke and coronary heart disease) was assessed using algorithms based on self-report and medication use. Results Persons with current anxiety disorders showed an about three-fold increased prevalence of coronary heart disease (OR anxiety only=2.70, 95%CI=1.31–5.56; OR comorbid anxiety/depression=3.54, 95%CI=1.79–6.98). No associations were found for persons with depressive disorders only or remitted disorders, nor for stroke. Severity of depressive and anxiety symptoms - but no other clinical characteristics - most strongly indicated increased prevalence of coronary heart disease. Limitations Cross-sectional design. Conclusions Within this large psychopathology-based cohort study, prevalence of coronary heart disease was especially increased among persons with anxiety disorders. Increased prevalence of coronary heart disease among depressed persons was largely owing to comorbid anxiety. Anxiety - alone as well as comorbid to depressive disorders - as risk indicator of coronary heart disease deserves more attention in both research and clinical practice. PMID:20223521

  16. Experience and appraisal of worry among high worriers with and without generalized anxiety disorder

    Microsoft Academic Search

    Ayelet Meron Ruscio; T. D. Borkovec

    2004-01-01

    Recent research has revealed that a large number of highly worried individuals do not qualify for a diagnosis of generalized anxiety disorder (GAD). This raises the intriguing question of why some high worriers are more impaired and distressed by their worrying than others, particularly when the severity of their worry is the same. The present investigation sought to address this

  17. Comorbid Depressive Disorders in Anxiety-disordered Youth: Demographic, Clinical, and Family Characteristics

    Microsoft Academic Search

    Kelly A. O’Neil; Jennifer L. Podell; Courtney L. Benjamin; Philip C. Kendall

    2010-01-01

    Research indicates that depression and anxiety are highly comorbid in youth. Little is known, however, about the clinical\\u000a and family characteristics of youth with principal anxiety disorders and comorbid depressive diagnoses. The present study\\u000a examined the demographic, clinical, and family characteristics of 200 anxiety-disordered children and adolescents (aged 7–17)\\u000a with and without comorbid depressive disorders (major depressive disorder or dysthymic

  18. Brief Cognitive Behavior Therapy in Patients with Social Anxiety Disorder: A Preliminary Investigation

    PubMed Central

    Pinjarkar, Ravikant G; Sudhir, Paulomi M; Math, Suresh Bada

    2015-01-01

    Context: Cognitive behavior therapy (CBT) is the treatment of choice in anxiety disorders. However, there is little evidence for the effectiveness brief CBT in social anxiety. Aims: We examined the effectiveness of a brief CBT of six sessions in patients with social anxiety disorder. Settings and Design: A single case design study baseline; post and 1 month follow-up was adopted. Materials and Methods: Seven patients with a DSM IV diagnosis of social anxiety underwent 6 weekly sessions of brief CBT. Their diagnosis was confirmed using structured diagnostic interviews. They were assessed at baseline, post and 1-month follow-up on CGI- Severity, Leibowitz Social Anxiety Scale (LSAS), Social Phobia Rating Scale, Brief Fear of Negative Evaluation, and Beck's Depression Inventory. Statistical Analysis: Data were analyzed using the method of clinical significance. Results: Results indicated that brief CBT was effective in reducing social anxiety in all patients. Brief CBT was also effective in reducing social avoidance and self consciousness. However, brief CBT was not effective in reducing fear of negative evaluation in all patients, suggesting the need for longer duration for cognitive changes in some dysfunctional beliefs. Conclusions: This preliminary case series indicates that brief CBT may be a promising and a cost and time effective approach to managing for social anxiety. PMID:25722507

  19. Assessing excessive reassurance seeking in the anxiety disorders.

    PubMed

    Rector, Neil A; Kamkar, Katy; Cassin, Stephanie E; Ayearst, Lindsay E; Laposa, Judith M

    2011-10-01

    Reassurance seeking has long been hypothesized to be a key factor in the maintenance of anxiety within contemporary cognitive-behavioral approaches to the conceptualization and treatment of anxiety disorders. However, empirical studies have lagged due to the absence of a reliable and valid measure of reassurance seeking. The present study sought to develop and examine the psychometric properties of a theoretically derived measure of reassurance seeking in treatment-seeking participants with DSM-IV-TR (American Psychiatric Association, 2000) social phobia (n=116), generalized anxiety disorder (n=75), panic disorder with or without agoraphobia (n=50), and obsessive compulsive disorder (n=42). Participants (N=283) completed the Reassurance Seeking Scale (RSS), Depression Anxiety Stress Scale, Beck Anxiety Inventory, and Beck Depression Inventory-II. An exploratory factor analysis resulted in a coherent three factor solution reflecting the need to seek excessive reassurance regarding: (1) uncertainty about decisions, (2) attachment and the security of relationships, and (3) perceived general threat and anxiety. The RSS was found to possess good internal consistency and was moderately correlated with measures of anxiety, stress, and depression. The psychometric properties of the RSS appear promising for the promotion of programmatic research on reassurance seeking and its treatment in the anxiety disorders. PMID:21641764

  20. Adjunctive couple and family intervention for patients with anxiety disorders.

    PubMed

    Chambless, Dianne L

    2012-05-01

    Family-focused therapy for anxiety disorders (FFT-AD), a flexible couple/family treatment provided in conjunction with cognitive-behavioral therapy (CBT) for anxiety disorders, is described. The treatment is based upon research showing that anxious patients are more likely to drop out of or fare poorly in CBT when they live with a family member who is hostile toward or emotionally over-involved with the patient, accommodates excessively to the patient's anxiety, or is perceived by the patient to be destructively critical. An adaptation of FFT for bipolar disorder, the treatment is intended for patients with anxiety disorders, regardless of their specific disorder type. FFT-AD is illustrated with two cases. PMID:22504613

  1. The pharmacological management of childhood anxiety disorders: a review

    Microsoft Academic Search

    Shauna P. Reinblatt; Mark A. Riddle

    2007-01-01

    Rationale  Pediatric anxiety is a prevalent psychiatric disorder that may have important implications for school, social, and academic\\u000a function. Psychopharmacological approaches to the treatment of pediatric anxiety have expanded over the past 20 years and\\u000a increasing empirical evidence helps guide current clinical practice.\\u000a \\u000a \\u000a \\u000a Objective  To review studies which examine the pharmacological treatment of pediatric anxiety disorders, including obsessive–compulsive\\u000a disorder and to summarize treatment

  2. Threat-confirming belief bias and symptoms of anxiety disorders

    Microsoft Academic Search

    Maartje S. Vroling; Peter J. de Jong

    2010-01-01

    This study tested the hypothesis that a generally enhanced threat-confirming reasoning style would set people at risk for the development of anxiety disorders. Therefore, a non-clinical student sample (N=146) was presented with a series of linear syllogisms referring to threatening and safety themes and with the anxiety subscale of the SCL-90 and trait anxiety in order to correlate reasoning with

  3. On the physiological symptom constellation in youth with Generalized Anxiety Disorder (GAD)

    Microsoft Academic Search

    Philip C. Kendall; Sandra S. Pimentel

    2003-01-01

    To investigate the physiological symptom constellation of Generalized Anxiety Disorder (GAD)\\/Overanxious Disorder (OAD) in children, the present study examined parent and child reports. Children (N=47; aged 9–13) were evaluated to meet criteria for a diagnosis of GAD. Child physiological symptoms were assessed including: (a) inability to sit still\\/relax, (b) difficulty paying attention\\/concentrating, (c) irritability\\/getting upset easily, (d) muscle aches, and

  4. Anxiety and Quality of Life: Clinically Anxious Children With and Without Autism Spectrum Disorders Compared

    Microsoft Academic Search

    Francisca J. A. van Steensel; Susan M. Bögels; Carmen D. Dirksen

    2012-01-01

    Comorbid anxiety disorders are common in children with autism spectrum disorders (ASD). However, studies comparing children with ASD to clinically anxious children are rare. This study investigated anxiety problems and health-related quality of life in children with high-functioning ASD and comorbid anxiety disorders (referred to as the ASD group), compared with children with anxiety disorders (referred to as the AD

  5. Prevalence and demographics of anxiety disorders: a snapshot from a community health centre in Pakistan

    Microsoft Academic Search

    Hassan Khan; Saira Kalia; Ahmed Itrat; Abdullah Khan; Mahwash Kamal; Muhammad A Khan; Roha Khalid; Salman Khalid; Sunniya Javed; Sanniya Javed; Affan Umer; Haider Naqvi

    2007-01-01

    BACKGROUND: The developing world is faced with a high burden of anxiety disorders. The exact prevalence of anxiety disorders in Pakistan is not known. There is a need to develop an evidence base to aid policy development on tackling anxiety and depressive disorders in the country. This is the first pilot study to address the prevalence of anxiety disorders and

  6. Impact of parental history of substance use disorders on the clinical course of anxiety disorders

    Microsoft Academic Search

    Maria E Pagano; Richard Rende; Benjamin F Rodriguez; Eric L Hargraves; Amanda T Moskowitz; Martin B Keller

    2007-01-01

    BACKGROUND: Among the psychological difficulties seen in children of parents with substance use problems, the anxiety disorders are among the most chronic conditions. Although children of alcoholic parents often struggle with the effects of parental substance use problems long into adulthood, empirical investigations of the influence of parental substance use disorders on the course of anxiety disorders in adult offspring

  7. Methylphenidate and Comorbid Anxiety Disorder in Children with both Chronic Multiple Tic Disorder and ADHD

    ERIC Educational Resources Information Center

    Gadow, Kenneth D.; Nolan, Edith E.

    2011-01-01

    Objective: To determine if comorbid anxiety disorder is associated with differential response to immediate release methylphenidate (MPH-IR) in children with both ADHD and chronic multiple tic disorder (CMTD). Method: Children with (n = 17) and without (n = 37) diagnosed anxiety disorder (ANX) were evaluated in an 8-week, placebo-controlled trial…

  8. Cognitive–Behavioral Therapy for Anxiety Disordered Youth: A Randomized Clinical Trial Evaluating Child and Family Modalities

    Microsoft Academic Search

    Philip C. Kendall; Jennifer L. Hudson; Elizabeth Gosch; Ellen Flannery-Schroeder; Cynthia Suveg

    2008-01-01

    This randomized clinical trial compared the relative efficacy of individual (child) cognitive–behavioral therapy (ICBT), family cognitive–behavioral therapy (FCBT), and a family-based education\\/support\\/attention (FESA) active control for treating anxiety disordered youth ages 7–14 years (M = 10.27). Youth (N = 161; 44% female; 85% Caucasian, 9% African American, 3% Hispanic, 3% other\\/mixed) with a principal diagnosis of separation anxiety disorder, social

  9. Somatic Symptoms in Children and Adolescents with Anxiety Disorders

    ERIC Educational Resources Information Center

    Ginsburg, Golda S.; Riddle, Mark A.; Davies, Mark

    2006-01-01

    Objective: To evaluate the prevalence of somatic symptoms (SSs) in children and adolescents with anxiety disorders; the relationship between SSs and anxiety severity, impairment, and child global functioning; and the impact of fluvoxamine (FLV) versus pill placebo (PBO) on reducing SSs. Method: As part of a double-blind, placebo-controlled trial,…

  10. Adapting Manualized Treatments: Treating Anxiety Disorders Among Native Americans

    Microsoft Academic Search

    Tami De Coteau; Jessiline Anderson; Debra Hope

    2006-01-01

    Although there is a small but growing body of literature examining the psychopathology of anxiety among Native Americans, no data are available regarding the efficacy of empirically supported treatments for anxiety disorders among Native Americans. Moreover, exceptional challenges arise in adapting mainstream approaches to Native Americans, such as language barriers, contrasting beliefs about the cause and treatment of emotional illness

  11. Duloxetine in the treatment of generalized anxiety disorder

    Microsoft Academic Search

    Trevor R Norman; James S Olver

    2008-01-01

    Duloxetine, a medication with effects on both serotonin and noradrenaline transporter molecules, has recently been approved for the treatment of generalized anxiety disorder. The evidence for its effi cacy lies in a limited number of double blind, placebo controlled comparisons. Statistically signifi cant improvements in the Hamilton Anxiety Rating Scale from baseline were demonstrated in all studies at doses of

  12. Assessment and Treatment of Anxiety Disorders in Children and Adolescents

    PubMed Central

    Wehry, Anna M.; Beesdo-Baum, Katja; Hennelly, Meghann M.; Connolly, Sucheta D.; Strawn, Jeffrey R.

    2015-01-01

    Recent advances in the developmental epidemiology, neurobiology and treatment of pediatric anxiety disorders have increased our understanding of these conditions and herald improved outcomes for affected children and adolescents. This article reviews the current epidemiology, longitudinal trajectory, and neurobiology of anxiety disorders in youth. Additionally, we summarize the current evidence for both psychotherapeutic and psychopharmacologic treatments of fear-based anxiety disorders (e.g., generalized, social and separation anxiety disorders) in children and adolescents. Current data suggest that these disorders begin in childhood and adolescence, exhibit homotypic continuity and increase the risk of secondary anxiety and mood disorders. Psychopharmacologic trials involving selective serotonin reuptake inhibitors (SSRIs) and selective serotonin norepinephrine reuptake inhibitors (SSNRIs) are effective in pediatric patients with anxiety disorders and have generally demonstrated moderate effect sizes. Additionally, current data support cognitive-behavioral therapy (CBT) are efficacious in the treatment of these conditions in youth and that combination of CBT + an SSRI may be associated with greater improvement than would be expected with either treatment as monotherapy. PMID:25980507

  13. Treatment of separation, generalized, and social anxiety disorders in youths.

    PubMed

    Mohatt, Justin; Bennett, Shannon M; Walkup, John T

    2014-07-01

    Separation, generalized, and social anxiety disorders are common and impairing for children and adolescents. Childhood-onset anxiety disorders frequently persist into adulthood and place youths at risk for future psychiatric disorders, including mood and substance use disorders. Comorbidity is common in childhood anxiety disorders, and studies increasingly take this into account when assessing potential treatments. Existing studies support a number of pharmacological and psychotherapeutic treatments for childhood anxiety disorders. The strongest evidence supports use of selective serotonin reuptake inhibitors (SSRIs) and cognitive-behavioral therapy (CBT). Combination treatment with SSRIs and CBT has been found to be more effective than either treatment alone. Early detection and treatment of childhood anxiety disorders can prevent substantial impairment over the course of a child's development and accumulation of functional disability. Early treatment also may prevent later development of adult psychiatric illness. The authors review the treatment literature and present the case of an adolescent who is brought in for evaluation after years of untreated anxiety. PMID:24874020

  14. The Course of Psychological Disorders in the 1st Year After Cancer Diagnosis

    ERIC Educational Resources Information Center

    Kangas, Maria; Henry, Jane L.; Bryant, Richard A.

    2005-01-01

    This study investigated the relationship between acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) and comorbid anxiety, depressive, and substance use disorders over the first 12-month period following a cancer diagnosis. Individuals recently diagnosed with 1st onset head and neck or lung malignancy were assessed for ASD within…

  15. Family Cognitive Behavioral Therapy for Child Anxiety Disorders

    Microsoft Academic Search

    JEFFREY J. WOOD; JOHN C. PIACENTINI; MICHAEL SOUTHAM-GEROW; BRIAN C. CHU; MARIAN SIGMAN

    2006-01-01

    ObjectiveThis study compared family-focused cognitive behavioral therapy (CBT; the Building Confidence Program) with traditional child-focused CBT with minimal family involvement for children with anxiety disorders.

  16. The feasibility and acceptability of virtual environments in the treatment of childhood social anxiety disorder.

    PubMed

    Sarver, Nina Wong; Beidel, Deborah C; Spitalnick, Josh S

    2014-01-01

    Two significant challenges for the dissemination of social skills training programs are the need to assure generalizability and provide sufficient practice opportunities. In the case of social anxiety disorder, virtual environments may provide one strategy to address these issues. This study evaluated the utility of an interactive virtual school environment for the treatment of social anxiety disorder in preadolescent children. Eleven children with a primary diagnosis of social anxiety disorder between 8 to 12 years old participated in this initial feasibility trial. All children were treated with Social Effectiveness Therapy for Children, an empirically supported treatment for children with social anxiety disorder. However, the in vivo peer generalization sessions and standard parent-assisted homework assignments were substituted by practice in a virtual environment. Overall, the virtual environment programs were acceptable, feasible, and credible treatment components. Both children and clinicians were satisfied with using the virtual environment technology, and children believed it was a high-quality program overall. In addition, parents were satisfied with the virtual environment augmented treatment and indicated that they would recommend the program to family and friends. Findings indicate that the virtual environments are viewed as acceptable and credible by potential recipients. Furthermore, they are easy to implement by even novice users and appear to be useful adjunctive elements for the treatment of childhood social anxiety disorder. PMID:24144182

  17. CULTURE AND THE ANXIETY DISORDERS: RECOMMENDATIONS FOR DSM-V

    PubMed Central

    Lewis-Fernández, Roberto; Hinton, Devon E.; Laria, Amaro J.; Patterson, Elissa H.; Hofmann, Stefan G.; Craske, Michelle G.; Stein, Dan J.; Asnaani, Anu; Liao, Betty

    2015-01-01

    Background The anxiety disorders specified in the fourth edition, text revision, of The Diagnostic and Statistical Manual (DSM-IV-TR) are identified universally in human societies, and also show substantial cultural particularities in prevalence and symptomatology. Possible explanations for the observed epidemiological variability include lack of measurement equivalence, true differences in prevalence, and limited validity or precision of diagnostic criteria. One central question is whether, through inadvertent “over-specification” of disorders, the post-DSM-III nosology has missed related but somewhat different presentations of the same disorder because they do not exactly fit specified criteria sets. This review canvases the mental health literature for evidence of cross-cultural limitations in DSM-IV-TR anxiety disorder criteria. Methods Searches were conducted of the mental health literature, particularly since 1994, regarding cultural or race/ethnicity-related factors that might limit the universal applicability of the diagnostic criteria for six anxiety disorders. Results Possible mismatches between the DSM criteria and the local phenomenology of the disorder in specific cultural contexts were found for three anxiety disorders in particular. These involve the unexpectedness and 10-minute crescendo criteria in Panic Disorder; the definition of social anxiety and social reference group in Social Anxiety Disorder; and the priority given to psychological symptoms of worry in Generalized Anxiety Disorder. Limited evidence was found throughout, particularly in terms of neurobiological markers, genetic risk factors, treatment response, and other DSM-V validators that could help clarify the cross-cultural applicability of criteria. Conclusions On the basis of the available data, options and preliminary recommendations for DSM-V are put forth that should be further evaluated and tested. PMID:20037918

  18. Predictors and Moderators of Treatment Response in Childhood Anxiety Disorders: Results from the CAMS Trial

    PubMed Central

    Compton, Scott N.; Peris, Tara S.; Almirall, Daniel; Birmaher, Boris; Sherrill, Joel; Kendall, Phillip C.; March, John S.; Gosch, Elizabeth A.; Ginsburg, Golda S.; Rynn, Moira A.; Piacentini, John C.; McCracken, James T.; Keeton, Courtney P.; Suveg, Cynthia M.; Aschenbrand, Sasha G.; Sakolsky, Dara; Iyengar, Satish; Walkup, John T.; Albano, Anne Marie

    2014-01-01

    Objective To examine predictors and moderators of treatment outcomes among 488 youth ages 7-17 years (50% female; 74% ? 12 years) with DSM-IV diagnoses of separation anxiety disorder, social phobia, or generalized anxiety disorder who were randomly assigned to receive either cognitive behavior therapy (CBT), sertraline (SRT), their combination (COMB), or medication management with pill placebo (PBO) in the Child/Adolescent Anxiety Multimodal Study (CAMS). Method Six classes of predictor and moderator variables (22 variables) were identified from the literature and examined using continuous (Pediatric Anxiety Ratings Scale; PARS) and categorical (Clinical Global Impression Scale-Improvement; CGI-I) outcome measures. Results Three baseline variables predicted better outcomes (independent of treatment condition) on the PARS, including low anxiety severity (as measured by parents and independent evaluators) and caregiver strain. No baseline variables were found to predict week 12 responder status (CGI-I). Participant's principal diagnosis moderated treatment outcomes, but only on the PARS. No baseline variables were found to moderate treatment outcomes on week 12 responder status (CGI-I). Discussion Overall, anxious children responded favorably to CAMS treatments. However, having more severe and impairing anxiety, greater caregiver strain, and a principal diagnosis of social phobia were associated with less favorable outcomes. Clinical implications of these findings are discussed. PMID:24417601

  19. Conceptual relations between anxiety disorder and fearful temperament.

    PubMed

    Rapee, Ronald M; Coplan, Robert J

    2010-01-01

    Fearful temperaments have been identified as a major risk factor for anxiety disorders. However, descriptions of fearful temperament and several forms of anxiety disorder show strong similarities. This raises the question whether these terms may simply refer to different aspects of the same underlying construct. The current review examines evidence for the overlap and distinction between these constructs. Although strong conclusions cannot be drawn from the extant literature, the bulk of the evidence appears to support a distinction between them. PMID:20205179

  20. Primary headaches in patients with generalized anxiety disorder

    Microsoft Academic Search

    Juliane P. P. MercanteMario; Mario F. P. Peres; Márcio A. Bernik

    2011-01-01

    Although anxiety disorders and headaches are comorbid conditions, there have been no studies evaluating the prevalence of\\u000a primary headaches in patients with generalized anxiety disorder (GAD). The aim of this study was to analyze the lifetime prevalence\\u000a of primary headaches in individuals with and without GAD. A total of 60 individuals were evaluated: 30 GAD patients and 30\\u000a controls without

  1. Exploring the association between cognitive functioning and anxiety in children with autism spectrum disorders: the role of social understanding and aggression.

    PubMed

    Niditch, Laura A; Varela, R Enrique; Kamps, Jodi L; Hill, Trenesha

    2012-01-01

    This study examined relations between anxiety, aggression, social understanding, IQ, and diagnosis in a sample of 231 children (ages 2-9) diagnosed with Autism Spectrum Disorders (ASDs; Autistic Disorder, Asperger's Disorder, Pervasive Developmental Disorder Not Otherwise Specified) in a hospital setting. Children were administered tests of IQ, and parents completed measures of remaining variables. ASD diagnosis was associated with level of anxiety, and level of IQ explained this relation. IQ was significantly and positively associated with anxiety. Tests of a developmental model to explain the relation between IQ and anxiety showed that social understanding and aggression mediated the relation for toddlers. For preschool- and early elementary school-aged children, respectively, three-way interactions between IQ, social understanding, and aggression predicted anxiety, and graphs of the interactions suggest that the association between IQ and anxiety is increasingly driven by either aggression or social understanding over the course of childhood. PMID:22417187

  2. Parental Anxiety Disorders, Child Anxiety Disorders, and the Perceived Parent–Child Relationship in an Australian High-Risk Sample

    Microsoft Academic Search

    Erin B. McClure; Patricia A. Brennan; Constance Hammen; Robyne M. Le Brocque

    2001-01-01

    This study was designed to explore the role of perceived parenting behavior in the relationship between parent and offspring anxiety disorders in a high-risk sample of adolescents. We examined the relationship between parental and child anxiety disorders and tested whether perceived parenting behavior acted as a mediator between these variables. Analyses were performed on a high-risk sample of 816 fifteen-year-olds

  3. Parental Anxiety Disorders, Child Anxiety Disorders, and the Perceived Parent-Child Relationship in an Australian High-Risk Sample

    Microsoft Academic Search

    Erin B. McClure; Patricia A. Brennan; Constance Hammen; Robyne M. Le Brocque

    2001-01-01

    This study was designed to explore the role of perceived parenting behavior in the relationship between parent and offspring anxiety disorders in a high-risk sample of adolescents. We examined the relationship between parental and child anxiety disorders and tested whether perceived parenting behavior acted as a mediator between these variables. Analyses were performed on a high-risk sample of 816 fifteen-year-olds

  4. Anxiety disorders and anxiety-related traits and serotonin transporter gene-linked polymorphic region (5-HTTLPR) in adolescents: case-control and trio studies.

    PubMed

    Bortoluzzi, Andressa; Blaya, Carolina; Salum, Giovanni A; Cappi, Carolina; Leistner-Segal, Sandra; Manfro, Gisele G

    2014-08-01

    The role of the serotonin transporter gene-linked polymorphic region (5-HTTLPR) in anxiety disorder and anxiety-related traits is controversial. Besides this study, few studies have evaluated the triallelic genotype in adolescents. The aim of this study was to investigate whether anxiety disorders and anxiety-related traits are associated with 5-HTTLPR (biallelic and triallelic) in adolescents, integrating both case-control-based and family-based designs in a community sample. This is a cross-sectional community study of 504 individuals and their families: 225 adolescents (129 adolescents with anxiety disorder and 96 controls) and their biological families. We assessed psychiatric diagnosis using the Kiddie Schedule for Affective Disorders and Schizophrenia. The Temperament and Character Inventory and the Resnick Behavioral Inhibition Scale were used to evaluate harm avoidance and behavioral inhibition. DNA was extracted from saliva and genotyped, including biallelic and triallelic 5-HTTLPR classification, by PCR-RFLP followed by agarose gel electrophoresis. We were not able to find any associations between 5-HTTLPR and anxiety-related phenotypes in both case-control and trio analyses. Further investigation and meta-analytic studies are needed to better clarify the inconsistent results with regard to the association between 5-HTTLPR and anxiety-related phenotypes in adolescents. PMID:24842237

  5. COURSE OF COMORBID ANXIETY DISORDERS AMONG ADULTS WITH BIPOLAR DISORDER IN THE U.S. POPULATION

    PubMed Central

    Sala, Regina; Goldstein, Benjamin I.; Morcillo, Carmen; Liu, Shang-Min; Castellanos, Mariela; Blanco, Carlos

    2012-01-01

    OBJECTIVE To examine the prevalence and correlates of comorbid anxiety disorders among individuals with bipolar disorders (BP) and their association with prospectively ascertained comorbidities, treatment, and psychosocial functioning. METHOD As part of the National Epidemiologic Survey on Alcohol and Related Conditions, 1600 adults who met lifetime DSM-IV criteria for BP-I (n=1172) and BP-II (n=428) were included. Individuals were evaluated using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DMS-IV Version and data was analyzed from Waves 1 and 2, approximately 3 years apart. RESULTS Sixty percent of individuals with BP had at least one lifetime comorbid anxiety disorder. Individuals with BP and anxiety disorders shared lifetime risk factors for major depressive disorder and had prospectively more depressive and manic/hypomanic episodes, suicidal ideation, suicide attempts, and more treatment seeking than those without anxiety. During the follow-up, higher incidence of panic disorder, drug use disorders, and lower psychosocial functioning were found in individuals with BP with versus without anxiety disorders. CONCLUSIONS Anxiety disorders are prospectively associated with elevated BP severity and BP-related mental health service use. Early identification and treatment of anxiety disorders are warranted to improve the course and outcome of individuals with BP. PMID:22534180

  6. Testing a cognitive model of generalized anxiety disorder in the eating disorders

    Microsoft Academic Search

    Anna Konstantellou; Mari Campbell; Ivan Eisler; Mima Simic; Janet Treasure

    2011-01-01

    Generalized anxiety disorder (GAD) is one of the most common comorbid disorders found in individuals with eating disorders. Despite this, little is known of shared vulnerability factors between the two disorders. The aim of the present study was to examine the four main components of a cognitive model for GAD in the eating disorders. One hundred and sixty-two females took

  7. [Differential diagnosis between dissociative disorders and schizophrenia].

    PubMed

    Shibayama, Masatoshi

    2011-01-01

    The differential diagnosis of dissociative disorders includes many psychiatric disorders, such as schizophrenia, bipolar disorders (especially bipolar II disorder), depressive disorder (especially atypical depression), epilepsy, Asperger syndrome, and borderline personality disorder. The theme of this paper is the differential diagnosis between dissociative disorders and schizophrenia. Schneiderian first-rank symptoms in schizophrenia are common in dissociative disorders, especially in dissociative identity disorder (DID). Many DID patients have been misdiagnosed as schizophrenics and treated with neuroleptics. We compared and examined Schneiderian symptoms of schizophrenia and those of dissociative disorders from a structural viewpoint. In dissociative disorders, delusional perception and somatic passivity are not seen. "Lateness" and "Precedence of the Other" originated from the concept of "Pattern Reversal" (H. Yasunaga)" is characteristic of schizophrenia. It is important to check these basic structure of schizophrenia in subjective experiences in differential diagnosis between dissociative disorders and schizophrenia. PMID:22117396

  8. A randomized controlled trial of the child anxiety multi-day program (CAMP) for separation anxiety disorder.

    PubMed

    Santucci, Lauren C; Ehrenreich-May, Jill

    2013-06-01

    While the efficacy of cognitive behavior therapy for childhood anxiety disorders, including separation anxiety disorder (SAD), has been established, tailoring such treatments to particular interests and needs may enhance uptake of evidence-based interventions. The current investigation evaluates the feasibility and preliminary efficacy of an intensive, cognitive-behavioral intervention for girls with SAD provided within the novel context of a 1-week camp-like setting, the Child Anxiety Multi-Day Program (CAMP). Twenty-nine female children aged 7-12 with a principal diagnosis of SAD were randomized to immediate CAMP treatment (n = 15) or waitlist (i.e., delayed treatment; n = 14) condition during the course of this randomized controlled trial. Children in the immediate treatment group evidenced significant reductions in SAD severity, functional impairment, and parent report of child anxiety symptoms relative to the waitlist condition. The intervention's positive therapeutic response suggests one possible delivery model for surmounting difficulties faced in the dissemination of weekly treatments for SAD. PMID:23053618

  9. Depression and anxiety disorders in children and adolescents with velo-cardio-facial syndrome (VCFS).

    PubMed

    Fabbro, Alice; Rizzi, Eleonora; Schneider, Maude; Debbane, Martin; Eliez, Stephan

    2012-07-01

    Velo-cardio-facial syndrome (VCFS) is characterized by a high prevalence of depression and anxiety disorders in childhood and adolescence. These disorders are a source of great impairment in everyday functioning, as well as important risk factors for the emergence of later psychotic disorders. Impairment in daily and social functioning as well as loss of IQ throughout growth are also are well-established correlates of the VCFS. This study aimed to confirm the high prevalence of depression and anxiety disorders. The second objective was to ascertain the correlation between anxious and depressive symptoms and the decline in adaptive and cognitive functioning. A total of 73 children and adolescents with VCFS (mean age 11.9 years) underwent psychiatric evaluation. Subjects were further divided into four age groups: ages 6-9, 9-12, 12-15 and 15-18 years. Assessments measuring intelligence, anxious and depressive symptoms, and adaptation skills reported by parents were submitted to a subsample of 62 children (mean age 12.2 years); 62.2 % of the sample showed an anxiety disorder, specific phobia being the most represented at all ages. Lifetime depression concerned 27 % of the sample, peaking at age 12-15 years. Anxious and depressive symptoms and low IQ were significantly associated with low adaptive functioning. Anxiety and depression are common disorders in children and adolescents with VCFS and have a great impact on adaptive functioning. Clinicians should pay great attention to diagnosis and treatment. PMID:22526976

  10. Functional Neuroimaging of Anxiety: A Meta-Analysis of Emotional Processing in PTSD, Social Anxiety Disorder, and Specific Phobia

    Microsoft Academic Search

    Amit Etkin; Tor D. Wager

    2007-01-01

    Objective: The study of human anxiety disorders has benefited greatly from func- tional neuroimaging approaches. Individ- ual studies, however, vary greatly in their findings. The authors searched for com- mon and disorder-specific functional neu- robiological deficits in several anxiety dis- orders. The authors also compared these deficits to the neural systems engaged during anticipatory anxiety in healthy subjects. Method: Functional

  11. Schmidt’s syndrome presenting as a generalised anxiety disorder: a case report

    PubMed Central

    Anyfantakis, D; Symvoulakis, EK; Vourliotaki, I; Kastanakis, S

    2013-01-01

    Abstract Schmidt’s syndrome or autoimmune polyglandurar syndrome type 2 represents an uncommon endocrine disorder composed by Addison’s disease with autoimmune thyroid disease and/or type 1 diabetes mellitus. The syndrome usually affects women in the fourth decade of their lives. Prompt diagnosis and treatment can prevent serious complications. We present the case of a 64-year-old woman with generalised anxiety, facing socio-economic problems. Her symptoms attributed to stress led to a late diagnosis. Physicians involved have to be aware about endocrine disorders of which first manifestations may have atypical components mimicking mental health problems. PMID:24868260

  12. Exploring the Association between Cognitive Functioning and Anxiety in Children with Autism Spectrum Disorders: The Role of Social Understanding and Aggression

    ERIC Educational Resources Information Center

    Niditch, Laura A.; Varela, R. Enrique; Kamps, Jodi L.; Hill, Trenesha

    2012-01-01

    This study examined relations between anxiety, aggression, social understanding, IQ, and diagnosis in a sample of 231 children (ages 2-9) diagnosed with Autism Spectrum Disorders (ASDs; Autistic Disorder, Asperger's Disorder, Pervasive Developmental Disorder Not Otherwise Specified) in a hospital setting. Children were administered tests of IQ,…

  13. Enhancing exposure therapy for anxiety disorders, obsessive-compulsive disorder and post-traumatic stress disorder.

    PubMed

    McGuire, Joseph F; Lewin, Adam B; Storch, Eric A

    2014-08-01

    Translating findings from basic science, several compounds have been identified that may enhance therapeutic outcomes and/or expedite treatment gains when administered alongside exposure-based treatments. Four of these compounds (referred to as cognitive enhancers) have been evaluated in the context of randomized controlled trials for anxiety disorders (e.g., specific phobias, panic disorder, social anxiety disorder), obsessive-compulsive disorder and post-traumatic stress disorder. These cognitive enhancers include D-cycloserine, yohimbine hydrochloride, glucocorticoids and cortisol and brain-derived neurotrophic factor. There is consistent evidence that cognitive enhancers can enhance therapeutic outcomes and/or expedite treatment gains across anxiety disorders, obsessive-compulsive disorder and post-traumatic stress disorder. Emerging evidence has highlighted the importance of within-session fear habituation and between-session fear learning, which can either enhance fear extinction or reconsolidate of fear responses. Although findings from these trials are promising, there are several considerations that warrant further evaluation prior to widespread use of cognitive enhancers in exposure-based treatments. Consistent trial design and large sample sizes are important in future studies of cognitive enhancers. PMID:24972729

  14. Psychosocial Treatment Prescriptions for Generalized Anxiety Disorder, Panic Disorder, and Social Phobia, 1991-1996

    Microsoft Academic Search

    Robert M. Goisman; Meredith G. Warshaw; Martin B. Keller

    Objective: Pharmacologic prescriptions for anxiety disorders have changed significantly in the last decade. This article investigates whether psychosocial treatments, as reported by 362 subjects in the Harvard\\/Brown Anxiety Disorders Research Program from 1991 to 1996, changed as well. Method: Subjects were interviewed in 1991 and 1995-1996 to de- termine which psychosocial treatments (behavioral, cognitive, dynamic, or relaxation or meditation) they

  15. A comparison of intolerance of uncertainty in analogue obsessive-compulsive disorder and generalized anxiety disorder

    Microsoft Academic Search

    Robert M. Holaway; Richard G. Heimberg; Meredith E. Coles

    2006-01-01

    Intolerance of uncertainty has been defined as the unwillingness to tolerate the possibility that negative events may occur in the future, no matter how low the probability [Personality Individual Differences 17 (1994), 791–802]. Previous research suggests that intolerance of uncertainty may be more specific to worry and generalized anxiety disorder (GAD) than to other anxiety disorders [e.g., Dugas, M. J.,

  16. Lifetime anxiety disorders in women with bulimia nervosa

    Microsoft Academic Search

    Cynthia M Bulik; Patrick F Sullivan; Frances A Carter; Peter R Joyce

    1996-01-01

    We examined the prevalence and ages at onset of additional childhood and adult psychiatric disorders in women with bulimia nervosa and evaluated the differential impact of a mood or anxiety disorder on the presentation of bulimia nervosa. One hundred fourteen women participating in a clinical trial of cognitive-behavioral therapy for bulimia nervosa were assessed at pretreatment with structured diagnostic methodology.

  17. Quality of life in older adults with generalized anxiety disorder

    Microsoft Academic Search

    S. L. Bourland; M. A. Stanley; A. G. Snyder; D. M. Novy; J. G. Beck; P. M. Averill; A. C. Swann

    2000-01-01

    Improving the quality of life is an important goal in the treatment of psychiatric disorders. The current study described subjective quality of life, or life satisfaction, in a sample of older adults with generalized anxiety disorder (GAD). Patients with GAD were compared to other anxious and nonpsychiatric samples on measures of life satisfaction. Older adults with GAD reported lower quality

  18. Efficacy of Cognitive Behaviour Therapy in Generalized Anxiety Disorders

    Microsoft Academic Search

    M. Linden; D. Zubraegel; T. Baer; U. Franke; P. Schlattmann

    2005-01-01

    Background: Generalized anxiety disorders (GAD) are amongst the most prevalent mental disorders. Recent studies have suggested that cognitive behaviour therapy (CBT) is an effective treatment for GAD. A controlled clinical trial was done to evaluate the efficacy of CBT treatment in outpatients with pure GAD who were treated by a therapist working in routine care. Methods: Seventy-two outpatients, fulfilling GAD

  19. Randomized Controlled Trial of Mindfulness Meditation for Generalized Anxiety Disorder: Effects on Anxiety and Stress Reactivity

    PubMed Central

    Hoge, Elizabeth A.; Bui, Eric; Marques, Luana; Metcalf, Christina A.; Morris, Laura K.; Robinaugh, Donald J.; Worthington, John J.; Pollack, Mark H.; Simon, Naomi M.

    2013-01-01

    Objective Mindfulness meditation has met increasing interest as a therapeutic strategy for anxiety disorders, but prior studies have been limited by methodological concerns, including a lack of an active comparison group. This is the first randomized, controlled trial comparing the manualized Mindfulness-Based Stress Reduction (MBSR) program with an active control for Generalized Anxiety Disorder, a disorder characterized by chronic worry and physiological hyperarousal symptoms. Method Ninety-three individuals with DSM-IV-diagnosed GAD were randomized to an 8-week group intervention with MBSR or to an attention control, Stress Management Education (SME) between 2009 and 2011. Anxiety symptoms were measured with the Hamilton Anxiety Scale (HAM-A, primary outcome measure), the Clinical Global Impression of Severity and Improvement (CGI-S and CGI-I), and the Beck Anxiety Inventory (BAI). Stress reactivity was assessed by comparing anxiety and distress during pre- and post-treatment Trier Social Stress Tests (TSST). Results A modified intent-to-treat analysis including participants who completed at least one session of MBSR (N=48) or SME (N=41) showed that both interventions led to significant reductions in HAM-A scores at endpoint, but did not significantly differ. MBSR, however, was associated with a significantly greater reduction in anxiety as measured by the CGI-S, the CGI-I, and the BAI (all Ps<0.05). MBSR was also associated with greater reductions than SME in anxiety and distress ratings in response to the TSST stress challenge (P<0.05), and a greater increase in positive self-statements (P=0.004). Conclusions These results suggest that MBSR may have a beneficial effect on anxiety symptoms in GAD, and may also improve stress reactivity and coping as measured in a laboratory stress challenge. PMID:23541163

  20. The German guidelines for the treatment of anxiety disorders.

    PubMed

    Bandelow, Borwin; Lichte, Thomas; Rudolf, Sebastian; Wiltink, Jörg; Beutel, Manfred E

    2015-08-01

    A consensus group consisting of 36 experts representing 20 leading German specialist societies and patient self-help organizations developed evidence-based recommendations for the treatment of anxiety disorders in Germany. These were based on a systematic review of randomized controlled trials on anxiety disorders (n = 403) and on preexisting German and international guidelines. According to the consensus committee, anxiety disorders should be treated with psychotherapy or pharmacological drugs or a combination of both. Cognitive behavioral therapy (CBT) was regarded as the psychological treatment with the highest level of evidence. Psychodynamic therapy (PDT) was recommended for cases in which CBT was not effective or not available or in which PDT was the informed patient's preferred option. First-line drugs for anxiety disorders include selective serotonin reuptake inhibitors and serotonin-noradrenaline reuptake inhibitors. After remission, medications should be continued for 6-12 months. When either drug or psychotherapy was not effective, treatment should be switched to the other approach or to a combination of both. For patients non-responsive to standard treatments, alternative strategies are suggested. When developing a treatment plan, efficacy, side effects, costs and the preference of the patient should be considered. A large amount of data available from randomized controlled trials permit the formulation of robust evidence-based recommendations for the treatment of anxiety disorders. The recommendations were not only developed for the special situation in Germany, but may also be helpful for developing treatment plans in other countries. PMID:25404200

  1. Emotion Reactivity and Regulation in Late-Life Generalized Anxiety Disorder

    E-print Network

    Gross, James J.

    Emotion Reactivity and Regulation in Late-Life Generalized Anxiety Disorder: Functional.D. Objectives: Generalized anxiety disorder (GAD) is one of the most prevalent mental disorders in the elderly connectivity, late-life generalized anxiety disorder, emotion regulation Received February 13, 2014; revised

  2. Extending Fear Extinction Beyond Anxiety Disorders Karen G. Martnez and Gregory J. Quirk

    E-print Network

    Quirk, Gregory J.

    of anxiety disorders such as post-traumatic stress disorder, in which both fear extinction and prefrontal-based therapies for anxiety disorders (2). How- ever, the prefrontal­amygdala­hippocampal circuit is also impliCOMMENTARY Extending Fear Extinction Beyond Anxiety Disorders Karen G. Martínez and Gregory J

  3. Comorbid Anxiety in Bipolar Disorder Alters Treatment and Prognosis

    Microsoft Academic Search

    Rif S. El-Mallakh; Michael Hollifield

    2008-01-01

    Mood disorders in general, and bipolar disorder in particular, are unique among the psychiatric conditions in that they are\\u000a associated with extraordinarily high rates of comorbidity with a multitude of psychiatric and medical conditions. Among all\\u000a the potential cormobidities, co-occurring anxiety disorders stand out due to their very high prevalence. Outcome in bipolar\\u000a illness is worse in the presence of

  4. Psychotherapy of Childhood Anxiety Disorders: A Meta-Analysis

    Microsoft Academic Search

    Tina In-Albon; Silvia Schneider

    2007-01-01

    Background: The present study compared the efficacy of psychotherapy for childhood anxiety disorders (excluding trials solely treating post-traumatic stress disorder or obsessive-compulsive disorder). Methods: The meta-analysis included studies that met the basic CONSORT (consolidated standards of reporting trials) criteria. Several outcome variables (e.g. effect sizes, percentage of recovery) were analyzed using completer and intent-to-treat analyses during post-treatment and follow-up assessment.

  5. Instruments for the assessment of social anxiety disorder: Validation studies

    PubMed Central

    Osório, Flávia de Lima; Crippa, José Alexandre de Souza; Loureiro, Sonia Regina

    2012-01-01

    Great progress has been observed in the literature over the last decade regarding the validation of instruments for the assessment of Social Anxiety Disorder in the Brazilian context. Particularly outstanding in this respect is the production of a group of Brazilian investigators regarding the psychometric study of the following instruments: Liebowitz Social Anxiety Scale, Social Phobia Inventory, Brief Social Phobia Scale, Disability Profile, Liebowitz Self-Rated Disability Scale, Social Phobia Safety Behaviors Scale and Self-Statements During Public Speaking Scale, which have proved to be appropriate and valid for use in the adult Brazilian population, representing resources for the assessment of social anxiety in clinical and experimental situations. PMID:24175172

  6. Instruments for the assessment of social anxiety disorder: Validation studies.

    PubMed

    Osório, Flávia de Lima; Crippa, José Alexandre de Souza; Loureiro, Sonia Regina

    2012-10-22

    Great progress has been observed in the literature over the last decade regarding the validation of instruments for the assessment of Social Anxiety Disorder in the Brazilian context. Particularly outstanding in this respect is the production of a group of Brazilian investigators regarding the psychometric study of the following instruments: Liebowitz Social Anxiety Scale, Social Phobia Inventory, Brief Social Phobia Scale, Disability Profile, Liebowitz Self-Rated Disability Scale, Social Phobia Safety Behaviors Scale and Self-Statements During Public Speaking Scale, which have proved to be appropriate and valid for use in the adult Brazilian population, representing resources for the assessment of social anxiety in clinical and experimental situations. PMID:24175172

  7. Anxiety Symptoms in Boys with Autism Spectrum Disorder, Attention-Deficit Hyperactivity Disorder, or Chronic Multiple Tic Disorder and Community Controls

    ERIC Educational Resources Information Center

    Guttmann-Steinmetz, Sarit; Gadow, Kenneth D.; DeVincent, Carla J.; Crowell, Judy

    2010-01-01

    We compared symptoms of generalized anxiety disorder (GAD) and separation anxiety disorder (SAD) in 5 groups of boys with neurobehavioral syndromes: attention-deficit/hyperactivity disorder (ADHD) plus autism spectrum disorder (ASD), ADHD plus chronic multiple tic disorder (CMTD), ASD only, ADHD only, and community Controls. Anxiety symptoms were…

  8. Ministry of Health Clinical Practice Guidelines: Anxiety Disorders

    PubMed Central

    Lim, Leslie; Chan, Hong Ngee; Chew, Peng Hoe; Chua, Sze Ming; Ho, Carolyn; Kwek, Seow Khee Daniel; Lee, Tih Shih; Loh, Patricia; Lum, Alvin; Tan, Yong Hui Colin; Wan, Yi Min; Woo, Matthew; Yap, Hwa Ling

    2015-01-01

    The Ministry of Health (MOH) has developed the clinical practice guidelines on Anxiety Disorders to provide doctors and patients in Singapore with evidence-based treatment for anxiety disorders. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the MOH clinical practice guidelines on anxiety disorders, for the information of SMJ readers. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_medical.html. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.

  9. Duloxetine treatment for relapse prevention in adults with generalized anxiety disorder: A double-blind placebo-controlled trial

    Microsoft Academic Search

    Jonathan R. T. Davidson; Hans-Ulrich Wittchen; Pierre-Michel Llorca; Janelle Erickson; Michael Detke; Susan G. Ball; James M. Russell

    2008-01-01

    The objective was to examine duloxetine 60–120 mg\\/day treatment for relapse prevention in adults with generalized anxiety disorder (GAD). Adult patients (N=887; mean age=43.3 years; 61.0% female) with DSM-IV-TR-defined GAD diagnosis were treated with duloxetine for 26 weeks. Patients who completed open-label phase and were treatment responders (?50% reduction in Hamilton Anxiety Rating Scale total score to ?11 and “much”\\/“very much improved” ratings

  10. Understanding the link between anxiety symptoms and suicidal ideation and behaviors in outpatients with bipolar disorder

    Microsoft Academic Search

    Naomi M. Simon; Mark H. Pollack; Michael J. Ostacher; Alyson K. Zalta; Candice W. Chow; Diana Fischmann; Christina M. Demopulos; Andrew A. Nierenberg; Michael W. Otto

    2007-01-01

    Background: Prior studies suggest an association between anxiety comorbidity and suicidal ideation and behaviors in bipolar disorder. However, the nature of this association remains unclear. Methods: We examined a range of anxiety symptoms, including panic, phobic avoidance, anxiety sensitivity, worry and fear of negative evaluation, in 98 patients with bipolar disorder. We predicted that each anxiety dimension would be linked

  11. The diagnostic utility of the Screen for Child Anxiety Related Emotional Disorders-71 (SCARED71)

    Microsoft Academic Search

    Denise H. M. Bodden; Susan M. Bögels; Peter Muris

    2009-01-01

    ObjectiveThis study investigated the diagnostic utility of the 71-item Screen for Child Anxiety Related Emotional Disorders (SCARED-71), as a screening tool for identifying anxiety disorders in youth aged 8–18 years.

  12. Psychometric Properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED): A Replication Study

    Microsoft Academic Search

    BORIS BIRMAHER; DAVID A. BRENT; LAUREL CHIAPPETTA; JEFFREY BRIDGE; SUNEETA MONGA; MARIANNE BAUGHER

    1999-01-01

    ObjectiveTo replicate and extend work on the psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED), a child and parent self-report instrument used to screen for children with anxiety disorders.

  13. Generalized anxiety disorder: new concepts and psychopharmacologic therapies.

    PubMed

    Dubovsky, S L

    1990-01-01

    Several classes of medications have been used to treat generalized anxiety disorders (GAD). Antidepressants are useful for chronic subpanic anxiety and anxiety associated with depression. Benzodiazepines are generally safe, but recent research suggests that the incidence of chronic abstinence syndromes may be higher than has been suspected. This class of medications is best used for circumscribed periods of time. Because buspirone has no significant interactions, it does not prevent benzodiazepine withdrawal and cannot be directly substituted for this class of medications. beta-Blockers are used when cardiovascular symptoms and tremor are prominent, for stage fright (propranolol) and possibly for social phobia (atenolol). Antihistamines have been used for elderly patients and for those with a history of substance abuse. Neuroleptics should only be prescribed for anxiety associated with psychosis, psychotic and possibly severe depression, and borderline personality disorder. Drug treatment of GAD should be used as part of a comprehensive treatment plan that includes assessment for medical illnesses that can aggravate anxiety, withdrawal of all unnecessary medications (especially CNS depressants) and caffeine, structured relaxation techniques, evaluation of the specific type of anxiety, and psychotherapy. PMID:1967248

  14. A community-based epidemiological study of health anxiety and generalized anxiety disorder.

    PubMed

    Lee, Sing; Lam, Ivy M H; Kwok, Kathleen P S; Leung, Candi M C

    2014-03-01

    This community-based study examined the frequency of worry about personal health in respondents with and without generalized anxiety disorder (GAD), and the impact of health anxiety on the disorder. A random community-based telephone survey of 5118 Chinese respondents aged 18-64 was conducted. A fully structured questionnaire covered the DSM-IV-TR criteria of GAD, major depressive episode (MDE), eight domains of worry, the seven-item Whiteley Index (WI-7), health service use, and socio-demographic information. Worry about personal health ranked fifth (75.6%) among eight domains of worries examined. GAD respondents with high level of health anxiety were significantly older, less educated, and had lower family income. High health anxiety significantly increased the occurrence of one-year MDE, previous persistent worry, previous persistent low mood, number of domains of worries, number of non-core DSM-IV-TR GAD symptoms, health service use, and mistrust of doctors. Health anxiety is common in GAD and may signify greater severity of the disorder. PMID:24295847

  15. The cortisol response to social stress in social anxiety disorder.

    PubMed

    Vaccarino, Oriana; Levitan, Robert; Ravindran, Arun

    2015-04-01

    This study evaluated the cortisol stress response (CSR) following the Trier Social Stress Test in Social Anxiety Disorder (SAD) and control participants, to determine whether individual differences in CSR associate more with SAD diagnosis or dimensional characteristics [i.e. childhood trauma (CT)]. Twenty-one participants (11 with SAD) had full data available for both CT-scores and cortisol area-under-the-curve (AUC). Linear regression produced significant results: predicting AUCG with study group, emotional abuse (EA) scores and their interaction (F=3.14, df=5,15; p=.039); of note, the study group by EA interaction was significant at p=.015, driven by a strong positive association between EA and cortisol AUCG in the control group, and a negative association between these variables in the SAD group (standardized-beta=1.56, t=2.75, p=.015). This suggests that EA in SAD patients is associated with altered CSR, highlighting need to measure dimensional characteristics. PMID:25864645

  16. Amygdala activation during emotional face processing in adolescents with affective disorders: the role of underlying depression and anxiety symptoms

    PubMed Central

    van den Bulk, Bianca G.; Meens, Paul H. F.; van Lang, Natasja D. J.; de Voogd, E. L.; van der Wee, Nic J. A.; Rombouts, Serge A. R. B.; Crone, Eveline A.; Vermeiren, Robert R. J. M.

    2014-01-01

    Depressive and anxiety disorders are often first diagnosed during adolescence and it is known that they persist into adulthood. Previous studies often tried to dissociate depressive and anxiety disorders, but high comorbidity makes this difficult and maybe even impossible. The goal of this study was to use neuroimaging to test what the unique contribution is of depression and anxiety symptomatology on emotional processing and amygdala activation, and to compare the results with a healthy control group. We included 25 adolescents with depressive and/or anxiety disorders and 26 healthy adolescents. Participants performed an emotional face processing task while in the MRI scanner. We were particularly interested in the relation between depression/anxiety symptomatology and patterns of amygdala activation. There were no significant differences in activation patterns between the control group and the clinical group on whole brain level and ROI level. However, we found that dimensional scores on an anxiety but not a depression subscale significantly predicted brain activation in the right amygdala when processing fearful, happy and neutral faces. These results suggest that anxiety symptoms are a better predictor for differentiating activation patterns in the amygdala than depression symptoms. Although the current study includes a relatively large sample of treatment naïve adolescents with depression/anxiety disorders, results might be influenced by differences between studies in recruitment strategies or methodology. Future research should include larger samples with a more equal distribution of adolescents with a clinical diagnosis of depression and/or anxiety. To conclude, this study shows that abnormal amygdala responses to emotional faces in depression and anxiety seems to be more dependent on anxiety symptoms than on depression symptoms, and thereby highlights the need for more research to better characterize clinical groups in future studies. PMID:24926249

  17. [Anxiety, anxiety disorders and sexuality. The complex relation between anxiety and sexual performance].

    PubMed

    Flichman, Andrés

    2013-01-01

    Anxiety and sexuality are in if same as inexhaustible as controversial universes. The relationship between them, a pair even more difficult to cover. This paper aims to describe the complex relationships existing between the different types of anxiety and its impact on sexuality. PMID:24260754

  18. Anxiety-Promoting Parenting Behaviors: A Comparison of Anxious Parents with and without Social Anxiety Disorder

    PubMed Central

    Budinger, Meghan Crosby; Drazdowski, Tess K.; Ginsburg, Golda S.

    2012-01-01

    While parenting behaviors among anxious parents have been implicated in the familial transmission of anxiety, little is known about whether these parenting behaviors are unique to specific parental anxiety disorders. The current study examined differences in the use of five specific parenting behaviors (i.e., warmth/positive affect, criticism, doubts of child competency, over-control, and granting of autonomy) in anxious parents with (n = 21) and without (n = 45) social anxiety disorder (SAD) during a five-minute task with their non-anxious child (aged 7-12 years, M = 9.14). Parents with SAD demonstrated less warmth/positive affect and more criticism and doubts of child competency than did those without SAD. There were no group differences in over-control or granting of autonomy. Findings help clarify inconsistent results in the literature, inform models of familial transmission, and suggest intervention targets for parents with SAD. PMID:23053617

  19. The Comorbidity of Sleep Apnea and Mood, Anxiety, and Substance Use Disorders among Obese Military Veterans within the Veterans Health Administration

    PubMed Central

    Babson, Kimberly A.; Del Re, A. C.; Bonn-Miller, Marcel O.; Woodward, Steven H.

    2013-01-01

    Objectives: To determine the relations between obstructive sleep apnea (OSA) diagnosis, the likelihood of being diagnosed with a psychological condition, among obese veterans, after accounting for severity of obesity and the correlated nature of patients within facility. We hypothesized that (1) individuals with a diagnosis of OSA would be more likely to receive a diagnosis of a (a) mood disorder and (b) anxiety disorder, but not (c) substance use disorder. Design: Cross-sectional retrospective database review of outpatient medical records between October 2009 and September 2010, conducted across all 140 Veterans Health Administration (VHA) facilities. Setting: The entire VA Health Care System. Patients or Participants: Population-based sample of veterans with obesity (N = 2,485,658). Main Outcome Measures: Physician- or psychologist-determined diagnosis of psychological conditions including mood, anxiety, and substance use disorders. Results: Using generalized linear mixed modeling, after accounting for the correlated nature of patients within facility and the severity of obesity, individuals with a diagnosis of sleep apnea had increased odds of receiving a mood disorder diagnosis (OR = 1.85; CI = 1.71-1.72; p < 0.001), anxiety disorder diagnosis (OR = 1.82; CI = 1.77-1.84; p < 0.001), but not a diagnosis of substance use disorder. Conclusions: Among obese veterans within VA, OSA is associated with increased risk for having a mood and anxiety disorder, but not substance use disorder, with the strongest associations observed for posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). In addition, this relation remained after accounting for severity of BMI. Citation: Babson KA; Del Re AC; Bonn-Miller MO; Woodward SH. The comorbidity of sleep apnea and mood, anxiety, and substance use disorders among obese military veterans within the Veterans Health Administration. J Clin Sleep Med 2013;9(12):1253-1258. PMID:24340286

  20. Children with Generalized Anxiety Disorder Do Not Have Peer Problems, Just Fewer Friends

    ERIC Educational Resources Information Center

    Scharfstein, Lindsay; Alfano, Candice; Beidel, Deborah; Wong, Nina

    2011-01-01

    A common assumption is that all youth with anxiety disorders (AD) experience impaired peer relationships relative to healthy control children. Social impairments have been identified among youth with certain AD (e.g., social anxiety disorder; SAD), but less is known about the peer relationships of children with generalized anxiety disorder (GAD).…

  1. No Differences between Group versus Individual Treatment of Childhood Anxiety Disorders in a Randomised Clinical Trial

    ERIC Educational Resources Information Center

    Liber, Juliette M.; Van Widenfelt, Brigit M.; Utens, Elisabeth M. W. J.; Ferdinand, Robert F.; Van Der Leeden, Adelinde J. M.; Van Gastel, Willemijn; Treffers, Philip D. A.

    2008-01-01

    Background: The present study compares an individual versus a group format in the delivery of manualised cognitive-behavioural therapy (FRIENDS) for children with anxiety disorders. Clinically referred children (aged 8 to 12) diagnosed with Separation Anxiety Disorder (n = 52), Generalised Anxiety Disorder (n = 37), Social Phobia (n = 22) or…

  2. No differences between group versus individual treatment of childhood anxiety disorders in a randomised clinical trial

    Microsoft Academic Search

    Juliette M. Liber; Brigit M. Van Widenfelt; Elisabeth M. W. J. Utens; Robert F. Ferdinand; Willemijn Van Gastel; Philip D. A. Treffers

    2008-01-01

    Background: The present study compares an individual versus a group format in the delivery of manualised cognitive-behavioural therapy (FRIENDS) for children with anxiety disorders. Clinically referred children (aged 8 to 12) diagnosed with Separation Anxiety Disorder (n ¼ 52), Generalised Anxiety Disorder (n ¼ 37), Social Phobia (n ¼ 22) or Specific Phobia (n ¼ 16) were randomly assigned to

  3. Metabolic syndrome among psychiatric outpatients with mood and anxiety disorders

    PubMed Central

    2014-01-01

    Background Few studies have simultaneously compared the impacts of pharmacotherapy and mental diagnoses on metabolic syndrome (MetS) among psychiatric outpatients with mood and anxiety disorders. This study aimed to investigate the impacts of pharmacotherapy and mental diagnoses on MetS and the prevalence of MetS among these patients. Methods Two-hundred and twenty-nine outpatients (men/women?=?85/144) were enrolled from 1147 outpatients with mood and anxiety disorders by systematic sampling. Psychiatric disorders and MetS were diagnosed using the Structured Clinical Interview for DSM-IV-TR and the new International Diabetics Federation definition, respectively. The numbers of antipsychotics, mood stabilizers, and antidepressants being taken were recorded. Logistic regression was used to investigate the impacts of pharmacotherapy and psychiatric diagnoses on MetS. Results Among 229 subjects, 51 (22.3%) fulfilled the criteria for MetS. The prevalence of MetS was highest in the bipolar I disorder (46.7%) patients, followed by bipolar II disorder (25.0%), major depressive disorder (22.0%), anxiety-only disorders (16.7%), and no mood and/or anxiety disorders (14.3%). The percentages of MetS among the five categories were correlated with those of the patients being treated with antipsychotics and mood stabilizers. Use of antipsychotics and/or mood stabilizers independently predicted a higher risk of MetS after controlling for demographic variables and psychiatric diagnoses. When adding body mass index (BMI) as an independent variable in the regression model, BMI became the most significant factor to predict MetS. Conclusion BMI was found to be an important factor related to MetS. Pharmacotherapy might be one of underlying causes of elevated BMI. The interactions among MetS, BMI, pharmacotherapy, and psychiatric diagnoses might need further research. PMID:24952586

  4. Localized gray matter volume abnormalities in generalized anxiety disorder

    Microsoft Academic Search

    Franz Ebner; Axel Schäfer

    2011-01-01

    Generalized anxiety disorder (GAD) is characterized by excessive and persistent worrying. Neural substrates of this disorder\\u000a are insufficiently understood, which relates to functional as well as to structural brain abnormalities. Especially, findings\\u000a on the neuroanatomy of GAD have been inconsistent and were predominantly derived from pediatric samples. Therefore, we studied\\u000a adult patients. Thirty-one women (16 patients with GAD and 15

  5. Efficacy of Cognitive-Behavioral Therapy for Comorbid Panic Disorder with Agoraphobia and Generalized Anxiety Disorder

    ERIC Educational Resources Information Center

    Labrecque, Joane; Marchand, Andre; Dugas, Michel J.; Letarte, Andree

    2007-01-01

    The goal of this study was to evaluate the efficacy of cognitive-behavioral therapy for comorbid panic disorder with agoraphobia (PDA) and generalized anxiety disorder (GAD) by combining treatment strategies for both disorders. A single-case, multiple-baseline design across participants was used. Three participants with primary PDA and secondary…

  6. Explained and Unexplained Medical Symptoms in Generalized Anxiety and Panic Disorder: Relationship to the Somatoform Disorders

    Microsoft Academic Search

    James G. Barbee; Alexandre A. Todorov; Andrzej R. Kuczmierczyk; Donna M. Mancuso; John J. Schwab; Richard J. Maddock; Rudolf Hoehn-Saric; Lee Ann Kelley; Jonathan R. T. Davidson

    1997-01-01

    We have examined the numbers and types of symptoms in a sample of 90 patients with generalized anxiety disorder (GAD) and 77 patients with panic disorder (PD) collected from six different sites during the conduct of a multicenter clinical trial. This information was obtained utilizing the Health Questionnaire, a 47-item self-report list of medical symptoms, patterned after the Somatization Disorder

  7. Efficacy of Modular Cognitive Behavior Therapy for Childhood Anxiety Disorders

    ERIC Educational Resources Information Center

    Chorpita, Bruce F.; Taylor, Alissa A.; Francis, Sarah E.; Moffitt, Catherine; Austin, Ayda A.

    2004-01-01

    The present investigation evaluated the initial efficacy of a modular approach to cognitive behavior therapy (CBT) for anxiety disorders in youth. Modular CBT consists of the guided combination of individually scripted techniques that are explicitly matched to the child's individual strengths and needs. Eleven youth primarily of Asian and Pacific…

  8. Efficacy of modular cognitive behavior therapy for childhood anxiety disorders

    Microsoft Academic Search

    Bruce F. Chorpita; Alissa A. Taylor; Sarah E. Francis; Catherine Moffitt; Ayda A. Austin

    2004-01-01

    The present investigation evaluated the initial efficacy of a modular approach to cog- nitive behavior therapy (CBT) for anxiety disorders in youth. Modular CBT consists of the guided combination of individually scripted techniques that are explicitly matched to the child's individual strengths and needs. Eleven youth primarily of Asian and Pacific Island ethnicity ranging in age from 7 to 13

  9. Problem Solving and Problem Orientation in Generalized Anxiety Disorder

    Microsoft Academic Search

    Robert Ladouceur; France Blais; Mark H. Freeston; Michel J. Dugas

    1998-01-01

    The present study’s main objective is to examine whether problem orientation and problem-solving skills differ according to generalized anxiety disorder (GAD) symptom level or clinical status (seeking help for GAD). Its secondary goal is to examine whether two cognitive variables (intolerance of uncertainty and beliefs about worry) vary according to GAD symptom level or clinical status. Three groups of subjects

  10. Treatment of Generalized Anxiety Disorder in Older Adults

    Microsoft Academic Search

    Julie Loebach Wetherell; Margaret Gatz; Michelle G. Craske

    2003-01-01

    Older adults with generalized anxiety disorder (GAD; N = 75; M age = 67.1 years) were randomly assigned to cognitive-behavioral therapy (CBT), a discussion group (DG) organized around worry-provoking topics, or a waiting period. Participants in both active conditions improved relative to the waiting list. Although CBT participants improved on more measures than DG participants, the authors found only 1

  11. Preliminary tests of a cognitive model of generalized anxiety disorder

    Microsoft Academic Search

    Adrian Wells; Karin Carter

    1999-01-01

    Although worry is the central feature of Generalised Anxiety Disorder (GAD), little is known about the factors that contribute to pathological or problematic worry. In a recent cognitive model of GAD, Wells, A. (1995) proposed that negative appraisal of worrying itself (meta-worry or type 2 worry) should be distinguished from other types of worrying (type 1 worry). A central feature

  12. Mindfulness-based cognitive therapy for generalized anxiety disorder

    Microsoft Academic Search

    Susan Evans; Stephen Ferrando; Marianne Findler; Charles Stowell; Colette Smart; Dean Haglin

    2008-01-01

    While cognitive behavior therapy has been found to be effective in the treatment of generalized anxiety disorder (GAD), a significant percentage of patients struggle with residual symptoms. There is some conceptual basis for suggesting that cultivation of mindfulness may be helpful for people with GAD. Mindfulness-based cognitive therapy (MBCT) is a group treatment derived from mindfulness-based stress reduction (MBSR) developed

  13. Generalized anxiety disorder: a preliminary test of a conceptual model

    Microsoft Academic Search

    Michel J. Dugas; Fabien Gagnon; Robert Ladouceur; Mark H. Freeston

    1998-01-01

    This study presents a preliminary test of a conceptual model of Generalized Anxiety Disorder (GAD) which is theoretically driven and has clear clinical implications. The model's main features are intolerance of uncertainty, beliefs about worry, poor problem orientation and cognitive avoidance. Subjects were 24 GAD patients and 20 non clinical control subjects. The results show that all main components of

  14. Preschool Predictors of Childhood Anxiety Disorders: A Prospective Community Study

    ERIC Educational Resources Information Center

    Wichstrøm, Lars; Belsky, Jay; Berg-Nielsen, Turid Suzanne

    2013-01-01

    Background: Anxiety disorders are often present at preschool age. Research on older children and studies contrasting preschoolers with high versus low behavioral inhibition (BI) highlight several risk factors, but these have not been investigated in community samples of young children. Child, parent, and peer factors at age 4 were therefore…

  15. Family Cognitive Behavioral Therapy for Child Anxiety Disorders

    ERIC Educational Resources Information Center

    Wood, Jeffrey J.; Piacentini, John C.; Southam-Gerow, Michael; Chu, Brian C.; Sigman, Marian

    2006-01-01

    Objective: This study compared family-focused cognitive behavioral therapy (CBT: the Building Confidence Program) with traditional child-focused CBT with minimal family involvement for children with anxiety disorders. Method: Forty clinically anxious youth (6-13 years old) were randomly assigned to a family- or child-focused cognitive-behavioral…

  16. A Critical Review of Pharmacotherapy for Youth with Anxiety Disorders

    Microsoft Academic Search

    Christopher A. Kearney; Wendy K. Silverman

    1998-01-01

    Given the increasing trend in clinical child psychology and psychiatry toward cost-effective and pharmacological treatment, a review of key factors that influence treatment outcomes in this area seems warranted. This is especially important for the rapidly changing area of childhood anxiety disorders. In this article, we look at different change producing procedures to illustrate the claim that pharmacological studies are

  17. Treating Anxiety Disorders in Children with High Functioning Autism Spectrum Disorders: A Controlled Trial

    Microsoft Academic Search

    Anne Marie Chalfant; Ron Rapee; Louisa Carroll

    2007-01-01

    A family-based, cognitive behavioural treatment for anxiety in 47 children with comorbid anxiety disorders and High Functioning\\u000a Autism Spectrum Disorder (HFA) was evaluated. Treatment involved 12 weekly group sessions and was compared with a waiting\\u000a list condition. Changes between pre- and post-treatment were examined using clinical interviews as well as child-, parent-\\u000a and teacher-report measures. Following treatment, 71.4% of the treated

  18. Balance Treatment Ameliorates Anxiety and Increases Self-Esteem in Children with Comorbid Anxiety and Balance Disorder

    ERIC Educational Resources Information Center

    Bart, Orit; Bar-Haim, Yair; Weizman, Einat; Levin, Moran; Sadeh, Avi; Mintz, Matti

    2009-01-01

    Comorbidity between balance and anxiety disorders in adult population is a well-studied clinical entity. Children might be particularly prone to develop balance-anxiety comorbidity, but surprisingly they are practically neglected in this field of research. The consequence is that children are treated for what seems to be the primary disorder

  19. Cognitive Behavioral Treatment for Childhood Anxiety Disorders: Long-Term Effects on Anxiety and Secondary Disorders in Young Adulthood

    ERIC Educational Resources Information Center

    Saavedra, Lissette M.; Silverman, Wendy K.; Morgan-Lopez, Antonio A.; Kurtines, William M.

    2010-01-01

    Background: The present study's aim was to examine the long-term effects (8 to 13 years post-treatment; M = 9.83 years; SD = 1.71) of the most widely used treatment approaches of exposure-based cognitive behavioral treatment for phobic and anxiety disorders in children and adolescents (i.e., group treatment and two variants of individual…

  20. Personality Disorders in Obsessive-Compulsive Disorder: A Comparative Study versus Other Anxiety Disorders

    PubMed Central

    Pena-Garijo, Josep; Edo Villamón, Silvia; Ruipérez, M. Ángeles

    2013-01-01

    Objective. The purpose of this paper is to provide evidence for the relationship between personality disorders (PDs), obsessive compulsive disorder (OCD), and other anxiety disorders different from OCD (non-OCD) symptomatology. Method. The sample consisted of a group of 122 individuals divided into three groups (41 OCD; 40 non-OCD, and 41 controls) matched by sex, age, and educational level. All the individuals answered the IPDE questionnaire and were evaluated by means of the SCID-I and SCID-II interviews. Results. Patients with OCD and non-OCD present a higher presence of PD. There was an increase in cluster C diagnoses in both groups, with no statistically significant differences between them. Conclusions. Presenting anxiety disorder seems to cause a specific vulnerability for PD. Most of the PDs that were presented belonged to cluster C. Obsessive Compulsive Personality Disorder (OCPD) is the most common among OCD. However, it does not occur more frequently among OCD patients than among other anxious patients, which does not confirm the continuum between obsessive personality and OCD. Implications for categorical and dimensional diagnoses are discussed. PMID:24453917

  1. Posttraumatic stress disorder?s dysphoria dimension and relations with generalized anxiety disorder symptoms.

    PubMed

    Durham, Tory A; Elhai, Jon D; Fine, Thomas H; Tamburrino, Marijo; Cohen, Gregory; Shirley, Edwin; Chan, Philip K; Liberzon, Israel; Galea, Sandro; Calabrese, Joseph R

    2015-07-30

    The present study investigated symptom relations between two highly comorbid disorders - posttraumatic stress disorder (PTSD) and generalized anxiety disorder (GAD) - by exploring their underlying dimensions. Based on theory and prior empirical research it was expected that the dysphoria factor of PTSD would be more highly related to GAD. As part of a longitudinal project of mental health among Ohio National Guard Soldiers, 1266 subjects were administered the Posttraumatic Stress Disorder Checklist (PCL) and Generalized Anxiety Disorder-7 scale (GAD-7). Confirmatory factor analyses (CFAs) were conducted to examine two models of PTSD and to determine which PTSD factors were more related to the GAD factor. The results indicate that the GAD factor was significantly more highly correlated with PTSD?s dysphoria factor than with all other PTSD factors, including PTSD?s reexperiencing factor, avoidance factor, and hyperarousal factor. Results indicate GAD was not significantly more highly correlated with numbing than most other factors of PTSD. The results are consistent with prior research. Implications of the results are discussed in regards to PTSD in DSM-5, comorbidity and diagnostic specificity. PMID:25983285

  2. Targeted Behavioral Therapy for childhood generalized anxiety disorder: a time-series analysis of changes in anxiety and sleep.

    PubMed

    Clementi, Michelle A; Alfano, Candice A

    2014-03-01

    This study examined the efficacy of Targeted Behavioral Therapy (TBT), a newly developed intervention targeting features of childhood generalized anxiety disorder (GAD). Using a time-series design, 4 children (7-12 years) with primary GAD were treated with TBT, which includes sleep improvement strategies, systematic desensitization for reducing intolerance of uncertainty, and in vivo exposures for anxiety. Diagnostic interviews and questionnaires were administered at baseline, post-treatment and 3 months follow-up. Anxiety symptoms and sleep characteristics/problems were rated weekly during a 4-week baseline and 14-weeks of treatment. Two children remitted at post-treatment and no child had a GAD diagnosis at follow-up. Child but not parent report revealed improvements in both worry and sleep. Despite improvements from pre- to post-assessment, considerable symptom fluctuation observed during the baseline period preclude conclusion that symptom changes are specifically attributable to the course of treatment. Overall, preliminary support is provided for the efficacy of TBT for childhood GAD. PMID:24289931

  3. Factors influencing health-related quality of life of Asians with anxiety disorders in Singapore

    Microsoft Academic Search

    Nan Luo; Calvin Soon-Leng Fones; Julian Thumboo; Shu-Chuen Li

    2004-01-01

    As little is known about health-related quality of life (HRQoL) in Asians with anxiety disorders, we assessed HRQoL in Singaporeans with anxiety disorders and identified factors influencing their HRQoL. Outpatients with anxiety disorders (n = 119) attending a hospital psychiatric clinic completed the Short Form 36 Health Survey (SF-36), Beck Anxiety Inventory (BAI) and General Health Questionnaire (GHQ-12). SF-36 score

  4. [Differential diagnosis between Schizotypal Personality Disorder and Autism Spectrum Disorders: a case report].

    PubMed

    Ünver, Buket; Öner, Özgür; Yurtba??, P?nar

    2015-01-01

    Schizotypal personality disorder is characterized by social and interpersonal deficits marked by discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior. Inappropriate or constricted affect, reduced capacity for relationships, lack of close friends and reduced capacity for social life are the symptoms that overlap both schizotypal personality disorder and autism spectrum disorders. The making of differential diagnosis may be difficult since several symptoms are similar between these disorders. In this study, we discussed the differential diagnosis issues on the basis of an adolescent case. Odd appearance, magical thoughts, reference thoughts suggests Schizotypal Personality Disorder whereas lack of eye contact at 2 years old, a preference to be isolated and play alone and referral to a child psychiatrist at 4 years old suggest Autism Spectrum Disorders. Based on the results of psychological assessment, Wechsler Intelligence Scale for Children-Revised (WISC-R) profile is compatible with autistic children's profiles. Based on Schizotypal Personality Questionnaire, the patient's anxiety, lack of close friends, constricted affect symptoms which take place in the category of interpersonal schizotypy seems to overlap with lack of communication of Autism Spectrum Disorders. This case report indicates that, separation of autism and schizophrenia, a very important historical breakthrough in autism research, may be blurred in cases with less typical clinical pictures representing autistic and schizophrenic "spectrum" diagnosis. PMID:25742039

  5. Facing Your Fears in Adolescence: Cognitive-Behavioral Therapy for High-Functioning Autism Spectrum Disorders and Anxiety

    PubMed Central

    Reaven, Judy; Blakeley-Smith, Audrey; Leuthe, Eileen; Moody, Eric; Hepburn, Susan

    2012-01-01

    Adolescents with high-functioning autism spectrum disorders (ASDs) are at high risk for developing psychiatric symptoms, with anxiety disorders among the most commonly cooccurring. Cognitive behavior therapies (CBTs) are considered the best practice for treating anxiety in the general population. Modified CBT approaches for youth with high-functioning ASD and anxiety have resulted in significant reductions in anxiety following intervention. The purpose of the present study was to develop an intervention for treating anxiety in adolescents with ASD based on a CBT program designed for school-aged children. The Facing Your Fears-Adolescent Version (FYF-A) program was developed; feasibility and acceptability data were obtained, along with initial efficacy of the intervention. Twenty-four adolescents, aged 13–18, completed the FYF-A intervention. Results indicated significant reductions in anxiety severity and interference posttreatment, with low rates of anxiety maintained at 3-month follow-up. In addition, nearly 46% of teen participants met criteria for a positive treatment response on primary diagnosis following the intervention. Initial findings from the current study are encouraging and suggest that modified group CBT for adolescents with high-functioning ASD may be effective in reducing anxiety symptoms. Limitations include small sample size and lack of control group. Future directions are discussed. PMID:23091719

  6. Dissociative identity disorder: a controversial diagnosis.

    PubMed

    Gillig, Paulette Marie

    2009-03-01

    A brief description of the controversies surrounding the diagnosis of dissociative identity disorder is presented, followed by a discussion of the proposed similarities and differences between dissociative identity disorder and borderline personality disorder. The phenomenon of autohypnosis in the context of early childhood sexual trauma and disordered attachment is discussed, as is the meaning of alters or alternate personalities. The author describes recent neurosciences research that may relate the symptoms of dissociative identity disorder to demonstrable disordered attention and memory processes. A clinical description of a typical patient presentation is included, plus some recommendations for approaches to treatment. PMID:19724751

  7. To what extent does the anxiety scale of the Four-Dimensional Symptom Questionnaire (4DSQ) detect specific types of anxiety disorder in primary care? A psychometric study

    PubMed Central

    2014-01-01

    Background Anxiety scales may help primary care physicians to detect specific anxiety disorders among the many emotionally distressed patients presenting in primary care. The anxiety scale of the Four-Dimensional Symptom Questionnaire (4DSQ) consists of an admixture of symptoms of specific anxiety disorders. The research questions were: (1) Is the anxiety scale unidimensional or multidimensional? (2) To what extent does the anxiety scale detect specific DSM-IV anxiety disorders? (3) Which cut-off points are suitable to rule out or to rule in (which) anxiety disorders? Methods We analyzed 5 primary care datasets with standardized psychiatric diagnoses and 4DSQ scores. Unidimensionality was assessed through confirmatory factor analysis (CFA). We examined mean scores and anxiety score distributions per disorder. Receiver operating characteristic (ROC) analysis was used to determine optimal cut-off points. Results Total n was 969. CFA supported unidimensionality. The anxiety scale performed slightly better in detecting patients with panic disorder, agoraphobia, social phobia, obsessive compulsive disorder (OCD) and post traumatic stress disorder (PTSD) than patients with generalized anxiety disorder (GAD) and specific phobia. ROC-analysis suggested that ?4 was the optimal cut-off point to rule out and ?10 the cut-off point to rule in anxiety disorders. Conclusions The 4DSQ anxiety scale measures a common trait of pathological anxiety that is characteristic of anxiety disorders, in particular panic disorder, agoraphobia, social phobia, OCD and PTSD. The anxiety score detects the latter anxiety disorders to a slightly greater extent than GAD and specific phobia, without being able to distinguish between the different anxiety disorder types. The cut-off points ?4 and ?10 can be used to separate distressed patients in three groups with a relatively low, moderate and high probability of having one or more anxiety disorders. PMID:24761829

  8. Substance Use Disorders and Anxiety: A Treatment Challenge for Social Workers

    PubMed Central

    Brady, Kathleen T.; Haynes, Louise F.; Hartwell, Karen J.; Killeen, Therese K.

    2013-01-01

    Converging evidence from epidemiologic and treatment studies indicate that anxiety disorders and substance use disorders commonly co-occur, and the interaction is multifaceted and variable. Epidemiological studies and investigations within clinical substance abuse populations have found an association between anxiety disorders and substance use disorders. Specific anxiety disorders including generalized anxiety disorder, panic disorder, and post traumatic stress disorder have all been associated with substance use. The association with obsessive–compulsive disorder is less robust, and some research has found a negative association. The risk of nicotine dependence is significantly higher among individuals with an anxiety disorder, and conversely, smoking has been found to be associated with trait anxiety and anxiety disorders. A review of the current literature and the relationship between specific anxiety disorders and alcohol and substance use disorders is discussed in detail. This article, written for social workers in a variety of practice settings, reviews the prevalence, diagnostic, and treatment issues at the interface of substance use disorders and anxiety disorders. PMID:23731428

  9. Posttyphoon prevalence of posttraumatic stress disorder, major depressive disorder, panic disorder, and generalized anxiety disorder in a Vietnamese sample.

    PubMed

    Amstadter, Ananda B; Acierno, Ron; Richardson, Lisa K; Kilpatrick, Dean G; Gros, Daniel F; Gaboury, Mario T; Tran, Trinh Luong; Trung, Lam Tu; Tam, Nguyen Thanh; Tuan, Tran; Buoi, La Thi; Ha, Tran Thu; Thach, Tran Duc; Galea, Sandro

    2009-06-01

    In 2006, typhoon Xangsane disrupted a multiagency health needs study of 4,982 individuals in Vietnam. Following this disaster, 798 of the original participants were reinterviewed to determine prevalence and risk factors associated with posttraumatic stress disorder (PTSD), major depressive disorder (MDD), panic disorder (PD), and generalized anxiety disorder (GAD). Posttyphoon prevalences were PTSD 2.6%, MDD 5.9%, PD 9.3%, and GAD 2.2%. Of those meeting criteria for a disorder, 70% reported only one disorder, 15% had two, 14% had three, and 1% met criteria for all four disorders. Risk factors for posttyphoon psychopathology differed among disorders, but generally were related to high typhoon exposure, prior trauma exposure, and in contrast to Western populations, higher age, but not gender. PMID:19455707

  10. Virtual Reality Exposure Therapy for Post-Traumatic Stress Disorder and Other Anxiety Disorders

    Microsoft Academic Search

    Maryrose Gerardi; Judith Cukor; JoAnn Difede; Albert Rizzo; Barbara Olasov Rothbaum

    2010-01-01

    Anxiety disorders, including phobias and post-traumatic stress disorder, are common and disabling disorders that often involve\\u000a avoidance behavior. Cognitive-behavioral treatments, specifically imaginal and in vivo forms of exposure therapy, have been\\u000a accepted and successful forms of treatment for these disorders. Virtual reality exposure therapy, an alternative to more traditional\\u000a exposure-based therapies, involves immersion in a computer-generated virtual environment that minimizes

  11. Informing Early Intervention: Preschool Predictors of Anxiety Disorders in Middle Childhood

    PubMed Central

    Hudson, Jennifer L.; Dodd, Helen F.

    2012-01-01

    Background To inform early intervention practice, the present research examines how child anxiety, behavioural inhibition, maternal overinvolvement, maternal negativity, mother-child attachment and maternal anxiety, as assessed at age four, predict anxiety at age nine. Method 202 children (102 behaviourally inhibited and 100 behaviourally uninhibited) aged 3–4 years were initially recruited and the predictors outlined above were assessed. Diagnostic assessments, using the Anxiety Disorders Interview Schedule, were then conducted five years later. Results Behavioural inhibition, maternal anxiety, and maternal overinvolvement were significant predictors of clinical anxiety, even after controlling for baseline anxiety (p<.05). No significant effect of negativity or attachment security was found over and above baseline anxiety (p>.1). Conclusions Preschool children who show anxiety, are inhibited, have overinvolved mothers and mothers with anxiety disorders are at increased risk for anxiety in middle childhood. These factors can be used to identify suitable participants for early intervention and can be targeted within intervention programs. PMID:22905126

  12. Pharmacological treatment of anxiety disorders: Current treatments and future directions?

    PubMed Central

    Farach, Frank J.; Pruitt, Larry D.; Jun, Janie J.; Jerud, Alissa B.; Zoellner, Lori A.; Roy-Byrne, Peter P.

    2012-01-01

    Modern pharmacological treatments for anxiety disorders are safer and more tolerable than they were 30 years ago. Unfortunately, treatment efficacy and duration have not improved in most cases despite a greater understanding of the pathophysiology of anxiety. Moreover, innovative treatments have not reached the market despite billions of research dollars invested in drug development. In reviewing the literature on current treatments, we argue that evidence-based practice would benefit from better research on the causes of incomplete treatment response as well as the comparative efficacy of drug combinations and sequencing. We also survey two broad approaches to the development of innovative anxiety treatments: the continued development of drugs based on specific neuroreceptors and the pharmacological manipulation of fear-related memory. We highlight directions for future research, as neither of these approaches is ready for routine clinical use. PMID:23023162

  13. Update on and Advances in Assessment and Cognitive–Behavioral Treatment of Anxiety Disorders in Children and Adolescents

    Microsoft Academic Search

    Olivia N. Velting; Nicole J. Setzer; Anne Marie Albano

    2004-01-01

    Most child psychologists would agree that treating anxiety disorders in children is extremely challenging at times but also rewarding. This article provides an updated look at assessment strategies and promising psychosocial treatment techniques for children with 3 common anxiety disorders: separation anxiety disorder, social phobia, and generalized anxiety disorder. The need for comprehensive diagnostic evaluations is highlighted through information on

  14. Fluoxetine for the Treatment of Childhood Anxiety Disorders: Open-Label, Long-Term Extension to a Controlled Trial

    ERIC Educational Resources Information Center

    Clark, Duncan B.; Birmaher, Boris; Axelson, David; Monk, Kelly; Kalas, Catherine; Ehmann, Mary; Bridge, Jeffrey; Wood, D. Scott; Muthen, Bengt; Brent, David

    2005-01-01

    Objective: To assess the efficacy of fluoxetine for the long-term treatment of children and adolescents with anxiety disorders, including generalized anxiety disorder, separation anxiety disorder, and/or social phobia. Method: Children and adolescents (7-17 years old) with anxiety disorders were studied in open treatment for 1 year after they…

  15. Short-term tolerability of a nonazapirone selective serotonin 1A agonist in adults with generalized anxiety disorder: A 28-day, open-label study

    Microsoft Academic Search

    Sanjay J. Mathew; Amir Garakani; Scott Oshana; Stephen Donahue

    2008-01-01

    Background: The serotonin 1A (5-hydroxytryptamine 1A [5-HT1A]) receptor likely plays a critical role in anxiety pathophysiology.Objective: In this proof-of-concept investigation, we tested the short-term tolerability of PRX-00023, a nonazapirone 5-HT1A selective partial agonist, in outpatients with generalized anxiety disorder (GAD).Methods: Patients with a diagnosis of GAD, as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and

  16. Disorder specific impact of CALM treatment for anxiety disorders in primary care

    PubMed Central

    Craske, Michelle G.; Stein, Murray B.; Sullivan, Greer; Sherbourne, Cathy; Bystritsky, Alexander; Rose, Raphael D.; Lang, Ariel J.; Welch, Stacy; Campbell-Sills, Laura; Golinelli, Daniela; Roy-Byrne, Peter

    2011-01-01

    Context Anxiety disorders commonly present in primary care where evidence-based mental health treatments often are unavailable or suboptimally delivered. Objective Compare evidence-based treatment for anxiety disorders to usual care in primary care, for principal and comorbid generalized anxiety disorder (GAD), panic disorder (PD), social anxiety disorder (SAD) and posttraumatic stress disorder (PTSD). We hypothesized superiority of CALM for principal anxiety disorders and comorbid disorders. Design A randomized, controlled trial comparing CALM intervention with Usual Care, at baseline, 6-month, 12-month and 18-month follow-ups. Setting 17 primary care clinics in the United States. Patients Referred primary care sample, 1004 patients, with principal DSM-IV diagnoses of GAD (n=549), PD (n=262), SAD (n=132), or PTSD (n=61), mean 43.7 years (SD=13.7), 70.9% female,. 80% completed 18-month follow-up. Interventions CALM (computer-guided CBT and/or pharmacotherapy recommendations) and Usual Care. Main Outcome Measures Generalized Anxiety Disorder Severity Scale, Panic Disorder Severity-Self Report scale, Social Phobia Inventory, and PTSD Checklist-Civilian Version. Results CALM was superior to Usual Care for principal GAD at 6-month (?1.61; 95% CI = ?2.42 to ?.79), 12-month (?2.34; 95% CI = ?3.22 to ?1.45) and 18-month (?2.37; 95% CI = ?3.24 to ?1.50), PD at 6-month (?2.00; 95% CI = ?3.55 to ?0.44) and 12-month (?2.71; 95% CI = ?4.29 to ?1.14), and SAD at 6-month (?7.05; 95% CI = ?12.11 to ?2.00) outcomes. CALM was superior to Usual Care for comorbid SAD at 6-month (?4.26; 95% CI = ?7.96 to ?0.56), 12-month (?8.12, 95% CI = ?11.84 to ?4.40) and 18- month (?6.23, 95% CI = ?9.90 to ?2.55) outcomes. Effect sizes favored CALM, but were not statistically significant for other comorbid disorders. Conclusions CALM (CBT and psychotropic recommendations) is more effective than Usual Care for principal anxiety disorders, and to a lesser extent, comorbid anxiety disorders that present in primary care. PMID:21464362

  17. Relationships between anxiety and externalizing disorders in youth: the influences of age and gender

    Microsoft Academic Search

    Naomi R. Marmorstein

    2007-01-01

    Minimal information about the relationship between anxiety disorders and externalizing disorders in youth is available. This study examined relationships between different specific anxiety and externalizing disorders and examined whether these associations varied by age and gender. The Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) data set, consisting of youth from ages 9 to 17 recruited at

  18. Selective processing of threatening information: effects of attachment representation and anxiety disorder on attention and memory

    Microsoft Academic Search

    INGEBORG A. ZEIJLMANS VAN EMMICHOVEN; IJzendoorn van M. H; CORINE DE RUITER; JOS F. BROSSCHOT

    2003-01-01

    To investigate the effect of the mental representation of attachment on information processing, 28 anxiety disorder outpatients, as diagnosed by the Anxiety Disorders Interview Schedule—Revised, were administered the Adult Attachment Interview and the State-Trait Anxiety Inventory. They also completed an emotional Stroop task with subliminal and supraliminal exposure conditions, a free recall memory task, and a recognition test. All tasks

  19. Selective processing of threatening information: effects of attachment representation and anxiety disorder on attention and memory

    Microsoft Academic Search

    I. A. Zeijlmans van Emmichhoven; IJzendoorn van M. H; Ruiter de C; J. F. Brosschot

    2003-01-01

    To investigate the effect of the mental representation of attachment on information processing, 28 anxiety disorder outpatients, as diagnosed by the Anxiety Disorders Interview Schedule?Revised, were administered the Adult Attachment Interview and the State-Trait Anxiety Inventory. They also completed an emotional Stroop task with subliminal and supraliminal exposure conditions, a free recall memory task, and a recognition test. All tasks

  20. Parental Representations Associated with Adult Separation Anxiety and Panic Disorder-Agoraphobia

    Microsoft Academic Search

    Vijaya Manicavasagar; Derrick Silove; Renate Wagner; Dusan Hadzi-Pavlovic

    1999-01-01

    Objective: Early bonding abnormalities have been associated with a range of anxiety and depressive disorders in adulthood, but no specific parental patterns have emerged for particular disorders. The present study investigated the possibility that parental overprotectiveness may be linked to a risk of separation anxiety (SA) in adulthood.Method: Two samples were recruited: volunteers (n=34) whose major anxieties focused on separation

  1. Prevalence and Associations of Anxiety Disorders in Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Reid, K. A.; Smiley, E.; Cooper, S.-A.

    2011-01-01

    Background: Anxiety disorders are known to be common in the general population. Previous studies with adults with intellectual disabilities (IDs) report a prevalence of general anxiety disorder ranging from less than 2% to 17.4%. Little is known about associated factors in this population. This study investigates point prevalence of anxiety

  2. A preliminary investigation of the Spence Children's Anxiety Parent Scale as a screening tool for anxiety in young people with autism spectrum disorders.

    PubMed

    Zainal, Hani; Magiati, Iliana; Tan, Julianne Wen-Li; Sung, Min; Fung, Daniel S S; Howlin, Patricia

    2014-08-01

    Despite high rates of clinically elevated anxiety difficulties in children and adolescents with autism spectrum disorders (ASDs), very few studies have systematically examined the usefulness of commonly used caregiver report anxiety screening tools with this population. This study investigated the use of the Spence Children's Anxiety Scale-Parent version (SCAS-P) as a screening tool for anxiety disorders when compared to a standardized DSM-IV-TR-based clinical interview, the Kiddie-Schedule for Schizophrenia and Affective Disorders-Present and Lifetime version (K-SADS-PL). Thirty-two caregivers of youth with a clinical diagnosis of ASD (mean age 10.3 years) attending a specialist autism school participated in this study. They first completed the SCAS-P, a measure of adaptive functioning and a checklist of other emotional and behavioral difficulties. They were then interviewed with the K-SADS-PL. Internal consistency for the SCAS Total score was .88, but Cronbach's alphas were <.70 in three of the six SCAS-P subscales. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the SCAS-P against K-SADS diagnosis were .75, .71, .27, and .95, respectively. All values were >.70, except for the PPV. Evidence of convergent validity between the SCAS-P, K-SADS-PL and DBC anxiety subscale was also found. The high false positive rates notwithstanding, the preliminary data of acceptable to excellent sensitivity, specificity and NPV values tentatively suggest that the SCAS-P may be useful for screening non-help seeking young people with ASD for elevated anxiety symptoms. Further replication in larger studies is needed and ways in which the SCAS-P could be further developed and investigated for use with youth with ASD are discussed. PMID:24573336

  3. Cognitive-Behavioral Therapy for Comorbid Generalized Anxiety Disorder and Panic Disorder with Agoraphobia

    ERIC Educational Resources Information Center

    Labrecque, Joane; Dugas, Michel J.; Marchand, Andre; Letarte, Andree

    2006-01-01

    The goal of this study was to evaluate the efficacy of a cognitive-behavioral treatment package for comorbid generalized anxiety disorder (GAD) and panic disorder with agoraphobia (PDA). A single-case, multiple-baseline, across-subjects design was used with 3 primary GAD patients with secondary PDA. The efficacy of the treatment was evaluated with…

  4. Cost-effectiveness of psychological and pharmacological interventions for generalized anxiety disorder and panic disorder

    Microsoft Academic Search

    Louise Heuzenroeder; Marie Donnelly; Michelle M. Haby; Cathrine Mihalopoulos; Ruth Rossell; Rob Carter; Gavin Andrews; Theo Vos

    2004-01-01

    Objective: To assess from a health sector perspective the incremental cost-effectiveness of interventions for generalized anxiety disorder (cognitive behavioural therapy (CBT) and serotonin and noradrenaline reuptake inhibitors (SNRIs)) and panic disorder (CBT, selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs)). Method: The health benefit is measured as a reduction in disability-adjusted life years (DALYs), based on effect size calculations

  5. Biases in Eye Movements to Threatening Facial Expressions in Generalized Anxiety Disorder and Depressive Disorder

    Microsoft Academic Search

    Karin Mogg; Neil Millar; Brendan P. Bradley

    2000-01-01

    The study investigated biases in selective attention to emotional face stimuli in generalized anxiety disorder (GAD) and depressive disorder, using a modified probe detection task. There were 4 face types: threatening, sad, happy, and neutral. Measures of attentional bias included (a) the direction and latency of the initial eye movement in response to the faces and (b) manual reaction time

  6. Variability in Anxiety and Depression Over Time Following Diagnosis in Patients with Prostate Cancer

    Microsoft Academic Search

    Christopher F. Sharpley; David R. H. Christie; Vicki Bitsika

    2010-01-01

    To determine the presence and nature of variability in anxiety and depression in patients with prostate cancer (PCa) over 3 years following diagnosis, 442 patients with PCa completed standardized anxiety and depression inventories via survey between 1 and 36 months after receiving their initial diagnosis. Data were analyzed from a series of 3-month cohorts, and results indicated that total scores

  7. Validity of the Revised Children's Anxiety and Depression Scale for youth with autism spectrum disorders.

    PubMed

    Sterling, Lindsey; Renno, Patricia; Storch, Eric A; Ehrenreich-May, Jill; Lewin, Adam B; Arnold, Elysse; Lin, Enjey; Wood, Jeffrey

    2015-01-01

    High rates of anxiety and depression are reported among youth with autism spectrum disorders. These conditions are generally assessed using measures validated for typically developing youth. Few studies have investigated their validity for autism spectrum disorders, which is crucial for accurate assessment and the provision of proper treatment. The Revised Children's Anxiety and Depression Scale was evaluated with 67 youth with autism spectrum disorders to examine its utility in measuring anxiety and depression in this population. Parents and children (aged 11-15 years) referred to a multisite intervention study completed the Pediatric Anxiety Rating Scale, Multidimensional Anxiety Scale for Children, Anxiety Disorders Interview Schedule, Child Behavior Checklist, and Revised Children's Anxiety and Depression Scale. Results suggest acceptable internal consistency of the Revised Children's Anxiety and Depression Scale. Modest convergent validity was found among the Revised Children's Anxiety and Depression Scale and other standardized measures of anxiety and depression. There were stronger correlations between Revised Children's Anxiety and Depression Scale Total scores and subscales of measures expected to correlate significantly than those not expected to correlate. One exception was a significant association between the Revised Children's Anxiety and Depression Scale and Child Behavior Checklist Attention subscale, calling into question the divergent validity in separating anxiety from attention problems. Overall, results suggest preliminary support for the Revised Children's Anxiety and Depression Scale in youth with high-functioning autism spectrum disorders. PMID:24419073

  8. Discovery of serum biomarkers predicting development of a subsequent depressive episode in social anxiety disorder.

    PubMed

    Gottschalk, M G; Cooper, J D; Chan, M K; Bot, M; Penninx, B W J H; Bahn, S

    2015-08-01

    Although social anxiety disorder (SAD) is strongly associated with the subsequent development of a depressive disorder (major depressive disorder or dysthymia), no underlying biological risk factors are known. We aimed to identify biomarkers which predict depressive episodes in SAD patients over a 2-year follow-up period. One hundred sixty-five multiplexed immunoassay analytes were investigated in blood serum of 143 SAD patients without co-morbid depressive disorders, recruited within the Netherlands Study of Depression and Anxiety (NESDA). Predictive performance of identified biomarkers, clinical variables and self-report inventories was assessed using receiver operating characteristics curves (ROC) and represented by the area under the ROC curve (AUC). Stepwise logistic regression resulted in the selection of four serum analytes (AXL receptor tyrosine kinase, vascular cell adhesion molecule 1, vitronectin, collagen IV) and four additional variables (Inventory of Depressive Symptomatology, Beck Anxiety Inventory somatic subscale, depressive disorder lifetime diagnosis, BMI) as optimal set of patient parameters. When combined, an AUC of 0.86 was achieved for the identification of SAD individuals who later developed a depressive disorder. Throughout our analyses, biomarkers yielded superior discriminative performance compared to clinical variables and self-report inventories alone. We report the discovery of a serum marker panel with good predictive performance to identify SAD individuals prone to develop subsequent depressive episodes in a naturalistic cohort design. Furthermore, we emphasise the importance to combine biological markers, clinical variables and self-report inventories for disease course predictions in psychiatry. Following replication in independent cohorts, validated biomarkers could help to identify SAD patients at risk of developing a depressive disorder, thus facilitating early intervention. PMID:25929723

  9. Interpersonal correlates of generalized anxiety disorder: Self versus other perception

    Microsoft Academic Search

    Winnie Eng; Richard G. Heimberg

    2006-01-01

    The present investigation examined the interpersonal functioning of undergraduate students who met self-report criteria for generalized anxiety disorder (GAD), both as they perceive it and as perceived by their self-nominated friends. Forty-eight participants who met self-report criteria for GAD endorsed greater global severity of interpersonal problems on the 64-item version of the Inventory of Interpersonal Problems [Horowitz, L. M., Alden,

  10. A self-report diagnostic measure of generalized anxiety disorder

    Microsoft Academic Search

    Lizabeth Roemer; Mary Borkovec; Sharon Posa; T. D. Borkovec

    1995-01-01

    The present study tested the reliability of a self-report diagnostic measure of generalized anxiety disorder (GAD) based on DSM criteria. Among two samples of undergraduate students, 47–80% of the GAD diagnoses by questionnaire were confirmed by diagnostic interview, with the higher rate being associated with DSM-IV criteria. Categorization of a participant as Non-GAD by questionnaire was found to be 100%

  11. Evidence-based Practice for Childhood Anxiety Disorders

    Microsoft Academic Search

    Golda S. Ginsburg; Julie Newman Kingery

    2007-01-01

    Anxiety disorders are among the most common psychiatric conditions in children and adolescents. Empirical evidence suggests\\u000a that the majority of youth will show clinically meaningful benefits after a short-term course of cognitive-behavioral therapy\\u000a (CBT). This article presents an update on the status of this treatment literature and provides clinicians with a description\\u000a of specific CBT strategies. A case example illustrating

  12. The utility of screen for child anxiety related emotional disorders (scared) as a tool for identifying children at high risk for prevalent anxiety disorders

    Microsoft Academic Search

    Peter Muris; Harald Merckelbach; Merel Kindt; Susan Bögels; Laura Dreessen; Ciona Van Dorp; Andrea Habets; Sandra Rosmuller; Nienke Snieder

    2001-01-01

    The current study examined the utility of the Screen for Child Anxiety Related Emotional Disorders (SCARED) as a screening tool for the identification of children at high risk for prevalent childhood anxiety disorders. The child version of the Structured Clinical Interview for DSM (KSCID) was used as the diagnostic standard. It was investigated whether SCARED scores are indicative for the

  13. Generalized Anxiety Disorder: Course and Risk Factors in Pregnancy

    PubMed Central

    Buist, Anne; Gotman, Nathan

    2011-01-01

    Background There are limited studies of generalized anxiety disorder (GAD) across pregnancy. Methods Women (n=2793) were enrolled in the Yale Pink and Blue study, a cohort enriched with subjects who suffered from major depressive disorder (MDD) within the past five years or used antidepressants in the past year. Subjects were evaluated with the Composite International Diagnostic Interview at three time points: twice in pregnancy and once after delivery. We defined a generalized anxiety disorder (GAD) episode as per DSM IV but with required duration reduced to one month or longer. Course and correlates of GAD were examined in women who had: 1) no GAD during the 6 months prior or in pregnancy (Group A), 2) GAD in the 6 months prior to but not in pregnancy (Group B), 3) GAD in pregnancy only (Group C) and 4) GAD both in the 6 months prior to and during pregnancy (Group D). Results 9.5% of the cohort suffered from GAD at some point in pregnancy. Anxiety symptoms were highest in the first trimester and decreased across pregnancy. Regression analysis revealed that previous GAD episodes, education, social support and a history of child abuse distinguished between membership in the four groups. Limitations The sample may not be representational, as it was enhanced with those at risk, and had relatively low representation of socio-economically disadvantaged women. Conclusions Identification of anxious patients during pregnancy may provide an opportunity to engage those in need of psychiatric treatment. PMID:21269708

  14. Development and Preliminary Evaluation of a 1-Week Summer Treatment Program for Separation Anxiety Disorder.

    PubMed

    Santucci, Lauren C; Ehrenreich, Jill T; Trosper, Sarah E; Bennett, Shannon M; Pincus, Donna B

    2009-08-01

    Numerous clinical trials have demonstrated the efficacy of cognitive behavior therapy (CBT) for the treatment of childhood Separation Anxiety Disorder (SAD) and other anxiety disorders (Velting, Setzer, & Albano, 2004), yet additional research may still be needed to better access and engage anxious youth (Kendall, Suveg, & Kingery, 2006). In this study, we investigated the acceptability and preliminary utility of a group cognitive-behavioral intervention for school-aged girls with SAD provided within an intensive, 1-week setting. The development of the proposed treatment strategy, a 1-week summer treatment program, was predicated on evidence supporting the need for childhood treatments that are developmentally sensitive, allow for creative application of intervention components, incorporate a child's social context, and ultimately establish new pathways for dissemination to the community. The summer treatment program for SAD was pilot-tested using a case-series design with 5 female children, aged 8 to 11, each with a principal diagnosis of SAD. For 4 of the 5 participants, treatment gains were evidenced by changes in diagnostic status, significant reductions in measures of avoidance, and improvements on self- and parent-report measures of anxiety symptomology. Specifically, severity of SAD symptoms decreased substantially at posttreatment for each participant and, 2 months following treatment, none of the participants met diagnostic criteria for the disorder. A fifth participant experienced substantive improvement in diagnostic status prior to the onset of treatment and, though she evidenced continued improvements following treatment, the role of the intervention in such improvements is less clear. PMID:21935300

  15. Which DSM-IV-TR criteria best differentiate high-functioning autism spectrum disorder from ADHD and anxiety disorders in older children?

    PubMed Central

    HARTLEY, SIGAN L.; SIKORA, DARRYN M.

    2010-01-01

    Diagnosis of autism spectrum disorder (ASD) is often delayed in high-functioning children with milder and more varied forms of ASD. The substantial overlap between ASD and other psychiatric disorders is thought to contribute to this delay. This study examined the endorsement of DSM-IV-TR diagnostic criteria for ASD based on semi-structured parent interviews across three groups of older children referred to an ASD clinic: 55 children diagnosed with high-functioning ASD, 27 children diagnosed with attention-deficit/hyperactivity disorder (ADHD), and 23 children diagnosed with anxiety disorder. Results indicate that the criteria within the domains of communication and social relatedness were largely able to discriminate the high-functioning ASD group from the ADHD and anxiety disorder groups, but criteria within the domain of restricted/repetitive/stereotyped patterns were not. PMID:19759063

  16. Correlations among two self-report questionnaires for measuring DSM-defined anxiety disorder symptoms in children: the Screen for Child Anxiety Related Emotional Disorders and the Spence Children’s Anxiety Scale

    Microsoft Academic Search

    Peter Muris; Henk Schmidt; Harald Merckelbach

    2000-01-01

    The Screen for Child Anxiety Related Emotional Disorders (SCARED) and the Spence Children’s Anxiety Scale (SCAS) are recently developed self-report questionnaires for measuring DSM-IV defined anxiety disorder symptoms in children. The present study examined correlations among these measures in a large sample of Dutch school children (N=1011). Results showed that there was a strong correlation between the total anxiety scores

  17. Attention Mechanisms in Children with Anxiety Disorders and in Children with Attention Deficit Hyperactivity Disorder: Implications for Research and Practice

    ERIC Educational Resources Information Center

    Weissman, Adam S.; Chu, Brian C.; Reddy, Linda A.; Mohlman, Jan

    2012-01-01

    Inattention is among the most commonly referred problems for school-aged youth. Research suggests distinct mechanisms may contribute to attention problems in youth with anxiety disorders versus youth with attention deficit hyperactivity disorder (ADHD). This study compared children (8-17 years) with anxiety disorders (n = 24) and children (8-16…

  18. Observing Interactions between Children and Adolescents and their Parents: The Effects of Anxiety Disorder and Age.

    PubMed

    Waite, Polly; Creswell, Cathy

    2015-08-01

    Parental behaviors, most notably overcontrol, lack of warmth and expressed anxiety, have been implicated in models of the development and maintenance of anxiety disorders in children and young people. Theories of normative development have proposed that different parental responses are required to support emotional development in childhood and adolescence, yet age has not typically been taken into account in studies of parenting and anxiety disorders. In order to identify whether associations between anxiety disorder status and parenting differ in children and adolescents, we compared observed behaviors of parents of children (7-10 years) and adolescents (13-16 years) with and without anxiety disorders (n?=?120), while they undertook a series of mildly anxiety-provoking tasks. Parents of adolescents showed significantly lower levels of expressed anxiety, intrusiveness and warm engagement than parents of children. Furthermore, offspring age moderated the association between anxiety disorder status and parenting behaviors. Specifically, parents of adolescents with anxiety disorders showed higher intrusiveness and lower warm engagement than parents of non-anxious adolescents. A similar relationship between these parenting behaviors and anxiety disorder status was not observed among parents of children. The findings suggest that theoretical accounts of the role of parental behaviors in anxiety disorders in children and adolescents should distinguish between these different developmental periods. Further experimental research to establish causality, however, would be required before committing additional resources to targeting parenting factors within treatment. PMID:25788041

  19. Agoraphobia, panic disorder and generalized anxiety disorder: some implications of recent advances.

    PubMed

    Roth, M

    1984-01-01

    The nature of the relationship between 'panic disorder', agoraphobia and general anxiety disorder remains open. The aetiological theories which have tried to link them with the aid of biological and psychological concepts fail to take account of conflicting observations. 'Panic' attacks are not confined to agoraphobic and related disorders, being indistinguishable from the attacks of acute anxiety and phobic aversion manifest in a wide range of anxiety and affective disorders. There is continuity and discontinuity in the evolution of agoraphobia; those affected differ in respect of a range of premorbid features from patients with other disorders and control subjects. These variables include family history, life development, trait anxiety and other personality characteristics including introversion, neuroticism and probably emotional dependence on others. Not all the claims made on behalf of the efficacy of pharmacological treatment on the one hand and behavioural therapies on the other are substantiated. The success achieved by behavioural treatment appear to endure over some years. But the residual disabilities and defects that follow all forms of treatment and the problems posed by patient selection and high drop-out rates have received insufficient attention. Aetiological theories of agoraphobia and related conditions have been advanced along biomedical, psychological and psychodynamic lines. Some evidence supports each kind of theory. But none is wholly consistent with the findings regarding its phenomenology and evolution. Recent biological investigations have led to the formulation of hypotheses in relation to anticipatory and chronic anxiety in terms of changes in synaptic connections, enhancement of transmitter release as well as alterations in molecular configuration and regulation of gene expression. It would be premature to conclude that these findings can provide a unitary conceptual framework for the explanation of human anxiety disorders. The psychological, behavioural and psychodynamic aspects of this group of disorders should all continue to receive due attention both in clinical management and scientific investigation. PMID:6371803

  20. Video feedback with peer ratings in naturalistic anxiety-provoking situations for social anxiety disorder: Preliminary report

    Microsoft Academic Search

    Junwen Chen; Toshi A. Furukawa; Yumi Nakano; Tetsuji Ietsugu; Sei Ogawa; Tadashi Funayama; Norio Watanabe; Yumiko Noda; Ronald M. Rapee

    2010-01-01

    The present study aimed to examine how video feedback can affect perceived performance and anticipatory anxiety in various naturalistic social anxiety-provoking situations among clinical patients diagnosed with social anxiety disorder (SAD) and to examine predictors that might influence response to video feedback. Participants were 52 consecutive patients with DSM-IV SAD who participated in a group-based CBT program. Our results demonstrated

  1. Do Comorbid Anxiety Disorders Moderate the Effects of Psychotherapy for Bipolar Disorder? Results From STEP-BD

    PubMed Central

    Deckersbach, Thilo; Peters, Amy T.; Sylvia, Louisa; Urdahl, Anna; Magalhães, Pedro V.S.; Otto, Michael W.; Frank, Ellen; Miklowitz, David J.; Berk, Michael; Kinrys, Gustavo; Nierenberg, Andrew

    2013-01-01

    Objective At least 50% of individuals with bipolar disorder have a lifetime anxiety disorder. Individuals with both bipolar disorder and a co-occurring anxiety disorder experience longer illness duration, greater illness severity, and poorer treatment response. The study explored whether comorbid lifetime anxiety in bipolar patients moderates psychotherapy treatment outcome. Method In the Systematic Treatment Enhancement Program randomized controlled trial of psychotherapy for bipolar depression, participants received up to 30 sessions of intensive psychotherapy (family-focused therapy, interpersonal and social rhythm therapy, or cognitive-behavioral therapy) or collaborative care, a three-session comparison treatment, plus pharmacotherapy. Using the number needed to treat, we computed effect sizes to analyze the relationship between lifetime anxiety disorders and rates of recovery across treatment groups after 1 year. Results A total of 269 patients (113 women) with a comorbid lifetime anxiety disorder (N=177) or without a comorbid lifetime anxiety disorder (N=92) were included in the analysis. Participants with a lifetime anxiety disorder were more likely to recover with psychotherapy than with collaborative care (66% compared with 49% recovered over 1 year; number needed to treat=5.88, small to medium effect). For patients without a lifetime anxiety disorder, there was no difference between rates of recovery in psychotherapy compared with collaborative care (64% compared with 62% recovered; number needed to treat=50, small effect). Participants with one lifetime anxiety disorder were likely to benefit from intensive psychotherapy compared with collaborative care (84% compared with 53% recovered; number needed to treat=3.22, medium to large effect), whereas patients with multiple anxiety disorders exhibited no difference in response to the two treatments (54% compared with 46% recovered; number needed to treat=12.5, small effect). Conclusions Depressed patients with bipolar disorder and comorbid anxiety may be in particular need of additional psychotherapy for treating acute depression. These results need to be replicated in studies that stratify bipolar patients to treatments based on their anxiety comorbidity status. PMID:24077657

  2. Comorbid anxiety disorders in late-life depression: results of a cohort study.

    PubMed

    van der Veen, D C; van Zelst, W H; Schoevers, R A; Comijs, H C; Voshaar, R C Oude

    2014-11-01

    ABSTRACT Background: Comorbid anxiety disorders are common in late-life depression and negatively impact treatment outcome. This study aimed to examine personality characteristics as well as early and recent life-events as possible determinants of comorbid anxiety disorders in late-life depression, taking previously examined determinants into account. Methods: Using the Composite International Diagnostic Interview (CIDI 2.0), we established comorbid anxiety disorders (social phobia (SP), panic disorder (PD), generalized anxiety disorder (GAD), and agoraphobia (AGO)) in 350 patients (aged ?60 years) suffering from a major depressive disorder according to DSM-IV-TR criteria within the past six months. Adjusted for age, sex, and level of education, we first examined previously identified determinants of anxious depression: depression severity, suicidality, partner status, loneliness, chronic diseases, and gait speed in multiple logistic regression models. Subsequently, associations were explored with the big five personality characteristics as well as early and recent life-events. First, multiple logistic regression analyses were conducted with the presence of any anxiety disorder (yes/no) as dependent variable, where after analyses were repeated for each anxiety disorder, separately. Results: In our sample, the prevalence rate of comorbid anxiety disorders in late-life depression was 38.6%. Determinants of comorbid anxiety disorders were a lower age, female sex, less education, higher depression severity, early traumatization, neuroticism, extraversion, and conscientiousness. Nonetheless, determinants differed across the specific anxiety disorders and lumping all anxiety disorder together masked some determinants (education, personality). Conclusions: Our findings stress the need to examine determinants of comorbid anxiety disorder for specific anxiety disorders separately, enabling the development of targeted interventions within subgroups of depressed patients. PMID:25370017

  3. Collaborative stepped care for anxiety disorders in primary care: aims and design of a randomized controlled trial

    Microsoft Academic Search

    Anna DT Muntingh; Christina M van der Feltz-Cornelis; Harm WJ van Marwijk; Philip Spinhoven; Willem JJ Assendelft; Margot WM de Waal; Leona Hakkaart-van Roijen; Herman J Adèr; Anton JLM van Balkom

    2009-01-01

    BACKGROUND: Panic disorder (PD) and generalized anxiety disorder (GAD) are two of the most disabling and costly anxiety disorders seen in primary care. However, treatment quality of these disorders in primary care generally falls beneath the standard of international guidelines. Collaborative stepped care is recommended for improving treatment of anxiety disorders, but cost-effectiveness of such an intervention has not yet

  4. Relations among Perceived Control over Anxiety-Related Events, Worry, and Generalized Anxiety Disorder in a Sample of Adolescents

    ERIC Educational Resources Information Center

    Frala, Jamie L.; Leen-Feldner, Ellen W.; Blumenthal, Heidemarie; Barreto, Carolina C.

    2010-01-01

    This study examined the associations among perceived control over anxiety-related events, worry, and both symptoms and diagnoses of generalized anxiety disorder (GAD). The sample was comprised of 140 adolescents (60 girls) between the ages of 10 and 17 years (M[subscript age] = 14.6 years; SD = 2.25) recruited from the general community. Findings…

  5. Childhood Anxiety/Withdrawal, Adolescent Parent-Child Attachment and Later Risk of Depression and Anxiety Disorder

    ERIC Educational Resources Information Center

    Jakobsen, Ida Skytte; Horwood, L. John; Fergusson, David M.

    2012-01-01

    Previous research has shown that children with high levels of early anxiety/withdrawal are at increased risk of later anxiety and depression. It has also been found that positive parent-child attachment reduces the risk of these disorders. The aim of this paper was to examine the extent to which positive parent-child attachment acted to mitigate…

  6. [Differential diagnosis of dissociative identity disorder (multiple personality disorder)].

    PubMed

    Stübner, S; Völkl, G; Soyka, M

    1998-05-01

    Recently the concept of dissociative identity disorder (formerly known as multiple personality disorder) has attracted increasing public and scientific interest. However, it is rarely diagnosed in the clinical setting. the reported case of a 47-year-old woman with a history of child abuse demonstrates the problems of differential diagnosis. A number of psychopathologic symptoms pointed to a multiple personality disorder, but in the follow-up psychotic symptoms such as delusions, possible hallucinations and bizarre behavior clearly emerged. The differential diagnosis of dissociative identity disorder includes paranoid schizophrenia, as in the case described, borderline personality disorder, hysteria, simulation and the false memory syndrome. Finally, social and cultural factors have to be considered. PMID:9629561

  7. Preschool Anxiety Disorders: Comprehensive Assessment of Clinical, Demographic, Temperamental, Familial, and Life Stress Correlates

    PubMed Central

    Dougherty, Lea R.; Tolep, Marissa R.; Bufferd, Sara J.; Olino, Thomas M.; Dyson, Margaret; Traditi, Jennifer; Rose, Suzanne; Carlson, Gabrielle A.; Klein, Daniel N.

    2013-01-01

    This study examined correlates of preschoolers’ anxiety disorders using a comprehensive, multi-method design. Participants included a community sample of 541 three-year-old children, of whom 106 (19.6%) met criteria for at least one anxiety disorder. Child and parental psychopathology and life stress were assessed with clinical interviews. Child temperament and parenting behavior were assessed with laboratory observations. Mothers and fathers reported on their parenting styles. Compared to preschoolers with no anxiety disorder, preschoolers with an anxiety disorder were more likely to meet criteria for comorbid depressive and oppositional defiant disorders and to exhibit greater temperamental behavioral inhibition and lower positive affectivity, and more sleep problems. Children with anxiety disorders also experienced more stressful life events in the previous six months, and their mothers had a higher rate of current anxiety disorders. Compared to children with other anxiety disorders, children with only specific phobia exhibited a somewhat different pattern of associations than children with other anxiety disorders. Overall, the findings suggest that many of the correlates observed in older youth with anxiety disorders are also observed in preschoolers. PMID:23368788

  8. Defense Styles and Personality Dimensions of Research Subjects with Anxiety and Depressive Disorders

    Microsoft Academic Search

    Barbara L. Kennedy; John J. Schwab; James A. Hyde

    2001-01-01

    We used the Bond Defense Style and Cloninger Tridimensional Personality questionnaires to assess defense styles and personality dimensions in subjects with anxiety and depressive disorders. When measured against a comparison group, maladaptive defense style scores were significantly higher in those with major depression, panic disorder, generalized anxiety disorder, and social phobia, and higher at a trend level in the subjects

  9. Anxiety Disorders 12-month Prevalence: 18.1% of U.S. adult

    E-print Network

    Baker, Chris I.

    Anxiety Disorders Prevalence · 12-month Prevalence: 18.1% of U.S. adult population1 · Severe: 22 of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General an anxiety disorder over their lifetime · Race: Non-Hispanic blacks are 20% less likely, and Hispanics are 30

  10. A pilot feasibility evaluation of the CALM Program for anxiety disorders in early childhood

    Microsoft Academic Search

    Jonathan S. Comer; Anthony C. Puliafico; Sasha G. Aschenbrand; Kate McKnight; Joanna A. Robin; Matthew E. Goldfine; Anne Marie Albano

    As many as 9% of preschoolers suffer from an anxiety disorder, and earlier onset of disorder is associated with more intractable forms of psychopathology in later life. At present there is a relative dearth of empirical work examining the development of evidence-based treatments for anxiety disorders presenting in early childhood. Building on previous work supporting extensions of PCIT for separation

  11. How cigarette smoking may increase the risk of anxiety symptoms and anxiety disorders: a critical review of biological pathways

    PubMed Central

    Moylan, Steven; Jacka, Felice N; Pasco, Julie A; Berk, Michael

    2013-01-01

    Multiple studies have demonstrated an association between cigarette smoking and increased anxiety symptoms or disorders, with early life exposures potentially predisposing to enhanced anxiety responses in later life. Explanatory models support a potential role for neurotransmitter systems, inflammation, oxidative and nitrosative stress, mitochondrial dysfunction, neurotrophins and neurogenesis, and epigenetic effects, in anxiety pathogenesis. All of these pathways are affected by exposure to cigarette smoke components, including nicotine and free radicals. This review critically examines and summarizes the literature exploring the role of these systems in increased anxiety and how exposure to cigarette smoke may contribute to this pathology at a biological level. Further, this review explores the effects of cigarette smoke on normal neurodevelopment and anxiety control, suggesting how exposure in early life (prenatal, infancy, and adolescence) may predispose to higher anxiety in later life. A large heterogenous literature was reviewed that detailed the association between cigarette smoking and anxiety symptoms and disorders with structural brain changes, inflammation, and cell-mediated immune markers, markers of oxidative and nitrosative stress, mitochondrial function, neurotransmitter systems, neurotrophins and neurogenesis. Some preliminary data were found for potential epigenetic effects. The literature provides some support for a potential interaction between cigarette smoking, anxiety symptoms and disorders, and the above pathways; however, limitations exist particularly in delineating causative effects. The literature also provides insight into potential effects of cigarette smoke, in particular nicotine, on neurodevelopment. The potential treatment implications of these findings are discussed in regards to future therapeutic targets for anxiety. The aforementioned pathways may help mediate increased anxiety seen in people who smoke. Further research into the specific actions of nicotine and other cigarette components on these pathways, and how these pathways interact, may provide insights that lead to new treatment for anxiety and a greater understanding of anxiety pathogenesis. PMID:23785661

  12. Trajectories of Change in Emotion Regulation and Social Anxiety During Cognitive-Behavioral Therapy for Social Anxiety Disorder

    PubMed Central

    Goldin, Philippe R.; Lee, Ihno; Ziv, Michal; Jazaieri, Hooria; Heimberg, Richard G.; Gross, James J.

    2014-01-01

    Cognitive-behavioral therapy (CBT) for social anxiety disorder (SAD) may decrease social anxiety by training emotion regulation skills. This randomized controlled trial of CBT for SAD examined changes in weekly frequency and success of cognitive reappraisal and expressive suppression, as well as weekly intensity of social anxiety among patients receiving 16 weekly sessions of individual CBT. We expected these variables to (1) differ from pre-to-post-CBT vs. Waitlist, (2) have differential trajectories during CBT, and (3) covary during CBT. We also expected that weekly changes in emotion regulation would predict (4) subsequent weekly changes in social anxiety, and (5) changes in social anxiety both during and post-CBT. Compared to Waitlist, CBT increased cognitive reappraisal frequency and success, decreased social anxiety, but had no impact on expressive suppression. During CBT, weekly cognitive reappraisal frequency and success increased, whereas weekly expressive suppression frequency and social anxiety decreased. Weekly decreases in social anxiety were associated with concurrent increases in reappraisal success and decreases in suppression frequency. Granger causality analysis showed that only reappraisal success increases predicted decreases in subsequent social anxiety during CBT. Reappraisal success increases pre-to-post-CBT predicted reductions in social anxiety symptom severity post-CBT. The trajectory of weekly changes in emotion regulation strategies may help clinicians understand whether CBT is effective and predict decreases in social anxiety. PMID:24632110

  13. [Pharmacogenetics and anxiety disorders: analysis of recent findings].

    PubMed

    Amitai, Maya; Kronenberg, Sefi; Cohen, Tali; Frisch, Amos; Weizman, Abraham; Apter, Alan

    2014-01-01

    Anxiety disorders are chronic disorders appearing with a high frequency in the general population and causing much distress to those suffering from them. The current common treatment consists of antidepressants, primarily from the serotonin-selective-reuptake-inhibitor (SSRI) class. However, despite the relative effectiveness of these medications the patients' responses vary widely with one third not responding at all. While we do not currently have the ability to predict who will respond positively to the medication, it is hoped that genetic research will make it possible to prospectively identify responders and thus help avoid failed treatment attempts and side-effects. The field of pharmacogenetics is divided into pharmaco-kinetics (genetic factors that influence the drug metabolism in the body) and pharmco-dynamics (genetic factors that affect the response to the drug at the level of the receptors/transporters/enzymes in the target organs). Contrary to the treatment of depression, there is little research available on the pharmacogenetics of anxiety disorders and the existing research coincides with the studies on depression. The primary pharmacogenetic-dynamic findings are related to serotonergic genes of which those with the long allele of the serotonin transporter gene (5-HTTLPR) are expected to respond positively to treatment, and the same is true regarding genetic variants of several serotonin receptors. The pharmacogenetic-kinetic findings focus on the CYP450 enzyme system. The hope is that with the progression of the pharmacogenetic research new genetic variants will be discovered which, when combined with the clinical characteristics of those suffering from anxiety disorders, will enable the development of novel treatment algorithms to be customized for each patient. PMID:24791568

  14. Treating late-life generalized anxiety disorder in primary care: an effectiveness pilot study.

    PubMed

    Calleo, Jessica S; Bush, Amber L; Cully, Jeffrey A; Wilson, Nancy L; Kraus-Schuman, Cynthia; Rhoades, Howard M; Novy, Diane M; Masozera, Nicholas; Williams, Susan; Horsfield, Matthew; Kunik, Mark E; Stanley, Melinda A

    2013-05-01

    To increase the sustainability of cognitive behavior therapy (CBT) in primary care for late-life anxiety, we incorporated nonexpert counselors, options for telephone meetings, and integration with primary care clinicians. This open trial examines the feasibility, satisfaction, and clinical outcomes of CBT delivered by experienced and nonexperienced counselors for older adults with generalized anxiety disorder (GAD). Clinical outcomes assessed worry (Penn State Worry Questionnaire), GAD (Generalized Anxiety Disorder Severity Scale), and anxiety (Beck Anxiety Inventory and Structured Interview Guide for Hamilton Anxiety Scale). After 3 months of treatment, Cohen's d effect sizes for worry and anxiety ranged from 0.48 to 0.78. Patients treated by experienced and nonexperienced counselors had similar reductions in worry and anxiety, although treatment outcomes were more improved on the Beck Anxiety Inventory for experienced therapists. Preliminary results suggest that adapted CBT can effectively reduce worry. The piloted modifications can provide acceptable and feasible evidence-based care. PMID:23588228

  15. Sensitivity for Treatment Effects of the Screen for Child Anxiety Related Emotional Disorders

    Microsoft Academic Search

    Peter Muris; Harald Merckelbach; Björn Gadet; Véronique Moulaert; Sandy Tierney

    1999-01-01

    The Screen for Child Anxiety Related Emotional Disorders (SCARED) is a relatively new self-report questionnaire that measures DSM-defined anxiety disorders symptoms in children. The present study examined the treatment sensitivity of the SCARED. Eleven anxiety-disordered children aged 10 to 13 years received cognitive-behavioral treatment, an intervention that is generally known to be effective. Children completed the SCARED on three occasions:

  16. The diagnostic utility of separation anxiety disorder symptoms: an item response theory analysis.

    PubMed

    Cooper-Vince, Christine E; Emmert-Aronson, Benjamin O; Pincus, Donna B; Comer, Jonathan S

    2014-01-01

    At present, it is not clear whether the current definition of separation anxiety disorder (SAD) is the optimal classification of developmentally inappropriate, severe, and interfering separation anxiety in youth. Much remains to be learned about the relative contributions of individual SAD symptoms for informing diagnosis. Two-parameter logistic Item Response Theory analyses were conducted on the eight core SAD symptoms in an outpatient anxiety sample of treatment-seeking children (N?=?359, 59.3 % female, M Age?=?11.2) and their parents to determine the diagnostic utility of each of these symptoms. Analyses considered values of item threshold, which characterize the SAD severity level at which each symptom has a 50 % chance of being endorsed, and item discrimination, which characterize how well each symptom distinguishes individuals with higher and lower levels of SAD. Distress related to separation and fear of being alone without major attachment figures showed the strongest discrimination properties and the lowest thresholds for being endorsed. In contrast, worry about harm befalling attachment figures showed the poorest discrimination properties, and nightmares about separation showed the highest threshold for being endorsed. Distress related to separation demonstrated crossing differential item functioning associated with age-at lower separation anxiety levels excessive fear at separation was more likely to be endorsed for children ?9 years, whereas at higher levels this symptom was more likely to be endorsed by children <9 years. Implications are discussed for optimizing the taxonomy of SAD in youth. PMID:23963543

  17. The diagnostic utility of separation anxiety disorder symptoms: An item response theory analysis

    PubMed Central

    Cooper-Vince, Christine E.; Emmert-Aronson, Benjamin O.; Pincus, Donna B.; Comer, Jonathan S.

    2013-01-01

    At present, it is not clear whether the current definition of separation anxiety disorder (SAD) is the optimal classification of developmentally inappropriate, severe, and interfering separation anxiety in youth. Much remains to be learned about the relative contributions of individual SAD symptoms for informing diagnosis. Two-parameter logistic Item Response Theory analyses were conducted on the eight core SAD symptoms in an outpatient anxiety sample of treatment-seeking children (N=359, 59.3% female, MAge=11.2) and their parents to determine the diagnostic utility of each of these symptoms. Analyses considered values of item threshold, which characterize the SAD severity level at which each symptom has a 50% chance of being endorsed, and item discrimination, which characterize how well each symptom distinguishes individuals with higher and lower levels of SAD. Distress related to separation and fear of being alone without major attachment figures showed the strongest discrimination properties and the lowest thresholds for being endorsed. In contrast, worry about harm befalling attachment figures showed the poorest discrimination properties, and nightmares about separation showed the highest threshold for being endorsed. Distress related to separation demonstrated crossing differential item functioning associated with age—at lower separation anxiety levels excessive fear at separation was more likely to be endorsed for children ?9 years, whereas at higher levels this symptom was more likely to be endorsed by children <9 years. Implications are discussed for optimizing the taxonomy of SAD in youth. PMID:23963543

  18. Factors affecting the presence of depression, anxiety disorders, and suicidal ideation in patients attending primary health care service in Lithuania

    PubMed Central

    Bunevicius, Robertas; Peceliuniene, Jurate; Raskauskiene, Nijole; Bunevicius, Adomas; Mickuviene, Narseta

    2014-01-01

    Abstract Objective. The aim of this study was to establish prevalence, recognition, and risk factors for mental disorders and suicidal ideation in PC patients. Design. A cross-sectional survey based on standard mental health evaluation. Setting. Lithuanian primary care. Subjects. 998 patients from four urban PC clinics. Main outcome measures. Current mental disorders and suicidal ideation assessed using the Mini International Neuropsychiatric Interview (MINI). Results. According to the MINI, 27% of patients were diagnosed with at least one current mental disorder. The most common mental disorders were generalized anxiety disorder (18%) and major depressive episode (MDE) (15%), followed by social phobia (3%), panic disorder (3%), and post-traumatic stress disorder (2%). Some 6% of patients reported suicidal ideation. About 70% of patients with current mental disorder had no documented psychiatric diagnosis and about 60% received no psychiatric treatment. Greater adjusted odds for current MDE were associated with being widowed or divorced patients (odds ratio, OR = 1.8, 95% CI 1.2–2.8) and with lower education (OR = 1.6, 95% CI 1.1–2.3), while greater adjusted odds for any current anxiety disorder were found for women (OR = 1.9, 95% CI 1.3–2.8) and for patients with documented insomnia (OR = 2.2, 95% CI 1.2–4.2). Suicidal ideation was independently associated with use of antidepressants (OR = 5.4, 95% CI 1.7–16.9), with current MDE (OR = 2.9, 95% CI 1.5–5.8), and with excessive alcohol consumption (OR = 2.0, 95% CI 1.1–3.8). Conclusions. Depression, anxiety disorders, and suicidal ideation are prevalent but poorly recognized among PC patients. The presence of current MDE is independently associated with marital status and with lower education, while current anxiety disorder is associated with female gender and insomnia. Suicidal ideation is associated with current MDE, and with antidepressants and alcohol use. PMID:24533847

  19. Borderline Personality Disorder: Ontogeny of a Diagnosis

    PubMed Central

    Gunderson, John G.

    2011-01-01

    Objective The purpose of this article is to describe the development of the borderline personality disorder diagnosis, highlighting both the obstacles encountered and the associated achievements. Method On the basis of a review of the literature, the author provides a chronological account of the borderline construct in psychiatry, summarizing progress in decade-long intervals. Results Borderline personality disorder has moved from being a psychoanalytic colloquialism for untreatable neurotics to becoming a valid diagnosis with significant heritability and with specific and effective psychotherapeutic treatments. Nonetheless, patients with this disorder pose a major public health problem while they themselves remain highly stigmatized and largely neglected. Conclusions Despite remarkable changes in our knowledge about borderline personality disorder, increased awareness involving much more education and research is still needed. Psychiatric institutions, professional organizations, public policies, and reimbursement agencies need to prioritize this need. PMID:19411380

  20. Cognitive impairment in generalized anxiety disorder revealed by event-related potential N270

    PubMed Central

    Yang, Yingxue; Zhang, Xiating; Zhu, Yu; Dai, Yakang; Liu, Ting; Wang, Yuping

    2015-01-01

    Background Cognitive function in anxiety disorders has been the subject of limited investigation, especially in generalized anxiety disorder (GAD). The purpose of this study was to investigate the cognitive function in subjects with GAD using mismatch-triggered negativity N270. Methods Fifteen medication-free patients with a DSM-IV diagnosis of GAD, and 15 well-matched healthy controls performed a dual-feature delayed matching task while event-related potentials were recorded from their scalp. Results The GAD group was characterized by the decreased N270 amplitude in the left hemisphere. The smaller N270 amplitude was associated with greater symptoms of anxiety and depression. Conclusion Since N270 is thought to index cognitive function in different domains, including attention and memory, our results suggest that individuals with GAD have an impaired cognitive function, particularly in selective attention and working memory. These cognitive deficits may have clinical significance in subjects with GAD and should be considered in treatment planning.

  1. The relationship between parents' poor emotional health status and childhood mood and anxiety disorder in Florida children, national survey of children's health, 2011-2012.

    PubMed

    Reid, Keshia M

    2015-05-01

    The purpose of this study was to examine how parents' emotional health relates to childhood mood and anxiety disorder among Florida children in the 2011-2012 National Survey of Children's Health. Analyses were restricted to 1,241 Florida children 6-17 years of age. Childhood mood and anxiety disorder was defined as a parent-reported diagnosis of current depression or anxiety. Parents' emotional health status was a composite measure of the lowest reported emotional health of any parent in the household. To assess the association between parents' emotional health and childhood mood and anxiety disorder, bivariate and multivariate logistic regression analyses were performed. Nearly 5 % of Florida children had a mood or anxiety disorder in 2011-2012. Children living with a parent in poor emotional health were significantly more likely to have a mood or anxiety disorder compared to children living with a parent in good emotional health (OR 5.01; 95 % CI 1.89, 13.29). After adjusting for covariates, this association remained substantial and significant (aOR 4.33; 95 % CI 1.49, 12.57). Findings presented here are consistent with national findings and emphasize the strong link between parents' emotional health status and childhood mood and anxiety disorders. To address the mental health of children in the state of Florida, Florida public health initiatives should consider family processes and child level characteristics. PMID:25272995

  2. Theory of mind impairments in social anxiety disorder.

    PubMed

    Hezel, Dianne M; McNally, Richard J

    2014-07-01

    Social anxiety disorder (SAD) is a common psychiatric disorder characterized by a persistent, excessive fear and avoidance of social and performance situations. Research on cognitive biases indicates individuals with SAD may lack an accurate view of how they are perceived by others, especially in social situations when they allocate important attentional resources to monitoring their own actions as well as external threat. In the present study, we explored whether socially anxious individuals also have impairments in theory of mind (ToM), or the ability to comprehend others' mental states, including emotions, beliefs, and intentions. Forty socially anxious and 40 non-socially-anxious comparison participants completed two ToM tasks: the Reading the Mind in the Eyes and the Movie for the Assessment of Social Cognition. Participants with SAD performed worse on ToM tasks than did non-socially-anxious participants. Relative to comparison participants, those with SAD were more likely to attribute more intense emotions and greater meaning to what others were thinking and feeling. These group differences were not due to interpretation bias. The ToM impairments in people with SAD are in the opposite direction of those in people with autism spectrum conditions whose inferences about the mental states of other people are absent or very limited. This association between SAD and ToM may have important implications for our understanding of both the maintenance and treatment of social anxiety disorder. PMID:24912465

  3. Depressive and anxiety disorders in different ethnic groups

    Microsoft Academic Search

    Matty A. S. de Wit; Wilco C. Tuinebreijer; Jack Dekker; Aart-Jan T. F. Beekman; Wim H. M. Gorissen; Agnes C. Schrier; Brenda W. J. H. Penninx; Ivan H. Komproe; Arnoud P. Verhoeff

    2008-01-01

    Introduction  To explore ethnic differences in psychopathology, this study examined the prevalence of depressive and anxiety disorders among\\u000a different ethnic groups in Amsterdam and determined whether ethnic differences can be explained by socio-demographic differences.\\u000a \\u000a \\u000a \\u000a Methods  A population-based sample of 321 Dutch, 231 Turkish, 191 Moroccan, 87 Surinamese\\/Antilleans was interviewed by well-trained\\u000a bilingual interviewers, using the CIDI 2.1. Educational level and income were

  4. Cognitive-Behavioral Treatments for Anxiety and Phobic Disorders in Children and Adolescents: A Review

    ERIC Educational Resources Information Center

    King, Neville J.; Heyne, David; Ollendick, Thomas H.

    2005-01-01

    This article provides an overview of cognitive-behavioural strategies used in the treatment of child-anxiety problems, emphasizing the need for exposure and caregiver involvement. Most of the paper focuses on developments in empirically supported cognitive-behavioral intervention protocols for generalized anxiety disorder, separation anxiety

  5. Treatment of panic disorder with agoraphobia in an anxiety disorders clinic: factors influencing psychiatrists’ treatment choices

    Microsoft Academic Search

    Vladan Starcevic; Michael Linden; E. H. Uhlenhuth; Dusan Kolar; Milan Latas

    2004-01-01

    The main objective of this report was to identify patient characteristics that led psychiatrists in an academic anxiety disorders clinic to make a decision about intensive treatment of patients with panic disorder with agoraphobia (PDA) with cognitive-behavioral therapy (CBT) alone, CBT plus a high-potency benzodiazepine (CBT+BZ) or CBT combined with BZ and an antidepressant, fluoxetine (CBT+BZ+AD). On the basis of

  6. Cholesterol levels in panic disorder, generalized anxiety disorder and major depression

    Microsoft Academic Search

    ACIOLY L. T. LACERDA; DORGIVAL CAETANO; SHEILA C. CAETANO

    2000-01-01

    Serum plasma total cholesterol levels were measured in 85 male or female outpatients with panic disorder (PD; N=41), generalized anxiety disorder (GAD; N=23) and major depression (MD; N=21) according to DSM-IV criteria. All the patients had a mean cholesterol level within the normal range; males (N=22) and females (N=63) had approximately the same serum cholesterol levels (p > .05). No

  7. Diagnosis and Management of Inherited Platelet Disorders

    PubMed Central

    Kirchmaier, Carl Maximilian; Pillitteri, Daniele

    2010-01-01

    Summary In clinical daily practice the definition of a bleeding tendency is rather subjective. Clinical manifestations usually include hematoma, epistaxis, menorrhagia, and severe bleeding episodes after surgery or injuries. The most common causes are disorders of primary hemostasis that occur sometimes due to platelet function disorders. Inherited thrombocytopathies are much less frequent in comparison to acquired platelet function disorders. However, congenital disorders can lead to severe bleeding tendency and are often not diagnosed. They are induced by different platelet defects based on disorders of platelet adhesion, receptors, secretion, and signal transduction. In some cases, they are associated with thrombocytopenias, giant platelets, and various comorbidities. This article gives an overview of the different defects, their diagnosis, and treatment options. PMID:21113246

  8. The role of perceived parenting in familial aggregation of anxiety disorders in children.

    PubMed

    van Gastel, W; Legerstee, J S; Ferdinand, R F

    2009-01-01

    This study was designed to explore the role of perceived parenting style in the familial aggregation of anxiety disorders. We examined the association between parental and child anxiety diagnoses, and tested whether this association was partly due to a perceived parenting style. The study was conducted in a clinical sample as well as in a control sample. Parental lifetime and current anxiety diagnoses were significantly associated with child anxiety diagnoses. When maternal and paternal lifetime and current anxiety diagnoses were entered as separate predictors, only maternal current anxiety diagnoses appeared to be significant. Perceived parenting style was assessed with the dimensions "overprotection," "emotional warmth," "rejection," and "anxious rearing." Results indicated that only maternal and paternal 'overprotection' was significantly but negatively associated with child anxiety. However, further analyses showed that 'overprotection' did not have a significant mediating role in the familial aggregation of anxiety disorders. PMID:18455361

  9. [Differential diagnosis of hearing disorders].

    PubMed

    Schulze, A; Zahnert, T

    2014-10-01

    Hearing impairment is considered as the most common impairment of a human sense system. According to WHO, 360 Million people worldwide were affected by hearing loss in 2012, out of which 91% were adults and 9% children.Hearing impairment can be triggered by various mechanisms, such as locally destructive processes (chronic otitis media, cholesteatoma or traumatic lesions) or systemic influences like infectious or ototoxic substances (measles, mumps, meningococcal meningitis or medication and industrial agents). Congenital dysplasia, perinatal complications and genetic modifications can lead to hearing loss as well. Moreover, the acute or chronic noise exposure associated with the changing spare time activities in industrial nations represents an increasingly significant source of hearing impairment. In order to achieve the best hearing rehabilita-tion, a specific differential diagnosis in each case is of significant importance. PMID:25302598

  10. AN OPEN TRIAL OF INTEGRATIVE THERAPY FOR GENERALIZED ANXIETY DISORDER

    PubMed Central

    Newman, Michelle G.; Castonguay, Louis G.; Borkovec, Thomas D.; Fisher, Aaron J.; Nordberg, Samuel S.

    2009-01-01

    Cognitive– behavioral therapy (CBT), although effective, has the lowest average effect size for generalized anxiety disorder (GAD), when compared to effect sizes of CBT for other anxiety disorders. Additional basic and applied research suggests that although interpersonal processes and emotional avoidance may be maintaining GAD symptomatology, CBT has not sufficiently addressed interpersonal issues or emotion avoidance. This study aimed to test the feasibility and preliminary efficacy of an integrative psychotherapy, combining CBT with techniques to address interpersonal problems and emotional avoidance. Eighteen participants received 14 sessions of CBT plus interpersonal emotional processing therapy and three participants (for training and feasibility purposes) received 14 sessions of CBT plus supportive listening. Results showed that the integrative therapy significantly decreased GAD symptomatology, with maintenance of gains up to 1 year following treatment. In addition, comparisons with extant literature suggested that the effect size for this new GAD treatment was higher than the average effect size of CBT for GAD. Results also showed clinically significant change in GAD symptomatology and interpersonal problems with continued gains during the 1-year follow-up. Implications of these results are discussed. PMID:19881891

  11. Pathological circuit function underlying addiction and anxiety disorders.

    PubMed

    Lüthi, Andreas; Lüscher, Christian

    2014-12-01

    Current models of addiction and anxiety stem from the idea that aberrant function and remodeling of neural circuits cause the pathological behaviors. According to this hypothesis, a disease-defining experience (for example, drug reward or stress) would trigger specific forms of synaptic plasticity, which in susceptible subjects would become persistent and lead to the disease. While the notion of synaptic diseases has received much attention, no candidate disorder has been sufficiently investigated to yield new, rational therapies that could be tested in the clinic. Here we review the arguments in favor of abnormal neuronal plasticity underlying addiction and anxiety disorders, with a focus on the functional diversity of neurons that make up the circuits involved. We argue that future research must strive to obtain a comprehensive description of the relevant functional anatomy. This will allow identification of molecular mechanisms that govern the induction and expression of disease-relevant plasticity in identified neurons. To establish causality, one will have to test whether normalization of function can reverse pathological behavior. With these elements in hand, it will be possible to propose blueprints for manipulations to be tested in translational studies. The challenge is daunting, but new techniques, above all optogenetics, may enable decisive advances. PMID:25402855

  12. Phenomenological and Pharmacological Study of Provoked Obsessive\\/Anxiety Symptoms in Obsessive–Compulsive Disorder: A Preliminary Study

    Microsoft Academic Search

    Suck Won Kim; Maurice W Dysken; Matt G Kushner; Michael A Kuskowski; Kathy M Hoover; Kate W Klein; Patricia L Faris; Boyd K Hartman

    1997-01-01

    Background: Inclusion of obsessive–compulsive disorder (OCD) as an anxiety disorder in DSM-IV assumes that anxiety is the primary symptom of OCD; however, persuasive empirical evidence in support of this view has not been presented yet. In the present study we hypothesized that provoked anxiety symptoms respond better to intravenous diazepam than would provoked obsessions. We, therefore, reasoned that anxiety symptoms

  13. Single Case Evaluation of an Intensive Cognitive Behavioral Treatment for Generalized Social Anxiety Disorder.

    PubMed

    Stoddard, Jill A; Rosellini, Anthony J; Hofmann, Stefan G

    2008-06-01

    The present study investigated the efficacy of an 8-day, 6-session, intensive individual cognitive behavioral therapy protocol for social anxiety disorder using a multiple baseline across subjects design with 1, 2, and 3 months follow-up assessments. Participants were 5 outpatients with generalized social anxiety disorder. The intervention had variable effects on clinician-rated and self-report measures of anxiety and depression. The results question the efficacy of intensive psychotherapy as a general therapeutic strategy for social anxiety disorder. Directions for future research are discussed. PMID:19169365

  14. Single Case Evaluation of an Intensive Cognitive Behavioral Treatment for Generalized Social Anxiety Disorder

    PubMed Central

    Stoddard, Jill A.; Rosellini, Anthony J.; Hofmann, Stefan G.

    2008-01-01

    The present study investigated the efficacy of an 8-day, 6-session, intensive individual cognitive behavioral therapy protocol for social anxiety disorder using a multiple baseline across subjects design with 1, 2, and 3 months follow-up assessments. Participants were 5 outpatients with generalized social anxiety disorder. The intervention had variable effects on clinician-rated and self-report measures of anxiety and depression. The results question the efficacy of intensive psychotherapy as a general therapeutic strategy for social anxiety disorder. Directions for future research are discussed. PMID:19169365

  15. Anxiety sensitivity and subjective social status in relation to anxiety and depressive symptoms and disorders among Latinos in primary care.

    PubMed

    Zvolensky, Michael J; Bakhshaie, Jafar; Garza, Monica; Valdivieso, Jeanette; Ortiz, Mayra; Bogiaizian, Daniel; Robles, Zuzuky; Vujanovic, Anka

    2015-05-01

    The present investigation examined the interactive effects of anxiety sensitivity and subjective social status in relation to anxiety and depressive symptoms and psychopathology among 143 Latinos (85.7% female; Mage=39.0, SD=10.9; 97.2% used Spanish as their first language) who attended a community-based primary healthcare clinic. Results indicated that the interaction between anxiety sensitivity and subjective social status was significantly associated with number of mood and anxiety disorders, panic, social anxiety, and depressive symptoms. The form of the significant interactions indicated that individuals reporting co-occurring higher levels of anxiety sensitivity and lower levels of subjective social status evidenced the greatest levels of psychopathology and panic, social anxiety, and depressive symptoms. The present findings suggest that there is merit in focusing further scientific attention on the interplay between anxiety sensitivity and subjective social status in regard to understanding, and thus, better intervening to reduce anxiety/depressive vulnerability among Latinos in primary care. PMID:25847548

  16. Clinical assessment of DSM-IV anxiety disorders in fragile X syndrome: prevalence and characterization

    Microsoft Academic Search

    Lisa Cordeiro; Elizabeth Ballinger; Randi Hagerman; David Hessl

    2011-01-01

    Fragile X syndrome (FXS) is the most common form of inherited intellectual disability (ID). Anxiety and social withdrawal\\u000a are considered core features of the FXS phenotype, yet there is limited diagnostic evidence of the prevalence of formal anxiety\\u000a disorders in FXS. This study assessed the prevalence of anxiety disorders in a sample of 58 males and 39 females with FXS

  17. Sleep-Related Problems Among Children and Adolescents With Anxiety Disorders

    Microsoft Academic Search

    CANDICE A. ALFANO; GOLDA S. GINSBURG; JULIE NEWMAN KINGERY

    2007-01-01

    ObjectiveThe present study examined sleep-related problems (SRPs) among a large sample (n = 128) of youth with anxiety disorders (i.e., generalized, separation, and social). The frequency of eight specific SRPs was examined in relation to age, gender, type of anxiety disorder, anxiety severity, and functional impairment. The impact of pharmacological treatment (fluvoxamine versus pill placebo) in reducing SRPs also was

  18. The Association Between Somatic Symptoms, Anxiety Disorders and Substance Use. A Literature Review

    Microsoft Academic Search

    Imran Hassan; Rizwan Ali

    The aim of this article is to review the association between somatic symptoms, anxiety disorders and substance use. A Pub\\u000a Med based literature review was conducted using various combinations of keywords related to substance use, somatic symptoms\\u000a and anxiety. In various studies somatic symptoms were found to be associated with substance use. Anxiety disorders were found\\u000a to have a high

  19. Predictors of unsuccessful magnetic resonance imaging scanning in older generalized anxiety disorder patients and controls

    Microsoft Academic Search

    Jan MohlmanDana; Dana A. Eldreth; Rebecca B. Price; Daniel Chazin; Dorie A. Glover

    A thorough understanding of the neurobiology of late life anxiety is likely to depend on the use of brain imaging techniques\\u000a such as magnetic resonance imaging (MRI). Generalized anxiety disorder (GAD) is one of the most prevalent anxiety disorders\\u000a in older adults, and is thus a focus for neurobiological studies using MRI. This study tested 1–3 weeks predictors of unsuccessful\\u000a scan

  20. Social anxiety disorder in the Chinese military: prevalence, comorbidities, impairment, and treatment-seeking.

    PubMed

    Wang, Huaning; Zhang, Ruiguo; Chen, Yunchun; Wang, Huaihai; Zhang, Yahong; Gan, Jingli; Zhang, Liyi; Tan, Qingrong

    2014-12-30

    The objective of this work is To investigate the prevalence, comorbidities, impairment, and treatment-seeking of social anxiety disorder in the Chinese military personnel. Military personnel (n=11,527) were surveyed from May to August 2007 using a multistage whole cohort probability sampling method. A Chinese version of the World Health Organization Composite International Diagnostic Interview (CIDI) was used for assessment, and a military-related socio-demographic questionnaire was used to describe the prevalence distribution. A unified survey was performed to investigate 11 different social situations. The short-form health survey was used to assess role impairment. The 12-month and lifetime prevalence rates of social anxiety disorder were 3.34% (95% CI: 3.25-3.42%) and 6.22% (95% CI: 6.11-6.32%), respectively. Social anxiety disorder was associated with increased odds of depression, substance abuse, panic attacks/disorder, and generalized anxiety disorder. Childhood foster, female, stressful life events, younger age, and being divorced/widowed increase the incidence of social anxiety disorder. Treatment-seeking was relatively rare. Social anxiety disorder is a common disorder in military personnel in China, and it is a risk factor for subsequent depressive illness, substance abuse and other mental disorder. Early detection and treatment of social anxiety disorder are important because of the low rate of treatment-seeking. PMID:25262639

  1. Comorbidity of PTSD in anxiety and depressive disorders: prevalence and shared risk factors.

    PubMed

    Spinhoven, Philip; Penninx, Brenda W; van Hemert, Albert M; de Rooij, Mark; Elzinga, Bernet M

    2014-08-01

    The present study aims to assess comorbidity of posttraumatic stress disorder (PTSD) in anxiety and depressive disorders and to determine whether childhood trauma types and other putative independent risk factors for comorbid PTSD are unique to PTSD or shared with anxiety and depressive disorders. The sample of 2402 adults aged 18-65 included healthy controls, persons with a prior history of affective disorders, and persons with a current affective disorder. These individuals were assessed at baseline (T0) and 2 (T2) and 4 years (T4) later. At each wave, DSM-IV-TR based anxiety and depressive disorder, neuroticism, extraversion, and symptom severity were assessed. Childhood trauma was measured at T0 with an interview and at T4 with a questionnaire, and PTSD was measured with a standardized interview at T4. Prevalence of 5-year recency PTSD among anxiety and depressive disorders was 9.2%, and comorbidity, in particular with major depression, was high (84.4%). Comorbidity was associated with female gender, all types of childhood trauma, neuroticism, (low) extraversion, and symptom severity. Multivariable significant risk factors (i.e., female gender and child sexual and physical abuse) were shared among anxiety and depressive disorders. Our results support a shared vulnerability model for comorbidity of anxiety and depressive disorders with PTSD. Routine assessment of PTSD in patients with anxiety and depressive disorders seems warranted. PMID:24629482

  2. CRITICAL REVIEW OF OUTCOME RESEARCH ON INTERPERSONAL PSYCHOTHERAPY FOR ANXIETY DISORDERS

    PubMed Central

    Markowitz, John C.; Lipsitz, Joshua; Milrod, Barbara L.

    2014-01-01

    Background Interpersonal psychotherapy (IPT) has demonstrated efficacy in treating mood and eating disorders. This article critically reviews outcome research testing IPT for anxiety disorders, a diagnostic area where cognitive behavioral therapy (CBT) has dominated research and treatment. Methods A literature search identified six open and five controlled trials of IPT for social anxiety disorder (SAD), panic disorder, and posttraumatic stress disorder. Results Studies were generally small, underpowered, and sometimes methodologically compromised. Nonetheless, minimally adapted from its standard depression strategies, IPT for anxiety disorders yielded positive results in open trials for the three diagnoses. In controlled trials, IPT fared better than waiting list (N = 2), was equipotent to supportive psychodynamic psychotherapy (N = 1), but less efficacious than CBT for SAD (N = 1), and CBT for panic disorder (N = 1) in a methodologically complicated study. IPT equaled CBT in a group residential format (N = 1). Conclusions IPT shows some promise for anxiety disorders but has thus far shown no advantages in controlled trials relative to other therapies. Methodological and ecological issues have complicated testing of IPT for anxiety disorders, clouding some findings. The authors discuss difficulties of conducting non-CBT research in a CBT-dominated area, investigator bias, and the probable need to further modify IPT for anxiety disorders. Untested therapies deserve the fairest possible testing. Depression and Anxiety 00:1–10, 2014. PMID:24493661

  3. Efficacy and Utility of Computer-Assisted Cognitive Behavioural Therapy for Anxiety Disorders

    ERIC Educational Resources Information Center

    Przeworski, Amy; Newman, Michelle G.

    2006-01-01

    Despite the efficacy of cognitive behavioural treatment for anxiety disorders, more than 70% of individuals with anxiety disorders go untreated every year. This is partially due to obstacles to treatment including limited access to mental health services for rural residents, the expense of treatment and the inconvenience of attending weekly…

  4. An Innovative Treatment Approach for Children with Anxiety Disorders and Medically Unexplained Somatic Complaints

    ERIC Educational Resources Information Center

    Reigada, Laura C.; Fisher, Paige H.; Cutler, Cynthia; Warner, Carrie Masia

    2008-01-01

    Anxiety disorders in children and adolescents are largely undetected and the majority of youth do not receive services. Given the deleterious consequences of anxiety disorders, early identification and intervention have public health implications. In order to increase identification and treatment of anxious youth, expansion to nonpsychiatric…

  5. Assessment of Anxiety in Children and Adolescents with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Grondhuis, Sabrina N.; Aman, Michael G.

    2012-01-01

    Anxiety disorders are among the most common comorbid conditions in children and adolescents with autism spectrum disorders (ASDs), although assessment presents unique challenges. Many symptoms of anxiety appear to overlap with common presentations of autism. Furthermore, deficits in language and cognitive functioning make it difficult for such…

  6. A pilot study of amygdala volumes in pediatric generalized anxiety disorder

    Microsoft Academic Search

    Michael D. De Bellis; B. J. Casey; Ronald E. Dahl; Boris Birmaher; Douglas E. Williamson; Kathleen M. Thomas; David A. Axelson; Karin Frustaci; Amy M. Boring; Julie Hall; Neal D. Ryan

    2000-01-01

    Background: The neurodevelopment of childhood anxiety disorders is not well understood. Basic research has implicated the amygdala and circuits related to these nuclei as being central to several aspects of fear and fear-related behaviors in animals.Methods: Magnetic resonance imaging was used to measure amygdala volumes and comparison brain regions in 12 child and adolescent subjects with generalized anxiety disorder and

  7. An Open Trial of an Acceptance-Based Behavior Therapy for Generalized Anxiety Disorder

    ERIC Educational Resources Information Center

    Roemer, Lizabeth; Orsillo, Susan M.

    2007-01-01

    Research suggests that experiential avoidance may play an important role in generalized anxiety disorder (GAD; see Roemer, L., & Orsillo, S.M. (2002). "Expanding our conceptualization of and treatment for generalized anxiety disorder: Integrating mindfulness/acceptance-based approaches with existing cognitive-behavioral models." "Clinical…

  8. Validity and Clinical Utility of the Fear Questionnaire for Anxiety-Disorder Patients

    Microsoft Academic Search

    Tian P. S. Oei; Ann Moylan; Larry Evans

    1991-01-01

    Although the Fear Questionnaire (FQ) has been widely used, its psychometric properties for anxiety disorder patients are still unclear. This study reports the psychometric properties of the FQ with a sample of 251 (178 female and 73 male) anxiety disorder patients. Factor analysis showed a clear 3-factor solution that accounted for 42% of the variance. The 3 factors corresponded to

  9. The natural history of depression and the anxiety disorders in older people

    Microsoft Academic Search

    Gill Livingston; Vivienne Watkin; Brian Milne; Monica V Manela; Cornelius Katona

    1997-01-01

    Background: This study reports the outcome of depression and anxiety disorders in older people. Methods: Follow-up of 165 subjects age 65 or over, initially identified in a community study in inner London as depressed or having an anxiety disorder. Results: 117 subjects still living in the area; 25 had died. Death was predicted only by activity limitation at first interview

  10. Prevalence and Incidence Studies of Anxiety Disorders: A Systematic Review of the Literature

    Microsoft Academic Search

    Julian M Somers; Elliot M Goldner; Paul Waraich; Lorena Hsu

    2006-01-01

    100 Objective: To present the results of a systematic review of literature published between 1980 and 2004 reporting findings of the prevalence and incidence of anxiety disorders in the general population. Method: A literature search of epidemiologic studies of anxiety disorders was conducted, using MEDLINE and HealthSTAR databases, canvassing English-language publications. Eligible publications were restricted to studies that examined age

  11. Evidence-Based Medicine Evaluation of Electrophysiological Studies of the Anxiety Disorders

    Microsoft Academic Search

    C. Richard Clark; Cherrie A. Galletly; David J. Ash; Kathryn A. Moores; Rebecca A. Penrose; Alexander C. McFarlane

    2009-01-01

    We provide a systematic, evidence-based medicine (EBM) review of the field of electrophysiology in the anxiety disorders. Presently, electrophysiological studies of anxiety focus primarily on etiological aspects of brain dysfunction. The review highlights many functional similarities across studies, but also identifies patterns that clearly differentiate disorder classifications. Such measures offer clinical utility as reliable and objective indicators of brain dysfunction

  12. Mood, Anxiety, and Substance-Use Disorders and Suicide Risk in a Military Population Cohort

    ERIC Educational Resources Information Center

    Conner, Kenneth R.; McCarthy, Michael D.; Bajorska, Alina; Caine, Eric D.; Tu, Xin M.; Knox, Kerry L.

    2012-01-01

    There are meager prospective data from nonclinical samples on the link between anxiety disorders and suicide or the extent to which the association varies over time. We examined these issues in a cohort of 309,861 U.S. Air Force service members, with 227 suicides over follow-up. Mental disorder diagnoses including anxiety, mood, and substance-use…

  13. Parent and Child Agreement on Anxiety Disorder Symptoms Using the DISC Predictive Scales

    ERIC Educational Resources Information Center

    Weems, Carl F.; Feaster, Daniel J.; Horigian, Viviana E.; Robbins, Michael S.

    2011-01-01

    Growing recognition of the negative impact of anxiety disorders in the lives of youth has made their identification an important clinical task. Multiple perspective assessment (e.g., parents, children) is generally considered a preferred method in the assessment of anxiety disorder symptoms, although it has been generally thought that disagreement…

  14. A Retrospective Examination of the Similarity between Clinical Practice and Manualized Treatment for Childhood Anxiety Disorders

    ERIC Educational Resources Information Center

    Vande Voort, Jennifer L.; Svecova, Jana; Jacobson, Amy Brown; Whiteside, Stephen P.

    2010-01-01

    The objective of this study was to facilitate the bidirectional communication between researchers and clinicians about the treatment of childhood anxiety disorders, including obsessive-compulsive disorder. Forty-four children were assessed before and after cognitive behavioral treatment with the parent versions of the Spence Child Anxiety Scale…

  15. Academic Impairment and Impact of Treatments among Youth with Anxiety Disorders

    ERIC Educational Resources Information Center

    Nail, Jennifer E.; Christofferson, Jennifer; Ginsburg, Golda S.; Drake, Kelly; Kendall, Philip C.; McCracken, James T.; Birmaher, Boris; Walkup, John T.; Compton, Scott N.; Keeton, Courtney; Sakolsky, Dara

    2015-01-01

    Background: Global academic difficulties have often been reported in youth with anxiety disorders, however, little is known about the specific academic deficits in this population. Objective: To (a) evaluate the prevalence of seven specific academic impairments in children and adolescents with anxiety disorders, (b) determine whether these…

  16. Relapse Prevention Techniques in the Treatment of Childhood Anxiety Disorders: A Case Example

    Microsoft Academic Search

    Teresa J Linares Scott; Norah C. Feeny

    2006-01-01

    Research has shown that cognitive behavioral therapy (CBT) is an efficacious treatment for children and adolescents with anxiety disorders. CBT incorporates techniques such as cognitive restructuring and exposure, which foster symptom reduction. While these components promote sustained fear reduction, greater attention to relapse prevention (RP) may be warranted, particularly given the comorbidity associated with anxiety disorders. A case example demonstrates

  17. Dissemination of Evidence-Based Practices for Anxiety Disorders in Wyoming: A Survey of Practicing Psychotherapists

    ERIC Educational Resources Information Center

    Hipol, Leilani J.; Deacon, Brett J.

    2013-01-01

    Despite the well-established effectiveness of exposure-based cognitive-behavioral therapy (CBT) in the treatment of anxiety disorders, therapists have been slow to adopt CBT into their clinical practice. The present study was conducted to examine the utilization of psychotherapy techniques for anxiety disorders among community practitioners in a…

  18. Dimensional assessment of anxiety disorders in parents and children for DSM-5.

    PubMed

    Möller, Eline L; Majdandži?, Mirjana; Craske, Michelle G; Bögels, Susan M

    2014-09-01

    The current shift in the DSM towards the inclusion of a dimensional component allows clinicians and researchers to demonstrate not only the presence or absence of psychopathology in an individual, but also the degree to which the disorder and its symptoms are manifested. This study evaluated the psychometric properties and utility of a set of brief dimensional scales that assess DSM-based core features of anxiety disorders, for children and their parents. The dimensional scales and the Screen for Child Anxiety Related Emotional Disorders (SCARED-71), a questionnaire to assess symptoms of all anxiety disorders, were administered to a community sample of children (n?=?382), aged 8-13 years, and their mothers (n?=?285) and fathers (n?=?255). The dimensional scales assess six anxiety disorders: specific phobia, agoraphobia, panic disorder, social anxiety disorder, generalized anxiety disorder, and separation anxiety disorder. Children rated their own anxiety and parents their child's anxiety. The dimensional scales demonstrated high internal consistency (??>?0.78, except for father reported child panic disorder, for reason of lack of variation), and moderate to high levels of convergent validity (rs ?=?0.29-0.73). Children who exceeded the SCARED cutoffs scored higher on the dimensional scales than those who did not, providing preliminary support for the clinical sensitivity of the scales. Given their strong psychometric properties and utility for both child and parent report, addition of the dimensional scales to the DSM-5 might be an effective way to incorporate dimensional measurement into the categorical DSM-5 assessment of anxiety disorders in children. PMID:24943058

  19. Diagnosis of eating disorders in primary care.

    PubMed

    Pritts, Sarah D; Susman, Jeffrey

    2003-01-15

    Eating disorders, particularly anorexia nervosa and bulimia nervosa, are significant causes of morbidity and mortality among adolescent females and young women. Eating disorders are associated with devastating medical and psychologic consequences, including death, osteoporosis, growth delay, and developmental delay. Prompt diagnosis is linked to better outcomes. A good medical history is the most powerful tool. Simple screening questions, such as "Do you think you should be dieting?" can be integrated into routine visits. Physical findings such as low body mass index, amenorrhea, bradycardia, gastrointestinal disturbances, skin changes, and changes in dentition can help detect eating disorders. Laboratory studies can help diagnose these conditions and exclude underlying medical conditions. The family physician can play an important role in diagnosing these illnesses and can coordinate the multidisciplinary team of psychiatrists, nutritionists, and other professionals to successfully treat patients with eating disorders. PMID:12562151

  20. Employment barriers, skills, and aspirations among unemployed job seekers with and without social anxiety disorder.

    PubMed

    Himle, Joseph A; Weaver, Addie; Bybee, Deborah; O'Donnell, Lisa; Vlnka, Sarah; Laviolette, Wayne; Steinberger, Edward; Golenberg, Zipora; Levine, Debra Siegel

    2014-07-01

    Objective The literature has consistently demonstrated that social anxiety disorder has substantial negative impacts on occupational functioning. However, to date, no empirical work has focused on understanding the specific nature of vocational problems among persons with social anxiety disorder. This study examined the association between perceived barriers to employment, employment skills, and job aspirations and social anxiety among adults seeking vocational rehabilitation services. Methods Data from intake assessments (June 2010-December 2011) of 265 low-income, unemployed adults who initiated vocational rehabilitation services in urban Michigan were examined to assess perceived barriers to employment, employment skills, job aspirations, and demographic characteristics among participants who did or did not screen positive for social anxiety disorder. Bivariate and multiple logistic regression analyses were performed. Results After adjustment for other factors, the multiple logistic regression analysis revealed that perceiving more employment barriers involving experience and skills, reporting fewer skills related to occupations requiring social skills, and having less education were significantly associated with social anxiety disorder. Participants who screened positive for social anxiety disorder were significantly less likely to aspire to social jobs. Conclusions Employment-related characteristics that were likely to have an impact on occupational functioning were significantly different between persons with and without social anxiety problems. Identifying these differences in employment barriers, skills, and job aspirations revealed important information for designing psychosocial interventions for treatment of social anxiety disorder. The findings underscored the need for vocational services professionals to assess and address social anxiety among their clients. PMID:24733524

  1. Anxious Solitude and Clinical Disorder in Middle Childhood: Bridging Developmental and Clinical Approaches to Childhood Social Anxiety

    ERIC Educational Resources Information Center

    Gazelle, Heidi; Workman, Jamie Olson; Allan, Wesley

    2010-01-01

    It was hypothesized that children identified by their peers at school as anxious solitary would report more symptoms of social anxiety disorder on a self report questionnaire and, on the basis of child and parent clinical interviews, receive more diagnoses of social anxiety disorder and additional anxiety and mood disorders. Participants were 192…

  2. RGS2 and Generalized Anxiety Disorder in an Epidemiologic Sample of Hurricane-Exposed Adults

    PubMed Central

    Koenen, Karestan C.; Amstadter, Ananda B.; Ruggiero, Kenneth J.; Acierno, Ron; Galea, Sandro; Kilpatrick, Dean G.; Gelernter, Joel

    2008-01-01

    Background Generalized anxiety disorder (GAD) is a common and sometimes disabling condition often associated with stressful life events that involve significant loss or danger. The disorder appears moderately heritable. Polymorphisms in the RGS2 (regulator of G-protein signaling 2) gene were recently associated with anxious behavior in mice and panic disorder and trait anxiety in humans. We examined whether rs4606, a single nucleotide polymorphism (SNP) in the 3’ UTR of RGS2, was associated with GAD in an epidemiologic sample of adults exposed to the 2004 Florida Hurricanes. Methods The sample for the current study is 607 adults from the 2004 Florida Hurricane Study who returned buccal DNA samples via mail. Participants were selected via random digit dial procedures and interviewed via telephone about hurricane exposure, social support, and GAD symptoms. The outcome measure was DSM-IV diagnosis of GAD derived from structured interviews. Results RGS2 SNP rs4606 was significantly associated with GAD in this sample. In logistic regression analyses, each C allele was associated with a 100% (p=.026) increased risk of GAD after controlling for age, sex, ancestry, hurricane exposure and social support. Conclusions These findings are consistent with a previously published study showing a higher prevalence of the C allele among panic disorder patients than controls. This work points toward a relevant polymorphism for GAD at the 3’ end of the RGS2 gene; and suggest that studying a recently disaster-exposed sample is both feasible and may improve power to find gene-disorder associations. PMID:18833580

  3. Diagnosis of inherited disorders of liver metabolism

    Microsoft Academic Search

    P. T. Clayton

    2003-01-01

    Summary: Diagnosis of the metabolic disorder responsible for liver disease can sometimes be straightforward but it can also present\\u000a a major challenge, particularly if the liver is sufficiently damaged to produce secondary biochemical abnormalities such as\\u000a galactosuria, hypoglycaemia with hypoketonaemia, or excretion of 3-oxo-?4 bile acids. It is important to consider the age of the patient, the nature of the

  4. Integrated care for comorbid alcohol dependence and anxiety and/or depressive disorder: study protocol for an assessor-blind, randomized controlled trial

    PubMed Central

    2013-01-01

    Background A major barrier to successful treatment in alcohol dependence is psychiatric comorbidity. During treatment, the time to relapse is shorter, the drop-out rate is increased, and long-term alcohol consumption is greater for those with comorbid major depression or anxiety disorder than those with an alcohol use disorder with no comorbid mental disorder. The treatment of alcohol dependence and psychological disorders is often the responsibility of different services, and this can hinder the treatment process. Accordingly, there is a need for an effective integrated treatment for alcohol dependence and comorbid anxiety and/or depression. Methods/Design We aim to assess the effectiveness of a specialized, integrated intervention for alcohol dependence with comorbid anxiety and/or mood disorder using a randomized design in an outpatient hospital setting. Following a three-week stabilization period (abstinence or significantly reduced consumption), participants will undergo complete formal assessment for anxiety and depression. Those patients with a diagnosis of an anxiety and/or depressive disorder will be randomized to either 1) integrated intervention (cognitive behavioral therapy) for alcohol, anxiety, and/or depression; or 2) usual counseling care for alcohol problems. Patients will then be followed up at weeks 12, 16, and 24. The primary outcome measure is alcohol consumption (total abstinence, time to lapse, and time to relapse). Secondary outcome measures include changes in alcohol dependence severity, depression, or anxiety symptoms and changes in clinician-rated severity of anxiety and depression. Discussion The study findings will have potential implications for clinical practice by evaluating the implementation of specialized integrated treatment for comorbid anxiety and/or depression in an alcohol outpatient service. Trial registration ClinicalTrials.gov Identifier: NCT01941693 PMID:24245491

  5. Convergent functional genomics of anxiety disorders: translational identification of genes, biomarkers, pathways and mechanisms

    Microsoft Academic Search

    H Le-Niculescu; Y Balaraman; S D Patel; M Ayalew; J Gupta; R Kuczenski; A Shekhar; N Schork; M A Geyer; A B Niculescu

    2011-01-01

    Anxiety disorders are prevalent and disabling yet understudied from a genetic standpoint, compared with other major psychiatric disorders such as bipolar disorder and schizophrenia. The fact that they are more common, diverse and perceived as embedded in normal life may explain this relative oversight. In addition, as for other psychiatric disorders, there are technical challenges related to the identification and

  6. Age at Onset, Precipitating Events, Sex Distribution, and Co-Occurrence of Anxiety Disorders

    Microsoft Academic Search

    Gabriele Scheibe; Margot Albus

    1992-01-01

    178 outpatients were administered to a structured interview evaluating diagnostic, illness history, and sociodemographic data of DSM-III-R anxiety disorders. Patients with panic disorder with agoraphobia were a more severely ill subgroup than patients with panic disorder without agoraphobia. Simple and social phobia had the earliest age at onset, panic disorder the latest age at onset. Conjugal stress was the most

  7. Association of ADHD, Tics, and Anxiety with Dopamine Transporter ("DAT1") Genotype in Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Gadow, Kenneth D.; Roohi, Jasmin; DeVincent, Carla J.; Hatchwell, Eli

    2008-01-01

    Background: Autism spectrum disorder (ASD) is associated with high rates of psychiatric disturbance to include attention-deficit/hyperactivity disorder (ADHD), tic disorder, and anxiety disorders. The aim of the present study was to examine the association between a variable number tandem repeat (VNTR) functional polymorphism located in the…

  8. Depressive and anxiety disorders in the postpartum period: how prevalent are they and can we improve their detection?

    PubMed

    Austin, Marie-Paule V; Hadzi-Pavlovic, Dusan; Priest, Susan R; Reilly, Nicole; Wilhelm, Kay; Saint, Karen; Parker, Gordon

    2010-10-01

    The objectives of this study were: (1) to examine Composite International Diagnostic Interview (CIDI) period prevalence and comorbidity for depression and anxiety disorder in a cohort of women assessed during the first 6-8 months postpartum and (2) to examine the benefits of combining the Edinburgh Postnatal Depression Scale (EPDS) with a simple "interval symptom" question to optimize screening postpartum. Women aged over 18 (N?=?1,549) were assessed during late pregnancy and reviewed at approximately 2, 4, and 6-8 months postpartum using the EPDS and an "interval symptom" question. The latter asked about any depressive symptoms in the interval since the last EPDS. Women who scored >12 on the EPDS and/or positive on the "interval symptom" question were then administered the CIDI. A further 65 randomly selected women that screened negative were also administered the CIDI. Loss to postnatal follow-up was very significant, and returns rates were inconsistent across the three postnatal time points. Almost 25% of those who screened positive did not complete a CIDI. For screen-positive status, a total of 314 (24.4%) of those that returned questionnaires (N?=?1,289) screened positive at least once across the 6- to 8-month interval. Of these, 79 were lost to follow-up; thus, 235 (74.8%) completed a CIDI. In this group, 34.7% had been positive both on the EPDS and the "interval" question, 15.9% on the EPDS alone, and 49.4% on the "interval" question alone. For the CIDI diagnosis and estimated 6- to 8-month period CIDI prevalence, among those 235 women who screened positive and completed a CIDI, 67.2% met the criteria for a CIDI diagnosis, as did 16.9% of those who screened negative. The breakdown in CIDI diagnoses in the 235 women was 32.8% major depression (± anxiety disorder); 26.4% minor depression alone; and 8.1% with a primary anxiety disorder (approximately half with minor depression). Put another way, 20.4% of these women had an anxiety disorder (approximately two thirds with comorbid depression) and 37.7% of women with a major depressive episode (MDE) had a comorbid anxiety disorder. The estimated 6- to 8-month prevalence rate for a CIDI diagnosis of anxiety or depression (major or minor) was 29.2% (95% CI 26.7%-31.7%). The use of the "interval symptom" question alone was 1.7 times more likely to identify positive CIDI cases than the EPDS alone. Almost 40% of postnatal women with a diagnosis of MDE have a comorbid diagnosis of anxiety disorder. The estimated 6- to 8-month period prevalence for CIDI cases of anxiety and depression was 29.2%. Screening for anxiety and depression using the EPDS alone was associated with a lesser capacity to identify CIDI caseness than a simple "interval symptom" question (for the 2 months prior) which almost doubled the yield. This paper demonstrates that combining the EPDS with the "interval symptom" question improves detection of CIDI caseness. PMID:20232218

  9. Fetal growth and the lifetime risk of generalized anxiety disorder

    PubMed Central

    Vasiliadis, Helen-Maria; Buka, Stephen L.; Martin, Laurie T.; Gilman, Stephen E.

    2010-01-01

    Background Anxiety disorders are thought to have their origins in early childhood, though they have not yet been studied as a potential outcome of impaired fetal growth, which has been implicated in the developmental etiologies of many psychopathologies. This study investigated the association between indicators of fetal growth and the development of generalized anxiety disorder (GAD). Methods Indicators of fetal growth, including birth weight (BW) and ponderal index (PI), were assessed among 682 offspring of participants in the Providence, RI, site of the Collaborative Perinatal Project. Participants were interviewed as adults, and their lifetime histories of GAD were assessed using the Diagnostic Interview Schedule. We used Cox regression to estimate the association between fetal growth indicators and the development of GAD. Results The lifetime risk of GAD differed between infants in the highest category of BW and PI and all others. Newborns with birth weights below 3.5 kg (hazard ratio, HR: 2.38; CI=1.25, 4.55), in the lowest four BW z-score quintiles (HR=2.49; CI=1.14, 5.45) or a PI in the lowest four quintiles (HR=2.33; CI=1.04, 5.00) had higher lifetime risks of GAD. Conclusion In contrast to prior studies on psychiatric outcomes in relation to fetal growth, there was not a linear relationship between birth weight and GAD. While these results generally support the hypothesis that a healthy nutritional fetal uptake, as indicated by BW and PI, is associated with better lifetime mental health, further work is needed to characterize the nature of the association between fetal growth and subsequent psychopathology. PMID:20734359

  10. Temperament and character among Korean children and adolescents with anxiety disorders

    Microsoft Academic Search

    Soo-churl Cho; Sun-woo Jung; Boong-nyun Kim; Jun-won Hwang; Min-sup Shin; Jae-won Kim; Dong-seon Chungh; Hyo-won Kim

    2009-01-01

    The purpose of this study was to evaluate the temperament and character of children and adolescents with anxiety disorders\\u000a in samples from Korean community. The study subjects were children and adolescents diagnosed with social phobia (n = 66), separation anxiety disorder (n = 47), specific phobia (n = 415), and obsessive–compulsive disorder (n = 42) with the diagnostic interview schedule for children, version IV (DISC-IV) in representative community

  11. Empirically Derived Subtypes of Lifetime Anxiety Disorders: Developmental and Clinical Correlates in U.S. Adolescents

    Microsoft Academic Search

    Marcy Burstein; Katholiki Georgiades; Femke Lamers; Sonja A. Swanson; Lihong Cui; Jian-Ping He; Shelli Avenevoli; Kathleen R. Merikangas

    2012-01-01

    Objective: The current study examined the sex- and age-specific structure and comorbidity of lifetime anxiety disorders among U.S. adolescents. Method: The sample consisted of 2,539 adolescents (1,505 females and 1,034 males) from the National Comorbidity Survey–Adolescent Supplement who met criteria for Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev. [DSM–IV–TR]) lifetime anxiety disorders (American Psychiatric Association, 2000).

  12. Emotional, behavioral, and cognitive factors that differentiate obsessive-compulsive disorder and other anxiety disorders in youth.

    PubMed

    Jacob, Marni L; Morelen, Diana; Suveg, Cynthia; Brown Jacobsen, Amy M; Whiteside, Stephen P

    2012-03-01

    Abstract The current study examined specific emotional, behavioral, and cognitive variables that may distinguish obsessive-compulsive disorder (OCD) from generalized anxiety disorder (GAD), social phobia (SoP), and separation anxiety disorder (SAD) in youth. Youth with OCD (n=26) and other anxiety disorders (ADs; n=31), aged 7-12 years (56.1% males), and their parents participated. The study compared the two anxious groups on levels of emotional, behavioral, and cognitive functioning, as well as impairment associated with the disorder. Results indicated that in comparison to youth with GAD, SoP, or SAD, youth with OCD were found to have poorer emotion regulation skills, as well as greater oppositionality, cognitive problems/inattention, and parent impairment associated with the disorder. The findings suggest that there are unique characteristics of OCD that may differentiate this disorder from other ADs in youth. Potential clinical implications and directions for future research are discussed. PMID:21512917

  13. Disseminating treatment for anxiety disorders step 2: peer recommendations to seek help.

    PubMed

    Schubert, Jessica R; Coles, Meredith E; Heimberg, Richard G; Weiss, Barry D

    2014-10-01

    Despite the high prevalence of and significant psychological burden caused by anxiety disorders, as few as 25% of individuals with these disorders seek treatment, and treatment seeking by African-Americans is particularly uncommon. This purpose of the current study was to gather information regarding the public's recommendations regarding help-seeking for several anxiety disorders and to compare Caucasian and African-American participants on these variables. A community sample of 577 US adults completed a telephone survey that included vignettes portraying individuals with generalized anxiety disorder (GAD), social phobia/social anxiety disorder (SP/SAD), panic disorder (PD), and for comparison, depression. The sample was ½ Caucasian and ½ African American. Respondents were significantly less likely to recommend help-seeking for SP/SAD and GAD (78.8% and 84.3%, respectively) than for depression (90.9%). In contrast, recommendations to seek help for panic disorder were common (93.6%) and similar to rates found for depression. The most common recommendations were to seek help from a primary care physician (PCP). African Americans were more likely to recommend help-seeking for GAD than Caucasians. Findings suggested that respondents believed individuals with anxiety disorders should seek treatment. Given that respondents often recommended consulting a PCP, we recommend educating PCPs about anxiety disorders and empirically-supported interventions. PMID:25145571

  14. Rare bleeding disorders: diagnosis and treatment.

    PubMed

    Palla, Roberta; Peyvandi, Flora; Shapiro, Amy D

    2015-03-26

    Despite the worldwide prevalence of rare bleeding disorders (RBDs), knowledge of these conditions and their management is suboptimal; health care professionals often have little diagnostic and treatment experience with variable access to diagnostic modalities required for accurate identification. Therefore, patients often experience morbidity and mortality due to delayed diagnosis. As RBDs represent a small potential commercial market, few, if any, specific therapies exist for these conditions. As a result, affected individuals commonly face delayed diagnosis, incomplete laboratory evaluation, and limited treatment options. Standardization and customization of coagulation assays, full genome sequencing, and global clotting assays will significantly improve diagnosis of patients with RBDs. In addition, new therapeutic modalities, both recombinant and plasma derived, are emerging, at least in developed countries. Registries and clinical trials have demonstrated decreased bleeding and improved outcomes when patients are appropriately diagnosed and properly treated. Expansion and harmonization of international registries has been initiated to correlate genotype, laboratory, and clinical phenotypes including bleeding severity to improve the diagnosis and therapeutic approach. This review focuses on the latest advances in our understanding, diagnosis, and treatment of RBDs. PMID:25712993

  15. [Health Care Barriers on the Pathways of Patients with Anxiety and Depressive Disorders - A Qualitative Interview Study.

    PubMed

    Kivelitz, Laura; Watzke, Birgit; Schulz, Holger; Härter, Martin; Melchior, Hanne

    2014-09-01

    Objective: Which health care barriers do patients with anxiety and depressive disorders experience on their clinical pathways? Methods: Semi-structured interviews were conducted among 30 patients with anxiety and depressive disorders. Interviews were audio-taped, transcribed, coded and content-analysed. Results: Following barriers perceived by patients were extracted: a lack of early diagnosis, communication and coordination problems between different services and providers, little information about their illness and its adequate treatment, as well as intrapersonal barriers. Conclusions: Patients perceive barriers on the individual, provider and system level. Especially barriers on the system and provider level indicate a need for more information, early recognition and support especially during the help-seeking process. PMID:25180678

  16. Daily Patterns of Anxiety in Anorexia Nervosa: Associations with Eating Disorder Behaviors in the Natural Environment

    PubMed Central

    Lavender, Jason M.; De Young, Kyle P.; Wonderlich, Stephen A.; Crosby, Ross D.; Engel, Scott G.; Mitchell, James E.; Crow, Scott J.; Peterson, Carol B.; Le Grange, Daniel

    2015-01-01

    The role of anxiety has been emphasized in etiological/maintenance models of anorexia nervosa. This study identified daily patterns of anxiety in anorexia nervosa and examined the likelihood of the occurrence of eating disorder behaviors in each trajectory, the daily temporal distribution of eating disorder behaviors in each trajectory, and the extent to which the tendency to exhibit particular anxiety trajectories was associated with baseline diagnostic and trait-level personality variables. Women with full or subthreshold anorexia nervosa (N = 118) completed a two-week ecological momentary assessment (EMA) protocol during which they reported on a variety of behavioral and affective variables, including anxiety and eating disorder behaviors. Using latent growth mixture modeling to classify EMA days (N = 1526) based on anxiety ratings, seven distinct daily anxiety trajectories were identified. Overall differences between trajectories were found for rates of binge eating, self-induced vomiting, body checking, skipping meals, and dietary restriction. Further, distinct daily temporal distributions of eating disorder behaviors were found across the trajectories, with peaks in the probability of behaviors frequently coinciding with high levels of anxiety. Finally, traits of personality pathology (affective lability, self-harm, social avoidance, and oppositionality) and the presence of a co-occurring mood disorder were both found to be associated with the tendency to experience particular daily anxiety trajectories (e.g., Stable High anxiety). Findings support the presence of within-person variability in daily anxiety patterns in anorexia nervosa and also provide evidence for an association between these anxiety patterns and eating disorder behaviors. PMID:23647124

  17. Symptom Overlap between Autism Spectrum Disorder, Generalized Social Anxiety Disorder and Obsessive-Compulsive Disorder in Adults: A Preliminary Case-Controlled Study

    Microsoft Academic Search

    Danielle C. Cath; Natalie Ran; Johannes H. Smit; Hannie C. Comijs

    2008-01-01

    Background: Obsessive-compulsive disorder (OCD) and social anxiety disorder (SAD) frequently co-occur in persons with autism spectrum disorder (ASD). We studied which features distinguish ‘pure’ anxiety disordered patients from those with co-morbid ASD. Method: In a case-controlled design in which groups were matched for age, sex and educational level, patients with OCD or SAD and co-morbid ASD were compared with patients

  18. Different measures of impulsivity in patients with anxiety disorders: a case control study.

    PubMed

    Del Carlo, Alessandra; Benvenuti, Marzia; Fornaro, Michele; Toni, Cristina; Rizzato, Salvatore; Swann, Alan C; Dell'Osso, Liliana; Perugi, Giulio

    2012-05-30

    The relationship between anxiety and impulsivity is controversial and not well explored. The present investigation aims to compare impulsivity, measured by different rating tools, in patients with anxiety disorders vs. healthy controls. Forty-seven subjects with different anxiety disorders and 45 matched controls underwent diagnostic and symptomatological evaluations by the Mini Neuropsychiatric Interview (M.I.N.I) Plus 5.0, Bech-Raphaelsen Depression and Mania Scale (BRDMS), State-Trait Anxiety Inventory (STAI), Hypomania Check List (HCL-32) and the Clinical Global Impression (CGI); temperamental evaluations by the Questionnaire for the Affective and Anxious Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Modified (TEMPS-M), the Separation Anxiety Sensitivity Index (SASI), the Interpersonal Sensitivity Symptoms Inventory (ISSI); and psychometric and a neurocognitive evaluations of impulsivity using the Barratt Impulsiveness Scale (BIS-11) and the Immediate and Delayed Memory Task (IMT-DMT). Subjects with anxiety disorders were more impulsive than the controls in all the explored measures, with higher scores in symptomatological and, temperamental scales. Patients with anxiety disorders but without a lifetime history of comorbid major mood episodes had greater trait and state impulsivity than controls. Further investigations are needed to assess the extent to which impulsivity might or might not be directly related to the anxiety disorder. PMID:22357357

  19. Bad Dream Frequency in Older Adults with Generalized Anxiety Disorder: Prevalence, Correlates, and Effect of Cognitive Behavioral Treatment for Anxiety

    PubMed Central

    Nadorff, Michael R.; Porter, Ben; Rhoades, Howard M.; Greisinger, Anthony J.; Kunik, Mark E.; Stanley, Melinda A.

    2012-01-01

    This study investigated the relation between generalized anxiety disorder (GAD) and frequency of bad dreams in older adults. A secondary analysis from a randomized clinical trial comparing cognitive behavioral therapy for anxiety (CBT) to enhanced usual care (EUC), it assessed bad dream frequency at baseline, post-treatment (3 months), and 6, 9, 12 and 15 months. Of 227 participants (mean age = 67.4), 134 met GAD diagnostic criteria (CBT = 70, EUC = 64), with the remaining 93 serving as a comparison group. Patients with GAD had significantly more bad dreams than those without, and bad dream frequency was significantly associated with depression, anxiety, worry, and poor quality of life. CBT for anxiety significantly reduced bad dream frequency at post-treatment and throughout follow-up compared to EUC. PMID:23470116

  20. Bad dream frequency in older adults with generalized anxiety disorder: prevalence, correlates, and effect of cognitive behavioral treatment for anxiety.

    PubMed

    Nadorff, Michael R; Porter, Ben; Rhoades, Howard M; Greisinger, Anthony J; Kunik, Mark E; Stanley, Melinda A

    2014-01-01

    This study investigated the relation between generalized anxiety disorder (GAD) and frequency of bad dreams in older adults. A secondary analysis from a randomized clinical trial comparing cognitive behavioral therapy (CBT) for anxiety to enhanced usual care (EUC) assessed bad dream frequency at baseline, post treatment (3 months), and at 6, 9, 12, and 15 months. Of 227 participants (mean age = 67.4), 134 met GAD diagnostic criteria (CBT = 70, EUC = 64), with the remaining 93 serving as a comparison group. Patients with GAD had significantly more bad dreams than those without, and bad dream frequency was significantly associated with depression, anxiety, worry, and poor quality of life. CBT for anxiety significantly reduced bad dream frequency at post treatment and throughout follow up compared to EUC. PMID:23470116

  1. Adjustment to Cancer: Anxiety and Distress (PDQ)

    MedlinePLUS

    ... symptoms of depression and anxiety or other emotional, social, or behavioral problems. Causes of adjustment disorders in cancer patients include the following: Diagnosis . Treatment. Recurrence . Side effects of treatment. An adjustment disorder usually begins ...

  2. A Preliminary Investigation of the Spence Children's Anxiety Parent Scale as a Screening Tool for Anxiety in Young People with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Zainal, Hani; Magiati, Iliana; Tan, Julianne Wen-Li; Sung, Min; Fung, Daniel S.; Howlin, Patricia

    2014-01-01

    Despite high rates of clinically elevated anxiety difficulties in children and adolescents with autism spectrum disorders (ASDs), very few studies have systematically examined the usefulness of commonly used caregiver report anxiety screening tools with this population. This study investigated the use of the Spence Children's Anxiety

  3. Efficacy of treatments for anxiety disorders: a meta-analysis.

    PubMed

    Bandelow, Borwin; Reitt, Markus; Röver, Christian; Michaelis, Sophie; Görlich, Yvonne; Wedekind, Dirk

    2015-07-01

    To our knowledge, no previous meta-analysis has attempted to compare the efficacy of pharmacological, psychological and combined treatments for the three main anxiety disorders (panic disorder, generalized anxiety disorder and social phobia). Pre-post and treated versus control effect sizes (ES) were calculated for all evaluable randomized-controlled studies (n=234), involving 37?333 patients. Medications were associated with a significantly higher average pre-post ES [Cohen's d=2.02 (1.90-2.15); 28?051 patients] than psychotherapies [1.22 (1.14-1.30); 6992 patients; P<0.0001]. ES were 2.25 for serotonin-noradrenaline reuptake inhibitors (n=23 study arms), 2.15 for benzodiazepines (n=42), 2.09 for selective serotonin reuptake inhibitors (n=62) and 1.83 for tricyclic antidepressants (n=15). ES for psychotherapies were mindfulness therapies, 1.56 (n=4); relaxation, 1.36 (n=17); individual cognitive behavioural/exposure therapy (CBT), 1.30 (n=93); group CBT, 1.22 (n=18); psychodynamic therapy 1.17 (n=5); therapies without face-to-face contact (e.g. Internet therapies), 1.11 (n=34); eye movement desensitization reprocessing, 1.03 (n=3); and interpersonal therapy 0.78 (n=4). The ES was 2.12 (n=16) for CBT/drug combinations. Exercise had an ES of 1.23 (n=3). For control groups, ES were 1.29 for placebo pills (n=111), 0.83 for psychological placebos (n=16) and 0.20 for waitlists (n=50). In direct comparisons with control groups, all investigated drugs, except for citalopram, opipramol and moclobemide, were significantly more effective than placebo. Individual CBT was more effective than waiting list, psychological placebo and pill placebo. When looking at the average pre-post ES, medications were more effective than psychotherapies. Pre-post ES for psychotherapies did not differ from pill placebos; this finding cannot be explained by heterogeneity, publication bias or allegiance effects. However, the decision on whether to choose psychotherapy, medications or a combination of the two should be left to the patient as drugs may have side effects, interactions and contraindications. PMID:25932596

  4. Prevalence of Psychiatric Disorders in Patients with a Diagnosis of Polycystic Ovary Syndrome in Kashmir

    PubMed Central

    Hussain, Arshad; Chandel, Rajesh Kumar; Ganie, Mohd Ashraf; Dar, Mansoor Ahmad; Rather, Yasir Hassan; Wani, Zaid Ahmad; Shiekh, Javid Ahmad; Shah, Majid Shafi

    2015-01-01

    Background: Polycystic ovary syndrome (PCOS) is one of the common endocrine disorders and is associated with reproductive, metabolic, and psychological disturbances affecting one in five women of reproductive age group. Objective: To investigate the prevalence of psychiatric disorders among women in ambulatory treatment with a diagnosis of PCOS. Materials and Methods: One hundred and ten patients of PCOS were evaluated using Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition criteria by means of Mini International Neuropsychiatric Interview, English version 5.0.0. Diagnosis of PCOS was confirmed according to the National Institute of Health/National Institute of Child Health and Human Development, 1990 consensus conference criteria. Forty subjects without PCOS who were matched for age and body mass index were taken as a comparison group. Results: About 23% of cases had major depressive disorder as compared to 7.5% of controls, 1.8% had dysthymia, 15.45% had panic disorder compared to 5% of controls, 6.36% had obsessive compulsive disorder compared to 2.5% of controls, 8% cases had suicidality, 2.72% of cases were bipolar affective disorder, and 15.45% had generalized anxiety disorder (GAD). Conclusion: A high prevalence of mental disorders was observed, especially major depression, panic disorder, and GAD in patients with PCOS in our study. The results suggest that screening and appropriate management for psychiatric disorders should be part of the routine evaluation of these patients. PMID:25722515

  5. Impact of separation anxiety on psychotherapy outcomes for adults with anxiety disorders

    Microsoft Academic Search

    Laura T. Kirsten; Brin F. S. Grenyer; Renate Wagner; Vijaya Manicavasagar

    2008-01-01

    Anxiety is highly prevalent in the community, and despite improvements in therapy a significant proportion of people tend to relapse, or remain significantly symptomatic. Theorists have proposed that untreated attachment anxieties and separation conflicts emerge from childhood development to be pervasive problems in adulthood. This study aimed to investigate the influence of juvenile and concurrent adult separation anxiety on psychotherapy

  6. Effect of short-term SSRI treatment on cognitive bias in generalised anxiety disorder

    Microsoft Academic Search

    Karin Mogg; David S. Baldwin; Paul Brodrick; Brendan P. Bradley

    2004-01-01

    Rationale There is considerable evidence showing that individuals with generalised anxiety disorder (GAD) selectively process threat-related information, e.g. they have a bias to interpret ambiguous information in a threat-related manner. Cognitive theories of anxiety, which provide the basis of cognitive-behaviour therapy, propose that such processing biases play an important role in causing and maintaining anxiety. Objectives Given that treatment with

  7. Relationship Between Alexithymia and Social Anxiety in Female Outpatients with Dermatological Disorder Presenting for Psychiatric Consultation

    Microsoft Academic Search

    Bilge Evren; Cuneyt Evren

    2007-01-01

    The aim of this study was to evaluate the relationship between alexithymia and social anxiety symptoms in female outpatients\\u000a with dermatological disorder. Fifty consecutive patients sent to a psychiatry outpatient clinic for consultation from a dermatology\\u000a outpatient clinic were included in the study. Social anxiety symptoms showed significant correlations with depression, trait\\u000a anxiety, alexithymia and global psychiatric symptom severity. A

  8. Anorexia nervosa and generalized anxiety disorder: Further explorations of the relation between anxiety and body mass index

    Microsoft Academic Search

    Laura M. Thornton; Jocilyn E. Dellava; Tammy L. Root; Paul Lichtenstein; Cynthia M. Bulik

    2011-01-01

    We explore comorbidity of anorexia nervosa (AN) and generalized anxiety disorder (GAD) and their relation with body mass index (BMI) and evaluate the presence of fasting and excessive exercise which both have anxiolytic and weight loss effects. All participants were female: 32 with AN only, 607 with GAD only, 22 with AN and GAD (AN+GAD), and 5424 with no history

  9. Neural Correlates of Emotional Interference in Social Anxiety Disorder

    PubMed Central

    Boehme, Stephanie; Ritter, Viktoria; Tefikow, Susan; Stangier, Ulrich; Strauss, Bernhard; Miltner, Wolfgang H. R.; Straube, Thomas

    2015-01-01

    Disorder-relevant but task-unrelated stimuli impair cognitive performance in social anxiety disorder (SAD); however, time course and neural correlates of emotional interference are unknown. The present study investigated time course and neural basis of emotional interference in SAD using event-related functional magnetic resonance imaging (fMRI). Patients with SAD and healthy controls performed an emotional stroop task which allowed examining interference effects on the current and the succeeding trial. Reaction time data showed an emotional interference effect in the current trial, but not the succeeding trial, specifically in SAD. FMRI data showed greater activation in the left amygdala, bilateral insula, medial prefrontal cortex (mPFC), dorsal anterior cingulate cortex (ACC), and left opercular part of the inferior frontal gyrus during emotional interference of the current trial in SAD patients. Furthermore, we found a positive correlation between patients’ interference scores and activation in the mPFC, dorsal ACC and left angular/supramarginal gyrus. Taken together, results indicate a network of brain regions comprising amygdala, insula, mPFC, ACC, and areas strongly involved in language processing during the processing of task-unrelated threat in SAD. However, specifically the activation in mPFC, dorsal ACC, and left angular/supramarginal gyrus is associated with the strength of the interference effect, suggesting a cognitive network model of attentional bias in SAD. This probably comprises exceeded allocation of attentional resources to disorder-related information of the presented stimuli and increased self-referential and semantic processing of threat words in SAD. PMID:26042738

  10. Signs of Mood and Anxiety Disorders in Chimpanzees

    PubMed Central

    Ferdowsian, Hope R.; Durham, Debra L.; Kimwele, Charles; Kranendonk, Godelieve; Otali, Emily; Akugizibwe, Timothy; Mulcahy, J. B.; Ajarova, Lilly; Johnson, Cassie Meré

    2011-01-01

    Background In humans, traumatic experiences are sometimes followed by psychiatric disorders. In chimpanzees, studies have demonstrated an association between traumatic events and the emergence of behavioral disturbances resembling posttraumatic stress disorder (PTSD) and depression. We addressed the following central question: Do chimpanzees develop posttraumatic symptoms, in the form of abnormal behaviors, which cluster into syndromes similar to those described in human mood and anxiety disorders? Methodology/Principal Findings In phase 1 of this study, we accessed case reports of chimpanzees who had been reportedly subjected to traumatic events, such as maternal separation, social isolation, experimentation, or similar experiences. We applied and tested DSM-IV criteria for PTSD and major depression to published case reports of 20 chimpanzees identified through PrimateLit. Additionally, using the DSM-IV criteria and ethograms as guides, we developed behaviorally anchored alternative criteria that were applied to the case reports. A small number of chimpanzees in the case studies met DSM-IV criteria for PTSD and depression. Measures of inter-rater reliability, including Fleiss' kappa and percentage agreement, were higher with use of the alternative criteria for PTSD and depression. In phase 2, the alternative criteria were applied to chimpanzees living in wild sites in Africa (n?=?196) and chimpanzees living in sanctuaries with prior histories of experimentation, orphanage, illegal seizure, or violent human conflict (n?=?168). In phase 2, 58% of chimpanzees living in sanctuaries met the set of alternative criteria for depression, compared with 3% of chimpanzees in the wild (p?=?0.04), and 44% of chimpanzees in sanctuaries met the set of alternative criteria for PTSD, compared with 0.5% of chimpanzees in the wild (p?=?0.04). Conclusions/Significance Chimpanzees display behavioral clusters similar to PTSD and depression in their key diagnostic criteria, underscoring the importance of ethical considerations regarding the use of chimpanzees in experimentation and other captive settings. PMID:21698223

  11. Daily and Nightly Anxiety Among Patients Affected by Night Eating Syndrome and Binge Eating Disorder

    Microsoft Academic Search

    Sandra Sassaroli; Giovanni Maria Ruggiero; Piergiuseppe Vinai; Silvia Cardetti; Gabriella Carpegna; Noemi Ferrato; Paola Vallauri; Donatella Masante; Silvio Scarone; Sara Bertelli; Roberta Bidone; Luca Busetto; Simona Sampietro

    2009-01-01

    We tested if there were any differences about nocturnal and diurnal anxiety between patients either affected by Binge Eating Disorder (BED) or Night eating Syndrome (NES). Fifty four patients affected by BED, 13 by NES and 16 by both BED and NES were tested using the Self Rating Anxiety Scale (SAS) and the Sleep Disturbance Questionnaire (SDQ). Their nocturnal eating

  12. Oxytocin Attenuates Amygdala Reactivity to Fear in Generalized Social Anxiety Disorder

    Microsoft Academic Search

    Izelle Labuschagne; K Luan Phan; Amanda Wood; Mike Angstadt; Phyllis Chua; Markus Heinrichs; Julie C Stout; Pradeep J Nathan

    2010-01-01

    Patients with generalized social anxiety disorder (GSAD) exhibit heightened activation of the amygdala in response to social cues conveying threat (eg, fearful\\/angry faces). The neuropeptide oxytocin (OXT) decreases anxiety and stress, facilitates social encounters, and attenuates amygdala reactivity to threatening faces in healthy subjects. The goal of this study was to examine the effects of OXT on fear-related amygdala reactivity

  13. Reduced resting-state functional connectivity between amygdala and orbitofrontal cortex in social anxiety disorder

    Microsoft Academic Search

    Andreas Hahn; Patrycja Stein; Christian Windischberger; Andreas Weissenbacher; Christoph Spindelegger; Ewald Moser; Siegfried Kasper; Rupert Lanzenberger

    2011-01-01

    Social anxiety disorder patients suffer from excessive anxious responses in social interaction leading to avoidance behavior and social impairment. Although the amygdala has a central role in perception and processing of threatening cues, little is known about the involved networks and corresponding dysfunctions in social anxiety. Therefore, this study aims to investigate the functional connectivity network of the amygdala in

  14. Internet-Delivered Indicated Prevention for Anxiety Disorders: Six-Month Follow-Up

    ERIC Educational Resources Information Center

    Kenardy, Justin; McCafferty, Kelly; Rosa, Virginia

    2006-01-01

    This project aims to conduct a medium-term follow-up to assess the efficacy of a preventive cognitive behavioural intervention delivered via the Internet to individuals at risk of developing anxiety disorders. Previous work on immediate outcome indicated that the program was effective in reducing depression and anxiety-related cognitions.…

  15. Complex Psychiatric Comorbidity of Treatment-Seeking Youth with Autism Spectrum Disorder and Anxiety Symptoms

    ERIC Educational Resources Information Center

    Hepburn, Susan L.; Stern, Jessica A.; Blakeley-Smith, Audrey; Kimel, Lila K.; Reaven, Judith A.

    2014-01-01

    This descriptive study examines the complexity of psychiatric comorbidity in treatment-seeking youth with ASD and anxiety symptoms. Forty-two parents of youth with ASD and anxiety (ages 8-14) completed a structured diagnostic interview (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version). Youth…

  16. Comorbidity of generalized social anxiety disorder and depression in a pediatric primary care sample

    Microsoft Academic Search

    Denise A Chavira; Murray B Stein; Kelly Bailey; Martin T Stein

    2004-01-01

    Background: Comorbidity between adult social anxiety disorder and major depression is extensive. Considerably less information about this relationship is available among youth. Methods: A randomly selected (from enrollees in a pediatric primary care clinic) sample of 190 families with children between the ages of 8 and 17 responded by mail to questionnaires assessing social anxiety, depression, and social functioning. Parents

  17. Effects of citalopram on worry and brain activation in patients with generalized anxiety disorder

    Microsoft Academic Search

    Rudolf Hoehn-Saric; Michael W Schlund; Steven H. Y Wong

    2004-01-01

    The effects of auditory statements describing a personal worry on brain activation as measured by functional magnetic resonance imaging were examined in patients with generalized anxiety disorder (GAD) before and after anxiety reduction with citalopram. Six patients were imaged while listening to verbal descriptions of a personal worry or a neutral statement before treatment with citalopram and after 7 weeks

  18. The vestibular dysfunction and anxiety disorder interface: a descriptive study with special reference to the elderly

    Microsoft Academic Search

    Nages Nagaratnam; Jerome Ip; Pascal Bou-Haidar

    2005-01-01

    Vestibular abnormalities co-existing with anxiety disorders are not uncommon and there has been a renewal of interest in recent times. Although well known over centuries, there is often a delay in the recognition of this relationship by the primary care physician and the specialist alike. Dizziness embracing vertigo, unsteadiness and imbalance are common in the elderly, so is generalized anxiety

  19. Child-Parent Interventions for Childhood Anxiety Disorders: A Systematic Review and Meta-Analysis

    ERIC Educational Resources Information Center

    Brendel, Kristen Esposito; Maynard, Brandy R.

    2014-01-01

    Objective: This study compared the effects of direct child-parent interventions to the effects of child-focused interventions on anxiety outcomes for children with anxiety disorders. Method: Systematic review methods and meta-analytic techniques were employed. Eight randomized controlled trials examining effects of family cognitive behavior…

  20. The Role of Self-Statements as a Mediator in Treatment for Youth With Anxiety Disorders

    Microsoft Academic Search

    Philip C. Kendall; Kimberli R. H. Treadwell

    2007-01-01

    The authors investigated features of self-statements as predictors of anxiety in children with and without anxiety disorder (AD) and as a mediator of treatment of ADs in children. Children (N = 145) between the ages of 9 and 13 years participated (71 AD youth, 84 controls). Self-statements were classified by valence and content. Results indicated that children's anxious, but not

  1. The Role of Self-Statements as a Mediator in Treatment for Youth with Anxiety Disorders

    ERIC Educational Resources Information Center

    Kendall, Philip C.; Treadwell, Kimberli R. H.

    2007-01-01

    The authors investigated features of self-statements as predictors of anxiety in children with and without anxiety disorder (AD) and as a mediator of treatment of ADs in children. Children (N = 145) between the ages of 9 and 13 years participated (71 AD youth, 84 controls). Self-statements were classified by valence and content. Results indicated…

  2. Commentary: Expanding the Research Agenda on Interventions for Child and Adolescent Anxiety Disorders

    Microsoft Academic Search

    Joel T. Sherrill

    2008-01-01

    The articles in this series describe complementary programs of research and innovative approaches to extend evidence-based interventions for youth with anxiety in several important directions: to extend the target age range [Pincus, D. B., Santucci, L. C., Ehrenreich, J. T., & Eyberg, S. M. (2008-this issue). Treating separation anxiety disorder in young children: Exploring the additive impact of exposure on

  3. Do Anxiety-Disordered Children Need to Come into the Clinic for Efficacious Treatment?

    ERIC Educational Resources Information Center

    Cobham, Vanessa E.

    2012-01-01

    Objective: This study compared 3 experimental conditions: wait-list, therapist-supported bibliotherapy, and individual therapy, in the treatment of child anxiety. Method: Participants were 55 children (25 girls and 30 boys), aged 7 to 14 years diagnosed with an anxiety disorder, and their parents. Families were assigned using a modified random…

  4. Self-Efficacy for Social Situations in Adolescents with Generalized Social Anxiety Disorder

    Microsoft Academic Search

    Brandon A. Gaudiano; James D. Herbert

    2007-01-01

    Self-efficacy is a potentially useful concept when applied to Social Anxiety Disorder (SAD). The aims of the current study were to examine the psychometric properties of the Self- Efficacy for Social Situations Scale (SESS; Gaudiano and Herbert, 2003) and to investigate the relationship between self-efficacy and anxiety in an adolescent sample with generalized SAD. Results replicated those found in a

  5. Impact of early adolescent anxiety disorders on self-esteem development from adolescence to young adulthood

    PubMed Central

    Maldonado, Lizmarie; Huang, Yangxin; Chen, Ren; Kasen, Stephanie; Cohen, Patricia; Chen, Henian

    2013-01-01

    Purpose To examine the association between early adolescent anxiety disorders and self-esteem development from early adolescence to young adulthood. Methods Self-esteem was measured at mean ages 13, 16 and 22 for 821 participants from the Children in the Community Study, a population-based longitudinal cohort. Anxiety disorders were measured at mean age 13 years. Multilevel growth models were employed to analyze the change in self-esteem from early adolescence to young adulthood and to evaluate whether adolescent anxiety disorders predict both average and slope of self-esteem development. Results Self-esteem increased during adolescence and continued to increase in young adulthood. Girls had lower average self-esteem than boys, but this difference disappeared when examining the effect of anxiety. Adolescents with anxiety disorder had lower self-esteem, on average, compared with healthy adolescents (effect size (ES) =?0.35, p<0.01). Social phobia was found to have the greatest relative impact on average self-esteem (ES=?0.30, p<0.01), followed by overanxious disorder (ES=?0.17, p<0.05), and simple phobia (ES=?0.17, p<0.05). Obsessive compulsive-disorder (OCD) predicted a significant decline in self-esteem from adolescence to young-adulthood ( =?0.1, p<0.05). Separation anxiety disorder was not found to have any significant impact on self-esteem development. Conclusions All but one of the assessed adolescent anxiety disorders were related to lower self-esteem, with social phobia having the greatest impact. OCD predicted a decline in self-esteem trajectory with age. The importance of raising self-esteem in adolescents with anxiety and other mental disorders is discussed. PMID:23648133

  6. Relationship of genetically transmitted alpha EEG traits to anxiety disorders and alcoholism

    SciTech Connect

    Enoch, M.A.; Rohrbaugh, W.; Harris, C.R. [Washington School of Medicine, St. Louis, MO (United States)] [and others

    1995-10-09

    We tested the hypothesis that a heritable EEG trait, the low voltage alpha (LV), is associated with psychiatric disorders. Modest to moderate evidence for genetic linkage of both panic disorder and the low voltage alpha trait to the same region of chromosome 20q has recently been reported, raising the issue of whether there is a phenotypic correlation between these traits. A total of 124 subjects including 50 unrelated index subjects and 74 relatives were studied. Alpha EEG power was measured and EEG phenotypes were impressionistically classified. Subjects were psychiatrically interviewed using the SADS-L and blind-rated by RDC criteria. Alcoholics were four times more likely to be LV (including so-called borderline low voltage alpha) than were nonalcoholic, nonanxious subjects. Alcoholics with anxiety disorder are 10 times more likely to be LV. However, alcoholics without anxiety disorder were similar to nonalcoholics in alpha power. An anxiety disorder (panic disorder, phobia, or generalized anxiety) was found in 14/17 LV subjects as compared to 34/101 of the rest of the sample (P < 0.01). Support for these observations was found in the unrelated index subjects in whom no traits would be shared by familial clustering. Lower alpha power in anxiety disorders was not state-dependent, as indicated by the Spielberger Anxiety Scale. Familial covariance of alpha power was 0.25 (P < 0.01). These findings indicate there may be a shared factor underlying the transmissible low voltage alpha EEG variant and vulnerability to anxiety disorders with associated alcoholism. This factor is apparently not rare, because LV was found in approximately 10% of unrelated index subjects and 5% of subjects free of alcoholism and anxiety disorders. 43 refs., 1 fig., 3 tabs.

  7. Depression and anxiety: predictors of eating disorder symptoms and substance addiction severity

    Microsoft Academic Search

    Leah B. Shapira; Christine M. Courbasson

    2011-01-01

    Depression, anxiety, and low self-esteem are frequently associated with eating and substance use disorders (SUD). Given the high prevalence of concurrent disorders in individuals with eating and substance use problems, it is critical to identify other psychological factors important for consideration in treatment of this population. Individuals (N = 314) seeking treatment for eating disorder (ED) and problematic substance use were administered

  8. Are Children with "Pure" Generalized Anxiety Disorder Impaired? A Comparison with Comorbid and Healthy Children

    ERIC Educational Resources Information Center

    Alfano, Candice A.

    2012-01-01

    Despite the approach of the "Diagnostic and Statistical Manual of Mental Disorders" (5th ed.), generalized anxiety disorder (GAD) of childhood continues to face questions as to whether it should be considered a distinct clinical disorder. A potentially critical issue embedded in this debate involves the role of functional impairment which has yet…

  9. Social physique anxiety and disordered eating: what’s the connection?

    Microsoft Academic Search

    Nancy S. Diehl; Courtney E. Johnson; Rebecca L. Rogers; Trent A. Petrie

    1998-01-01

    Social physique anxiety (SPA) is highly correlated with other body image measures that have been considered to be important in understanding eating disorders. However, SPA has not been directly studied with respect to eating disorders. Thus, the purpose of this investigation was to examine the link between SPA and measures of eating disorder symptomatology to determine if SPA should be

  10. Increased anxiety and other similarities in temperament of alcoholics with and without antisocial personality disorder across three diverse populations

    Microsoft Academic Search

    Francesca Ducci; Mary-Anne Enoch; Samuel Funt; Matti Virkkunen; Bernard Albaugh; David Goldman

    2007-01-01

    According to Cloninger's model, type I alcoholics are thought to be innately vulnerable to anxiety and depression. In contrast, type II alcoholics are thought to have increased likelihood of antisocial personality disorder (ASPD) and reduced anxiety. However, allostatic activations of stress, anxiety, and dysphoria may be a common thread in alcohol use disorders (AUDs). Our aim was to find commonalities

  11. Locus of Control Fails to Mediate between Stress and Anxiety and Depression in Parents of Children with a Developmental Disorder

    ERIC Educational Resources Information Center

    Hamlyn-Wright, Sarah; Draghi-Lorenz, Riccardo; Ellis, Jason

    2007-01-01

    Stress, anxiety and depression are raised amongst parents of children with a developmental disorder. However, the processes by which stress leads to depression and anxiety are poorly understood. In a cross-sectional survey, levels of parental stress, depression and anxiety were compared between parents of children with an autistic disorder,…

  12. A Multimethod Assessment of Anxiety and Problem Behavior in Children with Autism Spectrum Disorders and Intellectual Disability

    ERIC Educational Resources Information Center

    Moskowitz, Lauren J.; Mulder, Emile; Walsh, Caitlin E.; McLaughlin, Darlene Magito; Zarcone, Jennifer R.; Proudfit, Greg Hajcak; Carr, Edward G.

    2013-01-01

    Despite the increased risk for anxiety disorders in children with autism spectrum disorders (ASD), there is a lack of research on the assessment and treatment of anxiety in this population, particularly for those with an intellectual disability (ID). The present study evaluated a multimethod strategy for the assessment of anxiety and problem…

  13. Depressive and anxiety disorders in primary care: factors affecting physicians' use of screening information 

    E-print Network

    Maner, Ashley Meredith

    1999-01-01

    that influence management decisions after the provision of psychiatric screening results. Subjects were 112 family medicine patients who screened positive for a depressive or anxiety disorder. Based on a review of patients' medical charts and accounts...

  14. Influence of Psychiatric Comorbidity on Recovery and Recurrence in Generalized Anxiety Disorder, Social Phobia, and Panic Disorder: A 12Year Prospective Study

    Microsoft Academic Search

    Steven E. Bruce; Kimberly A. Yonkers; Michael W. Otto; Jane L. Eisen; Risa B. Weisberg; Maria Pagano; Martin B. Keller

    2005-01-01

    Objective: The authors sought to ob- serve the long-term clinical course of anx- iety disorders over 12 years and to exam- ine the influence of comorbid psychiatric disorders on recovery from or recurrence of panic disorder, generalized anxiety dis- order, and social phobia. Method: Data were drawn from the Har- vard\\/Brown Anxiety Disorders Research Program, a prospective, naturalistic, lon- gitudinal,

  15. Subcortical volumetric correlates of anxiety in familial pediatric bipolar disorder: A preliminary investigation

    PubMed Central

    Simeonova, Diana I.; Jackson, Valerie; Attalla, Ashraf; Karchemskiy, Asya; Howe, Meghan; Adleman, Nancy; Chang, Kiki

    2009-01-01

    Anxiety is a common comorbid condition in pediatric bipolar disorder (BD). However, there is little known about the effects of comorbidity on brain morphometry in this population. The aim of the present study was to examine subcortical correlates of anxiety in familial pediatric BD. 120 children (mean age = 12 ± 3.3 years) with at least one parent diagnosed with BD were evaluated. Bipolar offspring with BD were compared to bipolar offspring without BD on a measure of overall lifetime anxiety. A sub-sample of 20 bipolar offspring with BD (mean age = 14.6 ± 2.8 years) underwent magnetic resonance imaging (MRI) with a 3-T scanner. Correlational analyses were conducted between hippocampal and amygdalar volumes, and anxiety scores. The results showed significantly higher anxiety in bipolar offspring with BD compared to bipolar offspring without BD. There was a significant negative association between total hippocampal volume and anxiety scores. No significant association was found between total amygdalar volume and anxiety scores. Clinically, these findings suggest that anxiety comorbidity needs to be properly assessed and treated in the management of pediatric BD. This is the first study to show a negative association between hippocampal volume and anxiety in this population. The overlap between anxiety and familial pediatric BD suggest that anxiety may be one important area of future research in parsing out the heterogeneous nature and complex etiology of early-onset BD. PMID:19559573

  16. The Relationships Between Childhood Sexual Abuse, Social Anxiety, and Symptoms of Posttraumatic Stress Disorder in Women

    Microsoft Academic Search

    Margaret M. Feerick; Kyle L. Snow

    2005-01-01

    The relationships between childhood sexual abuse, social anxiety, and symptoms of posttraumatic stress disorder were examined\\u000a in a sample of 313 undergraduate women. Thirty-one percent of the women reported some form of sexual abuse in childhood. Women\\u000a with a history of sexual abuse reported more symptoms of anxiety, distress in social situations, and posttraumatic stress\\u000a disorder than other women. Women

  17. Differential Carbon Dioxide Sensitivity in Childhood Anxiety Disorders and Nonill Comparison Group

    Microsoft Academic Search

    Daniel S. Pine; Rachel G. Klein; Jeremy D. Coplan; Laszlo A. Papp; Christina W. Hoven; Jose Martinez; Pavel Kovalenko; Donald J. Mandell; Donna Moreau; Donald F. Klein; Jack M. Gorman

    2000-01-01

    toms. Children with an anxiety disorder, particularly sepa- ration anxiety disorder, exhibited greater changes in somatic symptoms during inhalation of CO2-enriched air, relative to the comparison group. During CO2 inhala- tion, symptom ratings were positively correlated with res- piratory rate increases, as well as with levels of tidal vol- ume, minute ventilation, end-tidal CO2, and irregularity in respiratory rate during

  18. Evaluation of therapist-supported parent-implemented CBT for anxiety disorders in rural children

    Microsoft Academic Search

    Heidi J. Lyneham; Ronald M. Rapee

    2006-01-01

    Supplementing bibliotherapy with therapist-client communication has been shown to be an effective way of providing services to under-resourced and isolated communities. The current study examined the efficacy of supplementing bibliotherapy for child anxiety disorders with therapist-initiated telephone or email sessions, or with client-initiated contact in a randomised trial using a waitlist control. Participants were 100 anxiety-disordered children and their parents

  19. Anxiety Disorders: Sex Differences in Prevalence, Degree, and Background, But Gender-Neutral Treatment

    Microsoft Academic Search

    Marrie H. J. Bekker; Janneke van Mens-Verhulst

    2007-01-01

    Background: Anxiety disorders are more prevalent among women than among men.Objective: The aim of this paper was to investigate to what degree current psychological theories and treatment of anxiety disorders incorporate sex and gender considerations.Methods: Relevant English, Dutch, German, or French empirical articles published until November 2006 were identified using the PsycINFO and PubMed databases as well as manual searches.

  20. Parents’ perceptions of pharmacological and cognitive-behavioral treatments for childhood anxiety disorders

    Microsoft Academic Search

    Amy M. Brown; Brett J. Deacon; Jonathan S. Abramowitz; Julie Dammann; Stephen P. Whiteside

    2007-01-01

    Cognitive-behavioral therapy (CBT) and pharmacotherapy are the most well-established treatments for childhood anxiety disorders. This study examined how parents (N=71) seeking treatment for their child's anxiety disorder perceive the acceptability, believability, and effectiveness of these treatments. While both treatments were perceived favorably, CBT was rated as more acceptable, believable, and effective in the short- and long-term. Children's treatment history influenced

  1. An Open Trial of an Acceptance-Based Behavior Therapy for Generalized Anxiety Disorder

    Microsoft Academic Search

    Lizabeth Roemer; Susan M. Orsillo

    2007-01-01

    Research suggests that experiential avoidance may play an important role in generalized anxiety disorder (GAD; see Roemer, L., & Orsillo, S.M. (2002). Expanding our conceptualization of and treatment for generalized anxiety disorder: Integrating mindfulness\\/acceptance-based approaches with existing cognitive-behavioral models. Clinical Psychology: Science and Practice, 9, 54–68, for a review). Therefore, a treatment that emphasizes experiential acceptance, as well as intentional

  2. Evidence for disturbed cortical signal processing and altered serotonergic neurotransmission in generalized anxiety disorder

    Microsoft Academic Search

    Daniel Senkowski; Michael Linden; Doris Zubrägel; Thomas Bär; Jürgen Gallinat

    2003-01-01

    BackgroundCurrent pathophysiological concepts of generalized anxiety disorder (GAD) assume a disturbed exteroceptive sensory system. Furthermore, central serotonergic neurotransmission has been shown to play an important role in anxiety disorder. Cortical signal processing as measured by auditory evoked potentials (AEPs) may reflect the integrity of the exteroceptive sensory system. Because a special aspect of AEP, the loudness dependence of the N1\\/P2-component

  3. School-Based Intervention for Adolescents with Social Anxiety Disorder: Results of a Controlled Study

    Microsoft Academic Search

    Carrie Masia-Warner; Rachel G. Klein; Heather C. Dent; Paige H. Fisher; Jose Alvir; Anne Marie Albano; Mary Guardino

    2005-01-01

    Social anxiety disorder, whose onset peaks in adolescence, is associated with significant impairment. Despite the availability\\u000a of effective treatments, few affected youth receive services. Transporting interventions into schools may circumvent barriers\\u000a to treatment. The efficacy of a school-based intervention for social anxiety disorder was examined in a randomized wait-list\\u000a control trial of 35 adolescents (26 females). Independent evaluators, blind to

  4. Changes in regional brain volumes in social anxiety disorder following 12 weeks of treatment with escitalopram

    Microsoft Academic Search

    Naseema Cassimjee; Jean-Pierre Fouche; Michael Burnett; Christine Lochner; James Warwick; Patrick Dupont; Dan J. Stein; Karen J. Cloete; Paul D. Carey

    2010-01-01

    It has been suggested that antidepressants, including the selective serotonin reuptake inhibitors have neurotrophic effects.\\u000a Nevertheless, the impact of treatment with a selective serotonin re-uptake inhibitor on regional brain volumes in social anxiety\\u000a disorder has not been studied. 11 subjects with social anxiety disorder completed magnetic resonance imaging both before and\\u000a after 12-weeks of treatment with 20 mg\\/day escitalopram. No increases

  5. The multiple dimensions of the social anxiety spectrum in mood disorders.

    PubMed

    Fournier, Jay C; Cyranowski, Jill M; Rucci, Paola; Cassano, Giovanni B; Frank, Ellen

    2012-09-01

    Major depressive disorder and bipolar spectrum disorders are debilitating conditions associated with severe impairment. The presence of co-occurring social phobia can make the clinical course of these disorders even more challenging. To better understand the nature of social anxiety in the context of ongoing mood disorders, we report the results of exploratory factor analyses of the Social Phobia Spectrum Self-Report Instrument (SHY), a 162-item measure designed to capture the full spectrum of manifestations and features associated with social anxiety experienced across the lifespan. We examined data from 359 adult outpatients diagnosed with major depressive disorder and 403 outpatients diagnosed with a bipolar spectrum disorder. The measure was divided into its two components: the SHY-General (SHY-G), reflecting general social anxiety features, and the SHY-Specific (SHY-S), reflecting anxiety in specific situations. Exploratory factor analyses were conducted for each using tetrachoric correlation matrices and an unweighted least squares estimator. Item invariance was evaluated for important patient subgroups. Five factors were identified for the SHY-G, representing general features of social anxiety: Fear of Social Disapproval, Childhood Social Anxiety, Somatic Social Anxiety, Excessive Agreeableness, and Behavioral Submission. Seven specific-situation factors were identified from the SHY-S: Writing in Public, Dating, Public Speaking, Eating in Public, Shopping Fears, Using Public Restrooms, and Unstructured Social Interactions. The identified dimensions provide clinically valuable information about the nature of the social fears experienced by individuals diagnosed with mood disorders and could help guide the development of tailored treatment strategies for individuals with co-occurring mood disorders and social anxiety. PMID:22771202

  6. Self-Talk in Youth With Anxiety Disorders: States of Mind, Content Specificity, and Treatment Outcome

    Microsoft Academic Search

    Kimberli R. H. Treadwell; Philip C. Kendall

    1996-01-01

    This study investigated the relationship between childhood anxiety disorders, the valence and content of self-statements, and the impact of treatment on the internal dialogue. Participants (151 8- to 13-year-olds) included 71 youth with anxiety disorders and 80 control participants. Positive and negative self-statements and a states-of-mind (SOM) ratio were examined. Results indicated that the negative self-statements and SOM ratio (but

  7. Shorter communication Thought-action fusion and anxiety disorders symptoms in normal adolescents

    Microsoft Academic Search

    Peter Muris; Cor Meesters; Eric Rassin; Harald Merckelbach; Jerehm Campbell

    The present study examined thought-action fusion (TAF) in a large sample of normal adolescents (n=427). Participants completed the Thought-Action Fusion Questionnaire for Adolescents (TAFQ-A) and scales measuring trait anxiety, symptoms of obsessive-compulsive disorder, other anxiety disorders, and depression. Results showed that the TAFQ-A is a reliable instrument assessing two dimensions of TAF, viz. Morality (i.e., the belief that unacceptable thoughts

  8. Thought–action fusion and anxiety disorders symptoms in normal adolescents

    Microsoft Academic Search

    Peter Muris; Cor Meesters; Eric Rassin; Harald Merckelbach; Jerehm Campbell

    2001-01-01

    The present study examined thought–action fusion (TAF) in a large sample of normal adolescents (n=427). Participants completed the Thought–Action Fusion Questionnaire for Adolescents (TAFQ–A) and scales measuring trait anxiety, symptoms of obsessive–compulsive disorder, other anxiety disorders, and depression. Results showed that the TAFQ–A is a reliable instrument assessing two dimensions of TAF, viz. Morality (i.e., the belief that unacceptable thoughts

  9. The Role of Emotion Regulation in the Treatment of Child Anxiety Disorders

    Microsoft Academic Search

    Dagmar Kristin Hannesdottir; Thomas H. Ollendick

    2007-01-01

    In this review, we examine the role of emotion regulation in the treatment of children with anxiety disorders. Cognitive-behavioral\\u000a therapy (CBT) has been shown to “work” for children with anxiety disorders and it has been categorized as an evidence-based\\u000a treatment. However, most studies have shown that the treatment is effective for about 60–70% of children, leaving the remaining\\u000a children symptomatic

  10. Sleep Problems Predict and are Predicted by Generalized Anxiety/Depression and Oppositional Defiant Disorder

    PubMed Central

    Shanahan, Lilly; Copeland, William E.; Angold, Adrian; Bondy, Carmen L.; Costello, E. Jane

    2014-01-01

    Objective We tested whether sleep problems co-occur with, precede, and/or follow common psychiatric disorders during childhood and adolescence. We also clarified the role of comorbidity, and tested for specificity of associations among sleep problems and psychiatric disorders. Method Data came from the Great Smoky Mountains Study, a representative population sample of 1,420 children, assessed 4 to 7 times per person between ages 9 and 16 for major DSM-IV disorders and sleep problems. Sleep-related symptoms were removed from diagnostic criteria when applicable. Results Sleep problems during childhood and adolescence were common, with restless sleep and difficulty falling asleep being the most common symptoms. Cross-sectional analyses showed that sleep problems co-occurred with many psychiatric disorders. Longitudinal analyses revealed that sleep problems predicted increases in the prevalence of later generalized anxiety disorder and high generalized anxiety disorder/depression symptoms, and oppositional defiant disorder. In turn, generalized anxiety disorder and/or depression and oppositional defiant disorder predicted increases in sleep problems over time. Conclusions Sleep problems both predict and are predicted by a diagnostic cluster that includes oppositional defiant disorder, generalized anxiety disorder and depression. Screening children for sleep problems could offer promising opportunities for reducing the burden from mental illness during the early life course. PMID:24745954

  11. Screening for depression and anxiety disorders from pregnancy to postpartum with the EPDS and STAI.

    PubMed

    Tendais, Iva; Costa, Raquel; Conde, Ana; Figueiredo, Bárbara

    2014-01-01

    The Edinburgh Postnatal Depression Scale (EPDS) and the State Anxiety Inventory (STAI-S) are widely used self-report measures that still need to be further validated for the perinatal period. The aim of this study was to examine the screening performance of the EPDS and the STAI-S in detecting depressive and anxiety disorders at pregnancy and postpartum. Women screening positive on EPDS (EPDS ? 9) or STAI-S (STAI-S ? 45) during pregnancy (n = 90), as well as matched controls (n = 58) were selected from a larger study. At 3 months postpartum, 99 of these women were reassessed. At a second stage, women were administered a clinical interview to establish a DSM-IV-TR diagnosis. Receiver operator characteristics (ROC) analysis yielded areas under the curve higher than .80 and .70 for EPDS and STAI-S, respectively. EPDS and STAI-S optimal cut-offs were found to be lower at postpartum (EDPS = 7; STAI-S = 34) than during pregnancy (EPDS = 9; STAI-S = 40). EPDS and STAI-S are reasonably valid screening tools during pregnancy and the postpartum. PMID:25012783

  12. Proteasome modulator 9 gene SNPs, responsible for anti-depressant response, are in linkage with generalized anxiety disorder.

    PubMed

    Gragnoli, Claudia

    2014-09-01

    Proteasome modulator 9 (PSMD9) gene single nucleotide polymorphism (SNP) rs1043307/rs2514259 (E197G) is associated with significant clinical response to the anti-depressant desipramine. PSMD9 SNP rs74421874 [intervening sequence (IVS) 3?+?nt460 G>A], rs3825172 (IVS3?+?nt437 C>T) and rs1043307/rs2514259 (E197G A>G) are all linked to type 2 diabetes (T2D), maturity-onset-diabetes-of the young 3 (MODY3), obesity and waist circumference, hypertension, hypercholesterolemia, T2D-macrovascular and T2D-microvascular disease, T2D-neuropathy, T2D-carpal tunnel syndrome, T2D-nephropathy, T2D-retinopathy, non-diabetic retinopathy and depression. PSMD9 rs149556654 rare SNP (N166S A>G) and the variant S143G A>G also contribute to T2D. PSMD9 is located in the chromosome 12q24 locus, which per se is in linkage with depression, bipolar disorder and anxiety. In the present study, we wanted to determine whether PSMD9 is linked to general anxiety disorder in Italian T2D families. Two-hundred Italian T2D families were phenotyped for generalized anxiety disorder, using the diagnostic criteria of DSM-IV. When the diagnosis was unavailable or unclear, the trait was reported as unknown. The 200 Italians families were tested for the PSMD9 T2D risk SNPs rs74421874 (IVS3?+?nt460 G>A), rs3825172 (IVS3?+nt437 T>C) and for the T2D risk and anti-depressant response SNP rs1043307/rs2514259 (E197G A>G) for evidence of linkage with generalized anxiety disorder. Non-parametric linkage analysis was executed via Merlin software. One-thousand simulation tests were performed to exclude results due to random chance. In our study, the PSMD9 gene SNPs rs74421874, rs3825172, and rs1043307/rs2514259 result in linkage to generalized anxiety disorder. This is the first report describing PSMD9 gene SNPs in linkage to generalized anxiety disorder in T2D families. PMID:24648162

  13. Nail disorders in children: diagnosis and management.

    PubMed

    Richert, Bertrand; André, Josette

    2011-04-01

    Nail disorders in children can be divided into seven categories. The first is physiologic alterations, which every physician should be aware of in order to reassure parents. These usually disappear with age and do not require any treatment. Among congenital and inherited conditions, the nail-patella syndrome, with its pathognomonic triangular lunula, should not be missed as recognition of the disease allows early diagnosis of associated pathologies. The most common infection is the periungual wart, whose treatment is delicate. Herpetic whitlow should be distinguished from bacterial whitlow as their therapeutic approaches differ. Dermatologic diseases encompass eczema, psoriasis, lichen planus, lichen striatus, trachyonychia, and parakeratosis pustulosa. Lichen planus, when it presents as in adults, is important to recognize because, if not treated, it may lead to permanent nail loss. Systemic or iatrogenic nail alterations may be severe but are usually not the first clue to the diagnosis. Beau lines on several fingernails are very common in children after temperature crest. Tumors are rare in children. Radiographic examination allows confirmation of the diagnosis of subungual exostosis. Other cases should undergo biopsy. Single-digit longitudinal melanonychia in children is mostly due to nevi. Its management should be tailored on a case-by-case basis. Acute trauma should never be underestimated in children and hand surgeons should be involved if necessary. Onychophagia and onychotillomania are responsible for chronic trauma. PMID:21348541

  14. A Systems Neuroscience Approach to the Pathophysiology of Pediatric Mood and Anxiety Disorders

    PubMed Central

    Leibenluft, Ellen; Brotman, Melissa A.

    2015-01-01

    Emotional dysregulation is a core feature of pediatric mood and anxiety disorders. Emerging evidence suggests that these disorders are mediated by abnormalities in the functions and structures of the developing brain. This chapter reviews recent behavioral and functional magnetic resonance imaging (fMRI) research on pediatric mood and anxiety disorders, focusing on the neural mechanisms underlying these disorders. Throughout the chapter, we highlight the relationship between neural and behavioral findings, and potential novel treatments. The chapter concludes with directions for future research. PMID:24281907

  15. An analysis of early developmental trauma in social anxiety disorder and posttraumatic stress disorder

    PubMed Central

    2014-01-01

    Background The early contributions of childhood trauma (emotional, physical, sexual, and general) have been hypothesized to play a significant role in the development of anxiety disorders, such as posttraumatic stress disorder (PTSD) and social anxiety disorder (SAD). The aim of this study was to assess childhood trauma differences between PTSD and SAD patients and healthy controls, as measured by the Early Trauma Inventory. Methods We examined individuals (N?=?109) with SAD with moderate/severe early developmental trauma (EDT) (n?=?32), individuals with SAD with low/no EDT (n?=?29), individuals with PTSD with EDT (n?=?17), and healthy controls (n?=?31). The mean age was 34 years (SD?=?11). Subjects were screened with the Mini-International Neuropsychiatric Interview (MINI), Liebowitz Social Anxiety Scale (LSAS), Clinician-Administered PTSD Scale (CAPS), and Childhood Trauma Questionnaire (CTQ). Analysis of variance was performed to assess group differences. Correlations were calculated between childhood traumas. Results Although not statistically significant, individuals with PTSD endorsed more physical and sexual childhood trauma compared with individuals with SAD with moderate/severe EDT who endorsed more emotional trauma. For all groups, physical and emotional abuse occurred between ages 6 and 11, while the occurrence of sexual abuse in individuals with PTSD was at 6–11 years and later (13–18 years) in individuals with SAD with moderate/severe EDT. For emotional abuse in all groups, the perpetrator was mostly a primary female caregiver; for sexual abuse, it was mostly a nonfamilial adult male, while for physical abuse, it was mostly a caregiver (male in PTSD and female in SAD with moderate/severe EDT). Conclusions The contribution of childhood abuse to the development of PTSD and SAD and the differences between these groups and other anxiety disorders should not be ignored and attention should be given to the frequency and severity of these events. The relationship of the perpetrator(s) and the age of onset of childhood abuse are also important considerations as they provide a useful starting point to assess impact over the life course. This can, in turn, guide clinicians on the optimal timing for the delivery of interventions for the prevention of PTSD and SAD. PMID:24920955

  16. Treating ethnic minority adults with anxiety disorders: Current status and future recommendations?

    PubMed Central

    Carter, Michele M; Mitchell, Frances E.; Sbrocco, Tracy

    2014-01-01

    The past three decades have witnessed an increase in the number of empirical investigations examining the phenomenology of anxiety and related conditions. There has also been an increase in efforts to understand differences that may exist between ethnic groups in the expression of the anxiety disorders. In addition, there is now substantial evidence that a variety of treatment approaches (most notably behavioral and cognitive behavioral) are efficacious in remediating anxiety. However, there continues to be comparatively few treatment outcome studies investigating the efficacy of anxiety treatments among minority populations. In this paper, we review the extant treatment outcome research for African American, Hispanic/Latino[a] American, Asian American, and Native Americans suffering with one of the anxiety disorders. We discuss some of the specific problems with the research in this area, and then provide specific recommendations for conducting treatment outcome research with minority populations in the future. PMID:22417877

  17. Psychometric Properties of the Liebowitz Social Anxiety Scale (LSAS) in a Longitudinal Study of African Americans with Anxiety Disorders

    PubMed Central

    Beard, Courtney; Rodriguez, Benjamin F.; Moitra, Ethan; Sibrava, Nicholas J.; Bjornsson, Andri; Weisberg, Risa B.; Keller, Martin B.

    2011-01-01

    The Liebowitz Social Anxiety Scale (LSAS) is a widely used measure of social anxiety. However, no study has examined the psychometric properties of the LSAS in an African American sample. The current study examined the LSAS characteristics in 97 African Americans diagnosed with an anxiety disorder. Overall, the original LSAS subscales showed excellent internal consistency and temporal stability. Similar to previous reports, fear and avoidance subscales were so highly correlated that they yielded redundant information. Confirmatory factor analyses for three previously proposed models failed to demonstrate an excellent fit to our data. However, a four-factor model showed minimally acceptable fit. Overall, the LSAS performed similarly in our African American sample as in previous European American samples. Exploratory factor analyses are warranted to determine whether a better factor structure exists for African Americans. PMID:21501944

  18. Role of Comorbid Depression and Co-Occurring Depressive Symptoms in Outcomes for Anxiety-Disordered Youth Treated with Cognitive-Behavioral Therapy

    ERIC Educational Resources Information Center

    O'Neil, Kelly A.; Kendall, Philip C.

    2012-01-01

    This study examined the role of comorbid depressive disorders (major depressive disorder or dysthymic disorder) and co-occurring depressive symptoms in treatment outcome and maintenance for youth (N = 72, aged 7-14) treated with cognitive-behavioral therapy for a principal anxiety disorder (generalized anxiety disorder, separation anxiety

  19. New research on anxiety disorders in the elderly and an update on evidence-based treatments.

    PubMed

    Andreescu, Carmen; Varon, Daniel

    2015-07-01

    Anxiety disorders are frequently encountered in the elderly, but they are largely undetected and untreated. Epidemiological studies indicate a prevalence ranging from 1.2 to 15 %. With the exception of generalized anxiety disorder and agoraphobia, which can often start in late life, most anxiety disorders in older patients are chronic and have their onset earlier in life. Anxiety disorders are an often unrecognized cause of distress, disability, and mortality risk in older adults, and they have been associated with cardiovascular disease, stroke, and cognitive decline. The mechanisms of anxiety in older adults differ from that in younger adults due to age-related neuropathology, as well as the loss and isolation so prominent in late life. Our review intends to provide a comprehensive summary of the most recent research done in the field of anxiety disorders in the elderly. Recent findings in clinical research, neuroimaging, neuroendocrinology, and neuropsychology are covered. An update on treatment options is discussed, including pharmacological and non-pharmacological alternatives. PMID:25980510

  20. Does D-Cycloserine Enhance Exposure Therapy for Anxiety Disorders in Humans? A Meta-Analysis

    PubMed Central

    Rodrigues, Helga; Figueira, Ivan; Lopes, Alessandra; Gonçalves, Raquel; Mendlowicz, Mauro Vitor; Coutinho, Evandro Silva Freire; Ventura, Paula

    2014-01-01

    The treatment of anxiety is on the edge of a new era of combinations of pharmacologic and psychosocial interventions. A new wave of translational research has focused on the use of pharmacological agents as psychotherapy adjuvants using neurobiological insights into the mechanism of the action of certain psychological treatments such as exposure therapy. Recently, d-cycloserine (DCS) an antibiotic used to treat tuberculosis has been applied to enhance exposure-based treatment for anxiety and has proved to be a promising, but as yet unproven intervention. The present study aimed to evaluate the efficacy of DCS in the enhancement of exposure therapy in anxiety disorders. A systematic review/meta-analysis was conducted. Electronic searches were conducted in the databases ISI-Web of Science, Pubmed and PsycINFO. We included only randomized, double-blind, placebo-controlled trials with humans, focusing on the role of DCS in enhancing the action of exposure therapy for anxiety disorders. We identified 328 references, 13 studies were included in our final sample: 4 on obsessive-compulsive disorder, 2 on panic disorder, 2 on social anxiety disorder, 2 on posttraumatic stress disorder, one on acrophobia, and 2 on snake phobia. The results of the present meta-analysis show that DCS enhances exposure therapy in the treatment of anxiety disorders (Cohen d?=? ?0.34; CI: ?0.54 to ?0.14), facilitating the specific process of extinction of fear. DCS seems to be effective when administered at a time close to the exposure therapy, at low doses and a limited number of times. DCS emerges as a potential new therapeutic approach for patients with refractory anxiety disorders that are unresponsive to the conventional treatments available. When administered correctly, DCS is a promising strategy for augmentation of CBT and could reduce health care costs, drop-out rates and bring faster relief to patients. PMID:24991926

  1. Startle reactivity and anxiety disorders: aversive conditioning, context, and neurobiology

    Microsoft Academic Search

    Christian Grillon

    2002-01-01

    The aim of this article is to review studies on human anxiety using the startle reflex methodology and to apply the literature on context conditioning in rats to interpret the results. A distinction is made between cued fear (as in specific phobia), a phasic response to an explicit threat cue, and anxiety, a more sustained and future-oriented response not linked

  2. A Multitrait-Multimethod Analysis of the Construct Validity of Child Anxiety Disorders in a Clinical Sample

    ERIC Educational Resources Information Center

    Langer, David A.; Wood, Jeffrey J.; Bergman, R. Lindsey; Piacentini, John C.

    2010-01-01

    The present study examines the construct validity of separation anxiety disorder (SAD), social phobia (SoP), panic disorder (PD), and generalized anxiety disorder (GAD) in a clinical sample of children. Participants were 174 children, 6 to 17 years old (94 boys) who had undergone a diagnostic evaluation at a university hospital based clinic.…

  3. Rare Genomic Variants Link Bipolar Disorder with Anxiety Disorders to CREB-Regulated Intracellular Signaling Pathways

    PubMed Central

    Kerner, Berit; Rao, Aliz R.; Christensen, Bryce; Dandekar, Sugandha; Yourshaw, Michael; Nelson, Stanley F.

    2013-01-01

    Bipolar disorder is a common, complex, and severe psychiatric disorder with cyclical disturbances of mood and a high suicide rate. Here, we describe a family with four siblings, three affected females and one unaffected male. The disease course was characterized by early-onset bipolar disorder and co-morbid anxiety spectrum disorders that followed the onset of bipolar disorder. Genetic risk factors were suggested by the early onset of the disease, the severe disease course, including multiple suicide attempts, and lack of adverse prenatal or early life events. In particular, drug and alcohol abuse did not contribute to the disease onset. Exome sequencing identified very rare, heterozygous, and likely protein-damaging variants in eight brain-expressed genes: IQUB, JMJD1C, GADD45A, GOLGB1, PLSCR5, VRK2, MESDC2, and FGGY. The variants were shared among all three affected family members but absent in the unaffected sibling and in more than 200 controls. The genes encode proteins with significant regulatory roles in the ERK/MAPK and CREB-regulated intracellular signaling pathways. These pathways are central to neuronal and synaptic plasticity, cognition, affect regulation and response to chronic stress. In addition, proteins in these pathways are the target of commonly used mood-stabilizing drugs, such as tricyclic antidepressants, lithium, and valproic acid. The combination of multiple rare, damaging mutations in these central pathways could lead to reduced resilience and increased vulnerability to stressful life events. Our results support a new model for psychiatric disorders, in which multiple rare, damaging mutations in genes functionally related to a common signaling pathway contribute to the manifestation of bipolar disorder. PMID:24348429

  4. Preschool Anxiety Disorders Predict Different Patterns of Amygdala-Prefrontal Connectivity at School-Age

    PubMed Central

    Carpenter, Kimberly L. H.; Angold, Adrian; Chen, Nan-Kuei; Copeland, William E.; Gaur, Pooja; Pelphrey, Kevin; Song, Allen W.; Egger, Helen L.

    2015-01-01

    Objective In this prospective, longitudinal study of young children, we examined whether a history of preschool generalized anxiety, separation anxiety, and/or social phobia is associated with amygdala-prefrontal dysregulation at school-age. As an exploratory analysis, we investigated whether distinct anxiety disorders differ in the patterns of this amygdala-prefrontal dysregulation. Methods Participants were children taking part in a 5-year study of early childhood brain development and anxiety disorders. Preschool symptoms of generalized anxiety, separation anxiety, and social phobia were assessed with the Preschool Age Psychiatric Assessment (PAPA) in the first wave of the study when the children were between 2 and 5 years old. The PAPA was repeated at age 6. We conducted functional MRIs when the children were 5.5 to 9.5 year old to assess neural responses to viewing of angry and fearful faces. Results A history of preschool social phobia predicted less school-age functional connectivity between the amygdala and the ventral prefrontal cortices to angry faces. Preschool generalized anxiety predicted less functional connectivity between the amygdala and dorsal prefrontal cortices in response to fearful faces. Finally, a history of preschool separation anxiety predicted less school-age functional connectivity between the amygdala and the ventral prefrontal cortices to angry faces and greater school-age functional connectivity between the amygdala and dorsal prefrontal cortices to angry faces. Conclusions Our results suggest that there are enduring neurobiological effects associated with a history of preschool anxiety, which occur over-and-above the effect of subsequent emotional symptoms. Our results also provide preliminary evidence for the neurobiological differentiation of specific preschool anxiety disorders. PMID:25625285

  5. Content specificity of attention bias to threat in anxiety disorders: a meta-analysis.

    PubMed

    Pergamin-Hight, Lee; Naim, Reut; Bakermans-Kranenburg, Marian J; van IJzendoorn, Marinus H; Bar-Haim, Yair

    2015-02-01

    Despite the established evidence for threat-related attention bias in anxiety, the mechanisms underlying this bias remain unclear. One important unresolved question is whether disorder-congruent threats capture attention to a greater extent than do more general or disorder-incongruent threat stimuli. Evidence for attention bias specificity in anxiety would implicate involvement of previous learning and memory processes in threat-related attention bias, whereas lack of content specificity would point to perturbations in more generic attention processes. Enhanced clarity of mechanism could have clinical implications for the stimuli types used in Attention Bias Modification Treatments (ABMT). Content specificity of threat-related attention bias in anxiety and potential moderators of this effect were investigated. A systematic search identified 37 samples from 29 articles (N=866). Relevant data were extracted based on specific coding rules, and Cohen's d effect size was used to estimate bias specificity effects. The results indicate greater attention bias toward disorder-congruent relative to disorder-incongruent threat stimuli (d=0.28, p<0.0001). This effect was not moderated by age, type of anxiety disorder, visual attention tasks, or type of disorder-incongruent stimuli. No evidence of publication bias was observed. Implications for threat bias in anxiety and ABMT are discussed. PMID:25462110

  6. Anxious Solitude and Clinical Disorder in Middle Childhood: Bridging Developmental and Clinical Approaches to Childhood Social Anxiety

    Microsoft Academic Search

    Heidi Gazelle; Jamie Olson Workman; Wesley Allan

    2010-01-01

    It was hypothesized that children identified by their peers at school as anxious solitary would report more symptoms of social\\u000a anxiety disorder on a self report questionnaire and, on the basis of child and parent clinical interviews, receive more diagnoses\\u000a of social anxiety disorder and additional anxiety and mood disorders. Participants were 192 children drawn from a community\\u000a sample of

  7. The Relationship Between Anxiety Disorders and Substance Use Among Adolescents in the Community: Specificity and Gender Differences

    Microsoft Academic Search

    Ping Wu; Renee D. Goodwin; Cordelia Fuller; Xinhua Liu; Jonathan S. Comer; Patricia Cohen; Christina W. Hoven

    2010-01-01

    Using a sample of 781 adolescents (ages 13–17, 52.8% male) from a community survey, this study examined gender differences\\u000a in the co-occurrence of specific anxiety disorders with substance use in adolescents. The associations between anxiety disorders\\u000a and substance use differed according to the particular anxiety disorders and forms of substance use being examined, as well\\u000a as by gender. Social phobia

  8. Post-Typhoon Prevalence of Post-traumatic Stress Disorder, Major Depressive Disorder, Panic Disorder and Generalized Anxiety Disorder in a Vietnamese Sample

    PubMed Central

    Amstadter, Ananda B.; Acierno, Ron; Richardson, Lisa; Kilpatrick, Dean G.; Gros, Daniel F.; Gaboury, Mario T.; Tran, Trinh Luong; Trung, Lam Tu; Tam, Nguyen Thanh; Tuan, Tran; Buoi, La Thi; Ha, Tran Thu; Thach, Tran Duc; Galea, Sandro

    2009-01-01

    In 2006, typhoon Xangsane disrupted a multi-agency health needs study of 4,982 individuals in Vietnam. Following this disaster, 798 of the original participants were re-interviewed to determine prevalence and risk-factors associated with post-traumatic stress disorder (PTSD), major depressive disorder (MDD), panic disorder (PD), and generalized anxiety disorder (GAD) according to the DSM-IV (APA, 1994). Post-typhoon prevalences were: PTSD 2.6%; MDD 5.9%; PD 9.3%; GAD 2.2%. Of those meeting criteria for a disorder, 70% reported only one disorder, 15% had two, 14% had three, and 1% met criteria for all four disorders. Risk factors for post-typhoon psychopathology differed among disorders, but generally were related to high typhoon exposure, prior trauma exposure, and in contrast to Western populations, higher age, but not gender. PMID:19455707

  9. Perseverative thought: A robust predictor of response to emotional challenge in generalized anxiety disorder and major depressive disorder

    Microsoft Academic Search

    Ayelet Meron Ruscio; Allison E. Seitchik; Emily L. Gentes; Jason D. Jones; Lauren S. Hallion

    2011-01-01

    Generalized anxiety disorder (GAD) and major depressive disorder (MDD) frequently co-occur, yet the reasons for their comorbidity remain poorly understood. In the present experiment, we tested whether a tendency to engage in negative, repetitive thinking constitutes a common risk process for the two disorders. A mixed sample of adults with comorbid GAD–MDD (n=50), GAD only (n=35), MDD only (n=34), or

  10. The Teachers' Role in the Assessment of Selective Mutism and Anxiety Disorders

    ERIC Educational Resources Information Center

    Martinez, Yvonne J.; Tannock, Rosemary; Manassis, Katharina; Garland, E. Jane; Clark, Sandra; McInnes, Alison

    2015-01-01

    Selective mutism (SM) is a childhood disorder characterized by failure to speak in social situations, despite there being an expectation to speak and the capacity to do so. There has been a focus on elucidating the differences between SM and anxiety disorder (ANX) in the recent literature. Although children with SM exhibit more symptoms at school…

  11. Familial clustering of major depression and anxiety disorders in Australian and Dutch twins and siblings

    Microsoft Academic Search

    Christel M. Middeldorp; Andrew J. Birley; Danielle C. Cath; Nathan A. Gillespie; Gonneke Willemsen; Dixie J. Statham; Geus de J. C. N; J. Gavin Andrews; Richard van Dyck; A. Leo Beem; Patrick F. Sullivan; Nicholas G. Martin; Dorret I. Boomsma

    2005-01-01

    The aim of this study was to investigate familial influences and their dependence on sex for panic disorder and\\/or agoraphobia, social phobia, generalized anxiety disorder and major depression. Data from Australian (N = 2287) and Dutch (N = 1185) twins and siblings who were selected for a linkage study and participated in clinical interviews to obtain lifetime Diagnostic and Statistical

  12. Pilot Study: Fluvoxamine Treatment for Depression and Anxiety Disorders in Children and Adolescents with Cancer

    ERIC Educational Resources Information Center

    Gothelf, Doron; Rubinstein, Maly; Shemesh, Eyal; Miller, Orit; Farbstein, Ilana; Klein, Anat; Weizman, Abraham; Apter, Alan; Yaniv, Isaac

    2005-01-01

    Objective: To evaluate the safety, tolerability, and benefit of fluvoxamine for the treatment of major depressive disorder or anxiety disorders in children and adolescents with cancer. Method: The study was conducted from 2001 to 2004 at a pediatric hematology-oncology center. Fifteen children and adolescents with cancer were treated with…

  13. Persistence of Sleep Problems in Children with Anxiety and Attention Deficit Hyperactivity Disorders

    ERIC Educational Resources Information Center

    Hansen, Berit Hjelde; Skirbekk, Benedicte; Oerbeck, Beate; Wentzel-Larsen, Tore; Kristensen, Hanne

    2013-01-01

    This study examines the persistence of sleep problems over 18 months in 76 referred children with anxiety disorders and/or attention deficit hyperactivity disorders (ADHD) and 31 nonreferred controls, and explores predictors of sleep problems at follow-up (T2) in the referred children. Diagnoses were assessed at initial assessment (T1) using the…

  14. Formal Thought Disorder and the Autism Spectrum: Relationship with Symptoms, Executive Control, and Anxiety

    ERIC Educational Resources Information Center

    Solomon, Marjorie; Ozonoff, Sally; Carter, Cameron; Caplan, Rochelle

    2008-01-01

    This study investigated whether children with autism spectrum disorders (ASDs) exhibit formal thought disorder (FTD), and whether this is related to ASD symptoms, executive control, and anxiety. Participants aged 8-17 with ASDs exhibited significantly more illogical thinking and loose associations than matched typically developing control…

  15. Anxiety Disorders: Treatable regardless of the Severity of Comorbid Alcohol Dependence

    Microsoft Academic Search

    Annemiek Schadé; Loes A. Marquenie; Maarten W. J. Koeter; Edwin de Beurs; Richard van Dyck; Wim van den Brink

    2007-01-01

    Aims: Clinical and epidemiological research has shown that comorbidity is the rule rather than exception in the case of psychiatric disorders. Cognitive behavioral therapy (CBT) has been clearly demonstrated to be effective in treating anxiety and avoidance symptoms in patient samples of social phobia and agoraphobia without comorbid alcohol use disorders. It has recently been shown that treatment of comorbid

  16. Treatment adequacy of anxiety and depressive disorders: Primary versus specialised care in Spain

    Microsoft Academic Search

    Anna Fernández; Josep Maria Haro; Miquel Codony; Gemma Vilagut; Montserrat Martínez-Alonso; Jaume Autonell; Luis Salvador-Carulla; José Luis Ayuso-Mateos; Miquel Angel Fullana; Jordi Alonso

    2006-01-01

    BackgroundLiterature suggests that a high proportion of the population with mental disorders remains either untreated or poorly treated. This study aimed to describe the adequacy of treatment for Anxiety and Depressive disorders in Spain, how this differs between providers (primary versus specialised care) and which factors are associated with appropriate care.

  17. Cognitive behavioral therapy for anxiety in children with autism spectrum disorders: a randomized, controlled trial

    Microsoft Academic Search

    Jeffrey J. Wood; Amy Drahota; Karen Sze; Kim Har; Angela Chiu; David A. Langer

    2009-01-01

    Background: Children with autism spectrum disorders often present with comorbid anxiety disorders that cause significant functional impairment. This study tested a modular cognitive behavioral therapy (CBT) program for children with this profile. A standard CBT program was augmented with multiple treatment components designed to accommodate or remediate the social and adaptive skill deficits of children with ASD that could pose

  18. Screening for generalized anxiety disorder using the Penn State Worry Questionnaire: a receiver operating characteristic analysis

    Microsoft Academic Search

    Evelyn Behar; Oscar Alcaine; Andrea R. Zuellig; T. D. Borkovec

    2003-01-01

    The present study examined the usefulness of the Penn State Worry Questionnaire (PSWQ) as a means of screening for generalized anxiety disorder (GAD). Using receiver operating characteristic analyses, the accuracy of the PSWQ in screening for GAD was examined in both clinical and analogue diagnosed GAD samples. Given high comorbidity between GAD and other emotional disorders, we also investigated the

  19. Characteristics of Generalized Anxiety Disorder in older adults: A descriptive study

    Microsoft Academic Search

    J. Gayle Beck; Melinda A. Stanley; Barbara J. Zebb

    1996-01-01

    Despite the prevalence of Generalized Anxiety Disorder (GAD) in older adults, little is known about psychopathological features of excessive worry in the elderly. This investigation compared 44 GAD patients (x? age 67.6), diagnosed using structured interview, with a matched sample free of psychiatric disorders on self-report and clinician measures. Results indicated that GAD in the elderly is associated with elevated

  20. Generalized Anxiety Disorder, Worries about Illness, and Hypochondriacal Fears and Beliefs

    Microsoft Academic Search

    Vladan Starcevic; Stephanie Fallon; E. H. Uhlenhuth; Dorothy Pathak

    1994-01-01

    In order to compare hypochondriacal phenomena in patients with generalized anxiety disorder (GAD) and panic disorder (PD), and in order to examine the relationship between worries about illness on one hand, and disease fears\\/phobias and hypochondriacal beliefs on the other, the authors administered the Illness Attitudes Scales to patients with both GAD and PD, and determined the spheres of worry

  1. Specificity of Treatment Effects: Cognitive Therapy and Relaxation for Generalized Anxiety and Panic Disorders

    ERIC Educational Resources Information Center

    Siev, Jedidiah; Chambless, Dianne L.

    2007-01-01

    The aim of this study was to address claims that among bona fide treatments no one is more efficacious than another by comparing the relative efficacy of cognitive therapy (CT) and relaxation therapy (RT) in the treatment of generalized anxiety disorder (GAD) and panic disorder without agoraphobia (PD). Two fixed-effects meta-analyses were…

  2. Delimiting the boundaries of generalized anxiety disorder: differentiating high worriers with and without GAD

    Microsoft Academic Search

    Ayelet Meron Ruscio

    2002-01-01

    Investigations of the boundary between generalized anxiety disorder (GAD) and normal worry have relied primarily on comparisons of GAD-diagnosed individuals with nonanxious controls. One limitation of this approach has been its inability to determine whether characteristics associated with GAD are unique to the disorder or are typical of severe worry more generally. The present studies made this differentiation using a

  3. The Factor Structure and Dimensional Scoring of the Generalized Anxiety Disorder Questionnaire for "DSM-IV"

    ERIC Educational Resources Information Center

    Rodebaugh, Thomas L.; Holaway, Robert M.; Heimberg, Richard G.

    2008-01-01

    Despite favorable psychometric properties, the Generalized Anxiety Disorder Questionnaire for the "Diagnostic and Statistical Manual of Mental Disorders" (4th ed.) (GAD-Q-IV) does not have a known factor structure, which calls into question use of its original weighted scoring system (usually referred to as the dimensional score). Analyses…

  4. Further validation of a cognitive-behavioral model of generalized anxiety disorder: diagnostic and symptom specificity

    Microsoft Academic Search

    Michel J. Dugas; André Marchand; Robert Ladouceur

    2005-01-01

    The goal of this study was to investigate the diagnostic and symptom specificity of a model of GAD that has four main features: intolerance of uncertainty, positive beliefs about worry, poor problem orientation, and cognitive avoidance. The authors compared 17 patients with non-comorbid generalized anxiety disorder (GAD) to 28 patients with non-comorbid panic disorder with agoraphobia (PDA) and found that

  5. Traumatic and socially stressful life events among persons with social anxiety disorder

    Microsoft Academic Search

    Brigette A. Erwin; Richard G. Heimberg; Brian P. Marx; Martin E. Franklin

    2006-01-01

    This study examined the frequency of reexperiencing, avoidance, and hyperarousal symptoms most often associated with posttraumatic stress disorder (PTSD) among 45 persons with social anxiety disorder and 30 nonanxious controls in response to an extremely stressful social event (which did not satisfy DSM-IV's PTSD Criterion A). Avoidance and hyperarousal in response to reminders of socially stressful events were common among

  6. Fear extinction in rats: Implications for human brain imaging and anxiety disorders

    E-print Network

    Quirk, Gregory J.

    memory for control of fear expression. Deficits in fear extinction are thought to contribute to post-traumatic stress disorder (PTSD). Herein, we review studies performed in rats showing that the medial prefrontal therapies for anxiety disorders. # 2006 Elsevier B.V. All rights reserved. Keywords: Fear extinction; Rats

  7. Association between glutamic acid decarboxylase genes and anxiety disorders, major depression, and neuroticism

    Microsoft Academic Search

    J M Hettema; S S An; M C Neale; J Bukszar; E J C G van den Oord; K S Kendler; X Chen

    2006-01-01

    Abnormalities in the gamma-aminobutyric acid (GABA) neurotransmitter system have been noted in subjects with mood and anxiety disorders. Glutamic acid decarboxylase (GAD) enzymes synthesize GABA from glutamate, and, thus, are reasonable candidate susceptibility genes for these conditions. In this study, we examined the GAD1 and GAD2 genes for their association with genetic risk across a range of internalizing disorders. We

  8. Separation Anxiety Disorder in Childhood as a Risk Factor for Future Mental Illness

    ERIC Educational Resources Information Center

    Lewinsohn, Peter M.; Holm-Denoma, Jill M.; Small, Jason W.; Seeley, John R.; Joiner, Thomas E.

    2008-01-01

    A study to examine the association between childhood separation anxiety disorder (SAD) and the risk of the development of psychopathology during young adulthood was conducted. Results showed that SAD contributed to the risk for the development of internalizing disorders, which are panic and depression, but decreased the risk for externalizing…

  9. Using the Edinburgh Postnatal Depression Scale to screen for anxiety disorders.

    PubMed

    Matthey, Stephen

    2008-01-01

    Screening for postnatal mood disorders in English-speaking women often uses the validated cut-off score of 13 or more on the Edinburgh Postnatal Depression Scale (EPDS) to detect probable major depression. Increasingly there is evidence that for many women, and men, anxiety disorders can occur postnatally in the absence of depression. This study therefore examined data on the three EPDS items frequently found to cluster together on an anxiety factor for women (items 3, 4, and 5: EPDS-3A), to determine the optimum cut-off score to screen for specified anxiety disorders. A sample of 238 women and 218 men were administered a diagnostic interview for anxiety and depressive disorders, and completed the EPDS, at 6 weeks postpartum. The receiver operating characteristics show that the optimum cut-off score on the EPDS-3A for women is 6 or more (possible range: 0-9), and for men it is 4 or more, though it appears that the factor structure for men is different than for women. The conclusion is that the EPDS can be used to screen for probable depression in women (using the validated total cut-off score of 13 or more) and also probable anxiety (using the EPDS-3A cut-off score of 6 or more). For men there is already a validated total cut-off score for both depression and anxiety (6 or more)--however, if services are not using this, they can use the EPDS-3A score of 4 or more to screen for probable anxiety disorders in fathers, though further work needs to be undertaken to clarify whether the anxiety factor structure for men is different to that found for women. PMID:18041072

  10. Paranoid delusional disorder follows social anxiety disorder in a long-term case series: evolutionary perspective.

    PubMed

    Veras, André B; Souza, Thalita Gabínio E; Ricci, Thaysse Gomes; de Souza, Clayton Peixoto; Moryiama, Matheus César; Nardi, Antonio E; Malaspina, Dolores; Kahn, Jeffrey P

    2015-06-01

    Social anxiety disorder (SAD) patients may have self-referential ideas and share other cognitive processes with paranoid delusional disorder (PDD) patients. From an evolutionary perspective, SAD may derive from biologically instinctive social hierarchy ranking, thus causing an assumption of inferior social rank, and thus prompting concerns about mistreatment from those of perceived higher rank. This naturalistic longitudinal study followed four patients with initial SAD and later onset of PDD. These four patients show the same sequence of diagnosed SAD followed by diagnosed PDD, as is often retrospectively described by other PDD patients. Although antipsychotic medication improved psychotic symptoms in all patients, those who also had adjunctive serotonin-specific reuptake inhibitors for SAD had much more improvement in both psychosis and social functioning. From an evolutionary perspective, it can be conjectured that when conscious modulation of the SAD social rank instinct is diminished due to hypofrontality (common to many psychotic disorders), then unmodulated SAD can lead to paranoid delusional disorder, with prominent ideas of reference. Non-psychotic SAD may be prodromal or causal for PDD. PMID:26034873

  11. The central amygdala as an integrative hub for anxiety and alcohol use disorders.

    PubMed

    Gilpin, Nicholas W; Herman, Melissa A; Roberto, Marisa

    2015-05-15

    The central amygdala (CeA) plays a central role in physiologic and behavioral responses to fearful stimuli, stressful stimuli, and drug-related stimuli. The CeA receives dense inputs from cortical regions, is the major output region of the amygdala, is primarily GABAergic (inhibitory), and expresses high levels of prostress and antistress peptides. The CeA is also a constituent region of a conceptual macrostructure called the extended amygdala that is recruited during the transition to alcohol dependence. We discuss neurotransmission in the CeA as a potential integrative hub between anxiety disorders and alcohol use disorder, which are commonly co-occurring in humans. Imaging studies in humans and multidisciplinary work in animals collectively suggest that CeA structure and function are altered in individuals with anxiety disorders and alcohol use disorder, the end result of which may be disinhibition of downstream "effector" regions that regulate anxiety-related and alcohol-related behaviors. PMID:25433901

  12. Altered Resting-State Functional Connectivity of the Frontal-Striatal Reward System in Social Anxiety Disorder

    E-print Network

    Reynolds, Gretchen

    We investigated differences in the intrinsic functional brain organization (functional connectivity) of the human reward system between healthy control participants and patients with social anxiety disorder. Functional ...

  13. Reduced Anterior Temporal and Hippocampal Functional Connectivity During Face Processing Discriminates Individuals with Social Anxiety Disorder from Healthy Controls and Panic Disorder, and Increases Following Treatment

    PubMed Central

    Pantazatos, Spiro P; Talati, Ardesheer; Schneier, Franklin R; Hirsch, Joy

    2014-01-01

    Group functional magnetic resonance imaging (fMRI) studies suggest that anxiety disorders are associated with anomalous brain activation and functional connectivity (FC). However, brain-based features sensitive enough to discriminate individual subjects with a specific anxiety disorder and that track symptom severity longitudinally, desirable qualities for putative disorder-specific biomarkers, remain to be identified. Blood oxygen level-dependent (BOLD) fMRI during emotional face perceptual tasks and a new, large-scale and condition-dependent FC and machine learning approach were used to identify features (pair-wise correlations) that discriminated patients with social anxiety disorder (SAD, N=16) from controls (N=19). We assessed whether these features discriminated SAD from panic disorder (PD, N=16), and SAD from controls in an independent replication sample that performed a similar task at baseline (N: SAD=15, controls=17) and following 8-weeks paroxetine treatment (N: SAD=12, untreated controls=7). High SAD vs HCs discrimination (area under the ROC curve, AUC, arithmetic mean of sensitivity and specificity) was achieved with two FC features during unattended neutral face perception (AUC=0.88, P<0.05 corrected). These features also discriminated SAD vs PD (AUC=0.82, P=0.0001) and SAD vs HCs in the independent replication sample (FC during unattended angry face perception, AUC=0.71, P=0.01). The most informative FC was left hippocampus-left temporal pole, which was reduced in both SAD samples (replication sample P=0.027), and this FC increased following the treatment (post>pre, t(11)=2.9, P=0.007). In conclusion, SAD is associated with reduced FC between left temporal pole and left hippocampus during face perception, and results suggest promise for emerging FC-based biomarkers for SAD diagnosis and treatment effects. PMID:24084831

  14. A Multitrait–Multimethod Analysis of the Construct Validity of Child Anxiety Disorders in a Clinical Sample

    PubMed Central

    Wood, Jeffrey J.; Bergman, R. Lindsey; Piacentini, John C.

    2010-01-01

    The present study examines the construct validity of separation anxiety disorder (SAD), social phobia (SoP), panic disorder (PD), and generalized anxiety disorder (GAD) in a clinical sample of children. Participants were 174 children, 6 to 17 years old (94 boys) who had undergone a diagnostic evaluation at a university hospital based clinic. Parent and child ratings of symptom severity were assessed using the Multidimensional Anxiety Scale for Children (MASC). Diagnostician ratings were obtained from the Anxiety Disorders Interview Schedule for Children and Parents (ADIS: C/P). Discriminant and convergent validity were assessed using confirmatory factor analytic techniques to test a multitrait–multimethod model. Confirmatory factor analyses supported the current classification of these child anxiety disorders. The disorders demonstrated statistical independence from each other (discriminant validity of traits), the model fit better when the anxiety syndromes were specified than when no specific syndromes were specified (convergent validity), and the methods of assessment yielded distinguishable, unique types of information about child anxiety (discriminant validity of methods). Using a multi-informant approach, these findings support the distinctions between childhood anxiety disorders as delineated in the current classification system, suggesting that disagreement between informants in psychometric studies of child anxiety measures is not due to poor construct validity of these anxiety syndromes. PMID:20443053

  15. Is a gin and tonic more like gin or tonic? A comparison of comorbid and non-comorbid anxiety disorder diagnostic pairs.

    PubMed

    Norton, Peter J; Chase, Tannah E

    2015-01-30

    Despite findings indicating that anxiety disorders are more likely to co-occur with each other than occur in isolation, little research has explored precise areas of overlap and differentiation among comorbid pairs of anxiety disorders. Furthermore, many studies comparing phenomena across anxiety disorders define comparison groups based on principal diagnoses, with lesser regard for comorbid diagnoses, raising the question as to whether this is a valid approach to analyzing comparisons. To better understand the extent to which comparisons by principal diagnoses are valid, the current study investigated whether comorbid hierarchically opposing diagnostic pairs showed similarities and differences from their non-comorbid, or "pure", counterparts on measures of clinician-rated functioning, specific symptoms, vulnerability factors, and demographic characteristics. The study included a total of 353 participants with diagnoses of either Panic Disorder (PD) only, Social Phobia (SP) only, Generalized Anxiety Disorder (GAD) only, or some comorbid pair of the three. Consistent with hypotheses, results demonstrated that hierarchically opposing diagnostic pairs showed more overlap than differentiation with each other and with non-comorbid counterparts on measures of a given specific non-comorbid diagnosis, indicating that defining comparisons by principal diagnoses may be invalid and misleading. The implications regarding the nosological structure of the DSM and research practice will be discussed. PMID:25468640

  16. Information Processing Bias and Pharmacotherapy Outcome in Older Adults with Generalized Anxiety Disorder

    PubMed Central

    Steiner, Amanda R. W.; Petkus, Andrew J.; Nguyen, Hoang; Loebach Wetherell, Julie

    2012-01-01

    Information processing bias was evaluated in a sample of 25 older adults with generalized anxiety disorder (GAD) over the course of 12 weeks of escitalopram pharmacotherapy. Using the CANTAB Affective Go/No Go test, treatment response (as measured by the Hamilton Anxiety Rating Scale, Penn State Worry Questionnaire, and Generalized Anxiety Disorder Severity Scale) was predicted from a bias score (i.e., difference score between response latencies for negative and positive words) using mixed-models regression. A more positive bias score across time predicted better response to treatment. Faster responses to positive words relative to negative words were associated with greater symptomatic improvement over time as reflected by scores on the GADSS. There was a trend towards significance for PSWQ scores and no significant effects related to HAMA outcomes. These preliminary findings offer further insights into the role of biased cognitive processing of emotional material in the manifestation of late-life anxiety symptoms. PMID:23245629

  17. Diagnostic Bias and Conduct Disorder: Improving Culturally Sensitive Diagnosis

    Microsoft Academic Search

    Lauren Mizock; Debra Harkins

    2011-01-01

    Disproportionately high rates of Conduct Disorder are diagnosed in African American and Latino youth of color. Diagnostic bias contributes to overdiagnosis of Conduct Disorder in these adolescents of color. Following a diagnosis of Conduct Disorder, adolescents of color face poorer outcomes than their White counterparts. These negative outcomes occur within mental health and juvenile justice settings. The aims of this

  18. Group Cognitive Behavior Therapy for Children with High-Functioning Autism Spectrum Disorders and Anxiety: A Randomized Trial

    ERIC Educational Resources Information Center

    Reaven, Judy; Blakeley-Smith, Audrey; Culhane-Shelburne, Kathy; Hepburn, Susan

    2012-01-01

    Background: Children with high-functioning autism spectrum disorders (ASD) are at high risk for developing significant anxiety. Anxiety can adversely impact functioning across school, home and community environments. Cognitive behavioral therapies (CBT) are frequently used with success for children with anxiety symptoms. Modified CBT interventions…

  19. Intolerance of Uncertainty as a Framework for Understanding Anxiety in Children and Adolescents with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Boulter, Christina; Freeston, Mark; South, Mikle; Rodgers, Jacqui

    2014-01-01

    Anxiety is a problem for many children diagnosed with Autism Spectrum Disorders (ASDs). There is a paucity of models of the cognitive processes underlying this. Intolerance of Uncertainty (IU) has utility in explaining anxiety in neurotypical populations but has only recently received attention in ASD. We modelled the relationship between anxiety

  20. Effects of Cognitive-Behavioral Therapy on Anxiety in Children with Autism Spectrum Disorders: A Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Sung, Min; Ooi, Yoon Phaik; Goh, Tze Jui; Pathy, Pavarthy; Fung, Daniel S. S.; Ang, Rebecca P.; Chua, Alina; Lam, Chee Meng

    2011-01-01

    We compared the effects of a 16-week Cognitive-Behavioral Therapy (CBT) program and a Social Recreational (SR) program on anxiety in children with Autism Spectrum Disorders (ASD). Seventy children (9-16 years old) were randomly assigned to either of the programs (n CBT = 36; n SR = 34). Measures on child's anxiety using the Spence Child Anxiety

  1. A follow-up study of cognitive bias in generalized anxiety disorder

    Microsoft Academic Search

    Karin Mogg; Brendan P. Bradley; Neil Millar; Jim White

    1995-01-01

    Patients with generalized anxiety disorder (GAD) without concurrent depression (n = 11) and normal controls (n = 17) were tested twice, about 2 months apart, on a modified Stroop colour-naming task, which presented anxiety-related, depression-related and neutral words in masked and unmasked exposure conditions. GAD patients received cognitive behaviour therapy in the test-retest interval, and were also retested at follow-up,

  2. Efficacy of Sertraline in a 12Week Trial for Generalized Anxiety Disorder

    Microsoft Academic Search

    Christer Allgulander; Alv A. Dahl; Carol Austin; Philip L. P. Morris; Jesper A. Sogaard; Rana Fayyad; Stan P. Kutcher; Cathryn M. Clary

    2004-01-01

    Objective: Sertraline's efficacy and toler- ability in treating generalized anxiety dis- order were evaluated. Method: Adult outpatients with DSM-IV generalized anxiety disorder and a total score of 18 or higher on the Hamilton Anx- iety Rating Scale were eligible. After a 1- week single-blind placebo lead-in, patients were randomly assigned to 12 weeks of double-blind treatment with placebo (N= 188,

  3. Applied relaxation vs. cognitive therapy in the treatment of generalized anxiety disorder

    Microsoft Academic Search

    Lars-Göran Öst; Elisabeth Breitholtz

    2000-01-01

    The present study investigated the efficacy of a coping-technique, applied relaxation (AR) and cognitive therapy (CT), in the treatment of generalized anxiety disorder. Thirty-six outpatients fulfilling the DSM-III-R criteria for generalized anxiety were assessed with independent assessor ratings and self-report scales before and after treatment and at a 1 yr follow-up. The patients were randomized and treated individually for 12

  4. Alprazolam versus buspirone in the treatment of outpatients with generalized anxiety disorder

    Microsoft Academic Search

    Rainer Enkelmann

    1991-01-01

    The efficacy and safety of alprazolam and buspirone for treating generalized anxiety disorder (GAD) were compared in a 6-week, double-blind, randomized, placebo-controlled study of 94 outpatients. Mean daily doses at the end of the study were 1.9 mg alprazolam and 18.7 mg buspirone. As judged by the Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, Physician's Global Improvement Scale, and

  5. Cognitive-Behavioral Treatment of Late-Life Generalized Anxiety Disorder

    Microsoft Academic Search

    Melinda A. Stanley; J. Gayle Beck; Diane M. Novy; Patricia M. Averill; Alan C. Swann; Gretchen J. Diefenbach; Derek R. Hopko

    2003-01-01

    This study addressed the efficacy of cognitive-behavioral therapy (CBT), relative to minimal contact control (MCC), in a sample of 85 older adults (age 60 years and over) with generalized anxiety disorder (GAD). All participants completed measures of primary outcome (worry and anxiety), coexistent symptoms (depressive symptoms and specific fears), and quality of life. Results of both completer and intent-to-treat analyses

  6. Remission After Acute Treatment in Children and Adolescents With Anxiety Disorders: Findings From the CAMS

    Microsoft Academic Search

    Golda S. Ginsburg; Philip C. Kendall; Dara Sakolsky; Scott N. Compton; John Piacentini; Anne Marie Albano; John T. Walkup; Joel Sherrill; Kimberly A. Coffey; Moira A. Rynn; Courtney P. Keeton; James T. McCracken; Lindsey Bergman; Satish Iyengar; Boris Birmaher; John March

    2011-01-01

    Objective: To report on remission rates in anxious youth who participated in the Child\\/Adolescent Anxiety Multimodal Study (CAMS). The CAMS, a multisite clinical trial, randomized 488 children and adolescents (ages 7–17 years; 79% Caucasian; 50% female) with separation, social, and\\/or generalized anxiety disorder to a 12-week treatment of sertraline (SRT), cognitive behavioral therapy (CBT), their combination (COMB), or clinical management

  7. Neuroimaging in Social Anxiety Disorder – a meta-analytic review resulting in a new neurofunctional model

    E-print Network

    Brühl, Annette Beatrix; Delsignore, Aba; Komossa, Katja; Weidt, Steffi

    2014-08-11

    to scrutiny 7 (Gimenez et al., 2012), anticipation of public speaking (Boehme et al., in press), pictures of social situations (Nakao et al., 2011), negative emotional voices (Quadflieg et al., 2008) and phobia related words (Schmidt et al., 2010... for the identification of neurocognitive endophenotypes in anxiety, affective and obsessive-compulsive disorders (Robbins et al., 2012). From a clinical point of view, this perspective of anxiety as a problem of involving central regulatory structures in addition...

  8. Integrating Acceptance and Mindfulness into Treatments for Child and Adolescent Anxiety Disorders

    Microsoft Academic Search

    Laurie A. Greco; John T. Blackledge; Lisa W. Coyne; Jill Ehrenreich

    In cognitive-behavioral therapy (CBT) for child and adolescent anxiety disorders, negatively evaluated thoughts and emotions\\u000a are viewed as problematic responses to be managed via control-oriented strategies such as distraction, systematic desensitization,\\u000a self-instruction, or cognitive restructuring. Within this framework, anxiety is conceptualized as “the problem,” and symptom\\u000a reduction is a standard index of treatment success. Acceptance- and mindfulness-based therapies such as

  9. Clinical Predictors of Response to Cognitive-Behavioral Therapy in Pediatric Anxiety Disorders: The Genes for Treatment (GxT) Study

    PubMed Central

    Hudson, Jennifer L.; Keers, Robert; Roberts, Susanna; Coleman, Jonathan R.I.; Breen, Gerome; Arendt, Kristian; Bögels, Susan; Cooper, Peter; Creswell, Cathy; Hartman, Catharina; Heiervang, Einar R.; Hötzel, Katrin; In-Albon, Tina; Lavallee, Kristen; Lyneham, Heidi J.; Marin, Carla E.; McKinnon, Anna; Meiser-Stedman, Richard; Morris, Talia; Nauta, Maaike; Rapee, Ronald M.; Schneider, Silvia; Schneider, Sophie C.; Silverman, Wendy K.; Thastum, Mikael; Thirlwall, Kerstin; Waite, Polly; Wergeland, Gro Janne; Lester, Kathryn J.; Eley, Thalia C.

    2015-01-01

    Objective The Genes for Treatment study is an international, multisite collaboration exploring the role of genetic, demographic, and clinical predictors in response to cognitive-behavioral therapy (CBT) in pediatric anxiety disorders. The current article, the first from the study, examined demographic and clinical predictors of response to CBT. We hypothesized that the child’s gender, type of anxiety disorder, initial severity and comorbidity, and parents’ psychopathology would significantly predict outcome. Method A sample of 1,519 children 5 to 18 years of age with a primary anxiety diagnosis received CBT across 11 sites. Outcome was defined as response (change in diagnostic severity) and remission (absence of the primary diagnosis) at each time point (posttreatment, 3-, 6-, and/or 12-month follow-up) and analyzed using linear and logistic mixed models. Separate analyses were conducted using data from posttreatment and follow-up assessments to explore the relative importance of predictors at these time points. Results Individuals with social anxiety disorder (SoAD) had significantly poorer outcomes (poorer response and lower rates of remission) than those with generalized anxiety disorder (GAD). Although individuals with specific phobia (SP) also had poorer outcomes than those with GAD at posttreatment, these differences were not maintained at follow-up. Both comorbid mood and externalizing disorders significantly predicted poorer outcomes at posttreatment and follow-up, whereas self-reported parental psychopathology had little effect on posttreatment outcomes but significantly predicted response (although not remission) at follow-up. Conclusion SoAD, nonanxiety comorbidity, and parental psychopathology were associated with poorer outcomes after CBT. The results highlight the need for enhanced treatments for children at risk for poorer outcomes. PMID:26004660

  10. Effects of anxiety on the long-term course of depressive disorders

    PubMed Central

    Coryell, William; Fiedorowicz, Jess G.; Solomon, David; Leon, Andrew C.; Rice, John P.; Keller, Martin B.

    2012-01-01

    Background It is well established that the presence of prominent anxiety within depressive episodes portends poorer outcomes. Important questions remain as to which anxiety features are important to outcome and how sustained their prognostic effects are over time. Aims To examine the relative prognostic importance of specific anxiety features and to determine whether their effects persist over decades and apply to both unipolar and bipolar conditions. Method Participants with unipolar (n = 476) or bipolar (n = 335) depressive disorders were intensively followed for a mean of 16.7 years (s.d. = 8.5). Results The number and severity of anxiety symptoms, but not the presence of pre-existing anxiety disorders, showed a robust and continuous relationship to the subsequent time spent in depressive episodes in both unipolar and bipolar depressive disorder. The strength of this relationship changed little over five successive 5-year periods. Conclusions The severity of current anxiety symptoms within depressive episodes correlates strongly with the persistence of subsequent depressive symptoms and this relationship is stable over decades. PMID:21984801

  11. Anxiety in youth with and without autism spectrum disorder: Examination of factorial equivalence

    PubMed Central

    White, Susan W.; Lerner, Matthew D.; McLeod, Bryce D.; Wood, Jeffrey J.; Ginsburg, Golda S.; Kerns, Connor; Ollendick, Thomas; Kendall, Philip C.; Piacentini, John; Walkup, John; Compton, Scott

    2014-01-01

    Although anxiety is frequently reported among children and adolescents with autism spectrum disorder (ASD), it has not been established that the manifest symptoms of anxiety in the context of ASD are the same as those seen in youth without ASD. This study sought to examine the metric and latent factor equivalence of anxiety as measured by the Multidimensional Anxiety Scale for Children, parent-report (MASC-P) and child-report (MASC-C), in youth with anxiety disorders and ASD with intact verbal ability (n = 109, Mage = 11.67 yrs, 99 male) and a gender-matched comparison group of typically developing (TD) children and adolescents with anxiety disorders but without ASD (n = 342, Mage = 11.25 yrs, 246 male). Multigroup factorial invariance (MFI) using structural equation modeling indicated equivalent latent factors in youth with and without ASD on the MASC-C (metric invariance). However, the item means and covariances along with the relations among the factor scores were different for the youth with ASD (i.e., lack of evidence for scalar or structural invariance). The MASC-P data did not fit the measure’s established structure for either the ASD or TD group, and post-hoc exploratory factor analysis revealed a different factor structure in the ASD group. Findings suggest that the MASC-C may not measure identical constructs in anxious youth with and without ASD. Further research on the structure of the MASC in clinical samples is warranted. PMID:25526834

  12. Peer Victimization During Adolescence and Risk for Anxiety Disorders in Adulthood: A Prospective Cohort Study

    PubMed Central

    Stapinski, Lexine A; Bowes, Lucy; Wolke, Dieter; Pearson, Rebecca M; Mahedy, Liam; Button, Katherine S; Lewis, Glyn; Araya, Ricardo

    2014-01-01

    Background Peer victimization is ubiquitous across schools and cultures, and has been suggested as one developmental pathway to anxiety disorders. However, there is a dearth of prospective studies examining this relationship. The purpose of this cohort study was to examine the association between peer victimization during adolescence and subsequent anxiety diagnoses in adulthood. A secondary aim was to investigate whether victimization increases risk for severe anxiety presentations involving diagnostic comorbidity. Methods The sample comprised 6,208 adolescents from the Avon Longitudinal Study of Parents and Children who were interviewed about experiences of peer victimization at age 13. Maternal report of her child's victimization was also assessed. Anxiety disorders at age 18 were assessed with the Clinical Interview Schedule–Revised. Multivariable logistic regression was used to examine the association between victimization and anxiety diagnoses adjusted for potentially confounding individual and family factors. Sensitivity analyses explored whether the association was independent of diagnostic comorbidity with depression. Results Frequently victimized adolescents were two to three times more likely to develop an anxiety disorder than nonvictimized adolescents (OR = 2.49, 95% CI: 1.62–3.85). The association remained after adjustment for potentially confounding individual and family factors, and was not attributable to diagnostic overlap with depression. Frequently victimized adolescents were also more likely to develop multiple internalizing diagnoses in adulthood. Conclusions Victimized adolescents are at increased risk of anxiety disorders in later life. Interventions to reduce peer victimization and provide support for victims may be an effective strategy for reducing the burden associated with these disorders. PMID:24788688

  13. Comorbidity of substance use disorders with mood and anxiety disorders: results of the International Consortium in Psychiatric Epidemiology.

    PubMed

    Merikangas, K R; Mehta, R L; Molnar, B E; Walters, E E; Swendsen, J D; Aguilar-Gaziola, S; Bijl, R; Borges, G; Caraveo-Anduaga, J J; DeWit, D J; Kolody, B; Vega, W A; Wittchen, H U; Kessler, R C

    1998-01-01

    This article reports the results of a cross-national investigation of patterns of comorbidity between substance use and psychiatric disorders in six studies participating in the International Consortium in Psychiatric Epidemiology. In general, there was a strong association between mood and anxiety disorders as well as conduct and antisocial personality disorder with substance disorders at all sites. The results also suggest that there is a continuum in the magnitude of comorbidity as a function of the spectrum of substance use category (use, problems, dependence), as well as a direct relationship between the number of comorbid disorders and increasing levels of severity of substance use disorders (which was particularly pronounced for drugs). Finally, whereas there was no specific temporal pattern of onset for mood disorders in relation to substance disorders, the onset of anxiety disorders was more likely to precede that of substance disorders in all countries. These results illustrate the contribution of cross-national data to understanding the patterns and risk factors for psychopathology and substance use disorders. PMID:9801724

  14. Autism spectrum disorder: diagnosis and management.

    PubMed

    O'Hare, Anne

    2009-12-01

    Autism spectrum disorders are of high prevalence and have a potentially complex range of presentations within the core impaired domains of social communication, reciprocal social interaction, imaginary thought and restricted and repetitive behaviours. Paediatricians need to recognise the possibility of these conditions among the high-risk populations of children with whom they work. This includes those presenting in the preschool years to child development clinics with delayed acquisition of language or general development delay or those presenting in the school years with coordination, academic, peer interaction and behavioural difficulties. In addition, paediatricians are essential members of the multidisciplinary teams charged with specialist assessment and their clinical history and examination can direct investigations for aetiology. This is a fast moving field with a challenging range of "grey evidence" causes and interventions. The approaches to managing these areas of work are discussed with an emphasis on recognition, important features in the history and clinical examination to aid differential diagnosis and investigations, interpreting the "grey evidence" and understanding intervention and prognosis. PMID:19933388

  15. Dual Diagnosis: Adolescents with Co-Occurring Brain Disorders and Substance Abuse Disorders

    MedlinePLUS

    ... Dual Diagnosis: Adolescents with Co-occurring Brain Disorders & Substance Abuse Disorders Adolescents are often referred to treatment for ... do model programs for treating mental illness and substance abuse look like? There is a growing number of ...

  16. Child-Report of Family Accommodation in Pediatric Anxiety Disorders: Comparison and Integration with Mother-Report.

    PubMed

    Lebowitz, Eli R; Scharfstein, Lindsay; Jones, Johnna

    2015-08-01

    Reducing family accommodation (FA) may be beneficial in cases of childhood anxiety disorders. Assessment of FA has so far relied on single-informant maternal report, which may be biased by factors including maternal anxiety. We compared child and mother reports of FA, and examined whether maternal anxiety moderates the association between mother and child report. Participants were fifty children with primary DSM-5 anxiety disorders, and their mothers. Mother-child agreement was good for overall FA and moderate for subdomains of FA. Mothers reported significantly more FA than children. Maternal anxiety moderated the association between mother and child report of FA, such that the correlation was stronger in more anxious mothers. Children agreed that FA helps them feel less anxious and did not agree that parents should accommodate less. FA is an important clinical characteristic of childhood anxiety disorders and assessment can be enhanced through child report and consideration of maternal anxiety. PMID:25209390

  17. Behavioral Inhibition as a Risk Factor for the Development of Childhood Anxiety Disorders: A Longitudinal Study.

    PubMed

    Muris, Peter; van Brakel, Anna M L; Arntz, Arnoud; Schouten, Erik

    2011-04-01

    This longitudinal study examined the additive and interactive effects of behavioral inhibition and a wide range of other vulnerability factors in the development of anxiety problems in youths. A sample of 261 children, aged 5 to 8 years, 124 behaviorally inhibited and 137 control children, were followed during a 3-year period. Assessments took place on three occasions to measure children's level of behavioral inhibition, anxiety disorder symptoms, other psychopathological symptoms, and a number of other vulnerability factors such as insecure attachment, negative parenting styles, adverse life events, and parental anxiety. Results obtained with Structural Equation Modeling indicated that behavioral inhibition primarily acted as a specific risk factor for the development of social anxiety symptoms. Furthermore, the longitudinal model showed additive as well as interactive effects for various vulnerability factors on the development of anxiety symptoms. That is, main effects of anxious rearing and parental trait anxiety were found, whereas behavioral inhibition and attachment had an interactive effect on anxiety symptomatology. Moreover, behavioral inhibition itself was also influenced by some of the vulnerability factors. These results provide support for dynamic, multifactorial models for the etiology of child anxiety problems. PMID:21475710

  18. Convergent functional genomics of anxiety disorders: translational identification of genes, biomarkers, pathways and mechanisms

    PubMed Central

    Le-Niculescu, H; Balaraman, Y; Patel, S D; Ayalew, M; Gupta, J; Kuczenski, R; Shekhar, A; Schork, N; Geyer, M A; Niculescu, A B

    2011-01-01

    Anxiety disorders are prevalent and disabling yet understudied from a genetic standpoint, compared with other major psychiatric disorders such as bipolar disorder and schizophrenia. The fact that they are more common, diverse and perceived as embedded in normal life may explain this relative oversight. In addition, as for other psychiatric disorders, there are technical challenges related to the identification and validation of candidate genes and peripheral biomarkers. Human studies, particularly genetic ones, are susceptible to the issue of being underpowered, because of genetic heterogeneity, the effect of variable environmental exposure on gene expression, and difficulty of accrual of large, well phenotyped cohorts. Animal model gene expression studies, in a genetically homogeneous and experimentally tractable setting, can avoid artifacts and provide sensitivity of detection. Subsequent translational integration of the animal model datasets with human genetic and gene expression datasets can ensure cross-validatory power and specificity for illness. We have used a pharmacogenomic mouse model (involving treatments with an anxiogenic drug—yohimbine, and an anti-anxiety drug—diazepam) as a discovery engine for identification of anxiety candidate genes as well as potential blood biomarkers. Gene expression changes in key brain regions for anxiety (prefrontal cortex, amygdala and hippocampus) and blood were analyzed using a convergent functional genomics (CFG) approach, which integrates our new data with published human and animal model data, as a translational strategy of cross-matching and prioritizing findings. Our work identifies top candidate genes (such as FOS, GABBR1, NR4A2, DRD1, ADORA2A, QKI, RGS2, PTGDS, HSPA1B, DYNLL2, CCKBR and DBP), brain–blood biomarkers (such as FOS, QKI and HSPA1B), pathways (such as cAMP signaling) and mechanisms for anxiety disorders—notably signal transduction and reactivity to environment, with a prominent role for the hippocampus. Overall, this work complements our previous similar work (on bipolar mood disorders and schizophrenia) conducted over the last decade. It concludes our programmatic first pass mapping of the genomic landscape of the triad of major psychiatric disorder domains using CFG, and permitted us to uncover the significant genetic overlap between anxiety and these other major psychiatric disorders, notably the under-appreciated overlap with schizophrenia. PDE10A, TAC1 and other genes uncovered by our work provide a molecular basis for the frequently observed clinical co-morbidity and interdependence between anxiety and other major psychiatric disorders, and suggest schizo-anxiety as a possible new nosological domain. PMID:22832404

  19. Convergent functional genomics of anxiety disorders: translational identification of genes, biomarkers, pathways and mechanisms.

    PubMed

    Le-Niculescu, H; Balaraman, Y; Patel, S D; Ayalew, M; Gupta, J; Kuczenski, R; Shekhar, A; Schork, N; Geyer, M A; Niculescu, A B

    2011-01-01

    Anxiety disorders are prevalent and disabling yet understudied from a genetic standpoint, compared with other major psychiatric disorders such as bipolar disorder and schizophrenia. The fact that they are more common, diverse and perceived as embedded in normal life may explain this relative oversight. In addition, as for other psychiatric disorders, there are technical challenges related to the identification and validation of candidate genes and peripheral biomarkers. Human studies, particularly genetic ones, are susceptible to the issue of being underpowered, because of genetic heterogeneity, the effect of variable environmental exposure on gene expression, and difficulty of accrual of large, well phenotyped cohorts. Animal model gene expression studies, in a genetically homogeneous and experimentally tractable setting, can avoid artifacts and provide sensitivity of detection. Subsequent translational integration of the animal model datasets with human genetic and gene expression datasets can ensure cross-validatory power and specificity for illness. We have used a pharmacogenomic mouse model (involving treatments with an anxiogenic drug--yohimbine, and an anti-anxiety drug--diazepam) as a discovery engine for identification of anxiety candidate genes as well as potential blood biomarkers. Gene expression changes in key brain regions for anxiety (prefrontal cortex, amygdala and hippocampus) and blood were analyzed using a convergent functional genomics (CFG) approach, which integrates our new data with published human and animal model data, as a translational strategy of cross-matching and prioritizing findings. Our work identifies top candidate genes (such as FOS, GABBR1, NR4A2, DRD1, ADORA2A, QKI, RGS2, PTGDS, HSPA1B, DYNLL2, CCKBR and DBP), brain-blood biomarkers (such as FOS, QKI and HSPA1B), pathways (such as cAMP signaling) and mechanisms for anxiety disorders--notably signal transduction and reactivity to environment, with a prominent role for the hippocampus. Overall, this work complements our previous similar work (on bipolar mood disorders and schizophrenia) conducted over the last decade. It concludes our programmatic first pass mapping of the genomic landscape of the triad of major psychiatric disorder domains using CFG, and permitted us to uncover the significant genetic overlap between anxiety and these other major psychiatric disorders, notably the under-appreciated overlap with schizophrenia. PDE10A, TAC1 and other genes uncovered by our work provide a molecular basis for the frequently observed clinical co-morbidity and interdependence between anxiety and other major psychiatric disorders, and suggest schizo-anxiety as a possible new nosological domain. PMID:22832404

  20. Physiological Mechanisms of Respiratory Phenomena in Anxiety and Depressive Disorders

    Microsoft Academic Search

    N. A. Agadzhanyan; P. I. Terekhin

    2002-01-01

    An analysis is presented of the current views on the functional respiratory disorders associated with depressive and panic disorders. The following subjects are discussed: the phenomenology of the problem, modern diagnostic methods, the role of hypocapnia in the symptomatological development of panic disorders, the relative contributions of psychogenic and biological factors in developing respiratory disorders, and the distinctions between dyspnea

  1. Functional topography of serotonergic systems supports the Deakin/Graeff hypothesis of anxiety and affective disorders.

    PubMed

    Paul, Evan D; Lowry, Christopher A

    2013-12-01

    Over 20 years ago, Deakin and Graeff hypothesized about the role of different serotonergic pathways in controlling the behavioral and physiologic responses to aversive stimuli, and how compromise of these pathways could lead to specific symptoms of anxiety and affective disorders. A growing body of evidence suggests these serotonergic pathways arise from topographically organized subpopulations of serotonergic neurons located in the dorsal and median raphe nuclei. We argue that serotonergic neurons in the dorsal/caudal parts of the dorsal raphe nucleus project to forebrain limbic regions involved in stress/conflict anxiety-related processes, which may be relevant for anxiety and affective disorders. Serotonergic neurons in the "lateral wings" of the dorsal raphe nucleus provide inhibitory control over structures controlling fight-or-flight responses. Dysfunction of this pathway could be relevant for panic disorder. Finally, serotonergic neurons in the median raphe nucleus, and the developmentally and functionally-related interfascicular part of the dorsal raphe nucleus, give rise to forebrain limbic projections that are involved in tolerance and coping with aversive stimuli, which could be important for affective disorders like depression. Elucidating the mechanisms through which stress activates these topographically and functionally distinct serotonergic pathways, and how dysfunction of these pathways leads to symptoms of neuropsychiatric disorders, may lead to the development of novel approaches to both the prevention and treatment of anxiety and affective disorders. PMID:23704363

  2. Disseminating treatment for anxiety disorders: step 1: recognizing the problem as a precursor to seeking help.

    PubMed

    Coles, Meredith E; Schubert, Jessica R; Heimberg, Richard G; Weiss, Barry D

    2014-12-01

    Untreated mental illness is a substantial public health issue in the United States, with only approximately 1/3 of the estimated 46 million adults in the US with mental illness receiving treatment. Many of the individuals with mental illness suffer from excessive anxiety, as over 25% of Americans experience an anxiety disorder during their lifetime and most of these individuals remain untreated. Building from the premise that recognizing one's symptoms precedes requests for help, the current paper presents data from 577 adults (50% Caucasian, 50% African American) in the US regarding their ability to recognize anxiety disorders. Findings from a national survey showed that when presented with detailed vignettes portraying symptoms and their impact, 50% of respondents correctly recognized depression, whereas less than 20% correctly recognized the anxiety disorders. Recognition that the symptoms were a cause for concern was much more common, with 75% or more of the sample noting concern. Responses were surprisingly similar across the two races, and few consistent moderators were found. In conclusion, increasing recognition of anxiety disorders may be a useful first step toward increasing service utilization. PMID:25222497

  3. Antidepressant medication augmented with cognitive-behavioral therapy for generalized anxiety disorder in older adults.

    PubMed

    Wetherell, Julie Loebach; Petkus, Andrew J; White, Kamila S; Nguyen, Hoang; Kornblith, Sander; Andreescu, Carmen; Zisook, Sidney; Lenze, Eric J

    2013-07-01

    OBJECTIVE Generalized anxiety disorder is common among older adults and leads to diminished health and cognitive functioning. Although antidepressant medications are efficacious, many elderly individuals require augmentation treatment. Furthermore, little is known about maintenance strategies for older people. The authors examined whether sequenced treatment combining pharmacotherapy and cognitive-behavioral therapy (CBT) boosts response and prevents relapse in older adults with generalized anxiety disorder. METHOD Participants were individuals at least 60 years of age with generalized anxiety disorder (N=73) who were recruited from outpatient clinics at three sites. Participants received 12 weeks of open-label escitalopram and were then randomly assigned to one of four conditions: 16 weeks of escitalopram (10-20 mg/day) plus modular CBT, followed by 28 weeks of maintenance escitalopram; escitalopram alone, followed by maintenance escitalopram; escitalopram plus CBT, followed by pill placebo; and escitalopram alone, followed by placebo. RESULTS Escitalopram augmented with CBT increased response rates on the Penn State Worry Questionnaire but not on the Hamilton Anxiety Rating Scale compared with escitalopram alone. Both escitalopram and CBT prevented relapse compared with placebo. CONCLUSIONS This study demonstrates effective strategies for treatment of generalized anxiety disorder in older adults. The sequence of antidepressant medication augmented with CBT leads to worry reduction in the short-term. Continued medication prevents relapse, but for many individuals, CBT would allow sustained remission without requiring long-term pharmacotherapy. PMID:23680817

  4. [Psychotherapy for anxiety disorders in childhood and adolescence--what is evidence-based?].

    PubMed

    Schneider, Silvia; In-Albon, Tina

    2006-05-01

    Anxiety disorders are the most frequent mental disorders in children and adolescents. They are also an important risk factor for psychological disturbances in adulthood and require adequate treatment. The effectiveness of psychotherapy in the treatment of anxiety disorders today can no longer be questioned. However, a meta-analysis of treatment studies shows that so far, only cognitive-behavior therapy has proved, on the basis of randomized, controlled trials (RCT), to be successful in the treatment of anxiety disorders in children and adolescents. Regardless of whether the cognitive behavior therapy took place individually or in a group, or whether it was carried out with the child alone or with the inclusion of the family, no differences in the effectiveness were found. The follow-up data show that the therapy success persisted for several years and that it was not limited only to the symptoms of anxiety. Although for many psychotherapeutic interventions there is still no empirical basis, initial RCT prove the short-term effectiveness of psychopharmacological treatment (SSRI). The central, empirically validated psychotherapeutic interventions include psychoeducation, cognitive treatment of dysfunctional thoughts, and systematic exposure to the situation triggering anxiety. These interventions will be presented briefly and open questions in psychotherapy research will be discussed in the conclusion. PMID:16771033

  5. Temperament and parental child-rearing style: unique contributions to clinical anxiety disorders in childhood.

    PubMed

    Lindhout, Ingeborg E; Markus, Monica Th; Hoogendijk, Thea H G; Boer, Frits

    2009-07-01

    Both temperament and parental child-rearing style are found to be associated with childhood anxiety disorders in population studies. This study investigates the contribution of not only temperament but also parental child-rearing to clinical childhood anxiety disorders. It also investigates whether the contribution of temperament is moderated by child-rearing style, as is suggested by some studies in the general population. Fifty children were included (25 with anxiety disorders and 25 non-clinical controls). Child-rearing and the child's temperament were assessed by means of parental questionnaire (Child Rearing Practices Report (CRPR) (Block in The Child-Rearing Practices Report. Institute of Human Development. University of California, Berkely, 1965; The Child-Rearing Practices Report (CRPR): a set of Q items for the description of parental socialisation attitudes and values. Unpublished manuscript. Institute of Human Development. University of California, Berkely, 1981), EAS Temperament Survey for Children (Boer and Westenberg in J Pers Assess 62:537-551, 1994; Buss and Plomin in Temperament: early developing personality traits. Lawrence Erlbaum Associates, Inc, Hillsdale, 1984s). Analysis of variance showed that anxiety-disordered children scored significantly higher on the temperamental characteristics emotionality and shyness than non-clinical control children. Hierarchical logistic regression analyses showed that temperament (emotionality and shyness) and child-rearing style (more parental negative affect, and less encouraging independence of the child) both accounted for a unique proportion of the variance of anxiety disorders. Preliminary results suggest that child-rearing style did not moderate the association between children's temperament and childhood anxiety disorders. The limited sample size might have been underpowered to assess this interaction. PMID:19198919

  6. The Trauma of Peer Abuse: Effects of Relational Peer Victimization and Social Anxiety Disorder on Physiological and Affective Reactions to Social Exclusion

    PubMed Central

    Iffland, Benjamin; Sansen, Lisa Margareta; Catani, Claudia; Neuner, Frank

    2014-01-01

    Background: Social exclusion elicits emotional distress, negative mood, and physiological stress. Recent studies showed that these effects were more intense and persisting in socially anxious subjects. The present study examined whether the abnormal reactions of socially anxious subjects can be traced back to previous experiences of relational peer victimization during childhood and adolescence. Methods: Participants (N?=?74) were patients with a diagnosis of social anxiety disorder as well as healthy controls. The patient and control groups were subdivided into two subgroups according to the subject’s reports about previous relational peer victimization. Immediate and delayed physiological (skin conductance level and heart rate) and affective reactions to a simulated social exclusion in a ball-toss game (Cyberball) were recorded. Results: Overall, subjects’ immediate reactions to social exclusion were an increase in skin conductance and a reduction of positive affect. Regardless of the diagnostic status, subjects with a history of relational peer victimization showed a more intense self-reported affective change that was accompanied by a blunted skin conductance response. However, the mood of the subjects with a history of peer victimization recovered during a 15?min waiting period. A diagnosis of social anxiety disorder did not affect the reactions to social exclusion on any measure. Conclusion: Findings indicate that stress reactions to social exclusion depend more on previous experiences of peer victimization than on a diagnosis of social anxiety disorder. The findings indicate that memories of negative social experiences can determine the initial stress reaction to social threats. PMID:24672491

  7. Diagnosis and management of post-partum disorders: a review

    PubMed Central

    Brockington, Ian

    2004-01-01

    This paper reviews the psychiatry of the puerperium, in the light of work published during the last eight years. Many distinct disorders are seen. In addition to various psychoses and a heterogeneous group of depressions, there are specific anxiety, obsessional and stress-related disorders. It is important to identify severe disorders of the mother-infant relationship, which usually respond to treatment, but have pernicious effects if untreated. The complexity of post-partum psychiatry requires the deployment of multidisciplinary specialist teams, which can handle the challenges of therapy, prevention, training, research and service development. PMID:16633463

  8. Shame and Guilt in Social Anxiety Disorder: Effects of Cognitive Behavior Therapy and Association with Social Anxiety and Depressive Symptoms

    PubMed Central

    Hedman, Erik; Ström, Peter; Stünkel, Angela; Mörtberg, Ewa

    2013-01-01

    Social anxiety disorder (SAD), characterized by fear of being scrutinized by others, has features that that are closely linked to the concept of shame. Despite this, it remains to be investigated whether shame is elevated in persons with SAD, and if cognitive behavior therapy (CBT) for SAD could reduce shame experience. In the present study, we focused on internal shame, i.e. the type of shame that pertains to how we judge ourselves. Although guilt is distinctly different from shame, we also viewed it as important to investigate its role in SAD as the two emotions are highly correlated. The aim of this study was to investigate: (I) if persons with SAD differ from healthy controls on shame and guilt, (II) if shame, guilt, depressive symptoms, and social anxiety are associated in persons with SAD, and (III) if CBT can reduce internal shame in patients with SAD. Firstly, we conducted a case-control study comparing a sample with SAD (n?=?67) with two samples of healthy controls, a main sample (n?=?72) and a replication sample (n?=?22). Secondly, all participants with SAD were treated with CBT and shame, measured with the Test of Self-Conscious affect, was assessed before and after treatment. The results showed that shame was elevated in person with SAD compared to the control replication sample, but not to the main control sample. In addition, shame, social anxiety, and depressive symptoms were significantly associated among participants with SAD. After CBT, participants with SAD had significantly reduced their shame (Cohen's d?=?0.44). Guilt was unrelated to social anxiety. We conclude that shame and social anxiety are associated and that it is likely that persons with SAD are more prone to experience shame than persons without SAD. Also, CBT is associated with shame reduction in the treatment of SAD. PMID:23620782

  9. Adding psychotherapy to antidepressant medication in depression and anxiety disorders: a meta-analysis

    PubMed Central

    Cuijpers, Pim; Sijbrandij, Marit; Koole, Sander L; Andersson, Gerhard; Beekman, Aartjan T; Reynolds, Charles F

    2014-01-01

    We conducted a meta-analysis of randomized trials in which the effects of treatment with antidepressant medication were compared to the effects of combined pharmacotherapy and psychotherapy in adults with a diagnosed depressive or anxiety disorder. A total of 52 studies (with 3,623 patients) met inclusion criteria, 32 on depressive disorders and 21 on anxiety disorders (one on both depressive and anxiety disorders). The overall difference between pharmacotherapy and combined treatment was Hedges' g?=?0.43 (95% CI: 0.31-0.56), indicating a moderately large effect and clinically meaningful difference in favor of combined treatment, which corresponds to a number needed to treat (NNT) of 4.20. There was sufficient evidence that combined treatment is superior for major depression, panic disorder, and obsessive-compulsive disorder (OCD). The effects of combined treatment compared with placebo only were about twice as large as those of pharmacotherapy compared with placebo only, underscoring the clinical advantage of combined treatment. The results also suggest that the effects of pharmacotherapy and those of psychotherapy are largely independent from each other, with both contributing about equally to the effects of combined treatment. We conclude that combined treatment appears to be more effective than treatment with antidepressant medication alone in major depression, panic disorder, and OCD. These effects remain strong and significant up to two years after treatment. Monotherapy with psychotropic medication may not constitute optimal care for common mental disorders. PMID:24497254

  10. [Treatment-resistant anxiety disorders: A literature review of drug therapy strategies].

    PubMed

    Ammar, G; Naja, W J; Pelissolo, A

    2015-06-01

    Anxiety disorders are widespread psychiatric conditions with significant social and professional disability, poor quality of life, an increased risk of suicide, and frequent attendance of medical services. Serotonin reuptake inhibitors (SRI) and serotonin and norepinephrine reuptake inhibitors (SNRI) have demonstrated a rather robust efficacy for the treatment of most of anxiety disorders. Nevertheless a substantial number of patients are resistant or still suffer from residual symptoms despite this first line treatment. The objective of our paper is to review relevant studies for the pharmacologic management of anxiety disorders resistant to the first line treatment. For this purpose, we conducted a pubmed/medline search for double-blind placebo-controlled trials of treatment-resistant anxiety disorders. An adequate trial for a SRI in the treatment of obsessive-compulsive disorder (OCD) should continue for at least 12 weeks. Special considerations of the comorbidities and symptom profile could help in the choice of an appropriate pharmacotherapy. Several trials have highlighted the efficacy of antipsychotics as an add-on to SRI in treatment-resistant OCD such as haloperidol more so when comorbid with a tic disorder, or risperidone that can reduce OCD as well as depressive symptoms. Aripiprazole has been shown efficacious in two placebo-controlled double-blind trials, while the efficacy of quetiapine and olanzapine remains controversial. Other trials showed some efficacy of anticonvulsants (lamotrigine, topiramate), pindolol, memantin and N-acetylcystein as an adjunctive treatment to SRI for resistant OCD. Few trials have investigated selective serotonin reuptake inhibitors (SSRI) or SNRI resistant generalized anxiety disorder showing a failure of adjunctive therapy with olanzapine, quetiapine, ziprasidone and risperidone. These studies were underpowered and very limited in number. Adjunctive risperidone for resistant post-traumatic stress disorder (PTSD) showed benefit in some but not all trials. Olanzapine was beneficial for the reduction of the CAPS score in addition to the improvement of sleep disturbances. Furthermore, prazosin was efficacious by reducing PTSD symptoms, sleep disturbances, nightmares, and psychological distress. One double-blind placebo-controlled study was conducted to investigate treatment-resistant social phobia showing no benefit of pindolol add-on paroxetine. Our results demonstrate that the pharmacological management of treatment-resistant anxiety disorders is not sufficiently investigated in double-blind placebo-controlled trials, despite a growing evidence in favor of antipsychotics and some other pharmacological agents in resistant OCD and, to a lesser extent, PTSD. Hence, there is a crucial need for larger double-blind placebo-controlled trials for resistant anxiety disorders. Finally, being out of the scope of our review, we omitted studies of non-pharmacologic therapies. PMID:25439852

  11. Group and Individual Cognitive-Behavioral Treatments for Youth With Anxiety Disorders: 1Year Follow-Up

    Microsoft Academic Search

    Ellen Flannery-Schroeder; Muniya S. Choudhury; Philip C. Kendall

    2005-01-01

    This study reports the 1-year follow-up of a cognitive-behavioral treatment for anxiety disorders in children and adolescents. Thirty-seven anxiety-disordered youth (aged 8–14 years at the time of treatment) were randomly assigned to individual cognitive-behavioral treatment (ICBT), group cognitive-behavioral treatment (GCBT), or a waitlist control (WLC) condition. Previously reported posttreatment results demonstrated significant reductions in anxiety whereas children in the WLC

  12. Physiological Response and Childhood Anxiety: Association With Symptoms of Anxiety Disorders and Cognitive Bias

    ERIC Educational Resources Information Center

    Weems, Carl F.; Zakem, Alan H.; Costa, Natalie M.; Cannon, Melinda F.; Watts, Sarah E.

    2005-01-01

    This study examined the physiological response (skin conductance and heart rate [HR]) of youth exposed to a mildly phobic stimulus (video of a large dog) and its relation to child- and parent-reported anxiety symptoms and cognitive bias in a community-recruited sample of youth (n = 49). The results of this study indicated that HR and…

  13. Family-Based Cognitive-Behavioral Treatment of Chronic Pediatric Headache and Anxiety Disorders: A Case Study

    ERIC Educational Resources Information Center

    Drake, Kelly L.; Ginsburg, Golda S.

    2012-01-01

    Background: Chronic pediatric headache disorders are pervasive, debilitating, and associated with high rates of comorbid anxiety disorders. The combination of headaches and anxiety presents unique challenges for clinicians. Cognitive behavioral therapy (CBT) is a promising treatment for pediatric headache, however, available treatments fail to…

  14. CBT for Childhood Anxiety Disorders: Differential Changes in Selective Attention between Treatment Responders and Non-Responders

    ERIC Educational Resources Information Center

    Legerstee, Jeroen S.; Tulen, Joke H. M.; Dierckx, Bram; Treffers, Philip D. A.; Verhulst, Frank C.; Utens, Elisabeth M. W. J.

    2010-01-01

    Background: This study examined whether treatment response to stepped-care cognitive-behavioural treatment (CBT) is associated with changes in threat-related selective attention and its specific components in a large clinical sample of anxiety-disordered children. Methods: Ninety-one children with an anxiety disorder were included in the present…

  15. Anticipatory Activation in the Amygdala and Anterior Cingulate in Generalized Anxiety Disorder and Prediction of Treatment Response

    Microsoft Academic Search

    Jack B. Nitschke; I. Sarinopoulos; D. J. Oathes; T. Johnstone; P. J. Whalen; R. J. Davidson; N. H. Kalin

    2009-01-01

    Objective: The anticipation of adverse outcomes, or worry, is a cardinal symp- tom of generalized anxiety disorder. Prior work with healthy subjects has shown that anticipating aversive events recruits a network of brain regions, including the amygdala and anterior cingulate cortex. This study tested whether patients with generalized anxiety disorder have alter- ations in anticipatory amygdala function and whether anticipatory

  16. Hybrid Cognitive Behavioral Therapy versus Relaxation Training for Co-Occurring Anxiety and Alcohol Disorder: A Randomized Clinical Trial

    ERIC Educational Resources Information Center

    Kushner, Matt G.; Maurer, Eric W.; Thuras, Paul; Donahue, Chris; Frye, Brenda; Menary, Kyle R.; Hobbs, Jennifer; Haeny, Angela M.; Van Demark, Joani

    2013-01-01

    Objective: Treatment for alcohol use disorder (AUD) is far less effective for those with a co-occurring anxiety disorder. Surprisingly, adding an independent anxiety treatment to AUD treatment does not substantially improve the poor alcohol outcomes of these patients. This may reflect the lack of attention from independent treatments to the…

  17. Cognitive-Behavioral Therapy for Anxiety in Youth with an Autism Spectrum Disorder: A Follow-Up Study

    ERIC Educational Resources Information Center

    Selles, Robert R.; Arnold, Elysse B.; Phares, Vicky; Lewin, Adam B.; Murphy, Tanya K.; Storch, Eric A.

    2015-01-01

    Cognitive-behavioral therapy for anxiety in youth with an autism spectrum disorder appears efficacious; however, maintenance of treatment gains has not yet been studied. Using a sample of 32 youth who had benefited at least minimally from a past trial of cognitive-behavioral therapy for anxiety in autism spectrum disorder, this study assessed…

  18. The Association of Quality of Social Relations, Symptom Severity and Intelligence with Anxiety in Children with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Eussen, Mart L. J. M.; Van Gool, Arthur R.; Verheij, Fop; De Nijs, Pieter F. A.; Verhulst, Frank C.; Greaves-Lord, Kirstin

    2013-01-01

    Limited quality of social relations, milder symptom severity and higher intelligence were shown to account for higher anxiety levels in autism spectrum disorders. The current study replicated and extended earlier findings by combining these three determinants of anxiety in autism spectrum disorders in one study. The sample consisted of 134…

  19. Group cognitive-behavioral therapy for heterogeneous anxiety disorders in children and adolescents: A multiple baseline study

    Microsoft Academic Search

    Peyton White Lumpkin

    1998-01-01

    This study investigated the efficacy of Group Cognitive-Behavioral Therapy (GCBT) in the treatment of heterogeneous anxiety disorders in children. A partially nonconcurrent multiple baseline across groups design was used to assess the effects of the treatment on 12 clinically referred children and adolescents between 6 and 16 years of age who met DSM-IV criteria for an anxiety disorder. Targeted diagnoses

  20. DSM-IV Criteria for Generalized Anxiety Disorder in Older Adults: Distinguishing the Worried From the Well

    Microsoft Academic Search

    Julie Loebach Wetherell; Hillary Le Roux; Margaret Gatz

    2003-01-01

    This study compared 36 older adults with generalized anxiety disorder (GAD), 22 older adults with subsyndromal anxiety symptoms, and 32 normal controls on criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) for GAD. GAD patients reported more frequent and uncontrollable worry, somewhat different worry content, higher prevalence of most associated symptoms, and more distress or impairment