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Sample records for anxiety disorder diagnosis

  1. Anxiety disorders diagnosis: some history and controversies.

    PubMed

    Bienvenu, O Joseph; Wuyek, Lisa A; Stein, Murray B

    2010-01-01

    Treatment of and research on anxiety disorders depends on the adequate conceptualization and measurement of these conditions. We review the history of the nosology of anxiety disorders and note that divisions of "neurosis" have inadvertently taken attention away from what is shared among conditions now classified separately. We note the changes in the definition of agoraphobia over time and the striking differences between DSM-IV and ICD-10 definitions. We mention ongoing controversies in the diagnoses of posttraumatic stress disorder, acute stress disorder, and generalized anxiety disorder. Finally, we discuss controversies surrounding the proper placement of obsessive-compulsive disorder and putatively related conditions in future diagnostic classifications. We hope that reviewing controversial aspects of diagnosis is useful to clinicians and researchers interested in the neurobiology of anxiety disorders. PMID:21309103

  2. 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

  3. Anxiety disorders in family practice. Diagnosis and management.

    PubMed Central

    Rosser, W. W.; Borins, M.; Audet, D.

    1994-01-01

    Anxiety disorders are common in family practice. Although not ideal, the DSM 3-R definitions of anxiety disorders provide a framework for diagnostic precision that assists physicians in choosing the best treatment. Assessing functional status helps determine the need for psychotherapeutic or pharmacologic intervention. We evaluate specific interventions and suggest the risks and benefits for each disorder. PMID:8312758

  4. Anxiety disorders

    MedlinePlus

    ... think your anxiety is uncontrollable. Can complementary or alternative medicine help manage anxiety disorders? Maybe. Some women say that complementary or alternative medicine (CAM) therapies helped lower their anxiety. CAM therapies ...

  5. Anxiety Disorders

    ERIC Educational Resources Information Center

    Klein, Rachel G.

    2009-01-01

    Because of their high prevalence and their negative long-term consequences, child anxiety disorders have become an important focus of interest. Whether pathological anxiety and normal fear are similar processes continues to be controversial. Comparative studies of child anxiety disorders are scarce, but there is some support for the current

  6. Anxiety Disorders

    ERIC Educational Resources Information Center

    Klein, Rachel G.

    2009-01-01

    Because of their high prevalence and their negative long-term consequences, child anxiety disorders have become an important focus of interest. Whether pathological anxiety and normal fear are similar processes continues to be controversial. Comparative studies of child anxiety disorders are scarce, but there is some support for the current…

  7. Social anxiety disorder/social phobia: epidemiology, diagnosis, neurobiology, and treatment.

    PubMed

    den Boer, J A

    2000-01-01

    Some anticipatory anxiety is expected on specific occasions such as giving a speech. However, some individuals have an excessive fear of such situations when they are under scrutiny, believing that their performance will cause them embarrassment or humiliation, frequently leading to deliberate avoidance of these situations. This disabling condition has been termed social anxiety disorder. Social anxiety disorder is common, with a lifetime prevalence of 2% to 5%, but is probably underreported. The sufferer often avoids seeking assistance, leading to comorbid mental disorders, greater disability, and an increased risk of suicide. Consequently, a high burden is placed on the patient's caregivers and on society. The diagnosis of social anxiety disorder is aided by the patient's history together with DSM-IV criteria. Research into the neurobiology of social anxiety disorder suggests a dysfunction of postsynaptic serotonin receptors and a hypersensitivity to challenge with caffeine, CO2, and pentagastrin. Neuroimaging studies suggest a dysfunction of the striatal presynaptic dopamine transporter in social anxiety disorder. Clear guidelines for the management of social anxiety disorder, including both pharmacotherapy and psychotherapy, are yet to be established. Selective serotonin reuptake inhibitors (SSRIs) show the most promise for the future, while cognitive-behavioral therapy may also be helpful. In the meantime, physicians should treat social anxiety disorder promptly and aggressively. PMID:11086145

  8. Anxiety Disorders.

    ERIC Educational Resources Information Center

    Dickey, Marilyn

    Anxiey, in general, helps one to cope. It rouses a person to action and gears one up to face a threatening situation. It makes students study harder for exams, and keeps presenters on their toes when making speeches. But an anxiety disorder can prevent one from coping and can disrupt daily life. Anxiety disorders are not just a case of "nerves,"…

  9. Anxiety Disorders

    MedlinePlus

    ... Learn more about generalized anxiety disorder (GAD). Social Phobia In social phobia, a person fears being judged by others or ... or meeting with friends. People who have social phobia often know that they shouldn't be so ...

  10. Anxiety Disorders

    MedlinePlus

    ... a sense of unease) to severe (frequent, disabling panic attacks). Severe anxiety disorders can lead the person to ... More Are there medications that can help with panic attacks? Yes. There are many medications that have FDA ...

  11. Psychopharmacology of anxiety disorders

    PubMed Central

    Cassano, Giovanni B.; Rossi, Nicolò Baldini; Pini, Stefano

    2002-01-01

    Exposure of the general population to a 1:4 lifetime risk of disabling anxiety has inspired generations of fundamental and clinical psychopharmacologists, from the era of the earliest benzodiazepines (BZ) to that of the selective serotonin reuptake inhibitors (SSRIs) and related compounds, eg, the serotonin and norepinephrine reuptake inhibitors (SNRIs). This comprehensive practical review summarizes current therapeutic research across the spectrum of individual disorders: generalized anxiety disorder (GAD), panic disorder (PD) and agoraphobia (social anxiety disorder), compulsive disorder (OCD), phobic disorder (including social phobia), and posttraumatic stress disorder (PTSD). Specific diagnosis is a precondition to successful therapy: despite substantial overlap, each disorder responds preferentially to specific pharmacotherapy. Comorbidity with depression is common; hence the success of the SSRIs, which were originally designed to treat depression. Assessment (multidomain measures versus individual end points) remains problematic, as-frequently-do efficacy and tolerability The ideal anxiolytic remains the Holy Grail of worldwide psychopharmacologic research. PMID:22033867

  12. Generalized anxiety disorder

    MedlinePlus

    GAD; Anxiety disorder ... Depression and substance abuse may occur with an anxiety disorder. ... VA: American Psychiatric Publishing. 2013. Gabbard GO. Generalized anxiety disorder. In: Gabbard GO. Gabbard's Treatments of Psychiatric Disorders . ...

  13. 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

  14. Generalized anxiety disorder.

    PubMed

    Gorman, J M

    2001-01-01

    The diagnosis of generalized anxiety disorder (GAD) was first introduced in 1980 with the publication of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) of the American Psychiatric Association. Prior to this, the diagnosis of "anxiety neurosis" was given to patients with symptoms similar to those now incorporated within the GAD category. Originally, GAD was created as a residual category within the anxiety disorders as a rubric for patients with serious anxiety problems but without panic attacks. Panic disorder therefore received far more research attention, and GAD was seen as a diagnosis of exclusion once panic disorder had been ruled out. It is now clear, however, that GAD is a serious psychiatric disorder that is more common than panic disorder and frequently encountered in primary care practice. Indeed, the primary care physician is more likely to see patients with pure GAD than is the psychiatrist. While the treatment of GAD is relatively straightforward, the diagnosis can be difficult. Hence, careful attention to several key symptomatic presentations is important. PMID:11351785

  15. Treatment for Anxiety Disorders

    MedlinePlus

    ... GAD) Panic Disorder & Agoraphobia Social Anxiety Disorder Specific Phobias Obsessive-Compulsive Disorder (OCD) Posttraumatic Stress Disorder (PTSD) ... Posttraumatic Stress Disorder (PTSD) Social Anxiety Disorder Specific Phobias Conference Why Attend? Continuing Education About ADAA Mission & ...

  16. High Current Anxiety Symptoms, But Not a Past Anxiety Disorder Diagnosis, are Associated with Impaired Fear Extinction.

    PubMed

    Duits, Puck; Cath, Danielle C; Heitland, Ivo; Baas, Johanna M P

    2016-01-01

    Although impaired fear extinction has repeatedly been demonstrated in patients with anxiety disorders, little is known about whether these impairments persist after treatment. The current comparative exploratory study investigated fear extinction in 26 patients treated for their anxiety disorder in the years preceding the study as compared to 17 healthy control subjects. Fear-potentiated startle and subjective fear were measured in a cue and context fear conditioning paradigm within a virtual reality environment. Results indicated no differences in fear extinction between treated anxiety patients and control subjects. However, scores on the Beck Anxiety Inventory across all participants revealed impaired extinction of fear potentiated startle in subjects with high compared to low anxiety symptoms over the past week. Taken together, this exploratory study found no support for impaired fear extinction in treated anxiety patients, and implies that current anxiety symptoms rather than previous patient status determine the success of extinction. PMID:26955364

  17. High Current Anxiety Symptoms, But Not a Past Anxiety Disorder Diagnosis, are Associated with Impaired Fear Extinction

    PubMed Central

    Duits, Puck; Cath, Danielle C.; Heitland, Ivo; Baas, Johanna M. P.

    2016-01-01

    Although impaired fear extinction has repeatedly been demonstrated in patients with anxiety disorders, little is known about whether these impairments persist after treatment. The current comparative exploratory study investigated fear extinction in 26 patients treated for their anxiety disorder in the years preceding the study as compared to 17 healthy control subjects. Fear-potentiated startle and subjective fear were measured in a cue and context fear conditioning paradigm within a virtual reality environment. Results indicated no differences in fear extinction between treated anxiety patients and control subjects. However, scores on the Beck Anxiety Inventory across all participants revealed impaired extinction of fear potentiated startle in subjects with high compared to low anxiety symptoms over the past week. Taken together, this exploratory study found no support for impaired fear extinction in treated anxiety patients, and implies that current anxiety symptoms rather than previous patient status determine the success of extinction. PMID:26955364

  18. 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…

  19. 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

  20. Illness anxiety disorder

    MedlinePlus

    Illness anxiety disorder is a preoccupation that physical symptoms are signs of a serious illness, even when there is no ... a serious disease is unreasonable or unfounded. Illness anxiety disorder is different from somatic symptom disorder. With somatic ...

  1. Anxiety Disorders

    MedlinePlus

    ... compulsions (repetitive actions to try to relieve anxiety). Phobias. These are intense fears of specific things or ... as heights, dogs, or flying in an airplane. Phobias usually cause people to avoid the things they ...

  2. Anxiety Disorders

    MedlinePlus

    ... and compulsions (actions that try to relieve anxiety). Phobias. These are intense fears of specific situations or ... as heights, dogs, or flying in an airplane. Phobias usually cause people to avoid the things they ...

  3. Social Phobia (Social Anxiety Disorder)

    MedlinePlus

    ... At Risk? Diagnosis Treatments Living With Clinical Trials Social Phobia (Social Anxiety Disorder) Causes Social phobia sometimes runs ... participants with social phobia. Share Science News About Social Phobia Bullying Exerts Psychiatric Effects Into Adulthood Brain Imaging ...

  4. Anxiety disorders in persons with developmental disabilities: empirically informed diagnosis and treatment. Reviews literature on anxiety disorders in DD population with practical take-home messages for the clinician.

    PubMed

    Davis, Ervin; Saeed, Sy Atezaz; Antonacci, Diana J

    2008-09-01

    Anxiety disorders are common in individuals with developmental disabilities (DDs), although they may not be diagnosed and treated as often as they are in patients without DDs. Patients with mental retardation, autism, and other pervasive developmental disorders may exhibit comorbid anxiety disorders, such as generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), phobias, and other anxiety symptoms at much higher rates than in the general population, but identification of these comorbid anxiety disorders may be made more difficult by the presence of the DD and concurrent difficulties with communication, other behavior problems, the lack of standardized assessments specific to diagnosing patients with DDs and psychiatric comorbidities, and the need for greater collateral sources of assessment information. In addition, systematic study of the treatment of anxiety in patients with DD is limited to a relatively small number of empirical studies done specifically in these patients along with case reports and theoretical reviews on the extension and modification of more well-studied treatments used for anxiety in patients without DDs. The present article reviews the literature on the prevalence, features, assessment and diagnosis of anxiety disorders in individuals with DDs, and also reviews empirical studies of pharmacological and psychological treatment of patients with comorbid anxiety and DD and summarizes the findings. Recommendations are made to guide treatment and further research in this area. PMID:18726156

  5. Depression and anxiety disorders.

    PubMed

    Brown, C S

    2001-06-01

    Depressive and anxiety disorders are common problems facing obstetrician-gynecologists. Although psychiatric disorders are equally common in men and women, women are at least twice as likely to present with depressive disorders and most anxiety disorders. The depressive disorders include major depression, dysthymia, seasonal affective disorder, and premenstrual dysphoric disorder. The anxiety disorders are panic disorder (with and without agoraphobia), generalized anxiety disorder, social phobia, obsessive compulsive disorder, and PTSD. One must diagnose and manage depressive and anxiety disorders during pregnancy, the purpureum, and while breastfeeding. General treatment principles include assessing suicide risk, psychotherapy, pharmacologic treatment, and an appropriate medical work-up for depressive and anxiety disorders. The SSRIs are the first-line treatment for most depressive and anxiety disorders because of data supporting their efficacy, the minimal need for dosage titration, the overall favorable side-effect profile, and the length of available clinical experience. Newer antidepressants, such as venlafaxine, bupropion, nefazodone, and mirtazapine, are options for patients unresponsive to, or intolerant of, the SSRIs. Treatment considerations include acute, maintenance, and continuation therapy, dosage regimens, adverse effects, and drug interactions. Specific guidelines are available for referring patients to a mental health specialist. PMID:11430175

  6. Anxiety Disorders Information: Helping Others

    MedlinePlus

    ... GAD) Panic Disorder & Agoraphobia Social Anxiety Disorder Specific Phobias Obsessive-Compulsive Disorder (OCD) Posttraumatic Stress Disorder (PTSD) ... Posttraumatic Stress Disorder (PTSD) Social Anxiety Disorder Specific Phobias Conference Why Attend? Continuing Education About ADAA Mission & ...

  7. Health Anxiety, Hypochondriasis, and the Anxiety Disorders

    ERIC Educational Resources Information Center

    Abramowitz, Jonathan S.; Olatunji, Bunmi O.; Deacon, Brett J.

    2007-01-01

    Although clinical observations suggest that health-related anxiety is present, to some extent, in a number of anxiety disorders, this relationship has not been examined empirically. The present study therefore utilized the Short Health Anxiety Inventory (SHAI) to elucidate the structure of such symptoms among patients with anxiety disorders and to

  8. Health Anxiety, Hypochondriasis, and the Anxiety Disorders

    ERIC Educational Resources Information Center

    Abramowitz, Jonathan S.; Olatunji, Bunmi O.; Deacon, Brett J.

    2007-01-01

    Although clinical observations suggest that health-related anxiety is present, to some extent, in a number of anxiety disorders, this relationship has not been examined empirically. The present study therefore utilized the Short Health Anxiety Inventory (SHAI) to elucidate the structure of such symptoms among patients with anxiety disorders and to…

  9. Beyond butterflies: generalized anxiety disorder in adolescents.

    PubMed

    McBride, Michon Elizabeth

    2015-03-12

    A generalized anxiety disorder diagnosis must include thorough history-taking, the use of age-appropriate screening tools, and physical assessment. Research and development into the use of screening tools and effectiveness of treatment strategies for generalized anxiety disorder is needed to better manage adolescents with the disorder. PMID:25642634

  10. Betaxolol in anxiety disorders.

    PubMed

    Swartz, C M

    1998-03-01

    Betaxolol, a long-acting beta-adrenergic blocker that enters the central nervous system, was examined for therapeutic effects on the persistent anxiety of anxiety disorders. Prior studies of beta-blockers examined only agents that were short-acting or did not enter the brain. Betaxolol was administered to 31 patients in open trials. Of 13 outpatients, 11 had generalized anxiety disorder (GAD) and 2 had adjustment disorder with anxiety. Five with GAD had concurrent panic disorder. Of 18 inpatients, 16 had GAD and 2 had adjustment disorder with anxiety. Betaxolol doses were increased until the patient responded or declined further dosage. Severity was rated on a 4-point global scale. Before betaxolol, all were moderately or severely ill. In all patients with panic disorder panic attacks stopped within 2 days (p<0.001). Anxiety decreased to no more than marginally ill in 85% of outpatients (p<0.0001) and all inpatients (p<0.0001). Betaxolol doses were usually 5 mg once or twice daily; four inpatients took 10 to 20 mg twice daily. In sum, betaxolol administration was rapidly followed by improvements that were easily noticed by the doctor, even in patients with longstanding anxiety and obsessive-compulsive personality disorder. Preliminary observations in posttraumatic stress disorder are similar. PMID:9622045

  11. Social anxiety disorder

    MedlinePlus

    Phobia - social ... affected equally with this disorder. People with social phobia are at high risk for alcohol or other ... treatment usually depends on the severity of the phobia. Anti-anxiety and antidepressant medications are sometimes used ...

  12. Memory and anxiety disorders.

    PubMed

    Mcnally, R J

    1997-11-29

    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

  13. Clinical Diagnosis of Anxiety

    PubMed Central

    Ghadirian, A. M.

    1981-01-01

    Although anxiety constitutes the chief symptom of neuroses and functional psychoses, there is little agreement on its definition. This article reviews such definitions, the epidemiology of anxiety, and distinguishes between anxiety, depression and stress. PMID:21289769

  14. Inattention symptoms and the diagnosis of comorbid attention-deficit/hyperactivity disorder among youth with generalized anxiety disorder

    PubMed Central

    Elkins, R. Meredith; Carpenter, Aubrey L.; Pincus, Donna B.; Comer, Jonathan S.

    2014-01-01

    Generalized anxiety disorder (GAD) and attention-deficit/hyperactivity disorder (ADHD) commonly co-occur in childhood. Inattention symptoms can be hallmarks of both conditions, however assessment tools of inattention may not effectively distinguish between the two conditions. The present study used receiver operating characteristic (ROC) analyses to examine the high-end specificity of the Attention Problems Scale of the Child Behavior Checklist (CBCL) for detecting comorbid ADHD among youth with GAD (N = 46). Results support the utility of the Attention Problems Scale for accurately distinguishing between the two groups (AUC = 0.84, SE = .06). Specifically, a cut score of 63 achieved the most favorable values across diagnostic utility indices; 74% of GAD youth with ADHD scored above this cutoff and 91% of GAD youth without ADHD scored below this cutoff. Findings provide support for the use of the CBCL Attention Problems Scale to supplement diagnostic interviews and identify inattention associated with ADHD among GAD youth. PMID:25260213

  15. [Social anxiety disorders].

    PubMed

    Renneberg, B; Ströhle, A

    2006-09-01

    A main feature of social anxiety disorders is the fear or avoidance of social situations in which one is the center of attention and fears criticism or negative judgement. According to current diagnostic systems, three types of these disorders can be classified: specific social phobia, generalised social phobia, and avoidant personality disorder. Social anxiety disorders are prevalent mental disorders (lifetime prevalence up to 13%). Other mental disorders often appear together with them. Following the criteria for evidence-based medicine, psychotherapeutic and pharmacologic interventions are described. Regarding psychotherapeutic approaches, the best results have been seen with cognitive-behavioural methods. Among psychopharmacologic treatments, selective serotonin reuptake inhibitors and the selective noradrenalin reuptake inhibitor Venlafaxin are the first-choice treatments. PMID:16710727

  16. Comorbid anxiety in bipolar disorder

    PubMed Central

    Nakagawa, Atsuo; Grunebaum, Michael F; Sullivan, Gregory M; Currier, Dianne; Ellis, Steven P; Burke, Ainsley K; Brent, David A; Mann, J John; Oquendo, Maria A

    2009-01-01

    Objective Comorbid anxiety disorder is reported to increase suicidality in bipolar disorder. However, studies of the impact of anxiety disorders on suicidal behavior in mood disorders have shown mixed results. The presence of personality disorders, often comorbid with anxiety and bipolar disorders, may explain these inconsistencies. This study examined the impact of comorbid Cluster B personality disorder and anxiety disorder on suicidality in bipolar disorder. Methods A total of 116 depressed bipolar patients with and without lifetime anxiety disorder were compared. Multiple regression analysis tested the association of comorbid anxiety disorder with past suicide attempts and severity of suicidal ideation, adjusting for the effect of Cluster B personality disorder. The specific effect of panic disorder was also explored. Results Bipolar patients with and without anxiety disorders did not differ in the rate of past suicide attempt. Suicidal ideation was less severe in those with anxiety disorders. In multiple regression analysis, anxiety disorder was not associated with past suicide attempts or with the severity of suicidal ideation, whereas Cluster B personality disorder was associated with both. The results were comparable when comorbid panic disorder was examined. Conclusions Comorbid Cluster B personality disorder appears to exert a stronger influence on suicidality than comorbid anxiety disorder in persons with bipolar disorder. Assessment of suicide risk in patients with bipolar disorder should include evaluation and treatment of Cluster B psychopathology. PMID:18452449

  17. Predictors of Generalized Anxiety Disorder stigma.

    PubMed

    Batterham, Philip J; Griffiths, Kathleen M; Barney, Lisa J; Parsons, Alison

    2013-04-30

    The stigma associated with mental illness can lead to a range of negative outcomes, including delaying or avoiding help seeking. Identifying the characteristics of people who are more likely to hold stigmatizing attitudes enables the development of targeted stigma reduction programs. However, no previous research has systematically examined the predictors of anxiety stigma. This study used the Generalized Anxiety Stigma Scale (GASS) to assess the predictors of personal stigma and perceived stigma associated with Generalized Anxiety Disorder. A community sample of 617 Australian adults completed a survey that included the GASS, the Depression Stigma Scale, exposure to anxiety disorders, emotional distress and a range of demographic characteristics. Linear regression models indicated that women, people with greater exposure to anxiety disorders and people reporting a previous anxiety diagnosis had lower personal stigma toward anxiety. Higher exposure to anxiety disorders and rurality were significantly associated with higher perceived anxiety stigma. Results also suggested that respondents who had only been exposed to anxiety disorders through the media tended to be no more stigmatizing than respondents who had direct contact with people with an anxiety disorder. Media campaigns may be an effective vehicle for decreasing stigmatizing views in the community. PMID:23218916

  18. 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.

  19. 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.…

  20. Screening for Generalized Anxiety Disorder (GAD)

    MedlinePlus

    ... GAD) Panic Disorder & Agoraphobia Social Anxiety Disorder Specific Phobias Obsessive-Compulsive Disorder (OCD) Posttraumatic Stress Disorder (PTSD) ... Screening for Social Anxiety Disorder Screening for Specific Phobias Screening for an Anxiety Disorder: Children Screening for ...

  1. Anxiety disorders in African Americans: an update.

    PubMed Central

    Paradis, C. M.; Hatch, M.; Friedman, S.

    1994-01-01

    This article discusses issues involved in the diagnosis of anxiety disorders, particularly panic disorder, in African Americans. Although epidemiological studies have shown similar prevalence rates of anxiety disorders among African Americans and non-African Americans, African Americans are underrepresented among those in treatment at mental health settings or serving as clinical research subjects. In addition, few studies have researched the unique demographic, diagnostic, and treatment characteristics of African-American patients with anxiety disorders. Most clinicians therefore are not educated to consider these issues in adapting their treatment approach to affect a more successful treatment outcome for African-American patients with anxiety-disorder. This article identifies and addresses relevant cross-cultural issues. PMID:7932839

  2. Electrodermal activity in anxiety disorders.

    PubMed

    Birket-Smith, M; Hasle, N; Jensen, H H

    1993-11-01

    Forty anxiety patients diagnosed according to DSM-III-R criteria were included: panic disorder (n = 12), agoraphobia (n = 11), generalized anxiety disorder (n = 9), anxiety disorder not otherwise specified (n = 8) and compared with 12 controls. Millon Clinical Multiaxial Inventory and Symptom Checklist-90R symptom and personality scales did not separate the diagnostic groups. Electrodermal activity showed delayed habituation and high spontaneous skin resistance fluctuations in the panic and agoraphobia groups compared with the non-panic groups. The generalized anxiety disorder patients could not be separated from the controls, and the anxiety disorder not otherwise specified patients showed less electrodermal activity than the controls on most variables. In contrast to self-report instruments, electrodermal activity discriminated between diagnostic groups of patients with DSM-III-R anxiety disorders, more specifically between patients with and without panic attacks. PMID:8296577

  3. Anxiety disorders in primary care.

    PubMed

    Combs, Heidi; Markman, Jesse

    2014-09-01

    Anxiety disorders are the most common psychiatric condition presenting to primary care practitioners. Yet they can be easily overlooked or misdiagnosed. Patients that struggle with anxiety disorders are more likely to seek treatment from primary care providers than mental health specialists. Given the costs in terms of debilitation and associated financial burden, and increased risk of suicide, the identification and successful treatment of anxiety is imperative. By means of clinical acumen and the use of screening tools, the provider can develop expertise in recognition and effective treatment of anxiety disorders. PMID:25134870

  4. Treating generalized anxiety disorder.

    PubMed

    Gorman, Jack M

    2003-01-01

    Generalized anxiety disorder (GAD) is characterized by chronically persistent worry and therefore requires effective long-term treatment. This article reviews the benefits and risks associated with various pharmacologic and psychological therapies to assess their ability to achieve the elimination of GAD symptomatology and restoration of normal function. Psychotherapeutic approaches such as applied relaxation, cognitive therapy, and cognitive-behavioral therapy have all been shown to be effective when used as monotherapies and may be beneficial when used adjunctively. Current effective pharmacotherapies for patients with GAD include anxiolytic benzodiazepines, buspirone, and antidepressants including venlafaxine and paroxetine. Benzodiazepines have long been used to treat anxiety and are particularly appropriate in short-term treatment situations; however, their adverse side-effect profile and their inability to treat depression commonly comorbid with GAD renders them less than ideal in many situations. Buspirone has demonstrated anxiolytic benefits but, like benzodiazepines, shows negligible antidepressant action. Antidepressants like paroxetine and venlafaxine are not only effective antidepressants but also effective anxiolytics, thus implying their special ability to treat GAD and concurrent depression, even over the long-term. PMID:12625796

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

    PubMed

    Özyurt, Gonca; Öztura, İbrahim; Alkın, Tunç; Özerdem, Ayşegül

    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

  6. Comparative Prevalence of Eating Disorders in Obsessive-Compulsive Disorder and Other Anxiety Disorders

    PubMed Central

    Tyagi, Himanshu; Patel, Rupal; Rughooputh, Fabienne; Abrahams, Hannah; Watson, Andrew J.; Drummond, Lynne

    2015-01-01

    Objective. The purpose of this study was to compare the prevalence of comorbid eating disorders in Obsessive-Compulsive Disorder (OCD) and other common anxiety disorders. Method. 179 patients from the same geographical area with a diagnosis of OCD or an anxiety disorder were divided into two groups based on their primary diagnosis. The prevalence of a comorbid eating disorder was calculated in both groups. Results. There was no statistically significant difference in the prevalence of comorbid eating disorders between the OCD and other anxiety disorders group. Conclusions. These results suggest that the prevalence of comorbid eating disorders does not differ in anxiety disorders when compared with OCD. However, in both groups, it remains statistically higher than that of the general population. PMID:26366407

  7. Generalized Anxiety Disorder

    MedlinePlus

    ... a word that describes feelings of worry, nervousness, fear, apprehension, concern or restlessness. Normal feelings of anxiety ... control, giving you a sense of dread and fear for no apparent reason. This kind of anxiety ...

  8. Worried Sick: Living with Anxiety Disorders

    MedlinePlus

    ... anxiety disorders, specific phobias are the most common. Social anxiety disorder . Leads to extreme anxiety and self-consciousness in everyday social situations. Also known as social phobia. Post-traumatic ...

  9. CEREBRAL BLOOD FLOW AND METABOLISM IN ANXIETY AND ANXIETY DISORDERS

    PubMed Central

    Mathew, Roy J.

    1994-01-01

    Anxiety disorders are some of the commonest psychiatric disorders and anxiety commonly co-exists with other psychiatric conditions. Anxiety can also be a normal emotion. Thus, study of the neurobiological effects of anxiety is of considerable significance. In the normal brain, cerebral blood flow (CBF) and metabolism (CMR) serve as indices of brain function. CBF/CMR research is expected to provide new insight into alterations in brain function in anxiety disorders and other psychiatric disorders. Possible associations between stress I anxiety I panic and cerebral ischemia I stroke give additional significance to the effects of anxiety on CBF. With the advent of non-invasive techniques, study of CBF/CMR in anxiety disorders became easier. A large numbers of research reports are available on the effects of stress, anxiety and panic on CBF/CMR in normals and anxiety disorder patients. This article reviews the available human research on this topic. PMID:21743685

  10. Discriminant and Convergent Validity of the Anxiety Construct in Children with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Renno, Patricia; Wood, Jeffrey J.

    2013-01-01

    Despite reports of high anxiety in children with autism spectrum disorders (ASD), there is controversy regarding differential diagnosis of ASD symptoms and anxiety symptoms. This study examined 88 children, aged 7-11years, with ASD referred for concerns about anxiety. A multitrait-(social anxiety, separation anxiety, overall anxiety severity, and

  11. Discriminant and Convergent Validity of the Anxiety Construct in Children with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Renno, Patricia; Wood, Jeffrey J.

    2013-01-01

    Despite reports of high anxiety in children with autism spectrum disorders (ASD), there is controversy regarding differential diagnosis of ASD symptoms and anxiety symptoms. This study examined 88 children, aged 7-11 years, with ASD referred for concerns about anxiety. A multitrait-(social anxiety, separation anxiety, overall anxiety severity, and…

  12. Emotion Regulation and Anxiety Disorders

    PubMed Central

    Cisler, Josh M.; Olatunji, Bunmi O.

    2013-01-01

    A growing body of research suggests that the construct of emotion regulation is important for understanding the onset, maintenance, and treatment of anxiety disorders. In this review, we provide a selective overview of this emerging field and highlight the major sources of evidence. First, evidence suggests that the construct of emotion regulation can be differentiated from the construct of emotion. Second, there is a large and consistent body of research demonstrating that emotion regulation strategies can modulate emotional responding, and this finding is observed in both behavioral and neuroimaging studies. Third, measures of emotion regulation explain incremental variance in measures of anxiety disorder symptoms not accounted for by measures of negative affect. Although the research implicating emotion regulation in the anxiety disorders is promising, future research will be necessary to further clarify causal mechanisms explaining how emotion regulation confers vulnerability for anxiety disorders and to improve the clarity and consistency of definitions of emotion regulation. PMID:22392595

  13. [Anxiety disorders and substance-related disorders].

    TOXLINE Toxicology Bibliographic Information

    Ochoa Mangado E

    1999-01-01

    Psychiatric comorbidity between anxiety disorders and substance-related disorders is studied. This relationship is complex due to the overlapping of symptoms (during the abstinence of alcohol and opiates as well as in the intoxication of cocaine) and also for the inaccurate definition of several disorders. Epidemiologic studies show an increase of prevalence of anxiety disorders, mainly agoraphobia and social phobia, in patients who are alcohol dependents and in heroine and cocaine users. Such studies also point out an augmentation of consume of substances (drugs and alcohol), with a prevalence of 24% in patients with several anxiety disorders. The relationship between these disorders is analysed. It is also studied the influence of such a comorbidity in the evolution and outcome of treatment.

  14. Anxiety Disorders of Childhood and Adolescence.

    ERIC Educational Resources Information Center

    Strauss, Cyd S.

    1990-01-01

    Describes recent advances in assessment and treatment of anxiety disorders in children and adolescents. Presents findings of descriptive studies of childhood anxiety disorders, types of assessment approaches used to evaluate anxiety, treatment strategies that have been applied to anxiety problems, and correlates of anxiety in childhood. Discusses

  15. Current concepts in clinical therapeutics: anxiety disorders, Part 1.

    PubMed

    Hayes, P E; Dommisse, C S

    1987-02-01

    The diagnosis, epidemiology, classification and clinical presentation, pathophysiology, and treatment of anxiety disorders are reviewed. Anxiety disorders, among the most common mental disorders, must be differentiated from medical diseases with anxious symptoms. A complete physical and mental status examination, as well as a thorough knowledge of the patient's medical, psychiatric, and drug history are required. Epidemiologic studies indicate an incidence of 4-8% in the United States. There are four categories of anxiety disorders: phobic disorders, anxiety states, posttraumatic stress disorders, and atypical anxiety disorders. Several psychoanalytic, behavioral, and cognitive theories have been advanced to explain the pathophysiologic mechanisms causing anxiety disorders. Of most interest are the biological theories involving the catecholamine neurotransmitter norepinephrine and the benzodiazepine receptor. Proper treatment for anxiety disorders involves nonpharmacologic and pharmacologic approaches. The benzodiazepines are widely used and are the mainstay of drug treatment for patients with situational anxiety and generalized anxiety disorder. However, problems with sedation, complications of drug withdrawal, and patients' fear of drug dependency may limit clinical usefulness. Buspirone is the first nonbenzodiazepine anxiolytic to be introduced in the United States in more than 25 years. Its unique role in treating anxiety, compared with the benzodiazepines, may include less sedation, minimal drug abuse potential, and fewer withdrawal symptoms upon drug discontinuation. Nonpharmacologic therapy is used extensively in the treatment of phobic disorders (simple and social phobia). Important advances in the diagnosis and treatment of anxiety disorders have been made. An accurate diagnosis is essential for optimal management. Unfortunately, many anxious patients do not seek treatment and some do not receive the most appropriate treatment. PMID:3311574

  16. 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

  17. 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…

  18. Suicidal Ideation in Anxiety-Disordered Youth

    ERIC Educational Resources Information Center

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

    2012-01-01

    Evidence is mixed regarding an independent association between anxiety and suicidality in youth. Study 1 examined suicidal ideation in treatment-referred, anxiety-disordered youth (N = 312, aged 7-17). Forty-one percent of anxiety-disordered youth endorsed suicidal ideation. Anxiety disorder severity, global impairment, and current depressive

  19. Suicidal Ideation in Anxiety-Disordered Youth

    ERIC Educational Resources Information Center

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

    2012-01-01

    Evidence is mixed regarding an independent association between anxiety and suicidality in youth. Study 1 examined suicidal ideation in treatment-referred, anxiety-disordered youth (N = 312, aged 7-17). Forty-one percent of anxiety-disordered youth endorsed suicidal ideation. Anxiety disorder severity, global impairment, and current depressive…

  20. Oxidative Imbalance and Anxiety Disorders

    PubMed Central

    R, Krolow; D. M, Arcego; C, Noschang; S. N, Weis; C, Dalmaz

    2014-01-01

    The oxidative imbalance appears to have an important role in anxiety development. Studies in both humans and animals have shown a strong correlation between anxiety and oxidative stress. In humans, for example, the increased malondialdehyde levels and discrepancies in antioxidant enzymes in erythrocytes have been observed. In animals, several studies also show that anxiety-like behavior is related to the oxidative imbalance. Moreover, anxiety-like behavior can be caused by pharmacological-induced oxidative stress. Studies using knockout or overexpression of antioxidant enzymes have shown a relationship between anxiety-like behavior and oxidative stress. Related factors of oxidative stress that could influence anxious behavior are revised, including impaired function of different mitochondrial proteins, inflammatory cytokines, and neurotrophic factors. It has been suggested that a therapy specifically focus in reducing reactive species production may have a beneficial effect in reducing anxiety. However, the neurobiological pathways underlying the effect of oxidative stress on anxiety symptoms are not fully comprehended. The challenge now is to identify the oxidative stress mechanisms likely to be involved in the induction of anxiety symptoms. Understanding these pathways could help to clarify the neurobiology of the anxiety disorder and provide tools for new discovery in therapies and preventive strategies. PMID:24669212

  1. Cognitive Therapy of Anxiety Disorders.

    ERIC Educational Resources Information Center

    Chambless, Dianne L.; Gillis, Martha M.

    1993-01-01

    Reviews studies of cognitive-behavioral therapy (CBT) for generalized anxiety disorder, panic disorder with and without agoraphobia, and social phobia. Sees CBT as consistently more effective than waiting-list and placebo control groups. Notes that cognitive change may be strong predictor of treatment outcome but that such change may be produced…

  2. Electrodermal lability in anxiety disorders.

    PubMed

    Jensen, H H; Hasle, N; Birket-Smith, M

    1996-03-01

    Twenty-eight anxiety patients, aged below 50 years, were diagnosed according to DSM-III-R criteria (panic disorder with and without agoraphobia, generalised anxiety disorder, and anxiety disorder not otherwise specified). The patients were characterised by high levels of state and trait anxiety and neuroticism, compared with the controls. However, there were no differences between patients and controls in electrodermal habituation rate, non-specific activity, or skin resistance level. When the patients were divided into electrodermally labile and stable subjects, significant differences were found between patients and controls in both electrodermal activity and Eysenck's personality dimensions. The labile patients were more introverted and attained higher psychoticism scores than either the stable patients or controls. Duration of anxiety symptoms removed the difference found in extroversion, but not in any other variable. The results are discussed in relation to the utility of electrodermal measurements in validation of diagnostic entities. It is concluded, that from the psychophysiological point of view, anxiety disorders may be examined within a dimensional framework. PMID:8900823

  3. Anxiety and Anxiety Disorders in Children and Adolescents: Developmental Issues and Implications for DSM-V

    PubMed Central

    Beesdo, Katja; Knappe, Susanne; Pine, Daniel S.

    2010-01-01

    This review summarizes findings on the epidemiology and etiology of anxiety disorders among children and adolescents including separation anxiety disorder, specific phobia, social phobia, agoraphobia, panic disorder, and generalized anxiety disorder, also highlighting critical aspects of diagnosis, assessment, and treatment. Childhood and adolescence is the core risk phase for the development of anxiety symptoms and syndromes, ranging from transient mild symptoms to full-blown anxiety disorders. This article critically reviews epidemiological evidence covering prevalence, incidence, course, and risk factors. The core challenge in this age span is the derivation of developmentally more sensitive assessment methods. Identification of characteristics that could serve as solid predictors for onset, course, and outcome will require prospective designs that assess a wide range of putative vulnerability and risk factors. This type of information is important for improved early recognition and differential diagnosis as well as prevention and treatment in this age span. PMID:19716988

  4. Nonpharmacological treatments for anxiety disorders

    PubMed Central

    Cottraux, Jean

    2002-01-01

    An evidence-based review of nonpharmacological treatments for anxiety disorders is presented. The vast majority of the controlled research is devoted to cognitive behavior therapy (CBT) and shows its efficiency and effectiveness in all the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) anxiety disorders in meta-analyses. Relaxation, psychoanalytic therapies, Rogerian nondirective therapy, hypnotherapy and supportive therapy were examined in a few controlled studies, which preclude any definite conclusion about their effectiveness in specific phobias, agoraphobia, panic disorder, obsessive-compulsive disorder (OCD), and posttraumatic stress disorder (PTSD), CBT was clearly better than psychoanalytic therapy in generalized anxiety disorder (GAD) and performance anxiety Psychological debriefing for PTSD appeared detrimental to the patients in one high-quality meta-analysis. Uncontrolled studies of psychosurgery techniques for intractable OCD demonstrated a limited success and detrimental side effects. The same was true for sympathectomy in ereutophobia. Transcranial neurostimulation for OCD is under preliminary study. The theoretical and practical problems of CBT dissemination are discussed. PMID:22034140

  5. [Anxiety disorders in DSM-5].

    PubMed

    Márquez, Miguel

    2014-01-01

    The fifth edition of Diagnostic and Statistical Manual, the DSM-5 appeared officially in May 2013 during the development of the 166th Annual Meetingof the American Psychiatric Association (APA) in San Francisco. The drafting process was long and complex; much of the debate became public so that the expectations were great. And it must be said that the new edition did not disappoint, as many changes were made in relation to their predecessors. In Chapter of Anxiety Disorders, which is reviewed in this article, the changes were significant. Obsessive-compulsive disorder and Stress-related disorders were excluded and new clinical pictures, such as separation anxiety disorder and selective mutism, were included. And took place was the long awaited split between panic disorder and agoraphobia, now two separate disorders. PMID:24887371

  6. 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…

  7. 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

  8. Panic disorder, phobias, and generalized anxiety disorder.

    PubMed

    Craske, Michelle G; Waters, Allison M

    2005-01-01

    This chapter provides a review of recent empirical developments, current controversies, and areas in need of further research in relation to factors that are common as well as specific to the etiology and maintenance of panic disorder, phobias, and generalized anxiety disorder. The relative contribution of broad risk factors to these disorders is discussed, including temperament, genetics, biological influences, cognition, and familial variables. In addition, the role that specific learning experiences play in relation to each disorder is reviewed. In an overarching hierarchical model, it is proposed that generalized anxiety disorder, and to some extent panic disorder, loads most heavily on broad underlying factors, whereas specific life history contributes most strongly to circumscribed phobias. PMID:17716087

  9. Pharmacotherapy of anxiety disorders: a critical review

    PubMed Central

    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

  10. 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

  11. Anxiety Sensitivity and Its Factors in Relation to Generalized Anxiety Disorder among Adolescents.

    PubMed

    Knapp, Ashley A; Blumenthal, Heidemarie; Mischel, Emily R; Badour, Christal L; Leen-Feldner, Ellen W

    2016-02-01

    Anxiety psychopathology, one of the most prevalent classes of disorder among youth, is linked to detrimental outcomes. Accordingly, identifying factors that influence vulnerability to anxiety disorders is important. One promising factor, given emerging evidence for its transdiagnostic nature, is anxiety sensitivity (AS); however, relatively little is known about the linkage between AS and indicators of generalized anxiety disorder (GAD), particularly among youth. The aim of the current investigation was to address this gap in the literature using a community-based sample of adolescents aged 10-17years (n?=?165; M age ?=?14.49years, SD?=?2.26). Results indicated global AS and the AS-physical concerns dimension were significantly associated with worry, generalized anxiety symptoms, and GAD diagnosis assessed via a structured clinical interview, above and beyond key theoretically-relevant covariates. These findings add to a growing body of work underscoring the relevance of AS for multiple types of anxiety-related disorders among youth. PMID:25724327

  12. Social Phobia (Social Anxiety Disorder): Always Embarrassed

    MedlinePlus

    ... having social phobia? For More Information Share Social Phobia (Social Anxiety Disorder): Always Embarrassed Download PDF Download ... also called social anxiety disorder. What is social phobia? Social phobia is a strong fear of being ...

  13. Diagnosis and Treatment Procedures for Patients With Anxiety Disorders by the Psychiatric Consultation Liaison Service in a General Hospital in Germany: A Retrospective Analysis

    PubMed Central

    Anderson, Christina; Tauch, Deborah; Quante, Arnim

    2015-01-01

    Objective: To investigate the population of patients with anxiety disorders in a general hospital in Germany who required treatment by a consultation psychiatrist. Method: A retrospective investigation of psychiatric consultations concerning 119 patients with anxiety disorders (DSM-IV criteria) from January 1, 2011, to December 31, 2012, was conducted in a general hospital of the Charité Berlin, Berlin, Germany. The frequency of different anxiety disorders, the distribution of anxiety disorders among the departments of the general hospital, and the recommended treatment procedure were investigated. Results: The largest group of patients with anxiety symptoms presented panic attacks. Many of these patients sought treatment in the emergency department of the hospital primarily due to their anxiety symptoms. Within the group of somatically ill patients, panic attacks were prominent, especially in patients with cardiac or respiratory diseases. Treatment procedures comprised pharmacologic and psychotherapeutic interventions. Benzodiazepines and psychoeducation were common acute treatments; antidepressants, pregabalin, and psychotherapy were recommended for long-term treatment. Conclusions: Many patients who primarily suffer from symptoms of anxiety seek treatment in a general hospital, especially in the emergency department. It is therefore very important for the individual patient as well as the health care system that the correct treatment is initiated. The consultation-liaison psychiatric service within a general hospital is important to ensure the best possible diagnostic procedures as well as treatment for patients with anxiety disorders. PMID:26835174

  14. Autism Spectrum Traits in Children with Anxiety Disorders

    ERIC Educational Resources Information Center

    van Steensel, Francisca J. A.; Bogels, Susan M.; Wood, Jeffrey J.

    2013-01-01

    The aim of this study was to examine ASD traits in children with clinical anxiety in early development, as well as current manifestations. Parents of 42 children with an anxiety disorder (but no known diagnosis of ASD) and 42 typically developing children were interviewed using the Autism Diagnostic Interview (ADI-R). They also completed

  15. Autism Spectrum Traits in Children with Anxiety Disorders

    ERIC Educational Resources Information Center

    van Steensel, Francisca J. A.; Bogels, Susan M.; Wood, Jeffrey J.

    2013-01-01

    The aim of this study was to examine ASD traits in children with clinical anxiety in early development, as well as current manifestations. Parents of 42 children with an anxiety disorder (but no known diagnosis of ASD) and 42 typically developing children were interviewed using the Autism Diagnostic Interview (ADI-R). They also completed…

  16. 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…

  17. 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

  18. Social anxiety disorder: etiology and early clinical presentation.

    PubMed

    Beidel, D C

    1998-01-01

    Behavioral and biological theories addressing the etiology of social anxiety disorder are discussed. Although not often diagnosed until adolescence or adulthood, social anxiety disorder can have its onset during childhood. Early recognition and treatment of this condition may prevent both immediate and long-term detrimental outcomes and, possibly, the onset of comorbid conditions. However, special considerations are required for the diagnosis and treatment of childhood social anxiety disorder. Therapists face special challenges when treating youth with social anxiety disorder, including patient and parent considerations. Although not documented specifically for children with social anxiety disorders, data from families with anxious children suggest that familial factors may play a role in treatment outcome. PMID:9811427

  19. Genetics of anxiety and trauma-related disorders.

    PubMed

    Norrholm, S D; Ressler, K J

    2009-11-24

    Anxiety disorders are the most common psychiatric illnesses in the United States with approximately 30% of the population experiencing anxiety-related symptoms in their lifetime [Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age-of-onset distributions of Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62:593-60]. Notably, a variety of studies have demonstrated that 30-40% of the variance contributing to these disorders is heritable. In the present review, we discuss the latest findings regarding the genetic and environmental influences on the development and symptomatology of anxiety disorders. Specific emphasis is placed on posttraumatic stress disorder (PTSD) due to its uniqueness as an anxiety disorder; its diagnosis is dependent on a precipitating traumatic event and its development appears to be mediated by both genetic and environmental contributions. The co-morbidity of anxiety disorders and the potential re-classification of anxiety disorders as part of DSM-V are reviewed given the potential impact on the interpretation and design of genetic investigations. Lastly, several keys to future genetic studies are highlighted. Thorough analyses of the gene by environment (GxE) interactions that govern one's vulnerability to anxiety disorder(s), the effectiveness of individual treatment strategies, and the severity of symptoms may lead to more effective prophylactic (e.g. social support) and treatment strategies. PMID:19540311

  20. Psychotherapy for Anxiety in Children With Autism Spectrum Disorder

    ClinicalTrials.gov

    2016-02-22

    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

    2016-03-07

    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

  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. Social Anxiety Disorders and Alcohol Abuse

    MedlinePlus

    ... GAD) Panic Disorder & Agoraphobia Social Anxiety Disorder Specific Phobias Obsessive-Compulsive Disorder (OCD) Posttraumatic Stress Disorder (PTSD) ... seem to pay too much attention to my phobia. I did what was expected as a “good” ...

  4. Diagnosed Anxiety Disorders and the Risk of Subsequent Anorexia Nervosa: A Danish Population Register Study.

    PubMed

    Meier, Sandra M; Bulik, Cynthia M; Thornton, Laura M; Mattheisen, Manuel; Mortensen, Preben B; Petersen, Liselotte

    2015-11-01

    Anxiety disorders and anorexia nervosa are frequently acknowledged to be highly comorbid conditions, but still, little is known about the clinical and aetiological cohesion of specific anxiety diagnoses and anorexia nervosa. Using the comprehensive Danish population registers, we aimed to determine the risk of anorexia nervosa in patients with register-detected severe anxiety disorders. We also explored whether parental psychopathology was associated with offspring's anorexia nervosa. Anxiety disorders increased the risk of subsequent anorexia nervosa, with the highest risk observed in obsessive-compulsive disorder. Especially, male anxiety patients were at an increased risk for anorexia nervosa. Furthermore, an increased risk was observed in offspring of fathers with panic disorder. A diagnosis of an anxiety disorder, specifically obsessive-compulsive disorder, constitutes a risk factor for subsequent diagnosis of anorexia nervosa. These observations support the notion that anxiety disorders and anorexia nervosa share etiological mechanisms and/or that anxiety represents one developmental pathway to anorexia nervosa. PMID:26347124

  5. A lifespan view of anxiety disorders

    PubMed Central

    Lenze, Eric J.; Wetherell, Julie Loebach

    2011-01-01

    Neurodevelopmental changes over the lifespan, from childhood through adulthood into old age, have important implications for the onset, presentation, course, and treatment of anxiety disorders. This article presents data on anxiety disorders as they appear in older adults, as compared with earlier in life. In this article, we focus on aging-related changes in the epidemiology, presentation, and treatment of anxiety disorders. Also, this article describes some of the gaps and limitations in our understanding and suggests research directions that may elucidate the mechanisms of anxiety disorder development later in life. Finally we describe optimal management of anxiety disorders across the lifespan, in eight simple steps for practitioners. PMID:22275845

  6. 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

  7. Relationship between anxiety, anxiety sensitivity and conduct disorder symptoms in children and adolescents with attention-deficit/hyperactivity disorder (ADHD).

    PubMed

    Bilgiç, Ayhan; Türkoğlu, Serhat; Ozcan, Ozlem; Tufan, Ali Evren; Yılmaz, Savaş; Yüksel, Tuğba

    2013-09-01

    Attention-deficit hyperactivity disorder (ADHD) is often comorbid with anxiety disorders and previous studies observed that anxiety could have an impact on the clinical course of ADHD and comorbid disruptive behavioral disorders (conduct disorders and oppositional-defiant disorders). Anxiety sensitivity (AS) is a different concept from anxiety per se and it is believed to represent the constitutionally based sensitivity of individuals to anxiety and anxiety symptoms. We aimed to assess the associations between anxiety, AS and symptoms of disruptive behavioral disorders (DBD) in a clinical sample of children and adolescents with ADHD. The sample consisted of 274 treatment naive children with ADHD aged 8-17 years. The severity of ADHD symptoms and comorbid DBD were assessed via parent rated Turgay DSM-IV-Based Child and Adolescent Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S), Conners' Parent Rating Scale (CPRS), and Conners' Teacher Rating Scale (CTRS). AS and severity of anxiety symptoms of children were evaluated by self-report inventories. The association between anxiety, AS, and DBD was evaluated using structural equation modeling. Analyses revealed that AS social subscale scores negatively predicted symptoms of conduct disorder (CD) reported in T-DSM-IV-S. On the other hand, CD symptoms positively predicted severity of anxiety. No direct relationships were detected between anxiety, AS and oppositional-defiant behavior scores in any scales. These results may suggest a protective effect of AS social area on the development of conduct disorder in the presence of a diagnosis of ADHD, while the presence of symptoms of CD may be a vulnerability factor for the development of anxiety symptoms in children and adolescents with ADHD. PMID:23460041

  8. Peer victimization among children and adolescents with anxiety disorders.

    PubMed

    Cohen, Jeremy S; Kendall, Philip C

    2015-06-01

    This study examined peer victimization among a sample of youth who were seeking treatment at an outpatient anxiety disorders clinic. The study examined the association between peer victimization and internalizing symptoms and looked at whether frequent victimization was more common among youth with Social Phobia (SoP) as compared to youth with other anxiety disorders The study also examined the relation between SoP and peer victimization dimensionally. Participants were 90 youth (47 boys; M age = 11.06 years) and their parents. Results showed that peer victimization was associated with social anxiety symptoms, and relational victimization, in particular, was associated with internalizing problems among youth with anxiety disorders. Negative beliefs about the peer group accounted for some of this relation. Victimization was associated with symptomatology rather than diagnosis. Peer victimization is important to assess and consider in the treatment of anxiety disorders in youth. PMID:25008188

  9. Cognitive Coping in Anxiety-Disordered Adolescents

    ERIC Educational Resources Information Center

    Legerstee, Jeroen S.; Garnefski, Nadia; Verhulst, Frank C.; Utens, Elisabeth M. W. J.

    2011-01-01

    The present study investigated differences in cognitive coping strategies between anxiety-disordered and non-anxious adolescents. In addition, the interaction effect with gender as well as differences between specific anxiety diagnoses was examined. A clinical sample of 159 anxiety-disordered adolescents and a general community sample of 370…

  10. FAMILY ACCOMMODATION IN PEDIATRIC ANXIETY DISORDERS

    PubMed Central

    Lebowitz, Eli R.; Woolston, Joseph; Bar-Haim, Yair; Calvocoressi, Lisa; Dauser, Christine; Warnick, Erin; Scahill, Lawrence; Chakir, Adi R.; Shechner, Tomer; Hermes, Holly; Vitulano, Lawrence A.; King, Robert A.; Leckman, James F.

    2014-01-01

    Background Family accommodation has been studied in obsessive compulsive disorder using the Family Accommodation Scale (FAS) and predicts greater symptom severity, more impairment, and poorer treatment outcomes. However, family accommodation has yet to be systematically studied among families of children with other anxiety disorders. We developed the Family Accommodation Scale—Anxiety (FASA) that includes modified questions from the FAS to study accommodation across childhood anxiety disorders. The objectives of this study were to report on the first study of family accommodation across childhood anxiety disorders and to test the utility of the FASA for assessing the phenomenon. Methods Participants were parents (n = 75) of anxious children from two anxiety disorder specialty clinics (n = 50) and a general outpatient clinic (n = 25). Measures included FASA, structured diagnostic interviews, and measures of anxiety and depression. Results Accommodation was highly prevalent across all anxiety disorders and particularly associated with separation anxiety. Most parents reported participation in symptoms and modification of family routines as well as distress resulting from accommodation and undesirable consequences of not accommodating. The FASA displayed good internal consistency and convergent and divergent validity. Accommodation correlated significantly with anxious but not depressive symptoms, when controlling for the association between anxiety and depression. Factor analysis of the FASA pointed to a two-factor solution; one relating to modifications, the other to participation in symptoms. Conclusions Accommodation is common across childhood anxiety disorders and associated with severity of anxiety symptoms. The FASA shows promise as a means of assessing family accommodation in childhood anxiety disorders. PMID:22965863

  11. 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…

  12. 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

  13. Anxiety disorders in subjects seeking treatment for eating disorders: a DSM-IV controlled study.

    PubMed

    Godart, Nathalie T; Flament, Martine F; Curt, Florence; Perdereau, Fabienne; Lang, François; Venisse, Jean Luc; Halfon, Olivier; Bizouard, Paul; Loas, Gwenolé; Corcos, Maurice; Jeammet, Philippe; Fermanian, Jacques

    2003-03-25

    Women who were referred with an eating disorder (ED) were compared with a matched normal control group to answer the following questions: What are the frequencies of anxiety disorders in cases of anorexia and bulimia nervosa diagnosed according to DSM-IV criteria? Are anxiety disorders significantly more frequent among women with an eating disorder than among women from the community? We assessed the frequencies of six specific anxiety disorders among 271 women with a current diagnosis of anorexia or bulimia nervosa and 271 controls, using the Mini-International Neuropsychiatric Interview, French DSM-IV version. A lifetime comorbidity with at least one anxiety disorder was found in 71% of both the anorexic and the bulimic subjects, significantly higher than the percentage of controls with an anxiety disorder. The prevalence was significantly higher in the eating disorder groups than in controls for most types of anxiety disorder, and between 41.8 and 53.3% of comorbid cases had an anxiety disorder preceding the onset of the eating disorder. Anxiety disorders are significantly more frequent in subjects with eating disorders than in volunteers from the community, a finding that has important etiological and therapeutic implications. PMID:12686367

  14. Your Adolescent: Anxiety and Avoidant Disorders

    MedlinePlus

    ... if the anxiety lasts over six months, seek professional advice. His doctor or teacher will be able to recommend a child and adolescent psychiatrist or other professional specializing in treating adolescents. Managing anxiety disorders - as ...

  15. Managing anxiety associated with neurodegenerative disorders

    PubMed Central

    Kumar, Anand

    2015-01-01

    Anxiety is a common symptom among patients with cognitive impairment. The presence of anxiety is correlated with poorer outcomes; despite this, there is limited research on anxiety related to neurodegenerative disorder. In this article, we discuss the prevalence of anxiety and factors involved in the etiology of anxiety in patients with diagnosed neurodegenerative disorders and related states of cognitive impairment as well as the evidence for currently available methods of evaluating and treating these symptoms. Specific treatments are highlighted in light of current evidence, followed by a discussion of the difficulties inherent in the study and treatment of anxiety in this population. PMID:25705388

  16. Sleep Quality Improvement During Cognitive Behavioral Therapy for Anxiety Disorders.

    PubMed

    Ramsawh, Holly J; Bomyea, Jessica; Stein, Murray B; Cissell, Shadha H; Lang, Ariel J

    2016-01-01

    Despite the ubiquity of sleep complaints among individuals with anxiety disorders, few prior studies have examined whether sleep quality improves during anxiety treatment. The current study examined pre- to posttreatment sleep quality improvement during cognitive behavioral therapy (CBT) for panic disorder (PD; [Formula: see text]) or generalized anxiety disorder (GAD; [Formula: see text]). Among sleep quality indices, only global sleep quality and sleep latency improved significantly (but modestly) during CBT. Sleep quality improvement was greater for treatment responders, but did not vary by diagnosis. Additionally, poor baseline sleep quality was independently associated with worse anxiety treatment outcome, as measured by higher intolerance of uncertainty. Additional intervention targeting sleep prior to or during CBT for anxiety may be beneficial for poor sleepers. PMID:26244485

  17. The epidemiology of anxiety disorders: a review

    PubMed Central

    Martin, Patrick

    2003-01-01

    Epidemiological studies show that anxiety disorders are highly prevalent and an important cause of functional impairment; they constitute the most frequent menial disorders in the community. Phobias are the most common with the highest rates for simple phobia and agoraphobia. Panic disorder (PD) and obsessive-compulsive disorder (OCD) are less frequent (2% lifetime prevalence), and there are discordant results for social phobia (SP) (2%-16%) and generalized anxiety disorder (GAD) (3%-30%). These studies underline the importance of an accurate definition of disorders using unambiguous diagnostic and assessment criteria. The boundaries between anxiety disorders are often ill defined and cases may vary widely according to the definition applied. Simple phobia, agoraphobia, and GAD are more common in vmrnen, while there is no gender différence for SP, PD, and OCD, Anxiety disorders are more common in separated, divorced, and widowed subjects; their prevalence is highest in subjects aged 25 to 44 years and lowest in subjects aged >65 years. The age of onset of the different types of anxiety disorders varies widely: phobic disorders begin early in life, whereas PD occurs in young adulthood. Clinical - rather than epidemiological - studies have examined risk factors such as life events, childhood experiences, and familial factors. Anxiety disorders have a chronic and persistent course, and are frequently comorbid with other anxiety disorders, depressive disorders, and substance abuse. Anxiety disorders most frequently precede depressive disorders or substance abuse, Comorbid diagnoses may influence risk factors like functional impairment and quality of life. It remains unclear whether certain anxiety disorders (eg, PD) are risk factors for suicide. The comorbidity of anxiety disorders has important implications for assessment and treatment and the risk factors should be explored. The etiology, natural history, and outcome of these disorders need to be further addressed in epidemiological studies. PMID:22034470

  18. Behavioural approaches to anxiety disorders.

    PubMed Central

    Drummond, L. M.

    1993-01-01

    Powerful behavioural treatments for many patients with anxiety disorders have been widely available since the 1970s. Despite this, the majority of such patients have continued to be treated with psychotrophic drugs. Recent litigation against the manufacturers of benzodiazepine drugs has made the public increasingly concerned about the prescription of anxiolytic agents. In parallel with the fall in popularity of drug treatment, advances have been made which increase the availability and applicability of behavioural treatments for these patients. This paper examines the impact of the development of self-exposure and cognitive methods on a number of common anxiety syndromes. Clinical examples of self-exposure are given to demonstrate the simplicity of the technique. PMID:8497438

  19. Anxiety disorders in people with epilepsy.

    PubMed

    Brandt, Christian; Mula, Marco

    2016-06-01

    Anxiety disorders are frequent, though probably underdiagnosed, comorbidities in epilepsy. Epilepsy and anxiety may share common neurobiological correlates as shown in animal models and suggested by studies demonstrating anxiety disorders before the manifestation of epilepsy. Comorbid anxiety disorders have a major impact on the affected patients' quality of life and may increase the risk for suicidality. Successful treatment of the epilepsy may alleviate anxiety symptoms. Treatment of anxiety is based on selective serotonin reuptake inhibitors, benzodiazepines (although only as second-line choices), and psychotherapy. Specific AEDs (especially pregabalin) have been shown to have anxiolytic properties. This paper is aimed at reviewing anxiety disorders in patients with epilepsy discussing current scientific evidence about pathophysiology, clinical aspects, and treatment strategies. PMID:27116536

  20. [Emotion Regulation and Emotional Vulnerability in Adolescents with Anxiety Disorders].

    PubMed

    Zimmermann, Peter; Iwanski, Alexandra; elik, Fatma

    2015-01-01

    From an attachment perspective, insecure attachment patterns in both infancy and adolescence are risk factors for the development of anxiety disorders in adolescence. Dysfunctional emotion regulation and biased social information processing are possible mediating processes. This study examines differences in emotion regulation, emotional vulnerability, and behaviour inhibition in adolescents with clinical diagnosis of anxiety disorder and healthy controls. Adolescents with anxiety disorder reported more maladaptive emotion regulation depending on the specific emotion and a higher incidence of reporting hurt feelings in social interactions. In contrast, behaviour inhibition did not explain additional variance. The results suggest that adolescents with anxiety disorders show a bias in the interpretation of social interactions as frequently emotionally hurting, and the use of dysfunctional emotion regulation strategies that minimize the possibility for effective social emotion regulation by close others or therapists. The results are interpreted within attachment framework. PMID:26562084

  1. Peer Perceptions and Liking of Children with Anxiety Disorders

    ERIC Educational Resources Information Center

    Verduin, Timothy L.; Kendall, Philip C.

    2008-01-01

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

  2. Peer Perceptions and Liking of Children with Anxiety Disorders

    ERIC Educational Resources Information Center

    Verduin, Timothy L.; Kendall, Philip C.

    2008-01-01

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

  3. Do Co-morbid Anxiety Disorders Predict Drinking Outcomes in Women with Alcohol Use Disorders?

    PubMed Central

    Farris, Samantha G.; Epstein, Elizabeth E.; McCrady, Barbara S.; Hunter-Reel, Dorian

    2012-01-01

    Aims: It is unclear whether co-morbid anxiety disorders predict worse drinking outcomes during attempts to change drinking behavior. Studies have yielded mixed results, and have rarely examined drinking outcomes based on a specific type of anxiety disorder. Women with alcohol use disorders (AUDs) are of particular interest as they are at risk for co-morbid anxiety [Kessler et al. (1997) Lifetime co-occurrence of DSM-III-R alcohol abuse and dependence with other psychiatric disorders in the national co-morbidity survey. Arch Gen Psychiat 54:313–21]. Methods: Participants were 260 women with AUDs participating in an alcohol-treatment outcome studies. The Timeline Follow-Back was used to assess drinking frequency (percent days drinking)  prior, within and 6 months post-treatment. The current study tested the hypothesis that having at least one lifetime anxiety disorder diagnosed at baseline using the Structured Clinical Interview for DSM Disorders would be associated with more drinking at all study time points. Exploratory analyses examined patterns of drinking outcomes by specific anxiety diagnoses. Results: Lifetime anxiety diagnosis was linked to poorer drinking outcomes post-treatment (β = 0.15, P = 0.020), despite less frequent drinking prior to treatment. Analyses by specific anxiety diagnosis indicated that generalized anxiety disorder predicted poorer drinking outcomes within treatment (β = 0.14, P = 0.018) and during follow-up (β = 0.16, P = 0.014). Conclusion: Co-morbid anxiety problems complicate treatment for AUDs among women. Further, specific anxiety disorders should be evaluated as distinct constructs as evidenced by the differential outcomes related to generalized anxiety disorder. Implications for treatment development for women with AUDs are discussed. PMID:22215000

  4. Anxiety

    MedlinePlus

    ... Facts & Information What is anxiety and what are anxiety disorders? Sometimes a little anxiety can be a good ... or gets worse over time is considered an anxiety disorder. As many as 14% of older adults have ...

  5. Perinatal Generalized Anxiety Disorder: Assessment and Treatment.

    PubMed

    Misri, Shaila; Abizadeh, Jasmin; Sanders, Shawn; Swift, Elena

    2015-09-01

    Perinatal generalized anxiety disorder (GAD) has a high prevalence of 8.5%-10.5% during pregnancy and 4.4%-10.8% postpartum. Despite its attendant dysfunction in the patient, this potentially debilitating mental health condition is often underdiagnosed. This overview will provide guidance for clinicians in making timely diagnosis and managing symptoms appropriately. A significant barrier to the diagnosis of GAD in the perinatal population is difficulty in distinguishing normal versus pathological worry. Because a perinatal-specific screening tool for GAD is nonexistent, early identification, diagnosis and treatment is often compromised. The resultant maternal dysfunction can potentially impact mother-infant bonding and influence neurodevelopmental outcomes in the children. Comorbid occurrence of GAD and major depressive disorder changes the illness course and its treatment outcome. Psychoeducation is a key component in overcoming denial/stigma and facilitating successful intervention. Treatment strategies are contingent upon illness severity. Cognitive behavior therapy (CBT), relaxation, and mindfulness therapy are indicated for mild GAD. Moderate/severe illness requires pharmacotherapy and CBT, individually or in combination. No psychotropic medications are approved by the FDA or Health Canada in pregnancy or the postpartum; off-label pharmacological treatment is instituted only if the benefit of therapy outweighs its risk. SSRIs/SNRIs are the first-line treatment for anxiety disorders due to data supporting their efficacy and overall favorable side effect profile. Benzodiazepines are an option for short-term treatment. While research on atypical antipsychotics is evolving, some can be considered for severe manifestations where the response to antidepressants or benzodiazepines has been insufficient. A case example will illustrate the onset, clinical course, and treatment strategies of GAD through pregnancy and the postpartum. PMID:26125602

  6. Autonomic arousal in childhood anxiety disorders: Associations with state anxiety and social anxiety disorder

    PubMed Central

    Alkozei, Anna; Creswell, Cathy; Cooper, Peter J.; Allen, John J.B.

    2015-01-01

    Background Psychophysiological theories suggest that individuals with anxiety disorders may evidence inflexibility in their autonomic activity at rest and when responding to stressors. In addition, theories of social anxiety disorder, in particular, highlight the importance of physical symptoms. Research on autonomic activity in childhood (social) anxiety disorders, however, is scarce and has produced inconsistent findings, possibly because of methodological limitations. Method The present study aimed to account for limitations of previous studies and measured respiratory sinus arrhythmia (RSA) and heart rate (HR) using Actiheart heart rate monitors and software (Version 4) during rest and in response to a social and a non-social stressor in 60 anxious (30 socially anxious and 30 ‘other’ anxious), and 30 nonanxious sex-and age-matched 7–12 year olds. In addition, the effect of state anxiety during the tasks was explored. Results No group differences at rest or in response to stress were found. Importantly, however, with increases in state anxiety, all children, regardless of their anxiety diagnoses showed less autonomic responding (i.e., less change in HR and RSA from baseline in response to task) and took longer to recover once the stressor had passed. Limitations This study focused primarily on parasympathetic arousal and lacked measures of sympathetic arousal. Conclusion The findings suggest that childhood anxiety disorders may not be characterized by inflexible autonomic responding, and that previous findings to the contrary may have been the result of differences in subjective anxiety between anxious and nonanxious groups during the tasks, rather than a function of chronic autonomic dysregulation. PMID:25590763

  7. 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,…

  8. 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,

  9. Generalized Anxiety Disorder (GAD): When Worry Gets Out of Control

    MedlinePlus

    ... to have GAD? For More Information Share Generalized Anxiety Disorder (GAD): When Worry Gets Out of Control Download ... go badly? If so, you may have an anxiety disorder called generalized anxiety disorder (GAD). What is GAD? ...

  10. Generalized Anxiety Disorder (GAD): When Worry Gets Out of Control

    MedlinePlus

    Generalized Anxiety Disorder: When Worry Gets Out of Control Are you extremely worried about everything in your life, even if ... go badly? If so, you may have an anxiety disorder called generalized anxiety disorder (GAD). national institute of ...

  11. Autism Spectrum Disorder Scale Scores in Pediatric Mood and Anxiety Disorders

    PubMed Central

    PINE, DANIEL S.; GUYER, AMANDA E.; GOLDWIN, MICHELLE; TOWBIN, KENNETH A.; LEIBENLUFT, ELLEN

    2009-01-01

    Objective To compare scores on autism spectrum disorder (ASD) symptom scales in healthy youths and youths with mood or anxiety disorders. Method A total of 352 youths were recruited (107 healthy participants, 88 with an anxiety disorder, 32 with major depressive disorder, 62 with bipolar disorder, and 63 with a mood disorder characterized by severe nonepisodic irritability). Participants received structured psychiatric interviews and parent ratings on at least one of three ASD symptom scales: Children’s Communication Checklist, Social Communication Questionnaire, and Social Responsiveness Scale. Results Relative to healthy youths, youths with mood or anxiety disorders exhibited higher scores on each ASD symptom scale. ASD symptom scale scores also showed an association with impairment severity and attention-deficit/hyperactivity disorder. Among patients with mood disorders but not those with anxiety disorders, consistent, statistically significant associations between diagnosis and ASD symptom scale scores remained even after controlling for potential confounders. Conclusions Patients with mood disorders exhibit higher scores on ASD symptom scales than healthy youths or youths with anxiety disorders. These data should alert clinicians to the importance of assessing ASD symptoms to identify social reciprocity and communication deficits as possible treatment targets in pediatric mood and anxiety disorders. PMID:18434923

  12. Discriminant and Convergent Validity of the Anxiety Construct in Children with Autism Spectrum Disorders

    PubMed Central

    Renno, Patricia; Wood, Jeffrey J.

    2013-01-01

    Despite reports of high anxiety in children with autism spectrum disorders (ASD), there is controversy regarding differential diagnosis of ASD symptoms and anxiety symptoms. This study examined 88 children, aged 7–11 years, with ASD referred for concerns about anxiety. A multitrait-(social anxiety, separation anxiety, overall anxiety severity, and overall ASD severity), multimethod- (diagnostic interviews, parent-, and child-based measures) analysis was conducted. Results from structural equation modeling suggest statistical discrimination between anxiety and ASD severity and convergence among differing reports of two of the anxiety subdomains (separation anxiety and overall anxiety). These findings suggest that anxiety symptoms experienced by children with ASD are separate from ASD symptom severity and may instead reflect anxiety syndromes (e.g., separation anxiety) similar to those that occur in typically developing children. PMID:23354538

  13. Common and disorder-specific neural responses to emotional faces in generalised anxiety, social anxiety and panic disorders

    PubMed Central

    Fonzo, Gregory A.; Ramsawh, Holly J.; Flagan, Taru M.; Sullivan, Sarah G.; Letamendi, Andrea; Simmons, Alan N.; Paulus, Martin P.; Stein, Murray B.

    2015-01-01

    Background Although evidence exists for abnormal brain function across various anxiety disorders, direct comparison of neural function across diagnoses is needed to elicit abnormalities common across disorders and those distinct to a particular diagnosis. Aims To delineate common and distinct abnormalities within generalised anxiety (GAD), panic and social anxiety disorder (SAD) during affective processing. Method Fifty-nine adults (15 with GAD, 15 with panic disorder, 14 with SAD, and 15 healthy controls) underwent functional magnetic resonance imaging while completing a facial emotion matching task with fearful, angry and happy faces. Results Greater differential right amygdala activation to matching fearful v. happy facial expressions related to greater negative affectivity (i.e. trait anxiety) and was heightened across all anxiety disorder groups compared with controls. Collapsing across emotional face types, participants with panic disorder uniquely displayed greater posterior insula activation. Conclusions These preliminary results highlight a common neural basis for clinical anxiety in these diagnoses and also suggest the presence of disorder-specific dysfunction. PMID:25573399

  14. 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.

  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. 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

  17. 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

  18. 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

  19. Anxiety

    MedlinePlus

    ... be afraid to leave home. These people have anxiety disorders. Types include Panic disorder Obsessive-compulsive disorder Post-traumatic stress disorder Phobias Generalized anxiety disorder Treatment can involve medicines, therapy or both. NIH: ...

  20. Overview and clinical presentation of generalized anxiety disorder.

    PubMed

    Rickels, K; Rynn, M

    2001-03-01

    1. To distinguish GAD from panic disorder is not difficult if a patient has frequent, spontaneous panic attacks and agoraphobic symptoms, but many patients with GAD have occasional anxiety attacks or panic attacks. Such patients should be considered as having GAD. An even closer overlap probably exists between GAD and social phobia. Patients with clear-cut phobic avoidant behavior may be distinguished easily from patients with GAD, but patients with social anxiety without clear-cut phobic avoidant behavior may overlap with patients with GAD and possibly should be diagnosed as having GAD and not social phobia. The cardinal symptoms of GAD commonly overlap with those of social phobia, particularly if the social phobia is more general and not focused on a phobic situation. For example, free-floating anxiety may cause the hands to perspire and may cause a person to be shy in dealing with people in public, and thus many patients with subthreshold social phobic symptoms have, in the authors' opinion, GAD and not generalized social phobia. The distinction between GAD and obsessive-compulsive disorder, acute stress disorder, and posttraumatic stress disorder should not be difficult by definition. At times, however, it may be difficult to distinguish between adjustment disorder with anxious mood from GAD or anxiety not otherwise specified, particularly if the adjustment disorder occurs in a patient with a high level of neuroticism or trait anxiety or type C personality disorder. Table 2 presents features distinguishing GAD from other psychiatric disorders. 2. Lifetime comorbid diagnoses of other anxiety or depression disorders, not active for 1 year or more and not necessitating treatment during that time period, should not effect a diagnosis of current GAD. On the other hand, if concomitant depressive symptoms are present and if these are subthreshold, a diagnosis of GAD should be made, and if these are full threshold, a diagnosis of MDD should be made. 3. If GAD is primary and if no such current comorbid diagnosis, such as other anxiety disorders or MDD, is present, except for minor depression and dysthymia, or if only subthreshold symptoms of other anxiety disorders are present, GAD should be considered primary and treated as GAD; however, patients with concurrent threshold anxiety or mood disorders should be diagnosed according to the definitions of these disorders in the DSM-IV and ICD-10 and treated as such. 4. Somatization disorders are now classified separately from anxiety disorders. Some of these, particularly undifferentiated somatization disorder, may overlap with GAD and be diagnostically difficult to distinguish. The authors believe that, as long as psychic symptoms of anxiety are present and predominant, patients should be given a primary diagnosis of GAD. 5. Two major shifts in the DSM diagnostic criteria for GAD have markedly redefined the definition of this disorder. One shift involves the duration criterion from 1 to 6 months, and the other, the increased emphasis on worry and secondary psychic [table: see text] symptoms accompanied by the elimination of most somatic symptoms. This decision has had the consequence of orphaning a large population of patients suffering from GAD that is more transient and somatic in its focus and who typically present not to psychiatrists but to primary care physicians. Therefore, clinicians should consider using the ICD-10 qualification of illness duration of "several months" to replace the more rigid DSM-IV criterion of 6 months and to move away from the DSM-IV focus on excessive worry as the cardinal symptom of anxiety and demote it to only another important anxiety symptom, similar to free-floating anxiety. One also might consider supplementing this ICD-10 criterion with an increased symptom severity criterion as, for example, a Hamilton Anxiety Scale of 18. Finally, the adjective excessive, not used in the definition of other primary diagnostic criteria, such as depressed mood for MDD, should be omitted (Table 3). 6. One may want to consider the distinction of trait (chronic) from state (acute) anxiety, but whether the presence of some personality characteristics, particularly anxious personality or Cluster C personality and increased neuroticism, as an indicator of trait [table: see text] anxiety is a prerequisite for anxiety disorders; occurs independently of anxiety disorders; or is a vulnerability factor that, in some patients, leads to anxiety symptoms and, in others, does not, is unknown. 7. Symptoms that some clinicians consider cardinal for a diagnosis of GAD, such as extreme worry, obsessive rumination, and somatization, also are present in other disorders, such as MDD. (ABSTRACT TRUNCATED) PMID:11225502

  1. Auditory evoked potentials in anxiety disorder.

    PubMed

    Drake, M E; Pakalnis, A; Phillips, B; Padamadan, H; Hietter, S A

    1991-04-01

    The pathophysiology of anxiety has received much recent attention. EEG findings in anxiety are nonspecific, and some changes in psychophysiological measures have been reported. We recorded short-latency brainstem auditory evoked potentials (BAEPs) and long-latency auditory event-related potentials (AEPs) in 12 patients with generalized anxiety disorder. All 12 patients had BAEP latencies within clinical norms, but I-V interpeak latencies were significantly longer in patients with anxiety than controls. N1, N2, P2, and P3 AEP components were within normal limits; N1 and P2 were reduced in amplitude in anxiety patients, but differences from controls were not significant. The BAEP findings may suggest altered brain-stem function in anxiety, which has been implied by biochemical studies of anxiety and depression. AEP differences may be related to difficulties in concentration and attention direction reported by anxious patients. PMID:2032349

  2. Perceived Family Impact of Preschool Anxiety Disorders

    PubMed Central

    Towe-Goodman, Nissa R.; Franz, Lauren; Copeland, William; Angold, Adrian; Egger, Helen

    2014-01-01

    Objective We examined the perceived impact of child anxiety disorders on family functioning, because such impact is a key predictor of mental health service receipt. Additionally, we examined the relative impact of preschool anxiety compared to other early childhood disorders, and whether this impact persisted after accounting for the effects of comorbidity, or varied by child age and sex. Method Drawing from a pediatric primary-care clinic and oversampling for children at risk for anxiety, 917 parents of preschoolers (ages 2–5 years) completed a diagnostic interview and reported on child psychiatric symptom impact on family finances, relationships, activities, and well-being. Results After accounting for comorbid disorders, families of children with anxiety were 3.5 times more likely to report negative impact of their child’s behavior on the family relative to non-disordered children. Generalized and separation anxiety had a similar impact on family functioning as ADHD and disruptive disorders. There was a significant family impact for girls with social phobia, whereas there was no impact for boys. Conclusions Preschool anxiety has a significant, unique impact on family functioning, particularly parental adjustment, highlighting the family impairment linked with early anxiety, and the need for further research on barriers to care for these disorders. PMID:24655653

  3. Treating Anxiety Disorders | NIH MedlinePlus the Magazine

    MedlinePlus

    ... of this page please turn Javascript on. Feature: Phobias and Anxiety Disorders Treating Anxiety Disorders Past Issues / ... such as worry, they're most helpful for phobias, particularly social phobia and performance anxiety. Commonly prescribed: ...

  4. [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

  5. Epidemiology of anxiety disorders in the 21st century

    PubMed Central

    Bandelow, Borwin; Michaelis, Sophie

    2015-01-01

    Anxiety disorders, including panic disorder with or without agoraphobia, generalized anxiety disorder, social anxiety disorder, specific phobias, and separation anxiety disorder, are the most prevalent mental disorders and are associated with immense health care costs and a high burden of disease. According to large population-based surveys, up to 33.7% of the population are affected by an anxiety disorder during their lifetime. Substantial underrecognition and undertreatment of these disorders have been demonstrated. There is no evidence that the prevalence rates of anxiety disorders have changed in the past years. In cross-cultural comparisons, prevalence rates are highly variable. It is more likely that this heterogeneity is due to differences in methodology than to cultural influences. Anxiety disorders follow a chronic course; however, there is a natural decrease in prevalence rates with older age. Anxiety disorders are highly comorbid with other anxiety disorders and other mental disorders. PMID:26487813

  6. Epidemiology of anxiety disorders in the 21st century.

    PubMed

    Bandelow, Borwin; Michaelis, Sophie

    2015-09-01

    Anxiety disorders, including panic disorder with or without agoraphobia, generalized anxiety disorder, social anxiety disorder, specific phobias, and separation anxiety disorder, are the most prevalent mental disorders and are associated with immense health care costs and a high burden of disease. According to large population-based surveys, up to 33.7% of the population are affected by an anxiety disorder during their lifetime. Substantial underrecognition and undertreatment of these disorders have been demonstrated. There is no evidence that the prevalence rates of anxiety disorders have changed in the past years. In cross-cultural comparisons, prevalence rates are highly variable. It is more likely that this heterogeneity is due to differences in methodology than to cultural influences. Anxiety disorders follow a chronic course; however, there is a natural decrease in prevalence rates with older age. Anxiety disorders are highly comorbid with other anxiety disorders and other mental disorders. PMID:26487813

  7. Comorbid Social Anxiety Disorder in Adults with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Maddox, Brenna B.; White, Susan W.

    2015-01-01

    Social anxiety symptoms are common among cognitively unimpaired youth with autism spectrum disorder (ASD). Few studies have investigated the co-occurrence of social anxiety disorder (SAD) in adults with ASD, although identification may aid access to effective treatments and inform our scientific efforts to parse heterogeneity. In this preliminary…

  8. Comorbid Social Anxiety Disorder in Adults with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Maddox, Brenna B.; White, Susan W.

    2015-01-01

    Social anxiety symptoms are common among cognitively unimpaired youth with autism spectrum disorder (ASD). Few studies have investigated the co-occurrence of social anxiety disorder (SAD) in adults with ASD, although identification may aid access to effective treatments and inform our scientific efforts to parse heterogeneity. In this preliminary

  9. Objective Sleep in Pediatric Anxiety Disorders and Major Depressive Disorder

    ERIC Educational Resources Information Center

    Forbes, Erika E.; Bertocci, Michele A.; Gregory, Alice M.; Ryan, Neal D.; Axelson, David A.; Birmaher, Boris; Dahl, Ronald E.

    2008-01-01

    A study to examine sleep problems encountered in anxiety and depressive disorders among children and adolescents is conducted. Results indicated subjective and objective sleep problems in children and adolescents with anxiety disorders and need to be kept in mind when treating young anxious people.

  10. Resistant social anxiety disorder response to Escitalopram

    PubMed Central

    2006-01-01

    Background Social Anxiety Disorder (SAD) is a common disorder and its high prevalence and lifelong chronicity are such that it represents a substantial public health problem. The observation that serotonergic agents appear to be effective for its treatment suggests that patients may have abnormal serotonergic neurotransmission within the central nervous system. We investigated the efficacy of Escitalopram in treatment resistant patients with SAD. Method Twenty-nine adult outpatients participated in a 12-week open-label trial of escitalopram. All the subjects had a primary diagnosis of SAD and had failed at least one previous adequate trial of paroxetine. Escitalopram was orally administered starting with a dose of 10 mg/day following a 1-week titration. Results The escitalopram treatment was characterized by good tolerability (drop-out rate due to intolerance: 10.3%), and 24 subjects completed the study trial. At the end of the 12-week treatment period, 14 subjects (48.3%) were considered as responders on the basis of the Clinical Global Impression-Improvement (CGI-I) (much or very much improved) scale and the Liebowitz Scale for Social Anxiety (LSAS) (reduction >35% compared to baseline). We observed a significant mean reduction in the Sheehan Disability Scale Work (p < .05) and Social (p < .05) subscores, but not in the Family subscore. Conclusion These data suggest escitalopram has a role in the treatment of resistant SAD, especially in view of the favourable tolerability profile observed in the patients. Controlled studies are required to further investigate these findings and to compare escitalopram with other treatments for this disorder. PMID:17166264

  11. Physical activity, exercise, depression and anxiety disorders.

    PubMed

    Ströhle, Andreas

    2009-06-01

    There is a general belief that physical activity and exercise have positive effects on mood and anxiety and a great number of studies describe an association of physical activity and general well-being, mood and anxiety. In line, intervention studies describe an anxiolytic and antidepressive activity of exercise in healthy subjects and patients. However, the majority of published studies have substantial methodological shortcomings. The aim of this paper is to critically review the currently available literature with respect to (1) the association of physical activity, exercise and the prevalence and incidence of depression and anxiety disorders and (2) the potential therapeutic activity of exercise training in patients with depression or anxiety disorders. Although the association of physical activity and the prevalence of mental disorders, including depression and anxiety disorders have been repeatedly described, only few studies examined the association of physical activity and mental disorders prospectively. Reduced incidence rates of depression and (some) anxiety disorders in exercising subjects raise the question whether exercise may be used in the prevention of some mental disorders. Besides case series and small uncontrolled studies, recent well controlled studies suggest that exercise training may be clinically effective, at least in major depression and panic disorder. Although, the evidence for positive effects of exercise and exercise training on depression and anxiety is growing, the clinical use, at least as an adjunct to established treatment approaches like psychotherapy or pharmacotherapy, is still at the beginning. Further studies on the clinical effects of exercise, interaction with standard treatment approaches and details on the optimal type, intensity, frequency and duration may further support the clinical administration in patients. Furthermore, there is a lack of knowledge on how to best deal with depression and anxiety related symptoms which hinder patients to participate and benefit from exercise training. PMID:18726137

  12. Primary care perspectives on generalized anxiety disorder.

    PubMed

    Roy-Byrne, Peter P; Wagner, Amy

    2004-01-01

    Recently, there has been increased interest in the impact and treatment of anxiety disorders. However, one type of anxiety disorder, generalized anxiety disorder (GAD), has received less attention than other disorders, such as panic disorder, despite the prevalence and amenability of this disorder to treatment in the primary care setting. Rates of GAD have been found to be between 2.8% and 8.5%, with a median prevalence of 5.8%-at least twice the rate reported in the National Comorbidity Survey. Up to one third of patients presenting to primary care clinics with somatic complaints had a mood or anxiety disorder. Generalized anxiety disorder is linked to the overuse of medical services: emergency department visits, hospitalizations, diagnostic and laboratory tests, pharmacy costs, and so on. Recognition of anxiety and depression in primary care is poor, with only 23% of pure anxiety cases being recognized compared with 56% of depression cases. The various stakeholders (patients, family members, employers, and insurers) in a patient's outcome often complicate treatment of anxiety. Barriers to effective treatment include time constraints, acute disease orientation of most care systems, lack of planned follow-up and monitoring, and relative unavailability of specialist access. The collaborative care approach is designed to overcome these barriers. With this approach, the patient is provided with additional educational materials, physicians are supported by physician extenders (nurses, social workers, or expert consultants) who provide case-based feedback, follow-up, extra visits, and telephone calls to patients. Providing efficacious treatment to primary care for GAD will require improving knowledge of providers and increasing patient engagement. PMID:15384933

  13. [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

  14. 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…

  15. Stable Early Maternal Report of Behavioral Inhibition Predicts Lifetime Social Anxiety Disorder in Adolescence

    ERIC Educational Resources Information Center

    Chronis-Tuscano, Andrea; Degnan, Kathryn Amey; Pine, Daniel S.; Perez-Edgar, Koraly; Henderson, Heather A.; Diaz, Yamalis; Raggi, Veronica L.; Fox, Nathan A.

    2009-01-01

    The odds of a lifetime diagnosis of social anxiety disorder increased by 3.79 times for children who had a stable report of behavioral inhibition from their mothers. This finding has important implications for the early identification and prevention of social anxiety disorder.

  16. Insomnia Symptoms Following Treatment for Comorbid Panic Disorder With Agoraphobia and Generalized Anxiety Disorder.

    PubMed

    Cousineau, Héloïse; Marchand, André; Bouchard, Stéphane; Bélanger, Claude; Gosselin, Patrick; Langlois, Frédéric; Labrecque, Joane; Dugas, Michel J; Belleville, Geneviève

    2016-04-01

    Patients with panic disorder with agoraphobia (PDA) or generalized anxiety disorder (GAD) frequently also suffer from insomnia. However, the impact of cognitive-behavioral therapy (CBT) for anxiety disorders on insomnia has been understudied. Furthermore, comorbidity between anxiety disorders is common. Our main objective was to assess the impact of CBT for PDA or GAD on insomnia. In a quasi-experimental design, 86 participants with PDA and GAD received conventional CBT for their primary disorder or combined CBT for both disorders. Overall, CBTs had a significant impact on reducing insomnia symptoms (η = 0.58). However, among people with insomnia at pretest (67%), 33% still had an insomnia diagnosis, and the majority (63%) had clinically significant residual insomnia following treatment. In conclusion, the CBTs had a positive effect on the reduction of insomnia, but a significant proportion of participants still had insomnia problems following treatment. Clinicians should address insomnia during CBT for PDA and GAD. PMID:27019339

  17. Anxiety sensitivity and treatment outcome in panic disorder.

    PubMed

    Hazen, A L; Walker, J R; Eldridge, G D

    1996-01-01

    The purpose of this study was to examine the relationship between change in anxiety sensitivity, as measured by the Anxiety Sensitivity Index (ASI), and treatment outcome in a sample of 106 subjects with a DSM-III-R diagnosis of panic disorder (with or without agoraphobia) who were participants in an evaluation study of cognitive-behavioral treatment. Results revealed that subjects who received active treatment had significantly lower anxiety sensitivity scores at post-treatment than the wait-list control group. We also examined change in anxiety sensitivity from pre- to post-treatment in reference to Clinical Global Improvement (CGI) ratings and with the effect size statistic. Subjects who showed improvement based on CGI ratings also demonstrated a reduction in anxiety sensitivity. Furthermore, the effect sizes obtained with the ASI were greater in magnitude than those obtained with other widely used anxiety self-report measures. Taken together, the finds supported the use of the Anxiety Sensitivity Index as a treatment outcome measure in panic disorder research. PMID:9160597

  18. 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

  19. [Psychoanalytic treatment for patients with anxiety disorder].

    PubMed

    Kawatani, Daiji

    2012-01-01

    Anxiety disorder commonly coexists with personality disorder and emotional disorder, which makes it difficult to prioritize thetreatment process. However, in psychoanalysis, we have developed our institution starting from studying "anxiety" towards human understanding. This approach enables us to account "anxiety" as one of the symptoms, which enables us to avoid the difficulty. In our country, the health insurance system does not allow psychoanalysis treatment beyond 4 sessions of 50 minutes therapy per week. This indicates that there is a need to amend the health insurance system. I will present a study of psychoanalysis treatment within the current insurance standards, one 50 minutes session per week to a patient with panic disorder and obsessive-compulsive disorder, followed by a study of insurance bound shortterm sessions of an outpatient psychodynamic psychotherapy treatment (psychoanalysis under the current heath insurance system). PMID:23198597

  20. 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

  1. Cross-cultural aspects of anxiety disorders.

    PubMed

    Hofmann, Stefan G; Hinton, Devon E

    2014-06-01

    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

  2. Interpretation and Expectations Among Mothers of Children with Anxiety Disorders: Associations With Maternal Anxiety Disorder

    PubMed Central

    Orchard, Faith; Cooper, Peter J; Creswell, Cathy

    2015-01-01

    Background Models of the development and maintenance of childhood anxiety suggest an important role for parent cognitions: that is, negative expectations of children's coping abilities lead to parenting behaviors that maintain child anxiety. The primary aims of the current study were to (1) compare expectations of child vulnerability and coping among mothers of children with anxiety disorders on the basis of whether or not mothers also had a current anxiety disorder, and (2) examine the degree to which the association between maternal anxiety disorder status and child coping expectations was mediated by how mothers interpreted ambiguous material that referred to their own experience. Methods The association between interpretations of threat, negative emotion, and control was assessed using hypothetical ambiguous scenarios in a sample of 271 anxious and nonanxious mothers of 7- to 12-year-old children with an anxiety disorder. Mothers also rated their expectations when presented with real life challenge tasks. Results There was a significant association between maternal anxiety disorder status and negative expectations of child coping behaviors. Mothers’ self-referent interpretations were found to mediate this relationship. Responses to ambiguous hypothetical scenarios correlated significantly with responses to real life challenge tasks. Conclusions Treatments for childhood anxiety disorders in the context of parental anxiety disorders may benefit from the inclusion of a component to directly address parental cognitions. Some inconsistencies were found when comparing maternal expectations in response to hypothetical scenarios with real life challenges. This should be addressed in future research. PMID:25763427

  3. Characteristics of Generalized Anxiety Disorder in Patients With Dementia

    PubMed Central

    Calleo, Jessica; Kunik, Mark E.; Reid, Dana; Kraus-Schuman, Cynthia; Paukert, Amber; Regev, Tziona; Wilson, Nancy; Petersen, Nancy J.; Snow, A. Lynn; Stanley, Melinda

    2011-01-01

    Background Overlap of cognitive and anxiety symptoms (i.e., difficulty concentrating, fatigue, restlessness) contributes to inconsistent, complicated assessment of generalized anxiety disorder (GAD)in persons with dementia. Methods Anxious dementia patients completed a psychiatric interview, the Penn State Worry Questionnaire-Abbreviated, and the Rating for Anxiety in Dementia scale. Analyses to describe the 43 patients with and without GAD included the Wilcoxon Mann-Whitney two-sample test, Fishers exact test. Predictors of GAD diagnosis were identified using logistic regression. Results Those with GAD were more likely to be male, have less severe dementia and endorsed more worry, and anxiety compared to patients without GAD. Gender, muscle tension and fatigue differentiated those with GAD from those without GAD. Conclusions Although this study is limited by a small sample, it describes clinical characteristics of GAD in dementia, highlighting the importance of muscle tension and fatigue in recognizing GAD in persons with dementia. PMID:22062223

  4. Grey matter abnormalities in social anxiety disorder: a pilot study.

    PubMed

    Syal, Supriya; Hattingh, Coenraad J; Fouché, Jean-Paul; Spottiswoode, Bruce; Carey, Paul D; Lochner, Christine; Stein, Dan J

    2012-09-01

    While a number of studies have explored the functional neuroanatomy of social anxiety disorder (SAD), data on grey matter integrity are lacking. We conducted structural MRI scans to examine the cortical thickness of grey matter in individuals with SAD. 13 unmedicated adult patients with a primary diagnosis of generalized social anxiety disorder and 13 demographically (age, gender and education) matched healthy controls underwent 3T structural magnetic resonance imaging. Cortical thickness and subcortical volumes were estimated using an automated algorithm (Freesurfer Version 4.5). Compared to controls, social anxiety disorder patients showed significant bilateral cortical thinning in the fusiform and post central regions. Additionally, right hemisphere specific thinning was found in the frontal, temporal, parietal and insular cortices of individuals with social anxiety disorder. Although uncorrected cortical grey matter volumes were significantly lower in individuals with SAD, we did not detect volumetric differences in corrected amygdala, hippocampal or cortical grey matter volumes across study groups. Structural differences in grey matter thickness between SAD patients and controls highlight the diffuse neuroanatomical networks involved in both social anxiety and social behavior. Additional work is needed to investigate the causal mechanisms involved in such structural abnormalities in SAD. PMID:22527992

  5. Diagnosis of Seizure Disorders

    PubMed Central

    Purves, Sherrill J.

    1990-01-01

    The author addresses the diagnosis of seizure disorders by discussing clinical features of the different types of seizures, including generalized tonic-clonic, absence, myoclonic, partial complex seizures, and non-epileptic or “pseudoseizures.” She also discusses the use of appropriate laboratory tests, electroencephalography, computed tomography, magnetic resonance imaging, and positron emission tomographic scanning. The rationale of and approach to treatment of these conditions with some of the common anticonvulsant drugs (phenytoin, carbamazepine, valproic acid, phenobarbital, and primidone) is provided. PMID:21234044

  6. Separation Anxiety Disorder in Children: Disorder-Specific Responses to Experimental Separation from the Mother

    ERIC Educational Resources Information Center

    Kossowsky, Joe; Wilhelm, Frank H.; Roth, Walton T.; Schneider, Silvia

    2012-01-01

    Background: Separation anxiety disorder (SAD) is one of the most common anxiety disorders in childhood and is predictive of adult anxiety disorders, especially panic disorder. However, the disorder has seldom been studied and the attempt to distinguish SAD from other anxiety disorders with regard to psychophysiology has not been made. We expected

  7. Separation Anxiety Disorder in Children: Disorder-Specific Responses to Experimental Separation from the Mother

    ERIC Educational Resources Information Center

    Kossowsky, Joe; Wilhelm, Frank H.; Roth, Walton T.; Schneider, Silvia

    2012-01-01

    Background: Separation anxiety disorder (SAD) is one of the most common anxiety disorders in childhood and is predictive of adult anxiety disorders, especially panic disorder. However, the disorder has seldom been studied and the attempt to distinguish SAD from other anxiety disorders with regard to psychophysiology has not been made. We expected…

  8. 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…

  9. 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

  10. Clinical characteristics of high-functioning youth with autism spectrum disorder and anxiety

    PubMed Central

    Ung, Danielle; Wood, Jeffrey J; Ehrenreich-May, Jill; Arnold, Elysse B; Fuji, Cori; Renno, Patricia; Murphy, Tanya K; Lewin, Adam B; Mutch, P Jane; Storch, Eric A

    2013-01-01

    SUMMARY Aim & methods Clinical characteristics were examined in 108 high-functioning youth (children with a full IQ scale of at least 70) with an autism spectrum disorder (ASD; aged 7–15 years) who were presenting for inclusion in one of four clinical trials examining the efficacy of cognitive behavioral therapy in youth with ASD and anxiety. Results We present baseline characteristics of this cohort, including prevalence rates of anxiety and comorbid disorders, and correlates of anxiety (e.g., comorbid diagnoses, impairment, anxiety severity and mental health services received) as a function of age and ASD diagnosis in treatment-seeking youth. Primary anxiety disorders were: 41.7% (n = 45) social phobia, 25.9% (n = 28) generalized anxiety disorder, 15.7% (n = 17) separation anxiety disorder, 12.0% (n = 13) obsessive–compulsive disorder and 4.6% (n = 5) specific phobia. Overall, 91.6% of participants (n = 99) met criteria for two or more anxiety disorders. Parents reported considerable functional impairment as measured by the Columbia Impairment Scale and anxiety severity as measured by the Pediatric Anxiety Rating Scale; this did not statistically differ as a function of ASD diagnosis or age. Anxiety severity, the number of comorbid anxiety diagnoses and total comorbid diagnoses were directly associated with parent-reported child impairment. Youth with ASD and anxiety present as a heterogeneous cohort with significant impairments and complex diagnostic presentations. Conclusion These data provide information about the nature of anxiety in youth with ASD, which may foster the development of tailored treatment protocols. PMID:24179485

  11. 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

  12. 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

  13. [Anxiety, depression, panic disorder and bronchial asthma].

    PubMed

    Vashadze, Sh

    2011-11-01

    The Research purpose was studying anxiety and depression, and also the disturbing attacks in bronchial asthma (BA) patients. Research problems included: specification of prevalence of anxiety, depression, and also panic frustration of BA patients; an establishment of psychosomatic parities between anxiety, depression, panic frustration and BA. The study included the analysis of a mental condition, subjective and objective anamnestic information and medical documentation. 50 patients with BA are examined - 32 women, 18 men (average age of the patients was 38,7 2,1). In 40% of cases the anxiety and depression is revealed. Subclinical expressed anxiety and depression is observed in 15 (39%) cases. Clinically expressed anxiety and depression is observed in 25 (50%) patients. During emotional and physical activities the phenomena of hypersthenic weaknesses is revealed in 45% of patients, short-term disturbance of falling asleep in 53%, propensity to revealing of polymorphic pathological corporal sensations (cephalgia, cardialgia, abdominalgia) is found out in 85% of cases. In all observation the beginning of mental frustration concerns to the second decade of life. In intervals between panic attacks are registered anxiety of expectation (fear of development of repeated panic attacks) and nosophobia (fear of development of myocardial heart attack, a stroke etc.). In all observation the beginning of mental frustration was revealed at the second decade of life. Symptoms of type "behavioral apnea (wind)" (breath dissatisfaction, feeling short of breath, arrhythmias and respiratory regularity of cycles) developed long before the manifestation of asthma (BA) and persist in its remission. The clinical manifestation of BA is extended by signs of panic attacks. Symptoms of anxiety and recurrent panic attacks worsen duration and outcome of BA. Hence, psychological and psychopharmacological therapy for anxiety disorders in addition to standard anti-asthma therapy could be suggested as one of the affective methods for treatment of BA patients with symptoms of anxiety and depression. PMID:22201083

  14. Assessment and treatment of anxiety disorders in children and adolescents.

    PubMed

    Connolly, Sucheta D; Suarez, Liza; Sylvester, Carrie

    2011-04-01

    This article reviews the current screening and assessment tools for anxiety disorders in children and adolescents, as well as evidence-based treatment interventions for these disorders. The following anxiety disorders are discussed: separation anxiety disorder, generalized anxiety disorder, specific phobia, panic disorder, social anxiety disorder (social phobia), and selective mutism. There are several well-studied screening and assessment tools to identify childhood anxiety disorders early and differentiate the various anxiety disorders. Evaluations of baseline somatic symptoms, severity, and impairment ratings of the anxiety disorders, and collecting ratings from several sources is clinically helpful in assessment and treatment follow-up. Cognitive-behavioral therapy (CBT) has been extensively studied and has shown good efficacy in treatment of childhood anxiety disorders. A combination of CBT and medication may be required for moderate to severely impairing anxiety disorders and may improve functioning better than either intervention alone. Selective serotonin reuptake inhibitors are currently the only medications that have consistently shown efficacy in treatment of anxiety disorders in children and adolescents. Despite proven efficacy, the availability of CBT in the community is limited. Current research is focusing on early identification of anxiety disorders in community settings, increasing the availability of evidence-based interventions, and modification of interventions for specific populations. PMID:21225481

  15. Understanding Anxiety Disorders: When Panic, Fear, and Worries Overwhelm

    MedlinePlus

    ... anxiety disorder is social anxiety disorder, or social phobia. It affects both women and men equally—a ... about 15 million U.S. adults. Without treatment, social phobia can last for years or even a lifetime. ...

  16. Studying Anxiety Disorders | NIH MedlinePlus the Magazine

    MedlinePlus

    ... of this page please turn Javascript on. Feature: Phobias and Anxiety Disorders Studying Anxiety Disorders Past Issues / ... palpitations, shortness of breath, dizziness, or abdominal distress. Phobias often result in panic attacks. Post-Traumatic Stress ...

  17. 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

  18. 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…

  19. Investigation of Individual Factors Associated with Anxiety in Youth with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Dubin, Ashley H.; Lieberman-Betz, Rebecca; Michele Lease, A.

    2015-01-01

    As youth with autism spectrum disorder (ASD) are more likely to experience anxiety than youth in the general population, investigation of associated factors is important for diagnosis and treatment. The present study extended prior research by examining factors associated with caregiver-reported anxiety in 2662 youth (mean age=8.82years) with

  20. Investigation of Individual Factors Associated with Anxiety in Youth with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Dubin, Ashley H.; Lieberman-Betz, Rebecca; Michele Lease, A.

    2015-01-01

    As youth with autism spectrum disorder (ASD) are more likely to experience anxiety than youth in the general population, investigation of associated factors is important for diagnosis and treatment. The present study extended prior research by examining factors associated with caregiver-reported anxiety in 2662 youth (mean age = 8.82 years) with…

  1. Emotion Regulation in Children with Anxiety Disorders

    ERIC Educational Resources Information Center

    Suveg, Cynthia; Zeman, Janice

    2004-01-01

    This study examined emotion management skills in addition to the role of emotional intensity and self-efficacy in emotion regulation in 26 children with anxiety disorders (ADs) ages 8 to 12 years and their counterparts without any form of psychopathology. Children completed the Children's Emotion Management Scales (CEMS) and Emotion Regulation

  2. Informant Disagreement for Separation Anxiety Disorder

    ERIC Educational Resources Information Center

    Foley, Debra; Rutter, Michael; Pickles, Andrew; Angold, Adrian; Maes, Hermine; Silberg, Judy; Eaves, Lindon

    2004-01-01

    Objective: To characterize informant disagreement for separation anxiety disorder (SAD). Method: The sample comprised 2,779 8- to 17-year-old twins from a community-based registry. Children and their parents completed a personal interview about the child's psychiatric history. Parents completed a personal interview about their own psychiatric…

  3. Emotion Regulation in Children with Anxiety Disorders

    ERIC Educational Resources Information Center

    Suveg, Cynthia; Zeman, Janice

    2004-01-01

    This study examined emotion management skills in addition to the role of emotional intensity and self-efficacy in emotion regulation in 26 children with anxiety disorders (ADs) ages 8 to 12 years and their counterparts without any form of psychopathology. Children completed the Children's Emotion Management Scales (CEMS) and Emotion Regulation…

  4. Is obsessive-compulsive disorder an anxiety disorder?

    PubMed

    Bartz, Jennifer A; Hollander, Eric

    2006-05-01

    Obsessive-compulsive disorder (OCD) is classified as an anxiety disorder in the DSM-IV-TR [American Psychiatric Association, 2000. Diagnostic and statistical manual of mental disorders, Fourth ed., rev. Washington, DC: Author]; however, the notion of a spectrum of obsessive-compulsive (OC) related disorders that is comprised of such disparate disorders as OCD, body dysmorphic disorder, certain eating disorders, pathological gambling, and autism, is gaining acceptance. The fact that these disorders share obsessive-compulsive features and evidence similarities in patient characteristics, course, comorbidity, neurobiology, and treatment response raises the question of whether OCD is best conceptualized as an anxiety or an OC spectrum disorder. This article reviews evidence from comorbidity and family studies, as well as biological evidence related to neurocircuitry, neurotransmitter function, and pharmacologic treatment response that bear on this question. The implications of removing OCD from the anxiety disorders category and moving it to an OC spectrum disorders category, as is being proposed for the DSM-V, is discussed. PMID:16455175

  5. The association between cannabis use and anxiety disorders: Results from a population-based representative sample.

    PubMed

    Feingold, Daniel; Weiser, Mark; Rehm, Jürgen; Lev-Ran, Shaul

    2016-03-01

    The cross-sectional association between cannabis use and anxiety disorders is well documented, yet less is known about the longitudinal association between the two. This study explored the association between cannabis use, cannabis use disorders (CUDs) and anxiety disorders in a 3-year prospective study. Data was drawn from waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Anxiety disorders, including generalized anxiety disorder, social anxiety, panic disorder and specific phobias, were controlled for at baseline. Initiation of cannabis use was defined as any cannabis use by former lifetime abstainers in the time period between baseline and follow-up, CUDs were defined as a diagnosis of cannabis abuse or dependence. Results indicate that cannabis use was not associated with increased incidence of any anxiety disorder (Adjusted Odds Ratio (AOR)=1.12(0.63-0.98)). Though heavy cannabis use was associated with increased incidence of social anxiety in most models, this was not fully retained in the final adjusted model (AOR=1.98(0.99-1.98)). Investigation of the association between baseline CUDs and anxiety disorders at follow-up revealed similar results. Any baseline anxiety disorder was not associated with future initiation of cannabis use (AOR=1.03(0.62-1.69)) or onset of a CUD (AOR=0.68(0.41-1.14)), yet individuals with baseline panic disorder were more prone to initiate cannabis use at follow-up (AOR=2.2(1.15-4.18)), possibly as a means of self-medication. Our findings suggest that cannabis use and CUDs are not associated with increased incidence of most anxiety disorders and inversely, most anxiety disorders are not associated with increased incidence of cannabis use or CUDs. PMID:26775742

  6. 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

  7. 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

  8. Sexual dysfunction, mood, anxiety, and personality disorders in female patients with fibromyalgia

    PubMed Central

    Kayhan, Fatih; Küçük, Adem; Satan, Yılmaz; İlgün, Erdem; Arslan, Şevket; İlik, Faik

    2016-01-01

    Background We aimed to investigate the current prevalence of sexual dysfunction (SD), mood, anxiety, and personality disorders in female patients with fibromyalgia (FM). Methods This case–control study involved 96 patients with FM and 94 healthy women. The SD diagnosis was based on a psychiatric interview in accordance with the Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria. Mood and anxiety disorders were diagnosed using the Structured Clinical Interview. Personality disorders were diagnosed according to the Structured Clinical Interview for DSM, Revised Third Edition Personality Disorders. Results Fifty of the 96 patients (52.1%) suffered from SD. The most common SD was lack of sexual desire (n=36, 37.5%) and arousal disorder (n=10, 10.4%). Of the 96 patients, 45 (46.9%) had a mood or anxiety disorder and 13 (13.5%) had a personality disorder. The most common mood, anxiety, and personality disorders were major depression (26%), generalized anxiety disorder (8.3%), and histrionic personality disorder (10.4%). Conclusion SD, mood, and anxiety disorders are frequently observed in female patients with FM. Pain plays a greater role in the development of SD in female patients with FM. PMID:26937190

  9. 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

  10. 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…

  11. Meta-Analysis of the Relations of Anxiety Sensitivity to the Depressive and Anxiety Disorders

    ERIC Educational Resources Information Center

    Naragon-Gainey, Kristin

    2010-01-01

    There is a substantial literature relating the personality trait "anxiety sensitivity" (AS; tendency to fear anxiety-related sensations) and its lower order dimensions to the mood and anxiety (i.e., internalizing) disorders. However, particularly given the disorders' high comorbidity rates, it remains unclear whether AS is broadly related to these

  12. Meta-Analysis of the Relations of Anxiety Sensitivity to the Depressive and Anxiety Disorders

    ERIC Educational Resources Information Center

    Naragon-Gainey, Kristin

    2010-01-01

    There is a substantial literature relating the personality trait "anxiety sensitivity" (AS; tendency to fear anxiety-related sensations) and its lower order dimensions to the mood and anxiety (i.e., internalizing) disorders. However, particularly given the disorders' high comorbidity rates, it remains unclear whether AS is broadly related to these…

  13. Automaticity in Anxiety Disorders and Major Depressive Disorder

    PubMed Central

    Teachman, Bethany A.; Joormann, Jutta; Steinman, Shari; Gotlib, Ian H.

    2012-01-01

    In this paper we examine the nature of automatic cognitive processing in anxiety disorders and Major Depressive Disorder (MDD). Rather than viewing automaticity as a unitary construct, we follow a social cognition perspective (Bargh, 1994) that argues for four theoretically independent features of automaticity: unconscious (processing of emotional stimuli occurs outside awareness), efficient (processing emotional meaning uses minimal attentional resources), unintentional (no goal is needed to engage in processing emotional meaning), and uncontrollable (limited ability to avoid, alter or terminate processing emotional stimuli). Our review of the literature suggests that most anxiety disorders are characterized by uncontrollable, and likely also unconscious and unintentional, biased processing of threat-relevant information. In contrast, MDD is most clearly typified by uncontrollable, but not unconscious or unintentional, processing of negative information. For the anxiety disorders and for MDD, there is not sufficient evidence to draw firm conclusions about efficiency of processing, though early indications are that neither anxiety disorders nor MDD are characterized by this feature. Clinical and theoretical implications of these findings are discussed and directions for future research are offered. In particular, it is clear that paradigms that more directly delineate the different features of automaticity are required to gain a more comprehensive and systematic understanding of the importance of automatic processing in emotion dysregulation. PMID:22858684

  14. Cigarette smoking, nicotine dependence and anxiety disorders: a systematic review of population-based, epidemiological studies

    PubMed Central

    2012-01-01

    Background Multiple studies have demonstrated that rates of smoking and nicotine dependence are increased in individuals with anxiety disorders. However, significant variability exists in the epidemiological literature exploring this relationship, including study design (cross-sectional versus prospective), the population assessed (random sample versus clinical population) and diagnostic instrument utilized. Methods We undertook a systematic review of population-based observational studies that utilized recognized structured clinical diagnostic criteria (Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD)) for anxiety disorder diagnosis to investigate the relationship between cigarette smoking, nicotine dependence and anxiety disorders. Results In total, 47 studies met the predefined inclusion criteria, with 12 studies providing prospective information and 5 studies providing quasiprospective information. The available evidence suggests that some baseline anxiety disorders are a risk factor for initiation of smoking and nicotine dependence, although the evidence is heterogeneous and many studies did not control for the effect of comorbid substance use disorders. The identified evidence however appeared to more consistently support cigarette smoking and nicotine dependence as being a risk factor for development of some anxiety disorders (for example, panic disorder, generalized anxiety disorder), although these findings were not replicated in all studies. A number of inconsistencies in the literature were identified. Conclusions Although many studies have demonstrated increased rates of smoking and nicotine dependence in individuals with anxiety disorders, there is a limited and heterogeneous literature that has prospectively examined this relationship in population studies using validated diagnostic criteria. The most consistent evidence supports smoking and nicotine dependence as increasing the risk of panic disorder and generalized anxiety disorder. The literature assessing anxiety disorders increasing smoking and nicotine dependence is inconsistent. Potential issues with the current literature are discussed and directions for future research are suggested. PMID:23083451

  15. Generalized Anxiety Disorder: Connections with Self-Reported Attachment

    ERIC Educational Resources Information Center

    Cassidy, Jude; Lichtenstein-Phelps, June; Sibrava, Nicholas J.; Thomas, Charles L., Jr.; Borkovec, Thomas D.

    2009-01-01

    Even though generalized anxiety disorder (GAD) is one of the most common of the anxiety disorders, relatively little is known about its precursors. Bowlby's attachment theory provides a framework within which these precursors can be considered. According to Bowlby, adult anxiety may be rooted in childhood experiences that leave a child uncertain…

  16. Generalized Anxiety Disorder: Connections with Self-Reported Attachment

    ERIC Educational Resources Information Center

    Cassidy, Jude; Lichtenstein-Phelps, June; Sibrava, Nicholas J.; Thomas, Charles L., Jr.; Borkovec, Thomas D.

    2009-01-01

    Even though generalized anxiety disorder (GAD) is one of the most common of the anxiety disorders, relatively little is known about its precursors. Bowlby's attachment theory provides a framework within which these precursors can be considered. According to Bowlby, adult anxiety may be rooted in childhood experiences that leave a child uncertain

  17. Neuroenhancement of Exposure Therapy in Anxiety Disorders

    PubMed Central

    Hofmann, Stefan G.; Mundy, Elizabeth A.; Curtiss, Joshua

    2015-01-01

    Although exposure-based treatments and anxiolytic medications are more effective than placebo for treating anxiety disorders, there is still considerable room for further improvement. Interestingly, combining these two modalities is usually not more effective than the monotherapies. Recent translational research has identified a number of novel approaches for treating anxiety disorders using agents that serve as neuroenhancers (also known as cognitive enhancers). Several of these agents have been studied to determine their efficacy at improving treatment outcome for patients with anxiety and other psychiatric disorders. In this review, we examine d-cycloserine, yohimbine, cortisol, catecholamines, oxytocin, modafinil, and nutrients such as caffeine and amino fatty acids as potential neuroenhancers. Of these agents, d-cycloserine shows the most promise as an effective neuroenhancer for extinction learning and exposure therapy. Yet, the optimal dosing and dose timing for drug administration remains uncertain. There is partial support for cortisol, catecholamines, yohimbine and oxytocin for improving extinction learning and exposure therapy. There is less evidence to indicate that modafinil and nutrients such as caffeine and amino fatty acids are effective neuroenhancers. More research is needed to determine their long term efficacy and clinical utility of these agents. PMID:26306326

  18. Comorbid Social Anxiety Disorder in Adults with Autism Spectrum Disorder.

    PubMed

    Maddox, Brenna B; White, Susan W

    2015-12-01

    Social anxiety symptoms are common among cognitively unimpaired youth with autism spectrum disorder (ASD). Few studies have investigated the co-occurrence of social anxiety disorder (SAD) in adults with ASD, although identification may aid access to effective treatments and inform our scientific efforts to parse heterogeneity. In this preliminary study, we examined the clinical presentation of SAD in adults with ASD (n = 28), relative to SAD uncomplicated by ASD (n = 26). A large subset (50 %) of the adults with ASD met diagnostic criteria for SAD. The adults with ASD plus SAD differed from those with ASD without SAD on several characteristics. Findings demonstrate that many adults with ASD are aware of their social difficulties and experience impairing social anxiety. PMID:26243138

  19. Sensitivity and Specificity of the Screen for Child Anxiety Related Emotional Disorders (SCARED): A Community-Based Study

    ERIC Educational Resources Information Center

    DeSousa, Diogo Araujo; Salum, Giovanni Abrahao; Isolan, Luciano Rassier; Manfro, Gisele Gus

    2013-01-01

    The aim of this cross-sectional community-based study was to examine the sensitivity and specificity of the Screen for Child Anxiety Related Emotional Disorders (SCARED) to the diagnosis of anxiety disorders (AD). Participants were 119 students aged 9-18. Psychiatric diagnoses were assessed by a psychiatrist throughout a structural clinical

  20. Sensitivity and Specificity of the Screen for Child Anxiety Related Emotional Disorders (SCARED): A Community-Based Study

    ERIC Educational Resources Information Center

    DeSousa, Diogo Araujo; Salum, Giovanni Abrahao; Isolan, Luciano Rassier; Manfro, Gisele Gus

    2013-01-01

    The aim of this cross-sectional community-based study was to examine the sensitivity and specificity of the Screen for Child Anxiety Related Emotional Disorders (SCARED) to the diagnosis of anxiety disorders (AD). Participants were 119 students aged 9-18. Psychiatric diagnoses were assessed by a psychiatrist throughout a structural clinical…

  1. Generalized anxiety disorder: between neglect and an epidemic.

    PubMed

    Starcevic, Vladan; Portman, Michael E; Beck, Aaron T

    2012-08-01

    This article reviews the main issues associated with the concept and the diagnosis of generalized anxiety disorder (GAD) and examines the proposed DSM-5 diagnostic criteria for GAD. The lack of specific features, which is the primary issue for GAD, will not be addressed in DSM-5. The hallmark of the condition will remain pathological worry, although it also characterizes other disorders. Likewise, the proposed behavioral diagnostic criteria lack specificity for GAD, and it is not clear how these will be assessed. The proposed changes will lower the diagnostic threshold for GAD in DSM-5. Although this will not necessarily lead to a better recognition of GAD and an improvement in the perception of its relevance and clinical utility, many currently subthreshold cases will qualify for this diagnosis. The likely inclusion of many such "false-positives" will result in an artificial increase in the prevalence of GAD and will have further negative consequences. PMID:22850300

  2. Gaze perception in social anxiety and social anxiety disorder

    PubMed Central

    Schulze, Lars; Renneberg, Babette; Lobmaier, Janek S.

    2013-01-01

    Clinical observations suggest abnormal gaze perception to be an important indicator of social anxiety disorder (SAD). Experimental research has yet paid relatively little attention to the study of gaze perception in SAD. In this article we first discuss gaze perception in healthy human beings before reviewing self-referential and threat-related biases of gaze perception in clinical and non-clinical socially anxious samples. Relative to controls, socially anxious individuals exhibit an enhanced self-directed perception of gaze directions and demonstrate a pronounced fear of direct eye contact, though findings are less consistent regarding the avoidance of mutual gaze in SAD. Prospects for future research and clinical implications are discussed. PMID:24379776

  3. Generalized social anxiety disorder: A still-neglected anxiety disorder 3 decades since Liebowitz's review.

    PubMed

    Nagata, Toshihiko; Suzuki, Futoshi; Teo, Alan R

    2015-12-01

    In the 3 decades since Liebowitz's review of 'a neglected anxiety disorder,' controversy and challenges have remained in the study of social anxiety disorder (SAD). This review examines evidence around the classification and subtyping of SAD, focusing on generalized SAD. Substantial discrepancies and variation in definition, epidemiology, assessment, and treatment of generalized SAD exist as the international literature on it has grown. In East Asian cultures in particular, study of taijin kyofusho has been important to a broadened conceptualization of SAD into generalized SAD. Despite important progress with biological and other studies, many challenges in the understanding of generalized SAD will remain in the years to come. PMID:26121185

  4. [Body dysmorphic disorder : Anxiety about deformity].

    PubMed

    Gieler, T; Brähler, E

    2016-05-01

    Between 0.8 and 1.8 % of the German population suffers from a body dysmorphic disorder. In specific settings like dermatological offices up to 11.9 % of patients suffer from this disease. The highest prevalence could be found in the field of cosmetic dermatology with a prevalence of 13.1 %. Until now, the diagnosis has been made too rarely. The body dysmorphic disorder is a chronic psychic disease, in which the patients feel disfigured and experience shame and disgust at the same time. Comorbidities like social phobia, depression, suicidality, and eating disorders are frequent. The diagnosis is made using questionnaires (e.g., dysmorphic concern questionnaire) or by use of the DSM-5 manual. An early diagnosis seems to be important to avoid chronification and suicidal ideas. Therapeutic approaches should include cognitive behavioral therapies as well as the use of SSRIs. PMID:26893009

  5. Genetics of affective and anxiety disorders.

    PubMed

    Leonardo, E D; Hen, Ren

    2006-01-01

    The study of the genetics of complex behaviors has evolved dramatically from the days of the nature versus nurture debates that dominated much of the past century. Here we discuss advances in our understanding of the genetics of affective and anxiety disorders. In particular, we highlight our growing understanding of specific gene-environment interactions that occur during critical periods in development, setting the stage for later behavioral phenotypes. We review the recent literature in the field, focusing on recent advances in our understanding of the role of the serotonin system in establishing normal anxiety levels during development. We emphasize the importance of understanding the effect of genetic variation at the level of functional circuits and provide examples from the literature of how such an approach has been exploited to study novel genetic endpoints, including genetically based variation in response to medication, a potentially valuable phenotype that has not received much attention to date. PMID:16318591

  6. Overview of antidepressants currently used to treat anxiety disorders.

    PubMed

    Feighner, J P

    1999-01-01

    The syndromes of anxiety and depression may reflect separate disorders with overlapping symptoms. They also may be comorbid or reflect illnesses with similar underlying pathophysiology based upon a spectrum of central nervous system dysfunction. Antidepressants effectively treat both anxiety and comorbid anxiety-depression. Tertiary tricyclic antidepressant agents (TCAs) with dual serotonergic-noradrenergic effects, such as imipramine and amitriptyline, appear consistently effective across the anxiety disorders. Selective serotonin reuptake inhibitors (SSRIs) are particularly effective in panic disorder and obsessive-compulsive disorder. SSRIs are similar in efficacy to TCAs but are more tolerable and cause fewer serious adverse events. However, they are relatively slow to act, and efficacy data are limited in states such as generalized anxiety disorder. Newer antidepressants, such as mirtazapine, nefazodone, and venlafaxine XR, may provide some benefits across the broad spectrum of anxiety disorders with the safety and tolerability that are the hallmarks of third generation antidepressants. PMID:10634351

  7. Rates of isolated sleep paralysis in outpatients with anxiety disorders.

    PubMed

    Otto, Michael W; Simon, Naomi M; Powers, Mark; Hinton, Devon; Zalta, Alyson K; Pollack, Mark H

    2006-01-01

    Initial research suggests that rates of isolated sleep paralysis (ISP) are elevated in individuals with panic disorder and particularly low in individuals with other anxiety disorders. To further evaluate these findings, we examined rates of ISP in a sample outpatients with primary diagnoses of panic disorder (n=24), social anxiety disorder (n=18), or generalized anxiety disorder (n=18). We obtained an overall rate of ISP of 19.7%; rates for patients with panic disorder (20.8%) fell between those with generalized anxiety disorder (15.8%) and social phobia (22.2%). Analysis of comorbidities failed to provide evidence of link between depressive disorders and ISP, but did indicate a significant association between anxiety comorbidity and higher rates of ISP. Results are discussed relative to other variables predicting variability in the occurrence of ISP. PMID:16099138

  8. Familial and Temperamental Risk Factors for Social Anxiety Disorder

    ERIC Educational Resources Information Center

    Hirshfeld-Becker, Dina R.

    2010-01-01

    Social anxiety disorder (SAD) is a common disorder that can lead to significant impairment. In this chapter, the author provides background on the disorder and reviews hypothesized familial and temperamental risk factors. In particular, it highlights the Massachusetts General Hospital (MGH) Longitudinal Study of Children at Risk for Anxiety, now

  9. Familial and Temperamental Risk Factors for Social Anxiety Disorder

    ERIC Educational Resources Information Center

    Hirshfeld-Becker, Dina R.

    2010-01-01

    Social anxiety disorder (SAD) is a common disorder that can lead to significant impairment. In this chapter, the author provides background on the disorder and reviews hypothesized familial and temperamental risk factors. In particular, it highlights the Massachusetts General Hospital (MGH) Longitudinal Study of Children at Risk for Anxiety, now…

  10. Social anxiety disorder: psychobiological and evolutionary underpinnings.

    PubMed

    Stein, Dan J; Vythilingum, Bavanisha

    2007-11-01

    Social anxiety disorder (SAD) also know as social phobia is increasingly recognized as a highly prevalent and disabling psychiatric disorder. SAD patients demonstrate cognitive-affective distortions in relation to social situations and abnormal activation patterns in limbic structures during functional imaging. Behavioral inhibition is an endophenotype that may be useful in understanding vulnerability to SAD, and that has specific imaging and genetic correlates. From an evolutionary perspective, it has been speculated that SAD represents a false appeasement alarm. It is notable that SAD responds to selective serotonin reuptake inhibitors and monoamine oxidase inhibitors, but not to most tricyclic antidepressants; this finding is consistent with the importance of serotonin and dopamine in mediating this disorder. PMID:17984853

  11. Parental responsibility beliefs: associations with parental anxiety and behaviours in the context of childhood anxiety disorders

    PubMed Central

    Apetroaia, Adela; Hill, Claire; Creswell, Cathy

    2015-01-01

    Background High levels of parental anxiety are associated with poor treatment outcomes for children with anxiety disorders. Associated parental cognitions and behaviours have been implicated as impediments to successful treatment. We examined the association between parental responsibility beliefs, maternal anxiety and parenting behaviours in the context of childhood anxiety disorders. Methods Anxious and non-anxious mothers of 7–12 year old children with a current anxiety disorder reported their parental responsibility beliefs using a questionnaire measure. Parental behaviours towards their child during a stressor task were measured. Results Parents with a current anxiety disorder reported a greater sense of responsibility for their child's actions and wellbeing than parents who scored within the normal range for anxiety. Furthermore, higher parental responsibility was associated with more intrusive and less warm behaviours in parent–child interactions and there was an indirect effect between maternal anxiety and maternal intrusive behaviours via parental responsibility beliefs. Limitations The sample was limited to a treatment-seeking, relatively high socio-economic population and only mothers were included so replication with more diverse groups is needed. The use of a range of stressor tasks may have allowed for a more comprehensive assessment of parental behaviours. Conclusions The findings suggest that parental anxiety disorder is associated with an elevated sense of parental responsibility and may promote parental behaviours likely to inhibit optimum child treatment outcomes. Parental responsibility beliefs may therefore be important to target in child anxiety treatments in the context of parental anxiety disorders. PMID:26363612

  12. Cognitive, affective, and behavioral characteristics of mothers with anxiety disorders in the context of child anxiety disorder.

    PubMed

    Creswell, Cathy; Apetroaia, Adela; Murray, Lynne; Cooper, Peter

    2013-02-01

    Parental emotional distress, particularly high maternal anxiety, is one of the most consistent predictors of child anxiety treatment outcome. In order to identify the cognitive, affective, and behavioral parenting characteristics of mothers of children with anxiety disorders who themselves have an anxiety disorder, we assessed the expectations, appraisals, and behaviors of 88 mothers of anxious children (44 mothers who were not anxious [NONANX] and 44 mothers with a current anxiety disorder [ANX]) when interacting with their 7-12-year-old children. There were no observed differences in anxiety and avoidance among children of ANX and NONANX mothers, but, compared with NONANX mothers, ANX mothers held more negative expectations, and they differed on observations of intrusiveness, expressed anxiety, warmth, and the quality of the relationship. Associations were moderated by the degree to which children expressed anxiety during the tasks. Maternal-reported negative emotions during the task significantly mediated the association between maternal anxiety status and the observed quality of the relationship. These findings suggest that maternal anxiety disorder is associated with reduced tolerance of children's negative emotions. This may interfere with the maintenance of a positive, supportive mother-child interaction under conditions of stress and, as such, this may impede optimum treatment outcomes. The findings identify potential cognitive, affective, and behavioral targets to improve treatment outcomes for children with anxiety disorders in the context of a current maternal anxiety disorder. PMID:22905861

  13. Anxiety Disorders in Adolescents and Psychosocial Outcomes at Age 30

    PubMed Central

    Essau, Cecilia A.; Lewinsohn, Peter M.; Olaya, Beatriz; Seeley, John R.

    2014-01-01

    Background Anxiety disorders are associated with adverse psychosocial functioning, and are predictive of a wide range of psychiatric disorders in adulthood. Objective The present study examined the associations between anxiety disorders during childhood and adolescence and psychosocial outcomes at age 30, and sought to address the extent to which psychopathology after age 19 mediated these relations. Method Eight hundred and sixteen participants from a large community sample were interviewed twice during adolescence, at age 24, and at age 30. They completed self-report measures of psychosocial functioning and semi-structured diagnostic interviews during adolescence and young adulthood. Results Childhood anxiety only predicted less years of completed education at age 30, whereas adolescent anxiety predicted income, unemployment, maladjustment, poor coping skills, more chronic stress and life events. Adult major depressive disorder (MDD) was the only disorder predicted by childhood anxiety, whereas adolescent anxiety predicted MDD, substance (SUD) and alcohol abuse/dependence (AUD) in adulthood. No adult psychopathology mediated the relationship between childhood anxiety disorders and psychosocial outcomes at age 30. Adult MDD, SUD and AUD partially or completely mediated the association between adolescent anxiety and most domains of psychosocial functioning at age 30. Limitations The participants are ethically and geographically homogenous, and changes in the diagnostic criteria and the interview schedules across the assessment periods. Conclusion Adolescent anxiety, compared to childhood anxiety, is associated with more adverse psychosocial outcomes at age 30. Adolescent anxiety affects negative outcomes at age 30 directly and through MDD, SUD and AUD. PMID:24456837

  14. Specificity of familial transmission of anxiety and comorbid disorders.

    PubMed

    Low, Nancy C P; Cui, Lihong; Merikangas, Kathleen R

    2008-06-01

    This study examines the specificity and impact of comorbid disorders in probands on the familial transmission of panic and social anxiety disorders. It employs a contemporary family study design with 225 probands (with and without panic and social anxiety disorders) sampled from outpatient clinics and the local community. Their 1053 adult first-degree relatives were assessed for lifetime disorders, based on best estimate diagnoses derived from semi-structured psychiatric diagnostic interviews (Schedule for Affective Disorders and Schizophrenia), multi-informant family history information, and medical records. Generalized estimating equations were used to examine the familial aggregation of panic and social anxiety disorders, and the contributions of comorbid disorders. Results show specificity of familial aggregation of both panic disorder and social anxiety in probands and relatives (i.e., panic odds ratio=3.7, 95%CI 1.5-9.3; social anxiety odds ratio=1.8, 95%CI 1.1-2.9) after controlling for comorbid disorders. There was no contribution of common comorbid disorders (depression, alcoholism, generalized anxiety disorder and agoraphobia) in probands on the familial aggregation of either disorder. These findings confirm prior studies of specificity of familial transmission of panic and social anxiety disorders, and demonstrate that the association between these disorders in probands is not attributable to comorbid mood, anxiety or substance use disorders. Therefore, despite the high magnitude of co-occurrence of panic disorder and social anxiety, there may be distinct etiologic factors underlying each disorder. These findings have implications for studies of the etiology, genetics, and treatment of these disorders. PMID:17706672

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

    PubMed Central

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

    2014-01-01

    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

  16. Body image in social anxiety disorder, obsessive-compulsive disorder, and panic disorder.

    PubMed

    Aderka, Idan M; Gutner, Cassidy A; Lazarov, Amit; Hermesh, Haggai; Hofmann, Stefan G; Marom, Sofi

    2014-01-01

    Body dysmorphic disorder falls under the category of obsessive-compulsive and related disorders, yet research has suggested it may also be highly associated with social anxiety disorder. The current study examined body image variables among 68 outpatients with primary obsessive-compulsive disorder (OCD; n=22), social anxiety disorder (SAD; n=25), and panic disorder (PD; n=21). Participants filled out self-report measures of body image disturbance, attitudes toward one's appearance, and anxiety. Body image disturbance and attitudes toward appearance did not significantly differ between the groups. However, SAD symptoms predicted body image disturbance, Appearance Evaluation and Body Areas Satisfaction, and OCD symptoms predicted Appearance Orientation. These findings suggest that SAD and OCD may be associated with different facets of body image. Implications for the treatment of anxiety disorders and for future research are discussed. PMID:24095651

  17. Anxiety Sensitivity in Children of Panic Disorder Patients

    ERIC Educational Resources Information Center

    van Beek, N.; Perna, G.; Schruers, K.; Muris, P.; Griez, E.

    2005-01-01

    Anxiety sensitivity (AS), which refers to the tendency to interpret anxiety-related bodily sensations as having potentially harmful somatic, psychological or social consequences, has been proposed as a vulnerability factor for the development of panic disorder (PD). The current study examined the anxiety sensitivity levels in children of parents…

  18. How are Sensory Features associated with seven anxiety disorders in boys with Autism Spectrum Disorder?

    PubMed

    Bitsika, Vicki; Sharpley, Christopher F; Mills, Richard

    2016-05-01

    The association between Sensory Features (SF) and seven anxiety disorders was investigated using self-reports and parental reports about 140 young males with an Autism Spectrum Disorder (ASD). Although there were significant correlations between SF and self- and parent-ratings of some of the seven anxiety disorders, overall, SF was found to have an inconsistent association across the seven anxiety disorders and this was also found for the 8 symptoms of Generalised Anxiety Disorder. These data challenge the practice of assessing SF and anxiety via global measures and argue for individualized disorder-specific assessments to develop more effective diagnoses and treatments for the effects of SF. PMID:26975191

  19. 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…

  20. 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

  1. Diagnosis of Copper Transport Disorders

    PubMed Central

    Møller, Lisbeth B.; Hicks, Julia D.; Holmes, Courtney S.; Goldstein, David S.; Brendl, Cornelia; Huppke, Peter; Kaler, Stephen G.

    2011-01-01

    Techniques for the diagnosis of copper transport disorders are increasingly important due to recent recognition of previously unappreciated clinical phenotypes and emerging advances in the treatment of these conditions. Here, we collate the diagnostic approaches and techniques currently employed for biochemical and molecular assessment of at-risk individuals in whom abnormal copper metabolism is suspected. PMID:21735378

  2. Situational Panic Attacks in Social Anxiety Disorder

    PubMed Central

    Potter, Carrie M.; Wong, Judy; Heimberg, Richard G.; Blanco, Carlos; Liu, Shang-Min; Wang, Shuai; Schneier, Franklin R.

    2014-01-01

    Background Panic attacks (PAs) are common in many psychiatric disorders other than panic disorder, especially social anxiety disorder (SAD). PAs have been associated with increased severity, comorbidity, and impairment in many disorders; therefore, PAs can now be used as a descriptive specifier across all DSM-5 disorders. However, the clinical implications of PAs in SAD remain unclear. Methods The aim of the present investigation was to examine demographic and clinical characteristics associated with SAD-related situational panic attacks in a large, representative epidemiological sample of individuals with SAD (N = 1138). We compared individuals with SAD who did and did not endorse situational PAs in terms of demographic factors, fear/avoidance of social situations, distress, impairment, and diagnostic comorbidity. Results Being male, black, Asian, or over 65 years old was associated with a decreased likelihood of experiencing situational PAs, whereas being unemployed was associated with an increased likelihood. Individuals with situational PAs also exhibited greater fear and avoidance of social situations, impairment, coping-oriented substance use, treatment utilization, and concurrent and longitudinal psychiatric comorbidity. Limitations Consistent with most epidemiologic studies, the information collected relied on self-report, and not all participants were available for both waves of assessment. Conclusions The present findings suggest that situational PAs are associated with more severe and complex presentations of SAD. Implications for the assessment and treatment of SAD, as well as for the use of PAs as a descriptive specifier for SAD, are discussed. PMID:25082106

  3. Episodic future thinking in generalized anxiety disorder.

    PubMed

    Wu, Jade Q; Szpunar, Karl K; Godovich, Sheina A; Schacter, Daniel L; Hofmann, Stefan G

    2015-12-01

    Research on future-oriented cognition in generalized anxiety disorder (GAD) has primarily focused on worry, while less is known about the role of episodic future thinking (EFT), an imagery-based cognitive process. To characterize EFT in this disorder, we used the experimental recombination procedure, in which 21 GAD and 19 healthy participants simulated positive, neutral and negative novel future events either once or repeatedly, and rated their phenomenological experience of EFT. Results showed that healthy controls spontaneously generated more detailed EFT over repeated simulations. Both groups found EFT easier to generate after repeated simulations, except when GAD participants simulated positive events. They also perceived higher plausibility of negative-not positive or neutral-future events than did controls. These results demonstrate a negativity bias in GAD individuals' episodic future cognition, and suggest their relative deficit in generating vivid EFT. We discuss implications for the theory and treatment of GAD. PMID:26398003

  4. Episodic Memories in Anxiety Disorders: Clinical Implications

    PubMed Central

    Zlomuzica, Armin; Dere, Dorothea; Machulska, Alla; Adolph, Dirk; Dere, Ekrem; Margraf, Jürgen

    2014-01-01

    The aim of this review is to summarize research on the emerging role of episodic memories in the context of anxiety disorders (AD). The available literature on explicit, autobiographical, and episodic memory function in AD including neuroimaging studies is critically discussed. We describe the methodological diversity of episodic memory research in AD and discuss the need for novel tests to measure episodic memory in a clinical setting. We argue that alterations in episodic memory functions might contribute to the etiology of AD. We further explain why future research on the interplay between episodic memory function and emotional disorders as well as its neuroanatomical foundations offers the promise to increase the effectiveness of modern psychological treatments. We conclude that one major task is to develop methods and training programs that might help patients suffering from AD to better understand, interpret, and possibly actively use their episodic memories in a way that would support therapeutic interventions and counteract the occurrence of symptoms. PMID:24795583

  5. [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

  6. Phenomenology and clinical correlates of family accommodation in pediatric anxiety disorders.

    PubMed

    Storch, Eric A; Salloum, Alison; Johnco, Carly; Dane, Brittney F; Crawford, Erika A; King, Morgan A; McBride, Nicole M; Lewin, Adam B

    2015-10-01

    Despite evidence documenting high prevalence of family accommodation in pediatric obsessive-compulsive disorder, examination in other pediatric anxiety disorders is limited. Preliminary evidence suggests that family accommodation is common amongst children with anxiety disorders; however, the impact on clinical presentation and functional impairment has not been addressed. This study assessed the nature and clinical correlates of family accommodation in pediatric anxiety, as well as validating a mechanistic model. Participants included 112 anxious youth and their parents who were administered a diagnostic clinical interview and measure of anxiety severity, as well as questionnaires assessing internalizing and externalizing symptoms, family accommodation and functional impairment. Some form of accommodation was present in all families. Family accommodation was associated with increased anxiety severity and externalizing behaviors, having a diagnosis of separation anxiety, and increased functional impairment. Family accommodation partially mediated the relationship between anxiety severity and functional impairment, as well as externalizing behaviors and functional impairment. Family accommodation is common in pediatric anxiety disorders, and is associated with more severe clinical presentations and functional impairment. These findings highlight the importance of parental involvement in treatment and the need to specifically target accommodation practices during interventions to mitigate negative outcomes in anxious youth. Further studies utilizing longitudinal data are needed to validate mechanistic models. PMID:26398305

  7. The relationships between perfectionism, pathological worry and generalised anxiety disorder

    PubMed Central

    2014-01-01

    Background The relationships between perfectionism, pathological worry and generalised anxiety disorder (GAD) were investigated in a clinical sample presenting for treatment of perfectionism. Method This study explored the utility of perfectionism in predicting pathological worry in a sample of individuals with elevated perfectionism and GAD (n = 36). Following this, the study examined whether perfectionism could predict a principal GAD diagnosis in the full sample (n = 42). Results Scores on the perfectionism dimensions Concern over Mistakes, Personal Standards, and Clinical Perfectionism significantly predicted pathological worry among participants with GAD after controlling for gender and depression. The perfectionism dimension Doubts about Actions significantly predicted whether individuals from the full sample received a principal diagnosis of GAD. Conclusions These findings support certain dimensions of perfectionism having significant associations with pathological worry and GAD. PMID:24693946

  8. Neuroendocrine models of social anxiety disorder

    PubMed Central

    van Honk, Jack; Bos, Peter A.; Terburg, David; Heany, Sarah; Stein, Dan J.

    2015-01-01

    Social anxiety disorder (SAD) is a highly prevalent and disabling disorder with key behavioral traits of social fearfulness, social avoidance, and submissiveness. Here we argue that hormonal systems play a key role in mediating social anxiety, and so may be important in SAD. Hormonal alterations, often established early in development through the interaction between biological and psychological factors (eg, genetic predisposition x early trauma), predispose to socially fearful, avoidant, and submissive behavior. However, whereas gene variants and histories of trauma persist, hormonal systems can be remodeled over the course of life. Hormones play a key role during the periods of all sensitive developmental windows (ie, prenatal, neonatal, puberty, aging), and are capable of opening up new developmental windows in adulthood. Indeed, the developmental plasticity of our social brain, and thus of social behavior in adulthood, critically depends on steroid hormones such as testosterone and peptide hormones such as oxytocin. These steroid and peptide hormones in interaction with social experiences may have potential for reprogramming the socially anxious brain. Certainly, single administrations of oxytocin and testosterone in humans reduce socially fearful, avoidant, and submissive behavior. Such work may ultimately lead to new approaches to the treatment of SAD. PMID:26487809

  9. Neuroendocrine models of social anxiety disorder.

    PubMed

    van Honk, Jack; Bos, Peter A; Terburg, David; Heany, Sarah; Stein, Dan J

    2015-09-01

    Social anxiety disorder (SAD) is a highly prevalent and disabling disorder with key behavioral traits of social fearfulness, social avoidance, and submissiveness. Here we argue that hormonal systems play a key role in mediating social anxiety, and so may be important in SAD. Hormonal alterations, often established early in development through the interaction between biological and psychological factors (eg, genetic predisposition x early trauma), predispose to socially fearful, avoidant, and submissive behavior. However, whereas gene variants and histories of trauma persist, hormonal systems can be remodeled over the course of life. Hormones play a key role during the periods of all sensitive developmental windows (ie, prenatal, neonatal, puberty, aging), and are capable of opening up new developmental windows in adulthood. Indeed, the developmental plasticity of our social brain, and thus of social behavior in adulthood, critically depends on steroid hormones such as testosterone and peptide hormones such as oxytocin. These steroid and peptide hormones in interaction with social experiences may have potential for reprogramming the socially anxious brain. Certainly, single administrations of oxytocin and testosterone in humans reduce socially fearful, avoidant, and submissive behavior. Such work may ultimately lead to new approaches to the treatment of SAD. PMID:26487809

  10. The extent of social anxiety in combination with mental disorders.

    PubMed

    Melfsen, Siebke; Walitza, Susanne; Warnke, Andreas

    2006-03-01

    The aim of the study was to investigate the extent of social anxiety in different mental disorders. A total of 341 patients aged 7-18 years participated in the study. To measure social anxiety, the German version (SPAIK) of the Social Phobia and Anxiety Inventory for Children (SPAI-C) was used. Subgroups were built dependent on mental disorders. A total score above 20, which was assumed to indicate social anxiety, was observed in children with selective mutism (n = 9; M = 22.68; SD = 11.29) and in children with Asperger's Syndrome (n = 7; M = 20.77; SD = 13.77). Patients who had the following mental disorders also showed a higher total score of social anxiety: obsessive-compulsive disorder, anorexia nervosa, schizophrenia, depression and conduct disorder. In none of these disorders, however, did the mean total score exceed the cut-off of 20. PMID:16523252

  11. Neural circuits in anxiety and stress disorders: a focused review

    PubMed Central

    Duval, Elizabeth R; Javanbakht, Arash; Liberzon, Israel

    2015-01-01

    Anxiety and stress disorders are among the most prevalent neuropsychiatric disorders. In recent years, multiple studies have examined brain regions and networks involved in anxiety symptomatology in an effort to better understand the mechanisms involved and to develop more effective treatments. However, much remains unknown regarding the specific abnormalities and interactions between networks of regions underlying anxiety disorder presentations. We examined recent neuroimaging literature that aims to identify neural mechanisms underlying anxiety, searching for patterns of neural dysfunction that might be specific to different anxiety disorder categories. Across different anxiety and stress disorders, patterns of hyperactivation in emotion-generating regions and hypoactivation in prefrontal/regulatory regions are common in the literature. Interestingly, evidence of differential patterns is also emerging, such that within a spectrum of disorders ranging from more fear-based to more anxiety-based, greater involvement of emotion-generating regions is reported in panic disorder and specific phobia, and greater involvement of prefrontal regions is reported in generalized anxiety disorder and posttraumatic stress disorder. We summarize the pertinent literature and suggest areas for continued investigation. PMID:25670901

  12. Anxiety disorder presentations in Asian populations: a review.

    PubMed

    Hinton, Devon E; Park, Lawrence; Hsia, Curtis; Hofmann, Stefan; Pollack, Mark H

    2009-01-01

    This article reviews typical anxiety presentations in Asia, and among Asian refugees. In Asia, there are multiple functional somatic syndromes that are common anxiety presentations. These distress syndromes often produce catastrophic cognitions about anxiety-type somatic and psychological symptoms. These functional somatic syndromes should be understood, and specifically assessed and addressed, in order to optimize the evaluation and treatment of anxiety disorders among Asian individuals. PMID:19691549

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

    PubMed Central

    Shin, Lisa M; Liberzon, Israel

    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 as neuroimaging studies of anxiety disorders. In general, these studies have reported relatively heightened amygdala activation in response to disorder-relevant stimuli in post-traumatic stress disorder, social phobia, and specific phobia. Activation in the insular cortex appears to be heightened in many of the anxiety disorders. Unlike other anxiety disorders, post-traumatic stress disorder is associated with diminished responsivity in the rostral anterior cingulate cortex and adjacent ventral medial prefrontal cortex. Additional research will be needed to (1) clarify the exact role of each component of the fear circuitry in the anxiety disorders, (2) determine whether functional abnormalities identified in the anxiety disorders represent acquired signs of the disorders or vulnerability factors that increase the risk of developing them, (3) link the findings of functional neuroimaging studies with those of neurochemistry studies, and (4) use functional neuroimaging to predict treatment response and assess treatment-related changes in brain function. PMID:19625997

  14. ADULT ANXIETY DISORDERS IN RELATION TO TRAIT ANXIETY AND PERCEIVED STRESS IN CHILDHOOD.

    PubMed

    Mundy, Elizabeth A; Weber, Mareen; Rauch, Scott L; Killgore, William D S; Simon, Naomi M; Pollack, Mark H; Rosso, Isabelle M

    2015-10-01

    It is well established that objective early life stressors increase risk for anxiety disorders and that environmental stressors interact with dispositional factors such as trait anxiety. There is less information on how subjective perception of stress during childhood relates to later clinical anxiety. This study tested whether childhood perceived stress and trait anxiety were independently and interactively associated with adult anxiety disorders. Forty-seven adults diagnosed with anxiety disorders (M age = 34 yr., SD = 11) and 29 healthy participants (M = 33 yr., SD = 13) completed the adult Perceived Stress Scale, the State-Trait Anxiety Inventory, and the Global Perceived Early Life Events Scale as a measure of perceived stress during childhood. In a logistic regression model, high childhood perceived stress (β = 0.64) and trait anxiety (β = 0.11) were associated with significantly greater odds of adult anxiety disorder. The association between childhood perceived stress and adult anxiety remained significant when controlling for adult perceived stress. These findings suggest that children's perception of stress in their daily lives may be an important target of intervention to prevent the progression of stress into clinically significant anxiety. PMID:26340052

  15. Defining Treatment Response and Symptom Remission for Anxiety Disorders in Pediatric Autism Spectrum Disorders Using the Pediatric Anxiety Rating Scale

    ERIC Educational Resources Information Center

    Johnco, Carly J.; De Nadai, Alessandro S.; Lewin, Adam B.; Ehrenreich-May, Jill; Wood, Jeffrey J.; Storch, Eric A.

    2015-01-01

    This study examined optimal guidelines to assess treatment response and remission for anxiety in youth with autism spectrum disorders (ASD) using the Pediatric Anxiety Rating Scale (PARS). Data was collected for 108 children aged 7-16 years with comorbid anxiety and ASD before and after receiving cognitive behavior therapy. Optimal cut-offs on the…

  16. Cannabidiol as a Potential Treatment for Anxiety Disorders.

    PubMed

    Blessing, Esther M; Steenkamp, Maria M; Manzanares, Jorge; Marmar, Charles R

    2015-10-01

    Cannabidiol (CBD), a Cannabis sativa constituent, is a pharmacologically broad-spectrum drug that in recent years has drawn increasing interest as a treatment for a range of neuropsychiatric disorders. The purpose of the current review is to determine CBD's potential as a treatment for anxiety-related disorders, by assessing evidence from preclinical, human experimental, clinical, and epidemiological studies. We found that existing preclinical evidence strongly supports CBD as a treatment for generalized anxiety disorder, panic disorder, social anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder when administered acutely; however, few studies have investigated chronic CBD dosing. Likewise, evidence from human studies supports an anxiolytic role of CBD, but is currently limited to acute dosing, also with few studies in clinical populations. Overall, current evidence indicates CBD has considerable potential as a treatment for multiple anxiety disorders, with need for further study of chronic and therapeutic effects in relevant clinical populations. PMID:26341731

  17. Salivary alpha amylase levels in youths with anxiety disorders.

    PubMed

    Yorbik, Ozgur; Mutlu, Caner; Ozturk, Ozlem; Altinay, Derya Koc; Tanju, Ilhan Asya; Kurt, Ismail

    2016-01-30

    It is suggested that salivary alpha-amylase (sAA) may be a marker of sympathoadrenal medullary system activity. Thus, it can be a possible relationship sAA and anxiety disorders. The aim of this study is to investigate sAA in children and adolescents with anxiety disorders and healthy controls. Thirty drug-free youths, aged 8-16 years, who were diagnosed as any anxiety disorders and 36 healthy controls with similar socio-demographic characteristics were included in this study. The sAA was found to be significantly increased in anxiety group compared to control group. However, there was no correlation between sAA and any anxiety scores of the scales. Present study suggested that anxiety disorders in youths may be associated with increased autonomic activity. PMID:26699881

  18. Nicotine modulation of fear memories and anxiety: Implications for learning and anxiety disorders.

    PubMed

    Kutlu, Munir Gunes; Gould, Thomas J

    2015-10-15

    Anxiety disorders are a group of crippling mental diseases affecting millions of Americans with a 30% lifetime prevalence and costs associated with healthcare of $42.3 billion. While anxiety disorders show high levels of co-morbidity with smoking (45.3% vs. 22.5% in healthy individuals), they are also more common among the smoking population (22% vs. 11.1% in the non-smoking population). Moreover, there is clear evidence that smoking modulates symptom severity in patients with anxiety disorders. In order to better understand this relationship, several animal paradigms are used to model several key symptoms of anxiety disorders; these include fear conditioning and measures of anxiety. Studies clearly demonstrate that nicotine mediates acquisition and extinction of fear as well as anxiety through the modulation of specific subtypes of nicotinic acetylcholine receptors (nAChRs) in brain regions involved in emotion processing such as the hippocampus. However, the direction of nicotine's effects on these behaviors is determined by several factors that include the length of administration, hippocampus-dependency of the fear learning task, and source of anxiety (novelty-driven vs. social anxiety). Overall, the studies reviewed here suggest that nicotine alters behaviors related to fear and anxiety and that nicotine contributes to the development, maintenance, and reoccurrence of anxiety disorders. PMID:26231942

  19. Biological predictors of pharmacological therapy in anxiety disorders

    PubMed Central

    Maron, Eduard; Nutt, David

    2015-01-01

    At least one third of patients with anxiety disorders do not adequately respond to available pharmacological treatment. The reason that some patients with anxiety disorders respond well, but others not, to the same classes of medication is not yet fully understood. It is suggested that several biological factors may influence treatment mechanisms in anxiety and therefore could be identified as possible biomarkers predicting treatment response. In this review, we look at current evidence exploring different types of treatment predictors, including neuroimaging, genetic factors, and blood-related measures, which could open up novel perspectives in clinical management of patients with anxiety disorders. PMID:26487811

  20. Temperament, Attentional Processes, and Anxiety: Diverging Links between Adolescents with and without Anxiety Disorders?

    ERIC Educational Resources Information Center

    Vervoort, Leentje; Wolters, Lidewij H.; Hogendoorn, Sanne M.; Prins, Pier J.; de Haan, Else; Boer, Frits; Hartman, Catharina A.

    2011-01-01

    The present study first examined the links between reactive temperament (negative affectivity), regulative temperament (effortful control [EC]) and internalizing problems in adolescents (12-18 years) with anxiety disorders (ANX; N = 39) and without anxiety disorders (nANX; N = 35). Links differed between ANX and nANX participants. Negative…

  1. Diagnosis and management of post-traumatic stress disorder.

    PubMed

    Grinage, Bradley D

    2003-12-15

    Although post-traumatic stress disorder (PTSD) is a debilitating anxiety disorder that may cause significant distress and increased use of health resources, the condition often goes undiagnosed. The lifetime prevalence of PTSD in the United States is 8 to 9 percent, and approximately 25 to 30 percent of victims of significant trauma develop PTSD. The emotional and physical symptoms of PTSD occur in three clusters: re-experiencing the trauma, marked avoidance of usual activities, and increased symptoms of arousal. Before a diagnosis of PTSD can be made, the patient's symptoms must significantly disrupt normal activities and last for more than one month. Approximately 80 percent of patients with PTSD have at least one comorbid psychiatric disorder. The most common comorbid disorders include depression, alcohol and drug abuse, and other anxiety disorders. Treatment relies on a multidimensional approach, including supportive patient education, cognitive behavior therapy, and psychopharmacology. Selective serotonin reuptake inhibitors are the mainstay of pharmacologic treatment. PMID:14705759

  2. 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…

  3. 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

  4. 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,

  5. Functional Gastrointestinal Symptoms in Children with Anxiety Disorders

    ERIC Educational Resources Information Center

    Waters, Allison M.; Schilpzand, Elizabeth; Bell, Clare; Walker, Lynn S.; Baber, Kari

    2013-01-01

    This study examined the incidence and correlates of functional gastrointestinal symptoms in children with anxiety disorders. Participants were 6-13 year old children diagnosed with one or more anxiety disorders (n = 54) and non-clinical control children (n = 51). Telephone diagnostic interviews were performed with parents to determine the presence

  6. 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,…

  7. 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…

  8. Functional Gastrointestinal Symptoms in Children with Anxiety Disorders

    ERIC Educational Resources Information Center

    Waters, Allison M.; Schilpzand, Elizabeth; Bell, Clare; Walker, Lynn S.; Baber, Kari

    2013-01-01

    This study examined the incidence and correlates of functional gastrointestinal symptoms in children with anxiety disorders. Participants were 6-13 year old children diagnosed with one or more anxiety disorders (n = 54) and non-clinical control children (n = 51). Telephone diagnostic interviews were performed with parents to determine the presence…

  9. Increased Anxiety, Akathisia, and Suicidal Thoughts in Patients with Mood Disorder on Aripiprazole and Lamotrigine

    PubMed Central

    Pondé, Milena Pereira; Freire, Antonio Carlos Cruz

    2015-01-01

    Introduction. Akathisia affects around 18% of patients with bipolar disorder treated with aripiprazole and may worsen when aripiprazole is combined with lamotrigine and antidepressants. Case. This paper reports on two clinical cases involving patients with a diagnosis of mood disorder who developed severe akathisia, anxiety, and suicidal ideation while using a combination of aripiprazole, antidepressants, and lamotrigine. Discussion. We recommend that patients with a mood disorder taking multiple drugs should begin aripiprazole therapy with low doses and be monitored for the development of akathisia, increased anxiety, or suicidal thoughts. The appearance of these limiting side effects requires discontinuation of the drug. PMID:26509095

  10. Anxiety sensitivity and drug or alcohol use in individuals with anxiety and substance use disorders.

    PubMed

    DeHaas, R A; Calamari, J E; Bair, J P; Martin, E D

    2001-01-01

    Anxiety sensitivity (AS) has been linked to both pathological anxiety and substance use problems. We evaluated relations between AS and substance use situations among individuals with substance use disorders (SUDs) and concurrent DSM-IV anxiety disorders. We predicted that AS would be most strongly associated with substance use in situations involving negative emotions and interpersonal conflict in substance abusers with anxiety disorders. This group was compared to substance abusers with concurrent mood disorders and substance abusers without other disorders (N=88). AS was positively related to negative emotion situations substance use for substance abusers with anxiety disorders and for substance abusers without other disorders. Contrary to predictions, significant differences between these groups were not found. The relationship between AS and negative emotion situations substance use remained after controlling trait anxiety in a combined group (anxiety disorders and substance abuse only groups). AS did not predict substance use for participants with concurrent mood disorders. Identification of factors that place anxious patients at risk for substance use problems will have implications for treatment and for the prevention of this form of maladaptive coping. PMID:11768545

  11. Anxiety and Depressive Symptoms and Medical Illness Among Adults with Anxiety Disorders

    PubMed Central

    Niles, Andrea N.; Dour, Halina J.; Stanton, Annette L.; Roy-Byrne, Peter P.; Stein, Murray B.; Sullivan, Greer; Sherbourne, Cathy D.; Rose, Raphael D.; Craske, Michelle G.

    2014-01-01

    Objective Anxiety is linked to a number of medical conditions, yet few studies have examined how symptom severity relates to medical comorbidity. Purpose The current study assessed associations between severity of anxiety and depression and presence of medical conditions in adults diagnosed with anxiety disorders. Method Nine-hundred eighty-nine patients diagnosed with panic, generalized anxiety, social anxiety, and posttraumatic stress disorders reported on the severity of anxiety and depressive symptoms and on diagnoses of 11 medical conditions. Results Severity of anxiety and depressive symptoms was strongly associated with having more medical conditions over and above control variables, and the association was as strong as that between BMI and disease. Odds of having asthma, heart disease, back problems, ulcer, migraine headache and eyesight difficulties also increased as anxiety and depressive symptom severity increased. Anxiety symptoms were independently associated with ulcer, whereas depressive symptoms were independently associated with heart disease, migraine, and eyesight difficulties. Conclusions These findings add to a growing body of research linking anxiety disorders with physical health problems and indicate that anxiety and depressive symptoms deserve greater attention in their association with disease. PMID:25510186

  12. Cognitive risk profiles for anxiety disorders in a high-risk population.

    PubMed

    Bardeen, Joseph R; Stevens, Erin N; Clark, Charles Brendan; Lahti, Adrienne C; Cropsey, Karen L

    2015-09-30

    The purpose of the present study was to identify subgroups of participants who may be at particularly high risk for anxiety pathology based on specific combinations of demographic characteristics and higher-order cognitive abilities in a population at disproportionate risk for deficits in cognitive abilities (i.e., smokers within the criminal justice system). Participants (N=495) provided demographic information, were administered a semi-structured diagnostic interview, and completed a number of measures assessing cognitive abilities. A receiver-operating characteristic (ROC) model using signal detection theory indicated that the strongest predictor of anxiety disorder diagnosis was race, with White participants having a 30.6% likelihood of diagnosis and participants in the non-White category (97% of which identified as Black/African American) having a 18.9% likelihood of diagnosis. Interestingly, the individual risk profile associated with the highest probability of having a current anxiety disorder was characterized by White participants with impaired response inhibition (58.6%), and the lowest probability of having a current anxiety disorder was among non-White males (13.9%). The findings, which indicated that White individuals with impaired response inhibition are at a disproportionately high risk for anxiety disorders, suggest a potential target for prevention and intervention. PMID:26089016

  13. Delineation of Differential Temporal Relations between Specific Eating and Anxiety Disorders

    PubMed Central

    Buckner, Julia D.; Silgado, Jose; Lewinsohn, Peter M.

    2010-01-01

    This study examined the temporal sequencing of eating and anxiety disorders to delineate which anxiety disorders increase eating disorder risk and whether individuals with eating disorders are at greater risk for particular anxiety disorders. The sample was drawn from the Oregon Adolescent Depression Project. Temporal relations between specific eating and anxiety disorders were examined after controlling for relevant variables (e.g., mood disorders, other anxiety disorders) over 14 years. After excluding those with anorexia nervosa (AN) in adolescence (T1), OCD was the only T1 anxiety disorder to predict AN by age 30 (T4). No T1 anxiety disorder was associated with T4 bulimia nervosa (BN). Although T1 AN did not increase risk of any T4 anxiety disorder, T1 BN appeared to increase risk for social anxiety and panic disorders. Evidence that eating disorders may have differential relations to particular anxiety disorders could inform prevention and treatment efforts. PMID:20185151

  14. 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

  15. Anger profiles in social anxiety disorder.

    PubMed

    Versella, Mark V; Piccirillo, Marilyn L; Potter, Carrie M; Olino, Thomas M; Heimberg, Richard G

    2016-01-01

    Individuals with social anxiety disorder (SAD) exhibit elevated levels of anger and anger suppression, which are both associated with increased depression, diminished quality of life, and poorer treatment outcomes. However, little is known about how anger experiences differ among individuals with SAD and whether any heterogeneity might relate to negative outcomes. This investigation sought to empirically define anger profiles among 136 treatment-seeking individuals with SAD and to assess their association with distress and impairment. A latent class analysis was conducted utilizing the trait subscales of the State-Trait Anger Expression Inventory-2 as indicators of class membership. Analysis revealed four distinct anger profiles, with greatest distress and impairment generally demonstrated by individuals with elevated trait anger, a greater tendency to suppress the expression of anger, and diminished ability to adaptively control their anger expression. These results have implications for tailoring more effective interventions for socially anxious individuals. PMID:26590429

  16. 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

  17. 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

  18. 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…

  19. Serum docosahexaenoic acid (DHA) is inversely associated with anxiety disorders in early pregnancy.

    PubMed

    Verly-Miguel, Marcus Vinícius Barbosa; Farias, Dayana Rodrigues; Pinto, Thatiana de Jesus Pereira; Lepsch, Jaqueline; Nardi, Antonio Egidio; Kac, Gilberto

    2015-03-01

    Little is known about the association between polyunsaturated fatty acids (PUFAs) and anxiety disorders during pregnancy. We evaluated this association at the first pregnancy trimester in 228 women. The study endpoint was the diagnosis of any anxiety disorder assessed by the Mini International Neuropsychiatric Interview. The independent variables were the serum concentrations of total n-3 and fractions (18:2, 20:5, 22:5, 22:6), total n-6 and fractions (18:2, 18:3, 20:2, 20:3, 20:4, 22:4, 22:5) and the n-6/n-3 ratio PUFAs. The prevalence of any anxiety disorders was 25%. The first tertile of the docosahexaenoic acid (DHA, 22:6 n-3) distribution represented 1.95 (95% CI: 1.00-3.77) higher chance of having an anxiety disorder diagnosis, compared to those in the second and third tertiles after adjusting the analyses for parity, family income, early pregnancy BMI and gestational age at the blood sampling. Serum concentrations of DHA were inversely associated with the occurrence of early pregnancy anxiety disorders. PMID:25591045

  20. [Separation anxiety disorder: evidence of literature and clinical implications].

    PubMed

    Bruschi, Angelo; De Angelis, Andrea; Grandinetti, Paolo; Pascucci, Marco; Janiri, Luigi; Pozzi, Gino

    2012-01-01

    Since the mid-90s several studies have proven the existence of an Adult form of the Separation Anxiety Disorder (ASAD) not yet nosologically recognized by the international psychiatric classification systems (DSM and ICD). An increasing amount of evidence showed that the separation anxiety disorder may arise at any age, not always in continuation with the correspondent childhood disorder. So, a revision of the diagnostic criteria for this disorder is brought into question, as the onset is currently limited before 18 years of age. Different tools have been developed for the assessment of ASAD: 1) the Adult Separation Anxiety Structured Interview (ASA-SI), a semi-structured interview with items derived and adapted from the DSM-IV-TR childhood disorder; 2) the Adult Separation Anxiety-27 (ASA-27), a self-administered rating scale containing the same items of ASA-SI; 3) the Structured Clinical Interview for Separation Anxiety Symptoms (SCI-SAS), a structured interview including two specific forms for childhood and adulthood. However, according to available evidence, the separation anxiety may be a dimension with cross-nosographical presentation in nearly all the commonest mood and anxiety disorders; moreover, it is connected to greater personal dysfunction and lower responsiveness to treatment. Furthermore, a deeper comprehension of the psychobiological nature of separation anxiety should lead to newer and more effective therapeutic intervention. Literature is reviewed awaiting the publication of DSM-V. PMID:23160046

  1. Pharmacotherapy for anxiety disorders in children and adolescents

    PubMed Central

    Kodish, Ian; Rockhill, Carol; Varley, Chris

    2011-01-01

    Anxiety disorders are the most common mental health diagnoses in youth, and carry risks for ongoing impairments and subsequent development of other psychiatric comorbidities into adulthood. This article discusses considerations for assessment and treatment of anxiety disorders in youth, with a focus on the evidence base of pharmacologic treatment and important clinical considerations to optimize care. We then briefly describe the impact of anxiety on neuronal elements of fear circuitry to highlight how treatments may ameliorate impairments through enhanced plasticity Overall, pharmacotherapy for anxiety disorders is effective in improving clinical symptoms, particularly in combination with psychotherapy. Response is typically seen within several weeks, yet longitudinal studies are limited. Selective serotonin reuptake inhibitors are thought to be relatively safe and effective for acute treatment of several classes of anxiety disorders in youth, with increasing evidence supporting the role of neuronal plasticity in recovery. PMID:22275849

  2. Treating Anxiety Disorders in Children: Results of a Randomized Clinical Trial.

    ERIC Educational Resources Information Center

    Kendall, Philip C.

    1994-01-01

    Investigated psychosocial treatment for 47 children with anxiety disorders, comparing cognitive-behavioral treatment with wait-list condition. Evaluated outcomes using child self-report, parent report, teacher report, cognitive assessment, and behavioral observations. Found that many treated subjects were without diagnosis at posttest and at

  3. 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

  4. Anxiety Disorder amongst Secondary School Children in an Urban City in Nigeria.

    PubMed

    Frank-Briggs, Angela I; Alikor, E A D

    2010-09-01

    Anxiety is a source of concern to the clinicians as it is co morbid with other mental disorders, particularly depression and learning disabilities, and it causes low self-esteem. The aim of this research was to evaluate the prevalence of anxiety disorder amongst secondary school children in Port Harcourt. A two-staged stratified sampling method was used to select the schools. Structured questionnaire based on Vanderbilt ADHD Diagnostic Teacher Rating Scale for anxiety and depression symptoms was used in evaluating the students. The questionnaires administered to the students were filled with the assistance of the researchers and the classroom teachers. Direct verbal interview was conducted for those noted to have symptoms of any of the various types of anxiety disorders and fears. Out of 885 students, 91 met the criteria for the diagnosis of anxiety/ depression disorder; prevalence was 10.28%, age range was 9-18 years. There were 37 males and 54 females giving a male: female ratio of 0.69:1. Majority 52 (57.14%) of the children lived with their parents, 28 (30.77%) of them lived with family relations and 11 (12.09%) of them were working as house helps to other families. The reasons given for being anxious were poor self image, fear of death, repeated physical and sexual abuses by their care givers and other adults. Learning disability was the major associated co morbid disorder (18.68%). Generalized anxiety was the most common type of anxiety disorder identified (32.97%). Anxiety disorders are debilitating chronic conditions. When it affects school aged children it contributes significantly to poor academic performance. PMID:23675199

  5. Anxiety disorders of childhood and adolescence: a critical review.

    PubMed

    Bernstein, G A; Borchardt, C M

    1991-07-01

    The 1980s were a decade of advancement in the knowledge of anxiety disorders in children and adolescents; this sets the stage for research achievements in the 1990s. This review examines the anxiety disorders of childhood and adolescence (separation anxiety disorder, overanxious disorder, and avoidant disorder), including prevalence rates, demographic profiles, comparisons of clinical presentations in different developmental age groups, and comorbidity patterns. Fears and simple phobias, obsessive-compulsive disorder, post-traumatic stress disorder, and panic disorder in children and adolescents are also evaluated. The controversy of whether panic attacks occur in prepubertal children is addressed. A brief review of behavioral and pharmacological treatment studies is included. Future directions for research are suggested. PMID:1890084

  6. Current approaches to the pharmacologic treatment of anxiety disorders.

    PubMed

    Sheehan, David V; Sheehan, Kathy Harnett

    2007-01-01

    Despite their high prevalence, the anxiety disorders are underdiagnosed and undertreated. Benzodiazepines, once the first line of treatment, have been superceded by SSRIs as the treatment of choice. Preclinical studies, however, suggest that CRF antagonists and antagonists of nicotinic,glutamate,5-HT1A,and NK-1 receptors may have potential anxiolytic action. Preliminary data suggest that tiagabine, the only available SGRI, may also be beneficial in the anxiety disorders. Further research on these novel agents in anxiety disorders is needed. PMID:17285100

  7. 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

  8. 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…

  9. Is childhood physical abuse associated with anxiety disorders among adults?

    PubMed

    Fuller-Thomson, E; Sohn, H R; Brennenstuhl, S; Baker, T M

    2012-01-01

    Several studies have examined the association between childhood physical abuse (CPA) and anxiety disorders with inconsistent results. In order to help clarify this relationship, we investigated the association between CPA and current anxiety disorders while controlling for the following groups of factors: (1) demographics; (2) family background; (3) current socioeconomic status (SES); (4) current stressors; and (5) current mood disorders. Data from the 2005 Canadian Community Health Survey were analyzed. The sample included 12,481 respondents from the Canadian provinces of Manitoba and Saskatchewan. The regional-level response rate was 84%. Fully 7.3% (n = 964) of respondents reported they had been physically abused as a child or adolescent by someone close to them and 4.4% (n = 540) reported they had been diagnosed with an anxiety disorder by a health professional. A significant association between CPA and anxiety disorders was found when controlling for demographic factors, family background, current SES and stressors (OR = 1.61; 95% CI = 1.25, 2.08). The odds of anxiety disorders declined to non-significance when further statistical adjustments were made for current mood disorders. The findings of this research suggest that the relationship between CPA and anxiety may be largely explained by co-morbid mood disorders. PMID:22681187

  10. The development of anxiety disorders in childhood: an integrative review.

    PubMed

    Murray, L; Creswell, C; Cooper, P J

    2009-09-01

    We present an integrative review of the development of child anxiety, drawing on a number of strands of research. Family aggregation and genetic studies indicate raised vulnerability to anxiety in offspring of adults with the disorder (e.g. the temperamental style of behavioural inhibition, or information processing biases). Environmental factors are also important; these include adverse life events and exposure to negative information or modelling. Parents are likely to be key, although not unique, sources of such influences, particularly if they are anxious themselves. Some parenting behaviours associated with child anxiety, such as overprotection, may be elicited by child characteristics, especially in the context of parental anxiety, and these may serve to maintain child disorder. Emerging evidence emphasizes the importance of taking the nature of child and parental anxiety into account, of constructing assessments and interventions that are both disorder specific, and of considering bidirectional influences. PMID:19215631

  11. Anxiety in youth with autism spectrum disorders: implications for treatment.

    PubMed

    Johnco, Carly; Storch, Eric A

    2015-01-01

    Anxiety disorders are one of the most common psychiatric comorbidities among children and adolescents with autism spectrum disorders (ASD). There has been a recent proliferation of research examining the prevalence, phenomenology, assessment and treatment of anxiety disorders among youth with ASD. While there is currently very limited support for the use of pharmacological agents to treat anxiety among youth with ASD and comorbid anxiety, there has been overwhelming support across numerous modestly sized controlled studies for the efficacy of cognitive behavioral therapy. This review discusses advances in the treatment literature for anxiety in youth with ASD, and discusses the current evidence base for whether standard treatment needs to be adapted for this population. PMID:26548429

  12. Symptoms: Personal snapshots of anxiety disorders | NIH MedlinePlus the Magazine

    MedlinePlus

    ... of this page please turn Javascript on. Feature: Phobias and Anxiety Disorders Symptoms: Personal snapshots of anxiety ... And it was scary.” Social Anxiety Disorder (Social Phobia): "In any social situation, I felt fear. I ...

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

    ERIC Educational Resources Information Center

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

    2013-01-01

    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,

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

    ERIC Educational Resources Information Center

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

    2013-01-01

    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,…

  15. Adjustment Disorder: epidemiology, diagnosis and treatment

    PubMed Central

    2009-01-01

    Background Adjustment Disorder is a condition strongly tied to acute and chronic stress. Despite clinical suggestion of a large prevalence in the general population and the high frequency of its diagnosis in the clinical settings, there has been relatively little research reported and, consequently, very few hints about its treatments. Methods the authors gathered old and current information on the epidemiology, clinical features, comorbidity, treatment and outcome of adjustment disorder by a systematic review of essays published on PUBMED. Results After a first glance at its historical definition and its definition in the DSM and ICD systems, the problem of distinguishing AD from other mood and anxiety disorders, the difficulty in the definition of stress and the implied concept of 'vulnerability' are considered. Comorbidity of AD with other conditions, and outcome of AD are then analyzed. This review also highlights recent data about trends in the use of antidepressant drugs, evidence on their efficacy and the use of psychotherapies. Conclusion AD is a very common diagnosis in clinical practice, but we still lack data about its rightful clinical entity. This may be caused by a difficulty in facing, with a purely descriptive methods, a "pathogenic label", based on a stressful event, for which a subjective impact has to be considered. We lack efficacy surveys concerning treatment. The use of psychotropic drugs such as antidepressants, in AD with anxious or depressed mood is not properly supported and should be avoided, while the usefulness of psychotherapies is more solidly supported by clinical evidence. To better determine the correct course of therapy, randomized-controlled trials, even for the combined use of drugs and psychotherapies, are needed vitally, especially for the resistant forms of AD. PMID:19558652

  16. Adapting Manualized Treatments: Treating Anxiety Disorders among Native Americans

    ERIC Educational Resources Information Center

    De Coteau, Tami; Anderson, Jessiline; Hope, Debra

    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…

  17. Illness anxiety disorder related to filariasis: a case report.

    PubMed

    Karia, Sagar; Shah, Nilesh; Sonavane, Sushma; De Sousa, Avinash

    2015-04-01

    Lymphatic filariasis is a parasitic disease which is associated with anxiety and depression and may also result in social isolation. We present here a case of illness anxiety disorder where the patient developed a morbid fear that he will develop filariasis. PMID:26012217

  18. 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,…

  19. Family Factors in the Development and Management of Anxiety Disorders

    ERIC Educational Resources Information Center

    Rapee, Ronald M.

    2012-01-01

    Family variables are thought to play a key role in a wide variety of psychopathology according to many theories. Yet, specific models of the development of anxiety disorders place little emphasis on general family factors despite clear evidence that anxiety runs in families. The current review examines evidence for the involvement of a number of…

  20. Examining the Screen for Child Anxiety-Related Emotional Disorder-71 as an Assessment Tool for Anxiety in Children with High-Functioning Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    van Steensel, Francisca J. A.; Deutschman, Amber A. C. G.; Bgels, Susan M.

    2013-01-01

    The psychometric properties of a questionnaire developed to assess symptoms of anxiety disorders (SCARED-71) were compared between two groups of children: children with high-functioning autism spectrum disorder and comorbid anxiety disorders (ASD-group; "n" = 115), and children with anxiety disorders (AD-group; "n" = 122).

  1. Examining the Screen for Child Anxiety-Related Emotional Disorder-71 as an Assessment Tool for Anxiety in Children with High-Functioning Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    van Steensel, Francisca J. A.; Deutschman, Amber A. C. G.; Bögels, Susan M.

    2013-01-01

    The psychometric properties of a questionnaire developed to assess symptoms of anxiety disorders (SCARED-71) were compared between two groups of children: children with high-functioning autism spectrum disorder and comorbid anxiety disorders (ASD-group; "n" = 115), and children with anxiety disorders (AD-group; "n" = 122).…

  2. The Development of Anxiety Disorders: Considering the Contributions of Attachment and Emotion Regulation

    ERIC Educational Resources Information Center

    Esbjorn, B. H.; Bender, P. K.; Reinholdt-Dunne, M. L.; Munck, L. A.; Ollendick, T. H.

    2012-01-01

    Anxiety disorders are among the most common psychiatric disorders in childhood. Nonetheless, theoretical knowledge of the development and maintenance of childhood anxiety disorders is still in its infancy. Recently, research has begun to investigate the influence of emotion regulation on anxiety disorders. Although a relation between anxiety

  3. Lifetime and Current Mood and Anxiety Disorders in Short-Term and Long-Term Abstinent Alcoholics

    PubMed Central

    Fein, George

    2013-01-01

    BACKGROUND A high prevalence of comorbid mood and anxiety disorders has been demonstrated in alcoholics. We examined lifetime and current mood and anxiety diagnoses and symptoms in long-term (mean 7.6 years; n = 110) and short-term (mean 10.1 weeks; n = 101) abstinent alcoholics (LTAA and STAA) and non substance abusing controls (NSAC; n = 82). All alcoholics met DSM-IV lifetime alcohol dependence criteria. About half of each alcoholic group had lifetime drug dependence. METHODS Alcohol use was assessed using timeline follow-back methodology and drug and alcohol use disorders were diagnosed using the AUDADIS-IV. Lifetime and current mood and anxiety disorder diagnoses and symptom counts were gathered using the c-DIS. RESULTS Over 60% of STAA and LTAA had a lifetime internalizing diagnosis vs. about 15% of NSAC, with no difference between STAA and LTAA. The Group effect on lifetime diagnoses was independent of comorbid drug dependence or gender and was of comparable size for mood and anxiety disorders. Current diagnoses showed a similar pattern, except that STAA had more current mood diagnoses than LTAA. Excluding individuals with lifetime internalizing diagnoses, alcoholics still had more mood and anxiety symptoms than controls. CONCLUSIONS 1) The presence of a lifetime mood or anxiety diagnosis or of a current anxiety diagnosis did not differ between STAA and LTAA, suggesting that such diagnoses do not impact one’s ability to achieve or maintain abstinence. 2) Prevalence of mood and anxiety diagnoses were unaffected by presence of a comorbid substance use disorder, and 3) excluding individuals with a mood or anxiety diagnosis does not eliminate mood and anxiety symptom count differences between groups. PMID:23895247

  4. Assessment and treatment of anxiety disorders in children and adolescents.

    PubMed

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

    2015-07-01

    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) for the treatment of these conditions in youth and suggest that the combination of psychotherapy?+?an SSRI may be associated with greater improvement than would be expected with either treatment as monotherapy. PMID:25980507

  5. 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

  6. [Adult attention deficit/hyperactivity disorder, associated symptoms and comorbid psychiatric disorders: diagnosis and pharmacological treatment].

    PubMed

    Paslakis, G; Schredl, M; Alm, B; Sobanski, E

    2013-08-01

    Adult attention deficit/hyperactivity disorder (ADHD) is characterised by inattention and/or hyperactivity and impulsivity and is a frequent psychiatric disorder with childhood onset. In addition to core symptoms, patients often experience associated symptoms like emotional dysregulation or low self-esteem and suffer from comorbid disorders, particularly depressive episodes, substance abuse, anxiety or sleep disorders. It is recommended to include associated symptoms and comorbid psychiatric disorders in the diagnostic set-up and in the treatment plan. Comorbid psychiatric disorders should be addressed with disorder-specific therapies while associated symptoms also often improve with treatment of the ADHD core symptoms. The most impairing psychiatric disorder should be treated first. This review presents recommendations for differential diagnosis and treatment of adult ADHD with associated symptoms and comorbid psychiatric disorders with respect to internationally published guidelines, clinical trials and expert opinions. PMID:23864520

  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. 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…

  9. Autism Spectrum Disorder Scale Scores in Pediatric Mood and Anxiety Disorders

    ERIC Educational Resources Information Center

    Pine, Daniel S.; Guyer, Amanda E.; Goldwin, Michelle; Towbin, Kenneth A.; Leibenluft, Ellen

    2008-01-01

    A study compares the scores on autism spectrum disorder (ASD) symptom scales in healthy children and in children with mood or anxiety disorders. It is observed that children with mood or anxiety disorders obtained higher scores on ASD symptom scales than healthy children.

  10. Drug development for anxiety disorders: new roles for atypical antipsychotics.

    PubMed

    Carson, William H; Kitagawa, Hisashi

    2004-01-01

    Anxiety disorders are prevalent and frequently comorbid with depression. Rates of response and remission for anxiety disorders are low despite marked improvements in treatment in the past several decades. Antidepressants and anxiolytics remain the most frequently prescribed agents for anxiety disorders, but the numbers of prescriptions for novel forms of therapy, such as anticonvulsants and atypical antipsychotics are increasing. For the atypical antipsychotics, agonist activity at the 5-HT1A receptor has been hypothesized to translate into anxiolytic effects. A small, but growing, literature suggests that atypical antipsychotics are useful as augmentation therapy for treatment of refractory anxiety disorders. The next generation antipsychotic, aripiprazole, has a unique mechanism of action (ie, combined D2 and 5-HT1A partial agonist and 5-HT2A antagonist) and improves depressive and depressive/anxiety symptoms in patients with schizophrenia. Further studies examining the effect of aripiprazole and other atypical antipsychotic drugs on depressive and anxiety symptoms in patients with refractory anxiety disorders are warranted. Psychopharmacology Bulletin. 2004;38(Suppl 1): 38-45. PMID:15278017

  11. Understanding Perceptions of Anxiety Disorders and Their Treatment.

    PubMed

    Schofield, Casey A; Dea Moore, Crystal; Hall, Anna; Coles, Meredith E

    2016-02-01

    Characterizing areas of limited knowledge about anxiety disorders and their treatment may help inform treatment dissemination efforts and public health programming. In a sample of 626 adults recruited via Amazon's Mechanical Turk, this study evaluated 1) perceptions of symptoms of anxiety disorders and depression, 2) perceived usefulness of coping approaches (i.e., professional and non-professional help), and 3) awareness of available resources. Results indicated that participants generally recognized that symptoms warranted professional help, and recognition was associated with self-efficacy for seeking mental health care, but not with participants' own symptoms. Furthermore, participants perceived psychotherapy to be the most useful coping approach. Of concern is the perception that symptoms are the result of personal weakness (particularly among male participants and for social anxiety disorder), as well as limited knowledge about publicly available resources. In all, results suggest that there are areas for growth regarding mental health literacy for anxiety disorders. PMID:26669982

  12. Nature and psychological management of anxiety disorders in youth.

    PubMed

    Rapee, Ronald M

    2015-03-01

    Anxiety disorders affect around 5% of the paediatric population at any given time and are associated with high social and personal impact. These disorders typically begin early in life, and children with anxiety disorders are at increased risk for a variety of later difficulties across the life-span. Although causes of anxiety in childhood are not fully understood, there is a strong heritable component. Additional risk factors include temperament, parent psychopathology, parent handling and peer interactions. Psychological treatments have demonstrated good efficacy with around 60% of anxious youth being in diagnostic remission immediately following treatment and a further 10% remitting over the following months. Because young people with anxiety disorders are among the least likely to seek appropriate help, paediatricians are in a unique position to identify anxious young people, educate families and recommend appropriate intervention. PMID:25758307

  13. Nightmares: from anxiety symptom to sleep disorder.

    PubMed

    Spoormaker, Victor I; Schredl, Michael; van den Bout, Jan

    2006-02-01

    The DSM-IV-TR definition of nightmares-extremely frightening dreams from which the person wakes up directly-is unnecessarily narrow. Other emotions (anger, grief) have also been reported in nightmares, and direct awakening from a bad dream seems to be unrelated to increased distress. In addition, assessment of nightmares is problematic. Polysomnographic recordings have an ameliorating effect on nightmare frequency, retrospective measurements tend to underestimate nightmare frequency, and persons with frequent nightmares may feel reluctant to fill out (daily) prospective measurements. For studying nightmares, it is necessary to distinguish idiopathic nightmares from posttraumatic nightmares, which are part of a posttraumatic stress reaction or disorder that may result from experiencing a traumatic event. Both types of nightmares have been associated with an elevated level of periodic limb movements, although only posttraumatic nightmares seem to be related to more and longer nocturnal awakenings. Nightmares have also been repeatedly associated with the general level of psychopathology, or the so-called personality factor neuroticism. Nightmare distress, the impact on daily functioning caused by nightmares, may function as a mediating variable. Several studies in the last decades have shown that nightmares can be treated with several cognitive-behavioral techniques. The cognitive-restructuring technique imagery rehearsal therapy is the treatment of choice for nightmares, although a randomized controlled trial with an attention control-group has not yet been carried out. Nightmares are more than a symptom of a larger (anxiety) syndrome and need to be viewed from a sleep medicine perspective: nightmares are a highly prevalent and separate sleep disorder that can and should receive specific treatment. PMID:16377217

  14. Withdrawing Benzodiazepines in Patients With Anxiety Disorders.

    PubMed

    Lader, Malcolm; Kyriacou, Andri

    2016-01-01

    The large class of CNS-depressant medications-the benzodiazepines-have been extensively used for over 50years, anxiety disorders being one of the main indications. A substantial proportion (perhaps up to 20-30%) of long-term users becomes physically dependent on them. Problems with their use became manifest, and dependence, withdrawal difficulties and abuse were documented by the 1980s. Many such users experience physical and psychological withdrawal symptoms on attempted cessation and may develop clinically troublesome syndromes even during slow tapering. Few studies have been conducted to establish the optimal withdrawal schedules. The usual management comprises slow withdrawal over weeks or months together with psychotherapy of various modalities. Pharmacological aids include antidepressants such as the SSRIs especially if depressive symptoms supervene. Other pharmacological agents such as the benzodiazepine antagonist, flumazenil, and the hormonal agent, melatonin, remain largely experimental. The purpose of this review is to analyse the evidence for the efficacy of the usual withdrawal regimes and the newer agents. It is concluded that little evidence exists outside the usual principles of drug withdrawal but there are some promising leads. PMID:26733324

  15. Post-traumatic stress disorder, depression and generalised anxiety disorder in adolescents after a natural disaster: a study of comorbidity

    PubMed Central

    2006-01-01

    Background Information on mental health sequel in adolescents following natural disasters from developing countries is scant. Method Around one year after a super-cyclone, proportion of adolescents exhibiting post-traumatic psychiatric symptoms, prevalence of post-traumatic stress disorder (PTSD), major depression and generalized anxiety disorder, comorbidity and impairment of performance in school were studied in Orissa, India. Mini International Neuropsychiatric Interview for children and adolescents was used for evaluation and diagnosis. The criteria for diagnoses were based on Diagnostic and Statistical Manual of Mental Disorders – IV. Results Post-disaster psychiatric presentation in adolescents was a conglomeration of PTSD, depression and anxiety symptoms. The prevalences of PTSD, major depressive disorder and generalised anxiety disorder were 26.9%, 17.6% and 12.0% respectively. Proportion of adolescents with any diagnosis was 37.9%. Comorbidity was found in 39.0% of adolescents with a psychiatric diagnosis. Adolescents from middle socioeconomic status were more affected. There were gender differences in the presentation of the symptoms rather than on the prevalence of diagnoses. Prolonged periods of helplessness and lack of adequate post-disaster psychological support were perceived as probable influencing factors, as well as the severity of the disaster. Conclusion The findings of the study highlight the continuing need for identification and intervention for post-disaster psychiatric morbidities in adolescent victims in developing countries. PMID:16869979

  16. 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

  17. 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

  18. Interventions to improve management of anxiety disorders in general practice: a systematic review

    PubMed Central

    Heideman, Jantien; van Rijswijk, Eric; van Lin, Nieke; de Loos, Sandra; Laurant, Miranda; Wensing, Michel; van de Lisdonk, Eloy; Grol, Richard

    2005-01-01

    Background Anxiety disorders are common in general practice and are associated with several problems regarding recognition and management. Aim To systematically evaluate the effectiveness of interventions aimed at improving recognition, diagnosis, and management of patients with anxiety disorders. Design of study Systematic review. Method MEDLINE, EMBASE, PsychINFO, and the Cochrane Clinical Trials' Register were searched up until 2003. Randomised controlled trials, controlled before/after trials, and interrupted time series for professional, organisational, financial, and regulatory interventions were eligible. Primary effect measures consisted of anxiety outcomes, diagnosis, prescription, and referral. Two reviewers independently made eligibility judgments: eight out of 563 articles were found to be eligible. Two reviewers participated independently in the quality assessment and data extraction process using a standardised form based on the Effective Practice and Organisation of Care checklist. Relative risks or standardised mean differences were calculated when possible. Results Four professional interventions and three organisational interventions were examined. In general, the professional interventions seemed to increase recognition, referral, and prescription as well as improving anxiety outcomes. Two out of three organisational interventions showed a positive effect on anxiety outcomes. The one study that took prescription into account showed no effect. Conclusions The quality of care for patients with anxiety can be improved. A combination of professional and organisational interventions in which an external expert is introduced seems to be most promising. Additional research is nevertheless necessary to determine the exact effects of such interventions using patient effect measures, economic evaluations, and feasibility studies. PMID:16282004

  19. Predictors of treatment outcome in an effectiveness trial of cognitive behavioral therapy for children with anxiety disorders.

    PubMed

    Wergeland, Gro Janne H; Fjermestad, Krister W; Marin, Carla E; Bjelland, Ingvar; Haugland, Bente Storm Mowatt; Silverman, Wendy K; Öst, Lars-Göran; Bjaastad, Jon Fauskanger; Oeding, Kristin; Havik, Odd E; Heiervang, Einar R

    2016-01-01

    A substantial number of children with anxiety disorders do not improve following cognitive behavioral therapy (CBT). Recent effectiveness studies have found poorer outcome for CBT programs than what is typically found in efficacy studies. The present study examined predictors of treatment outcome among 181 children (aged 8-15 years), with separation anxiety, social phobia, or generalized anxiety disorder, who participated in a randomized, controlled effectiveness trial of a 10-session CBT program in community clinics. Potential predictors included baseline demographic, child, and parent factors. Outcomes were as follows: a) remission from all inclusion anxiety disorders; b) remission from the primary anxiety disorder; and c) child- and parent-rated reduction of anxiety symptoms at post-treatment and at 1-year follow-up. The most consistent findings across outcome measures and informants were that child-rated anxiety symptoms, functional impairment, a primary diagnosis of social phobia or separation anxiety disorder, and parent internalizing symptoms predicted poorer outcome at post-treatment. Child-rated anxiety symptoms, lower family social class, lower pretreatment child motivation, and parent internalizing symptoms predicted poorer outcome at 1-year follow-up. These results suggest that anxious children with more severe problems, and children of parents with elevated internalizing symptom levels, may be in need of modified, additional, or alternative interventions to achieve a positive treatment outcome. PMID:26583954

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

    PubMed Central

    Wong, Nina; Beidel, Deborah C.; Spitalnick, Josh

    2013-01-01

    Objective 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. Method 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. Results 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. Additionally, parents were satisfied with the virtual environment augmented treatment and indicated that they would recommend the program to family and friends. Conclusion 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

  1. Examining the Panic Attack Specifier in Social Anxiety Disorder.

    PubMed

    Allan, Nicholas P; Oglesby, Mary E; Short, Nicole A; Schmidt, Norman B

    2016-04-01

    Panic attacks (PAs) are characterized by overwhelming surges of fear and discomfort and are one of the most frequently occurring symptoms in psychiatric populations. The most recent version of the Diagnostic and Statistical Manual of Mental Disorders (i.e. DSM-5) allows for a panic attack (PA) specifier for all disorders, including social anxiety disorder (SAD). However, there is little research examining differences between individuals diagnosed with SAD with the PA specifier versus individuals diagnosed with SAD without the PA specifier. The current study examined social anxiety, mood, anxiety, and anxiety sensitivity social concerns, a risk factor for social anxiety in SAD-diagnosed individuals without (N = 52) and with (N = 14) the PA specifier. The groups differed only in somatic symptoms of anxiety. Result of the current study provides preliminary evidence that the presence of the PA specifier in social anxiety does not result in elevated levels of comorbidity or a more severe presentation of social anxiety. PMID:26750995

  2. Object relations theory and pharmacopsychotherapy of anxiety disorders.

    PubMed

    Hamilton, N G; Sacks, L H; Hamilton, C A

    1994-01-01

    This paper provides an overview of object relations concepts, applying them specifically to combined psychoterapy-pharmacotherapy of anxiety disorders. Anxiety in this clinical theory is conceptualized as arising from threatened loss of the self- and object-relationship. At a rudimentary level, individuals can attempt to manage potential loss through splitting and projective identification. As benign and loving experiences accumulate and ego functions neurophysiologically develop, whole object relations provide alternate and more modulated ways of coping with anxiety. In anxiety disorders, these more mature coping styles break down. Treatment combining object relations approaches to psychotherapy with pharmacotherapy pay particular attention to the relationship aspects and meanings of medication and prescribing. These approaches use the concepts of empathy, containment, countertransference, splitting, projective identification, and transitional object formation to help patients come to terms with their anxiety and with the treatment relationship. PMID:7992869

  3. Treating adolescents with social anxiety disorder in schools.

    PubMed

    Ryan, Julie L; Warner, Carrie Masia

    2012-01-01

    As is evident from the topic of this issue, schools can play an important role in addressing the unmet mental health needs of youth. Social anxiety disorder is particularly suited to being treated in the school setting. This article describes an empirically supported school-based intervention for social anxiety disorder, skills for academic and social success, and provides specific strategies to school counselors, teachers and community practitioners for implementing these methods. This article focuses on practical approaches for working with socially anxious adolescents in the school setting and how to increase awareness of social anxiety with parents and school personnel. PMID:22137815

  4. The serotonin-1A receptor in anxiety disorders.

    PubMed

    Akimova, Elena; Lanzenberger, Rupert; Kasper, Siegfried

    2009-10-01

    The serotonin system plays an important role in the neural processing of anxiety. The involvement of the main inhibitory serotonergic receptor, the serotonin-1A (5-HT1A) subtype, in dysfunctional forms of anxiety has been supported by findings from a wide range of preclinical research and clinical trials, including treatment studies, genetic research, and neuroimaging data. The following article summarizes preclinical results with a focus on 5-HT1A receptor knockout and transgenic mice as genetic models of anxiety. Behavioral, autonomic, and endocrinological changes in these mice are reported. This article also presents genetic polymorphisms in humans associated with increased anxiety scores and pharmacological data focused on 5-HT1A receptor agonists and antagonists. Furthermore, molecular neuroimaging results are presented. Recent positron emission tomography (PET) studies have reported reduced 5-HT1A receptor binding in patients with panic disorder and social anxiety disorder, but not in posttraumatic stress disorder. In healthy subjects, increased anxiety scores might be associated with lower 5-HT1A receptor binding. This overview of preclinical and clinical data provides strong evidence for the key role of the 5-HT1A receptor in the serotonergic dysregulation of anxiety disorders. PMID:19423077

  5. Neurocircuitry underlying risk and resilience to social anxiety disorder

    PubMed Central

    Clauss, Jacqueline A.; Avery, Suzanne N.; VanDerKlok, Ross M.; Rogers, Baxter P.; Cowan, Ronald L.; Benningfield, Margaret M.; Blackford, Jennifer Urbano

    2015-01-01

    Background Almost half of children with an inhibited temperament will develop social anxiety disorder by late adolescence. Importantly, this means that half of children with an inhibited temperament will not develop social anxiety disorder. Studying adults with an inhibited temperament provides a unique opportunity to identify neural signatures of both risk and resilience to social anxiety disorder. Methods Functional MRI was used to measure brain activation during the anticipation of viewing fear faces in 34 young adults (17 inhibited, 17 uninhibited). To identify neural signatures of risk, we tested for group differences in functional activation and connectivity in regions implicated in social anxiety disorder, including the prefrontal cortex, amygdala, and insula. To identify neural signatures of resilience, we tested correlations between brain activation and both emotion regulation and social anxiety scores. Results Inhibited subjects had greater activation of a prefrontal network when anticipating viewing fear faces, relative to uninhibited subjects. No group differences were identified in the amygdala. Inhibited subjects had more negative connectivity between the rostral anterior cingulate cortex (ACC) and the bilateral amygdala. Within the inhibited group, those with fewer social anxiety symptoms and better emotion regulation skills had greater ACC activation and greater functional connectivity between the ACC and amygdala. Conclusions These finding suggest that engaging regulatory prefrontal regions during anticipation may be a protective factor, or putative neural marker of resilience, in high-risk individuals. Cognitive training targeting prefrontal cortex function may provide protection against anxiety, especially in high-risk individuals, such as those with inhibited temperament. PMID:24753211

  6. Distress tolerance in OCD and anxiety disorders, and its relationship with anxiety sensitivity and intolerance of uncertainty.

    PubMed

    Laposa, Judith M; Collimore, Kelsey C; Hawley, Lance L; Rector, Neil A

    2015-06-01

    There is a growing interest in the role of distress tolerance (i.e., the capacity to withstand negative emotions) in the onset and maintenance of anxiety. However, both empirical and theoretical knowledge regarding the role of distress tolerance in the anxiety disorders is relatively under examined. Accumulating evidence supports the relationship between difficulties tolerating distress and anxiety in nonclinical populations; however, very few studies have investigated distress tolerance in participants with diagnosed anxiety disorders. Individuals with social anxiety disorder (SAD), generalized anxiety disorder (GAD), panic disorder with and without agoraphobia (PD/A) and obsessive-compulsive disorder (OCD) completed measures of distress tolerance (DT), conceptually related measures (i.e., anxiety sensitivity (AS), intolerance of uncertainty (IU)), and anxiety symptom severity. Results showed that DT was negatively associated with AS and IU. DT was correlated with GAD, SAD and OCD symptoms, but not PD/A symptoms, in individuals with those respective anxiety disorders. DT was no longer a significant predictor of OCD or anxiety disorder symptom severity when AS and IU were also taken into account. There were no between group differences on DT across OCD and the anxiety disorder groups. Implications for the role of distress tolerance in anxiety pathology are discussed. PMID:25956557

  7. Neuroimaging predictors of treatment response in anxiety disorders

    PubMed Central

    2013-01-01

    Although several psychological and pharmacological treatment options are available for anxiety disorders, not all patients respond well to each option. Furthermore, given the relatively long duration of adequate treatment trials, finding a good treatment fit can take many months or longer. Thus, both clinicians and patients would benefit from the identification of objective pre-treatment measures that predict which patients will best respond to a given treatment. Recent studies have begun to use biological measures to help predict symptomatic change after treatment in anxiety disorders. In this review, we summarize studies that have used structural and functional neuroimaging measures to predict treatment response in obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), generalized anxiety disorder (GAD), and social anxiety disorder (SAD). We note the limitations of the current studies and offer suggestions for future research. Although the literature is currently small, we conclude that pre-treatment neuroimaging measures do appear to predict treatment response in anxiety disorders, and future research will be needed to determine the relative predictive power of neuroimaging measures as compared to clinical and demographic measures. PMID:23915782

  8. Physiological markers for anxiety: panic disorder and phobias.

    PubMed

    Roth, Walton T

    2005-01-01

    Physiological activation is a cardinal symptom of anxiety, although physiological measurement is still not used for psychiatric diagnosis. An ambulatory study of phobics who were afraid of highway driving showed a concordance between self-reported anxiety during driving, autonomic activation, hypocapnia, and sighing respiration. Patients with panic attacks do not exhibit autonomic activation when they are quietly sitting and not having panic attacks, but do have the same respiratory abnormalities as driving phobics, suggesting that these abnormalities could be a marker for panic disorder. Such abnormalities are compatible with both the false suffocation alarm (D. Klein) and hyperventilation (R. Ley) theories of panic. Hypocapnia, however, is often absent during full-blown panic attacks. Since activation functions as preparation for physical activity, it may not occur when a patient has learned that avoidance of fear by flight or fight is futile. We developed a capnometry feedback assisted breathing training therapy for panic disorder designed to reduce hyperventilation and making breathing regular. Without feedback, conventional therapeutic breathing instructions may actually increase hyperventilation by increasing dyspnea. Five weekly therapy sessions accompanied by daily home practice with a capnometer produced marked clinical improvement compared to changes in an untreated group. Improvement was sustained over a 12-month follow-up period. The therapist avoided any statements or procedures designed to alter cognitions. Improvement occurred regardless of whether patients initially reported mostly respiratory or non-respiratory symptoms during their attacks. There is evidence that modifying any of the three systems comprising a fear network can be therapeutic, as exemplified by cognitive therapy modifying thoughts, exposure therapy modifying avoidance, and breathing training procedures modifying pCO(2). PMID:16137780

  9. Parents' State and Trait Anxiety: Relationships with Anxiety Severity and Treatment Response in Adolescents with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Conner, Caitlin M.; Maddox, Brenna B.; White, Susan W.

    2013-01-01

    Comorbid anxiety is common among children with Autism Spectrum Disorder (ASD), and parents of children with ASD are more likely to have anxiety disorders. This study investigated the relationship between parents' state and trait anxiety and parent-reported internalizing and externalizing symptoms among adolescents (n = 30) with ASD, as well

  10. Ambiguity in the Manifestation of Adult Separation Anxiety Disorder Occurring in Complex Anxiety Presentations: Two Clinical Case Reports

    ERIC Educational Resources Information Center

    Dudaee-Faass, Sigal; Marnane, Claire; Wagner, Renate

    2009-01-01

    Two case reports are described in which patients presented for the treatment of multiple comorbid anxiety disorders, all of which appeared to derive from prolonged separation anxiety disorder. In particular, these adults had effectively altered their lifestyles to avoid separation, thereby displaying only ambiguous separation anxiety symptoms that

  11. Ambiguity in the Manifestation of Adult Separation Anxiety Disorder Occurring in Complex Anxiety Presentations: Two Clinical Case Reports

    ERIC Educational Resources Information Center

    Dudaee-Faass, Sigal; Marnane, Claire; Wagner, Renate

    2009-01-01

    Two case reports are described in which patients presented for the treatment of multiple comorbid anxiety disorders, all of which appeared to derive from prolonged separation anxiety disorder. In particular, these adults had effectively altered their lifestyles to avoid separation, thereby displaying only ambiguous separation anxiety symptoms that…

  12. Parents' State and Trait Anxiety: Relationships with Anxiety Severity and Treatment Response in Adolescents with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Conner, Caitlin M.; Maddox, Brenna B.; White, Susan W.

    2013-01-01

    Comorbid anxiety is common among children with Autism Spectrum Disorder (ASD), and parents of children with ASD are more likely to have anxiety disorders. This study investigated the relationship between parents' state and trait anxiety and parent-reported internalizing and externalizing symptoms among adolescents (n = 30) with ASD, as well…

  13. Family Factors in the Development, Treatment, and Prevention of Childhood Anxiety Disorders

    ERIC Educational Resources Information Center

    Drake, Kelly L.; Ginsburg, Golda S.

    2012-01-01

    It is now widely accepted that anxiety disorders run in families, and current etiological models have proposed both genetic and environmental pathways to anxiety development. In this paper, the familial role in the development, treatment, and prevention of anxiety disorders in children is reviewed. We focus on three anxiety disorders in youth,…

  14. Family Factors in the Development, Treatment, and Prevention of Childhood Anxiety Disorders

    ERIC Educational Resources Information Center

    Drake, Kelly L.; Ginsburg, Golda S.

    2012-01-01

    It is now widely accepted that anxiety disorders run in families, and current etiological models have proposed both genetic and environmental pathways to anxiety development. In this paper, the familial role in the development, treatment, and prevention of anxiety disorders in children is reviewed. We focus on three anxiety disorders in youth,

  15. The Relationship between Anxiety and Repetitive Behaviours in Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Rodgers, J.; Glod, M.; Connolly, B.; McConachie, H.

    2012-01-01

    Children with Autism Spectrum Disorder are vulnerable to anxiety. Repetitive behaviours are a core feature of Autism Spectrum Disorder (ASD) and have been associated with anxiety. This study examined repetitive behaviours and anxiety in two groups of children with autism spectrum disorder, those with high anxiety and those with lower levels of

  16. The Relationship between Anxiety and Repetitive Behaviours in Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Rodgers, J.; Glod, M.; Connolly, B.; McConachie, H.

    2012-01-01

    Children with Autism Spectrum Disorder are vulnerable to anxiety. Repetitive behaviours are a core feature of Autism Spectrum Disorder (ASD) and have been associated with anxiety. This study examined repetitive behaviours and anxiety in two groups of children with autism spectrum disorder, those with high anxiety and those with lower levels of…

  17. 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

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

    PubMed Central

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

    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 are rare. The purpose of this study was to examine prospectively the relationship between parental substance use disorders and the course of anxiety disorders in adulthood over the course of 12 years. Methods Data on 618 subjects were derived from the Harvard/Brown Anxiety Research Project (HARP), a longitudinal naturalistic investigation of the clinical course of multiple anxiety disorders. Kaplan-Meier survival estimates were used to calculate probabilities of time to anxiety disorder remission and relapse. Proportional hazards regressions were conducted to determine whether the likelihood of remission and relapse for specific anxiety disorders was lower for those who had a history of parental substance use disorders than for individuals without this parental history. Results Adults with a history of parental substance use disorders were significantly more likely to be divorced and to have a high school level of education. History of parental substance use disorder was a significant predictor of relapse of social phobia and panic disorders. Conclusion These findings provide compelling evidence that adult children of parents with substance use disorders are more likely to have relapses of social phobia and panic disorders. Clinicians who treat adults with anxiety disorders should assess parental substance use disorders and dependence histories. Such information may facilitate treatment planning with regards to their patients' level of vulnerability to perceive scrutiny by others in social situations, and ability to maintain a long-term panic-free state. PMID:17466067

  19. Correlation of cerebrovascular disorder and anxiety: The Kecskemet study

    NASA Astrophysics Data System (ADS)

    Sipos, Kornel; Bodo, Michael; Szalay, Piroska; Szucs, Attila

    2010-04-01

    In order to test the hypothesis that anxiety is a risk factor for cardiovascular disease, specifically stroke, we simultaneously measured anxiety and cerebral vascular alternation, using a computer-based system, "Cerberus." Sixty nine psychiatric patients (including an alcoholic subgroup) were selected as subjects for measurements conducted in Kecskemet, Hungary. The five-item short form of anxiety test (STAI) was administered twice during the same session. Between each test, brain pulse waves were recorded by rheoencephalogram (REG). A REG peak time above 180 milliseconds was considered a cerebrovascular alteration (modified after Jenkner). Data were sorted into two groups: low anxiety (N=10) and high anxiety (N=10). Significant differences were found between cardiovascular risk factors (p< 0.001), REG peak time (p<0.043), and heart rate (p< 0.045). Six subjects showed cerebrovascular alteration in the high anxiety group, and two in the low anxiety group. For the two anxiety groups, there were no significant differences in body mass index, cardiovascular sympathetic-parasympathetic balance, age and symptoms of transient ischemic attack. The correlation of REG and age was significantly different only for the alcoholic subgroup (Szalay et al, 2007). These data support the hypothesis that a correlation exists between cerebrovascular disorder and anxiety in the studied population.

  20. Atomoxetine Treatment for Pediatric Patients with Attention-Deficit/Hyperactivity Disorder with Comorbid Anxiety Disorder

    ERIC Educational Resources Information Center

    Geller, Daniel; Donnelly, Craig; Lopez, Frank; Rubin, Richard; Newcorn, Jeffrey; Sutton, Virginia; Bakken, Rosalie; Paczkowski, Martin; Kelsey, Douglas; Sumner, Calvin

    2007-01-01

    Objective: Research suggests 25% to 35% of children with attention-deficit/hyperactivity disorder (ADHD) have comorbid anxiety disorders. This double-blind study compared atomoxetine with placebo for treating pediatric ADHD with comorbid anxiety, as measured by the ADHD Rating Scale-IV-Parent Version: Investigator Administered and Scored…

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

    ERIC Educational Resources Information Center

    Chalfant, Anne Marie; Rapee, Ron; Carroll, Louisa

    2007-01-01

    A family-based, cognitive behavioural treatment for anxiety in 47 children with comorbid anxiety disorders and High Functioning Autism Spectrum Disorder (HFA) was evaluated. Treatment involved 12 weekly group sessions and was compared with a waiting list condition. Changes between pre- and post-treatment were examined using clinical interviews as…

  2. Targeting the endocannabinoid system to treat anxiety-related disorders.

    PubMed

    Korem, Nachshon; Zer-Aviv, Tomer Mizrachi; Ganon-Elazar, Eti; Abush, Hila; Akirav, Irit

    2016-05-01

    The endocannabinoid system plays an important role in the control of emotions, and its dysregulation has been implicated in several psychiatric disorders. The most common self-reported reason for using cannabis is rooted in its ability to reduce feelings of stress, tension, and anxiety. Nevertheless, there are only few studies in controlled clinical settings that confirm that administration of cannabinoids can benefit patients with a post-traumatic stress disorder (PTSD). There are considerable encouraging preclinical data to suggest that endocannabinoid-targeted therapeutics for anxiety disorders should continue. In this review, we will describe data supporting a role for the endocannabinoid system in preventing and treating anxiety-like behavior in animal models and PTSD patients. Cannabinoids have shown beneficial outcomes in rat and mouse models of anxiety and PTSD, but they also may have untoward effects that discourage their chronic usage, including anxiogenic effects. Hence, clinical and preclinical research on the endocannabinoid system should further study the effects of cannabinoids on anxiety and help determine whether the benefits of using exogenous cannabinoids outweigh the risks. In general, this review suggests that targeting the endocannabinoid system represents an attractive and novel approach to the treatment of anxiety-related disorders and, in particular, PTSD. PMID:26426887

  3. Interpersonal Emotion Regulation Model of Mood and Anxiety Disorders

    PubMed Central

    Hofmann, Stefan G.

    2014-01-01

    Although social factors are of critical importance in the development and maintenance of emotional disorders, the contemporary view of emotion regulation has been primarily limited to intrapersonal processes. Based on diverse perspectives pointing to the communicative function of emotions, the social processes in self-regulation, and the role of social support, this article presents an interpersonal model of emotion regulation of mood and anxiety disorders. This model provides a theoretical framework to understand and explain how mood and anxiety disorders are regulated and maintained through others. The literature, which provides support for the model, is reviewed and the clinical implications are discussed. PMID:25267867

  4. The overlap between anxiety, depression, and obsessive-compulsive disorder.

    PubMed

    Goodwin, Guy M

    2015-09-01

    The anxiety disorders include generalized anxiety disorder, specific phobia, social phobia, agoraphobia, and panic disorder. In addition to the specific symptoms of these disorders, there may be a common experience of anxiety and even dysphoria across the conditions, and of course recourse to the same drug or choice of drugs for treatment. This overlap probably occurs because of universal dimensions of distress or negative affectivity, a shared genetic predisposition, and a common neurobiology Evidence of shared genes is still based mainly on twin studies, but the shared neurobiology can be investigated directly by the investigation of emotional or cognitive bias either behaviorally or using functional brain imaging. This intermediate phenotype can then provide a substrate for understanding and developing medicines and psychological treatments. PMID:26487806

  5. Sibling relationships of anxiety disordered children--a research note.

    PubMed

    Lindhout, Ingeborg E; Boer, Frits; Markus, Monica T; Hoogendijk, Thea H G; Maingay, Ragna; Borst, Sophie R

    2003-01-01

    There is a paucity of knowledge on the role of sibling relationships in internalizing disorders. Research in nonclinical populations suggests an association between internalizing problems in children and negative sibling interactions. Further, an association is reported between internalizing problems and actual or perceived parental differential treatment. This study examines sibling relationship qualities and perceived parental differential treatment in a clinical sample. Participants included 24 anxiety disordered children (ages 8-13 years) and 25 nondisordered control children (ages 7-13 years). Anxiety disordered and nondisordered children do not differ with regard to perceived affection or hostility from a sibling. Anxiety disordered children, however, report significantly more parental differential treatment than do nondisordered children. PMID:12941369

  6. The overlap between anxiety, depression, and obsessive-compulsive disorder

    PubMed Central

    Goodwin, Guy M.

    2015-01-01

    The anxiety disorders include generalized anxiety disorder, specific phobia, social phobia, agoraphobia, and panic disorder. In addition to the specific symptoms of these disorders, there may be a common experience of anxiety and even dysphoria across the conditions, and of course recourse to the same drug or choice of drugs for treatment. This overlap probably occurs because of universal dimensions of distress or negative affectivity, a shared genetic predisposition, and a common neurobiology Evidence of shared genes is still based mainly on twin studies, but the shared neurobiology can be investigated directly by the investigation of emotional or cognitive bias either behaviorally or using functional brain imaging. This intermediate phenotype can then provide a substrate for understanding and developing medicines and psychological treatments. PMID:26487806

  7. 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

  8. 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,

  9. 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,…

  10. Treatment of comorbid anxiety and autism spectrum disorders

    PubMed Central

    Nadeau, Joshua; Sulkowski, Michael L; Ung, Danielle; Wood, Jeffrey J; Lewin, Adam B; Murphy, Tanya K; May, Jill Ehrenreich; Storch, Eric A

    2011-01-01

    Summary Clinically significant anxiety occurs frequently among individuals with autism spectrum disorders (ASDs) and is linked to increased psychosocial, familial, behavioral and academic impairment beyond the core autism symptoms when present. Although efforts are underway to establish empirically supported treatments for anxiety among individuals with ASDs, this remains an emerging research area. This literature review summarizes available information on the efficacy of pharmacological and psychosocial approaches for treating anxiety and repetitive behaviors in children, adolescents and adults with ASDs. Specifically, we evaluate evidence for the use of cognitive–behavioral therapy and selective serotonin-reuptake inhibitors. Evidence is growing in support of using cognitive–behavioral therapy to treat anxiety in youths with ASDs; however, mixed evidence exists for its application in treating repetitive behaviors, as well as the use of selective serotonin-reuptake inhibitors for anxiety in youths with ASDs. We conclude the article with a discussion of the strength of current information and next steps in research. PMID:24174992

  11. Panic Disorder, Social Anxiety Disorder, and a possible medical syndrome previously linked to Chromosome 13

    PubMed Central

    Talati, Ardesheer; Ponniah, Kathryn; Strug, Lisa J.; Hodge, Susan E.; Fyer, Abby J.; Weissman, Myrna M.

    2010-01-01

    Background Several studies have identified increased medical problems among individuals with panic disorder (PD). We previously found that specific conditions— interstitial cystitis (IC), mitral valve prolapse (MVP), migraines, and thyroid disorders— aggregated non-randomly among panic families (we called this the “PD syndrome”), and that families with and without the syndrome were genetically distinguishable on chromosome 13. We present data from a new case-control study that replicates and extends the syndrome phenotype clinically. Method Probands with a definite diagnosis and family history of PD (N= 219), social anxiety disorder (SAD; 199), or both (173), and 102 controls with no personal/family history of anxiety, were interviewed using the SADS-LA diagnostic instrument. Medical history was obtained via medical checklist and the family history screen; IC symptoms were assessed using criteria developed by the National Institute for Diabetes and Digestive and Kidney Diseases. Subjects and interviewers were unaware of the syndrome hypothesis; final best-estimate diagnoses were blind to syndrome data. Results Probands with PD or SAD, as compared to controls, were five or more times as likely to report IC symptoms, and twice as likely to report MVP and migraines (other genitourinary and cardiovascular problems were not elevated). First-degree relatives of probands with PD or SAD were also at increased risk for IC, MVP, thyroid problems and headaches, regardless of whether the proband reported the same condition. Conclusion These findings are consistent with previous data supporting a PD syndrome, and further suggest that this syndrome may include other anxiety disorders well. PMID:17920564

  12. Mechanisms of Selective Attention in Generalized Anxiety Disorder

    PubMed Central

    Yiend, Jenny; Mathews, Andrew; Burns, Tom; Dutton, Kevin; Fernández-Martín, Andrés; Georgiou, George A.; Luckie, Michael; Rose, Alexandra; Russo, Riccardo; Fox, Elaine

    2015-01-01

    A well-established literature has identified different selective attentional orienting mechanisms underlying anxiety-related attentional bias, such as engagement and disengagement of attention. These mechanisms are thought to contribute to the onset and maintenance of anxiety disorders. However, conclusions to date have relied heavily on experimental work from subclinical samples. We therefore investigated individuals with diagnosed generalized anxiety disorder (GAD), healthy volunteers, and individuals with high trait anxiety (but not meeting GAD diagnostic criteria). Across two experiments we found faster disengagement from negative (angry and fearful) faces in GAD groups, an effect opposite to that expected on the basis of the subclinical literature. Together these data challenge current assumptions that we can generalize, to those with GAD, the pattern of selective attentional orienting to threat found in subclinical groups. We suggest a decisive two-stage experiment identifying stimuli of primary salience in GAD, then using these to reexamine orienting mechanisms across groups. PMID:26504675

  13. 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

  14. An overview of Indian research in anxiety disorders

    PubMed Central

    Trivedi, J. K.; Gupta, Pawan Kumar

    2010-01-01

    Anxiety is arguably an emotion that predates the evolution of man. Its ubiquity in humans, and its presence in a range of anxiety disorders, makes it an important clinical focus. Developments in nosology, epidemiology and psychobiology have led to significant advancement in our understanding of the anxiety disorders in recent years. Advances in pharmacotherapy and psychotherapy of these disorders have brought realistic hope for relief of symptoms and improvement in functioning to patients. Neurotic disorders are basically related to stress, reaction to stress (usually maladaptive) and individual proneness to anxiety. Interestingly, both stress and coping have a close association with socio-cultural factors. Culture can effect symptom presentation, explanation of the illness and help-seeking. Importance given to the symptoms and meaning assigned by the physician according to their cultural background also differs across culture. In this way culture can effect epidemiology, phenomenology as well as treatment outcome of psychiatric illness especially anxiety disorders. In this review an attempt has been made to discuss such differences, as well as to reflect the important areas in which Indian studies are lacking. An attempt has been made to include most Indian studies, especially those published in Indian Journal of Psychiatry. PMID:21836680

  15. Anxiety trajectories in response to a speech task in social anxiety disorder: Evidence from a randomized controlled trial of CBT.

    PubMed

    Morrison, Amanda S; Brozovich, Faith A; Lee, Ihno A; Jazaieri, Hooria; Goldin, Philippe R; Heimberg, Richard G; Gross, James J

    2016-03-01

    The subjective experience of anxiety plays a central role in cognitive behavioral models of social anxiety disorder (SAD). However, much remains to be learned about the temporal dynamics of anxiety elicited by feared social situations. The aims of the current study were: (1) to compare anxiety trajectories during a speech task in individuals with SAD (n=135) versus healthy controls (HCs; n=47), and (2) to compare the effects of CBT on anxiety trajectories with a waitlist control condition. SAD was associated with higher levels of anxiety and greater increases in anticipatory anxiety compared to HCs, but not differential change in anxiety from pre- to post-speech. CBT was associated with decreases in anxiety from pre- to post-speech but not with changes in absolute levels of anticipatory anxiety or rates of change in anxiety during anticipation. The findings suggest that anticipatory experiences should be further incorporated into exposures. PMID:26760456

  16. Anxiety disorders and GABA neurotransmission: a disturbance of modulation

    PubMed Central

    Nuss, Philippe

    2015-01-01

    Lines of evidence coming from many branches of neuroscience indicate that anxiety disorders arise from a dysfunction in the modulation of brain circuits which regulate emotional responses to potentially threatening stimuli. The concept of anxiety disorders as a disturbance of emotional response regulation is a useful one as it allows anxiety to be explained in terms of a more general model of aberrant salience and also because it identifies avenues for developing psychological, behavioral, and pharmacological strategies for the treatment of anxiety disorder. These circuits involve bottom-up activity from the amygdala, indicating the presence of potentially threatening stimuli, and top-down control mechanisms originating in the prefrontal cortex, signaling the emotional salience of stimuli. Understanding the factors that control cortical mechanisms may open the way to identification of more effective cognitive behavioral strategies for managing anxiety disorders. The brain circuits in the amygdala are thought to comprise inhibitory networks of γ-aminobutyric acid-ergic (GABAergic) interneurons and this neurotransmitter thus plays a key role in the modulation of anxiety responses both in the normal and pathological state. The presence of allosteric sites on the GABAA receptor allows the level of inhibition of neurons in the amygdala to be regulated with exquisite precision, and these sites are the molecular targets of the principal classes of anxiolytic drugs. Changes in the levels of endogenous modulators of these allosteric sites as well as changes in the subunit composition of the GABAA receptor may represent mechanisms whereby the level of neuronal inhibition is downregulated in pathological anxiety states. Neurosteroids are synthesized in the brain and act as allosteric modulators of the GABAA receptor. Since their synthesis is itself regulated by stress and by anxiogenic stimuli, targeting the neurosteroid-GABAA receptor axis represents an attractive target for the modulation of anxiety. PMID:25653526

  17. 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

  18. Coping and Social Support as Potential Moderators of the Relation Between Anxiety and Eating Disorder Symptomatology

    PubMed Central

    Fitzsimmons, Ellen E.; Bardone-Cone, Anna M.

    2010-01-01

    Trait anxiety and eating disorder (ED) symptomatology are often thought to be inextricably linked. Because anxiety often precedes an ED, predicts poor outcome, and persists even after recovery from an ED, it is important to examine whether certain factors have the ability to potentially attenuate anxiety’s effect on eating pathology. In the current study, we examined two possible moderating factors: coping skills and social support. Participants were 96 females seen at one point for an ED at a Midwestern clinic, including 53 with a current ED diagnosis and 43 who no longer met criteria for an ED and who were at varying levels of recovery. Results revealed that emotion-oriented coping moderated the relation between anxiety and ED symptoms. Individuals who were high in trait anxiety and who reported low levels of emotion-oriented coping reported much lower levels of ED symptomatology than those with high trait anxiety and high emotion-oriented coping. Contrary to our hypotheses, task-oriented coping, avoidance-oriented coping, and perceived social support (total, family, friend, and special person) did not emerge as moderators of the relation between trait anxiety and eating pathology. Results provide growing support that factors that interact with anxiety can lessen anxiety’s effect on eating pathology. Implications for treatment and future directions are discussed. PMID:21184969

  19. Social anxiety and eating disorder comorbidity: The role of negative social evaluation fears

    PubMed Central

    Levinson, Cheri A.; Rodebaugh, Thomas L.

    2011-01-01

    Social anxiety and eating disorders are highly comorbid. However, it is unknown how specific domains of social anxiety relate to disordered eating. We provide data on these relationships and investigate social appearance anxiety and fear of negative evaluation as potential vulnerabilities linking social anxiety with eating disorders. Specifically, we examined five domains of social anxiety: Social interaction anxiety, fear of scrutiny, fear of positive evaluation, fear of negative evaluation, and social appearance anxiety. Results indicated that social appearance anxiety predicted body dissatisfaction, bulimia symptoms, shape concern, weight concern, and eating concern over and above fear of scrutiny, social interaction anxiety, and fear of positive evaluation. Fear of negative evaluation uniquely predicted drive for thinness and restraint. Structural equation modeling supported a model in which social appearance anxiety and fear of negative evaluation are vulnerabilities for both social anxiety and eating disorder symptoms. Interventions that target these negative social evaluation fears may help prevent development of eating disorders. PMID:22177392

  20. Stable Early Maternal Report of Behavioral Inhibition Predicts Lifetime Social Anxiety Disorder in Adolescence

    PubMed Central

    Chronis-Tuscano, Andrea; Degnan, Kathryn Amey; Pine, Daniel S.; Perez-Edgar, Koraly; Henderson, Heather A.; Diaz, Yamalis; Raggi, Veronica L.; Fox, Nathan A.

    2009-01-01

    Objective Behavioral inhibition (BI), a temperamental style identifiable in early childhood, is considered a risk factor for the development of anxiety disorders, particularly social anxiety disorder (SAD). However, few studies examining this question have evaluated the stability of BI across multiple developmental time points and followed participants into adolescence—the developmental period during which risk for SAD onset is at its peak. The current study used a prospective longitudinal design to determine whether stable early BI predicted the presence of psychiatric disorders and continuous levels of social anxiety in adolescents. It was hypothesized that stable BI would predict the presence of adolescent psychiatric diagnoses, specifically SAD. Method Participants included 126 adolescents aged 14 to 16 years who were first recruited at 4 months of age from hospital birth records. Temperament was measured at multiple time points between the ages of 14 months and 7 years. In adolescence, diagnostic interviews were conducted with parents and adolescents, and continuous measures of adolescent- and parent-reported social anxiety were collected. Results Stable maternal-reported early BI was associated with 3.79 times increased odds of a lifetime SAD diagnosis, but not other diagnoses, during adolescence (95% confidence interval 1.18–12.12). Stable maternal-reported early BI also predicted independent adolescent and parent ratings of ongoing social anxiety symptoms. Conclusions Findings suggesting that stable maternal-reported early BI predicts lifetime SAD have important implications for the early identification and prevention of SAD. PMID:19625982

  1. Effect of Mindfulness Based Stress Management on Reduction of Generalized Anxiety Disorder

    PubMed Central

    Asmaee Majid, S; Seghatoleslam, T; Homan, HA; Akhvast, A; Habil, H

    2012-01-01

    Background: The aim of this study was to evaluate whether an eight-week group mindfulness-based stress reduction program would be an acceptable and effective treatment for patients suffering from GAD. Methods: Eligible subjects with generalized anxiety disorder were recruited to Parsa Hospital and Shahid Rajaee Counseling and Social Work Center from June 2009 to October 2011. An experienced psychiatrist diagnosed these patients with a structured clinical interview for axis I disorders and a clinical psychologist conducted a clinical interview for in order to confirm the diagnosis. Subjects were randomized to an eight week course of group mindfulness based stress reduction program (16 subjects) or a control group (15 subjects). Subjects completed measures of anxiety, depressive symptoms and worry at baseline and end of treatment. To investigate the relationship between anxiety, depression and worry symptoms and mindfulness based stress reduction as well as controlling pretest effect, data were analyzed with analysis of covariance. Results: There were significant reductions in anxiety (P<0/001), depressive (P<0/001) and worry symptoms (P<0/001) from baseline to end of treatment. Conclusion: Mindfulness- based stress reduction may be an acceptable intervention in the improvement of generalized anxiety disorder symptoms. Future trials include development of randomized clinical trials of MBSR for GAD. PMID:23308349

  2. The Development of Anxiety Disorders: Considering the Contributions of Attachment and Emotion Regulation

    ERIC Educational Resources Information Center

    Esbjorn, B. H.; Bender, P. K.; Reinholdt-Dunne, M. L.; Munck, L. A.; Ollendick, T. H.

    2012-01-01

    Anxiety disorders are among the most common psychiatric disorders in childhood. Nonetheless, theoretical knowledge of the development and maintenance of childhood anxiety disorders is still in its infancy. Recently, research has begun to investigate the influence of emotion regulation on anxiety disorders. Although a relation between anxiety…

  3. Anxiety Disorders and Risk for Alcohol Use Disorders: The Moderating Effect of Parental Support

    PubMed Central

    Gorka, Stephanie M.; Shankman, Stewart A.; Olino, Thomas M.; Seeley, John R.; Kosty, Derek B.; Lewinsohn, Peter M.

    2014-01-01

    Background There have been mixed findings on the temporal relation between anxiety disorders and alcohol use disorders (AUDs), suggesting that the pathway to AUDs may differ among individuals. The aim of the current study was to test whether parental support moderated the association between anxiety disorders and the development of AUDs. We also tested whether our effects differed as a function of age of AUD onset. Methods 817 individuals were assessed for lifetime diagnoses of psychopathology during 4-waves between adolescence (mean age = 16) and adulthood (mean age = 30). Results Proportional hazards model analyses indicated that baseline anxiety disorders interacted with baseline perceived maternal support to prospectively predict onset of AUDs. At high levels of maternal support, anxiety disorders were associated with a reduced risk for AUD onset (HR=0.74, 95% CI = 0.55–1.00). However, this effect was more robust for AUDs that developed prior to age 20. At low levels of maternal support, anxiety disorders were associated with an increased risk for AUD onset (HR=1.65, 95% CI = 1.21–2.26). This effect was present for AUDs that developed across adolescence and adulthood. Paternal support was not associated with AUDs and did not interact with anxiety disorders. Conclusions Prevention and intervention efforts targeted at maternal support in adolescents with anxiety disorders may be valuable, as this may represent a factor that has a significant impact on the developmental course of AUDs. PMID:24846596

  4. Enhancing Exposure Therapy for Anxiety Disorders, Obsessive Compulsive Disorder, and Posttraumatic Stress Disorder

    PubMed Central

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

    2014-01-01

    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 (OCD), and posttraumatic stress disorder (PTSD). 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, OCD, and PTSD. 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 wide-spread 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

  5. 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. PMID:26106237

  6. Ministry of Health Clinical Practice Guidelines: Anxiety Disorders.

    PubMed

    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

    2015-06-01

    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. PMID:26106237

  7. SEPARATION ANXIETY DISORDER IN YOUTH: PHENOMENOLOGY, ASSESSMENT, AND TREATMENT

    PubMed Central

    Ehrenreich, Jill T.; Santucci, Lauren C.; Weiner, Courtney L.

    2009-01-01

    Separation Anxiety Disorder (SAD) is the most commonly diagnosed and impairing childhood anxiety disorder, accounting for approximately 50% of the referrals for mental health treatment of anxiety disorders. While considered a normative phenomenon in early childhood, SAD has the potential to negatively impact a child’s social and emotional functioning when it leads to avoidance of certain places, activities and experiences that are necessary for healthy development. Amongst those with severe symptoms, SAD may result in school refusal and a disruption in educational attainment. This paper provides a comprehensive review of the current literature on SAD etiology, assessment strategies, and empirically supported treatment approaches. New and innovative approaches to the treatment of SAD that also employ empirically supported techniques are highlighted. In addition, future directions and challenges in the assessment and treatment of SAD are addressed. PMID:19966943

  8. Neuroinflammatory pathways in anxiety, posttraumatic stress, and obsessive compulsive disorders.

    PubMed

    Furtado, Melissa; Katzman, Martin A

    2015-09-30

    As prevalence of anxiety, posttraumatic stress, and obsessive compulsive disorders continue to rise worldwide, increasing focus has been placed on immune mediated theories in understanding the underlying mechanisms of these disorders. Associations between the dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and these disorders have been recognized in the scientific literature, specifically in regard to cortisol levels, as well as changes in pro- and anti-inflammatory cytokines. The present commentary will systematically assess the scientific literature within the past decade in regard to the psychoneuroimmunology of anxiety, posttraumatic stress, and obsessive compulsive disorders. Understanding the mechanisms of these disorders is essential in order to determine efficacious and targeted treatment strategies, which may lead to substantial improvements in overall functioning, as well as significant decreases in societal and economic burden. PMID:26296951

  9. Social functioning in youth with anxiety disorders: association with anxiety severity and outcomes from cognitive-behavioral therapy.

    PubMed

    Settipani, Cara A; Kendall, Philip C

    2013-02-01

    Social functioning was assessed using the Child Behavior Checklist and Teacher Report Form for children with anxiety disorders who participated in a randomized clinical trial (N = 161, aged 7-14). Significant relationships were found between severity of children's principal anxiety disorder and most measures of social functioning, such that poorer social functioning was associated with more severe anxiety. Among youth who received cognitive-behavioral therapy (n = 111), significant associations were found between parent-reported social competence and both absence of principal anxiety disorder and lower anxiety severity at posttreatment and 1-year follow-up, controlling for the severity of the child's principal anxiety disorder at pretreatment. Findings support a relationship between anxiety severity and social difficulties, and suggest the importance of social competence for a favorable treatment response. PMID:22581270

  10. 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

  11. 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…

  12. [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

  13. [Differential Diagnosis of ADHD from Personality Disorders].

    PubMed

    Ushijima, Sadanobu

    2015-01-01

    The author discussed some points regarding the process of differentially diagnosing ADHD from antisocial personality disorder with antisocial behaviors, such as the use of amphetamines, theft, and violence, and borderline personality disorder with eating disorder, self-harming, overdose, and domestic violence. Firstly, the characteristics of ADHD are a lack of interest in criminal activity, cunning, cruelty, or coming from a broken home, which are frequently observed in cases of conduct disorder. The second point concerns the main anxieties and conflicts of those with ADHD and borderline personality disorder. ADHD patients usually do not have anxieties regarding sensitiveness in interpersonal relationships, which borderline patients are likely to have. The characteristic anxieties of ADHD patients usually involve self-reproach, self-deprecation, and self-hatred derived from various kinds of mistake associated with ADHD symptoms, such as a short attention span, restlessness, and impulsiveness. Finally, the author points out that we also have to be aware of the various kinds of identity problem, even in the case of patients with typical symptoms of ADHD. PMID:26721071

  14. Brain membrane lipids in major depression and anxiety disorders.

    PubMed

    Müller, Christian P; Reichel, Martin; Mühle, Christiane; Rhein, Cosima; Gulbins, Erich; Kornhuber, Johannes

    2015-08-01

    Major depression and anxiety disorders have high prevalence rates and are frequently comorbid. The neurobiological bases for these disorders are not fully understood, and available treatments are not always effective. Current models assume that dysfunctions in neuronal proteins and peptide activities are the primary causes of these disorders. Brain lipids determine the localization and function of proteins in the cell membrane and in doing so regulate synaptic throughput in neurons. Lipids may also leave the membrane as transmitters and relay signals from the membrane to intracellular compartments or to other cells. Here we review how membrane lipids, which play roles in the membrane's function as a barrier and a signaling medium for classical transmitter signaling, contribute to depression and anxiety disorders and how this role may provide targets for lipid-based treatment approaches. Preclinical findings have suggested a crucial role for the membrane-forming n-3 polyunsaturated fatty acids, glycerolipids, glycerophospholipids, and sphingolipids in the induction of depression- and anxiety-related behaviors. These polyunsaturated fatty acids also offer new treatment options such as targeted dietary supplementation or pharmacological interference with lipid-regulating enzymes. While clinical trials support this view, effective lipid-based therapies may need more individualized approaches. Altogether, accumulating evidence suggests a crucial role for membrane lipids in the pathogenesis of depression and anxiety disorders; these lipids could be exploited for improved prevention and treatment. This article is part of a Special Issue entitled Brain Lipids. PMID:25542508

  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. Comorbidity of dependent personality disorder and separation anxiety disorder in addictive disorders and in healthy subjects.

    PubMed

    Loas, Gwenolé; Atger, Frédéric; Perdereau, Fabienne; Verrier, Annie; Guelfi, Julien-Daniel; Halfon, Olivier; Lang, François; Bizouard, Paul; Venisse, Jean-Luc; Perez-Diaz, Fernando; Corcos, Maurice; Flament, Martine; Jeammet, Philippe

    2002-01-01

    The aim of the study was to determine the comorbidity of dependent personality disorder (DPD) and separation anxiety disorder (SAD) in large nonclinical and clinical samples. Using a cross-sectional method, the relationship between these disorders was studied in 784 healthy subjects and in 708 subjects presenting with various addictive behaviors. DPD was significantly associated with SAD in healthy subjects, alcoholics, drug abusers and anorectic and bulimic patients. The comorbidities of SAD and DPD suggest that specific therapeutic strategies could be discussed. Moreover, longitudinal studies are required to determine if SAD constitutes a risk factor for DPD. PMID:12239442

  17. Scalp acupuncture treatment protocol for anxiety disorders: a case report.

    PubMed

    He, Yuxin; Chen, Jia; Pan, Zimei; Ying, Zhou

    2014-07-01

    Anxiety disorders are among the most common psychiatric illnesses, and acupuncture treatment is widely accepted in the clinic without the side effects seen from various medications. We designed a scalp acupuncture treatment protocol by locating two new stimulation areas. The area one is between Yintang (M-HN-3) and Shangxing (DU-23) and Shenting (DU-24), and the area two is between Taiyang (M-HN-9) and Tianchong (GB-9) and Shuaigu (GB-8). By stimulating these two areas with high-frequency continuous electric waves, remarkable immediate and long-term effects for anxiety disorders have been observed in our practice. The first case was a 70-year-old male with general anxiety disorder (GAD) and panic attacks at night. The scalp acupuncture treatment protocol was applied with electric stimulation for 45 minutes once every week. After four sessions of acupuncture treatments, the patient reported that he did not have panic attacks at night and he had no feelings of anxiety during the day. Follow-up 4 weeks later confirmed that he did not have any episodes of panic attacks and he had no anxiety during the day since his last acupuncture treatment. The second case was a 35-year-old male who was diagnosed with posttraumatic stress disorder (PTSD) with a history of providing frontline trauma care as a Combat Medics from the Iraq combat field. He also had 21 broken bones and multiple concussions from his time in the battlefield. He had symptoms of severe anxiety, insomnia, nightmares with flashbacks, irritability, and bad temper. He also had chest pain, back pain, and joint pain due to injuries. The above treatment protocol was performed with 30 minutes of electric stimulation each time in combination with body acupuncture for pain management. After weekly acupuncture treatment for the first two visits, the patient reported that he felt less anxious and that his sleep was getting better with fewer nightmares. After six sessions of acupuncture treatments, the patient completely recovered from PTSD, went back to work, and now lives a healthy and happy family life. The above cases and clinical observation show that the scalp acupuncture treatment protocol with electric stimulation has a significant clinic outcome for GAD, panic disorder and PTSD. The possible mechanism of action of scalp acupuncture on anxiety disorder may be related to overlapping modulatory effects on the cortical structures (orbitofrontal cortex [OFC]) and medial prefrontal cortex [mPFC]) and subcortical/limbic regions (amygdala and hippocampus), and biochemical effect of acupuncture through immunohistochemistry (norepinephrine, serotonin) performed directly to the brain tissue for anxiety disorders. PMID:25105075

  18. Scalp Acupuncture Treatment Protocol for Anxiety Disorders: A Case Report

    PubMed Central

    Chen, Jia; Pan, Zimei; Ying, Zhou

    2014-01-01

    Anxiety disorders are among the most common psychiatric illnesses, and acupuncture treatment is widely accepted in the clinic without the side effects seen from various medications. We designed a scalp acupuncture treatment protocol by locating two new stimulation areas. The area one is between Yintang (M-HN-3) and Shangxing (DU-23) and Shenting (DU-24), and the area two is between Taiyang (M-HN-9) and Tianchong (GB-9) and Shuaigu (GB-8). By stimulating these two areas with high-frequency continuous electric waves, remarkable immediate and long-term effects for anxiety disorders have been observed in our practice. The first case was a 70-year-old male with general anxiety disorder (GAD) and panic attacks at night. The scalp acupuncture treatment protocol was applied with electric stimulation for 45 minutes once every week. After four sessions of acupuncture treatments, the patient reported that he did not have panic attacks at night and he had no feelings of anxiety during the day. Follow-up 4 weeks later confirmed that he did not have any episodes of panic attacks and he had no anxiety during the day since his last acupuncture treatment. The second case was a 35-year-old male who was diagnosed with posttraumatic stress disorder (PTSD) with a history of providing frontline trauma care as a Combat Medics from the Iraq combat field. He also had 21 broken bones and multiple concussions from his time in the battlefield. He had symptoms of severe anxiety, insomnia, nightmares with flashbacks, irritability, and bad temper. He also had chest pain, back pain, and joint pain due to injuries. The above treatment protocol was performed with 30 minutes of electric stimulation each time in combination with body acupuncture for pain management. After weekly acupuncture treatment for the first two visits, the patient reported that he felt less anxious and that his sleep was getting better with fewer nightmares. After six sessions of acupuncture treatments, the patient completely recovered from PTSD, went back to work, and now lives a healthy and happy family life. The above cases and clinical observation show that the scalp acupuncture treatment protocol with electric stimulation has a significant clinic outcome for GAD, panic disorder and PTSD. The possible mechanism of action of scalp acupuncture on anxiety disorder may be related to overlapping modulatory effects on the cortical structures (orbitofrontal cortex [OFC]) and medial prefrontal cortex [mPFC]) and subcortical/limbic regions (amygdala and hippocampus), and biochemical effect of acupuncture through immunohistochemistry (norepinephrine, serotonin) performed directly to the brain tissue for anxiety disorders. PMID:25105075

  19. Anxiety Profiles in Children with and without Developmental Coordination Disorder

    ERIC Educational Resources Information Center

    Pratt, Michelle L.; Hill, Elisabeth L.

    2011-01-01

    Previous work has highlighted that children diagnosed with DCD may be at risk of greater problems related to emotional wellbeing. However, to date much work has relied on population based samples, and anxiety has not been examined within a group of children given a clinical diagnosis of DCD. Additionally, the profile of individual differences has

  20. Depression, anxiety disorders, and metabolic syndrome in a population at risk for type 2 diabetes mellitus

    PubMed Central

    Kahl, Kai G; Schweiger, Ulrich; Correll, Christoph; Müller, Conrad; Busch, Marie-Luise; Bauer, Michael; Schwarz, Peter

    2015-01-01

    Background Depressive symptoms have been associated with type 2 diabetes mellitus (T2DM), but less is known about anxiety disorders that can be comorbid or exist without depression. Methods We evaluated the prevalence of psychiatric disorders in subjects consecutively examined at an outpatient clinic for diabetes prevention who were at-risk for T2DM, defined by FINDRISK scores, and compared metabolic syndrome (MetS) frequencies between subjects with and without psychiatric morbidity, entering also relevant variables for MetS into multivariate analyses. All subjects underwent an oral glucose tolerance test (OGTT). Psychiatric diagnosis was confirmed using a Structured Clinical Interview for DSM-IV. Results Of 260 consecutively screened subjects, 150 (56.9 ± 8.1 years old, males = 56.7%, BMI = 27.2 ± 4.1 kg/m2) were at-risk for T2DM and were included. MetS, present in 27% of males and 25% of females, was significantly associated with having a current anxiety disorder (P < 0.001) and lifetime major depression (P < 0.001). In logistic regression analysis, MetS was significantly associated with lifetime major depression, presence of any anxiety disorder, body weight, and physical activity. Conclusions Our data in a high-risk group for T2DM support the association between depressive disorders and MetS, pointing to a similar role of anxiety disorders. Screening for anxiety and depression is recommended in this group at risk for T2DM. PMID:25642391

  1. Impression formation and revision in social anxiety disorder.

    PubMed

    Haker, Ayala; Aderka, Idan M; Marom, Sofi; Hermesh, Haggai; Gilboa-Schechtman, Eva

    2014-03-01

    Interpersonal relations are markedly impaired in social anxiety. Yet, little is known about the ways social anxiety affects social cognition. We examined impression formation and impression revision among individuals with social anxiety disorder (SAD, n = 26) and non-anxious individuals (n = 29). Participants read initial descriptions of protagonists depicted as dominant, neutral or submissive and rated them on social rank and affiliation dimensions. Next, participants were presented with behavioral acts that were either congruent, incongruent or irrelevant to the initial descriptions, and re-rated the protagonists. Individuals with SAD (a) rated others as more extreme on social rank dimension, (b) rated others as lower on the affiliation dimension, and (c) revised their impressions of others to a greater extent than did the non-anxious individuals. Understanding the ways social anxiety affects the formation and revision of perceptions of others can improve our understanding of maintaining processes in SAD. PMID:23774009

  2. Characteristics and Anxiety Symptom Presentation Associated with Autism Spectrum Traits in Youth with Anxiety Disorders

    PubMed Central

    Settipani, Cara A.; Puleo, Connor M.; Conner, Bradley T.; Kendall, Philip C.

    2012-01-01

    There is limited information about the nature of anxiety among youth with symptoms of autism spectrum disorder (ASD). The present study examined (a) differences in the clinical characteristics of anxious youth with and without symptoms of ASD and (b) the symptoms of anxiety that best distinguish between these groups. Results indicated that anxious youth with elevated ASD symptoms had significantly more diagnoses (e.g., specific phobias), and were more likely to meet diagnostic criteria for social phobia (and list social concerns among their top fears) than youth without elevated ASD symptoms. At the symptom level, severity of interpersonal worry based on parent report and severity of fear of medical (doctor/dentist) visits based on youth report best differentiated ASD status. The findings inform diagnostic evaluations, case conceptualization, and treatment planning for youth with anxiety disorders and ASD symptoms. PMID:22366448

  3. Psychometric Properties of the Liebowitz Social Anxiety Scale in a Longitudinal Study of Latinos with Anxiety Disorders

    ERIC Educational Resources Information Center

    Beard, Courtney; Rodriguez, Benjamin F.; Weisberg, Risa B.; Perry, Ashley; Keller, Martin B.

    2012-01-01

    The Liebowitz Social Anxiety Scale (LSAS) is one of the most commonly used measures of social anxiety symptoms. To date, no study has examined its psychometric properties in a Latino sample. The authors examined the reliability, temporal stability, and convergent validity of the LSAS in 73 Latinos diagnosed with an anxiety disorder. The original

  4. Psychometric Properties of the Liebowitz Social Anxiety Scale in a Longitudinal Study of Latinos with Anxiety Disorders

    ERIC Educational Resources Information Center

    Beard, Courtney; Rodriguez, Benjamin F.; Weisberg, Risa B.; Perry, Ashley; Keller, Martin B.

    2012-01-01

    The Liebowitz Social Anxiety Scale (LSAS) is one of the most commonly used measures of social anxiety symptoms. To date, no study has examined its psychometric properties in a Latino sample. The authors examined the reliability, temporal stability, and convergent validity of the LSAS in 73 Latinos diagnosed with an anxiety disorder. The original…

  5. Treatment of Co-occurring Anxiety Disorders and Substance Use Disorders

    PubMed Central

    McHugh, R. Kathryn

    2015-01-01

    Anxiety disorders co-occur with substance use disorders at a high rate in both the general population and in treatment-seeking samples. The co-occurrence of these disorders is associated with greater symptom severity, higher levels of disability, and poorer course of illness relative to either disorder alone. However, relatively little research focus has been afforded to the treatment of co-occurring anxiety and substance use disorders. This notable gap in the research literature may not only leave anxiety untreated or under-treated, but may also increase the risk for relapse and poor substance use outcomes. The aim of this manuscript is to provide a review of the current state of the literature on the treatment of co-occurring anxiety and substance use disorders. This review includes brief overview of the epidemiology of this co-occurrence, challenges in assessing anxiety in the context of a substance use disorder, evidence for treatment approaches, and new advancements and future directions in this understudied area. The importance of future research to identify optimal behavioral and pharmacologic treatments for co-occurring anxiety and substance use disorders is highlighted. PMID:25747923

  6. Not to be overshadowed or overlooked: functional impairments associated with comorbid anxiety disorders in youth with ASD.

    PubMed

    Kerns, Connor M; Kendall, Philip C; Zickgraf, Hana; Franklin, Martin E; Miller, Judith; Herrington, John

    2015-01-01

    This study's objective was to examine associations between comorbid anxiety disorders and difficulties commonly attributed to both anxiety and ASD (autism spectrum disorder) including self-injury, depressive symptoms, functional communication, social skill deficits and parent stress, in a well-characterized sample of youth with ASD. Fifty-nine verbally fluent participants (7-17 years; 93% Caucasian) diagnosed with ASD and their parents completed semistructured diagnostic interviews to confirm ASD diagnosis and assess for anxiety disorders. Parents completed questionnaires on child behavior and social skill as well as parental stress. Co-occurring anxiety disorders were associated with more parent-reported self-injurious behavior, depressive symptoms, and parental stress in youth with ASD, after controlling for other influential variables (e.g., ASD severity, cognitive ability, medication status). In contrast, youth with co-occurring anxiety disorders appeared to have significantly stronger parent-reported functional communication than youth with ASD alone as well as a comparable ability, according to parents, to initiate social interaction and develop relationships. Findings support a profile of challenges and relative strengths associated with the presence of anxiety disorders in youth with ASD. Though more research is needed to determine the direction of these associations, results provide further rationale for improving recognition and targeted treatment of this comorbidity in clinical practice. PMID:25526833

  7. SLEEP QUALITY PREDICTS TREATMENT OUTCOME IN CBT FOR SOCIAL ANXIETY DISORDER

    PubMed Central

    Zalta, Alyson K.; Dowd, Sheila; Rosenfield, David; Smits, Jasper A. J.; Otto, Michael W.; Simon, Naomi M.; Meuret, Alicia E.; Marques, Luana; Hofmann, Stefan G.; Pollack, Mark H.

    2014-01-01

    Background Sleep quality may be an important, yet relatively neglected, predictor of treatment outcome in cognitive-behavioral therapy (CBT) for anxiety disorders. Specifically, poor sleep quality may impair memory consolidation of in-session extinction learning. We therefore examined sleep quality as a predictor of treatment outcome in CBT for social anxiety disorder and the impact of d-cycloserine (DCS) on this relationship. Methods One hundred sixty-nine participants with a primary diagnosis of DSM-IV generalized social anxiety disorder were recruited across three sites. Participants were enrolled in 12 weeks of group CBT. Participants randomly received 50 mg of DCS (n = 87) or pill placebo (n = 82) 1 hr prior to sessions 3–7. Participants completed a baseline measure of self-reported sleep quality and daily diaries recording subjective feelings of being rested upon wakening. Outcome measures including social anxiety symptoms and global severity scores were assessed at each session. Results Poorer baseline sleep quality was associated with slower improvement and higher posttreatment social anxiety symptom and severity scores. Moreover, patients who felt more “rested” after sleeping the night following a treatment session had lower levels of symptoms and global severity at the next session, controlling for their symptoms and severity scores the previous session. Neither of these effects were moderated by DCS condition. Conclusions Our findings suggest that poor sleep quality diminishes the effects of CBT for social anxiety disorder and this relation is not attenuated by DCS administration. Therapeutic attention to sleep quality prior to initiation of CBT and during the acute treatment phase may be clinically indicated. PMID:24038728

  8. 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

  9. Treatment of co-morbid obsessive compulsive disorder, mood, and anxiety disorders.

    PubMed

    Coffey, Barbara J; Shechter, Rachel L

    2006-01-01

    In Sumary, OCD, non-OCD anxiety disorders and mood disorders are common co-morbid psychiatric disorders are common co-morbid psychiatric disorders in clinically referred youth with TS. Emotional disorders such as anxiety and depression may be more problematic to the patient than the tics, with regard to overall illness severity and the potential for adverse outcomes, such as school and social failure. The emotional symptoms and co-morbid mood and anxiety disorders must be comprehensively identified because they will require specific intervention and treatment. Treatment must be tailored to each individual, and should ideally include education, monitoring, and prioritization of symptoms based on distress and impairment. There is growing evidence to support the use of several medications, particularly the selective serotonin reuptake inhibitors, and some cognitive behavioral techniques to treat the psychiatric co-morbid disorders. PMID:16536368

  10. Resting-state neuroimaging studies: a new way of identifying differences and similarities among the anxiety disorders?

    PubMed

    Peterson, Andrew; Thome, Janine; Frewen, Paul; Lanius, Ruth A

    2014-06-01

    This review examines recent functional neuroimaging research of resting-state regional connectivity between brain regions in anxiety disorders. Studies compiled in the PubMed- National Center for Biotechnology Information database targeting resting-state functional connectivity in anxiety disorders were reviewed. Diagnoses included posttraumatic stress disorder (PTSD), generalized anxiety disorder (GAD), social anxiety disorder (SAD), obsessive-compulsive disorder (OCD), panic disorder (PD), and specific phobia (SP). Alterations to network connectivity were demonstrated in PTSD, GAD, SAD, OCD, and PD in several resting-state investigations. Differences from control subjects were primarily observed in the default mode network within PTSD, SAD, and OCD. Alterations within the salience network were observed primarily in PTSD, GAD, and SAD. Alterations in corticostriatal networks were uniquely observed in OCD. Finally, alterations within somatosensory networks were observed in SAD and PD investigations. Resting-state studies involving SPs as a primary diagnosis (with or without comorbidities) were not generated during the literature search. The emerging use of resting-state paradigms may be an effective method for understanding associations between anxiety disorders. Targeted studies of PD and SPs, meta-analyses of the studies conducted to date, and studies of the impact of specific comorbid presentations, are recommended future research directions. PMID:25007403

  11. Recent Insight Into the Subtypes of Social Anxiety Disorder.

    PubMed

    D'Avanzato, Catherine; Dalrymple, Kristy L

    2016-05-01

    Systems for subtyping individuals with social anxiety disorder have been the focus of much research attention as a means to improve assessment and treatment of the disorder. This article highlights recent revisions to social anxiety disorder (SAD) subtypes from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) to DSM-V, reviewing empirical evidence that served as the impetus for the revisions. Recent research examining the validity of the DSM-V system and alternative subtyping systems is reviewed. Overall, there appears to be greater empirical support for a dimensional subtyping system. Concerns therefore remain with the DSM-V system, which retained a categorical system but replaced the previous subtypes with a subtype of individuals fearing only performance situations. Recommendations for future research are discussed, as well as alternate options for capturing the variability in SAD presentations, including the possibility of eliminating subtyping altogether. PMID:27017831

  12. 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…

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

    ERIC Educational Resources Information Center

    Wichstrm, 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

  14. Treatment of Anxiety Disorders in a Psychology Clinic.

    PubMed

    Labrador, Francisco J; Estupiñá, Francisco J; Bernaldo-de-Quirós, Mónica; Fernández-Arias, Ignacio; Alonso, Pablo; Ballesteros, Francisco; Blanco, Carmen; Gómez, Laura

    2015-01-01

    People with anxiety disorders demand psychological attention most often. Therefore, it seems important to identify both the characteristics of the patients who demand help and the clinical variables related to that demand and its treatment. A cohort of 292 patients who requested help at a university clinical facility was studied. The typical profile of the patient was: being female, young, unmarried, with some college education, and having previously received treatment, especially pharmacological one. The three most frequent diagnoses of anxiety, which include 50% of the cases, were: Anxiety Disorder not otherwise specified, Social Phobia, and Panic Disorder with Agoraphobia. Regarding the characteristics of the intervention, the average duration of the assessment was 3.5 sessions (SD = 1.2), and the duration of the treatment was 14 sessions (SD = 11.2). The percentage of discharges was 70.2%. The average cost of treatment was around €840. The results are discussed, underlining the value of empirically supported treatments for anxiety disorders. PMID:26514227

  15. Attention Bias toward Threat in Pediatric Anxiety Disorders

    ERIC Educational Resources Information Center

    Roy, Amy Krain; Vasa, Roma A.; Bruck, Maggie; Mogg, Karin; Bradley, Brendan P.; Sweeney, Michael; Bergman, R. Lindsey; McClure-Tone, Erin B.; Pine, Daniel S.

    2008-01-01

    Attention bias towards threat faces is examined for a large sample of anxiety-disordered youths using visual probe task. The results showed that anxious individuals showed a selective bias towards threat due to perturbation in neural mechanisms that control vigilance.

  16. 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

  17. Emotional Schemas and Resistance to Change in Anxiety Disorders

    ERIC Educational Resources Information Center

    Leahy, Robert L.

    2007-01-01

    Cognitive-behavioral treatment for all anxiety disorders involves exposure to feared situations and feared emotions. Dropout from therapy is a continued problem for final treatment effectiveness. A meta-emotional model of fear of negative emotions (and anxious sensations and thoughts) is advanced that can be used as a transdiagnostic treatment…

  18. Group Therapy for Anxiety in Children with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    McConachie, Helen; McLaughlin, Eleanor; Grahame, Victoria; Taylor, Helen; Honey, Emma; Tavernor, Laura; Rodgers, Jacqui; Freeston, Mark; Hemm, Cahley; Steen, Nick; Le Couteur, Ann

    2014-01-01

    Aim: To investigate the acceptability and feasibility of adapted group therapy for anxiety in children with autism spectrum disorder in a pilot randomised controlled trial. Method: A total of 32 children aged 9-13 years were randomised to immediate or delayed therapy using the "Exploring Feelings" manual (Attwood, 2004). Child and parent…

  19. Emotion Socialization in Families of Children with an Anxiety Disorder

    ERIC Educational Resources Information Center

    Suveg, Cynthia; Zeman, Janice; Flannery-Schroeder, Ellen; Cassano, Michael

    2005-01-01

    Compared emotion socialization in 26 children with anxiety disorders ages 8-12 years and their mothers to 26 nonclinical counterparts without psychopathology. Children and their mothers participated in an emotion interaction task in which they discussed occasions when the child felt worry, sadness, and anger. Responses were coded for length of…

  20. 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

  1. 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).

  2. Anxiety and Quality of Life: Clinically Anxious Children with and without Autism Spectrum Disorders Compared

    ERIC Educational Resources Information Center

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

    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

  3. A Longitudinal Look at Parent?Child Diagnostic Agreement in Youth Treated for Anxiety Disorders

    ERIC Educational Resources Information Center

    Safford, Scott M.; Kendall, Philip C.; Flannery-Schroeder, Ellen; Webb, Alicia; Sommer, Heath

    2005-01-01

    This study examined diagnostic agreement between children and their parents for seventy 9- to 13-year-olds (45 boys and 25 girls) who had received cognitive?behavioral treatment for anxiety disorders. Parent-child diagnostic rates and agreements for generalized anxiety disorder, separation anxiety disorder, and social phobia were evaluated at 3…

  4. Anxiety and Quality of Life: Clinically Anxious Children with and without Autism Spectrum Disorders Compared

    ERIC Educational Resources Information Center

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

    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…

  5. 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…

  6. 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).…

  7. Knowledge of Social Anxiety Disorder Relative to Attention Deficit Hyperactivity Disorder Among Educational Professionals

    ERIC Educational Resources Information Center

    Herbert, James D.; Crittenden, Kia; Dalrymple, Kristy L.

    2004-01-01

    Social anxiety disorder (SAD), the 3rd most common psychiatric disorder in the United States, follows a chronic and unremitting course, often resulting in severe impairments in multiple areas of functioning. Despite a typical age of onset in early adolescence, the disorder is rarely recognized and treated in adolescent populations. Given its early…

  8. 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

  9. 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…

  10. Mental Health Literacy for Anxiety Disorders: How perceptions of symptom severity might relate to recognition of psychological distress

    PubMed Central

    Paulus, Daniel J.; Wadsworth, Lauren Page; Hayes-Skelton, Sarah A.

    2015-01-01

    Purpose Improving mental health literacy is an important consideration when promoting expedient and effective treatment seeking for psychological disorders. Low recognition serves as a barrier to treatment (Coles and Coleman, 2010), and this article examines recognition by lay individuals of severity for three psychological disorders: social anxiety, generalized anxiety, and major depression using a dimensional approach. Design Vignettes of mild/subclinical, moderate, and severe cases of each disorder were rated for severity by a team of expert assessors and 270 participants (mean age = 26.8; 76.7% women). Findings Difference ratings were calculated comparing participants’ responses to scores from the assessors. A within-groups factorial ANOVA with LSD follow-up was performed to examine the effects of Diagnosis and Severity on difference ratings. Both main effects [Diagnosis, F(2, 536)=35.26, Mse=1.24; Severity, F(2, 536)=9.44, Mse=1.93] and the interaction were significant [F(4, 1072)=13.70, Mse=1.13] all p’s < 0.001. Social anxiety cases were underrated in the mild/subclinical and moderate cases, generalized anxiety cases were underrated at all three severities, and major depression cases were overrated at all three severities. Social implications Judgments of severity may underlie the low recognition rates for social anxiety disorder and generalized anxiety disorder. Future efforts should focus on improved recognition and education regarding anxiety disorders in the population, particularly before they become severe. Value This project demonstrates the importance of considering judgments of symptom severity on a continuum, and in a range of cases, rather than just the ability to correctly label symptoms, when determining whether or not people recognize psychological disorders. PMID:26893607

  11. Persistence of sleep problems in children with anxiety and attention deficit hyperactivity disorders.

    PubMed

    Hansen, Berit Hjelde; Skirbekk, Benedicte; Oerbeck, Beate; Wentzel-Larsen, Tore; Kristensen, Hanne

    2013-04-01

    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 semi-structured interview Kaufman Schedule for Affective Disorders and Schizophrenia. Sleep problems were assessed using the Children's Sleep Habit Questionnaire at T1 and at T2. Persistence rate of total sleep problems in the clinical range was 72.4 % in referred children, and did not differ significantly between children with a T1 diagnosis of anxiety disorder (76.0 %), ADHD (70.6 %), anxiety disorder and ADHD (68.8 %) or nonreferred controls (50.0 %) The total sleep problems score at T1 significantly predicted the total sleep problems score at T2, whereas age, sex, parent education level and total number of life events did not. PMID:22833310

  12. Barriers in recognising, diagnosing and managing depressive and anxiety disorders as experienced by Family Physicians; a focus group study

    PubMed Central

    van Rijswijk, Eric; van Hout, Hein; van de Lisdonk, Eloy; Zitman, Frans; van Weel, Chris

    2009-01-01

    Background The recognition and treatment of depressive- and anxiety disorders is not always in line with current standards. The results of programs to improve the quality of care, are not encouraging. Perhaps these programs do not match with the problems experienced in family practice. This study aims to systematically explore how FPs perceive recognition, diagnosis and management of depressive and anxiety disorders. Methods focus group discussions with FPs, qualitative analysis of transcriptions using thematic coding. Results The FPs considered recognising, diagnosing and managing depressive- and anxiety disorders as an important task. They expressed serious doubts about the validity and usefulness of the DSM IV concept of depressive and anxiety disorders in family practice especially because of the high frequency of swift natural recovery. An important barrier was that many patients have difficulties in accepting the diagnosis and treatment with antidepressant drugs. FPs lacked guidance in the assessment of patients' burden. The FPs experienced they had too little time for patient education and counseling. The under capacity of specialised mental health care and its minimal collaboration with FPs were experienced as problematic. Valuable suggestions for solving the problems encountered were made Conclusion Next to serious doubts regarding the diagnostic concept of depressive- and anxiety disorders a number of factors were identified which serve as barriers for suitablemental health care by FPs. These doubts and barriers should be taken into account in future research and in the design of interventions to improve mental health care in family practice. PMID:19619278

  13. Bipolar Disorder in Adolescence: Diagnosis and Treatment.

    ERIC Educational Resources Information Center

    Wilkinson, Great Buyck; Taylor, Priscilla; Holt, Jan R.

    2002-01-01

    Due to developmental issues and overlapping symptoms with other disorders, diagnosing bipolar disorder in adolescents is often a confusing and complex process. This article highlights diagnostic criteria, symptoms and behaviors, and the differential diagnosis process. Treatment options are also discussed. (Contains 17 references.) (GCP)

  14. Personality disorders, but not cancer severity or treatment type, are risk factors for later generalised anxiety disorder and major depressive disorder in non metastatic breast cancer patients.

    PubMed

    Champagne, Anne-Laure; Brunault, Paul; Huguet, Grégoire; Suzanne, Isabelle; Senon, Jean-Louis; Body, Gilles; Rusch, Emmanuel; Magnin, Guillaume; Voyer, Mélanie; Réveillère, Christian; Camus, Vincent

    2016-02-28

    This study aimed to determine whether personality disorders were associated with later Major Depressive Disorder (MDD) or Generalised Anxiety Disorder (GAD) in breast cancer patients. This longitudinal and multicentric study included 120 French non-metastatic breast cancer patients. After cancer diagnosis (T1) and 7 months after diagnosis (T3), we assessed MDD and GAD (Mini International Neuropsychiatric Interview 5.0). We assessed personality disorders 3 months after diagnosis (VKP). We used multiple logistic regression analysis to determine what were the factors associated with GAD and MDD at T3. At T3, prevalence rate was 10.8% for MDD and 19.2% for GAD. GAD at T3 was significantly and independently associated with GAD at T1 and with existence of a personality disorder, no matter the cluster type. MDD at T3 was significantly and independently associated with MDD at T1 and with the existence of a cluster C personality disorder. Initial cancer severity and the type of treatment used were not associated with GAD or MDD at T3. Breast cancer patients with personality disorders are at higher risk for GAD and MDD at the end of treatment. Patients with GAD should be screened for personality disorders. Specific interventions for patients with personality disorders could prevent psychiatric disorders. PMID:26747215

  15. Social Functioning in Youth with Anxiety Disorders: Association with Anxiety Severity and Outcomes from Cognitive-Behavioral Therapy

    ERIC Educational Resources Information Center

    Settipani, Cara A.; Kendall, Philip C.

    2013-01-01

    Social functioning was assessed using the Child Behavior Checklist and Teacher Report Form for children with anxiety disorders who participated in a randomized clinical trial (N = 161, aged 7-14). Significant relationships were found between severity of children's principal anxiety disorder and most measures of social functioning, such that poorer

  16. 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

  17. Social Functioning in Youth with Anxiety Disorders: Association with Anxiety Severity and Outcomes from Cognitive-Behavioral Therapy

    ERIC Educational Resources Information Center

    Settipani, Cara A.; Kendall, Philip C.

    2013-01-01

    Social functioning was assessed using the Child Behavior Checklist and Teacher Report Form for children with anxiety disorders who participated in a randomized clinical trial (N = 161, aged 7-14). Significant relationships were found between severity of children's principal anxiety disorder and most measures of social functioning, such that poorer…

  18. A Randomized Controlled Trial of the Child Anxiety Multi-Day Program (CAMP) for Separation Anxiety Disorder

    ERIC Educational Resources Information Center

    Santucci, Lauren C.; Ehrenreich-May, Jill

    2013-01-01

    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…

  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. Generalized anxiety disorder - self-care

    MedlinePlus

    American Psychiatric Association. Diagnostic and statistical manual of mental disorders . 5th ed. Arlington, VA: American Psychiatric Publishing. 2013. Bui E, Pollack MH, Kinrys G, Delong H, Vasconcelos e Sa ...

  1. Orexins and fear: implications for the treatment of anxiety disorders.

    PubMed

    Flores, África; Saravia, Rocío; Maldonado, Rafael; Berrendero, Fernando

    2015-09-01

    An understanding of the neurobiological mechanisms involved in the regulation of fear is essential for the development of new treatments for anxiety disorders, such as phobias, panic, and post-traumatic stress disorders (PTSD). Orexins, also known as hypocretins, are neuropeptides located exclusively in hypothalamic neurons that have extensive projections throughout the central nervous system. Although this system was initially believed to be primarily involved in the regulation of feeding behavior, recent studies have shown that orexins also modulate neural circuits implicated in the expression and extinction of fear memories. Here, we discuss recent findings involving orexins in anxiety disorders and current clinical trials using orexin ligands that could be applied to identify new therapies for diseases characterized by pathological fear. PMID:26216377

  2. Improving homework compliance in the treatment of generalized anxiety disorder.

    PubMed

    Leahy, Robert L

    2002-05-01

    Generalized anxiety disorder is a chronic condition characterized by beliefs that worry prepares and protects, but that excessive worry is out of control. In this article, I review the cognitive-behavioral model of generalized anxiety, focusing specifically on problems related to excessive worrying. Noncompliance in self-help homework is reflected in the patient's excessive focus on negative feelings, difficulty identifying automatic thoughts, demand for immediate results, and the belief that worries are realistic. Interventions for these problems are illustrated in the case of the treatment of a patient characterized by persistent worries, low self-confidence, procrastination, and avoidance. PMID:11967876

  3. 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

  4. 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

  5. Brain function in social anxiety disorder.

    PubMed

    Argyropoulos, S V; Bell, C J; Nutt, D J

    2001-12-01

    What have these studies revealed about SAD? First, few studies have been performed so far, with even fewer replications. Most of the work has been exploratory in nature and follows the paradigms used in PD. This approach has been justifiably criticized. The use of psychological (naturalistic) challenges may be more appropriate in SP than chemical challenges. The paradigms of public speaking, autobiographical scripts, or similar behavioral challenges merit further use, exploration, and validation if symptoms resembling those of the condition proper are to be induced in experimental circumstances. However, some tentative conclusions can be drawn from the research performed so far. There is no enough evidence to support the presence of structural brain abnormality in SAD. Admittedly, such a finding would have been very unlikely. On the other hand, evidence of subtle functional abnormalities is accumulating. On the nosologic question, there appear to be differences from PD. While in some challenges (e.g., CO2 and pentagastrin) the two conditions differ only in degree, in others (e.g., lactate, caffeine, and flumazenil), the separation is clearer. Equally, there is a strong argument to differentiate the generalized from the specific form of social anxiety on the basis of substantial (albeit accidental) findings outlined earlier. More sophisticated neuroimaging techniques, directly comparing patients from both groups before and after pharmacologic or psychological treatment, should provide more conclusive evidence on this issue. What might also help future research is the integration of biological investigations with specific personality profiles. In one study, SAD patients scored low in novelty seeking, self-directedness and cooperativeness and high in harm avoidance. It has been hypothesized that such results indicate serotonergic and dopaminergic dysregulation, which is consistent with the findings described earlier. The best evidence for neurotransmitter abnormality so far is for altered dopamine function at the level of the basal ganglia, either pre- or postsynaptic, which may result in reduced basal ganglia function so that the normal fluidity of social motor functions (e.g., smiling, eye movements, and speech) are impaired, thus leading to the cognitive symptoms of social anxiety and the subsequent generation of avoidance behavior. Such patients should respond poorly to antipsychotics, and additional challenges with these drugs could be used to test this theory. Furthermore, more research needs to be done to elucidate the mechanism by which SSRIs work in SAD. Neuroanatomical models of social anxiety (Fig. 4) [see structure: Text], explaining the site of action of drugs and psychological treatments, have been proposed in recent years. Central to these models is the notion of an innate anxiety circuit, which could be tentatively identified with the behavioral inhibition system, the septohippocampal system. This area receives 5-HT, NE, and dopamine input and has connections with the cortex and limbic structures. The relevance of these models remains to be assessed in experiments that are specifically designed to test them. PMID:11723629

  6. Personality Disorders and the Persistence of Anxiety Disorders: Evidence of a Time-of-Measurement Effect in NESARC

    PubMed Central

    Vergés, Avaro; Kushner, Matt G.; Jackson, Kristina M.; Bucholz, Kathleen K.; Trull, Timothy J.; Lane, Sean P.; Sher, Kenneth J.

    2013-01-01

    Recent studies using data from the National Epidemiological Survey of Alcohol and Related Conditions (NESARC) have found that some personality disorders (PDs) increase the persistence of several Axis I disorders. However, these effects are potentially confounded with the data collection wave in which PDs were assessed. Our aim was to extend published analyses to the case of anxiety disorders and to determine the robustness of the associations to analyses examining time-of-measurement effects. Persistence of anxiety disorders was defined either as follow-up diagnosis among participants diagnosed at baseline (“prediction”) or baseline diagnosis among participants diagnosed at follow-up (“post-diction”). Results revealed a robust pattern of higher odds ratios for post-diction among PDs assessed at baseline, and lower odds ratios for post-diction among PDs assessed at follow-up, suggesting a time of measurement artifact. Although only 4% of associations were robust to both predictive and post-dictive analyses, these were consistent with previous research. PMID:24211148

  7. 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

  8. Anxiety and Depression Symptoms in Children with Asperger Syndrome Compared with Attention-Deficit/Hyperactivity Disorder and Depressive Disorder

    ERIC Educational Resources Information Center

    Park, Subin; Park, Min-Hyeon; Kim, Hyo Jin; Yoo, Hee Jeong

    2013-01-01

    The objective of this study was to examine (a) anxiety and depression symptoms in children with Asperger syndrome (AS) compared to children with attention-deficit/hyperactivity disorder (ADHD) and children with depressive disorder; (b) parental anxiety and depressive symptoms in the three groups; and (c) the association between the anxiety and

  9. Anxiety and Depression Symptoms in Children with Asperger Syndrome Compared with Attention-Deficit/Hyperactivity Disorder and Depressive Disorder

    ERIC Educational Resources Information Center

    Park, Subin; Park, Min-Hyeon; Kim, Hyo Jin; Yoo, Hee Jeong

    2013-01-01

    The objective of this study was to examine (a) anxiety and depression symptoms in children with Asperger syndrome (AS) compared to children with attention-deficit/hyperactivity disorder (ADHD) and children with depressive disorder; (b) parental anxiety and depressive symptoms in the three groups; and (c) the association between the anxiety and…

  10. Treating anxiety disorders in children with high functioning autism spectrum disorders: a controlled trial.

    PubMed

    Chalfant, Anne Marie; Rapee, Ron; Carroll, Louisa

    2007-11-01

    A family-based, cognitive behavioural treatment for anxiety in 47 children with comorbid anxiety disorders and High Functioning Autism Spectrum Disorder (HFA) was evaluated. Treatment involved 12 weekly group sessions and was compared with a waiting list condition. Changes between pre- and post-treatment were examined using clinical interviews as well as child-, parent- and teacher-report measures. Following treatment, 71.4% of the treated participants no longer fulfilled diagnostic criteria for an anxiety disorder. Comparisons between the two conditions indicated significant reductions in anxiety symptoms as measured by self-report, parent report and teacher report. Discussion focuses on the implications for the use of cognitive behaviour therapy with HFA children, for theory of mind research and for further research on the treatment components. PMID:17171539

  11. Treatment of co-occurring anxiety disorders and substance use disorders.

    PubMed

    McHugh, R Kathryn

    2015-01-01

    Anxiety disorders commonly co-occur with substance use disorders both in the general population and in treatment-seeking samples. This co-occurrence is associated with greater symptom severity, higher levels of disability, and poorer course of illness relative to either disorder alone. Little research has been conducted, however, on the treatment of these co-occurring disorders. This gap may not only leave anxiety untreated or undertreated but also increase the risk for relapse and poor substance use outcomes. The aim of this article is to review the current state of the literature on treating co-occurring anxiety and substance use disorders. In addition to presenting a brief overview of the epidemiology of this co-occurrence, the article discusses the challenges in assessing anxiety in the context of a substance use disorder, the evidence for various treatment approaches, and recent advances and future directions in this understudied area. Also highlighted is the need for future research to identify optimal behavioral and pharmacologic treatments for co-occurring anxiety and substance use disorders. PMID:25747923

  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. A Contemporary View of Applied Relaxation for Generalized Anxiety Disorder

    PubMed Central

    Hayes-Skelton, Sarah A.; Roemer, Lizabeth

    2013-01-01

    Applied Relaxation (AR), originally developed by Lars-Göran Öst, is a long standing, efficacious treatment for generalized anxiety disorder (GAD). While newer treatments are continuing to be developed, AR remains one of the most efficacious treatments for GAD. However, AR has received less in-depth attention more recently, particularly in terms of potential mechanisms of action. This paper is written to honor the development and history of AR and to highlight the ways that it has continued to be adapted. In this paper, the AR treatment strategies are presented, which include: noticing early signs of anxiety, learning relaxation skills, and applying relaxation at the first sign of anxiety. Then, additional adaptations to AR are presented along with recommendations of how AR may be enhanced by understanding potential mechanisms of change. Finally, recommendations are made for the continued evolution of AR as a powerful and efficacious treatment for GAD. PMID:23731329

  14. Frequency and Patterns of Psychiatric Comorbidity in a Sample of Primary Care Patients With Anxiety Disorders

    PubMed Central

    Rodriguez, Benjamin F.; Weisberg, Risa B.; Pagano, Maria E.; Machan, Jason T.; Culpepper, Larry; Keller, Martin B.

    2012-01-01

    The current report examines the rates of psychiatric comorbidity in a sample of 539 primary care patients diagnosed with anxiety disorders using the Structured Clinical Interview for DSM-IV (SCID-IV). Though not a typical psychiatric sample, rates of comorbidity were found to be as high or higher than those reported in studies conducted in traditional mental health settings. Multiple anxiety disorders were diagnosed in over 60% of participants and over 70% of participants had more than one current axis I diagnosis. Rates of current and lifetime comorbid major depression were also very high. Patterns of diagnostic comorbidity were also examined, with significantly elevated risks for the co-occurrence of several specific pairings of disorders being found. The study results are discussed in context of a recently published, large-scale study of anxiety disorder comorbidity in psychiatric patients (Brown et al., 2001). Implications of these results for both the mental health and primary care fields are also discussed. PMID:14999664

  15. The child anxiety impact scale: examining parent- and child-reported impairment in child anxiety disorders.

    PubMed

    Langley, Audra K; Falk, Avital; Peris, Tara; Wiley, Joshua F; Kendall, Philip C; Ginsburg, Golda; Birmaher, Boris; March, John; Albano, Ann Marie; Piacentini, John

    2014-01-01

    The purpose of the current investigation was to examine the factor structure, reliability, and construct validity of both the Child and Parent version of the Child Anxiety Impact Scale (CAIS) using data obtained from the Child/Adolescent Anxiety Multimodal Study (Walkup et al., 2008 ). The CAIS child and parent versions measure anxiety-related functional impairment in school, social, and family domains. Participants were 488 children ages 7 to 17 (M age = 10.7, SD = 2.8 years) enrolled as part of the CAMS study across 6 sites and their primary parent or caregiver. Families participated in a structured diagnostic interview and then completed the CAIS along with other measures. Confirmatory factor analysis revealed that the a priori three-factor structure (school, social, and home/family) for the CAIS parent- and CAIS child-report was a reasonable fit, with a comparative fit index of .88 and root mean square error of approximation of .05. Internal consistency was very good for total score and subscales of both versions of the scale (Cronbach's α = .70-.90). The CAIS total scores demonstrated good construct validity, showing predicted significant correlations with the Child Behavior Checklist (CBCL) Internalizing Scale, the Multidimensional Anxiety Scale for Children (MASC) and Screen for Child Anxiety Related Emotional Disorders (SCARED) Total Scores, the Pediatric Anxiety Rating Scale, and the Children's Global Assessment Scale. In addition, CAIS Social and School subscales were significantly related to similar subscales on the CBCL, SCARED, and MASC. The results provide support that the CAIS is a reliable and valid measure for the assessment of the impact of anxiety on child and adolescent functioning. PMID:23915200

  16. Internet screening for anxiety disorders: Treatment-seeking outcomes in a three-month follow-up study.

    PubMed

    Van Ameringen, Michael; Simpson, William; Patterson, Beth; Turna, Jasmine

    2015-12-15

    Although many people use the internet to diagnose mental health problems, little is known about the relationship between internet self-diagnosis and treatment-seeking. The MACSCREEN (a validated, self-report screening tool for anxiety and depression) was posted on our clinic homepage and respondents were invited to take an anxiety test. Three months after completing the MACSREEN and a variety of symptom severity scales, respondents were emailed a follow up questionnaire asking about treatment-seeking behaviours. Of the 770 MACSCREEN respondents, 103 completed the follow-up questionnaire. Of these, 100% met criteria for at least one anxiety or mood disorder diagnosis and 51% sought treatment after completing the MACSCREEN. In the 49% who did not seek treatment, fear of medication (57%), discomfort talking to their doctor about anxiety (28%) and the belief that symptoms were not severe enough (28%) were cited as barriers. Compared to non-seekers, treatment-seekers were significantly more likely to meet screening criteria for Generalized Anxiety Disorder, Obsessive Compulsive Disorder, Posttraumatic Stress Disorder and Depression. Higher Sheehan Disability Scale scores and being married (versus single) significantly increased the odds of treatment-seeking, suggesting that functional impairment and disease burden on the family may be stronger predictors of treatment seeking than overall severity of symptoms. PMID:26553144

  17. 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

  18. Traditional and atypical presentations of anxiety in youth with autism spectrum disorder.

    PubMed

    Kerns, Connor Morrow; Kendall, Philip C; Berry, Leandra; Souders, Margaret C; Franklin, Martin E; Schultz, Robert T; Miller, Judith; Herrington, John

    2014-11-01

    We assessed anxiety consistent (i.e., "traditional") and inconsistent (i.e., "atypical") with diagnostic and statistical manual (DSM) definitions in autism spectrum disorder (ASD). Differential relationships between traditional anxiety, atypical anxiety, child characteristics, anxiety predictors and ASD-symptomology were explored. Fifty-nine participants (7-17 years, M(age) = 10.48 years; IQ > 60) with ASD and parents completed semi-structured interviews, self- and parent-reports. Seventeen percent of youth presented with traditional anxiety, 15 % with atypical anxiety, and 31 % with both. Language ability, anxious cognitions and hypersensitivity predicted traditional anxiety, whereas traditional anxiety and ASD symptoms predicted atypical anxiety. Findings suggest youth with ASD express anxiety in ways similar and dissimilar to DSM definitions. Similarities support the presence of comorbid anxiety disorders in ASD. Whether dissimilarities are unique to ASD requires further examination. PMID:24902932

  19. Transdiagnostic Treatment of Co-occurrence of Anxiety and Depressive Disorders based on Repetitive Negative Thinking: A Case Series

    PubMed Central

    Akbari, Mehdi; Roshan, Rasool; Shabani, Amir; Fata, Ladan; Shairi, Mohamad Reza; Zarghami, Firouzeh

    2015-01-01

    Objective: The transdiagnostic cognitive behavioral treatments for treating the coexistence of anxiety and mood disorders received useful empirical supports in the recent years. However, these treatments still have moderate efficacy. Following the improvements and developments in transdiagnostic protocols and considering the importance of repetitive negative thinking as a core transdiagnostic factor in emotional disorders, this study examined a new form of transdiagnostic treatment based on Repetitive Negative Thinking (TTRNT) of co-occurrence of anxiety and depressive disorders. Methods: Treatment efficacy was assessed using single case series with multiple baselines. Three patients meeting the criteria for co-occurrence of anxiety and depressive disorders were selected using the Anxiety Disorders Interview Schedule for DSM-IV. The patients were treated individually for 12 weekly sessions. Participants completed the standardized outcome measures during the baseline, treatment and one-month follow-up. Results: At post-treatment, all participants showed significant clinical changes on a range of standardized outcome measures, and these gains were largely maintained through the one-month follow-up both in the principle and co-principal diagnosis. Conclusions: Although the results of this preliminary investigation indicated that TTRNT could be a time effective and efficient treatment for individuals with co-occurrence of anxiety and depressive disorders, further controlled clinical trials are necessary to examine this new treatment approach. PMID:26877754

  20. A Selective Intervention Program for Inhibited Preschool-Aged Children of Parents with an Anxiety Disorder: Effects on Current Anxiety Disorders and Temperament

    ERIC Educational Resources Information Center

    Kennedy, Susan J.; Rapee, Ronald M.; Edwards, Susan L.

    2009-01-01

    The efficacy of early intervention for preschool-aged children at risk of anxiety disorders is investigated. Brief early intervention delivered through parents can reduce anxiety and associated risk and may alter the developmental trajectory of anxiety in some young children.

  1. Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence

    PubMed Central

    Kaczkurkin, Antonia N.; Foa, Edna B.

    2015-01-01

    A large amount of research has accumulated on the efficacy and effectiveness of cognitive-behavioral therapy (CBT) for anxiety disorders including posttraumatic stress disorder, obsessive-compulsive disorder, panic disorder, generalized anxiety disorder, social anxiety disorder, and specific phobia. The purpose of the current article is to provide an overview of two of the most commonly used CBT methods used to treat anxiety disorders (exposure and cognitive therapy) and to summarize and discuss the current empirical research regarding the usefulness of these techniques for each anxiety disorder. Additionally, we discuss the difficulties that arise when comparing active CBT treatments, and we suggest directions for future research. Overall, CBT appears to be both efficacious and effective in the treatment of anxiety disorders, but dismantling studies are needed to determine which specific treatment components lead to beneficial outcomes and which patients are most likely to benefit from these treatment components. PMID:26487814

  2. Conditioned Fear Acquisition and Generalization in Generalized Anxiety Disorder.

    PubMed

    Tinoco-González, Daniella; Fullana, Miquel Angel; Torrents-Rodas, David; Bonillo, Albert; Vervliet, Bram; Blasco, María Jesús; Farré, Magí; Torrubia, Rafael

    2015-09-01

    Abnormal fear conditioning processes (including fear acquisition and conditioned fear-generalization) have been implicated in the pathogenesis of anxiety disorders. Previous research has shown that individuals with panic disorder present enhanced conditioned fear-generalization in comparison to healthy controls. Enhanced conditioned fear-generalization could also characterize generalized anxiety disorder (GAD), but research so far is inconclusive. An important confounding factor in previous research is comorbidity. The present study examined conditioned fear-acquisition and fear-generalization in 28 patients with GAD and 30 healthy controls using a recently developed fear acquisition and generalization paradigm assessing fear-potentiated startle and online expectancies of the unconditioned stimulus. Analyses focused on GAD patients without comorbidity but included also patients with comorbid anxiety disorders. Patients and controls did not differ as regards fear acquisition. However, contrary to our hypothesis, both groups did not differ either in most indexes of conditioned fear-generalization. Moreover, dimensional measures of GAD symptoms were not correlated with conditioned fear-generalization indexes. Comorbidity did not have a significant impact on the results. Our data suggest that conditioned fear-generalization is not enhanced in GAD. Results are discussed with special attention to the possible effects of comorbidity on fear learning abnormalities. PMID:26459843

  3. Reliability and Validity of Parent- and Child-Rated Anxiety Measures in Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Kaat, Aaron J.; Lecavalier, Luc

    2015-01-01

    Autism spectrum disorder (ASD) and anxiety frequently co-occur. Research on the phenomenology and treatment of anxiety in ASD is expanding, but is hampered by the lack of instruments validated for this population. This study evaluated the self- and parent-reported Revised Child Anxiety and Depression Scale and the Multidimensional Anxiety Scale in

  4. Traditional and Atypical Presentations of Anxiety in Youth with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Kerns, Connor Morrow; Kendall, Philip C.; Berry, Leandra; Souders, Margaret C.; Franklin, Martin E.; Schultz, Robert T.; Miller, Judith; Herrington, John

    2014-01-01

    We assessed anxiety consistent (i.e., "traditional") and inconsistent (i.e., "atypical") with diagnostic and statistical manual (DSM) definitions in autism spectrum disorder (ASD). Differential relationships between traditional anxiety, atypical anxiety, child characteristics, anxiety predictors and ASD-symptomology were

  5. Measuring Anxiety as a Treatment Endpoint in Youth with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Lecavalier, Luc; Wood, Jeffrey J.; Halladay, Alycia K.; Jones, Nancy E.; Aman, Michael G.; Cook, Edwin H.; Handen, Benjamin L.; King, Bryan H.; Pearson, Deborah A.; Hallett, Victoria; Sullivan, Katherine Anne; Grondhuis, Sabrina; Bishop, Somer L.; Horrigan, Joseph P.; Dawson, Geraldine; Scahill, Lawrence

    2014-01-01

    Despite the high rate of anxiety in individuals with autism spectrum disorder (ASD), measuring anxiety in ASD is fraught with uncertainty. This is due, in part, to incomplete consensus on the manifestations of anxiety in this population. Autism Speaks assembled a panel of experts to conduct a systematic review of available measures for anxiety in

  6. Traditional and Atypical Presentations of Anxiety in Youth with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Kerns, Connor Morrow; Kendall, Philip C.; Berry, Leandra; Souders, Margaret C.; Franklin, Martin E.; Schultz, Robert T.; Miller, Judith; Herrington, John

    2014-01-01

    We assessed anxiety consistent (i.e., "traditional") and inconsistent (i.e., "atypical") with diagnostic and statistical manual (DSM) definitions in autism spectrum disorder (ASD). Differential relationships between traditional anxiety, atypical anxiety, child characteristics, anxiety predictors and ASD-symptomology were…

  7. Reliability and Validity of Parent- and Child-Rated Anxiety Measures in Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Kaat, Aaron J.; Lecavalier, Luc

    2015-01-01

    Autism spectrum disorder (ASD) and anxiety frequently co-occur. Research on the phenomenology and treatment of anxiety in ASD is expanding, but is hampered by the lack of instruments validated for this population. This study evaluated the self- and parent-reported Revised Child Anxiety and Depression Scale and the Multidimensional Anxiety Scale in…

  8. Measuring Anxiety as a Treatment Endpoint in Youth with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Lecavalier, Luc; Wood, Jeffrey J.; Halladay, Alycia K.; Jones, Nancy E.; Aman, Michael G.; Cook, Edwin H.; Handen, Benjamin L.; King, Bryan H.; Pearson, Deborah A.; Hallett, Victoria; Sullivan, Katherine Anne; Grondhuis, Sabrina; Bishop, Somer L.; Horrigan, Joseph P.; Dawson, Geraldine; Scahill, Lawrence

    2014-01-01

    Despite the high rate of anxiety in individuals with autism spectrum disorder (ASD), measuring anxiety in ASD is fraught with uncertainty. This is due, in part, to incomplete consensus on the manifestations of anxiety in this population. Autism Speaks assembled a panel of experts to conduct a systematic review of available measures for anxiety in…

  9. The health preoccupation diagnostic interview: inter-rater reliability of a structured interview for diagnostic assessment of DSM-5 somatic symptom disorder and illness anxiety disorder.

    PubMed

    Axelsson, Erland; Andersson, Erik; Ljótsson, Brjánn; Wallhed Finn, Daniel; Hedman, Erik

    2016-06-01

    Somatic symptom disorder (SSD) and illness anxiety disorder (IAD) are two new diagnoses introduced in the DSM-5. There is a need for reliable instruments to facilitate the assessment of these disorders. We therefore developed a structured diagnostic interview, the Health Preoccupation Diagnostic Interview (HPDI), which we hypothesized would reliably differentiate between SSD, IAD, and no diagnosis. Persons with clinically significant health anxiety (n = 52) and healthy controls (n = 52) were interviewed using the HPDI. Diagnoses were then compared with those made by an independent assessor, who listened to audio recordings of the interviews. Ratings generally indicated moderate to almost perfect inter-rater agreement, as illustrated by an overall Cohen's κ of .85. Disagreements primarily concerned (a) the severity of somatic symptoms, (b) the differential diagnosis of panic disorder, and (c) SSD specifiers. We conclude that the HPDI can be used to reliably diagnose DSM-5 SSD and IAD. PMID:27096407

  10. Nutritional and herbal supplements for anxiety and anxiety-related disorders: systematic review

    PubMed Central

    2010-01-01

    Background Over the past several decades, complementary and alternative medications have increasingly become a part of everyday treatment. With the rising cost of prescription medications and their production of unwanted side effects, patients are exploring herbal and other natural remedies for the management and treatment of psychological conditions. Psychological disorders are one of the most frequent conditions seen by clinicians, and often require a long-term regimen of prescription medications. Approximately 6.8 million Americans suffer from generalized anxiety disorder. Many also suffer from the spectrum of behavioural and physical side effects that often accompany its treatment. It is not surprising that there is universal interest in finding effective natural anxiolytic (anti-anxiety) treatments with a lower risk of adverse effects or withdrawal. Methods An electronic and manual search was performed through MEDLINE/PubMed and EBSCO. Articles were not discriminated by date of publication. Available clinical studies published in English that used human participants and examined the anxiolytic potential of dietary and herbal supplements were included. Data were extracted and compiled into tables that included the study design, sample population, intervention, control, length of treatment, outcomes, direction of evidence, and reported adverse events. Results A total of 24 studies that investigated five different CAM monotherapies and eight different combination treatments and involved 2619 participants met the inclusion criteria and were analyzed. There were 21 randomized controlled trials and three open-label, uncontrolled observational studies. Most studies involved patients who had been diagnosed with either an anxiety disorder or depression (n = 1786). However, eight studies used healthy volunteers (n = 877) who had normal levels of anxiety, were undergoing surgery, tested at the upper limit of the normal range of a trait anxiety scale, had adverse premenstrual symptoms or were peri-menopausal, reported anxiety and insomnia, or had one month or more of elevated generalized anxiety. Heterogeneity and the small number of studies for each supplement or combination therapy prevented a formal meta-analysis. Of the randomized controlled trials reviewed, 71% (15 out of 21) showed a positive direction of evidence. Any reported side effects were mild to moderate. Conclusions Based on the available evidence, it appears that nutritional and herbal supplementation is an effective method for treating anxiety and anxiety-related conditions without the risk of serious side effects. There is the possibility that any positive effects seen could be due to a placebo effect, which may have a significant psychological impact on participants with mental disorders. However, based on this systematic review, strong evidence exists for the use of herbal supplements containing extracts of passionflower or kava and combinations of L-lysine and L-arginine as treatments for anxiety symptoms and disorders. Magnesium-containing supplements and other herbal combinations may hold promise, but more research is needed before these products can be recommended to patients. St. John's wort monotherapy has insufficient evidence for use as an effective anxiolytic treatment. PMID:20929532

  11. Tailored internet-administered treatment of anxiety disorders for primary care patients: study protocol for a randomised controlled trial

    PubMed Central

    2012-01-01

    Background Internet-administered cognitive behavioural therapy (ICBT) has been found to be effective for a range of anxiety disorders. However, most studies have focused on one specific primary diagnosis and co-morbidity has not been considered. In primary care settings, patients with anxiety often suffer from more than one psychiatric condition, making it difficult to disseminate ICBT for specific conditions. The aim of this study will be to investigate if ICBT tailored according to symptom profile can be a feasible treatment for primary care patients with anxiety disorders. It is a randomised controlled trial aimed to evaluate the treatment against an active control group. Methods Participants with anxiety disorders and co-morbid conditions (N = 128), will be recruited from a primary care population. The Clinical Outcome in Routine Evaluation (CORE-OM) will serve as the primary outcome measure. Secondary measures include self-reported depression, anxiety, quality of life and loss of production and the use of health care. All assessments will be collected via the Internet and measure points will be baseline, post treatment and 12 months post treatment. Discussion This trial will add to the body of knowledge on the effectiveness of ICBT for anxiety disorders in primary care. The trial will also add knowledge on the long term effects of ICBT when delivered for regular clinic patients Trial Registration ClinicalTrials.gov: NCT01390168 PMID:22321916

  12. Virtual reality in the treatment of generalized anxiety disorders.

    PubMed

    Gorini, Alessandra; Pallavicini, Federica; Algeri, Davide; Repetto, Claudia; Gaggioli, Andrea; Riva, Giuseppe

    2010-01-01

    Generalized anxiety disorder (GAD) is a common anxiety disorder characterized by 6 months of "excessive anxiety and worry" about a variety of events and situations. Anxiety and worry are often accompanied by additional symptoms like restlessness, being easily fatigued, difficulty concentrating, irritability, muscle tension and disturbed sleep. GAD is usually treated with medications and/or psychotherapy. In particular, the two most promising treatments seem to be cognitive therapy and applied relaxation. In this study we integrated these approaches through the use of a biofeedback enhanced virtual reality (VR) system used both for relaxation and controlled exposure. Moreover, this experience is strengthened by the use of a mobile phone that allows patients to perform the virtual experience even in an outpatient setting. This paper describe the results of a controlled trial (NCT00602212) involving 20 GAD patients randomly assigned to the following groups: (1) the VR and Mobile group (VRMB) including biofeedback; (2) the VR and Mobile group (VRM) without biofeedback; (3) the waiting list (WL) group. The clinical data underlined that (a) VR can be used also in the treatment of GAD; (b) in a VR treatment, patients take advantage of a mobile device that delivers in an outpatient setting guided experiences, similar to the one experienced in VR. PMID:20543266

  13. 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

  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. 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

  16. Defining treatment response and symptom remission for anxiety disorders in pediatric autism spectrum disorders using the Pediatric Anxiety Rating Scale.

    PubMed

    Johnco, Carly J; De Nadai, Alessandro S; Lewin, Adam B; Ehrenreich-May, Jill; Wood, Jeffrey J; Storch, Eric A

    2015-10-01

    This study examined optimal guidelines to assess treatment response and remission for anxiety in youth with autism spectrum disorders (ASD) using the Pediatric Anxiety Rating Scale (PARS). Data was collected for 108 children aged 7-16 years with comorbid anxiety and ASD before and after receiving cognitive behavior therapy. Optimal cut-offs on the PARS were assessed using signal detection analyses using receiver operating characteristic methods. Maximum agreement with response criteria was achieved at 15 % reduction in symptoms on the PARS. Maximum agreement with remission criteria was achieved at 40 % reduction in symptoms, or at a score of 10 or below at post-treatment. Results have implications for standardizing criteria used in research trials and clinical practice. PMID:26031924

  17. Anxiety and Repetitive Behaviours in Autism Spectrum Disorders and Williams Syndrome: A Cross-Syndrome Comparison

    ERIC Educational Resources Information Center

    Rodgers, Jacqui; Riby, Deborah M.; Janes, Emily; Connolly, Brenda; McConachie, Helen

    2012-01-01

    Children with Autism Spectrum Disorder or Williams syndrome are vulnerable to anxiety. The factors that contribute to this risk remain unclear. This study compared anxiety in autism spectrum disorder and Williams Syndrome and examined the relationship between repetitive behaviours and anxiety. Thirty-four children with autism and twenty children…

  18. The Relation between Anxiety Disorder and Experiential Avoidance in Inpatient Adolescents

    ERIC Educational Resources Information Center

    Venta, Amanda; Sharp, Carla; Hart, John

    2012-01-01

    The current study aimed to examine the relation between experiential avoidance and anxiety disorders, as well as the usefulness of the Avoidance and Fusion Questionnaire for Youth (AFQ-Y; Greco, Lambert, & Baer, 2008) in detecting anxiety disorder in a sample of adolescent inpatients. First, the relation between experiential avoidance and anxiety

  19. 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

  20. Anxiety and Repetitive Behaviours in Autism Spectrum Disorders and Williams Syndrome: A Cross-Syndrome Comparison

    ERIC Educational Resources Information Center

    Rodgers, Jacqui; Riby, Deborah M.; Janes, Emily; Connolly, Brenda; McConachie, Helen

    2012-01-01

    Children with Autism Spectrum Disorder or Williams syndrome are vulnerable to anxiety. The factors that contribute to this risk remain unclear. This study compared anxiety in autism spectrum disorder and Williams Syndrome and examined the relationship between repetitive behaviours and anxiety. Thirty-four children with autism and twenty children

  1. Sleep-Related Problems among Children and Adolescents with Anxiety Disorders

    ERIC Educational Resources Information Center

    Alfano, Candice A.; Ginsburg, Golda S.; Kingery, Julie Newman

    2007-01-01

    Objective: The 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

  2. Sleep-Related Problems among Children and Adolescents with Anxiety Disorders

    ERIC Educational Resources Information Center

    Alfano, Candice A.; Ginsburg, Golda S.; Kingery, Julie Newman

    2007-01-01

    Objective: The 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…

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

    PubMed Central

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

    2016-01-01

    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 United States Air Force service members, with 227 suicides over follow-up. Mental disorder diagnoses including anxiety, mood, and substance use disorders (SUD) were based on treatment encounters. Risk for suicide associated with anxiety disorders were lower compared to mood disorders and similar to SUD. Moreover, the associations between mood and anxiety disorders with suicide were greatest within a year of treatment presentation. PMID:23094649

  4. Examining Shared and Unique Aspects of Social Anxiety Disorder and Autism Spectrum Disorder Using Factor Analysis

    ERIC Educational Resources Information Center

    White, Susan W.; Bray, Bethany C.; Ollendick, Thomas H.

    2012-01-01

    Social Anxiety Disorder (SAD) and Autism Spectrum Disorders (ASD) are fairly common psychiatric conditions that impair the functioning of otherwise healthy young adults. Given that the two conditions frequently co-occur, measurement of the characteristics unique to each condition is critical. This study evaluated the structure and construct

  5. Associations between Prolonged Grief Disorder, Depression, Posttraumatic Stress Disorder, and Anxiety in Rwandan Genocide Survivors

    ERIC Educational Resources Information Center

    Schaal, Susanne; Dusingizemungu, Jean-Pierre; Jacob, Nadja; Neuner, Frank; Elbert, Thomas

    2012-01-01

    A number of studies have demonstrated that symptoms of prolonged grief disorder (PGD) represent a symptom cluster distinct from bereavement-related depression, anxiety, and posttraumatic stress disorder (PTSD). The aim of the present study was to confirm and extend these findings using the most recent criteria defining PGD. The authors interviewed

  6. 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

  7. 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…

  8. Anxiety Disorders and Obsessive Compulsive Disorder Nine Months after Perinatal Loss

    PubMed Central

    Boggs, Martha E.; Muzik, Maria; Sen, Ananda

    2015-01-01

    Objective Perinatal loss (stillbirth after 20 weeks gestational age or infant death in the first month) impacts 1–2 infants per hundred live births in the United States and can be a devastating experience for parents. We assessed prevalence of anxiety disorders and obsessive compulsive disorder (OCD) among bereaved and live-birth mothers. Methods We collaborated with the Michigan Department of Public Health to survey Michigan mothers with perinatal death or live birth. We measured symptoms of generalized anxiety disorder, social phobia, panic disorder, and OCD using validated written self-report screens and collected data on maternal demographics, psychiatric history, social support, and intimate partner violence. Results 609/1400 mothers (44%) participated, returning surveys nine months post-delivery. 232 mothers had live birth and 377 had perinatal loss. In unadjusted analyses, bereaved mothers had higher odds of all four disorders. In logistic regression adjusted for covariates, bereaved mothers still had higher odds of moderate-severe generalized anxiety disorder (OR: 2.39, CI: 1.10–5.18, p=0.028) and social phobia (OR: 2.32, CI: 1.52–3.54, p<0.0005 but not panic disorder or OCD. Conclusion Bereaved mothers struggle with clinically-significant anxiety disorders in the first year after perinatal loss; improved identification and treatment are essential to improve mental health for this vulnerable population. PMID:25305711

  9. Associations between Prolonged Grief Disorder, Depression, Posttraumatic Stress Disorder, and Anxiety in Rwandan Genocide Survivors

    ERIC Educational Resources Information Center

    Schaal, Susanne; Dusingizemungu, Jean-Pierre; Jacob, Nadja; Neuner, Frank; Elbert, Thomas

    2012-01-01

    A number of studies have demonstrated that symptoms of prolonged grief disorder (PGD) represent a symptom cluster distinct from bereavement-related depression, anxiety, and posttraumatic stress disorder (PTSD). The aim of the present study was to confirm and extend these findings using the most recent criteria defining PGD. The authors interviewed…

  10. Preferred Psychological Internet Resources for Addressing Anxiety Disorders, Parenting Problems, Eating Disorders, and Chemical Dependency.

    ERIC Educational Resources Information Center

    Morse, Laura; Doran, Matt; Simonin, Danielle; Smith, Allyson; Maloney, Colleen; Wright, Cara; Underwood, Michelle; Hoppel, Andrea; O'Donnell, Shannon; Chambliss, Catherine

    Although the Internet offers information about psychological problems and support resources for behavioral health problems, the quality of this information varies widely. So as to offer guidance in this area, preferred sites pertaining to anxiety disorders, parenting problems, eating disorders, and chemical dependency were analyzed. A total of 365

  11. Examining Shared and Unique Aspects of Social Anxiety Disorder and Autism Spectrum Disorder Using Factor Analysis

    ERIC Educational Resources Information Center

    White, Susan W.; Bray, Bethany C.; Ollendick, Thomas H.

    2012-01-01

    Social Anxiety Disorder (SAD) and Autism Spectrum Disorders (ASD) are fairly common psychiatric conditions that impair the functioning of otherwise healthy young adults. Given that the two conditions frequently co-occur, measurement of the characteristics unique to each condition is critical. This study evaluated the structure and construct…

  12. Anxiety and Mood Disorders in Adolescents with Childhood Attention-Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Bagwell, Catherine L.; Molina, Brooke S.G.; Kashdan, Todd B.; Pelham, William E.; Hoza, Betsy

    2006-01-01

    In this study, the authors examined the association between childhood attention-deficit/hyperactivity disorder (ADHD) and anxiety and mood disorders in adolescence. They compared a group of 142 adolescents ages 13 to 18 years with a history of ADHD in childhood to group of 100 community-recruited adolescents without ADHD. The two groups did not…

  13. The Relationship between Sluggish Cognitive Tempo, Subtypes of Attention-Deficit/Hyperactivity Disorder, and Anxiety Disorders

    ERIC Educational Resources Information Center

    Skirbekk, Benedicte; Hansen, Berit Hjelde; Oerbeck, Beate; Kristensen, Hanne

    2011-01-01

    The objective of the present study was to examine the relationship between sluggish cognitive tempo (SCT), subtypes of attention-deficit/hyperactivity disorder (ADHD), and anxiety disorders (AnxDs). One hundred and forty-one children (90 males, 51 females) aged 7-13 years were assigned to four groups, i.e., referred children with comorbid AnxDs…

  14. Is selective mutism an anxiety disorder? Rethinking its DSM-IV classification.

    PubMed

    Anstendig, K D

    1999-01-01

    The relationship between selective mutism (SM) and childhood anxiety disorders is illustrated through an examination of their temperamental, environmental, and biological etiologies. SM is also explored as a symptom of the specific anxiety disorders of social phobia, separation anxiety, and posttraumatic stress disorder. The etiology and symptom overlap demonstrates SM as being an anxiety disorder or a variant of a specific anxiety disorder. The conceptualization of SM as an anxiety disorder is helpful in effectively treating afflicted children. There is enough evidence in the current literature to challenge the current classification, from the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders of SM as an Other Disorder of Infancy, Childhood, and Adolescence. PMID:10504110

  15. Associations of anxiety disorders, depressive disorders and body weight with hypertension during pregnancy.

    PubMed

    Winkel, Susanne; Einsle, Franziska; Pieper, Lars; Höfler, Michael; Wittchen, Hans-Ulrich; Martini, Julia

    2015-06-01

    The purpose of this study was to prospectively examine the relationships between maternal DSM-IV-TR anxiety disorders, depressive disorders, and body mass index (BMI) with arterial hypertension and blood pressure during pregnancy. In the Maternal Anxiety in Relation to Infant Development (MARI) study, N = 306 women were enrolled in early pregnancy and repeatedly assessed during peripartum period. DSM-IV-TR anxiety and depressive disorders prior to pregnancy, lifetime anxiety/depression liability, and BMI during early pregnancy were assessed with the Composite International Diagnostic Interview for Women (CIDI-V). Based on their prepregnancy status, all participants were assigned to one of the following initial diagnostic groups: no anxiety nor depressive disorder (no AD), pure depressive disorder (pure D), pure anxiety disorder (pure A), and comorbid anxiety and depressive disorder (comorbid AD). Blood pressure measurements were derived from medical records. Arterial hypertension during pregnancy was defined by at least two blood pressure values ≥140 mmHg systolic and/or ≥90 mmHg diastolic. N = 283 women with at least four documented blood pressure measurements during pregnancy were included in the analyses. In this sample, N = 47 women (16.6 %) were identified with arterial hypertension during pregnancy. Women with comorbid AD (reference group: no AD) had a significantly higher blood pressure after adjustment for age, parity, smoking, occupation, household income, and education (systolic: linear regression coefficient [β] = 3.0, 95 % confidence interval [CI] = 0.2-5.7; diastolic, β = 2.3, 95 % CI = 0.1-4.4). Anxiety liability was associated with an increased risk of hypertension (odds ratio [OR] = 1.1, 95 % CI = 1.0-1.3) and a higher systolic blood pressure (β = 0.4, 95 % CI = 0.0-0.7). The adjusted interaction model revealed a significant interaction between the diagnostic group pure A and BMI for hypertension (ORIT = 1.5, 95 % CI = 1.1-2.1). Especially, women with a lifetime history of comorbid anxiety and depression and obese pregnant women with a lifetime history of pure anxiety disorder should be informed about their heightened risk of hypertension, monitored with regular blood pressure measurements, and provided with strategies for prevention and early intervention such as changes in diet and physical activity. PMID:25422149

  16. A Comparative Study on Alexithymia in Depressive, Somatoform, Anxiety, and Psychotic Disorders among Koreans

    PubMed Central

    Son, Sung hwa; Jo, Hyunyoung; Rim, Hyo Deog; Kim, Ju Hee; Kim, Hea Won; Bae, Geum Ye

    2012-01-01

    Objective Little is known about the characteristic differences in alexithymic construct in various psychiatric disorders because of a paucity of direct comparisons between psychiatric disorders. Therefore, this study explored disorder-related differences in alexithymic characteristics among Korean patients diagnosed with four major psychiatric disorders (n=388). Methods Alexithymic tendencies, as measured by the Korean version of the 20-item Toronto Alexithymia Scale (TAS-20K), of patients classified into four groups according to major psychiatric diagnosis were compared. The groups consisted of patients with depressive disorders (DP; n=125), somatoform disorders (SM; n=78), anxiety disorders (AX; n=117), and psychotic disorders (PS; n=68). Results We found that substantial portions of patients in all groups were classified as having alexithymia and no statistical intergroup differences emerged (42.4%, 35.9%, 35.3%, and 33.3% for DP, SM, PS, and AX). However, patients with DP obtained higher scores in factor 2 (difficulties describing feelings) than those with SM or AX, after adjusting for demographic variables. Conclusion These findings suggest that alexithymia might be associated with a higher vulnerability to depressive disorders and factor 2 of TAS-20K could be a discriminating feature of depressive disorders. PMID:23251195

  17. Anxiety disorders in children and adolescents in the second six months after traumatic brain injury.

    PubMed

    Max, Jeffrey E; Lopez, Aholibama; Wilde, Elisabeth A; Bigler, Erin D; Schachar, Russell J; Saunders, Ann; Ewing-Cobbs, Linda; Chapman, Sandra B; Yang, Tony T; Levin, Harvey S

    2015-12-01

    The objective of this prospective longitudinal study was to assess the nature, rate, predictive variables, and neuroimaging characteristics of novel (new-onset) anxiety disorders (compared with no novel anxiety disorders) 6-12 months after pediatric traumatic brain injury (TBI). Psychiatric and psychosocial interviews were administered to children who sustained mild to severe TBI at baseline (soon after injury) and at the 12-month follow-up post-injury (n= 125). The psychiatric outcome of children 12-months post-injury revealed that novel anxiety disorders present in the second six months after TBI were heterogeneous and occurred in 13 (10.4%) participants. Novel anxiety disorder was significantly associated with concurrent novel depressive disorder and with novel personality change due to TBI. Novel anxiety disorder was marginally associated with younger age at injury and with pre-injury anxiety disorder in univariate analyses. Age at injury, pre-injury anxiety disorder, and personality change due to TBI were each significantly and independently related to novel anxiety disorder in a logistic regression analysis. There were no significant neuroimaging group differences. These findings suggest that the emergence of novel anxiety disorder after TBI might be related to a broader problem of affective dysregulation especially in younger children and those with a vulnerability even to pre-injury anxiety disorder. PMID:26684074

  18. 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

  19. Early Diagnosis of Autism Spectrum Disorders.

    PubMed

    Pinto-Martin, Jennifer; Levy, Susan E.

    2004-09-01

    Autistic spectrum disorders (ASD) are an often-disabling continuum of disorders affecting two to four in 1000 children. These disorders have a core set of defining features including impaired verbal and nonverbal communication, impaired social interaction, and restricted or repetitive patterns of behavior. The cause of autism is unclear. The disorder can be defined only by related behaviors. Although there has been considerable improvement in standardized screening techniques for ASD in the past 10 years, screening and diagnostic practices in medicine and education lag far behind clinical research. Various studies have found the average age of diagnosis to be between 3 and 6 years, with significant differences as a function of ethnicity and socio-economic status. Preliminary research suggests that in some populations, missed diagnosis and misdiagnosis of ASD are common. This may be caused partly by inadequate screening practices. It also may reflect that presentation of symptoms varies from patient to patient. Lack of resources for appropriate referral, diagnosis, and treatment may play an important role. This article discusses recent progress in ASD screening, what is known of current screening and diagnostic practices, and future directions for research and practice improvement. The best practice model for the screening and early diagnosis of autism spectrum disorders and other developmental disabilities should include routine developmental surveillance as part of well-child pediatric care. General developmental screening should be followed by autism-specific screening for those children who fail the initial developmental screen, or whose parents report suspect behaviors. PMID:15279760

  20. 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

  1. Postural balance in patients with social anxiety disorder.

    PubMed

    Levitan, M N; Crippa, J A; Bruno, L M; Pastore, D L; Freire, R C; Arrais, K C; Hallak, J E; Nardi, A E

    2012-01-01

    Body stability is controlled by the postural system and can be affected by fear and anxiety. Few studies have addressed freezing posture in psychiatric disorders. The purpose of the present study was to assess posturographic behavior in 30 patients with social anxiety disorder (SAD) and 35 without SAD during presentation of blocks of pictures with different valences. Neutral images consisted of objects taken from a catalog of pictures, negative images were mutilation pictures and anxiogenic images were related to situations regarding SAD fears. While participants were standing on a force platform, similar to a balance, displacement of the center of pressure in the mediolateral and anteroposterior directions was measured. We found that the SAD group exhibited a lower sway area and a lower velocity of sway throughout the experiment independent of the visual stimuli, in which the phobic pictures, a stimulus associated with a defense response, were unable to evoke a significantly more rigid posture than the others. We hypothesize that patients with SAD when entering in a situation of exposure, from the moment the pictures are presented, tend to move less than controls, remaining this way until the experiment ends. This discrete body manifestation can provide additional data to the characterization of SAD and its differentiation from other anxiety disorders, especially in situations regarding facing fear. PMID:22086467

  2. Postural balance in patients with social anxiety disorder

    PubMed Central

    Levitan, M.N.; Crippa, J.A.; Bruno, L.M.; Pastore, D.L.; Freire, R.C.; Arrais, K.C.; Hallak, J.E.; Nardi, A.E.

    2011-01-01

    Body stability is controlled by the postural system and can be affected by fear and anxiety. Few studies have addressed freezing posture in psychiatric disorders. The purpose of the present study was to assess posturographic behavior in 30 patients with social anxiety disorder (SAD) and 35 without SAD during presentation of blocks of pictures with different valences. Neutral images consisted of objects taken from a catalog of pictures, negative images were mutilation pictures and anxiogenic images were related to situations regarding SAD fears. While participants were standing on a force platform, similar to a balance, displacement of the center of pressure in the mediolateral and anteroposterior directions was measured. We found that the SAD group exhibited a lower sway area and a lower velocity of sway throughout the experiment independent of the visual stimuli, in which the phobic pictures, a stimulus associated with a defense response, were unable to evoke a significantly more rigid posture than the others. We hypothesize that patients with SAD when entering in a situation of exposure, from the moment the pictures are presented, tend to move less than controls, remaining this way until the experiment ends. This discrete body manifestation can provide additional data to the characterization of SAD and its differentiation from other anxiety disorders, especially in situations regarding facing fear. PMID:22086467

  3. Neuroplasticity as a target for the pharmacotherapy of anxiety disorders, mood disorders, and schizophrenia

    PubMed Central

    Krystal, John H.; Tolin, David F.; Sanacora, Gerard; Castner, Stacy; Williams, Graham; Aikins, Deane; Hoffman, Ralph; D’Souza, D. Cyril

    2009-01-01

    Current treatments for psychiatric disorders were developed with the aim of providing symptomatic relief rather than reversing underlying abnormalities in neuroplasticity or neurodevelopment that might contribute to psychiatric disorders. This review considers the possibility that psychiatric treatments might be developed that target neuroplasticity deficits or that manipulate neuroplasticity in novel ways. These treatments might not provide direct symptomatic relief. However, they might complement or enhance current pharmacotherapies and psychotherapies aimed at the prevention and treatment of psychiatric disorders. In considering neuroplasticity as a target for the treatment of psychiatric disorders, we build on exciting new findings in the areas of anxiety disorders, mood disorders, and schizophrenia. PMID:19460458

  4. Implicit associations in social anxiety disorder: the effects of comorbid depression.

    PubMed

    Wong, Judy; Morrison, Amanda S; Heimberg, Richard G; Goldin, Philippe R; Gross, James J

    2014-08-01

    Implicit associations of the self to concepts like "calm" have been shown to be weaker in persons with social anxiety than in non-anxious healthy controls. However, other implicit self associations, such as those to acceptance or rejection, have been less studied in social anxiety, and none of this work has been conducted with clinical samples. Furthermore, the importance of depression in these relationships has not been well investigated. We addressed these issues by administering two Implicit Association Tests (IATs; Greenwald, McGhee, & Schwartz, 1998), one examining the implicit association of self/other to anxiety/calmness and the other examining the association of self/other to rejection/acceptance, to individuals with generalized social anxiety disorder (SAD, n=85), individuals with generalized SAD and a current or past diagnosis of major depressive disorder or current dysthymic disorder (n=47), and non-anxious, non-depressed healthy controls (n=44). The SAD and SAD-depression groups showed weaker implicit self-calmness associations than healthy controls, with the comorbid group showing the weakest self-calmness associations. The SAD-depression group showed the weakest implicit self-acceptance associations; no difference was found between non-depressed individuals with SAD and healthy controls. Post hoc analyses revealed that differences appeared to be driven by those with current depression. The SAD-only and SAD-depression groups did not differ in self-reported (explicit) social anxiety. The implications of these findings for the understanding of SAD-depression comorbidity and for the treatment of SAD are considered. PMID:24983794

  5. Implicit Associations in Social Anxiety Disorder: The Effects of Comorbid Depression

    PubMed Central

    Wong, Judy; Morrison, Amanda S.; Heimberg, Richard G.; Goldin, Philippe R.; Gross, James J.

    2014-01-01

    Implicit associations of the self to concepts like “calm” have been shown to be weaker in persons with social anxiety than in non-anxious healthy controls. However, other implicit self associations, such as those to acceptance or rejection, have been less studied in social anxiety, and none of this work has been conducted with clinical samples. Furthermore, the importance of depression in these relationships has not been well investigated. We addressed these issues by administering two Implicit Association Tests (IATs; Greenwald, McGhee, & Schwartz, 1998), one examining the implicit association of self/other to anxiety/calmness and the other examining the association of self/other to rejection/acceptance, to individuals with generalized social anxiety disorder (SAD, n = 85), individuals with generalized SAD and a current or past diagnosis of major depressive disorder or current dysthymic disorder (n = 47), and non-anxious, non-depressed healthy controls (n = 44). The SAD and SAD-depression groups showed weaker implicit self-calmness associations than healthy controls, with the comorbid group showing the weakest self-calmness associations. The SAD-depression group showed the weakest implicit self-acceptance associations; no difference was found between non-depressed individuals with SAD and healthy controls. Post hoc analyses revealed that differences appeared to be driven by those with current depression. The SAD-only and SAD-depression groups did not differ in self-reported (explicit) social anxiety. The implications of these findings for the understanding of SAD-depression comorbidity and for the treatment of SAD are considered. PMID:24983794

  6. Prenatal diagnosis of genetic disorders.

    PubMed Central

    Niermeijer, M F; Sachs, E S; Jahodova, M; Tichelaar-Klepper, C; Kleijer, W J; Galjaard, H

    1976-01-01

    Three hundred and fifty pregnancies were monitored by transabdominal amniocentesis in the fourteenth to sixteenth week of gestation followed by karyotyping or biochemica assays of cultured amniotic fluid cells and analysis of alpha-fetoprotein in the amniotic fluid supernatant. The pregnancy was interrupted in 36 cases (10%) either becasue of a fetal abnormality or the presence of a male fetus in pregnancies at risk for an X-linked disease. Four chromosomal aberrations were found in 87 pregnancies tested because of advanced maternal age. In 101 pregnancies with a recurrence risk of Down's syndrome, 2 fetuses with an abnormal karyotype were detected. In 11 cases, in which 1 parent was a carrier of a balanced translocation, 2 unbalanced fetal karyotypes were found. Fetal chromosome studies in 43 pregancies at risk for an X-linked disease indicated the presence of a male fetus in 21 cases. Prenatal diagnosis of 11 different metabolic diseases was performed in a total of 34 cases. Microchemical techniques were used to allow completion of the diagnosis of seven different enzyme deficiencies within 9 to 22 days after amniocentesis. Alpha-fetoprotein assay in the amniotic fluid supernatant of 47 pregnancies at risk for an open neural tube defect resulted in the detection of 3 anencephalic fetuses during the second half of pregnancy. The safety and reliability of amniocentesis and the possible effects on the outcome of pregnancy are evaluated. Prenatal diagnosis offers a promising alternative for parents who are at risk of having a child with a genetic disease which can be detected in amniotic fluid or in cultured amniotic fluid cells. Images PMID:58990

  7. 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

  8. Towards a mechanistic understanding of pathological anxiety: the dorsal medial prefrontal-amygdala ‘aversive amplification’ circuit in unmedicated generalized and social anxiety disorders

    PubMed Central

    Robinson, Oliver J; Krimsky, Marissa; Lieberman, Lynne; Allen, Phillip; Vytal, Katherine; Grillon, Christian

    2014-01-01

    Background We have delineated, across four prior studies, the role of positive dorsal medial prefrontal/anterior cingulate cortex (dmPFC/ACC)-amygdala circuit coupling during aversive processing in healthy individuals under stress. This translational circuit, termed the ‘aversive amplification circuit’, is thought to drive adaptive, harm-avoidant behavior in threatening environments. Here, in a natural progression of this prior work, we confirm that this circuit also plays a role in the pathological manifestation of anxiety disorders. Methods Forty-five unmedicated participants (N=22 generalized and social anxiety disorder/N=23 controls) recruited from Washington DC metropolitan area completed a simple emotion identification task during functional magnetic resonance imaging at the National Institutes of Health, Bethesda, MD, USA. Findings As predicted, a diagnosis by valence interaction was seen in whole-brain amygdala connectivity within the dmPFC/ACC clusters identified in our prior study; driven by significantly greater circuit coupling during fearful versus happy face processing in anxious, but not healthy, participants. Critically, and in accordance with contemporary theoretical approaches to psychiatry, circuit coupling correlated positively with self-reported anxious symptoms, providing evidence of a continuous circuit-subjective symptomatology relationship. Interpretation We track the functional role of a single neural circuit from its involvement in adaptive threat-biases under stress, to its chronic engagement in anxiety disorders in the absence of experimentally induced stress. Thus, we uniquely map a mood and anxiety related circuit across its adaptive and maladaptive stages. Clinically, this may provide a step towards a more mechanistic spectrum-based approach to anxiety disorder diagnosis and may ultimately lead to more targeted treatments. PMID:25722962

  9. Treatment of childhood anxiety disorder in the context of maternal anxiety disorder: a randomised controlled trial and economic analysis.

    PubMed Central

    Creswell, Cathy; Cruddace, Susan; Gerry, Stephen; Gitau, Rachel; McIntosh, Emma; Mollison, Jill; Murray, Lynne; Shafran, Rosamund; Stein, Alan; Violato, Mara; Voysey, Merryn; Willetts, Lucy; Williams, Nicola; Yu, Ly-Mee; Cooper, Peter J

    2015-01-01

    BACKGROUND Cognitive-behavioural therapy (CBT) for childhood anxiety disorders is associated with modest outcomes in the context of parental anxiety disorder. OBJECTIVES This study evaluated whether or not the outcome of CBT for children with anxiety disorders in the context of maternal anxiety disorders is improved by the addition of (i) treatment of maternal anxiety disorders, or (ii) treatment focused on maternal responses. The incremental cost-effectiveness of the additional treatments was also evaluated. DESIGN Participants were randomised to receive (i) child cognitive-behavioural therapy (CCBT); (ii) CCBT with CBT to target maternal anxiety disorders [CCBT + maternal cognitive-behavioural therapy (MCBT)]; or (iii) CCBT with an intervention to target mother-child interactions (MCIs) (CCBT + MCI). SETTING A NHS university clinic in Berkshire, UK. PARTICIPANTS Two hundred and eleven children with a primary anxiety disorder, whose mothers also had an anxiety disorder. INTERVENTIONS All families received eight sessions of individual CCBT. Mothers in the CCBT + MCBT arm also received eight sessions of CBT targeting their own anxiety disorders. Mothers in the MCI arm received 10 sessions targeting maternal parenting cognitions and behaviours. Non-specific interventions were delivered to balance groups for therapist contact. MAIN OUTCOME MEASURES Primary clinical outcomes were the child's primary anxiety disorder status and degree of improvement at the end of treatment. Follow-up assessments were conducted at 6 and 12 months. Outcomes in the economic analyses were identified and measured using estimated quality-adjusted life-years (QALYs). QALYS were combined with treatment, health and social care costs and presented within an incremental cost-utility analysis framework with associated uncertainty. RESULTS MCBT was associated with significant short-term improvement in maternal anxiety; however, after children had received CCBT, group differences were no longer apparent. CCBT + MCI was associated with a reduction in maternal overinvolvement and more confident expectations of the child. However, neither CCBT + MCBT nor CCBT + MCI conferred a significant post-treatment benefit over CCBT in terms of child anxiety disorder diagnoses [adjusted risk ratio (RR) 1.18, 95% confidence interval (CI) 0.87 to 1.62, p = 0.29; adjusted RR CCBT + MCI vs. control: adjusted RR 1.22, 95% CI 0.90 to 1.67, p = 0.20, respectively] or global improvement ratings (adjusted RR 1.25, 95% CI 1.00 to 1.59, p = 0.05; adjusted RR 1.20, 95% CI 0.95 to 1.53, p = 0.13). CCBT + MCI outperformed CCBT on some secondary outcome measures. Furthermore, primary economic analyses suggested that, at commonly accepted thresholds of cost-effectiveness, the probability that CCBT + MCI will be cost-effective in comparison with CCBT (plus non-specific interventions) is about 75%. CONCLUSIONS Good outcomes were achieved for children and their mothers across treatment conditions. There was no evidence of a benefit to child outcome of supplementing CCBT with either intervention focusing on maternal anxiety disorder or maternal cognitions and behaviours. However, supplementing CCBT with treatment that targeted maternal cognitions and behaviours represented a cost-effective use of resources, although the high percentage of missing data on some economic variables is a shortcoming. Future work should consider whether or not effects of the adjunct interventions are enhanced in particular contexts. The economic findings highlight the utility of considering the use of a broad range of services when evaluating interventions with this client group. TRIAL REGISTRATION Current Controlled Trials ISRCTN19762288. FUNDING This trial was funded by the Medical Research Council (MRC) and Berkshire Healthcare Foundation Trust and managed by the National Institute for Health Research (NIHR) on behalf of the MRC-NIHR partnership (09/800/17) and will be published in full in Health Technology Assessment; Vol. 19, No. 38. PMID:26004142

  10. Attention deficit and hyperactivity in social anxiety disorder: relationship with trauma history and impulsivity.

    PubMed

    Koyuncu, Ahmet; Çelebi, Fahri; Ertekin, Erhan; Kök, Burcu Ece; Tükel, Raşit

    2016-06-01

    The aim of this study is to investigate the rate of childhood traumatic experiences and assess the relationship between childhood trauma and impulsivity in the presence of attention deficit-hyperactivity disorder (ADHD) in patients with social anxiety disorder (SAD). A total of 123 patients with a primary diagnosis of SAD were enrolled. All patients were assessed by using the clinical version of Structured Clinical Interview for DSM-IV (SCID-I/CV) and Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime version (K-SADS-PL), ADHD module. A clinical and sociodemographic data form and rating scales were filled out. We found higher rates of emotional traumatic experiences and impulsivity along with more severe symptoms of depression, anxiety and social anxiety in the group of SAD patients with childhood ADHD than in SAD patients without ADHD in childhood. The presence of ADHD is associated with higher severity in several domains in patients with SAD. Patients with SAD should be assessed carefully whether they have ADHD, especially when their SAD symptoms are severe, when they have a history of traumatic experiences or problems with impulse control. PMID:26797941

  11. An open-label trial of escitalopram in children and adolescents with social anxiety disorder.

    TOXLINE Toxicology Bibliographic Information

    Isolan L; Pheula G; Salum GA Jr; Oswald S; Rohde LA; Manfro GG

    2007-12-01

    Social anxiety disorder (SAD) is a highly prevalent and disabling disorder in children and adolescents. This study was designed to evaluate the efficacy and safety of a highly potent and selective serotonin reuptake inhibitor, escitalopram, in the treatment of SAD in children and adolescents. Twenty outpatients with a primary diagnosis of SAD were treated in a 12-week open trial with escitalopram. The primary outcome variable was the change from baseline to end point in Clinical Global Impression-Improvement scale (CGI-I). Secondary efficacy measures included the CGI-Severity scale (CGI-S), the Social Phobia and Anxiety Inventory for Children (SPAI-C), the Screen for Child and Anxiety Related Emotional Disorders (SCARED)-Child and Parent version, and The Youth Quality of Life Instrument-Research Version (Y-QOL-R). On the CGI-I scale, 13 of 20 patients (65%) had a score < or =2, meaning response to treatment. All symptomatic and quality of life measures showed improvements from baseline to week 12, with large effect sizes ranging from 0.9 to 1.9 (all p < 0.001). Escitalopram was generally well-tolerated. These results suggest that escitalopram may be an effective and safe treatment for pediatric SAD. Future double-blind, placebo-controlled, randomized clinical trials are warranted.

  12. An open-label trial of escitalopram in children and adolescents with social anxiety disorder.

    PubMed

    Isolan, Luciano; Pheula, Gabriel; Salum, Giovanni Abraho; Oswald, Sylvia; Rohde, Luis Augusto; Manfro, Gisele Gus

    2007-12-01

    Social anxiety disorder (SAD) is a highly prevalent and disabling disorder in children and adolescents. This study was designed to evaluate the efficacy and safety of a highly potent and selective serotonin reuptake inhibitor, escitalopram, in the treatment of SAD in children and adolescents. Twenty outpatients with a primary diagnosis of SAD were treated in a 12-week open trial with escitalopram. The primary outcome variable was the change from baseline to end point in Clinical Global Impression-Improvement scale (CGI-I). Secondary efficacy measures included the CGI-Severity scale (CGI-S), the Social Phobia and Anxiety Inventory for Children (SPAI-C), the Screen for Child and Anxiety Related Emotional Disorders (SCARED)-Child and Parent version, and The Youth Quality of Life Instrument-Research Version (Y-QOL-R). On the CGI-I scale, 13 of 20 patients (65%) had a score < or =2, meaning response to treatment. All symptomatic and quality of life measures showed improvements from baseline to week 12, with large effect sizes ranging from 0.9 to 1.9 (all p < 0.001). Escitalopram was generally well-tolerated. These results suggest that escitalopram may be an effective and safe treatment for pediatric SAD. Future double-blind, placebo-controlled, randomized clinical trials are warranted. PMID:18315447

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

    PubMed Central

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

    2011-01-01

    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

  14. Psychiatric Disorders: Diagnosis to Therapy

    PubMed Central

    Krystal, John H.; State, Matthew W.

    2014-01-01

    Recent findings in a range of scientific disciplines are challenging the conventional wisdom regarding the etiology, classification and treatment of psychiatric disorders. This review focuses on the current state of the psychiatric diagnostic nosology and recent progress in three areas: genomics, neuroimaging, and therapeutics development. The accelerating pace of novel and unexpected findings is transforming the understanding of mental illness and represents a hopeful sign that the approaches and models that have sustained the field for the past 40 years are yielding to a flood of new data and presaging the emergence of a new and more powerful scientific paradigm. PMID:24679536

  15. Neural temporal dynamics of stress in comorbid major depressive disorder and social anxiety disorder

    PubMed Central

    2012-01-01

    Background Despite advances in neurobiological research on Major Depressive Disorder and Social Anxiety Disorder, little is known about the neural functioning of individuals with comorbid depression/social anxiety. We examined the timing of neural responses to social stress in individuals with major depression and/or social anxiety. We hypothesized that having social anxiety would be associated with earlier responses to stress, having major depression would be associated with sustained responses to stress, and that comorbid participants would exhibit both of these response patterns. Methods Participants were females diagnosed with pure depression (n = 12), pure social anxiety (n = 16), comorbid depression/social anxiety (n = 17), or as never having had any Axis-I disorder (control; n = 17). Blood oxygenation-level dependent activity (BOLD) was assessed with functional magnetic resonance imaging (fMRI). To induce social stress, participants prepared a speech that was ostensibly to be evaluated by a third party. Results Whereas being diagnosed with depression was associated with a resurgence of activation in the medial frontal cortex late in the stressor, having social anxiety was associated with a vigilance-avoidance activation pattern in the occipital cortex and insula. Comorbid participants exhibited activation patterns that generally overlapped with the non-comorbid groups, with the exception of an intermediate level of activation, between the level of activation of the pure depression and social anxiety groups, in the middle and posterior cingulate cortex. Conclusions These findings advance our understanding of the neural underpinnings of major depression and social anxiety, and of their comorbidity. Future research should elucidate more precisely the behavioral correlates of these patterns of brain activation. PMID:22738335

  16. Validation of candidate anxiety disorder genes using a carbon dioxide challenge task.

    PubMed

    Savage, Jeanne E; McMichael, Omari; Gorlin, Eugenia I; Beadel, Jessica R; Teachman, Bethany; Vladimirov, Vladimir I; Hettema, John M; Roberson-Nay, Roxann

    2015-07-01

    Few replicable genetic variants have been identified in the etiology of heritable anxiety disorders such as panic disorder. Endophenotypic measures that have reduced heterogeneity may provide more powerful targets for gene identification. We assessed hypersensitivity to carbon dioxide (a reliable endophenotype of panic and anxiety) in 174 Caucasian college students, who were genotyped on 26 polymorphic markers from 11 genes previously associated with panic/anxiety. Individual trajectories of respiratory and subjective anxiety response to carbon dioxide were measured and tested for association with these genetic markers. One marker in the acid-sensing ion channel 1 (ASIC1) gene, rs1108923, had a significant association with respiratory rate. No genes had a significant association with subjective anxiety response. Our findings support previously reported associations between ASIC1 and panic/anxiety, but not other genes previously associated with anxiety disorders. The use of endophenotypic markers is a promising avenue for gene identification in anxiety and other complex disorders. PMID:25913301

  17. Two-Year Course of Generalized Anxiety Disorder, Social Anxiety Disorder and Panic Disorder with Agoraphobia in a Sample of Latino Adults

    PubMed Central

    Bjornsson, Andri S.; Sibrava, Nicholas J.; Beard, Courtney; Moitra, Ethan; Weisberg, Risa B.; Pérez Benítez, Carlos I.; Keller, Martin B.

    2014-01-01

    Objective It is imperative to study the clinical course of anxiety disorders among Latinos, given the implications for culturally-sensitive treatment in this population. The current study is the first prospective, observational, longitudinal study of anxiety disorders among Latinos. Method Data are reported on 139 adult Latinos (mean age 34.65, SD =10.98, 70.5% female) diagnosed with social anxiety disorder (SAD, n = 86), generalized anxiety disorder (GAD, n = 90) or panic disorder with agoraphobia (PDA, n = 62). The participants were interviewed with standardized clinical interviews at intake and annually over two years of follow-up. Probabilities of recovery were calculated using standard survival analysis methods. Results The two-year recovery rates in this study were 0.07 for SAD, 0.14 for GAD, 0.03 for PDA, and 0.50 for major depressive disorder (MDD). Overall functioning, social adjustment and life satisfaction in this sample were poor. Conclusions The recovery rates for anxiety disorders in this Latino sample were markedly low. Although caution must be used in comparing these data with prior longitudinal studies, these recovery rates seem to be much lower than in non-Latino White samples. However, the clinical course of MDD in this sample was similar to its course among non-Latino Whites, invoking the pressing question of whether there is something about the experience of anxiety disorders (but not MDD) among Latinos that makes them more impairing and persistent. The answer to that question should inform future treatment development for this population. PMID:24731232

  18. Anxiety sensitivity, catastrophic misinterpretations and panic self-efficacy in the prediction of panic disorder severity: towards a tripartite cognitive model of panic disorder.

    PubMed

    Sandin, Bonifacio; Sánchez-Arribas, Carmen; Chorot, Paloma; Valiente, Rosa M

    2015-04-01

    The present study examined the contribution of three main cognitive factors (i.e., anxiety sensitivity, catastrophic misinterpretations of bodily symptoms, and panic self-efficacy) in predicting panic disorder (PD) severity in a sample of patients with a principal diagnosis of panic disorder. It was hypothesized that anxiety sensitivity (AS), catastrophic misinterpretation of bodily sensations, and panic self-efficacy are uniquely related to panic disorder severity. One hundred and sixty-eight participants completed measures of AS, catastrophic misinterpretations of panic-like sensations, and panic self-efficacy prior to receiving treatment. Results of multiple linear regression analyses indicated that AS, catastrophic misinterpretations and panic self-efficacy independently predicted panic disorder severity. Results of path analyses indicated that AS was direct and indirectly (mediated by catastrophic misinterpretations) related with panic severity. Results provide evidence for a tripartite cognitive account of panic disorder. PMID:25727680

  19. 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

  20. Aetiological overlap between obsessive-compulsive related and anxiety disorder symptoms: multivariate twin study.

    PubMed

    López-Solà, Clara; Fontenelle, Leonardo F; Bui, Minh; Hopper, John L; Pantelis, Christos; Yücel, Murat; Menchón, José M; Alonso, Pino; Harrison, Ben J

    2016-01-01

    BackgroundThe aetiological boundary between obsessive-compulsive related disorders (OCRDs) including obsessive-compulsive disorder (OCD) and anxiety disorders is unclear and continues to generate debate.AimsTo determine the genetic overlap and the pattern of causal relationships among OCRDs and anxiety disorders.MethodMultivariate twin modelling methods and a new regression analysis to infer causation were used, involving 2495 male and female twins.ResultsThe amount of common genetic liability observed for OCD symptoms was higher when considering anxiety disorders and OCRDs in the model v. modelling OCRD symptoms alone. OCD symptoms emerged as risk factors for the presence of generalised anxiety, panic and hoarding symptoms, whereas social phobia appeared as a risk factor for OCD symptoms.ConclusionsOCD represents a complex phenotype that includes important shared features with anxiety disorders and OCRDs. The novel patterns of risk identified between OCD and anxiety disorder may help to explain their frequent co-occurrence. PMID:26494870

  1. Cognitive Hypnotherapy for Accessing and Healing Emotional Injuries for Anxiety Disorders.

    PubMed

    Alladin, Assen

    2016-07-01

    Although anxiety disorders on the surface may appear simple, they often represent complex problems that are compounded by underlying factors. For these reasons, treatment of anxiety disorders should be individualized. This article describes cognitive hypnotherapy, an individual comprehensive treatment protocol that integrates cognitive, behavioral, mindfulness, psychodynamic, and hypnotic strategies in the management of anxiety disorders. The treatment approach is based on the self-wounds model of anxiety disorders, which provides the rationale for integrating diverse strategies in the psychotherapy for anxiety disorders. Due to its evidence-based and integrated nature, the psychotherapy described here provides accuracy, efficacy, and sophistication in the formulation and treatment of anxiety disorders. This model can be easily adapted to the understanding and treatment of other emotional disorders. PMID:27196009

  2. 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

  3. 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…

  4. Diagnosis and Treatment of Eating Disorders.

    ERIC Educational Resources Information Center

    Neuman, Patricia; And Others

    This paper was designed to provide professional counselors with a comprehensive but concise method of accurately evaluting, interviewing, and planning for treatment of eating disorder clients. The paper is organized in five sections. The first section, Diagnosis, compares, contrasts, and offers clear explanations of the diagnostic criteria for

  5. Diagnosis and Treatment of Eating Disorders.

    ERIC Educational Resources Information Center

    Neuman, Patricia; And Others

    This paper was designed to provide professional counselors with a comprehensive but concise method of accurately evaluting, interviewing, and planning for treatment of eating disorder clients. The paper is organized in five sections. The first section, Diagnosis, compares, contrasts, and offers clear explanations of the diagnostic criteria for…

  6. Adapting parent-child interaction therapy to treat anxiety disorders in young children.

    PubMed

    Puliafico, Anthony C; Comer, Jonathan S; Pincus, Donna B

    2012-07-01

    Anxiety disorders are prevalent in children 7 years and younger; however, these children generally do not possess developmental skills required in cognitive behavior treatment. Recent efforts have adapted parent-child interaction therapy (PCIT), originally developed for disruptive and noncompliant behavior, for young children with anxiety. This article reviews the principles underlying PCIT and the rationale for adapting it to target anxiety symptoms. The authors describe two related treatment approaches that have modified PCIT to treat anxiety: (1) Pincus and colleagues' treatment for separation anxiety, and (2) Puliafico, Comer, and Albano's CALM Program for the range of early child anxiety disorders. PMID:22800997

  7. 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…

  8. 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…

  9. 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

  10. 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…

  11. Anxiety and sensory over-responsivity in toddlers with autism spectrum disorders: bidirectional effects across time.

    PubMed

    Green, Shulamite A; Ben-Sasson, Ayelet; Soto, Timothy W; Carter, Alice S

    2012-06-01

    This report focuses on the emergence of and bidirectional effects between anxiety and sensory over-responsivity (SOR) in toddlers with autism spectrum disorders (ASD). Participants were 149 toddlers with ASD and their mothers, assessed at 2 annual time points. A cross-lag analysis showed that anxiety symptoms increased over time while SOR remained relatively stable. SOR positively predicted changes in anxiety over and above child age, autism symptom severity, NVDQ, and maternal anxiety, but anxiety did not predict changes in SOR. Results suggest that SOR emerges earlier than anxiety, and predicts later development of anxiety. PMID:21935727

  12. Mitochondrial disorders: Challenges in diagnosis & treatment

    PubMed Central

    Khan, Nahid Akhtar; Govindaraj, Periyasamy; Meena, Angamuthu Kannan; Thangaraj, Kumarasamy

    2015-01-01

    Mitochondrial dysfunctions are known to be responsible for a number of heterogenous clinical presentations with multi-systemic involvement. Impaired oxidative phosphorylation leading to a decrease in cellular energy (ATP) production is the most important cause underlying these disorders. Despite significant progress made in the field of mitochondrial medicine during the last two decades, the molecular mechanisms underlying these disorders are not fully understood. Since the identification of first mitochondrial DNA (mtDNA) mutation in 1988, there has been an exponential rise in the identification of mtDNA and nuclear DNA mutations that are responsible for mitochondrial dysfunction and disease. Genetic complexity together with ever widening clinical spectrum associated with mitochondrial dysfunction poses a major challenge in diagnosis and treatment. Effective therapy has remained elusive till date and is mostly efficient in relieving symptoms. In this review, we discuss the important clinical and genetic features of mitochondrials disorders with special emphasis on diagnosis and treatment. PMID:25857492

  13. A study of poor insight in social anxiety disorder.

    PubMed

    Vigne, Paula; de Menezes, Gabriela B; Harrison, Ben J; Fontenelle, Leonardo F

    2014-11-30

    We investigated levels of insight among patients with Social Anxiety Disorder (SAD) as compared to patients with Obsessive-Compulsive Disorder (OCD) and evaluated whether levels of insight in SAD were related to specific sociodemographic and/or clinical features. Thirty-seven SAD patients and 51 OCD patients attending a tertiary obsessive-compulsive and anxiety disorders clinic were assessed with a sociodemographic and clinical questionnaire, a structured diagnostic interview, the Brown Assessment of Beliefs Scale (BABS), the Social Phobia Inventory (SPIN), the Beck Depression Inventory (BDI), the Sheehan Disability Scale (SDS), and the Treatment Adherence Survey-patient version (TAS-P). According to the BABS, SAD patients exhibited insight levels that were as low as those exhibited by OCD patients, with up to 29.7% of them being described as "poor insight" SAD. Although poor insight SAD patients were more frequently married, less depressed and displayed a statistical trend towards greater rates of early drop-out from cognitive-behavioral therapy, their insight levels were not associated with other variables of interest, including sex, age, employment, age at onset, duration of illness, associated psychiatric disorders, SPIN and SDS scores. Patients with poor insight SAD might perceive their symptoms as being less distressful and thus report fewer depressive symptoms and high rates of treatment non-adherence. PMID:24972547

  14. Feasibility of guided cognitive behaviour therapy (CBT) self-help for childhood anxiety disorders in primary care.

    PubMed

    Creswell, Cathy; Hentges, Francoise; Parkinson, Monika; Sheffield, Paul; Willetts, Lucy; Cooper, Peter

    2010-03-01

    Anxiety disorders in childhood are common, disabling and run a chronic course. Cognitive behaviour therapy (CBT) is effective but expensive and trained therapists are scarce. Guided self-help treatments may be a means of widening access to treatment. This study aimed to examine the feasibility of guided CBT self-help in primary care for childhood anxiety disorders, specifically in terms of therapist adherence, patient and therapist satisfaction and clinical gain.Participants were children aged between five and 12 years referred to two primary child and adolescent mental health services (PCAMHSs) in Oxfordshire, UK, who met diagnostic criteria for a primary anxiety disorder. Of the 52 eligible children, 41 anxious children were assessed for anxiety severity and interference before and after receiving CBT self-help delivered via a parent (total therapy time = five hours) by primary mental health workers (PMHWs). Therapy sessions were rated for treatment adherence and parents and PMHWs completed satisfaction questionnaires after treatment completion. Over 80% of therapy sessions were rated at a high level of treatment adherence. Parents and PMHWs reported high satisfaction with the treatment. Sixty-one percent of the children assessed no longer met the criteria for their primary anxiety disorder diagnosis following treatment, and 76% were rated as 'much'/'very much' improved on the Clinical Global Impression-Improvement (CGI-I) scale. There were significant reductions on parent and child report measures of anxiety symptoms, interference and depression. Preliminary exploration indicated that parental anxiety was associated with child treatment outcome. The findings suggest that guided CBT self-help represents a promising treatment for childhood anxiety in primary care. PMID:22477922

  15. Risk Factors for Anxiety in Major Depressive Disorder Patients

    PubMed Central

    Xin, Li-Min; Chen, Lin; Ji, Zhen-Peng; Zhang, Suo-Yuan; Wang, Jun; Liu, Yan-Hong; Chen, Da-Fang; Yang, Fu-De; Wang, Gang; Fang, Yi-Ru; Lu, Zheng; Yang, Hai-Chen; Hu, Jian; Chen, Zhi-Yu; Huang, Yi; Sun, Jing; Wang, Xiao-Ping; Li, Hui-Chun; Zhang, Jin-Bei; Si, Tian-Mei

    2015-01-01

    Objective To analyze the sociodemographic and clinical factors related to anxiety in patients with major depressive disorder (MDD). Methods This study involved a secondary analysis of data obtained from the Diagnostic Assessment Service for People with Bipolar Disorders in China (DASP), which was initiated by the Chinese Society of Psychiatry (CSP) and conducted from September 1, 2010 to February 28, 2011. Based on the presence or absence of anxiety-related characteristics, 1,178 MDD patients were classified as suffering from anxious depression (n=915) or non-anxious depression (n=263), respectively. Results Compared with the non-anxious group, the anxious-depression group had an older age at onset (t=−4.39, p<0.001), were older (t=−4.69, p<0.001), reported more lifetime depressive episodes (z=−3.24, p=0.001), were more likely to experience seasonal depressive episodes (χ2=6.896, p=0.009) and depressive episodes following stressful life events (χ2=59.350, p<0.001), and were more likely to have a family history of psychiatric disorders (χ2=6.091, p=0.014). Their positive and total scores on the Mood Disorder Questionnaire (MDQ) and the 32-item Hypomania Checklist (HCL-32) (p<0.05) were also lower. The logistic regression analysis indicated that age (odds ratio [OR]=1.03, p<0.001), a lower total MDQ score (OR=0.94, p=0.011), depressive episodes following stressful life events (OR=3.04, p<0.001), and seasonal depressive episodes (OR=1.75, p=0.039) were significantly associated with anxious depression. Conclusion These findings indicate that older age, fewer subclinical bipolar features, an increased number of depressive episodes following stressful life events, and seasonal depressive episodes may be risk factors for anxiety-related characteristics in patients with MDD. PMID:26598584

  16. 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

  17. Galen's Anxious Patients: Lypē as Anxiety Disorder.

    PubMed

    Mattern, Susan P

    2016-01-01

    Galen describes a syndrome he associates with an emotion called lypē, with specific symptoms and a course that may lead to humoral imbalance, disease, and death. Lypē is an emotion that encompasses distress at a loss, as the death of a close friend or the destruction of one's books by fire; but Galen also associates it with chronic worry about a future threat, and a physiology between the emotions of worry and fear (that is, 'anxiety'). Lypē can cause a progressive syndrome characterised by insomnia, fever, pallor, and weight loss that can kill patients or degenerate into psychotic illness. This syndrome can be described in modern terms as an anxiety disorder. PMID:26946678

  18. Treating Anxiety Disorders in Older Adults: Current Treatments and Future Directions.

    PubMed

    Bower, Emily S; Wetherell, Julie Loebach; Mon, Thetsu; Lenze, Eric J

    2015-01-01

    Anxiety disorders are highly prevalent among the elderly and are associated with increased disability, poor quality of life, and cognitive impairment. Despite this high prevalence and associated morbidities, anxiety disorders in late life are underreported and understudied. In this article, we discuss the epidemiology, disease presentation, and current treatment of anxiety disorders in older adults. We also discuss limitations in the current understanding of such disorders in this population, as well as future research directions that may reveal the mechanisms and rationale for treatment regimens for anxiety disorders in late life. We present material on the application of the Research Domain Criteria (RDoC) model to geriatric anxiety. Finally, we describe optimal management strategies of anxiety disorders. PMID:26332216

  19. Preschool anxiety disorders: comprehensive assessment of clinical, demographic, temperamental, familial, and life stress correlates.

    PubMed

    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, multimethod design. Participants included a community sample of 541 three-year-old children, of whom 106 (19.6%) met criteria for at least 1 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 6 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

  20. 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

  1. The manifestation of anxiety disorders after traumatic brain injury: a review.

    PubMed

    Mallya, Sasha; Sutherland, Jessica; Pongracic, Syb; Mainland, Brian; Ornstein, Tisha J

    2015-04-01

    The development of anxiety disorders after a traumatic brain injury (TBI) is a strong predictor of social, personal, and work dysfunction; nevertheless, the emergence of anxiety has been largely unexplored and poorly understood in the context of TBI. This article provides an overview of the limited published research to date on anxiety disorders that are known to develop after TBI, including post-traumatic stress disorder, generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, specific phobia, and social anxiety disorder. This review also examines diagnostic criteria, the epidemiology of each disorder, and the factors that influence the expression of these conditions, including injury-related and psychosocial variables. Putative neural correlates will be reviewed where known. A discussion of current treatment options and avenues for further research are explored. PMID:25227240

  2. Brief Measures of Anxiety in Non-Treatment-Seeking Youth with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Kerns, Connor Morrow; Maddox, Brenna B.; Kendall, Philip C.; Rump, Keiran; Berry, Leandra; Schultz, Robert T.; Souders, Margaret C.; Bennett, Amanda; Herrington, John; Miller, Judith

    2015-01-01

    This study investigated the accuracy of brief anxiety scales for non-treatment-seeking youth with autism spectrum disorder. In all, 54 youth (7-17?years; IQ: 67-158) with autism spectrum disorder and their parents completed (a) an expanded version of the Anxiety Disorders Interview Schedule--Child/Parent designed to capture typical and atypical…

  3. A literature review of quetiapine for generalized anxiety disorder.

    PubMed

    Kreys, Tiffany-Jade M; Phan, Stephanie V

    2015-02-01

    To evaluate the efficacy and tolerability of quetiapine for the treatment of generalized anxiety disorder (GAD), a literature search of the Medline database was conducted from inception to May 2014. The search was not restricted by language. Keywords used in the search were quetiapine and generalized anxiety disorder or anxiety. All studies assessing the use of quetiapine as monotherapy or adjunct therapy for the primary management of GAD in adults 18-65 years of age were included in this review. The nine studies included in this review were three studies evaluating the use of quetiapine extended release (XR) as monotherapy for acute GAD treatment, one study evaluating quetiapine XR monotherapy for maintenance treatment of GAD, and five studies evaluating quetiapine (2 XR, 3 immediate release) as adjunct therapy for acute GAD treatment. Quetiapine displayed both efficacy and tolerability in all monotherapy trials evaluating its use for acute and long-term treatment of GAD. Despite some limitations to and heterogeneity among the five adjunct therapy studies, three studies showed that quetiapine resulted in statistically significant changes in the Hamilton Anxiety Rating Scale or Clinical Global Impressions-Severity of Illness Scale scores. Although future studies of longer duration with broader inclusion criteria are needed to further evaluate the benefits and risks of quetiapine for GAD, in patients failing to respond to conventional antidepressant therapy, quetiapine may be a potential treatment option. With appropriate monitoring and management of adverse effects, the potential benefits of quetiapine in patients with treatment-refractory GAD may outweigh the risks associated with its use. PMID:25689246

  4. Self-esteem and social anxiety in an adolescent female eating disorder population: age and diagnostic effects.

    PubMed

    Obeid, Nicole; Buchholz, Annick; Boerner, Katelynn E; Henderson, Katherine A; Norris, Mark

    2013-01-01

    This study explored symptoms of social anxiety and multidimensional self-esteem in a clinical, adolescent female eating disorder population. Using self-report measures, data from 344 females revealed significant negative relationships between dimensions of self-esteem and social anxiety. A diagnostic difference emerged, with the restricting subgroup reporting significantly higher perceived physical appearance and global self-worth than those with binge/purge symptoms or bulimia nervosa. No significant age differences or age by diagnosis interaction effects emerged. These findings suggest that in clinical samples of adolescent eating disorders, self-esteem and social anxiety share a significant inverse relationship and seem to remain fairly constant across adolescence. PMID:23421697

  5. Emotional Imagery and the Differential Diagnosis of Anxiety.

    ERIC Educational Resources Information Center

    Cook, Edwin W., III; And Others

    1988-01-01

    For 38 anxiety patients, exposure to phobic imagery resulted in significantly larger heart rate and skin conductance increases than control imagery. Results suggest that simple phobia is avoidance disposition, social phobia involves multiple problems of interpersonal dominance, and agoraphobia may be more similar to generalized anxiety disorder…

  6. Examining the Relationship Between Parental Anxiety and Treatment Response in Children and Adolescents with Autism Spectrum Disorder and Anxiety.

    PubMed

    Reaven, Judy; Washington, Lindsay; Moody, Eric J; Stern, Jessica A; Hepburn, Susan L; Blakeley-Smith, Audrey

    2015-08-01

    In response to the high co-occurrence of anxiety symptoms in youth with autism spectrum disorder (ASD), several interventions have been developed for this population. In spite of promising findings, some youth with ASD respond only minimally to such interventions. To understand potential factors that may impact treatment response, the current study explores the role of parental anxiety in youth treatment outcome. Thirty-one youth with ASD, ages 7-18, and their parents participated in the study. Parents completed the State/Trait Anxiety Inventory pre- and post-treatment. Contrary to previous research, there was no correlation between parental anxiety and youth anxiety at baseline or post-treatment. However, parental trait anxiety significantly decreased from pre- to post-treatment for parents of treatment responders. The findings are consistent with previous research and suggest a youth-to-parent influence. PMID:25778837

  7. Role of corticotropin releasing factor in anxiety disorders: a translational research perspective.

    PubMed

    Risbrough, Victoria B; Stein, Murray B

    2006-11-01

    Anxiety disorders are a group of mental disorders that include generalized anxiety disorder (GAD), panic disorder, phobic disorders (e.g., specific phobias, agoraphobia, social phobia) and posttraumatic stress disorder (PTSD). Anxiety disorders are among the most common of all mental disorders and, when coupled with an awareness of the disability and reduced quality of life they convey, they must be recognized as a serious public health problem. Over 20 years of preclinical studies point to a role for the CRF system in anxiety and stress responses. Clinical studies have supported a model of CRF dysfunction in depression and more recently a potential contribution to specific anxiety disorders (i.e., panic disorder and PTSD). Much work remains in both the clinical and preclinical fields to inform models of CRF function and its contribution to anxiety. First, we will review the current findings of CRF and HPA axis abnormalities in anxiety disorders. Second, we will discuss startle reflex measures as a tool for translational research to determine the role of the CRF system in development and maintenance of clinical anxiety. PMID:16870185

  8. Child sexual abuse in the etiology of anxiety disorders: a systematic review of reviews.

    PubMed

    Maniglio, Roberto

    2013-04-01

    There is considerable controversy about the role of child sexual abuse in the etiology of anxiety disorders. Although a growing number of research studies have been published, these have produced inconsistent results and conclusions regarding the nature of the associations between child sexual abuse and the various forms of anxiety problems as well as the potential effects of third variables, such as moderators, mediators, or confounders. This article provides a systematic review of the several reviews that have investigated the literature on the role of child sexual abuse in the etiology of anxiety disorders. Seven databases were searched, supplemented with hand search of reference lists from retrieved papers. Four meta-analyses, including 3,214,482 subjects from 171 studies, were analyzed. There is evidence that child sexual abuse is a significant, although general and nonspecific, risk factor for anxiety disorders, especially posttraumatic stress disorder, regardless of gender of the victim and severity of abuse. Additional biological or psychosocial risk factors (such as alterations in brain structure or function, information processing biases, parental anxiety disorders, family dysfunction, and other forms of child abuse) may interact with child sexual abuse or act independently to cause anxiety disorders in victims in abuse survivors. However, child sexual abuse may sometimes confer additional risk of developing anxiety disorders either as a distal and indirect cause or as a proximal and direct cause. Child sexual abuse should be considered one of the several risk factors for anxiety disorders and included in multifactorial etiological models for anxiety disorders. PMID:23262751

  9. Children and adolescents referred for treatment of anxiety disorders: Differences in clinical characteristics

    PubMed Central

    Waite, Polly; Creswell, Cathy

    2014-01-01

    Background Reports of the clinical characteristics of children and adolescents with anxiety disorders are typically based on community populations or from clinical samples with exclusion criterion applied. Little is known about the clinical characteristics of children and adolescents routinely referred for treatment for anxiety disorders. Furthermore, children and adolescents are typically treated as one homogeneous group although they may differ in ways that are clinically meaningful. Methods A consecutive series of children (n=100, aged 6–12 years) and adolescents (n=100, aged 13–18 years), referred to a routine clinical service, were assessed for anxiety and comorbid disorders, school refusal and parental symptoms of psychopathology. Results Children with a primary anxiety disorder were significantly more likely to be diagnosed with separation anxiety disorder than adolescents. Adolescents with a primary anxiety disorder had significantly higher self and clinician rated anxiety symptoms and had more frequent primary diagnoses of social anxiety disorder, diagnoses and symptoms of mood disorders, and irregular school attendance. Limitations Childhood and adolescence were considered categorically as distinct, developmental periods; in reality changes would be unlikely to occur in such a discrete manner. Conclusions The finding that children and adolescents with anxiety disorders have distinct clinical characteristics has clear implications for treatment. Simply adapting treatments designed for children to make the materials more ‘adolescent-friendly’ is unlikely to sufficiently meet the needs of adolescents. PMID:25016489

  10. The Burden of Anxiety Disorders in Pediatric Medical Settings: Prevalence, Phenomenology, and a Research Agend

    PubMed Central

    Ramsawh, Holly J.; Chavira, Denise A.; Stein, Murray B.

    2011-01-01

    The current review describes the phenomenology of several common anxiety disorders in children and adolescents as they present in medical settings. Anxiety disorders and associated features in children are described, along with epidemiology, functional impairment, common somatic complaints, medical comorbidity, health care utilization, and presentation in general and specialty pediatric medical settings. Recommendations for clinical management in pediatric settings are presented, and evidence-based interventions are described along with emerging treatments for pediatric anxiety disorders. The review concludes with a discussion of future research directions that may lead to increased recognition and improved management of anxiety disorders in pediatric medical settings. PMID:20921356

  11. Anxiety sensitivity and mindful attention in terms of anxiety and depressive symptoms and disorders among Latinos in primary care.

    PubMed

    Zvolensky, Michael J; Bakhshaie, Jafar; Garza, Monica; Paulus, Daniel J; Valdivieso, Jeanette; Lam, Hantin; Bogiaizian, Daniel; Robles, Zuzuky; Schmidt, Norman B; Vujanovic, Anka

    2015-09-30

    The present investigation examined the interactive effects of anxiety sensitivity and mindful attention in relation to anxiety and depressive symptoms and psychopathology among 145 adult Latinos (85.5% female; Mage=39.9, SD=10.8 and 98.6% used Spanish as their first language) who attended a community-based primary healthcare clinic. As expected, the interaction between anxiety sensitivity and mindful attention was significantly related to number of mood and anxiety disorders, social anxiety, and depressive symptoms. No significant interaction, however, was evident for panic (anxious arousal) symptoms. The form of the significant interaction indicated that Latinos reporting co-occurring higher levels of anxiety sensitivity and lower levels of mindful attention evinced the greatest levels of anxiety/depressive psychopathology, social anxiety, and depressive symptoms. These data provide novel empirical evidence suggesting that there is clinically-relevant interplay between anxiety sensitivity and mindful attention in regard to a relatively wide array of anxiety and depressive variables among Latinos in a primary care medical setting. PMID:26205630

  12. 38 CFR 4.125 - Diagnosis of mental disorders.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Diagnosis of mental... SCHEDULE FOR RATING DISABILITIES Disability Ratings Mental Disorders § 4.125 Diagnosis of mental disorders. (a) If the diagnosis of a mental disorder does not conform to DSM-IV or is not supported by...

  13. 38 CFR 4.125 - Diagnosis of mental disorders.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Diagnosis of mental... SCHEDULE FOR RATING DISABILITIES Disability Ratings Mental Disorders § 4.125 Diagnosis of mental disorders. (a) If the diagnosis of a mental disorder does not conform to DSM-IV or is not supported by...

  14. 38 CFR 4.125 - Diagnosis of mental disorders.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Diagnosis of mental... SCHEDULE FOR RATING DISABILITIES Disability Ratings Mental Disorders § 4.125 Diagnosis of mental disorders. (a) If the diagnosis of a mental disorder does not conform to DSM-IV or is not supported by...

  15. 38 CFR 4.125 - Diagnosis of mental disorders.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Diagnosis of mental... SCHEDULE FOR RATING DISABILITIES Disability Ratings Mental Disorders § 4.125 Diagnosis of mental disorders. (a) If the diagnosis of a mental disorder does not conform to DSM-IV or is not supported by...

  16. 38 CFR 4.125 - Diagnosis of mental disorders.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Diagnosis of mental... SCHEDULE FOR RATING DISABILITIES Disability Ratings Mental Disorders § 4.125 Diagnosis of mental disorders. (a) If the diagnosis of a mental disorder does not conform to DSM-IV or is not supported by...

  17. Disordered gambling and co-morbidity of psychiatric disorders among college students: an examination of problem drinking, anxiety and depression.

    TOXLINE Toxicology Bibliographic Information

    Martin RJ; Usdan S; Cremeens J; Vail-Smith K

    2014-06-01

    We assessed the occurrence of co-morbid psychiatric disorders (i.e., problem drinking, anxiety, and depression) among college students who met the threshold for disordered gambling. The participants included a large sample of undergraduate students (n = 1,430) who were enrolled in an introductory health course at a large, southeastern university in Spring 2011 and completed an online assessment that included scales to assess disordered gambling, problem drinking, anxiety, and depression. We calculated screening scores, computed prevalence rates for each disorder, and calculated Pearson correlations and Chi square tests to examine correlations and co-morbid relationships between the four disorders. Analyses indicated that all disorders were significantly associated (p < .01) except for disordered gambling and anxiety. Because college students who experience disordered gambling (and other psychiatric disorders) are at increased risk of experiencing co-occurring disorders, it might be useful for college health professionals to concurrently screen and intervene for co-occurring disorders.

  18. Covariance in the measurement of depression/anxiety and three Cluster C personality disorders (avoidant, dependent, obsessive-compulsive).

    PubMed

    Rees, A; Hardy, G E; Barkham, M

    1997-09-01

    One hundred and eight-four clients referred to a research outpatient psychological clinic, and meeting the acceptance criterion of 16 or more on the BDI at screening, were diagnosed as either-depressed and/or anxious using both Present State Examination and the Diagnostic and Statistical Manual of Mental State Disorders criteria. Clients were assessed for the presence of Cluster C personality disorders using the Personality Disorder Examination of Loranger et al. (1985). Twenty-two per cent made diagnosis of avoidant, dependent or obsessive-compulsive personality disorder. Significant correlation was found between screening/intake depression index scores and total scores on the three Cluster C personality disorders, although little correlation was found between diagnostic criteria for affective and personality disorders. Some association was shown between the clinical components of personality disorder traits in the anxious-fearful group and current anxiety symptoms, although not as clearly as expected. PMID:9298427

  19. Depression and Anxiety Symptoms in Children and Adolescents with Autism Spectrum Disorders without Intellectual Disability

    ERIC Educational Resources Information Center

    Strang, John F.; Kenworthy, Lauren; Daniolos, Peter; Case, Laura; Wills, Meagan C.; Martin, Alex; Wallace, Gregory L.

    2012-01-01

    Recent studies have shown that rates of depression and anxiety symptoms are elevated among individuals with autism spectrum disorders (ASDs) of various ages and IQs and that depression/anxiety symptoms are associated with higher IQ and fewer ASD symptoms. In this study which examined correlates of depression and anxiety symptoms in the full

  20. Social Anxiety Mediates the Effect of Autism Spectrum Disorder Characteristics on Hostility in Young Adults

    ERIC Educational Resources Information Center

    White, Susan Williams; Kreiser, Nicole L.; Pugliese, Cara; Scarpa, Angela

    2012-01-01

    Problems with social anxiety are frequently reported in people with autism spectrum disorders (ASD). It is possible that social anxiety, when present, exacerbates the experience of hostility and other forms of aggression in relation to ASD symptoms. This study sought to determine if social anxiety symptoms mediate the relationship between features