Sample records for anxiety disorder diagnosis

  1. Anxiety Disorders

    Microsoft Academic Search

    Julie Loebach Wetherell; Ariel J. Lang; Murray B. Stein

    The psychiatric disorders that are designated as anxiety disorders include the specific diagnoses of panic disorder with and\\u000a without agoraphobia, agoraphobia without history of panic disorder, specific phobia, social phobia, obsessive-compulsive disorder\\u000a (OCD), posttraumatic stress disorder (PTSD), acute stress disorder, generalized anxiety disorder (GAD), anxiety disorder due\\u000a to a general medical condition, substance-induced anxiety disorder, and anxiety disorder not otherwise

  2. Anxiety Disorders

    MedlinePLUS

    ... of the brain are key actors in the production of fear and anxiety. Using brain imaging technology and neurochemical techniques, scientists have discovered that the amygdala and the hippocampus play significant roles in most anxiety disorders. The amygdala is an ...

  3. 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,"…

  4. Anxiety Disorders

    MedlinePLUS

    ... that caused the anxiety. Back Continue Causes Experts don't know exactly what causes anxiety disorders. Several things seem to play a role, including genetics, brain biochemistry, an overactive fight-flight response, stressful life circumstances, and learned behavior. A child with a ...

  5. Genetics of anxiety disorders

    Microsoft Academic Search

    Paul D. Arnold; Gwyneth Zai; Margaret A. Richter

    2004-01-01

    There is considerable evidence that genetic determinants play a major role in the etiology of anxiety. Investigations into\\u000a susceptibility genes for anxiety are well underway, particularly for panic disorder and obsessive-compulsive disorder and\\u000a more broadly defined anxiety-related traits, such as neuroticism and harm avoidance. This review will discuss some of the\\u000a core issues related to diagnosis and molecular genetic methodology,

  6. Anxiety Disorders

    MedlinePLUS

    ... can be mild or extreme. The fight-flight response happens instantly when a person senses a threat. It takes a few seconds ... they have. Different anxiety disorders are named to reflect their specific ... a person worries excessively about many things. Someone with generalized ...

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

    Microsoft Academic Search

    Ervin Davis; Sy Atezaz Saeed; Diana J. Antonacci

    2008-01-01

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

  8. Anxiety, Depression, and Substance Use Disorders: Diagnosis, Treatment, and Prescribing Practices

    Microsoft Academic Search

    Mim J. Landry; David E. Smith; John R. Steinberg

    1991-01-01

    Attending physicians routinely encounter patients with signs and symptoms of anxiety and mood disorders as well as psychoactive substance use and psychoactive substance-induced organic mental disorders. These symptoms may represent either primary disorders or pathology that is secondary to other disorders. This article describes some of the relationships between substance use disorders and symptoms of anxiety and depressive disorders. In

  9. Anxiety Disorders

    MedlinePLUS

    ... afraid, but they can't control their fear. Panic Disorder In panic disorder, a person has sudden, unexplained attacks of terror, ... impending doom, or a fear of losing control. Panic attacks can occur at any time. Post-Traumatic Stress Disorder (PTSD) Post-traumatic stress disorder (PTSD) develops after ...

  10. Genotype over-diagnosis in amygdala responsiveness: affective processing in social anxiety disorder

    PubMed Central

    Furmark, Tomas; Henningsson, Susanne; Appel, Lieuwe; Ĺhs, Fredrik; Linnman, Clas; Pissiota, Anna; Faria, Vanda; Oreland, Lars; Bani, Massimo; Pich, Emilio Merlo; Eriksson, Elias; Fredrikson, Mats

    2009-01-01

    Background Although the amygdala is thought to be a crucial brain region for negative affect, neuroimaging studies do not always show enhanced amygdala response to aversive stimuli in patients with anxiety disorders. Serotonin (5-HT)–related genotypes may contribute to interindividual variability in amygdala responsiveness. The short (s) allele of the 5-HT transporter linked polymorphic region (5-HTTLPR) and the T variant of the G-703T polymorphism in the tryptophan hydroxylase-2 (TPH2) gene have previously been associated with amygdala hyperresponsivity to negative faces in healthy controls. We investigated the influence of these polymorphisms on amygdala responsiveness to angry faces in patients with social anxiety disorder (SAD) compared with healthy controls. Methods We used positron emission tomography with oxygen 15-labelled water to assess regional cerebral blood flow in 34 patients with SAD and 18 controls who viewed photographs of angry and neutral faces presented in counterbalanced order. We genotyped all participants with respect to the 5-HTTLPR and TPH2 polymorphisms. Results Patients with SAD and controls had increased left amygdala activation in response to angry compared with neutral faces. Genotype but not diagnosis explained a significant portion of the variance in amygdala responsiveness, the response being more pronounced in carriers of s and/or T alleles. Limitations Our analyses were limited owing to the small sample and the fact that we were unable to match participants on genotype before enrolment. In addition, other imaging techniques not used in our study may have revealed additional effects of emotional stimuli. Conclusion Amygdala responsiveness to angry faces was more strongly related to serotonergic polymorphisms than to diagnosis of SAD. Emotion activation studies comparing amygdala excitability in patient and control groups could benefit from taking variation in 5-HT–related genes into account. PMID:19125211

  11. Epidemiology of Anxiety Disorders

    Microsoft Academic Search

    Ronald C. Kessler; Ayelet Meron Ruscio; Katherine Shear; Hans-Ulrich Wittchen

    \\u000a This chapter presents an overview of the descriptive epidemiology of anxiety disorders based on recently completed surveys\\u000a of the general population. The overall prevalence of anxiety disorders is shown to be quite high, but with considerable variation\\u000a from the most prevalent (specific phobias) to the least prevalent (agoraphobia without a history of panic disorder) disorders.\\u000a Age-of-onset (AOO) of anxiety disorders

  12. Ictal fear: semiologic characteristics and differential diagnosis with interictal anxiety disorders

    Microsoft Academic Search

    Vivianne Pellegrino Rosa; Gerardo Maria de Araújo Filho; Márcio Andriani Rahal; Luís Otávio; Ferreira Caboclo; Américo Ceiki Sakamoto

    2006-01-01

    Introduction: Ictal fear (IF) is one of the most frequent emotional auras. It is the sole or predominant manifestation of simple partial seizures or initial expression of a complex partial seizure. It is more often experienced in patients with mesial temporal lobe epilepsy (TLE), probably associated with mesial temporal structures, like the amygdala. Anxiety disorders are very common psychiatric disorders

  13. Prevention of Anxiety Disorders

    Microsoft Academic Search

    Elizabeth X. Lau; Ronald M. Rapee

    2011-01-01

    Research into the prevention of anxiety has increased dramatically in the past few years. Prevention programs have been directed\\u000a at broad, nonspecific anxiety and at more specific anxiety types, such as panic disorder and post-traumatic stress disorder.\\u000a Prevention of anxiety is still a relatively new field, but there has been a recent surge of literature reporting on different\\u000a prevention programs.

  14. Anxiety and Alcohol Use Disorders

    PubMed Central

    Smith, Joshua P.; Randall, Carrie L.

    2012-01-01

    The co-occurrence of anxiety disorders and alcohol use disorders (AUDs) is relatively common and is associated with a complex clinical presentation. Sound diagnosis and treatment planning requires that clinicians have an integrated understanding of the developmental pathways and course of this comorbidity. Moreover, standard interventions for anxiety disorders or AUDs may need to be modified and combined in targeted ways to accommodate the unique needs of people who have both disorders. Optimal combination of evidence-based treatments should be based on a comparative balance that considers the advantages and disadvantages of sequential, parallel, and integrated approaches. PMID:23584108

  15. Anxiety Disorders and the Family

    PubMed Central

    Hunsley, John

    1991-01-01

    Family functioning and anxiety disorders, the most prevalent forms of psychiatric disorder, influence one another. The empirical literature on family studies of anxiety disorder (ie, aggregration of disorders within families), on parent-child relationships and anxiety disorders, and on marriage and anxiety disorders is reviewed. Finally, the challenges for patients and their families of post-traumatic stress disorder are discussed. PMID:21228991

  16. 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…

  17. 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

  18. Dimensional Diagnosis of Anxiety in Youth

    Microsoft Academic Search

    Melanie W. Moretz; Dean McKay

    \\u000a The diagnosis of anxiety disorders in children and adolescents is associated with several problems including high comorbidity\\u000a and low clinical utility of diagnostic categories. This chapter will begin by outlining the weaknesses of the current categorical\\u000a diagnostic system and reviewing the history and evidence for taking a dimensional approach to the diagnosis of anxiety disorders\\u000a in children and adolescents. The

  19. Genetics of pediatric anxiety disorders.

    PubMed

    Sakolsky, Dara J; McCracken, James T; Nurmi, Erika L

    2012-07-01

    This article reviews the familiality, linkage, candidate gene, and genomewide association studies of obsessive-compulsive disorder, panic disorder, posttraumatic stress disorder, and other anxiety disorders (ie, generalized anxiety disorder, separation anxiety disorder, social phobia, and specific phobia). Studies involving children and adolescents are highlighted. Clinical and research implications are discussed. PMID:22800990

  20. Anxiety and medical disorders

    Microsoft Academic Search

    Jacqueline E. Muller; Liezl Koen; Dan J. Stein

    2005-01-01

    Anxiety symptoms and disorders are associated with a range of general medical disorders. This association may be a physiologic\\u000a consequence of the general medical disorder, a psychologic reaction to the experience of having a medical illness, a side\\u000a effect of treatment, or a chance occurrence. This article briefly reviews the associations of panic disorder with seizure\\u000a disorder, Klüver-Bucy syndrome, mitral

  1. Personality and anxiety disorders

    Microsoft Academic Search

    Mina Brandes; O. Joseph Bienvenu

    2006-01-01

    Personality traits and most anxiety disorders are strongly related. In this article, we review existing evidence for ways\\u000a in which personality traits may relate to anxiety disorders: 1) as predisposing factors, 2) as consequences, 3) as results\\u000a of common etiologies, and 4) as pathoplastic factors. Based on current information, we conclude the following: 1) Personality\\u000a traits such as high neuroticism,

  2. Rating scales for anxiety\\/anxiety disorders

    Microsoft Academic Search

    Richard Balon; UPC Jefferson

    2007-01-01

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

  3. Neuroimaging in anxiety disorders

    PubMed Central

    Holzschneider, Kathrin; Mulert, Christoph

    2011-01-01

    Over the last few years, neuroimaging techniques have contributed greatly to the identification of the structural and functional neuroanatomy of anxiety disorders. The amygdala seems to be a crucial structure for fear and anxiety, and has consistently been found to be activated in anxiety-provoking situations. Apart from the amygdala, the insula and anterior cinguiate cortex seem to be critical, and all three have been referred to as the “fear network.” In the present article, we review the main findings from three major lines of research. First, we examine human models of anxiety disorders, including fear conditioning studies and investigations of experimentally induced panic attacks. Then we turn to research in patients with anxiety disorders and take a dose look at post-traumatic stress disorder and obsessive-compulsive disorder. Finally, we review neuroimaging studies investigating neural correlates of successful treatment of anxiety, focusing on exposure-based therapy and several pharmacological treatment options, as well as combinations of both. PMID:22275850

  4. The anxiety disorder spectrum

    PubMed Central

    Lang, Peter J.; McTeague, Lisa M.

    2008-01-01

    This review considers recent research assessing psychophysiological reactivity to fear imagery in anxiety disorder patients. As in animal subjects, fear cues prompt in humans a state of defensive motivation in which autonomic and somatic survival reflexes are markedly enhanced. Thus, a startle stimulus presented in a fear context yields a stronger (potentiated) reflex, providing a quantitative measure of fearful arousal. This fear potentiation is further exaggerated in specific or social phobia individuals when viewing pictures or imagining the phobic object. Paradoxically, fear imagery studies with more severe anxiety disorder patients—panic disorder with agoraphobia, generalized anxiety disorder, or anxious patients with comorbid depression—show a blunted, less robust fear potentiated response. Furthermore, this reflex blunting appears to systematically be more pronounced over the anxiety disorder spectrum, coincident with lengthier chronicity, worsening clinician-based judgments of severity and prognosis, and increased questionnaire-based indices of negative affectivity, suggesting that normal defensive reactivity may be compromised by an experience of long-term stress. PMID:19096959

  5. 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.…

  6. Anxiety

    MedlinePLUS

    ... Information Causes & Symptoms Diagnosis & Tests Care & Treatment Lifestyle ... and what are anxiety disorders? Sometimes a little anxiety can be a good thing. If you have a project to finish for work or are having a ...

  7. [Social anxiety disorder and alcohol use disorders].

    PubMed

    Iancu, Iulian

    2014-11-01

    Social anxiety disorder is a mental condition with anxiety and avoidance in social settings and is frequently accompanied by self-medication with alcohol. Epidemiological studies demonstrate that the risk that patients with social anxiety disorder will develop alcohol dependence is more than two-fold. We will discuss epidemiological research findings about this comorbidity, as well as reasons for the comorbidity and the various treatments available for these conditions. Very few studies have analyzed the efficacy of treatments for the combination of these disorders and it is not yet clear whether to treat the social anxiety disorder first, to treat the alcohol use disorder first or to treat both conditions simultaneously. Nevertheless, we propose to treat the symptoms of social anxiety disorder and alcohol use disorder in combination with the hope of achieving maximal improvement in these patients. Disclosure: I received financial assistance from Lundbeck Israel. PMID:25563026

  8. Cognitive Hypnotherapy for Anxiety Disorders

    Microsoft Academic Search

    William L. Golden

    2012-01-01

    Cognitive hypnotherapy, also known as cognitive-behavioral hypnotherapy (CBH), is applied to the treatment of anxiety disorders. Specific techniques are described and illustrated. The research on CBH is discussed. CBH seems to be at least as effective as behavior therapy (BT) and cognitive-behavior therapy (CBT) treatments that employ imagery and relaxation techniques for anxiety disorders. However, more research is needed because

  9. Affect Traits in Differential Diagnosis of Anxiety, Depressive, and Schizophrenic Disorders Using the Multiple Affect Adjective Check List-Revised.

    ERIC Educational Resources Information Center

    Lubin, Bernard; Van Whitlock, Rodney; Zuckerman, Marvin

    1998-01-01

    The effectiveness of the affect trait scales of the revised Multiple Affect Adjective Check List (MAACL-R) (M. Zuckerman and B. Lubin, 1985) in differentiating anxiety, mood, and schizophrenic disorders was studied with 185 psychiatric patients and 185 matched comparisons. Results indicate that the MAACL-R is valid for both global and specific…

  10. Anxiety Disorders Association of America

    NSDL National Science Digital Library

    Millions of people across the United States live with a variety of anxiety disorders and for twenty-five years, the Anxiety Disorders Association of American (ADAA) has worked to promote the prevention, treatment and cure of these disorders. From the siteâ??s homepage visitors can learn about some of the most common anxiety disorders, such as panic disorder, social phobia, and post-traumatic stress disorder. The siteâ??s homepage also offers visitors the opportunity to sign up to receive their e-newsletter. As might be expected, there is a rather useful section titled â??Getting Helpâ?ť. Here visitors can learn about how they find a therapist for themselves (or a loved one). There are a myriad of resources within this particular area that will be of great use, including a section where visitors can learn about how to pick a therapist and a place for first-person narratives about living with a variety of anxiety disorders.

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

    PubMed

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

    2015-01-01

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

  12. Women and anxiety disorders: implications for diagnosis and treatment. Proceedings of a conference, November 19-21, 2003, Chantilly, Virginia, USA.

    PubMed

    2004-09-01

    Community studies indicate that 19% of men and 31% of women will develop some type of anxiety disorder during their lifetime. The impact of gender is profound in that it increases the likelihood of developing an anxiety disorder by 85% in women compared to men. Sex difference in prevalence rates are apparent as early as age 6, when girls are twice as likely as boys to have an anxiety disorder. In the National Comorbidity Survey, the prevalence rates for panic disorder in women and men were 5% and 2%, respectively. Agoraphobia, which often coexists with panic disorder, has a lifetime prevalence rate of 7% in women and 3.5% in men. Prevalence of trauma is increased in young women as well, and is experienced earlier in life; 62% of sexual assaults are inflicted on females < or = 18 years of age, and 29% occur in children < 11 years of age. Comorbidity of anxiety in women complicates other medical conditions as well. For example, panic disorder is highly comorbid with CHD, which remains the leading cause of death in women in developed countries. Fluctuations in reproductive hormone levels during the female life cycle is thought to be responsible for modulating anxiety. This is often implicated in the later age of onset, the more sudden and acute symptom emergence, and the more episodic course of OCD in women, and in the high prevalence(47.4%) of PMDD. Pregnancy appears to be a protective period for some anxiety disorders, including panic, while for others, such as OCD, it may be associated with onset. Hormonal changes during pregnancy, such as increased prolactin, oxytocin, and cortisol, may contribute to the suppression of stress response that occurs during this period. Despite a large and growing body of literature on anxiety disorders in general, the available data relating to women and girls falls short of informing aspects of diagnosis, treatment, and prevention that may entail sex differences. Additional work is required to understand the biological and psychosocial causes of these differences. PMID:15487127

  13. 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…

  14. Cognitive Enhancers for Anxiety Disorders

    PubMed Central

    Hofmann, Stefan G.; Smits, Jasper A. J.; Asnaani, Anu; Gutner, Cassidy A.; Otto, Michael W.

    2010-01-01

    Cognitive behavioral therapy is an effective intervention for anxiety disorders. However, a significant number of people do not respond or only show partial response even after an adequate course of the treatment. Recent research has shown that the efficacy of the intervention can be improved by the use of cognitive enhancers that augment the core learning processes of cognitive-behavior therapy. This manuscript provides a review of the current state of cognitive enhancers for the treatment of anxiety disorders. PMID:21134394

  15. 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…

  16. Psychopharmacology of the anxiety disorders.

    PubMed

    Ballenger, J C

    1984-12-01

    Although anxiety is a familiar part of all our lives, pathologic anxiety states that lead to occupational and social dysfunction require medical treatment. Currently, the anxiety disorders are divided into nonphobic and phobic disorders. However, recent studies suggest that the disorders should be divided into three symptom groups: (1) generalized anxiety, (2) episodes with severe panic anxiety (panic attacks) plus generalized anxiety or even phobic avoidance, and (3) phobic anxiety and avoidance (alone, without panic attacks). This grouping is highly predictive of response to antianxiety medications. The generalized anxiety group responds well to psychosocial/psychotherapy treatments and to the antianxiety BZs. Many people with nonpanic, nonphobic (situational or generalized) anxiety only require simple psychotherapy or other nonpharmacologic methods to manage their anxiety. However, if the anxious patient is becoming dysfunctional or symptomatology is severe or persistent enough to warrant the use of medication, BZs are certainly the drugs of choice. Despite persistent public or media opinion that they are over-utilized or over-prescribed, most objective data suggest this is not the case. Most individuals for whom they are prescribed need them, use them in proper doses, and discontinue them when the indication passes. Most of the reported abuse occurs in the approximately 8 to 12 per cent who abuse other drugs, most notably alcohol. As anxiety is usually transient, BZs should be prescribed for limited periods (1 to 4 weeks) and then discontinued. This practice allows the physician to properly monitor the amount utilized and to evaluate need for continued BZs. The principal differences among the available BZs are their elimination half-lives, with some greater than 24 hours and others in the 8 to 12 hour range. Side effects are mostly mild (sedation, clumsiness) and drug-drug interactions are uncommon. Until recently, most patients suffering from disorders with panic attacks with or without phobias were either untreated or treated with long, but largely unsuccessful, treatments. Blockade of panic attacks with TCAs, MAOIs and alprazolam has dramatically improved our ability to treat these disorders, with 60 to 95 per cent of patients reporting marked alleviation of symptoms. Adequate amounts of medication and length of treatment period are the keys to successful treatment. This is a period of much productive interest and research in the anxiety disorders. Continued rapid progress in the understanding of the biologic substrates of these conditions and the development of new treatments promise much in this area of medicine in the near future. PMID:6151647

  17. 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

  18. 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

  19. Treatment of generalized anxiety disorder

    Microsoft Academic Search

    Rob C. Durham

    2007-01-01

    Generalized anxiety disorder (GAD) is a relatively common presentation in primary care and a significant vulnerability factor for future morbidity, particularly depression and alcohol abuse. Despite this it is frequently overlooked and undertreated in both primary and secondary care when comorbid disorders are present. Recent clinical guidelines emphasize a stepped approach to care with individual therapy (cognitive–behaviour therapy (CBT)), pharmacological

  20. Social anxiety disorder

    MedlinePLUS

    ... anxiety Alcohol or other drug dependence Loneliness and social isolation ... Call your health care provider or mental health professional if fear is affecting your work and relationships with others.

  1. [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

  2. 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…

  3. Anxiety disorders in the elderly

    Microsoft Academic Search

    Cheryl N. Carmin; Pamela S. Wiegartz; Christy Scher

    2000-01-01

    Although the epidemiology, neurobiology, and treatment of anxiety disorders have received considerable attention in the child\\u000a and adult literature, they have not received the same consideration in the geriatric population. This disparity is remarkable\\u000a given the prevalence and associated costs of these disorders that can persist into late life. Further, although a considerable\\u000a amount is known about these disorders in

  4. 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

  5. Anxiety Disorders in Children and Adolescents

    MedlinePLUS

    ... pain, and headaches. Many children who have a chronic illness such as asthma also have an anxiety disorder. Common medical conditions associated with anxiety disorders include migraine headaches, abdominal problems, asthma, and seasonal allergies. Having ...

  6. Generalized Anxiety Disorder

    MedlinePLUS

    ... 2 Items) Post-Traumatic Stress Disorder (7 Items) Schizophrenia (2 Items) Social Phobia (2 Items) Populations Children ... 2 Items) Post-Traumatic Stress Disorder (7 Items) Schizophrenia (2 Items) Social Phobia (2 Items) Populations Children ...

  7. Pharmacological Treatment for Phobias and Anxiety Disorders

    Microsoft Academic Search

    Michael H. Bloch; Joseph F. McGuire

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

  8. 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…

  9. Anxiety disorders, active component, U.S. Armed Forces, 2000-2012.

    PubMed

    2013-10-01

    Anxiety is a normal reaction to stress; however, in individuals with anxiety disorder, the anxiety becomes chronic and exaggerated, and affects the physical and psychological health of the individual. The main types of anxiety disorders are generalized anxiety disorder, panic disorder, post-traumatic stress disorder (PTSD), phobias, and obsessive-compulsive disorder (OCD). Incident diagnoses of anxiety disorders among active component service members steadily increased from 2000 to 2012. A majority of incident anxiety disorder diagnoses were "non-specific" anxiety disorders (ICD-9-CM codes: 300.0, 300.00, or 300.09) and over 75 percent of service members diagnosed with "non-specific" anxiety disorders did not have a more specific anxiety disorder diagnosis during subsequent medical encounters. Incidence rates of anxiety disorders were highest among females, white, non-Hispanics, in the youngest age groups, and among recruits and junior enlisted service members. About one-third of anxiety disorder cases also had a co-occurring diagnosis of either adjustment or depressive disorder within one year before or after the incident anxiety disorder encounter. PMID:24191766

  10. Psychotherapy for Anxiety in Children With Autism Spectrum Disorder

    ClinicalTrials.gov

    2015-02-03

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

  11. Psychotherapy for Anxiety in Children With Autism Spectrum Disorder

    ClinicalTrials.gov

    2014-04-09

    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

  12. 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

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

    PubMed Central

    2014-01-01

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

  14. 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 / ... actual danger. One of the most common is social anxiety disorder. People with social phobia feel overwhelming anxiety and ...

  15. 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

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

    PubMed

    Bilgiç, Ayhan; Türko?lu, Serhat; Ozcan, Ozlem; Tufan, Ali Evren; Y?lmaz, Sava?; Yüksel, Tu?ba

    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

  17. 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

  18. 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…

  19. Antisocial personality disorder and anxiety disorder: A diagnostic variant?

    Microsoft Academic Search

    Jeremy Coid; Simone Ullrich

    2010-01-01

    Antisocial personality disorder (ASPD) with co-morbid anxiety disorder may be a variant of ASPD with different etiology and treatment requirements. We investigated diagnostic co-morbidity, ASPD criteria, and anxiety\\/affective symptoms of ASPD\\/anxiety disorder. Weighted analyses were carried out using survey data from a representative British household sample. ASPD\\/anxiety disorder demonstrated differing patterns of antisocial criteria, co-morbidity with clinical syndromes, psychotic symptoms,

  20. Social Anxiety Disorders and Alcohol Abuse

    MedlinePLUS

    ... and not really knowing myself, I started attending AA meetings. For the first year I couldn’t ... social anxiety disorder symptoms through therapy. Find an AA meeting near you . Some people with social anxiety, ...

  1. Attachment and Parenting in Adult Patients with Anxiety Disorders

    PubMed Central

    Picardi, Angelo; Caroppo, Emanuele; Fabi, Elisa; Proietti, Serena; Gennaro, Giancarlo Di; Meldolesi, Giulio Nicolň; Martinotti, Giovanni

    2013-01-01

    Background: The literature suggests that dysfunctional parenting and insecure attachment may increase risk of anxiety-related psychopathology. This study aimed at testing the association between anxiety disorders, attachment insecurity and dysfunctional parenting while controlling for factors usually not controlled for in previous studies, such as gender, age, and being ill. Methods: A sample of 32 non-psychotic inpatients with SCID-I diagnosis of an anxiety disorder, either alone or in comorbidity, was compared with two age- and sex-matched control groups consisting of 32 non-clinical participants and 32 in-patients with drug-resistant epilepsy. Study measures included the Experience in Close Relationships questionnaire (ECR) and the Parental Bonding Instrument (PBI). Results: The patients with anxiety disorders scored significantly higher on attachment-related anxiety and avoidance than patients with drug-resistant epilepsy and non-clinical participants. These findings were independent of comorbidity for mood disorders. ECR scores did not differ among diagnostic subgroups (generalized anxiety disorder, panic disorder, other anxiety disorders). Patients with anxiety disorders scored significantly lower on PBI mother’s care and borderline significantly lower on PBI father's care than patients with drug-resistant epilepsy. Conclusions: Although limitations such as the relatively small sample size and the cross-sectional nature suggest caution in interpreting these findings, they are consistent with the few previous adult studies performed on this topic and corroborate Bowlby's seminal hypothesis of a link between negative attachment-related experiences, attachment insecurity, and clinical anxiety. Attachment theory provides a useful theoretical framework for integrating research findings from several fields concerning the development of anxiety disorders and for planning therapeutic interventions. PMID:24155770

  2. Health anxiety disorders: a cognitive construal.

    PubMed

    Rachman, S

    2012-08-01

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

  3. 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

  4. Anxiety Disorders in Children and Adolescents

    MedlinePLUS

    ... NAMI to help millions of Americans who face mental illness every day. Donate Now Keep up with NAMI ... others they are not alone. Share your story Mental Illness ADHD Anxiety Disorders Autism Bipolar Disorder Borderline Personality ...

  5. The comorbidity between eating disorders and anxiety disorders: Prevalence in an eating disorder sample and anxiety disorder sample

    Microsoft Academic Search

    Jessica Swinbourne; Caroline Hunt; Maree Abbott; Janice Russell; Tamsen St Clare; Stephen Touyz

    2012-01-01

    Objective: To investigate the prevalence of comorbid eating and anxiety disorders in women presenting for inpatient and outpatient treatment of an eating disorder and women presenting for outpatient treatment of an anxiety disorder.Methods: The prevalence of comorbidity was investigated from a sample of 152 women, which included 100 women presenting for treatment of an eating disorder and 52 women presenting

  6. 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

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

    PubMed

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

    2015-03-01

    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

  8. 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.…

  9. Screening for depression and anxiety disorders in primary care patients.

    PubMed

    Bunevicius, Adomas; Peceliuniene, Jurate; Mickuviene, Narseta; Valius, Leonas; Bunevicius, Robertas

    2007-01-01

    Mood and anxiety disorders are highly prevalent in primary health care. In this study we assessed performance of the Hospital Anxiety and Depression Scale (HADS) for screening of depression and anxiety disorders in a population of primary care patients. A total of 503 primary care patients consecutively admitted to the primary care medical center in Kaunas, Lithuania, completed the study. We found that the HADS subscale of depression (HADS-D) at a cutoff score of 6 or more showed the best performance screening for a major depressive episode diagnosed by means of the Mini International Neuropsychiatric Interview (MINI), with a sensitivity of 80%, specificity of 69%, positive predictive value of 80%, negative predictive value of 92%, and area under the receiver operating characteristic (ROC) curve of 0.75. Performance of the HADS-D against MINI diagnosis of dysthymia was weak. The HADS subscale of anxiety (HADS-A) at a cutoff score of 9 or more showed the best performance screening for MINI diagnosis of overall anxiety disorders, with a sensitivity of 77%, specificity of 75%, positive predictive value of 53%, negative predictive value of 90%, and area under the ROC curve of 0.76. These results suggest that in primary care patients HADS is an adequate screening instrument for the MINI diagnoses of major depressive episode, but not for dysthymia at a cutoff score of 6, and for anxiety disorders at a cutoff score of 9. PMID:17117433

  10. 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

  11. Anxiety

    MedlinePLUS

    ... 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 ...

  12. Association between anxiety and depression in children and adolescents with anxiety disorders

    Microsoft Academic Search

    Cyd C. Strauss; Cynthia G. Last; Michel Hersen; Alan E. Kazdin

    1988-01-01

    The relationship between anxiety and depression was examined in a sample of 106 children and adolescents referred to an outpatient anxiety disorder clinic for children. Twenty-eight percent of patients with DSM-III diagnoses of anxiety disorders displayed a concurrent major depression. Children with anxiety disorders plus major depression were found (1) to be older, (2) to demonstrate more severe anxiety symptomatology,

  13. Peer Perceptions and Liking of Children with Anxiety Disorders

    Microsoft Academic Search

    Timothy L. Verduin; Philip C. Kendall

    2008-01-01

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

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

    PubMed

    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

  15. 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

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

    PubMed

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

    2015-04-01

    With the recent updates to the Diagnostic and Statistical Manual of Mental Disorders (5th edition; DSM-5), there are many questions on how to care for older adults with generalized anxiety disorder (GAD) and other psychiatric conditions. The current article reviews the new changes to the DSM-5 for diagnosis of GAD, discusses new anxiety assessment scales that are validated in older adults, evaluates pharmacological agents that have been studied in older adults for GAD treatment, and provides monitoring recommendations to help those who provide care to older adults experiencing GAD. [Journal of Gerontological Nursing, 41(4), 10-20.]. PMID:25848826

  17. 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.

  18. [Anxiety and depressive disorders in tobacco dependence].

    PubMed

    Lagrue, G; Dupont, P; Fakhfakh, R

    2002-01-01

    The association between tobacco dependence and various forms of anxiety and depressive disorders is well established. The presence of these disorders constitutes a key cause of failure in subjects seeking to stop smoking. In addition to the clinically manifest forms of such anomalies, systematic screening for minor forms of these disorders was performed at the Centre for Tobacco Studies of Créteil, France; as well as the standard questionnaire concerning personal and familial history and current psychological well-being, subjects were asked to complete two self-questionnaires, the HAD (Hospital Anxiety Depression score) and the BDI (Beck Depression Inventory, abridged version) together with the MINI (structured mini-interview). In a series of 400 heavy smokers, sub-syndromes of such anxiety and depressive disorders were noted in 34% of subjects, and a combination of anxiety and depressive disorders was seen in 2/3 of these subjects, mainly general anxiety and social phobia, which were frequently preceded by depressive episodes. In these forms of tobacco dependence with anxiety and depressive disorder, relapse was very common in spite of nicotine substitution therapy (NST), usually as a result of a depressive episode that tended to subside very rapidly on resumption of cigarette smoking. Psychotropic therapy involving selective serotonin reuptake inhibitors (SSRIs) coupled with NST resulted in lasting success accompanied by an often unexpected and spectacular improvement in psychological status. These findings confirm the role of mood disorders in tobacco addiction in keeping with other types of addiction. PMID:12232547

  19. Late-life Anxiety Disorders: A Review

    Microsoft Academic Search

    Josien Schuurmans; Anton van Balkom

    2011-01-01

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

  20. [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

  1. Functional network dysfunction in anxiety and anxiety disorders

    PubMed Central

    Sylvester, C.M.; Corbetta, M.; Raichle, M.E.; Rodebaugh, T.; Schlaggar, B.L.; Sheline, Y.I.; Zorumski, C.F.; Lenze, E.J.

    2012-01-01

    A recent paradigm shift in systems neuroscience is the division of the human brain into functional networks. Functional networks are collections of brain regions with strongly correlated activity both at rest and during cognitive tasks, and each network is believed to implement a different aspect of cognition. Here, we propose that anxiety disorders and high trait anxiety are associated with a particular pattern of functional network dysfunction: increased functioning of the cingulo-opercular and ventral attention networks as well as decreased functioning of the fronto-parietal and default mode networks. This functional network model can be used to differentiate the pathology of anxiety disorders from other psychiatric illnesses such as major depression and provides targets for novel treatment strategies. PMID:22658924

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

    Microsoft Academic Search

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

    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

  3. Antidepressant treatment in anxiety disorders.

    PubMed

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

    2010-01-01

    Antidepressant drug treatment is the clinical standard of care for all types of anxiety disorders. Broad efficacy of selective serotonin reuptake inhibitors suggests the importance of enhanced serotonergic function of the anxiolytic properties of current antidepressants. However, analysis of the preclinical evidence indicates that most conventional "anxiolytic" drug tests are not sensitive to antidepressants. Such dissociation is not surprising because of the traditional approach to validation of preclinical tests that is to a large extent based on establishing face validity as well as sensitivity to benzodiazepine anxiolytics. The present review argues for extending the cognitive model of antidepressant drug action to cover their anxiolytic properties as well. Such an approach is based on ambiguity or uncertainty in a broad sense as the hallmark of human stress that has different expressions ready for experimental modeling. These possibilities include schedule-induced behaviors that are directly based on intermittent reinforcement, conditioning to ambiguous stimuli, social stress where agonistic confrontations are possible but not predictable or controlled by the subject, and an even larger class of behaviors that are critically dependent on the inhibition of the prepotent responses in exchange for the ambiguous possibility of a later gain in reinforcement. Interestingly, in all these cases, antidepressant drug treatment is clearly effective in preclinical laboratory settings. One of the cognitive functions that appears to be affected by antidepressant drugs is inhibitory control. Inhibition of prepotent responding has beneficial effects in the "uncertainty" stress situations discussed above and therefore it is this cognitive function that may be critical for anxiolytic effects of antidepressants and novel anxiolytic drug development. PMID:21309117

  4. 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…

  5. Parenting and Child Anxiety Disorders

    Microsoft Academic Search

    Bryce D. McLeod; Jeffrey J. Wood; Shelley B. Avny

    \\u000a What role does parenting play in the development, maintenance, and amelioration of child anxiety? In this chapter, we address\\u000a this question by reviewing the current state of knowledge regarding the nature and direction of the relationship between parenting\\u000a and child anxiety. Numerous theoretical models outline the role that various parenting practices may play in the development,\\u000a maintenance, and amelioration of

  6. Anxiety Disorders are Associated with Reduced Heart Rate Variability: A Meta-Analysis

    PubMed Central

    Chalmers, John A.; Quintana, Daniel S.; Abbott, Maree J.-Anne; Kemp, Andrew H.

    2014-01-01

    Background: Anxiety disorders increase risk of future cardiovascular disease (CVD) and mortality, even after controlling for confounds including smoking, lifestyle, and socioeconomic status, and irrespective of a history of medical disorders. While impaired vagal function, indicated by reductions in heart rate variability (HRV), may be one mechanism linking anxiety disorders to CVD, prior studies have reported inconsistent findings highlighting the need for meta-analysis. Method: Studies comparing resting-state HRV recordings in patients with an anxiety disorder as a primary diagnosis and healthy controls were considered for meta-analysis. Results: Meta-analyses were based on 36 articles, including 2086 patients with an anxiety disorder and 2294 controls. Overall, anxiety disorders were characterized by lower HRV [high frequency (HF): Hedges’ g?=??0.29. 95% CI: ?0.41 to ?0.17, p?disorder (n?=?447), post-traumatic stress disorder (n?=?192), generalized anxiety disorder (n?=?68), and social anxiety disorder (n?=?90), but not obsessive–compulsive disorder (n?=?40), displayed reductions in HF HRV relative to controls (all ps?Anxiety disorders are associated with reduced HRV, findings associated with a small-to-moderate effect size. Findings have important implications for future physical health and well-being of patients, highlighting a need for comprehensive cardiovascular risk reduction. PMID:25071612

  7. Social anxiety disorder in genuine halitosis patients

    PubMed Central

    2011-01-01

    Background There is a possibility that genuine halitosis patients' anxiety do not recover after oral malodor treatment due to their social anxiety disorder. The objective of this study was to investigate the influence of social anxiety disorder on the level of anxiety in genuine halitosis patients before and after treatment for oral malodor. Methods The subjects were 262 genuine halitosis patients who visited the Fresh Breath Clinic from March, 2008 to October, 2009. The subjects who had score 2 or higher by the organoleptic test were diagnosed as genuine halitosis patients. Gas chromatography (GC) was conducted before and after oral malodor treatment for the oral malodor measurement. Based on their risk of social anxiety disorder, subjects were divided into low- and high-risk groups using the Liebowitz Social Anxiety Scale (LSAS). The questions related to oral malodor and the clinical oral examination were both conducted before oral malodor treatment. The level of anxiety before and after oral malodor treatment was evaluated using the Visual Analogue Scale of Anxiety (VAAS). Results More than 20% of subjects had a score of 60 or more on the LSAS (high LSAS group). The mean age and the percentage of females were significantly higher in the high LSAS group compared to the low LSAS group. The high LSAS group was more likely to have problems associated with oral malodor and to adopt measures against oral malodor compared to the low LSAS group. The mean concentrations of H2S and CH3SH by GC significantly decreased after the oral malodor treatment in both LSAS groups. VAAS scores also significantly decreased after treatment in both LSAS groups. The logistic regression analysis indicated that the high LSAS group had a 2.28 times higher risk of having a post-VAAS score of 50 or more compared to the low LSAS group. Conclusions This study revealed that genuine halitosis patients with a strong trait of social anxiety disorder have difficulty overcoming their anxiety about oral malodor. Oral malodor treatment of genuine halitosis patients requires not only regular oral malodor treatment but also attention to social anxiety disorder. PMID:22051118

  8. The molecular neuroimaging of anxiety disorders

    Microsoft Academic Search

    Peter S. Talbot

    2004-01-01

    This paper reviews the molecular neuroimaging of anxiety disorders, and attempts to put recent advances in the context of\\u000a previous findings. Knowledge of the metabolic correlates of symptom severity and treatment response in obsessive-compulsive\\u000a disorder has been significantly extended, particularly response to selective serotonin reuptake inhibitor medication. However,\\u000a the first neuroreceptor studies of serotonin transporter availability in obsessive-compulsive disorder have

  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. Interoceptive sensitivity in anxiety and anxiety disorders: An overview and integration of neurobiological findings

    Microsoft Academic Search

    Katharina Domschke; Stephan Stevens; Bettina Pfleiderer; Alexander L. Gerlach

    2010-01-01

    Interoceptive sensitivity, particularly regarding heartbeat, has been suggested to play a pivotal role in the pathogenesis of anxiety and anxiety disorders. This review provides an overview of methods which are frequently used to assess heartbeat perception in clinical studies and summarizes presently available results referring to interoceptive sensitivity with respect to heartbeat in anxiety-related traits (anxiety sensitivity, state\\/trait anxiety), panic

  11. Visually Induced Postural Sway in Anxiety Disorders

    PubMed Central

    Redfern, Mark S.; Furman, Joseph M.; Jacob, Rolf G.

    2007-01-01

    Postural sensitivity to moving visual environments in patients with anxiety disorders was studied. We hypothesized that patients with anxiety disorders would have greater sway in response to a moving visual environment compared to healthy adults, especially if they have space and motion discomfort (SMD). Twenty one patients with generalized anxiety without panic (NPA), and 38 patients with panic and agoraphobia (PAG) were compared to 22 healthy controls. SMD was evaluated in all subjects via questionnaire. Subjects stood on a force platform that was either fixed or rotating with the subject (i.e. sway referenced) during exposure to a sinusoidally moving visual surround. Center of Pressure (COP) data were computed from force transducers in the platform as a measure of sway. Results showed that patients swayed significantly more in response to the moving visual scene compared to control subjects, with no differences between the NPA and PAG groups. SMD was a predictor of sway response in the patients: patients with high SMD swayed significantly more than both Controls and anxiety patients with low SMD. These results indicate that patients with anxiety disorders, particularly those with SMD, are more visually dependent for balance. This subgroup of patients may be amenable to treatment used for patients with balance disorders (i.e. vestibular rehabilitation) that focuses on sensory re-integration processes that address visual sensitivity. PMID:17045776

  12. 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

  13. 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

  14. 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…

  15. Preschool Anxiety Disorders in Pediatric Primary Care: Prevalence and Comorbidity

    PubMed Central

    Franz, Lauren; Angold, Adrian; Copeland, William; Costello, E. Jane; Towe-Goodman, Nissa; Egger, Helen

    2013-01-01

    Objective We sought to establish prevalence rates and detail patterns of comorbidity for generalized anxiety disorder, separation anxiety disorder, and social phobia, in preschool aged children. Method The Duke Preschool Anxiety Study, a screen-stratified, cross-sectional study, drew from pediatric primary-care and oversampled for children at risk for anxiety. 917 parents of preschoolers (aged 2 to 5 years) completed the Preschool Age Psychiatric Assessment. Results Generalized anxiety disorder, separation anxiety disorder, and social phobia are common in preschool-aged children attending pediatric primary care. Three quarters of preschoolers with an anxiety disorder only had a single anxiety disorder. Generalized anxiety disorder displayed the greatest degree of comorbidity: with separation anxiety disorder (odds ratio [OR] = 4.1, 95% CI, 2.0–8.5), social phobia (OR = 6.4, 95% CI, 3.1–13.4), disruptive behavior disorders (OR = 5.1, 95% CI, 1.6–15.8), and depression (OR = 3.7, 95% CI, 1.1–12.4). Conclusions The weakness of association between generalized anxiety disorder and depression stands in contrast to substantial associations between these 2 disorders reported in older individuals. Attenuated associations in preschool aged children could translate into clinical opportunities for targeted early interventions, aimed at modifying the developmental trajectory of anxiety disorders. PMID:24290462

  16. Generalized Anxiety Disorders Three to Four Months after Ischemic Stroke

    Microsoft Academic Search

    Antero Leppävuori; Tarja Pohjasvaara; Risto Vataja; Markku Kaste; Timo Erkinjuntti

    2003-01-01

    Background and Objective: The main objective of our study was to detail the frequency and clinical determinants of poststroke generalized anxiety disorders in a large, well-defined stroke cohort. Methods: A total of 277 stroke patients aged 55–85 were subjected to a comprehensive psychiatric evaluation between 3 and 4 months after ischemic stroke. Primary generalized anxiety disorder or generalized anxiety disorder

  17. 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…

  18. 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…

  19. Quality of attachment relationships and peer relationship dysfunction among late adolescents with and without anxiety disorders.

    PubMed

    Brumariu, Laura E; Obsuth, Ingrid; Lyons-Ruth, Karlen

    2013-01-01

    Little is known about the links between anxiety disorders and parent-child attachment disorganization and quality of peer relationships in late adolescence. This study examined the quality of attachment and peer relationships among adolescents with and without anxiety disorders in a sample of 109 low- to moderate-income families. Psychopathology was assessed with the SCID-I. Attachment disorganization and dysfunction in peer relationships were measured using semi-structured interviews and behavioral observations. Adolescents with anxiety disorders and comorbid conditions showed higher levels of attachment disorganization across three measurement approaches, as well as higher levels of dysfunction in peer relationships than those with no Axis I diagnosis. Adolescents without anxiety disorders but with other Axis I disorders differed only in the quality of school relationships from those with no diagnoses. The pattern of results suggests that pathological anxiety, in the context of other comorbidities, may be a marker for more pervasive levels of social impairment. PMID:23247207

  20. 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

  1. [Comparison study on child anxiety disorder with different family characteristics

    PubMed

    Wang, Ji-Yue; Zhu, Hong; Zhou, Jun-Fu; He, Hui-Xia; Hong, You-Ping

    2002-08-01

    OBJECTIVE: To investigate the relations between child anxiety disorder with different family characte ristics. METHODS Family characteristics were measured by family environment scale. 144 mothers of child with anxiety disorder and 100 mothers of health children were invited to fill out questionnaires. RESULTS There were obviously different family characteristics between health children and those with anxiety disorder except phobic anxiety disorder. The scores of cohesion, independence, achievement orientation and active recreational orientation in children with anxiety disorder were significantly lower than those in health children P<0.01). In 4 groups of children with anxiety disorder cohesion showed correlation with intellectual- cultural orientation r=0.9219, 0.8348, 0.8935, 0.9550 respectively, P<0.001). CONCLUSION: The importance of family characteristics must be emphasized for children with anxiety disorder. PMID:12601890

  2. 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…

  3. Quality of life and the anxiety disorders.

    PubMed

    Quilty, Lena C; Van Ameringen, Michael; Mancini, Catherine; Oakman, Jonathan; Farvolden, Peter

    2003-01-01

    Quality of life (QoL) is a concept that has become increasingly used in mental health care. Recent studies have compared the impact of different anxiety disorders on different domains of QoL; however, instruments generally used to assess QoL in this population have varying specificity, considerable redundancy, and occasionally inappropriate content. Three hundred and sixty consecutive admissions to an anxiety disorders clinic were assessed. Participants and clinicians completed a number of QoL measures. Results indicated that impairment measures designed for use with anxiety-disordered samples in fact assess only occupational functioning and relationships and activities outside of occupation, and that individuals with Social Phobia (SP) were more impaired on the latter than those with Panic Disorder (PD). Furthermore, only Social Phobia accounted for unique variance in the three Medical Outcome Study Health Survey (MOS) subscales relevant to quality of life. Of the MOS subscales relevant to symptoms, mood regulation, physical functioning, and pain were associated with compromised overall QoL. PMID:12826089

  4. 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…

  5. Behavioral avoidance mediates the relationship between anxiety and depressive symptoms among social anxiety disorder patients

    Microsoft Academic Search

    Ethan Moitra; James D. Herbert; Evan M. Forman

    2008-01-01

    This study investigated the relationship between social anxiety, depressive symptoms, and behavioral avoidance among adult patients with Social Anxiety Disorder (SAD). Epidemiological literature shows SAD is the most common comorbid disorder associated with Major Depressive Disorder (MDD), though the relationship between these disorders has not been investigated. In most cases, SAD onset precedes MDD, suggesting symptoms associated with SAD might

  6. Affective and Anxiety Disorders and Alcohol and Drug Dependence

    Microsoft Academic Search

    Robert M. Anthenelli; Marc A. Schuckit

    1993-01-01

    Depression and anxiety frequently coexist in patients with substance use disorders. This clinically-oriented article examiens the relationship between these conditions and emphasizes data showing that substances of abuse can cause signs and symptoms of both depression and anxiety. These substance-related syndromes appear to have a different course and prognosis than uncomplicated, independent anxiety and major depressive disorders, and clinicians should

  7. 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…

  8. 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

  9. Animal models of social anxiety disorder and their validity criteria.

    PubMed

    Réus, Gislaine Z; Dos Santos, Maria Augusta B; Abelaira, Helena M; Quevedo, Joăo

    2014-09-26

    Anxiety disorders pose one of the largest threats to global mental health, and they predominantly emerge early in life. Social anxiety disorder, also known as social phobia, is the most common of all anxiety disorders. Moreover, it has severe consequences and is a disabling disorder that can cause an individual to be unable to perform the tasks of daily life. Social anxiety disorder is associated with the subsequent development of major depression and other mental diseases, as well as increased substance abuse. Although some neurobiological alterations have been found to be associated with social anxiety disorder, little is known about this disorder. Animal models are useful tools for the investigation of this disorder, as well as for finding new pharmacological targets for treatment. Thus, this review will highlight the main animal models of anxiety associated with social phobia. PMID:25132362

  10. Self-compassion and social anxiety disorder

    Microsoft Academic Search

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

    2011-01-01

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

  11. Self-compassion and social anxiety disorder

    Microsoft Academic Search

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

    2012-01-01

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

  12. Psychological Treatment of Social Anxiety Disorder Improves Body Dysmorphic Concerns

    PubMed Central

    Fang, Angela; Sawyer, Alice T.; Aderka, Idan M.; Hofmann, Stefan G.

    2013-01-01

    Social anxiety disorder and body dysmorphic disorder are considered nosologically distinct disorders In contrast, some cognitive models suggest that social anxiety disorder and body dysmorphic disorder share similar cognitive maintenance factors. The aim of this study was to examine the effects of psychological treatments for social anxiety disorder on body dysmorphic disorder concerns. In Study 1, we found that 12 weekly group sessions of cognitive-behavioral therapy led to significant decreases in body dysmorphic symptom severity. In Study 2, we found that an attention retraining intervention for social anxiety disorder was associated with a reduction in body dysmorphic concerns, compared to a placebo control condition. These findings support the notion that psychological treatments for individuals with primary social anxiety disorder improve co-occurring body dysmorphic disorder symptoms. PMID:24121100

  13. Understanding the Root Cause of Anxiety and Depression Mental illnesses such as anxiety disorders, depression, bipolar disorder, and

    E-print Network

    Understanding the Root Cause of Anxiety and Depression Mental illnesses such as anxiety disorders impact physical health. Anxiety disorders are the most common mental illnesses and are frequently, the worst outcome of mental illness, suicide, is increasing and is among the leading causes of death

  14. Anxiety disorders in children with Williams syndrome, their mothers, and their siblings: Implications for the etiology of anxiety disorders

    Microsoft Academic Search

    Ovsanna Leyfer; Janet Woodruff-Borden; Carolyn B. Mervis

    2009-01-01

    This study examines the prevalence of anxiety disorders in children with Williams syndrome (WS), their sibling closest in\\u000a age, and their mothers as well as the predictors of anxiety in these groups. The prevalence of anxiety disorders was assessed\\u000a and compared to that in the general population. Children with WS had a significantly higher prevalence of specific phobia,\\u000a generalized anxiety

  15. Psychiatric comorbidity in Greek patients with generalized anxiety disorder.

    PubMed

    Garyfallos, G; Adamopoulou, A; Karastergiou, A; Voikli, M; Milis, V; Donias, S; Giouzepas, J; Parashos, A

    1999-01-01

    From a total sample of 1,448 psychiatric outpatients, 81 (5.6%) received a diagnosis of generalized anxiety disorder (GAD) according to DSM-III-R criteria. Fifty-three (65%) of them had another Axis I diagnosis, while this percentage increased to 78% (63/81) when lifetime psychiatric diagnoses were recorded. The most frequent comorbid diagnoses were panic disorder, dysthymia, major depression and social phobia. Forty-three (53%) of the GAD patients met the criteria for personality disorder. They manifested obsessive-compulsive, avoidant personality and personalities of cluster C in general significantly more frequently than the rest of the total sample. The presence of a personality disorder was related to a significantly higher score on almost all the Minnesota Multiphasic Personality Inventory clinical and research scales, to a worse level of functioning and to an earlier age of onset of GAD. The results of the present study (1) support previous findings of high rates of comorbidity of clinical syndromes in GAD, (2) indicate that GAD co-occurs frequently with cluster C personality disorders, mainly avoidant and obsessive-compulsive, and (3) that the presence of a concomitant personality disorder is related to severer psychopathology and to a worse level of functioning. PMID:10575329

  16. 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…

  17. Unmentalized aspects of panic and anxiety disorders.

    PubMed

    Busch, Fredric N; Sandberg, Larry S

    2014-06-01

    Somatic or emotional experience that has not been symbolically represented, referred to as unmentalized experience, has been given an increasingly prominent role in understanding psychopathology. Panic and anxiety disorders provide a useful model for exploring these factors, as the affective and bodily symptoms can be understood in part as unmentalized experience. The authors explore models of Freud's actual neurosis, Marty and DeM'uzan's pensee operatoire, Klein's unconscious fantasy, Bion's alpha function, Bucci's multiple code system, and relational models to describe how somatic and affective experiences can be translated into symbolic representations, and what factors can interfere with these processes. Approaches to unmentalized aspects of panic and anxiety include symbolizing somatic symptoms, identifying emotional states, and identifying contextual and traumatic links to symptoms. PMID:24828589

  18. Relationship between genuine and pseudohalitosis and social anxiety disorder.

    PubMed

    Kursun, S; Acar, B; Atakan, C; Oztas, B; Paksoy, C S

    2014-11-01

    Halitosis is described as offensive breath caused by various factors such as periodontal diseases, bacterial coating of tongue, systemic disorders and different types of foods. Pseudohalitosis is a situation that patients complain of oral malodor even though they do not have offensive odour. The purpose of this study was to compare the relationships between social anxiety estimations and both pseudohalitosis and genuine halitosis cases. Liebowitz Social Anxiety Scale (LSAS) and questionnaire regarding halitosis were applied to 100 participants. Halitosis was determined using organoleptic method, gas chromatography and portable sulphur monitor. anova test and 2-tailed Spearman's rank-order correlation coefficient were used to determine the differences and relations between groups. With reference to LSAS, 62% of participants had anxiety. Among these patients, 98% had genuine halitosis (P < 0·05). The mean measurements of VSC values were 248·65 ppm in halimeter, 298·02 ppm of H2 S, 95·33 ppm of CH3 SH and 47·00 ppm of (CH3 )2 S in gas chromatography. Halitosis was present in 90% of participants, and it was absent in 10% by organoleptic assessment. There was a significant correlation between organoleptic and halimeter measurements. Moreover, statistically significant relationship was detected between anxiety and halitosis. Genuine halitosis patients exhibit social anxiety, so it can be said that there is a causal relationship between halitosis and anxiety. Comparison of the results of objective measurements (sulphur monitor, gas chromatography, organoleptic method) was statistically significant; therefore, it can be said that these methods can be used in diagnosis of halitosis with high accuracy. PMID:25040179

  19. 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

  20. 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

  1. 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…

  2. Self-compassion and social anxiety disorder.

    PubMed

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

    2012-01-01

    Self-compassion refers to having an accepting and caring orientation towards oneself. Although self-compassion has been studied primarily in healthy populations, one particularly compelling clinical context in which to examine self-compassion is social anxiety disorder (SAD). SAD is characterized by high levels of negative self-criticism as well as an abiding concern about others' evaluation of one's performance. In the present study, we tested the hypotheses that: (1) people with SAD would demonstrate less self-compassion than healthy controls (HCs), (2) self-compassion would relate to severity of social anxiety and fear of evaluation among people with SAD, and (3) age would be negatively correlated with self-compassion for people with SAD, but not for HC. As expected, people with SAD reported less self-compassion than HCs on the Self-Compassion Scale and its subscales. Within the SAD group, lesser self-compassion was not generally associated with severity of social anxiety, but it was associated with greater fear of both negative and positive evaluation. Age was negatively correlated with self-compassion for people with SAD, whereas age was positively correlated with self-compassion for HC. These findings suggest that self-compassion may be a particularly important target for assessment and treatment in persons with SAD. PMID:21895450

  3. 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…

  4. 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

  5. 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

  6. 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

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

    Microsoft Academic Search

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

    2007-01-01

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

  8. 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

  9. Self-help interventions for anxiety disorders: An overview

    Microsoft Academic Search

    Pim Cuijpers; Josien Schuurmans

    2007-01-01

    Anxiety disorders are highly prevalent and are associated with a marked impairment in quality of life and a huge economic\\u000a cost to society. Unfortunately, a considerable number of people who struggle with anxiety do not seek or receive adequate\\u000a treatment. Self-help interventions have been proposed to constitute a relatively cheap, effective, efficient, and low-threshold\\u000a intervention for anxiety disorders. This paper

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

    Microsoft Academic Search

    Siebke Melfsen; Susanne Walitza; Andreas Warnke

    2006-01-01

    The aim of the study was to investigate the extent of social anxiety in different mental disorders. A total of 341 patients\\u000a aged 7–18 years participated in the study. To measure social anxiety, the German version (SPAIK) of the Social Phobia and\\u000a Anxiety Inventory for Children (SPAI-C) was used. Subgroups were built dependent on mental disorders. A total score above

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

    Microsoft Academic Search

    Lisa M Shin; Israel Liberzon

    2010-01-01

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

  12. 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…

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  14. Temperament, Personality, and the Mood and Anxiety Disorders

    Microsoft Academic Search

    Lee Anna Clark; David Watson; Susan Mineka

    1994-01-01

    Literature on temperament, personality, and mood and anxiety disorders is reviewed. The review is organized primarily around L. A. Clark and D. Watson’s (1991b) tripartite model for these disorders, but other influential approaches are also examined. Negative affectivity (or neuroticism) appears to be a vulnerability factor for the development of anxiety and depression, indicates poor prognosis, and is itself affected

  15. Treating Alcoholics with a Co-Occurring Anxiety Disorder

    Microsoft Academic Search

    Rebecca S. Boehm McNeil; Kit N. Simpson

    2005-01-01

    Objectives: Psychiatric comorbidity likely complicates the treatment of alcoholism. Studies of alcoholics with and without co-occurring anxiety disorders suggest that the presence of an anxiety disorder can significantly impact alcoholism treatment efficacy and can increase subsequent alcohol relapse rates. The objective of this study was to estimate the long-term relapse rates and costs associated with treating an alcoholic with an

  16. Publication trends in individual anxiety disorders: 1980–2015

    Microsoft Academic Search

    Mark J. Boschen

    2008-01-01

    The aim of the current study was to examine trends in anxiety disorder publication over the past 25 years, and to project likely future trends from these. Medline searches were used to find a representative sample of the total number of journal articles published each year from 1980 to 2005 that were focused on each particular anxiety disorder. Results demonstrated

  17. Exploring Maternal and Child Effects of Comorbid Anxiety Disorders among African American Mothers with Depression

    PubMed Central

    Boyd, Rhonda C; Tervo-Clemmens, Brenden

    2013-01-01

    Comorbid depression and anxiety disorders are commonly experienced in mothers. Both maternal depression and anxiety as well as their comorbidity has been shown to increase psychopathology in children, however, there is limited research focusing on African American families. The aim of this study is to examine whether comorbid anxiety disorders are associated with maternal depression severity, kinship support, and child behavioral problems in a sample of African American mothers with depression. African American mothers (n = 77) with a past year diagnosis of a depressive disorder and a child between the ages of ages 8–14 were administered a clinician interview and measures of maternal depression severity, kinship support, and child behavior problems (internalizing and externalizing) in a cross-sectional design. Results showed that more than half (58%) of the mothers had a comorbid anxiety disorder and a third had Posttraumatic Stress Disorder (PTSD). Regression analyses showed that comorbid PTSD and Social Phobia were positively associated with maternal depression severity. Maternal comorbid Obsessive Compulsive Disorder (OCD) was associated with child internalizing symptoms. The findings are consistent with other research demonstrating negative outcomes with maternal comorbidity of depression and anxiety, however, there is limited research focused on maternal depression and OCD or PTSD. The study suggests that it is important to consider comorbid anxiety and cultural issues when conceptualizing, studying, and treating mothers with depression and their families. PMID:24040577

  18. Coping style of substance-abuse patients: effects of anxiety and mood disorders on coping change.

    PubMed

    Franken, I H; Hendriks, V M; Haffmans, P M; van der Meer, C W

    2001-03-01

    The authors studied the coping style of substance-abuse patients during clinical cognitive-behavioral group therapy, and the effects of mood and anxiety disorders on changes in coping style. Change in coping style was studied prospectively in a cohort of 132 residential-drug-abuse patients. In addition to pretreatment assessments, which included diagnosis of mood and anxiety disorders and addiction severity, repeated measurements of coping style were performed at predetoxification, pretreatment, and after three and six months of treatment. Considerable change in coping style between predetoxification and pretreatment was found, suggesting that coping assessment in a predetoxification phase is confounded by state factors surrounding treatment entry. Coping style of detoxified substance abusers is related to the presence of mood and anxiety disorders. Coping style was not found to be related to the severity of drug abuse. Furthermore, maladaptive coping styles decreased after three months of inpatient-substance-abuse treatment, and more-adaptive coping styles remained stable for another three months of inpatient treatment. Patients with an anxiety disorder improved less on coping style when compared to non-anxiety patients. Presence of a mood disorder had no impact on coping-style improvement. The results indicate that more attention should be focused on anxiety disorders during substance-abuse treatment in order to improve coping style. Furthermore, more studies are needed on the relation between substance abuse, coping style, and psychopathology. PMID:11241361

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

    Microsoft Academic Search

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

    1998-01-01

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

  20. Prevention and early intervention for anxiety disorders: a controlled trial.

    PubMed

    Dadds, M R; Spence, S H; Holland, D E; Barrett, P M; Laurens, K R

    1997-08-01

    The Queensland Early Intervention and Prevention of Anxiety Project evaluated the effectiveness of a cognitive-behavioral and family-based group intervention for preventing the onset and development of anxiety problems in children. A total of 1,786 7- to 14-year-olds were screened for anxiety problems using teacher nominations and children's self-report. After recruitment and diagnostic interviews, 128 children were selected and assigned to a 10-week school-based child- and parent-focused psychosocial intervention or to a monitoring group. Both groups showed improvements immediately postintervention. At 6 months follow-up, the improvement maintained in the intervention group only, reducing the rate of existing anxiety disorder and preventing the onset of new anxiety disorders. Overall, the results showed that anxiety problems and disorders identified using child and teacher reports can be successfully targeted through an early intervention school-based program. PMID:9256564

  1. Differentiating anxiety-panic disorders from psychologic dental anxiety.

    PubMed

    Weiner, A A; Sheehan, D V

    1988-10-01

    It has always been believed that fear and anxiety of dental treatment was a simple continuum of experience that occurs in mild, moderate, or severe form. Past and present studies that attempt to both trace etiology and measure it reflect this view. The numerous studies that are concerned with methods of management are based on this accepted philosophy regarding the etiology of dental fear and anxiety. To a large extent, this may be true. However, there are some notable exceptions, and it is these cases that present the greatest management problem. Omitting the symptoms of fear and anxiety related to physical illness, drug withdrawal, or major mental illness, they present anxiety as a unidimensional learned problem usually conditioned by externally negative forces or experiences. They postulate that the fear and anxiety seen is due to a variety of factors. The interpretation of the definitions of fear, anxiety, and phobias by many in the profession that are presented in this issue also reflect the view that fear, anxiety, and phobias are learned or conditioned responses. This single-minded view has determined much of our understanding and subsequent management of this problem in dentistry. PMID:3053273

  2. Atomoxetine Treatment for Pediatric Patients With Attention-Deficit\\/Hyperactivity Disorder With Comorbid Anxiety Disorder

    Microsoft Academic Search

    DANIEL GELLER; CRAIG DONNELLY; FRANK LOPEZ; RICHARD RUBIN; JEFFREY NEWCORN; VIRGINIA SUTTON; ROSALIE BAKKEN; MARTIN PACZKOWSKI; DOUGLAS KELSEY; CALVIN SUMNER

    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 (ADHDRS-IV-PI) and the Pediatric Anxiety Rating Scale (PARS).

  3. 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

  4. Subclinical eating disorders and their comorbidity with mood and anxiety disorders in adolescent girls

    Microsoft Academic Search

    Evelyne Touchette; Adina Henegar; Nathalie T. Godart; Laura Pryor; Bruno Falissard; Richard E. Tremblay; Sylvana M. Côté

    2011-01-01

    The present study assesses the prevalence of subclinical eating disorders and examines their comorbidity with mood and anxiety disorders in a sample of adolescent girls. A DSM-III-R computerized self-reported interview was administered to 833 adolescent girls (mean age=15.7±0.5years) from a population sample to assess the prevalence of subclinical eating disorders, major depression, dysthymia, separation anxiety, and generalized anxiety disorders. The

  5. 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

  6. The association of personality disorders with the prospective 7-year course of anxiety disorders

    PubMed Central

    Ansell, E. B.; Pinto, A.; Edelen, M. O.; Markowitz, J. C.; Sanislow, C. A.; Yen, S.; Zanarini, M.; Skodol, A. E.; Shea, M. T.; Morey, L. C.; Gunderson, J. G.; McGlashan, T. H.; Grilo, C. M.

    2013-01-01

    Background This study prospectively examined the natural clinical course of six anxiety disorders over 7 years of follow-up in individuals with personality disorders (PDs) and/or major depressive disorder. Rates of remission, relapse, new episode onset and chronicity of anxiety disorders were examined for specific associations with PDs. Method Participants were 499 patients with anxiety disorders in the Collaborative Longitudinal Personality Disorders Study, who were assessed with structured interviews for psychiatric disorders at yearly intervals throughout 7 years of follow-up. These data were used to determine probabilities of changes in disorder status for social phobia (SP), generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), panic disorder and panic disorder with agoraphobia. Results Estimated remission rates for anxiety disorders in this study group ranged from 73% to 94%. For those patients who remitted from an anxiety disorder, relapse rates ranged from 34% to 67%. Rates for new episode onsets of anxiety disorders ranged from 3% to 17%. Specific PDs demonstrated associations with remission, relapse, new episode onsets and chronicity of anxiety disorders. Associations were identified between schizotypal PD with course of SP, PTSD and GAD; avoidant PD with course of SP and OCD; obsessive-compulsive PD with course of GAD, OCD, and agoraphobia; and borderline PD with course of OCD, GAD and panic with agoraphobia. Conclusions Findings suggest that specific PD diagnoses have negative prognostic significance for the course of anxiety disorders underscoring the importance of assessing and considering PD diagnoses in patients with anxiety disorders. PMID:20836909

  7. Social adversities and anxiety disorders in the Gaza Strip

    Microsoft Academic Search

    A A M Thabet; P Vostanis

    1998-01-01

    AIMTo investigate the rate and nature of anxiety symptoms and disorders in children, and their relation to social adversities in a cultural sample not previously researched.METHODS237 children aged 9 to 13 years living in the Gaza Strip were selected randomly from 112 schools. Children completed the revised manifest anxiety scale (a questionnaire with yes\\/no answers for 28 anxiety items and

  8. 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,…

  9. 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

  10. 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,…

  11. ARandomizedTrialofMBSRVersusAerobicExerciseforSocial AnxietyDisorder

    E-print Network

    Gross, James J.

    ARandomizedTrialofMBSRVersusAerobicExerciseforSocial AnxietyDisorder Hooria Jazaieri,1 Philippe R-intervention, participants completed measures of clinical symptoms (Liebowitz Social Anxiety Scale, Social Interaction-being (Rosenberg Self-Esteem Scale, Satisfaction with Life Scale, Self-Compassion Scale, and UCLA-8 Loneliness

  12. 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…

  13. Evidence That Psychotic Symptoms Are Prevalent in Disorders of Anxiety and Depression, Impacting on Illness Onset, Risk, and Severity—Implications for Diagnosis and Ultra–High Risk Research

    PubMed Central

    Wigman, Johanna T. W.; van Nierop, Martine; Vollebergh, Wilma A. M.; Lieb, Roselind; Beesdo-Baum, Katja; Wittchen, Hans-Ullrich; van Os, Jim

    2012-01-01

    Background: It is commonly assumed that there are clear lines of demarcation between anxiety and depressive disorders on the one hand and psychosis on the other. Recent evidence, however, suggests that this principle may be in need of updating. Methods: Depressive and/or anxiety disorders, with no previous history of psychotic disorder, were examined for the presence of psychotic symptoms in a representative community sample of adolescents and young adults (Early Developmental Stages of Psychopathology study; n = 3021). Associations and consequences of psychotic symptomatology in the course of these disorders were examined in terms of demographic distribution, illness severity, onset of service use, and risk factors. Results: Around 27% of those with disorders of anxiety and depression displayed one or more psychotic symptoms, vs 14% in those without these disorders (OR 2.23, 95% CI 1.89–2.66, P < .001). Presence as compared with nonpresence of psychotic symptomatology was associated with younger age (P < .0001), male sex (P < .0058), and poorer illness course (P < .0002). In addition, there was greater persistence of schizotypal (P < .0001) and negative symptoms (P < .0170), more observable illness behavior (P < .0001), greater likelihood of service use (P < .0069), as well as more evidence of familial liability for mental illness (P < .0100), exposure to trauma (P < .0150), recent and more distant life events (P < .0006–.0244), cannabis use (P < .0009), and any drug use (P < .0008). Conclusion: Copresence of psychotic symptomatology in disorders of anxiety and depression is common and a functionally and etiologically highly relevant feature, reinforcing the view that psychopathology is represented by a network or overlapping and reciprocally impacting dimensional liabilities. PMID:22258882

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

    Microsoft Academic Search

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

    2007-01-01

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

  15. 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…

  16. 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

  17. Neurobiology of Anxiety Disorders and Implications for Treatment

    Microsoft Academic Search

    AMIR GARAKANI; SANJAY J. MATHEW; DENNIS S. CHARNEY

    2006-01-01

    The neurobiology of the anxiety disorders, which include panic disorder, post-traumatic stress disorder (PTSD), and specific ph o- bias, among others, has been clarified by advances in the field of classical or Pavlovian conditioning, and in our understandin g of basic mechanisms of memory and learning. Fear conditioning occurs when a neutral conditioned stimulus (such as a tone) is paired

  18. 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

  19. The psychobiology of resilience and vulnerability to anxiety disorders: implications for prevention and treatment

    PubMed Central

    Charney, Dennis S.

    2003-01-01

    Much of the research on the neurobiology of human anxiety disorders has focused on psychopaihological abnormalities in patients with anxiety disorders. While this line of research is obviously important, more investigation is needed to elucidate the psychobiology of resilience to extreme stress. Study of the psychobiology of resilience has the potential to identify neurochemical, neuropeptide, and hormonal mediators of vulnerability and resilience to severe stress. In addition, the relevance of neural mechanisms of reward and motivation, fear responsiveness, and social behavior to character traits associated with risk and resistance to anxiety disorders may be clarified. These areas of investigation should lead to improved methods of diagnosis, novel approaches to prevention, and new targets for antianxiety drug discovery. PMID:22034473

  20. 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

  1. 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

  2. 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

  3. 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

  4. [Pathomorphosis of anxiety disorder in patients with intestinal dysbiosis].

    PubMed

    Uspenski?, Iu P; Balukova, E V

    2009-01-01

    It is known, that anxiety is one of the most wide-spread mental disorders in-between psychiatric state and it takes part in pathogenesis a lot of somatic diseases as well. At the same time the host bowel microbiota participates in metabolic control of vital human functions such as mood and behavioural reactions. This title connection reveals some new therapeutic opportunity in treatment of psychiatric disorders that based on using with probiotics. In case non-clinically significant anxiety it is claimed to use probiotic (Enterol) however in case clinically significant anxiety it is claimed to use non-benzodiazepine tranquilizer (Stresam). PMID:20469713

  5. [Treatment of adjustment disorder with anxiety: efficacy and tolerance of etifoxine in a double-blind controlled study].

    PubMed

    Servant, D; Graziani, P L; Moyse, D; Parquet, P J

    1998-01-01

    Adjustment disorder with anxiety is defined as a clinically significant anxiety that occurs within 3 months after the onset of an identifiable psychological stressor. Recent studies indicate that this disorder is not uncommon and must be quickly identified and treated. However, few therapeutic trials have been done in relation with this disorder. According to the criteria set by DSM IV, 170 patients with a primary diagnosis of adjustment disorder with anxiety have been enrolled in a double blind multicenter controlled trial. Patients were treated for 4 weeks with etifoxine (150-200 mg/d), or buspirone (15-20 mg/d). Also both etifoxine and buspirone show clinical efficacy and safety, the two treatments are not equivalent. The global improvement score and the efficacy index are significantly improved in the etifoxine group. These results show the interest of using etifoxine in the treatment of adjustment disorder with anxiety and should be confirmed by further studies. PMID:9949940

  6. Associations Among Anxiety Disorders and Non-anxiety Disorders, Functional Impairment and Medication in Children and Adolescents

    Microsoft Academic Search

    Lourdes Ezpeleta; Josep Toro

    2009-01-01

    This is a study of comorbid anxiety disorders and how they affect the clinical picture of comorbid cases. The sample consisted\\u000a of 576 Spanish children aged 8 to 17 years receiving psychiatric outpatient consultation that were evaluated using a semi-structured\\u000a diagnostic interview for both parents and children. A specific association of homotypic comorbidity among anxiety disorders\\u000a that was independent of the

  7. Mindfulness-Based Cognitive Behavior Therapy in Patients with Anxiety Disorders: A Case Series

    PubMed Central

    Sharma, Mahendra P.; Mao, Angelina; Sudhir, Paulomi M.

    2012-01-01

    The present study is aimed at evaluating the effectiveness of a Mindfulness-Based Cognitive Behavior Therapy (MBCBT) for reducing cognitive and somatic anxiety and modifying dysfunctional cognitions in patients with anxiety disorders. A single case design with pre- and post-assessment was adopted. Four patients meeting the specified inclusion and exclusion criteria were recruited for the study. Three patients received a primary diagnosis of generalized anxiety disorder (GAD), while the fourth patient was diagnosed with Panic Disorder. Patients were assessed on the Cognitive and Somatic Anxiety Questionnaire (CSAQ), Penn State Worry Questionnaire (PSWQ), Hamilton's Anxiety Inventory (HAM-A), and Dysfunctional Attitudes Scale. The therapeutic program consisted of education regarding nature of anxiety, training in different versions of mindfulness meditation, cognitive restructuring, and strategies to handle worry, such as, worry postponement, worry exposure, and problem solving. A total of 23 sessions over four to six weeks were conducted for each patient. The findings of the study are discussed in light of the available research, and implications and limitations are highlighted along with suggestions for future research. PMID:23439854

  8. Mindfulness-based cognitive behavior therapy in patients with anxiety disorders: a case series.

    PubMed

    Sharma, Mahendra P; Mao, Angelina; Sudhir, Paulomi M

    2012-07-01

    The present study is aimed at evaluating the effectiveness of a Mindfulness-Based Cognitive Behavior Therapy (MBCBT) for reducing cognitive and somatic anxiety and modifying dysfunctional cognitions in patients with anxiety disorders. A single case design with pre- and post-assessment was adopted. Four patients meeting the specified inclusion and exclusion criteria were recruited for the study. Three patients received a primary diagnosis of generalized anxiety disorder (GAD), while the fourth patient was diagnosed with Panic Disorder. Patients were assessed on the Cognitive and Somatic Anxiety Questionnaire (CSAQ), Penn State Worry Questionnaire (PSWQ), Hamilton's Anxiety Inventory (HAM-A), and Dysfunctional Attitudes Scale. The therapeutic program consisted of education regarding nature of anxiety, training in different versions of mindfulness meditation, cognitive restructuring, and strategies to handle worry, such as, worry postponement, worry exposure, and problem solving. A total of 23 sessions over four to six weeks were conducted for each patient. The findings of the study are discussed in light of the available research, and implications and limitations are highlighted along with suggestions for future research. PMID:23439854

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

    PubMed

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

    2014-08-01

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

  10. 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…

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

    PubMed

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

    2012-01-01

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

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

    PubMed Central

    Santucci, Lauren C.; Ehrenreich-May, Jill

    2012-01-01

    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 intensive, cognitive-behavioral intervention for girls with SAD provided within the novel context of a one-week camp-like setting, the Child Anxiety Multi-Day Program (CAMP). Twenty-nine female children aged 7 to 12 with a principal diagnosis of SAD were randomized to immediate CAMP treatment (n = 15) or waitlist (i.e., delayed treatment; n = 14) condition during the course of this randomized controlled trial. Children in the immediate treatment group evidenced significant reductions in SAD severity, functional impairment, and parent report of child anxiety symptoms relative to the waitlist condition. The intervention’s positive therapeutic response suggests one possible delivery model for surmounting difficulties faced in the dissemination of weekly treatments for SAD. PMID:23053618

  13. 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…

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

    Microsoft Academic Search

    Amit Etkin; Tor D. Wager

    2007-01-01

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

  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. 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,…

  17. Childhood stressful events, HPA axis and anxiety disorders

    PubMed Central

    Faravelli, Carlo; Lo Sauro, Carolina; Godini, Lucia; Lelli, Lorenzo; Benni, Laura; Pietrini, Francesco; Lazzeretti, Lisa; Talamba, Gabriela Alina; Fioravanti, Giulia; Ricca, Valdo

    2012-01-01

    Anxiety disorders are among the most common of all mental disorders and their pathogenesis is a major topic in psychiatry, both for prevention and treatment. Early stressful life events and alterations of hypothalamic pituitary adrenal (HPA) axis function seem to have a significant role in the onset of anxiety. Existing data appear to support the mediating effect of the HPA axis between childhood traumata and posttraumatic stress disorder. Findings on the HPA axis activity at baseline and after stimuli in panic disordered patients are inconclusive, even if stressful life events may have a triggering function in the development of this disorder. Data on the relationship between stress, HPA axis functioning and obsessive-compulsive disorder (OCD) are scarce and discordant, but an increased activity of the HPA axis is reported in OCD patients. Moreover, normal basal cortisol levels and hyper-responsiveness of the adrenal cortex during a psychosocial stressor are observed in social phobics. Finally, abnormal HPA axis activity has also been observed in generalized anxiety disordered patients. While several hypothesis have attempted to explain these findings over time, currently the most widely accepted theory is that early stressful life events may provoke alterations of the stress response and thus of the HPA axis, that can endure during adulthood, predisposing individuals to develop psychopathology. All theories are reviewed and the authors conclude that childhood life events and HPA abnormalities may be specifically and transnosographically related to all anxiety disorders, as well as, more broadly, to all psychiatric disorders. PMID:24175164

  18. [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

  19. Lifetime comorbidity of antisocial personality disorder and anxiety disorders among adults in the community

    Microsoft Academic Search

    Renee D Goodwin; Steven P Hamilton

    2003-01-01

    The association between lifetime anxiety disorders, conduct disorder (CD), and antisocial personality disorder (ASPD) among adults in the community was explored. Data were drawn from the National Comorbidity Survey (n=5,877), a representative community sample of adults aged 15–54 in the 48 contiguous US states. Multiple logistic regression analyses were used to determine the association between anxiety disorders, CD and ASPD,

  20. Lipopolysaccharide-induced cytokine production in obsessive–compulsive disorder and generalized social anxiety disorder

    Microsoft Academic Search

    Sjoerd Fluitman; Damiaan Denys; Nienke Vulink; Sara Schutters; Cobi Heijnen; Herman Westenberg

    2010-01-01

    The immune system is implicated in the pathophysiology of various psychiatric disorders. In anxiety disorders such as obsessive–compulsive disorder (OCD) and generalized social anxiety disorder (GSAD), immunological findings are equivocal and sparse. In this study, we investigated the lipopolysaccharide (LPS)- stimulated cytokine levels of tumor necrosis factor-alpha (TNF-?), interleukin-6 (IL-6), and interleukin-8 (IL-8) by peripheral blood leukocytes in 26 OCD

  1. 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.

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

    Microsoft Academic Search

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

    2006-01-01

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

  3. 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…

  4. Comorbid anxiety disorders and divalproex sodium use among partial hospital patients with psychotic disorders

    Microsoft Academic Search

    Mark H. Townsend; Michael S. Wilson

    2005-01-01

    We conducted this study to determine anxiety disorder comorbidity and divalproex sodium use among 26 patients with psychotic disorders after their referral to a partial hospital. Each subject was diagnosed by structured interview, and 4 Brief Psychiatric Rating Scale (BPRS) items associated with agitation were assessed: anxiety, hostility, excitement, and tension. Subjects' medical records were then examined to determine discharge

  5. Efficacy of Cognitive Behaviour Therapy in Generalized Anxiety Disorders

    Microsoft Academic Search

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

    2005-01-01

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

  6. 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

  7. Physical activity, exercise, depression and anxiety disorders

    Microsoft Academic Search

    Andreas Ströhle

    2009-01-01

    There is a general belief that physical activity and exercise have positive effects on mood and anxiety and a great number\\u000a of studies describe an association of physical activity and general well-being, mood and anxiety. In line, intervention studies\\u000a describe an anxiolytic and antidepressive activity of exercise in healthy subjects and patients. However, the majority of\\u000a published studies have substantial

  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. Cognitive constructs and social anxiety disorder: beyond fearing negative evaluation.

    PubMed

    Teale Sapach, Michelle J N; Carleton, R Nicholas; Mulvogue, Myriah K; Weeks, Justin W; Heimberg, Richard G

    2015-01-01

    Pioneering models of social anxiety disorder (SAD) underscored fear of negative evaluation (FNE) as central in the disorder's development. Additional cognitive predictors have since been identified, including fear of positive evaluation (FPE), anxiety sensitivity, and intolerance of uncertainty (IU), but rarely have these constructs been examined together. The present study concurrently examined the variance accounted for in SAD symptoms by these constructs. Participants meeting criteria for SAD (n = 197; 65% women) completed self-report measures online. FNE, FPE, anxiety sensitivity, and IU all accounted for unique variance in SAD symptoms. FPE accounted for variance comparable to FNE, and the cognitive dimension of anxiety sensitivity and the prospective dimension of IU accounted for comparable variance, though slightly less than that accounted for by FNE and FPE. The results support the theorized roles that these constructs play in the etiology of SAD and highlight both FNE and FPE as central foci in SAD treatment. PMID:25277488

  10. Anxiety and oppositional defiant disorder: a transdiagnostic conceptualization.

    PubMed

    Fraire, Maria G; Ollendick, Thomas H

    2013-03-01

    This review puts forth a transdiagnostic lens through which to examine the oft-found comorbidity between anxiety and oppositional defiant disorder in children and adolescents. Children who experience these co-occurring disorders may be at greater risk for adverse outcomes. Our review begins with a broad examination of the comorbidity between anxiety and oppositionality and then highlights three underlying processes that characterize both anxiety and oppositionality: emotion regulation difficulties, information processing biases, and specific parenting practices. These underlying processes are then discussed within the context of developing a treatment to target these transdiagnostic processes for families with a child who experiences comorbid anxiety and oppositionality. Our review concludes with future directions for this emerging area of research. PMID:23313760

  11. 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

  12. Anxiety disorders in children and adolescents with autistic spectrum disorders: a meta-analysis.

    PubMed

    van Steensel, Francisca J A; Bögels, Susan M; Perrin, Sean

    2011-09-01

    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 review of the literature identified 31 studies involving 2,121 young people (aged <18 years) with ASD, and where the presence of anxiety disorder was assessed using standardized questionnaires or diagnostic interviews. Across studies, 39.6% of young people with ASD had at least one comorbid DSM-IV anxiety disorder, the most frequent being specific phobia (29.8%) followed by OCD (17.4%) and social anxiety disorder (16.6%). Associations were found between the specific anxiety disorders and ASD subtype, age, IQ, and assessment method (questionnaire versus interview). Implications for the identification and treatment of anxiety in young people with ASD are discussed. PMID:21735077

  13. 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

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

    PubMed

    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 ?-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

  15. 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 ?-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

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

    PubMed

    Shibayama, Masatoshi

    2011-01-01

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

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

    Microsoft Academic Search

    Tina In-Albon; Silvia Schneider

    2007-01-01

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

  18. Comorbid Anxiety in Bipolar Disorder Alters Treatment and Prognosis

    Microsoft Academic Search

    Rif S. El-Mallakh; Michael Hollifield

    2008-01-01

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

  19. Journal of Anxiety Disorders 28 (2014) 537546 Contents lists available at ScienceDirect

    E-print Network

    Gross, James J.

    2014-01-01

    ) are two of the most common mental disorders in the US (Kessler, Chiu, Demler, Merikangas, & Walters, 2005Journal of Anxiety Disorders 28 (2014) 537­546 Contents lists available at ScienceDirect Journal of Anxiety Disorders Implicit associations in social anxiety disorder: The effects of comorbid depression

  20. Anxiety disorders in anorexia nervosa and bulimia nervosa: co-morbidity and chronology of appearance

    Microsoft Academic Search

    N. T. Godart; M. F. Flament; Y. Lecrubier; P. Jeammet

    2000-01-01

    The objectives of the study were to assess lifetime prevalence of specific anxiety disorders, and their age of onset relative to that of eating disorders (ED), in a French sample of patients with anorexia nervosa (AN) or bulimia nervosa (BN). We assessed frequencies of seven anxiety disorders and childhood histories of separation anxiety disorder among 63 subjects with a current

  1. New developments in the management of major depressive disorder and generalized anxiety disorder: role of quetiapine

    Microsoft Academic Search

    Bernhard T Baune

    Quetiapine has demonstrated effi cacy in schizophrenia, bipolar disorder and in the treatment of specifi c symptom clusters such as agitation and sleep problems in mood disorders. In this review, randomized controlled studies demonstrating effi cacy, safety and tolerability of quetiapine in major depressive disorder (MDD) and general anxiety disorder (GAD) are evaluated. The results show that quetiapine monotherapy and

  2. Symptomatology and markers of anxiety disorders in Parkinson's disease: a cross-sectional study.

    PubMed

    Leentjens, Albert F G; Dujardin, Kathy; Marsh, Laura; Martinez-Martin, Pablo; Richard, Irene H; Starkstein, Sergio E

    2011-02-15

    Anxiety is understudied in Parkinson's disease (PD), which is not justified by the prevalence and impact of anxiety disorders on quality of life in PD patients. In this cross-sectional study, 342 patients suffering from idiopathic PD underwent a research-based assessment including DSM IV criteria for anxiety disorders, the Hamilton anxiety rating scale (HARS) and the beck anxiety inventory (BAI). Thirty-four percent (34%) of subjects met the DSM IV criteria for at least one anxiety disorder; 11.8% met criteria for multiple anxiety disorders; and 11.4% had clinically relevant anxiety symptoms without meeting the criteria for any specific anxiety disorder. Score profiles on the HARS and BAI differed significantly between the disorders, but these differences were associated with different scores on a limited number of items, and the respective symptom profiles were not readily interpretable. Female sex, the presence of motor fluctuations, as well as a previous history of an anxiety disorder were markers for anxiety disorders. The use of a mono-amino oxidase (MAO)-B inhibitor was associated with a reduced prevalence of anxiety disorders. Research into anxiety in PD is hampered by the questionable validity of DSM IV defined anxiety disorders in this population. A first focus for research should therefore be the identification of clinically useful anxiety presentations and their validation in PD. PMID:21312281

  3. Neural systems underlying approach and avoidance in anxiety disorders

    PubMed Central

    Robin L., Aupperle; Martin, P. Paulus

    2010-01-01

    Approach-avoidance conflict is an important psychological concept that has been used extensively to better understand cognition and emotion. This review focuses on neural systems involved in approach, avoidance, and conflict decision making, and how these systems overlap with implicated neural substrates of anxiety disorders. In particular, the role of amygdala, insula, ventral striatal, and prefrontal regions are discussed with respect to approach and avoidance behaviors. Three specific hypotheses underlying the dysfunction in anxiety disorders are proposed, including: (i) over-representation of avoidance valuation related to limbic overactivation; (ii) under- or over-representation of approach valuation related to attenuated or exaggerated striatal activation respectively; and (iii) insufficient integration and arbitration of approach and avoidance valuations related to attenuated orbitofrontal cortex activation. These dysfunctions can be examined experimentally using versions of existing decision-making paradigms, but may also require new translational and innovative approaches to probe approach-avoidance conflict and related neural systems in anxiety disorders. PMID:21319496

  4. 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…

  5. Anxiety Disorders in Children and Adolescents

    MedlinePLUS

    ... 2 Items) Post-Traumatic Stress Disorder (7 Items) Schizophrenia (2 Items) Social Phobia (2 Items) Populations Children ... 2 Items) Post-Traumatic Stress Disorder (7 Items) Schizophrenia (2 Items) Social Phobia (2 Items) Populations Children ...

  6. 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

  7. 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

  8. [Anxiety-phobic disorders in the early childhood stage].

    PubMed

    Volkova, O M; Kozlovskaia, G V; Proselkova, M O

    2012-01-01

    The complex of such phenomena as anxiety and fear in children of the early age and their relationship with risk factors for psychic pathology were investigated. Eighty cases of anxiety-phobic disorders in children of the first five years of life were studied. The types of behavioral and somatic reactions that allowed to reveal not only the clinically expressed phenomena of anxiety and fear but the higher readiness to them were described. The first anxiety-phobic reactions appeared at the age when emotional functions were not completely formed and might be considered as the presentations of emotional dysontogenesis. The authors assume that characteristics of fear expression in the early age allow to suspect a mental disease which might be timely diagnosed in case of its manifestation. The conclusions made in the paper may be useful for clinical practice of pediatricians, children neurologists, psychologists and psychiatrists. PMID:22678672

  9. 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

  10. 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

  11. Ethical issues and ethical therapy associated with anxiety disorders.

    PubMed

    Altis, Kaylan L; Elwood, Lisa S; Olatunji, Bunmi O

    2015-01-01

    The prevalence of anxietyAnxiety disorders is among the highest of all psychiatric diagnoses, with a lifetime morbidity rate of nearly 30 %. Given this prevalence, it is important to identify effective and ethicalEthical treatments. Empirically based treatments considered efficacious for anxiety disorders largely include cognitive behavioral treatments (CBT)Cognitive behavioral treatments (CBT) , and among these, exposureExposure therapy stands out as both useful and potentially concerning. Ethical concerns regarding exposureExposure treatment for anxietyAnxiety include fears of symptom exacerbation, high treatment dropout rates, client safety concerns, and the blurring of boundary lines between therapists and clients. Although concerns have been raised regarding exposureExposure treatment generally, specific concerns have been raised related to the treatment of post-traumatic stress disorder (PTSD) given the vulnerable nature of the population. Despite these concerns, research largely supports both the efficacy and safety of exposureExposure therapy. The present chapter provides a review of extant literature highlighting potential ethicalEthical concerns, research regarding the raised concerns, and suggestions for minimizing risk in treatment. PMID:25151292

  12. 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 naďve 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

  13. 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

  14. 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…

  15. Resting-State Neuroimaging Studies: A New Way of Identifying Differences and Similarities Among the Anxiety Disorders?

    PubMed Central

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

    2014-01-01

    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

  16. Anxiety Disorders and Sensory Over-Responsivity in Children with Autism Spectrum Disorders: Is There a Causal Relationship?

    Microsoft Academic Search

    Shulamite A. Green; Ayelet Ben-Sasson

    2010-01-01

    Anxiety disorders and sensory over-responsivity (SOR) are common in children with autism spectrum disorders (ASD), and there\\u000a is evidence for an association between these two conditions. Currently, it is unclear what causal mechanisms may exist between\\u000a SOR and anxiety. We propose three possible theories to explain the association between anxiety and SOR: (a) SOR is caused\\u000a by anxiety; (b) Anxiety

  17. Interpersonal Pathoplasticity in Individuals with Generalized Anxiety Disorder

    PubMed Central

    Przeworski, Amy; Newman, Michelle G.; Pincus, Aaron L.; Kasoff, Michele B.; Yamasaki, Alissa S.; Castonguay, Louis G.; Berlin, Kristoffer S.

    2011-01-01

    Recent theories of Generalized Anxiety Disorder (GAD) have emphasized interpersonal and personality functioning as important aspects of the disorder. The current paper examines heterogeneity in interpersonal problems in two studies of individuals with GAD (n = 47 and n = 83). Interpersonal subtypes were assessed using the Inventory of Interpersonal Problems (IIP-C; Alden, Wiggins, & Pincus, 1990). Across both studies, individuals with GAD exhibited heterogeneous interpersonal problems, and cluster analyses of these patients' interpersonal characteristics yielded four replicable clusters identified as intrusive, exploitable, cold, and nonassertive subtypes. Consistent with our pathoplasticity hypotheses, clusters did not differ in GAD severity, anxiety severity, depression severity. Clusters in study two differed on rates of personality disorders, including avoidant personality disorder, further providing support for the validity of interpersonal subtypes. The presence of interpersonal subtypes in GAD may have important implications for treatment planning and efficacy. PMID:21553942

  18. Alternative psychotherapy approaches for social anxiety disorder.

    PubMed

    Lipsitz, J D; Marshall, R D

    2001-12-01

    Alternative therapies and therapy modalities for SAD are needed because: Established treatments (CBT and pharmacologic) do not help everyone who seeks help. Established treatments provide only partial decrease in symptoms for many patients. Patients may experience recurrence of symptoms in long-term follow-up. CBT does not reach enough patients in need. Alternative treatment approaches and modalities may also be needed to address the successful outcomes of CBT. Success in overcoming social anxiety symptoms can generate a whole new set of challenges. For example, a 31-year-old man who overcomes his fear of dating and begins his first romantic relationship may need a less symptomatically focused therapy to deal with issues that arise in this relationship. Likewise, a woman whose decreased social anxiety enables her to get a long-awaited promotion may need to deal with the stress of adjusting to her new responsibilities. An individual who overcomes phobia of public speaking and still has mild anxiety may need to graduate to a forum such as Toastmasters to provide continued exposure to further develop confidence and skills in public speaking. PMID:11723635

  19. 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…

  20. Heterogeneity in development of adolescent anxiety disorder symptoms in an 8-year longitudinal community study.

    PubMed

    Nelemans, Stefanie A; Hale, William W; Branje, Susan J T; Raaijmakers, Quinten A W; Frijns, Tom; van Lier, Pol A C; Meeus, Wim H J

    2014-02-01

    In this study, we prospectively examined developmental trajectories of five anxiety disorder symptom dimensions (generalized anxiety disorder, panic disorder, school anxiety, separation anxiety disorder, and social anxiety disorder) from early to late adolescence in a community sample of 239 adolescents, assessed annually over 8 years. Latent growth modeling indicated different developmental trajectories from early into late adolescence for the different anxiety disorder symptoms, with some symptoms decreasing and other symptoms increasing over time. Sex differences in developmental trajectories were found for some symptoms, but not all. Furthermore, latent class growth analysis identified a normal developmental profile (including a majority of adolescents reporting persistent low anxiety disorder symptoms over 8 years) and an at-risk developmental profile (including a minority of adolescents reporting persistent high anxiety disorder symptoms over 8 years) for all of the anxiety disorder symptom dimensions except panic disorder. Additional analyses longitudinally supported the validity of these normal and at-risk developmental profiles and suggested differential associations between different anxiety disorder symptom dimensions and developmental trajectories of substance use, parenting, and identity development. Taken together, our results emphasize the importance of examining separate dimensions of anxiety disorder symptoms in contrast to a using a global, one-dimensional approach to anxiety. PMID:24229471

  1. Memory bias for anxiety information in patients with panic disorder

    Microsoft Academic Search

    Richard J. McNally; Edna B. Foa; Christina D. Donnell

    1989-01-01

    Based on Foa and Kozak's (1986) information processing theory of fear, we hypothesised that panic-disordered (PD) patients, in contrast to normal controls (NC), would exhibit a memory bias for anxiety-related information, and that physiological arousal would enhance this bias. PD subjects met DSM-III-R criteria for panic disorder. Self-report measures of mood, heart rate, and spontaneous skin conductance fluctuations were taken

  2. Emotion Socialization in Families of Children With an Anxiety Disorder

    Microsoft Academic Search

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

    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 discussion, proportion of words spoken by child vs. mother, frequency

  3. Anxiety disorders and pediatric continuous ambulatory peritoneal dialysis.

    PubMed

    Fukunishi, I; Honda, M; Kamiyama, Y; Ito, H

    1993-01-01

    This paper compared 23 children with end-stage renal disease (ESRD) on continuous ambulatory peritoneal dialysis to a matched sample of healthy children. The rate of separation anxiety disorder was significantly higher in the children with ESRD. In their family environments, mothers of ESRD children reported significantly lower independence and achievement orientation than mothers of control children. PMID:8404246

  4. 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…

  5. 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.

  6. 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…

  7. Cigarette Smoking and Onset of Mood and Anxiety Disorders

    PubMed Central

    Crum, Rosa M.

    2013-01-01

    Objectives. We examined the association between regular cigarette smoking and new onset of mood and anxiety disorders. Methods. We used logistic regression analysis to detect associations between regular smoking and new-onset disorders during the 3-year follow-up among 34?653 participants in the longitudinal US National Epidemiologic Survey on Alcohol and Related Conditions (2001–2005). We used instrumental variable methods to assess the appropriateness of these models. Results. Regular smoking was associated with an increased risk of new onset of mood and anxiety disorders in multivariable analyses (Fdf?=?5,61?=?11.73; P?disorders. Age moderated the association of smoking with most new-onset disorders. The association was mostly statistically significant and generally stronger in participants aged 18 to 49 years but was smaller and mostly nonsignificant in older adults. Conclusions. Our finding of a stronger association between regular cigarette smoking and increased risk of new-onset mood and anxiety disorders among younger adults suggest the need for vigorous antismoking campaigns and policy initiatives targeting this age group. PMID:23327282

  8. Screening for Generalized Anxiety Disorder (GAD)

    MedlinePLUS

    ... loved ones? Reference: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC, American Psychiatric Association, 1994. Print this form ... Papers Donate Press Room News & Updates ...

  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. 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…

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

    Microsoft Academic Search

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

    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 im- pairments in multiple areas of functioning. Despite a typical age of onset in early ado- lescence, the disorder is rarely recognized and treated in adolescent populations. Given its early age of onset, school professionals are

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

    PubMed Central

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

    2013-01-01

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

  13. 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…

  14. Comorbidities in adult attention-deficit/hyperactivity disorder: a practical guide to diagnosis in primary care.

    PubMed

    Mao, Alice R; Findling, Robert L

    2014-09-01

    Diagnosis and management of attention-deficit/hyperactivity disorder (ADHD) in adults is complex and challenging because of the frequent comorbidity of other psychiatric disorders that have symptoms overlapping with those of ADHD. The presence of comorbidities can create challenges to making an accurate diagnosis and also impact treatment options and outcomes. This review discusses disorders that may be comorbid with ADHD in adults, including anxiety, mood, substance use disorder, antisocial personality disorder, and borderline personality disorder. Suggestions for recognizing these comorbidities and distinguishing them from ADHD and perspectives on their possible impact on ADHD treatment are included. Adjunctive nonpharmacologic modalities may be especially helpful in the case of comorbid mood, anxiety, substance abuse, or personality disorders. PMID:25295649

  15. Emotion beliefs and cognitive behavioural therapy for social anxiety disorder.

    PubMed

    De Castella, Krista; Goldin, Philippe; Jazaieri, Hooria; Heimberg, Richard G; Dweck, Carol S; Gross, James J

    2015-03-01

    Despite strong support for the efficacy of cognitive behavioural therapy (CBT) for social anxiety disorder (SAD), little is known about mechanisms of change in treatment. Within the context of a randomized controlled trial of CBT, this study examined patients' beliefs about the fixed versus malleable nature of anxiety-their 'implicit theories'-as a key variable in CBT for SAD. Compared to waitlist (n = 29; 58% female), CBT (n = 24; 52% female) led to significantly lower levels of fixed beliefs about anxiety (Mbaseline = 11.70 vs. MPost = 7.08, d = 1.27). These implicit beliefs indirectly explained CBT-related changes in social anxiety symptoms (?(2) = .28, [95% CI = 0.12, 0.46]). Implicit beliefs also uniquely predicted treatment outcomes when controlling for baseline social anxiety and other kinds of maladaptive beliefs (perceived social costs, perceived social self-efficacy, and maladaptive interpersonal beliefs). Finally, implicit beliefs continued to predict social anxiety symptoms at 12 months post-treatment. These findings suggest that changes in patients' beliefs about their emotions may play an important role in CBT for SAD. PMID:25380179

  16. The functioning and well-being of patients with unrecognized anxiety disorders and major depressive disorder

    Microsoft Academic Search

    Warren H Schonfeld; Carol J Verboncoeur; Sheila K Fifer; Ruth C Lipschutz; Deborah P Lubeck; Don P Buesching

    1997-01-01

    This study examines the degree to which untreated anxiety disorders and major depressive disorder, occurring either singly or in combination, reduce functioning and well-being among primary care patients. Adult patients were screened using the SCL-52 to identify those with clinically significant anxiety symptoms. They also completed the Rand Short-Form (SF-36) to measure self-reported patient functioning and well-being. Patients with untreated

  17. Neural indicators of error processing in generalized anxiety disorder, obsessive-compulsive disorder, and major depressive disorder.

    PubMed

    Weinberg, Anna; Kotov, Roman; Proudfit, Greg H

    2015-02-01

    The ability to detect and respond to errors is critical to successful adaptation to a changing environment, and variation in error-related brain activity has been linked to psychopathology. The error-related negativity (ERN), an event-related potential component, represents a unique neural response to errors and is generated in the anterior cingulate cortex (ACC). In the present study, we measured the ERN in a sample of individuals with Generalized Anxiety Disorder (GAD), Obsessive Compulsive Disorder (OCD), Major Depressive Disorder (MDD), or some combination of the 3. Also included were 56 healthy control participants. Consistent with previous research, a diagnosis of GAD, only in the absence of a comorbid diagnosis of depression, was characterized by a larger ERN than controls. No such enhancement was evident in the depressed group, or the comorbid group, suggesting comorbid depression may eliminate the relationship between the ERN and GAD. Across all groups, symptoms of checking were associated with a larger ERN, whereas symptoms of psychomotor retardation were associated with a smaller ERN. The results of the present study indicate that interactions among transdiagnostic dimensions will likely need to be considered in the creation of neurobiologically informed classification schemes. (PsycINFO Database Record (c) 2015 APA, all rights reserved). PMID:25384068

  18. The relationships among separation anxiety disorder, adult attachment style and agoraphobia in patients with panic disorder.

    PubMed

    Pini, Stefano; Abelli, Marianna; Troisi, Alfonso; Siracusano, Alberto; Cassano, Giovanni B; Shear, Katherine M; Baldwin, David

    2014-12-01

    Epidemiological studies indicate that separation anxiety disorder occurs more frequently in adults than children. It is unclear whether the presence of adult separation anxiety disorder (ASAD) is a manifestation of anxious attachment, or a form of agoraphobia, or a specific condition with clinically significant consequences. We conducted a study to examine these questions. A sample of 141 adult outpatients with panic disorder participated in the study. Participants completed standardized measures of separation anxiety, attachment style, agoraphobia, panic disorder severity and quality of life. Patients with ASAD (49.5% of our sample) had greater panic symptom severity and more impairment in quality of life than those without separation anxiety. We found a greater rate of symptoms suggestive of anxious attachment among panic patients with ASAD compared to those without ASAD. However, the relationship between ASAD and attachment style is not strong, and adult ASAD occurs in some patients who report secure attachment style. Similarly, there is little evidence for the idea that separation anxiety disorder is a form of agoraphobia. Factor analysis shows clear differentiation of agoraphobic and separation anxiety symptoms. Our data corroborate the notion that ASAD is a distinct condition associated with impairment in quality of life and needs to be better recognized and treated in patients with panic disorder. PMID:25218272

  19. The specificity of cognitive vulnerabilities to emotional disorders: anxiety sensitivity, looming vulnerability and explanatory style.

    PubMed

    Reardon, John M; Williams, Nathan L

    2007-01-01

    Mood and anxiety disorders share considerable phenomenological and diagnostic overlap. Several models have advanced the understanding of the phenomenological overlap of anxiety and depression; however, identification of disorder-specific etiological mechanisms remains elusive. Recently, research has advanced several cognitive vulnerability-stress models proposing that one's characteristic way of attending to, interpreting, and remembering negative events contributes vulnerability to psychopathology. These cognitive vulnerabilities may elucidate specific etiological mechanisms that distinguish mood and anxiety pathology. The present study examines the specificity of three cognitive vulnerability constructs, the looming cognitive style, anxiety sensitivity, and explanatory style, in the prediction of latent anxiety disorder symptoms and latent depression symptoms. Structural equation modeling analyses indicated that the looming cognitive style demonstrated specificity predicting only anxiety disorder symptoms whereas anxiety sensitivity and a pessimistic explanatory style predicted both anxiety disorder and mood disorder symptoms. Implications for future research are discussed. PMID:17070666

  20. DSM-IV obsessive-compulsive personality disorder: prevalence in patients with anxiety disorders and in healthy comparison subjects.

    PubMed

    Albert, Umberto; Maina, Giuseppe; Forner, Federica; Bogetto, Filippo

    2004-01-01

    The relationship between obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) has not yet been fully clarified. The aim of the present study was to analyze DSM-IV OCPD prevalence rates in OCD and panic disorder (PD) patients to test for the specificity of the OCPD-OCD link, and to compare them to OCPD prevalence in a control group of subjects without any psychiatric disorder. A total of 109 patients with a principal diagnosis of DSM-IV (SCID-I) OCD and 82 with PD were interviewed using the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II) in order to assess the prevalence of OCPD. All patients with a coexisting axis I diagnosis were excluded from the study to eliminate confounding factors when evaluating the association between prevalence rates of OCPD and anxiety disorder diagnoses. An exclusion criteria was also a Hamilton Depression Rating Scale (HAM-D) score >/=16. A sample of comparison subjects (age 18 to 65 years) without any psychiatric disorder was recruited from people registered with two general practitioners (GPs), whether or not they consulted the doctor, in order to evaluate OCPD prevalence rate in the community. A significant difference was found between the prevalence of OCPD in OCD (22.9%) and in PD (17.1%) on one hand, and that in the comparison sample (3.0%) on the other. No differences were found between the two psychiatric groups, even when splitting the samples according to gender. Our study failed to support the hypothesis of a specific relationship between OCPD and OCD; we confirmed the higher prevalence rate of this personality disorder in OCD subjects with regard to the general population, but we also confirmed the higher rate of OCPD in another anxiety disorder which is phenomenologically well characterized and different from OCD, such as PD. PMID:15332194

  1. Social appearance anxiety, perfectionism, and fear of negative evaluation: Distinct or shared risk factors for social anxiety and eating disorders?

    PubMed Central

    Levinson, Cheri A.; Rodebaugh, Thomas L.; White, Emily K.; Menatti, Andrew; Weeks, Justin W.; Iacovino, Juliette M.; Warren, Cortney S.

    2013-01-01

    Social anxiety and eating disorders are highly comorbid. Social appearance anxiety (i.e., fear of negative evaluation of one's appearance), general fear of negative evaluation, and perfectionism have each been proposed as risk factors for both social anxiety disorder and the eating disorders. However, no research to date has examined all three factors simultaneously. Using structural equation modeling in two diverse samples (N = 236; N = 136) we tested a model in which each of these risk factors were uniquely associated with social anxiety and eating disorder symptoms. We found support for social appearance anxiety as a shared risk factor between social anxiety and eating disorder symptoms, whereas fear of negative evaluation was a risk factor only for social anxiety symptoms. Despite significant zero-order relationships, two facets of perfectionism (high standards and maladaptive perfectionism) did not emerge as a risk factor for either disorder when all constructs were considered. These results were maintained when gender, body mass index, trait negative affect, and depression were included in the model. It is possible that treating negative appearance evaluation fears may reduce both eating disorder and social anxiety symptoms. PMID:23583741

  2. 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

  3. 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

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

    PubMed Central

    2014-01-01

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

  5. 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…

  6. Anxiety and depressive disorders are associated with delusional-like experiences: a replication study based on a National Survey of Mental Health and Wellbeing

    PubMed Central

    Scott, James; Varghese, Daniel; McGrath, John

    2012-01-01

    Objectives There is growing evidence that delusional-like experiences (DLE) are associated with common mental disorders. In particular, a National Mental Health Survey conducted in Australia during 2007 reported an association between DLE and both anxiety disorder and major depressive disorder (MDD). However, the previous study did not examine this association with respect to subtypes of anxiety disorder nor with severity of MDD. The aim of this study was to examine the associations between DLE and both anxiety disorder and MDD in more detail based on an independent population sample. Design Cross-sectional study. Setting Subjects were drawn from the Australian Survey of Mental Health and Wellbeing 1997 using a stratified multistage area sampling of persons living in private dwellings in all States and Territories of Australia. Participants Approximately 13?600 private dwellings were initially selected with one person aged 18?years or older from each dwelling invited to participate. In total, 10?641 individuals participated in the survey. Primary and secondary outcome measures The Composite International Diagnostic Interview was used to identify individuals with DLE and Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition (DSM IV) lifetime diagnoses of anxiety disorders and MDD. The influence of various anxiety disorders and MDD on DLE was assessed with logistic regression. Results Having a lifetime diagnosis of either any anxiety disorder or MDD was significantly associated with the endorsement of DLE. The association was found for each of the main anxiety disorders when examined separately. There was a dose–response relationship between increasing severity of MDD and higher odds of DLE endorsement. Conclusions DLE are associated with a wide range of anxiety disorders and are more prevalent in those with MDD. Understanding the relationship between DLE, anxiety disorders and depression may provide insights into shared pathways that underpin both psychotic disorders and common mental disorders. PMID:22649176

  7. 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

  8. 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

  9. 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 ? = .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

  10. 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…

  11. 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…

  12. 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

  13. Neuroendocrine responses to psychological stress in adolescents with anxiety disorder.

    PubMed

    Gerra, G; Zaimovic, A; Zambelli, U; Timpano, M; Reali, N; Bernasconi, S; Brambilla, F

    2000-01-01

    Neurotransmitter-neuroendocrine and cardiovascular responses to the administration of a psychologically stressful mixed-model test (Mental Arithmetic, Stroop Color Word Interference Task, Trier Social Stress Test) were examined in 20 male peripubertal subjects affected by anxiety disorder (group A: 14 with generalized anxiety disorder, 6 with generalized anxiety disorder and separation anxiety disorder) and 20 junior school adolescents, matched for age, without overt psychological disorders (group B). Plasma levels of norepinephrine (NE), epinephrine (EPI), adrenocorticotropic hormone (ACTH), beta-endorphin (beta-EP), cortisol (CORT), growth hormone (GH), prolactin (PRL) and testosterone (Te) were measured immediately before the beginning of the tests and 30 min later at their end. Mean prestress values of GH, PRL, beta-EP and ACTH were significantly higher in anxious subjects than in controls. There was no difference in NE, EPI, CORT and Te prestress levels in the two groups. After the psychological stress session NE, GH and Te concentrations increased significantly in anxious subjects (A), but not in controls. In contrast, beta-EP and PRL decreased significantly during the psychological stress session in anxious subjects, and were unaffected by stress in the subjects without anxiety. No significant changes were found in ACTH, CORT and EPI during the challenge either in anxious subjects or in controls, which may be attributed to the late time of poststress blood sampling. In contrast to controls, heart rate and systolic blood pressure increased significantly in anxious subjects after psychological stress testing. Our data support the hypothesis that the hyperactivity of the noradrenergic system in response to stress is associated with anxiety disorders in adolescents and might influence the responses of GH and Te. High prestress basal values of stress hormones seem to be induced in anxious subjects by the anticipation of the task or by a persistent hyperactivity of the noradrenergic system. Further studies are needed to investigate in more detail the involvement of the HPA axis in anxious adolescents by a more refined resolution of time points of blood sampling. PMID:10940763

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

    Microsoft Academic Search

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

    2010-01-01

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

  15. Neurosteroids as Neuromodulators in the Treatment of Anxiety Disorders

    PubMed Central

    Longone, Patrizia; di Michele, Flavia; D’Agati, Elisa; Romeo, Elena; Pasini, Augusto; Rupprecht, Rainer

    2011-01-01

    Anxiety disorders are the most common psychiatric disorders. They are frequently treated with benzodiazepines, which are fast acting highly effective anxiolytic agents. However, their long-term use is impaired by tolerance development and abuse liability. In contrast, antidepressants such as selective serotonin reuptake inhibitors (SSRIs) are considered as first-line treatment but have a slow onset of action. Neurosteroids are powerful allosteric modulators of GABAA and glutamate receptors. However, they also modulate sigma receptors and they are modulated themselves by SSRIs. Both pre-clinical and clinical studies have shown that neurosteroid homeostasis is altered in depression and anxiety disorders and antidepressants may act in part through restoring neurosteroid disbalance. Moreover, novel drugs interfering with neurosteroidogenesis such as ligands of the translocator protein (18?kDa) may represent an attractive pharmacological option for novel anxiolytics which lack the unwarranted side effects of benzodiazepines. Thus, neurosteroids are important endogenous neuromodulators for the physiology and pathophysiology of anxiety and they may constitute a novel therapeutic approach in the treatment of these disorders. PMID:22654814

  16. Hippocampal Network Connectivity and Activation Differentiates Post-Traumatic Stress Disorder From Generalized Anxiety Disorder

    PubMed Central

    Chen, Ashley C; Etkin, Amit

    2013-01-01

    Anxiety disorders are a diverse group of clinical states. Post-traumatic stress disorder (PTSD) and generalized anxiety disorder (GAD), eg, share elevated anxiety symptoms, but differ with respect to fear-related memory dysregulation. As the hippocampus is implicated in both general anxiety and fear memory, it may be an important brain locus for mapping the similarities and differences among anxiety disorders. Anxiety and fear also functionally associate with different subdivisions of the hippocampus along its longitudinal axis: the human posterior (rodent dorsal) hippocampus is involved in memory, through connectivity with the medial prefrontal-medial parietal default-mode network, whereas the anterior (rodent ventral) hippocampus is involved in anxiety, through connectivity with limbic-prefrontal circuits. We examined whether differential hippocampal network functioning may help account for similarities and differences in symptoms in PTSD and GAD. Network-sensitive functional magnetic resonance imaging-based resting-state intrinsic connectivity methods, along with task-based assessment of posterior hippocampal/default-mode network function, were used. As predicted, in healthy subjects resting-state connectivity dissociated between posterior hippocampal connectivity with the default-mode network, and anterior hippocampal connectivity to limbic-prefrontal circuitry. The posterior hippocampus and the associated default-mode network, across both resting-state connectivity and task-based measures, were perturbed in PTSD relative to each of the other groups. By contrast, we found only modest support for similarly blunted anterior hippocampal connectivity across both patient groups. These findings provide new insights into the neural circuit-level dysfunctions that account for similar vs different features of two major anxiety disorders, through a translational framework built on animal work and carefully selected clinical disorders. PMID:23673864

  17. Smoking cessation is associated with lower rates of mood/anxiety and alcohol use disorder

    PubMed Central

    Cavazos-Rehg, Patricia A.; Breslau, Naomi; Hatsukami, Dorothy; Krauss, Melissa J.; Spitznagel, Edward L.; Grucza, Richard A.; Salyer, Patricia; Hartz, Sarah M.; Bierut, Laura J.

    2014-01-01

    Background The psychological outcomes that accompany smoking cessation are not yet conclusive but positive outcomes could help to persuade quitting. Method We use data from the longitudinal National Epidemiological Study of Alcohol and Related Conditions. Logistic regression was used to examine associations between cigarette smoking reduction and Wave 2 status of addiction/mental health disorder among daily smokers at Wave 1, stratified by status of the diagnosis of interest at Wave 1. We adjusted for differences in baseline covariates between smokers with different levels of smoking reduction between Wave 1 and Wave 2 using propensity score regression adjustment. Results After adjusting for propensity scores and other mental health/addiction comorbidities at Wave 2, among daily smokers who had current or lifetime history diagnosis of the outcome of interest at Wave 1, quitting by Wave 2 predicted a decreased risk of mood/anxiety disorder (aOR 0.6, 95% CI 0.4, 0.9) and alcohol disorder (aOR 0.7, 95% CI 0.5, 0.99) at Wave 2. Among daily smokers with no lifetime history diagnosis of the outcome of interest at Wave 1, quitting smoking by Wave 2 predicted a decreased risk of drug use disorder at Wave 2 aOR 0.3, 95% CI 0.1, 0.9). Conclusions There is no support in our data for the concern that smoking cessation would result in smokers’ increased risk of some mental disorders. To the contrary, our data suggest that smoking cessation is associated with risk reduction for mood/anxiety or alcohol use disorder, even among smokers who have had a pre-existing disorder. PMID:25055171

  18. Improving recognition of late life anxiety disorders in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition: observations and recommendations of the Advisory Committee to the Lifespan Disorders Work Group

    PubMed Central

    Mohlman, Jan; Bryant, Christina; Lenze, Eric J.; Stanley, Melinda A.; Gum, Amber; Flint, Alastair; Beekman, Aartjan T. F.; Wetherell, Julie Loebach; Thorp, Steven R.; Craske, Michelle G.

    2014-01-01

    Background Recognition of the significance of anxiety disorders in older adults is growing. The revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM) provides a timely opportunity to consider potential improvements to diagnostic criteria for psychiatric disorders for use with older people. The authors of this paper comprise the Advisory Committee to the DSM5 Lifespan Disorders Work Group, the purpose of which was to generate informative responses from individuals with clinical and research expertise in the field of late-life anxiety disorders. Methods This paper reviews the unique features of anxiety in later life and synthesizes the work of the Advisory Committee. Results Suggestions are offered for refining our understanding of the effects of aging on anxiety and other disorders (e.g., mood disorders) and changes to the DSM5 criteria and text that could facilitate more accurate recognition and diagnosis of anxiety disorders in older adults. Several of the recommendations are not limited to the study of anxiety but rather are applicable across the broader field of geriatric mental health. Conclusions DSM5 should provide guidelines for the thorough assessment of avoidance, excessiveness, and comorbid conditions (e.g., depression, medical illness, cognitive impairment) in anxious older adults. PMID:21773996

  19. Your Adolescent: Anxiety and Avoidant Disorders

    MedlinePLUS

    ... may be consulted to identify how the teen's performance and function in school has been affected by the disorder. The evaluating ... unrecognized learning disability. He may also be skipping school in order to be with ... about performance or separation. If the teenager has engaged in ...

  20. 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

  1. Duloxetine in the treatment of generalized anxiety disorder

    PubMed Central

    Norman, Trevor R; Olver, James S

    2008-01-01

    Duloxetine, a medication with effects on both serotonin and noradrenaline transporter molecules, has recently been approved for the treatment of generalized anxiety disorder. The evidence for its efficacy lies in a limited number of double blind, placebo controlled comparisons. Statistically significant improvements in the Hamilton Anxiety Rating Scale from baseline were demonstrated in all studies at doses of 60 to 120 mg per day. The significance of such changes in terms of clinical improvements compared to placebo is less certain, particularly when the effect size of the change is calculated. In comparative trials with venlafaxine, duloxetine was as effective in providing relief of anxiety symptoms. In addition to improvements in clinical symptoms duloxetine has also been associated with restitution of role function as measured by disability scales. Duloxetine use is associated with nausea, dizziness, dry mouth, constipation, insomnia, somnolence, hyperhidrosis, decreased libido and vomiting. These treatment emergent side effects were generally of mild to moderate severity and were tolerated over time. Using a tapered withdrawal schedule over two weeks in the clinical trials, duloxetine was associated with only a mild withdrawal syndrome in up to about 30% of patients compared to about 17% in placebo treated patients. Duloxetine in doses of up to 200 mg twice daily did not prolong the QTc interval in healthy volunteers. Like other agents with dual neurotransmitter actions duloxetine reduces the symptoms of generalized anxiety disorder in short term treatments. Further evidence for its efficacy and safety in long term treatment is required. PMID:19337457

  2. 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

  3. 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…

  4. 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…

  5. 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

  6. Clinical Decision-Making about Child and Adolescent Anxiety Disorders Using the Achenbach System of Empirically Based Assessment

    PubMed Central

    Van Meter, Anna; Youngstrom, Eric A.; Ollendick, Thomas; Demeter, Christine; Findling, Robert L.

    2014-01-01

    Objective Anxiety disorders are common among children, but can be difficult to diagnose. An actuarial approach to the diagnosis of anxiety may improve the efficiency and accuracy of the process. The objectives of this study were to determine the clinical utility of the Achenbach CBCL and YSR, two widely used assessment tools, for diagnosing anxiety disorders in youth, and to aid clinicians in incorporating scale scores into an actuarial approach to diagnosis through a clinical vignette. Method Demographically diverse youth, aged 5 to 18 years, were drawn from two samples; one (N=1084) was recruited from a research center, the second (N=651) was recruited from an urban community mental health center. Consensus diagnoses integrated information from semi-structured interview, family history, treatment history, and clinical judgment. Results The CBCL and YSR internalizing problems T scores discriminated cases with any anxiety disorder or with GAD from all other diagnoses in both samples (p values <.0005); the two scales had equivalent discriminative validity (p values > .05 for tests of difference). No other scales, nor any combination of scales, significantly improved on the performance of the Internalizing scale. In the highest risk group, Internalizing scores >69 (CBCL) or >63 (YSR) resulted in a Diagnostic Likelihood Ratio of 1.5; low scores reduced the likelihood of anxiety disorders by a factor of 4. Conclusions Combined with other risk factor information in an actuarial approach to assessment and diagnosis, the CBCL and YSR Internalizing scales provide valuable information about whether or not a youth is likely suffering from an anxiety disorder. PMID:24697608

  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. 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…

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

    Microsoft Academic Search

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

    2004-01-01

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

  10. 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…

  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. [Differential diagnosis between schizotypal personality disorder and autism spectrum disorders: a case report].

    PubMed

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

    2015-01-01

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

  13. Idiopathic unilateral focal hyperhidrosis with social anxiety disorder.

    PubMed

    Ghorpade, V Anand Prakash

    2009-01-01

    Hyperhidrosis especially palmoplantar type are commonly referred to psychiatrist for management. Focal type of hyperhidrosis is less commonly seen more so associated with social anxiety disorder. Focal type is associated with variety of organic causes which has to be excluded before labeling it as Idiopathic variety. The variety of treatment that they are subjected to and its outcome are discussed in this case report. PMID:19881053

  14. A Meta-Analysis of Transdiagnostic Cognitive Behavioural Therapy in the Treatment of Child and Young Person Anxiety Disorders.

    PubMed

    Ewing, Donna L; Monsen, Jeremy J; Thompson, Ellen J; Cartwright-Hatton, Sam; Field, Andy

    2013-12-13

    Background: Previous meta-analyses of cognitive-behavioural therapy (CBT) for children and young people with anxiety disorders have not considered the efficacy of transdiagnostic CBT for the remission of childhood anxiety. Aim: To provide a meta-analysis on the efficacy of transdiagnostic CBT for children and young people with anxiety disorders. Methods: The analysis included randomized controlled trials using transdiagnostic CBT for children and young people formally diagnosed with an anxiety disorder. An electronic search was conducted using the following databases: ASSIA, Cochrane Controlled Trials Register, Current Controlled Trials, Medline, PsycArticles, PsychInfo, and Web of Knowledge. The search terms included "anxiety disorder(s)", "anxi*", "cognitive behavio*, "CBT", "child*", "children", "paediatric", "adolescent(s)", "adolescence", "youth" and "young pe*". The studies identified from this search were screened against the inclusion and exclusion criteria, and 20 studies were identified as appropriate for inclusion in the current meta-analysis. Pre- and posttreatment (or control period) data were used for analysis. Results: Findings indicated significantly greater odds of anxiety remission from pre- to posttreatment for those engaged in the transdiagnostic CBT intervention compared with those in the control group, with children in the treatment condition 9.15 times more likely to recover from their anxiety diagnosis than children in the control group. Risk of bias was not correlated with study effect sizes. Conclusions: Transdiagnostic CBT seems effective in reducing symptoms of anxiety in children and young people. Further research is required to investigate the efficacy of CBT for children under the age of 6. PMID:24331028

  15. 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

  16. Fearful responding to interoceptive exposure in social anxiety disorder.

    PubMed

    Collimore, Kelsey C; Asmundson, Gordon J G

    2014-03-01

    There is accumulating evidence suggesting that anxiety sensitivity (AS) may play a role in social anxiety disorder (SAD; e.g., Ball, Otto, Pollack, Uccello, & Rosenbaum, 1995). Precedent research has demonstrated the role of AS in panic disorder and posttraumatic stress disorder, and subsequently, treatment techniques aimed at reducing AS (i.e., interoceptive exposure (IE)) have been studied in these populations (Schmidt & Trakowski, 2004; Wald & Taylor, 2008). The purpose of this study was to examine the types of responses elicited during IE exercises among individuals with SAD. This study describes the responses of individuals with SAD (n = 37) and nonclinical control participants (n = 28) to six IE exercises. Significant differences in responses to the IE exercises were found between participants with SAD and nonclinical controls. However, there were no significant differences in responses to the exercises among persons with SAD, depending on whether the exercises were completed in private versus group settings. Similarity to symptoms during naturally occurring anxiety significantly predicted fearful responding across all exercises in persons with SAD. Implications and directions for future research are discussed. PMID:24295848

  17. Dissociative identity disorder: a controversial diagnosis.

    PubMed

    Gillig, Paulette Marie

    2009-03-01

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

  18. Anxiety disorders in 8-11-year-old children: motor skill performance and self-perception of competence.

    PubMed

    Ekornĺs, Belinda; Lundervold, Astri J; Tjus, Tomas; Heimann, Mikael

    2010-06-01

    This study investigates motor skill performance and self-perceived competence in children with anxiety disorders compared with children without psychiatric disorders. Motor skills and self-perception were assessed in 329 children aged 8 to 11 years, from the Bergen Child Study. The Kiddie-SADS PL diagnostic interview was employed to define a group of children with an anxiety disorder without comorbid diagnosis, and a control group (no diagnosis) matched according to gender, age, and full-scale IQ. Children in the anxiety disorder group displayed impaired motor skills and poor self-perceived peer acceptance and physical competence compared with the control group. Two-thirds of the anxious boys scored on the Motor Assessment Battery for Children (MABC) as having motor problems. The present study demonstrated impaired motor skills in boys with "pure" anxiety disorders. Anxious children also perceived themselves as being less accepted by peers and less competent in physical activities compared with children in the control group. PMID:20132456

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

    PubMed

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

    2010-03-01

    The present study aimed to examine how video feedback can affect perceived performance and anticipatory anxiety in various naturalistic social anxiety-provoking situations among clinical patients diagnosed with social anxiety disorder (SAD) and to examine predictors that might influence response to video feedback. Participants were 52 consecutive patients with DSM-IV SAD who participated in a group-based CBT program. Our results demonstrated that video feedback was associated with a decrease in the underestimation of own performance as well as the perception of feared outcomes. Moreover, anticipatory anxiety decreased after video feedback combined with peer feedback. Male sex, comorbidity with other anxiety disorders, and benzodiazepine prn, as well as patients' initial anxiety and avoidance were negative predictors of the effect of video feedback. PMID:19729149

  20. 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

  1. 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…

  2. 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

  3. 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

  4. Risk factors for an anxiety disorder comorbidity among Thai patients with bipolar disorder: results from the Thai Bipolar Disorder Registry

    PubMed Central

    Paholpak, Suchat; Kongsakon, Ronnachai; Pattanakumjorn, Wasana; Kanokvut, Roongsang; Wongsuriyadech, Wiroj; Srisurapanont, Manit

    2014-01-01

    Background The aim of the study was to determine in a clinical setting the risk factors for current anxiety disorder (AD) comorbidity among Thai patients with bipolar disorder (BD), being treated under the Thai Bipolar Disorder Registry Project (TBDR). Methods The TBDR was a multisite naturalistic study conducted at 24 psychiatric units (ie, at university, provincial mental, and government general hospitals) between February 2009 and January 2011. Participants were in- or out-patients over 18 years of age who were diagnosed with BD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Instruments used in this study included the Thai Mini International Neuropsychiatric Interview version 5; Thai Montgomery–Ĺsberg Depression Rating Scale (MADRS); Thai Young Mania Rating Scale; Clinical Global Impression of Bipolar Disorder-Severity (CGI-BP-S), CGI-BP-S-mania, CGI-BPS-depression, and CGI-BP-S-overall BP illness; and the Thai SF-36 quality of life questionnaire. Results Among the 424 BD patients, 404 (95.3%) had BD type I. The respective mean ± standard deviation of age of onset of mood disturbance, first diagnosis of BD, and first treatment of BD was 32.0±11.9, 36.1±12.2, and 36.2±12.2 years. The duration of illness was 10.7±9.0 years. Fifty-three (12.5%) of the 424 participants had a current AD while 38 (9%) had a substance use disorder (SUD). The univariate analysis revealed 13 significant risks for current AD comorbidity, which the multivariate analysis narrowed to age at first diagnosis of BD (odds ratio =0.95, P<0.01), family history of SUD (odds ratio =2.18, P=0.02), and having a higher current MADRS score (odds ratio =1.11, P<0.01). Conclusion A diagnosis of AD comorbid with BD is suggested by early-age onset of BD together with a higher MADRS score and a family history of SUD. The likelihood of AD comorbidity decreases by 5% with each passing year; early-age onset of BD is a risk while later age onset is protective. Our results underscore how SUD within the family significantly contributes to the risk of an AD comorbidity. PMID:24868157

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

    PubMed

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

    2014-11-01

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

  6. 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…

  7. Assessing Client Progress Session by Session in the Treatment of Social Anxiety Disorder: The Social Anxiety Session Change Index

    Microsoft Academic Search

    Sarah A. Hayes; Nathan A. Miller; Debra A. Hope; Richard G. Heimberg; Harlan R. Juster

    2008-01-01

    Frequent assessment during therapy can improve treatments and provide accountability. However, clinicians often do not monitor progress because of the time it takes to administer and score assessments. In response, the Social Anxiety Session Change Index (SASCI) was developed. The SASCI is a short, easily administered rating of subjective improvement that asks clients with social anxiety disorder how much they

  8. Cultural Barriers to African American Participation in Anxiety Disorders Research

    PubMed Central

    Williams, Monnica T.; Beckmann-Mendez, Diana A.; Turkheimer, Eric

    2014-01-01

    Anxiety disorders are understudied, underdiagnosed, and undertreated in African Americans. Research focused on the phenomenology, etiology, and treatment of anxiety in African Americans has been hampered by lack of inclusion of this population in clinical research studies. The reason for exclusion is not well understood, although cultural mistrust has been hypothesized as a major barrier to research participation. This article reviews the relevant literature to date and examines the experience of 6 African American adults who participated in a larger clinical assessment study about anxiety. Drawing upon in-depth semistructured interviews about their subjective experiences, we examined participant perspectives about the assessment process, opinions about African American perception of anxiety studies, and participant-generated ideas about how to improve African American participation. Based on a qualitative analysis of responses, feelings of mistrust emerged as a dominant theme. Concerns fell under 6 categories, including not wanting to speak for others, confidentiality, self and group presentation concerns, repercussions of disclosure, potential covert purposes of the study, and the desire to confide only in close others. Suggestions for increasing African American participation are discussed, including assurances of confidentiality, adequate compensation, and a comfortable study environment. PMID:23862294

  9. Prospective study of risk factors for suicidal behavior in individuals with anxiety disorders

    PubMed Central

    Uebelacker, L. A.; Weisberg, R.; Millman, M.; Yen, S.; Keller, M.

    2013-01-01

    Background Anxiety disorders are very common and increase risk for suicide attempts. Little is known about predictors of increased risk specifically among individuals with anxiety disorders. The purpose of this study was to investigate whether specific anxiety disorders and other co-morbid psychiatric disorders, physical health, or work or social functioning increased the future likelihood of a suicide attempts among individuals with anxiety disorders. Method In this prospective study, 676 individuals with an anxiety disorder were followed for an average of 12 years. Results As hypothesized, we found that post-traumatic stress disorder, major depressive disorder (MDD), intermittent depressive disorder (IDD), epilepsy, pain, and poor work and social functioning all predicted a shorter time to a suicide attempt in univariate analyses. In multivariate analyses, baseline MDD and IDD were independent predictors of time to suicide attempt, even when controlling for a past history of suicide attempt. No specific anxiety disorder was an independent predictor of time to attempt in this anxiety-disordered sample. Adding baseline physical health variables and social functioning did not improve the ability of the model to predict time to suicide attempt. Conclusions Mood disorders and past history of suicide attempts are the most powerful predictors of a future suicide attempt in this sample of individuals, all of whom have an anxiety disorder. PMID:23137440

  10. Feasibility of guided cognitive behaviour therapy (CBT) self?help for childhood anxiety disorders in primary care

    PubMed Central

    2010-01-01

    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

  11. 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)

  12. 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

  13. Validity of the K-10 in detecting DSM-IV-defined depression and anxiety disorders among HIV-infected individuals.

    PubMed

    Spies, G; Kader, K; Kidd, M; Smit, J; Myer, L; Stein, D J; Seedat, S

    2009-09-01

    It has been suggested that an HIV diagnosis may increase the likelihood of mental disorders among infected individuals and that the progression of HIV may be hastened by mental disorders like anxiety and depression. Therefore, a brief screening measure, with good sensitivity/specificity for psychiatric diagnoses that could be given to HIV-infected individuals would be useful. We assessed the validity of the K-10, using the MINI International Neuropsychiatric Interview as the gold standard, in a sample of 429 HIV-infected adults enrolled in HIV care and treatment services near Cape Town, South Africa. There was significant agreement between the K-10 and the MINI-defined depressive and anxiety disorders. A receiver operating characteristic (ROC) curve analysis indicated that the K-10 showed agreeable sensitivity and specificity in detecting depression (area under the ROC curve, 0.77), generalized anxiety disorder (0.78), and posttraumatic stress disorder (PTSD) (0.77). The K-10 may be a useful screening measure for detecting mood and anxiety disorders, including PTSD, in patients with HIV/AIDS. PMID:20024776

  14. Variability in anxiety and depression over time following diagnosis in patients with prostate cancer.

    PubMed

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

    2010-01-01

    To determine the presence and nature of variability in anxiety and depression in patients with prostate cancer (PCa) over 3 years following diagnosis, 442 patients with PCa completed standardized anxiety and depression inventories via survey between 1 and 36 months after receiving their initial diagnosis. Data were analyzed from a series of 3-month cohorts, and results indicated that total scores and incidence of clinically significant anxiety and depression varied over time, but that this variability was restricted to specific subfactors of anxiety and depression. Provision of effective psychological treatment to patients with PCa is discussed. PMID:21058161

  15. Shame- and guilt-proneness: relationships with anxiety disorder symptoms in a clinical sample.

    PubMed

    Fergus, Thomas A; Valentiner, David P; McGrath, Patrick B; Jencius, Simon

    2010-12-01

    Researchers postulate that both shame and guilt are emotions important to anxiety disorders. Extant data, however, indicate that guilt-proneness shares non-significant relationships with psychopathology symptoms after controlling for shame-proneness. To further investigate the relevance of shame and guilt to the anxiety disorders domain, the current study examined associations between shame- and guilt-proneness and anxiety disorder symptoms using data from patients (N=124) with primary anxiety disorder diagnoses. Results indicated that only symptoms of social anxiety disorder (SAD) and generalized anxiety disorder (GAD) shared significant relations with shame-proneness after controlling for other types of anxiety disorder symptoms, depression symptoms, and guilt-proneness. Further, changes in shame-proneness during treatment were found to share significant relations with changes in obsessive-compulsive disorder, SAD, and GAD symptoms. The current results indicate that shame is more relevant to symptoms of the anxiety disorders domain than is guilt. The implications of these results for the conceptualization and treatment of anxiety disorders are discussed. PMID:20591613

  16. 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

  17. 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

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

    PubMed

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

    2013-05-01

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

  19. Evidenced-Based Practice for Anxiety Disorders in College Mental Health

    ERIC Educational Resources Information Center

    Baez, Thomas

    2005-01-01

    Anxiety disorders are the most common mental health concerns in the United States and they tend to be among the most frequently reported in college mental health. While efficacious research for the psychotherapy treatment of specific anxiety disorders (e.g., social phobia, panic disorder, etc.) exists, the picture is more complex in clinical…

  20. Anxiety and depressive disorders and dental fear among adults in Finland.

    PubMed

    Pohjola, Vesa; Mattila, Aino K; Joukamaa, Matti; Lahti, Satu

    2011-02-01

    We studied the association between dental fear and anxiety or depressive disorders, as well as the comorbidity of dental fear with anxiety and depressive disorders, controlling for socio-demographic characteristics, dental attendance, and dental health. Nationally representative data on Finnish adults, ? 30 yr of age (n = 5,953), were gathered through interviews and clinical examination. Dental fear was measured using the question: 'How afraid are you of visiting a dentist?' Anxiety and/or depressive disorders were assessed using a standardized structured psychiatric interview according to criteria presented in the Diagnostic and Statistical Manual of Mental Disorders (4th edition) (DSM-IV).Those with depressive disorders, generalized anxiety disorder or social phobia more commonly reported high dental fear than did those without these disorders. When age, gender, education, dental attendance, and the number of decayed, missing, and restored teeth were considered, those with generalized anxiety disorder were more likely to have high dental fear than were participants with neither anxiety nor depressive disorders. The comorbidity of depressive and anxiety disorders also remained statistically significantly associated with dental fear; those with both depressive and anxiety disorders were more likely to have high dental fear than were those without these disorders. Our findings support the suggestion that some individuals may have a personality that is vulnerable to dental fear. PMID:21244512

  1. Antiepileptic drugs in the treatment of anxiety disorders: role in therapy.

    PubMed

    Van Ameringen, Michael; Mancini, Catherine; Pipe, Beth; Bennett, Mark

    2004-01-01

    Pharmacotherapy for anxiety disorders is an active area of research. A variety of drug groups have been shown to be effective in treating many of the anxiety disorders, with selective serotonin reuptake inhibitors (SSRIs) being considered first-line agents for virtually all anxiety disorders. There is a clinical need for alternative drug treatments, as many patients do not achieve a complete response and experience significant adverse effects. The successful use of antiepileptic drugs in mood disorders has led clinicians and researchers to investigate their potential efficacy in other psychiatric disorders, particularly in anxiety disorders. There have been a number of investigations conducted in the form of case reports, case series and open-label trials, suggesting the potential usefulness of antiepileptic drug treatment in a variety of anxiety disorders. More reliable evidence for the use of antiepileptic drugs in anxiety disorders can be gleaned from recent placebo-controlled trials. Thus far, the strongest placebo-controlled evidence has demonstrated the efficacy of pregabalin in treating social phobia and generalised anxiety disorder, while smaller or less robust controlled trials have suggested the potential efficacy of gabapentin in social phobia, lamotrigine in post-traumatic stress disorder, and valproic acid in panic disorder. Antiepileptic drugs may have a place in the treatment of anxiety disorders; however, further investigation is warranted to determine in what circumstances they should be used as monotherapy or as augmenting agents in individuals who are partially or non-responsive to conventional therapy. PMID:15456335

  2. Childhood Anxiety\\/Withdrawal, Adolescent Parent–Child Attachment and Later Risk of Depression and Anxiety Disorder

    Microsoft Academic Search

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

    Previous research has shown that children with high levels of early anxiety\\/withdrawal are at increased risk of later anxiety\\u000a and depression. It has also been found that positive parent–child attachment reduces the risk of these disorders. The aim\\u000a of this paper was to examine the extent to which positive parent–child attachment acted to mitigate the risk of later internalising\\u000a disorders

  3. Exposure to Maternal Pre- and Postnatal Depression and Anxiety Symptoms: Risk for Major Depression, Anxiety Disorders, and Conduct Disorder in Adolescent Offspring

    PubMed Central

    Glasheen, Cristie; Richardson, Gale A.; Kim, Kevin H.; Larkby, Cynthia A.; Swartz, Holly A.; Day, Nancy L.

    2015-01-01

    This study evaluated whether exposure to maternal pre- or postnatal depression or anxiety symptoms predicted psychopathology in adolescent offspring. Growth mixture modeling was used to identify trajectories of pre- and postnatal depression and anxiety symptoms in 577 women of low socioeconomic status selected from a prenatal clinic. Logistic regression models indicated that maternal pre- and postnatal depression trajectory exposure was not associated with offspring major depression, anxiety, or conduct disorder but exposure to the high depression trajectory was associated with lower anxiety symptoms in males. Exposure to medium and high pre- and postnatal anxiety was associated with the risk of conduct disorder among offspring. Male offspring exposed to medium and high pre- and postnatal anxiety had higher odds of conduct disorder than males with low exposure levels. Females exposed to medium or high pre- and postnatal anxiety were less likely to meet conduct disorder criteria than females with lower exposure. To the best of our knowledge, this is the first study to examine the effect of pre- and postnatal anxiety trajectories on the risk of conduct disorder in offspring. These results suggest new directions for investigating the etiology of conduct disorder with a novel target for intervention. PMID:24229548

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

    PubMed Central

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

    2013-01-01

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

  5. The Prevalence of Anxiety Disorders Among Adults with Asthma: A Meta-Analytic Review

    Microsoft Academic Search

    Eric B. Weiser

    2007-01-01

    Research estimating the comorbidity of asthma and anxiety disorders has produced highly disparate findings and little consensus.\\u000a This study is a meta-analytic review of data from 15 independent studies of the co-occurrence of adult asthma and anxiety\\u000a disorders and was conducted to provide more precise comorbidity estimates. Aggregating across studies, the average prevalence\\u000a of any anxiety disorder among adults with

  6. Attachment in individuals with social anxiety disorder: the relationship among adult attachment styles, social anxiety, and depression.

    PubMed

    Eng, W; Heimberg, R G; Hart, T A; Schneier, F R; Liebowitz, M R

    2001-12-01

    Despite their apparent implications for social functioning, adult attachment styles have never been specifically explored among persons with social anxiety disorder. In the current study, a cluster analysis of the Revised Adult Attachment Scale (N. L. Collins, 1996) revealed that 118 patients with social anxiety were best represented by anxious and secure attachment style clusters. Members of the anxious attachment cluster exhibited more severe social anxiety and avoidance, greater depression, greater impairment, and lower life satisfaction than members of the secure attachment cluster. This pattern was replicated in a separate sample of 56 patients and compared with the pattern found in 36 control participants. Social anxiety mediated the association between attachment insecurity and depression. Findings are discussed in the context of their relevance to the etiology, maintenance, and cognitive-behavioral treatment of social anxiety disorder. PMID:12901398

  7. 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

  8. 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

  9. Panic disorder and health-related quality of life: the predictive roles of anxiety sensitivity and trait anxiety.

    PubMed

    Kang, Eun-Ho; Kim, Borah; Choe, Ah Young; Lee, Jun-Yeob; Choi, Tai Kiu; Lee, Sang-Hyuk

    2015-01-30

    Panic disorder (PD) is a very common anxiety disorder and is often a chronic disabling condition. However, little is known about the factors that predict health-related quality of life (HRQOL) other than sociodemographic factors and illness-related symptomatology that explain HRQOL in only small to modest degrees. This study explored whether anxiety-related individual traits including anxiety sensitivity and trait anxiety can predict independently HRQOL in panic patients. Patients with panic disorder with or without agoraphobia (N=230) who met the diagnostic criteria in the Structured Clinical Interview for DSM-IV were recruited. Stepwise regression analysis was performed to determine the factors that predict HRQOL in panic disorder. HRQOL was assessed by the 36-item Short-Form Health Survey (SF-36). Anxiety sensitivity was an independent predictor of bodily pain and social functioning whereas trait anxiety independently predicted all of the eight domains of the SF-36. Our data suggests that the assessment of symptomatology as well as individual anxiety-related trait should be included in the evaluation of HRQOL in panic patients. PMID:25466228

  10. The Relationship Between Parents' Poor Emotional Health Status and Childhood Mood and Anxiety Disorder in Florida Children, National Survey of Children's Health, 2011-2012.

    PubMed

    Reid, Keshia M

    2015-05-01

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

  11. Psychiatric disorders and cardiac anxiety in exercising and sedentary coronary artery disease patients: a case-control study

    PubMed Central

    Sardinha, A.; Araújo, C.G.S.; Nardi, A.E.

    2012-01-01

    Regular physical exercise has been shown to favorably influence mood and anxiety; however, there are few studies regarding psychiatric aspects of physically active patients with coronary artery disease (CAD). The objective of the present study was to compare the prevalence of psychiatric disorders and cardiac anxiety in sedentary and exercising CAD patients. A total sample of 119 CAD patients (74 men) were enrolled in a case-control study. The subjects were interviewed to identify psychiatric disorders and responded to the Cardiac Anxiety Questionnaire. In the exercise group (N = 60), there was a lower prevalence (45 vs 81%; P < 0.001) of at least one psychiatric diagnosis, as well as multiple comorbidities, when compared to the sedentary group (N = 59). Considering the Cardiac Anxiety Questionnaire, sedentary patients presented higher scores compared to exercisers (mean ± SEM = 55.8 ± 1.9 vs 37.3 ± 1.6; P < 0.001). In a regression model, to be attending a medically supervised exercise program presented a relevant potential for a 35% reduction in cardiac anxiety. CAD patients regularly attending an exercise program presented less current psychiatric diagnoses and multiple mental-related comorbidities and lower scores of cardiac anxiety. These salutary mental effects add to the already known health benefits of exercise for CAD patients. PMID:23011407

  12. Anxiety Levels in Students with Autism Spectrum Disorder Making the Transition from Primary to Secondary School

    ERIC Educational Resources Information Center

    Hannah, Elizabeth F.; Topping, Keith J.

    2012-01-01

    The anxiety levels of students with autism spectrum disorder (ASD) over the period of transition from primary to secondary school are investigated. A repeated measures design and an adapted version of a self-report measure, the Spence Children's Anxiety Scale (SCAS), are used to compare the anxiety levels of eight students before and after the…

  13. 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…

  14. Attentional Threat Avoidance and Familial Risk are Independently Associated with Childhood Anxiety Disorders

    ERIC Educational Resources Information Center

    Brown, Hannah M.; McAdams, Tom A.; Lester, Kathryn J.; Goodman, Robert; Clark, David M.; Eley, Thalia C.

    2013-01-01

    Background: Twin studies in children reveal that familial aggregation of anxiety disorders is due to both genetic and environmental factors. Cognitive biases for threat information are considered a robust characteristic of childhood anxiety. However, little is known regarding the underlying aetiology of such biases and their role in anxiety

  15. Lifetime posttraumatic stress disorder in Turkish alcohol-dependent inpatients: relationship with depression, anxiety and erectile dysfunction.

    PubMed

    Evren, Cuneyt; Can, Suat; Evren, Bilge; Saatcioglu, Omer; Cakmak, Duran

    2006-02-01

    The aim of the present study was to evaluate the prevalence of lifetime posttraumatic stress disorder (PTSD) in Turkish male alcohol-dependent inpatients, and to investigate the relationship of lifetime PTSD diagnosis with anxiety, depression, hopelessness, erectile dysfunction and psychosocial problems related with alcohol dependency. Eighty-two male inpatients who met DSM-IV criteria for alcohol dependence and 48 subjects without substance use disorder as a control group were included in the study. Subjects were applied the Hamilton Depression Rating Scale (HAM-D), the Hamilton Anxiety Rating Scale (HAM-A), the Michigan Alcoholism Screening Test (MAST), the Beck Hopelessness Scale (BHS) and the International Index of Erectile Function (IIEF). Rate of lifetime PTSD diagnosis was found to be 26.8% among alcohol-dependent inpatients. The mean age of patients with lifetime PTSD was lower than in patients without this diagnosis, while there were no significant differences between these two groups in terms of age of first alcohol use, lifetime major depression, current depression, presence and severity of erectile dysfunction. Mean scores of HAM-D, HAM-A, BHS and MAST in the group with lifetime PTSD were significantly higher than the group without this diagnosis. There was a positive relationship between lifetime PTSD diagnosis and depression, anxiety, hopelessness and severity of psychosocial problems related to alcohol dependency, while there was no relationship between lifetime PTSD comorbidity and erectile dysfunction in alcohol-dependent patients. PMID:16472362

  16. Disordered gambling and co-morbidity of psychiatric disorders among college students: an examination of problem drinking, anxiety and depression.

    PubMed

    Martin, Ryan J; Usdan, Stuart; Cremeens, Jennifer; Vail-Smith, Karen

    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. PMID:23430449

  17. Anxiety and quality of life: clinically anxious children with and without autism spectrum disorders compared.

    PubMed

    van Steensel, Francisca J A; Bögels, 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 group), compared with children with anxiety disorders (referred to as the AD group). In total, 237 families participated; 115 children were in the ASD group (90 boys and 25 girls, M age = 11.37 years), and 122 children were in the AD group (62 boys and 60 girls, M age = 12.79 years). Anxiety disorders, anxiety symptoms, ASD-like symptoms, and health-related quality of life were assessed with the ADIS-C/P, SCARED-71, CSBQ, and EuroQol-5D, respectively. The number and types of anxiety disorders, as well as their severity, were similar in the ASD and AD groups; however, specific phobias were more common in the ASD group than in the AD group. As compared to the AD group, parents from the ASD group reported their children to have higher scores for total anxiety, social anxiety disorder, and panic disorder. More ASD-like behaviors and higher anxiety severity predicted a lower quality of life, irrespective of group. The results of this study support a highly similar phenotype of anxiety disorders in children with ASD; however, additional research is needed to examine the etiology and treatment effectiveness of anxiety disorders in children with ASD. PMID:22775580

  18. Psychophysiologic Responses to Combat Imagery of Vietnam Veterans With Posttraumatic Stress Disorder Versus Other Anxiety Disorders

    Microsoft Academic Search

    Roger K. Pitman; Scott P. Orr; Dennis F. Forgue; Bruce Altman; Jacob B. de Jong; Lawrence R. Herz

    1990-01-01

    We used psychophysiologic techniques to assess responses to imagery of psychologically stressful past experiences in medication-free Vietnam combat veterans classified, on the basis of DSM-III-R criteria into posttraumatic stress disorder (PTSD; n = 7) or non-PTSD anxiety disorder (anxious; n = 7) groups. Scripts describing each individual's combat experiences were recorded and played back in the laboratory. Ss were instructed

  19. Cost-Effectiveness of Psychological and Pharmacological Interventions for Generalized Anxiety Disorder and Panic Disorder

    Microsoft Academic Search

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

    2004-01-01

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

  20. Efficacy of vilazodone on anxiety symptoms in patients with major depressive disorder

    PubMed Central

    Chen, Dalei; Edwards, John; Ruth, Adam

    2014-01-01

    Anxiety symptoms are prevalent in patients with major depressive disorder. A post-hoc analysis of two phase III trials was conducted to evaluate the efficacy of vilazodone on depression-related anxiety. Using the 17-item Hamilton Depression Rating Scale (HAMD17) Anxiety/Somatization subscale, patients were classified as anxious or nonanxious. Improvements in depressive symptoms were based on least squares mean changes in HAMD17 and Montgomery–Asberg Depression Rating Scale total scores. Anxiety symptoms in the anxious subgroup were evaluated using Hamilton Anxiety Rating Scale (HAMA) total and subscale (Psychic Anxiety, Somatic Anxiety) scores, HAMD17 Anxiety/Somatization subscale and item (Psychic Anxiety, Somatic Anxiety) scores, and the Montgomery–Asberg Depression Rating Scale Inner Tension item score. Most of the pooled study population [82.0% (708/863)] was classified with anxious depression. After 8 weeks of treatment, least squares mean differences between vilazodone and placebo for changes in HAMA total and HAMD17 Anxiety/Somatization subscale scores were ?1.82 (95% confidence interval ?2.81 to ?0.83; P<0.001) and ?0.75 (95% confidence interval ?1.17 to ?0.32; P<0.001), respectively. Statistically significant improvements with vilazodone were also found on all other anxiety-related measures, except the HAMA Somatic Anxiety subscale. Vilazodone may be effective in treating patients with major depressive disorder who exhibit somatic and/or psychic symptoms of anxiety. PMID:24978955

  1. Anxiety and depression in patients with gastrointestinal cancer: does knowledge of cancer diagnosis matter?

    Microsoft Academic Search

    Azadeh Tavoli; Mohammad Ali Mohagheghi; Ali Montazeri; Rasool Roshan; Zahra Tavoli; Sepideh Omidvari

    2007-01-01

    BACKGROUND: Gastrointestinal cancer is the first leading cause of cancer related deaths in men and the second among women in Iran. An investigation was carried out to examine anxiety and depression in this group of patients and to investigate whether the knowledge of cancer diagnosis affect their psychological distress. METHODS: This was a cross sectional study of anxiety and depression

  2. Eye Movement Desensitization and Reprocessing (EMDR) and the Anxiety Disorders

    Microsoft Academic Search

    Francine Shapiro

    1999-01-01

    Four recent, independent, rigorously controlled studies of Eye Movement Desensitization and Reprocessing (EMDR) have reported that 84 to 100% of single-trauma victims no longer maintain the posttraumatic stress disorder diagnosis after the equivalent of three 90-minute sessions. The rapidity of EMDR treatment effects makes many ancillary research opportunities available. Specifically, the increased number of cases resolved in a relatively short

  3. Integrating neurobiology and psychopathology into evidence-based treatment of social anxiety disorder.

    PubMed

    Liebowitz, Michael R; Ninan, Philip T; Schneier, Franklin R; Blanco, Carlos

    2005-10-01

    Social anxiety disorder (SAD) is a common, chronic psychiatric disorder characterized by a persistent fear of social or performance situations in which embarrassment can occur. This disorder typically appears during the mid-adolescent years and is unremitting throughout life if not properly treated. SAD presents as two subtypes: the more common and debilitating generalized form, and the nongeneralized form, which consists predominantly of performance anxiety. The majority of patients with SAD have comorbid mental disorders, including mood, anxiety, and substance abuse. No single development theory has been proposed to account for the origins of SAD, although current understanding of the etiology of SAD posits an interaction between psychological and biological factors. Risk factors include environmental and parenting influences and dysfunctional cognitive and conditioning events in early childhood. The neurobiology of SAD appears to involve neurochemical dysfunction, as evidenced by studies of neuroreceptor imaging, neuroendocrine function, and profiles of response to specific medications. Clinical trials have demonstrated that benzodiazepines and antidepressants are effective in the treatment of SAD. The selective serotonin reuptake inhibitors are emerging as the first-line treatment for SAD, based on their proven safety, tolerability, and efficacy. Goals for ongoing future research include development of approaches to achieve remission, to convert nonresponders and partial responders to full responders, and to prevent relapse and maintain long-term efficacy. This monograph explores the epidemiology, clinical presentation, and differential diagnosis of SAD, with a focus on neural circuitry of social relationships and neurochemical dysfunction. The prevalence, rates of recognition and treatment, patterns of comorbidity, quality-of-life issues, and natural history of SAD are discussed as well as pharmacologic and psychosocial treatment strategies for SAD. PMID:16404800

  4. Pharmacotherapy of anxiety disorders in German-speaking countries: current status and changes between 1994 and 2011.

    PubMed

    Holl, Anna K; Grohmann, Renate; Letmaier, Martin; Painold, Annamaria; Mörkl, Sabrina; Toto, Sermin; Kasper, Siegfried

    2015-04-01

    Over the past years, international treatment guidelines have been established for the treatment of anxiety disorders. Nevertheless, little is known as to whether the actual inpatient treatment follows these guidelines. The main goal of this study was to answer the question whether patients with anxiety disorder are treated according to treatment guidelines. A total of 2,573 psychiatric inpatients with the diagnosis of anxiety disorder (920 men, 1,653 women) were identified on the basis of the data of the international drug safety programme in psychiatry AMSP. Of these patients, 25.3 % presented with phobia, 26.6 % with panic disorder, 18.7 % with generalized anxiety disorder (GAD), and 29.4 % with other diagnoses of anxiety. In all of the patients, 12.7 % did not receive any psychotropic medication and 22.9 % were not treated with antidepressants. Only 59.3 % of patients with GAD, 73.9 % of patients with panic disorder, and 52.1 % of patients with phobia were treated according to diagnostic guidelines. The majority (60.3 %) of all patients received one or two psychotropic drugs, and only 3.7 % received five or more psychotropic drugs. In two groups of patients (one group with phobia and one with panic disorder), the annual prescription rate of antidepressants significantly increased over time. The prescription rate for anticonvulsants in patients with GAD increased from 0 % in 1997 to 41.7 % in 2011, and for antipsychotics, from 40.7 % in 1997 to 47.2 % in 2011. In particular, patients with GAD were commonly treated with antipsychotics. PMID:25138236

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

    Microsoft Academic Search

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

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

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

    ERIC Educational Resources Information Center

    Hipol, Leilani J.; Deacon, Brett J.

    2013-01-01

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

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

    Microsoft Academic Search

    Teresa J Linares Scott; Norah C. Feeny

    2006-01-01

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

  8. The Implementation of Modified Parent-Child Interaction Therapy for Youth with Separation Anxiety Disorder

    Microsoft Academic Search

    Donna B. Pincus; Lauren C. Santucci; Jill T. Ehrenreich; Sheila M. Eyberg

    2008-01-01

    Separation Anxiety Disorder (SAD) is the most prevalent anxiety disorder experienced by children, and yet empirical treatment studies of SAD in young children are virtually nonexistent. This paper will describe the development and implementation of an innovative treatment for SAD in young children. First, we will highlight the rationale for developing interventions specifically for SAD in young children. Second, we

  9. Risk factors, prevalence, and treatment of anxiety and depressive disorders in Pakistan: systematic review

    Microsoft Academic Search

    Ilyas Mirza; Rachel Jenkins

    2004-01-01

    Objectives To assess the available evidence on the prevalence, aetiology, treatment, and prevention of anxiety and depressive disorders in Pakistan. Design Systematic review of published literature. Studies reviewed 20 studies, of which 17 gave prevalence estimates and 11 discussed risk factors. Main outcome measures Prevalence of anxiety and depressive disorders, risk factors, effects of treatment. Results Factors positively associated with

  10. The Role of Emotion Regulation in the Treatment of Child Anxiety Disorders

    ERIC Educational Resources Information Center

    Hannesdottir, Dagmar Kristin; Ollendick, Thomas H.

    2007-01-01

    In this review, we examine the role of emotion regulation in the treatment of children with anxiety disorders. Cognitive-behavioral therapy (CBT) has been shown to "work" for children with anxiety disorders and it has been categorized as an evidence-based treatment. However, most studies have shown that the treatment is effective for about 60-70%…

  11. Patterns of Emotional Reactivity and Regulation in Children with Anxiety Disorders

    E-print Network

    Gross, James J.

    Patterns of Emotional Reactivity and Regulation in Children with Anxiety Disorders Tal Carthy + Business Media, LLC 2009 Abstract Emotion dysregulation is believed to be a key factor in anxiety disorders. However, the empirical basis for this view is limited, particularly in children and adolescents

  12. Disability Associated with Comorbid Anxiety Disorders in Women with Chronic Physical Illness in Ontario, Canada

    Microsoft Academic Search

    Tahany M. Gadalla

    2008-01-01

    Anxiety disorders are more prevalent in individuals with chronic physical illness compared to individuals with no such illness, and about twice as prevalent in women as in men. This study used data collected in the 2005 Canadian Community Health Survey (21,198 women and 20,478 men) to examine factors associated with comorbid anxiety disorders and to assess the relation of these

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

    ERIC Educational Resources Information Center

    Przeworski, Amy; Newman, Michelle G.

    2006-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2014-09-01

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

  17. 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

  18. An Innovative Treatment Approach for Children With Anxiety Disorders and Medically Unexplained Somatic Complaints

    PubMed Central

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

    2009-01-01

    Anxiety disorders in children and adolescents are largely undetected and the majority of youth do not receive services. Given the deleterious consequences of anxiety disorders, early identification and intervention have public health implications. In order to increase identification and treatment of anxious youth, expansion to nonpsychiatric settings (i.e., pediatric medical settings, schools) is necessary. Pediatric medical offices represent ideal settings for detection and intervention for several reasons: (1) access to large numbers of children, (2) high prevalence of unrecognized anxiety disorders in medical settings, and (3) an association between anxiety disorders and medically unexplained somatic symptoms. This paper describes a cognitive-behavioral intervention for youth who present to pediatric medical settings with nonmedical somatic symptoms and undiagnosed anxiety disorders. We explain the rationale for and focus of our treatment approach, present two case studies illustrating the treatment process, and conclude with a discussion of implementation considerations. PMID:19484139

  19. Relations Among Perceived Control Over Anxiety-Related Events, Worry, and Generalized Anxiety Disorder in a Sample of Adolescents

    Microsoft Academic Search

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

    2010-01-01

    This study examined the associations among perceived control over anxiety-related events, worry, and both symptoms and diagnoses\\u000a of generalized anxiety disorder (GAD). The sample was comprised of 140 adolescents (60 girls) between the ages of 10 and 17 years\\u000a (M\\u000a \\u000a age\\u000a ?=?14.6 years; SD?=?2.25) recruited from the general community. Findings were consistent with hypotheses. Self-reported perceived\\u000a control over anxiety-related events related negatively

  20. Acute Stress Disorder Following Diagnosis of Cancer

    Microsoft Academic Search

    Elizabeth L. McGarvey; Randolph J. Canterbury; Cheryl Koopman; Gail J. Clavet; Roger Cohen; Kimberly Largay; David Spiegel

    1998-01-01

    We conducted a study to examine prevalence, predictors, and concomitants of acute stress disorder (ASD) following diagnosis of cancer among 89 patients. In addition to other measures, each participant completed the Stanford Acute Stress Reaction Questionnaire (SASRQ). One-third (33%) of the sample met all ASD symptom criteria. Significantly more women than men met criteria for ASD. For women, predictors for

  1. 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…

  2. Anxiety disorders and comorbid sleep problems in school-aged youth: review and future research directions.

    PubMed

    Peterman, Jeremy S; Carper, Matthew M; Kendall, Philip C

    2015-06-01

    This review examines the relationship between anxiety disorders and sleep related problems (SRPs) in school-aged youth. Following an overview of normative sleep patterns and maturational sleep changes, the review addresses issues related to sleep measurement. SRPs are reviewed in relation to executive functions (e.g. affect regulation) as is the shared role of neurological regions in the regulation of anxiety and sleep. Studies of the association between SRPs and anxiety in anxiety-disordered samples are reviewed with explicit consideration of the potential mechanisms underlying the sleep-anxiety relationship (e.g., arousal, sleep hygiene, parental accommodation). Specific cognitive-behavioral treatments for SRPs and anxiety are reviewed with regard to their impact on comorbid anxiety or SRPs. Methodological limitations are noted and recommendations for future research are proposed. PMID:24962165

  3. Patterns and Predictors of Anxiety among Siblings of Children with Autism Spectrum Disorders

    PubMed Central

    Shivers, Carolyn M.; Deisenroth, Lauren K.; Taylor, Julie Lounds

    2012-01-01

    The purpose of this study was to examine patterns of anxiety among siblings of children with autism spectrum disorders (ASD), and determine the characteristics of the child with ASD and their parents that predicted anxiety. Data was collected from 1755 siblings of children with ASD whose families participated in the Simons Simplex Collection; siblings ranged in age from 3 to 18 years (M=9 years). Male siblings were at increased risk for sub-clinical anxiety problems during middle childhood. Parental history of anxiety disorders, higher maternal pragmatic language, and more proband behavior problems predicted higher anxiety. While siblings overall did not show elevated anxiety symptoms, higher rates of sub-clinical anxiety problems among males and siblings in middle childhood are cause for concern. PMID:23076507

  4. Differential effects of safety behaviour subtypes in social anxiety disorder.

    PubMed

    Plasencia, M Leili; Alden, Lynn E; Taylor, Charles T

    2011-10-01

    Clinical observations indicate that individuals with Social Anxiety Disorder (SAD) use a variety of safety behaviours; however, virtually no research has examined the functional effect of different safety-seeking strategies. Accordingly, we conducted two studies to address this issue. Study 1 measured global patterns of safety behaviour use in a large analogue sample. Factor analysis revealed two primary safety behaviour categories, avoidance and impression management. Study 2 assessed situational use of safety behaviours during a controlled social interaction in a clinical sample of 93 patients with Generalised SAD. Factor analysis again revealed support for avoidance and impression-management subtypes. Notably, the two types of safety behaviours were associated with different social outcomes. Avoidance safety behaviours were associated with higher state anxiety during the interaction and negative reactions from participants' interaction partners. Impression-management strategies appeared to impede corrections in negative predictions about subsequent interactions. These findings suggest that it may be beneficial to consider the unique effects of different safety-seeking strategies when assessing and treating SAD. PMID:21831356

  5. Gender Role Traits Among Individuals with Social Anxiety Disorder.

    PubMed

    Roberts, Karen E; Hart, Trevor A; Coroiu, Adina; Heimberg, Richard G

    2011-12-01

    The present study investigated differences between individuals with and without social anxiety disorder (SAD) in instrumentality and expressiveness, personality traits traditionally linked to the male and female gender roles, respectively. Based on evolutionary and self-discrepancy theories, it was hypothesized that individuals with SAD would score lower on instrumentality and report a discrepancy between their perceived and ideal level of instrumentality compared to control participants. Sixty-four patients with SAD and 31 non-anxious control participants completed a battery of questionnaires, including ratings of their perceived and ideal gender role attributes and current psychosocial distress. Results supported the hypotheses, and provided initial evidence that a discrepancy between perceived and ideal instrumentality may be linked to social anxiety severity, depression and lower quality of life. No differences were detected between groups in expressiveness. The present findings suggest that individuals with SAD perceive themselves to be deficient in instrumentality. They also suggest that increasing instrumentality among individuals with SAD may be beneficial for treatment. PMID:22131614

  6. Gender Role Traits Among Individuals with Social Anxiety Disorder

    PubMed Central

    Roberts, Karen E.; Hart, Trevor A.; Coroiu, Adina; Heimberg, Richard G.

    2011-01-01

    The present study investigated differences between individuals with and without social anxiety disorder (SAD) in instrumentality and expressiveness, personality traits traditionally linked to the male and female gender roles, respectively. Based on evolutionary and self-discrepancy theories, it was hypothesized that individuals with SAD would score lower on instrumentality and report a discrepancy between their perceived and ideal level of instrumentality compared to control participants. Sixty-four patients with SAD and 31 non-anxious control participants completed a battery of questionnaires, including ratings of their perceived and ideal gender role attributes and current psychosocial distress. Results supported the hypotheses, and provided initial evidence that a discrepancy between perceived and ideal instrumentality may be linked to social anxiety severity, depression and lower quality of life. No differences were detected between groups in expressiveness. The present findings suggest that individuals with SAD perceive themselves to be deficient in instrumentality. They also suggest that increasing instrumentality among individuals with SAD may be beneficial for treatment. PMID:22131614

  7. Pregabalin for the treatment of generalized anxiety disorder: an update

    PubMed Central

    Baldwin, David S; Ajel, Khalil; Masdrakis, Vasilios G; Nowak, Magda; Rafiq, Rizwan

    2013-01-01

    A previous review summarized what was then known about the potential role of pregabalin in the treatment of patients with generalized anxiety disorder (GAD): this review provides an update on its pharmacological properties and presumed mechanism of action, the liability for abuse, and efficacy and tolerability in patients with GAD. Pregabalin has a similar molecular structure to the inhibitory neurotransmitter gamma amino butyric acid (GABA) but its mechanism of action does not appear to be mediated through effects on GABA. Instead, its anxiolytic effects may arise through high-affinity binding to the alpha-2-delta sub-unit of the P/Q type voltage-gated calcium channel in “over-excited” presynaptic neurons, thereby reducing the release of excitatory neurotransmitters such as glutamate. The findings of randomized controlled trials and meta-analyses together indicate that pregabalin is efficacious in both acute treatment and relapse prevention in GAD, with some evidence of an early onset of effect, and broad efficacy in reducing the severity of psychological and physical symptoms of anxiety. It also has efficacy as an augmenting agent after non-response to antidepressant treatment in GAD. Continuing vigilance is needed in assessing its potential abuse liability but the tolerability profile of pregabalin may confer some advantages over other pharmacological treatments in the short term for treatment in patients with GAD. PMID:23836974

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

    PubMed Central

    2013-01-01

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

  9. Social anxiety disorder: A review of environmental risk factors

    PubMed Central

    Brook, Christina A; Schmidt, Louis A

    2008-01-01

    Social anxiety disorder (SAD) is a debilitating and chronic illness characterized by persistent fear of one or more social or performance situations, with a relatively high lifetime prevalence of 7% to 13% in the general population. Although the last two decades have witnessed enormous growth in the study of biological and dispositional factors underlying SAD, comparatively little attention has been directed towards environmental factors in SAD, even though there has been much ongoing work in the area. In this paper, we provide a recent review and critique of proposed environmental risk factors for SAD, focusing on traditional as well as some understudied and overlooked environmental risk factors: parenting and family environment, adverse life events, cultural and societal factors, and gender roles. We also discuss the need for research design improvements and considerations for future directions. PMID:18728768

  10. Association of ADHD, Tics, and Anxiety with Dopamine Transporter ("DAT1") Genotype in Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Gadow, Kenneth D.; Roohi, Jasmin; DeVincent, Carla J.; Hatchwell, Eli

    2008-01-01

    Background: Autism spectrum disorder (ASD) is associated with high rates of psychiatric disturbance to include attention-deficit/hyperactivity disorder (ADHD), tic disorder, and anxiety disorders. The aim of the present study was to examine the association between a variable number tandem repeat (VNTR) functional polymorphism located in the…

  11. The effect of communication deficits on anxiety symptoms in infants and toddlers with autism spectrum disorders.

    PubMed

    Davis, Thompson E; Moree, Brittany N; Dempsey, Timothy; Hess, Julie A; Jenkins, Whitney S; Fodstad, Jill C; Matson, Johnny L

    2012-03-01

    Autism spectrum disorders (ASDs) are life-long developmental disorders characterized by impairments in the development of reciprocal social and communication skills, abnormal language development, and a restricted repertoire of behaviors and interests. While it has been known for some time that children with ASD can evince elevated rates of anxiety symptoms, little research has been conducted on whether deficits in communication skills affect the range of anxiety symptoms in infants and toddlers with ASD. This study represents a first attempt to determine whether deficits in communication skills have an effect on the expression of anxiety in infants and toddlers with autistic disorder and pervasive developmental disorder-not otherwise specified. Seven hundred thirty-five infants were evaluated with respect to the nature and extent of anxiety symptoms and developmental functioning. Both receptive and expressive communication skills appeared to play a significant role in the manifestation of anxiety symptoms. PMID:22304886

  12. Obsessive–compulsive disorder, anxiety disorders, and self-esteem: an exploratory study

    Microsoft Academic Search

    Kimberly A Ehntholt; Paul M Salkovskis; Katharine A Rimes

    1999-01-01

    In a preliminary investigation of the link between self-esteem and obsessional problems, patients with OCD were compared with people suffering from other anxiety disorders and non-anxious controls. A questionnaire was devised which allowed the reliable coding of open ended responses focussed on issues surrounding self-worth; standardized measures of self-esteem and clinical symptomatology were also administered. Results indicated that both clinical

  13. DSM-IV and DSM-5 social anxiety disorder in the Australian community

    PubMed Central

    Grove, Rachel; Baillie, Andrew J; Sunderland, Matthew; Teesson, Maree; Slade, Tim

    2015-01-01

    Objective: Current and accurate estimates of prevalence, correlates, comorbid concerns and treatment-seeking behaviours associated with disorders are essential for informing policy, clinical practice and research. The most recent snapshot of social anxiety disorder in Australia was published more than a decade ago, with significant changes to the accessibility of mental health treatment services and diagnostic measures occurring during this period. This paper aims to (i) update the understanding of social anxiety disorder, its associations and patterns of treatment-seeking behaviours in the Australian population, and (ii) explore the impact of revised diagnostic criteria detailed in the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) on prevalence estimates. Methods: The National Survey of Mental Health and Wellbeing (NSMHWB) was conducted by the Australian Bureau of Statistics in 2007, collecting information from a nationally representative random sample of 8841 Australians aged 16–85 years. The presence of social anxiety disorder diagnostic criteria and related disorders were assessed over 12 months and lifetime periods using the World Mental Health Composite International Diagnostic Interview. Results: Profiles of social anxiety disorder were consistent with previous estimates, with higher prevalence in females and younger age groups. Of the 8.4% of Australians meeting criteria for social anxiety disorder at some point in their lifetime (12-month prevalence 4.2%), a majority also experienced comorbid mental health concerns (70%). The revised performance-only specifier included in the DSM-5 was applicable to only 0.3% of lifetime cases. Just over 20% of people reporting social anxiety disorder as their primary concern sought treatment, most commonly through general practitioners. Conclusions: Social anxiety disorder continues to be prevalent in the Australian population and highly related to other disorders, yet few people experiencing social anxiety disorder seek treatment PMID:25122449

  14. Efficacy of a Manualized and Workbook-Driven Individual Treatment for Social Anxiety Disorder

    Microsoft Academic Search

    David M. Fresco; Richard G. Heimberg; Debra A. Hope; Sarah A. Hayes; Talia I. Zaider; Melanie Van Dyke; Cynthia L. Turk; Cynthia Kraus

    2009-01-01

    Social anxiety disorder is a prevalent and impairing disorder for which viable cognitive-behavioral therapies exist. However, these treatments have not been easily packaged for dissemination and may be underutilized as a result. The current study reports on the findings of a randomized controlled trial of a manualized and workbook-driven individual cognitive-behavioral treatment for social anxiety disorder (Hope, Heimberg, Juster, &

  15. Threat Reappraisal as a Mediator of Symptom Change in Cognitive-Behavioral Treatment of Anxiety Disorders: A Systematic Review

    PubMed Central

    Smits, Jasper A. J.; Julian, Kristin; Rosenfield, David; Powers, Mark B.

    2012-01-01

    Objective Identifying mediators of therapeutic change is important to the development of interventions and augmentation strategies. Threat reappraisal is considered a key mediator underlying the effects of cognitive-behavioral therapy for anxiety disorders. The present study systematically reviewed the evidence for the threat reappraisal mediation hypothesis. Method In our review we included studies that: (1) investigated the threat reappraisal mediation hypothesis; (2) included adults with an anxiety disorder diagnosis; (3) employed a longitudinal design; and (4) did not report on previously published findings (to avoid the inclusion of multiple reports of the same data). After data extraction, we made review-specific quality judgments for each study using the following a priori criteria informed by mediation theory: (1) demonstrated statistical mediation; (2) demonstrated that CBT caused threat reappraisal; (3) demonstrated that threat reappraisal caused anxiety reduction; and (4) demonstrated specificity of the threat reappraisal-anxiety reduction relation. Results Of the 2,296 studies we identified, 25 met inclusion criteria. Of these studies, 56% tested and 52% established statistical mediation, 52% tested and 28% established CBT as a cause of threat reappraisal, 28% tested and 24% established threat reappraisal as a cause of anxiety reduction, and 44% tested and 36% established specificity of the threat reappraisal-anxiety reduction relation. Conclusions While threat reappraisal is related to anxiety symptom improvement with CBT, there are few extant studies that meet most of the criteria necessary to conclusively demonstrate that it causes symptom improvement in CBT and that it is not a proxy for other third variables. Recommendations for future research in this area are discussed. PMID:22686124

  16. The impacts of migraine and anxiety disorders on painful physical symptoms among patients with major depressive disorder

    PubMed Central

    2014-01-01

    Background No study has simultaneously investigated the impacts of migraine and anxiety disorders on painful physical symptoms (PPS) among patients with major depressive disorder (MDD). The study aimed to investigate this issue. Methods This open-label study enrolled 155 outpatients with MDD, who were then treated with venlafaxine 75 mg per day for four weeks. Eighty-five participants with good compliance completed the treatment. Migraine was diagnosed according to the International Classification of Headache Disorders. MDD and anxiety disorders were diagnosed using the Structured Clinical Interview for DSM-IV-TR. The visual analog scale (VAS) was used to evaluate the severity of eight PPS. Multiple linear and logistic regressions were used to investigate the impacts of migraine and anxiety disorders on PPS. Results Compared with patients without migraine, patients with migraine had a greater severity of PPS at baseline and post-treatment. After controlling for demographic variables and depressive severity, migraine independently predicted the intensities of eight PPS at baseline and four PPS post-treatment. Moreover, migraine independently predicted poorer treatment responses of chest pain and full remission of pains in the head, chest, neck and/or shoulder. Anxiety disorders predicted less full remission of pains in the abdomen and limbs. Conclusion Migraine and anxiety disorders have negative impacts on PPS among patients with MDD. Integrating the treatment of migraine and anxiety disorders into the management of depression might help to improve PPS and the prognosis of MDD. PMID:25382691

  17. The ?-endomannosidase gene (MANEA) is associated with panic disorder and social anxiety disorder

    PubMed Central

    Jensen, K P; Stein, M B; Kranzler, H R; Yang, B Z; Farrer, L A; Gelernter, J

    2014-01-01

    Unbiased genome-wide approaches can provide novel insights into the biological pathways that are important for human behavior and psychiatric disorder risk. The association of ?-endomannosidase gene (MANEA) variants and cocaine-induced paranoia (CIP) was initially described in a study that used a whole-genome approach. Behavioral effects have been reported for other mannosidase genes, but MANEA function in humans and the clinical potential of the previous findings remain unclear. We hypothesized that MANEA would be associated with psychiatric phenotypes unrelated to cocaine use. We used a multi-stage association study approach starting with four psychiatric disorders to show an association between a MANEA single-nucleotide polymorphism (SNP; rs1133503) and anxiety disorders. In the first study of 2073 European American (EA) and 2459 African American subjects mostly with comorbid drug or alcohol dependence, we observed an association in EAs of rs1133503 with panic disorder (PD) (191 PD cases, odds ratio (OR)=1.7 (95% confidence interval (CI): 1.22–2.41), P=0.002). We replicated this finding in an independent sample of 142 PD cases (OR =1.53 (95% CI: 1.00–2.31), P=0.043) and extended it in an independent sample of 131 generalized social anxiety disorder cases (OR=2.15 (95% CI: 1.27–3.64), P=0.004). MANEA alleles and genotypes were also associated with gene expression differences in whole blood cells. Using publically available data, we observed a consistent effect on expression in brain tissue. We conclude that pathways involving ?-endomannosidase warrant further investigation in relation to anxiety disorders. PMID:24473444

  18. The ?-endomannosidase gene (MANEA) is associated with panic disorder and social anxiety disorder.

    PubMed

    Jensen, K P; Stein, M B; Kranzler, H R; Yang, B Z; Farrer, L A; Gelernter, J

    2014-01-01

    Unbiased genome-wide approaches can provide novel insights into the biological pathways that are important for human behavior and psychiatric disorder risk. The association of ?-endomannosidase gene (MANEA) variants and cocaine-induced paranoia (CIP) was initially described in a study that used a whole-genome approach. Behavioral effects have been reported for other mannosidase genes, but MANEA function in humans and the clinical potential of the previous findings remain unclear. We hypothesized that MANEA would be associated with psychiatric phenotypes unrelated to cocaine use. We used a multi-stage association study approach starting with four psychiatric disorders to show an association between a MANEA single-nucleotide polymorphism (SNP; rs1133503) and anxiety disorders. In the first study of 2073 European American (EA) and 2459 African American subjects mostly with comorbid drug or alcohol dependence, we observed an association in EAs of rs1133503 with panic disorder (PD) (191 PD cases, odds ratio (OR)=1.7 (95% confidence interval (CI): 1.22-2.41), P=0.002). We replicated this finding in an independent sample of 142 PD cases (OR =1.53 (95% CI: 1.00-2.31), P=0.043) and extended it in an independent sample of 131 generalized social anxiety disorder cases (OR=2.15 (95% CI: 1.27-3.64), P=0.004). MANEA alleles and genotypes were also associated with gene expression differences in whole blood cells. Using publically available data, we observed a consistent effect on expression in brain tissue. We conclude that pathways involving ?-endomannosidase warrant further investigation in relation to anxiety disorders. PMID:24473444

  19. Disseminating treatment for anxiety disorders step 2: peer recommendations to seek help.

    PubMed

    Schubert, Jessica R; Coles, Meredith E; Heimberg, Richard G; Weiss, Barry D

    2014-10-01

    Despite the high prevalence of and significant psychological burden caused by anxiety disorders, as few as 25% of individuals with these disorders seek treatment, and treatment seeking by African-Americans is particularly uncommon. This purpose of the current study was to gather information regarding the public's recommendations regarding help-seeking for several anxiety disorders and to compare Caucasian and African-American participants on these variables. A community sample of 577 US adults completed a telephone survey that included vignettes portraying individuals with generalized anxiety disorder (GAD), social phobia/social anxiety disorder (SP/SAD), panic disorder (PD), and for comparison, depression. The sample was ˝ Caucasian and ˝ African American. Respondents were significantly less likely to recommend help-seeking for SP/SAD and GAD (78.8% and 84.3%, respectively) than for depression (90.9%). In contrast, recommendations to seek help for panic disorder were common (93.6%) and similar to rates found for depression. The most common recommendations were to seek help from a primary care physician (PCP). African Americans were more likely to recommend help-seeking for GAD than Caucasians. Findings suggested that respondents believed individuals with anxiety disorders should seek treatment. Given that respondents often recommended consulting a PCP, we recommend educating PCPs about anxiety disorders and empirically-supported interventions. PMID:25145571

  20. The Relationship Between Sluggish Cognitive Tempo, Subtypes of Attention-Deficit\\/Hyperactivity Disorder, and Anxiety Disorders

    Microsoft Academic Search

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

    2011-01-01

    The objective of the present study was to examine the relationship between sluggish cognitive tempo (SCT), subtypes of attention-deficit\\/hyperactivity\\u000a disorder (ADHD), and anxiety disorders (AnxDs). One hundred and forty-one children (90 males, 51 females) aged 7–13 years\\u000a were assigned to four groups, i.e., referred children with comorbid AnxDs and ADHD (n?=?25), ADHD (n?=?39), AnxDs (n?=?41), and nonreferred controls (n?=?36). Furthermore we

  1. Bad dream frequency in older adults with generalized anxiety disorder: prevalence, correlates, and effect of cognitive behavioral treatment for anxiety.

    PubMed

    Nadorff, Michael R; Porter, Ben; Rhoades, Howard M; Greisinger, Anthony J; Kunik, Mark E; Stanley, Melinda A

    2014-01-01

    This study investigated the relation between generalized anxiety disorder (GAD) and frequency of bad dreams in older adults. A secondary analysis from a randomized clinical trial comparing cognitive behavioral therapy (CBT) for anxiety to enhanced usual care (EUC) assessed bad dream frequency at baseline, post treatment (3 months), and at 6, 9, 12, and 15 months. Of 227 participants (mean age = 67.4), 134 met GAD diagnostic criteria (CBT = 70, EUC = 64), with the remaining 93 serving as a comparison group. Patients with GAD had significantly more bad dreams than those without, and bad dream frequency was significantly associated with depression, anxiety, worry, and poor quality of life. CBT for anxiety significantly reduced bad dream frequency at post treatment and throughout follow up compared to EUC. PMID:23470116

  2. 38 CFR 4.125 - Diagnosis of mental disorders.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...disorder is changed, the rating agency shall determine whether the new diagnosis represents progression of the prior diagnosis, correction of an error in the prior diagnosis, or development of a new and separate condition. If it is not...

  3. Association between exposure to traumatic events and anxiety disorders in a post-conflict setting: a cross-sectional community study in South Sudan

    PubMed Central

    2014-01-01

    Background The negative effect of exposure to traumatic events on mental health is well known. Most studies of the effects of trauma on mental health in war-affected populations have focused on post-traumatic stress disorder (PTSD) and depression. Although some studies confirm the existence of anxiety symptoms in war-affected populations, the extent to which exposure to traumatic events is independently associated with anxiety diagnoses (other than PTSD) has received less attention. The study aimed to determine whether having an anxiety diagnosis, other than PTSD, was associated with experiencing traumatic events in a post-conflict setting, across genders and after controlling for demographic and socio-economic variables. Methods In this cross-sectional community study (n?=?1200), we applied the Harvard Trauma Questionnaire (HTQ) to investigate the extent of trauma exposure and PTSD. The Mini-International Neuropsychiatric Interview (MINI) was used to investigate the prevalence of anxiety disorders: generalized anxiety disorder (GAD), panic disorder (PD), social phobia, obsessive-compulsive disorder (OCD), and agoraphobia. Multinomial logistic regression analyses were conducted to examine the association between these disorders, previous trauma exposure, and socio-economic factors. Results The participants were 56.4% male and 43.6% female. The age ranged between 18 and 73 years old (Mean 34.63, SD?=?12.03). The estimated rates of GAD-only and PD-only (without comorbidity with PTSD) were 5.5% and 3.1%, respectively. Exposure to traumatic events and socio-economic disadvantage were significantly associated with having one or more anxiety diagnoses. After controlling for age, sex, rural/urban setting, and socio-economic disadvantage, exposure to trauma was independently associated with anxiety diagnosis. There were gender differences in the pattern of risk factors for having PTSD, GAD or PD. Conclusion In individuals with a history of war-related trauma exposure, attention should be given to symptoms of GAD and PD, in addition to PTSD symptoms. PMID:24410951

  4. A Preliminary Investigation of the Spence Children's Anxiety Parent Scale as a Screening Tool for Anxiety in Young People with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

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

    2014-01-01

    Despite high rates of clinically elevated anxiety difficulties in children and adolescents with autism spectrum disorders (ASDs), very few studies have systematically examined the usefulness of commonly used caregiver report anxiety screening tools with this population. This study investigated the use of the Spence Children's Anxiety

  5. Decreased hair cortisol concentrations in generalised anxiety disorder.

    PubMed

    Steudte, Susann; Stalder, Tobias; Dettenborn, Lucia; Klumbies, Elisabeth; Foley, Paul; Beesdo-Baum, Katja; Kirschbaum, Clemens

    2011-04-30

    Previous research examining hypothalamic-pituitary-adrenal (HPA) axis activity in generalised anxiety disorder (GAD) has suggested a general hypercortisolism. These studies have mostly relied on salivary, plasma or urinary assessments, reflecting cortisol secretion over short time periods. The current study utilised the novel method of cortisol assessment in hair to obtain a retrospective index of cortisol secretion over a prolonged period of time. Hair cortisol levels were determined in 15 GAD patients and in 15 age- and gender-matched controls. In addition, participants collected six saliva samples (on awakening, +30 min, 12:00, 16:00, 20:00 h and at bedtime) on two consecutive weekdays for the assessment of the diurnal cortisol profile. Results revealed significantly lower (50-60%) cortisol levels in the first and second 3-cm hair segments of GAD patients compared to those of controls. No significant between-group differences were seen in diurnal cortisol profiles. The hair cortisol findings tentatively suggest that under naturalistic conditions GAD is associated with hypocortisolism. If corroborated by future research, this demonstrates the important qualities of cortisol measurement in hair as an ecologically valid, retrospective index of long-term cortisol secretion and as a marker for psychiatric disorders associated with hypo- or hypercortisolism. PMID:20889215

  6. Symptom Overlap between Autism Spectrum Disorder, Generalized Social Anxiety Disorder and Obsessive-Compulsive Disorder in Adults: A Preliminary Case-Controlled Study

    Microsoft Academic Search

    Danielle C. Cath; Natalie Ran; Johannes H. Smit; Hannie C. Comijs

    2008-01-01

    Background: Obsessive-compulsive disorder (OCD) and social anxiety disorder (SAD) frequently co-occur in persons with autism spectrum disorder (ASD). We studied which features distinguish ‘pure’ anxiety disordered patients from those with co-morbid ASD. Method: In a case-controlled design in which groups were matched for age, sex and educational level, patients with OCD or SAD and co-morbid ASD were compared with patients

  7. Commentary on Empirical Examinations of the Association between Anxiety and Eating Disorders

    PubMed Central

    Keel, Pamela K.

    2013-01-01

    A substantial body of research supports comorbidity between eating and anxiety disorders, and articles in this special section explore the nature of this association using severity different research designs. This commentary reviews findings from these articles included, focusing on inferences that may be drawn from each design. Collectively, articles support the need for future studies to examine whether eating and anxiety disorders share underlying mechanisms. If identified, such mechanisms could create opportunities for transdiagnostic interventions that ameliorate suffering from both eating and anxiety disorders PMID:24187397

  8. Perceived Control is a Transdiagnostic Predictor of Cognitive-Behavior Therapy Outcome for Anxiety Disorders.

    PubMed

    Gallagher, Matthew W; Naragon-Gainey, Kristin; Brown, Timothy A

    2014-02-01

    Perceived control has been proposed to be a general psychological vulnerability factor that confers an elevated risk for developing anxiety disorders, but there is limited research examining perceived control during cognitive-behavioral therapies (CBT). The present study examined whether treatment resulted in improvements in perceived control, and the indirect effects of CBT on changes in symptoms of obsessive-compulsive disorder, social phobia, generalized anxiety disorder, and panic disorder via changes in perceived control. Participants (n = 606) were a large clinical sample presenting for treatment at an outpatient anxiety disorders clinic. Participants completed a series of self-report questionnaires and a structured clinical interview at an intake evaluation and at two follow-up assessments 12 and 24 months later, with the majority of participants initiating CBT between the first two assessments. Results of latent growth curve models indicated that individuals initiating CBT subsequently reported large increases in perceived control and significant indirect effects of treatment on intraindividual changes in each of the four anxiety disorders examined via intraindividual changes in perceived control. These results suggest that the promotion of more adaptive perceptions of control is associated with recovery from anxiety disorders. Furthermore, the consistent finding of indirect effects across the four anxiety disorders examined underscores the transdiagnostic importance of perceived control in predicting CBT outcomes. PMID:24563563

  9. Mindfulness and Anxiety Disorders: Developing a Wise Relationship with the Inner Experience of Fear

    Microsoft Academic Search

    Jeffrey Greeson; Jeffrey Brantley

    \\u000a Perhaps no condition better illustrates the intimate relationship between brain and behavior – mind and body – as the inner\\u000a experience of fear. In this chapter, we present an integrative scientific view of anxiety and clinical anxiety disorders,\\u000a with an emphasis on awareness and acceptance as a foundation for mind\\/body health. Whereas anxiety-related psychopathology\\u000a is characterized by a desire to

  10. Fibromyalgia comorbid with anxiety disorders and depression: combined medical and psychological treatment.

    PubMed

    Bernik, Marcio; Sampaio, Thiago P A; Gandarela, Lucas

    2013-09-01

    Fibromyalgia is associated with high level of pain and suffering. Lack of diagnosis leads to onerous indirect economic costs. Recent data indicate that fibromyalgia; anxiety disorders, and depression tend to occur as comorbid conditions. They also share some common neurochemical dysfunctions and central nervous system alterations such as hypofunctional serotonergic system and altered reactivity of the hypothalamic-pituitary-adrenal axis. Conversely, functional neuroimaging findings point to different patterns of altered pain processing mechanisms between fibromyalgia and depression. There is no cure for fibromyalgia, and treatment response effect size is usually small to moderate. Treatment should be based on drugs that also target the comorbid psychiatric condition. Combined pharmacotherapy and cognitive-behavior therapy should ideally be offered to all patients. Lifestyle changes, such as physical exercise should be encouraged. The message to patients should be that all forms of pain are true medical conditions and deserve proper care. PMID:23904203

  11. Childhood Maltreatment Is Associated with Larger Left Thalamic Gray Matter Volume in Adolescents with Generalized Anxiety Disorder

    PubMed Central

    Liao, Mei; Yang, Fan; Zhang, Yan; He, Zhong; Song, Ming; Jiang, Tianzi; Li, Zexuan; Lu, Shaojia; Wu, Weiwei; Su, Linyan; Li, Lingjiang

    2013-01-01

    Background Generalized anxiety disorder (GAD) is a common anxiety disorder that usually begins in adolescence. Childhood maltreatment is highly prevalent and increases the possibility for developing a variety of mental disorders including anxiety disorders. An earlier age at onset of GAD is significantly related to maltreatment in childhood. Exploring the underpinnings of the relationship between childhood maltreatment and adolescent onset GAD would be helpful in identifying the potential risk markers of this condition. Methods Twenty-six adolescents with GAD and 25 healthy controls participated in this study. A childhood trauma questionnaire (CTQ) was introduced to assess childhood maltreatment. All subjects underwent high-resolution structural magnetic resonance scans. Voxel-based morphometry (VBM) was used to investigate gray matter alterations. Results Significantly larger gray matter volumes of the right putamen were observed in GAD patients compared to healthy controls. In addition, a significant diagnosis-by-maltreatment interaction effect for the left thalamic gray matter volume was revealed, as shown by larger volumes of the left thalamic gray matter in GAD patients with childhood maltreatment compared with GAD patients without childhood maltreatment as well as with healthy controls with/without childhood maltreatment. A significant positive association between childhood maltreatment and left thalamic gray matter volume was only seen in GAD patients. Conclusions These findings revealed an increased volume in the subcortical regions in adolescent GAD, and the alterations in the left thalamus might be involved in the association between childhood maltreatment and the occurrence of GAD. PMID:23951265

  12. Signs of Mood and Anxiety Disorders in Chimpanzees

    PubMed Central

    Ferdowsian, Hope R.; Durham, Debra L.; Kimwele, Charles; Kranendonk, Godelieve; Otali, Emily; Akugizibwe, Timothy; Mulcahy, J. B.; Ajarova, Lilly; Johnson, Cassie Meré

    2011-01-01

    Background In humans, traumatic experiences are sometimes followed by psychiatric disorders. In chimpanzees, studies have demonstrated an association between traumatic events and the emergence of behavioral disturbances resembling posttraumatic stress disorder (PTSD) and depression. We addressed the following central question: Do chimpanzees develop posttraumatic symptoms, in the form of abnormal behaviors, which cluster into syndromes similar to those described in human mood and anxiety disorders? Methodology/Principal Findings In phase 1 of this study, we accessed case reports of chimpanzees who had been reportedly subjected to traumatic events, such as maternal separation, social isolation, experimentation, or similar experiences. We applied and tested DSM-IV criteria for PTSD and major depression to published case reports of 20 chimpanzees identified through PrimateLit. Additionally, using the DSM-IV criteria and ethograms as guides, we developed behaviorally anchored alternative criteria that were applied to the case reports. A small number of chimpanzees in the case studies met DSM-IV criteria for PTSD and depression. Measures of inter-rater reliability, including Fleiss' kappa and percentage agreement, were higher with use of the alternative criteria for PTSD and depression. In phase 2, the alternative criteria were applied to chimpanzees living in wild sites in Africa (n?=?196) and chimpanzees living in sanctuaries with prior histories of experimentation, orphanage, illegal seizure, or violent human conflict (n?=?168). In phase 2, 58% of chimpanzees living in sanctuaries met the set of alternative criteria for depression, compared with 3% of chimpanzees in the wild (p?=?0.04), and 44% of chimpanzees in sanctuaries met the set of alternative criteria for PTSD, compared with 0.5% of chimpanzees in the wild (p?=?0.04). Conclusions/Significance Chimpanzees display behavioral clusters similar to PTSD and depression in their key diagnostic criteria, underscoring the importance of ethical considerations regarding the use of chimpanzees in experimentation and other captive settings. PMID:21698223

  13. History of trauma and dissociative symptoms among patients with obsessive-compulsive disorder and social anxiety disorder

    Microsoft Academic Search

    Leonardo F. Fontenelle; Aline M. Domingues; Wanderson F. Souza; Mauro V. Mendlowicz; Gabriela B. de Menezes; Ivan L. Figueira; Marcio Versiani

    2007-01-01

    We aimed to compare the history of trauma and the profile and severity of dissociative symptoms of patients with obsessive-compulsive\\u000a disorder (OCD) to those of patients with social anxiety disorder (SAD). Patients with OCD (n = 34) and patients with SAD (n = 30) were examined with the following instruments: Trauma History Questionnaire (THQ), Dissociative Experience Scale (DES),\\u000a Obsessive-Compulsive Inventory (OCI), Liebowitz Social Anxiety

  14. Do Anxiety-Disordered Children Need to Come into the Clinic for Efficacious Treatment?

    ERIC Educational Resources Information Center

    Cobham, Vanessa E.

    2012-01-01

    Objective: This study compared 3 experimental conditions: wait-list, therapist-supported bibliotherapy, and individual therapy, in the treatment of child anxiety. Method: Participants were 55 children (25 girls and 30 boys), aged 7 to 14 years diagnosed with an anxiety disorder, and their parents. Families were assigned using a modified random…

  15. Cognitive?Behavioral Group Treatments in Childhood Anxiety Disorders: The Role of Parental Involvement

    Microsoft Academic Search

    SANDRA L. MENDLOWITZ; KATHARINA MANASSIS; SUSAN BRADLEY; DONNA SCAPILLATO; SOLVEIGA MIEZITIS; BRIAN E SHAW

    1999-01-01

    ObjectiveThis study examined (1) the effect of a cognitive-behavioral group intervention on anxiety, depression, and coping strategies in school-age children (aged 7–12 years) with Axis I anxiety disorders; and (2) the effect of parental involvement on treatment outcomes.

  16. Child-Parent Interventions for Childhood Anxiety Disorders: A Systematic Review and Meta-Analysis

    ERIC Educational Resources Information Center

    Brendel, Kristen Esposito; Maynard, Brandy R.

    2014-01-01

    Objective: This study compared the effects of direct child-parent interventions to the effects of child-focused interventions on anxiety outcomes for children with anxiety disorders. Method: Systematic review methods and meta-analytic techniques were employed. Eight randomized controlled trials examining effects of family cognitive behavior…

  17. Is Behavioral Regulation in Children with ADHD Aggravated by Comorbid Anxiety Disorder?

    ERIC Educational Resources Information Center

    Sorensen, Lin; Plessen, Kerstin J.; Nicholas, Jude; Lundervold, Astri J.

    2011-01-01

    Background: The present study investigated the impact of coexisting anxiety disorder in children with ADHD on their ability to regulate behavior. Method: Parent reports on the Behavior Rating Inventory of Executive Function (BRIEF) in a comorbid group of children with ADHD and anxiety (n = 11) were compared to BRIEF reports in a group of children…

  18. Anxiety, Sensory Over-Responsivity, and Gastrointestinal Problems in Children with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Mazurek, Micah O.; Vasa, Roma A.; Kalb, Luther G.; Kanne, Stephen M.; Rosenberg, Daniel; Keefer, Amy; Murray, Donna S.; Freedman, Brian; Lowery, Lea Ann

    2013-01-01

    Children with autism spectrum disorders (ASD) experience high rates of anxiety, sensory processing problems, and gastrointestinal (GI) problems; however, the associations among these symptoms in children with ASD have not been previously examined. The current study examined bivariate and multivariate relations among anxiety, sensory…

  19. Complex Psychiatric Comorbidity of Treatment-Seeking Youth with Autism Spectrum Disorder and Anxiety Symptoms

    ERIC Educational Resources Information Center

    Hepburn, Susan L.; Stern, Jessica A.; Blakeley-Smith, Audrey; Kimel, Lila K.; Reaven, Judith A.

    2014-01-01

    This descriptive study examines the complexity of psychiatric comorbidity in treatment-seeking youth with ASD and anxiety symptoms. Forty-two parents of youth with ASD and anxiety (ages 8-14) completed a structured diagnostic interview (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version). Youth…

  20. The Role of Self-Statements as a Mediator in Treatment for Youth with Anxiety Disorders

    ERIC Educational Resources Information Center

    Kendall, Philip C.; Treadwell, Kimberli R. H.

    2007-01-01

    The authors investigated features of self-statements as predictors of anxiety in children with and without anxiety disorder (AD) and as a mediator of treatment of ADs in children. Children (N = 145) between the ages of 9 and 13 years participated (71 AD youth, 84 controls). Self-statements were classified by valence and content. Results indicated…

  1. The Role of Self-Statements as a Mediator in Treatment for Youth With Anxiety Disorders

    Microsoft Academic Search

    Philip C. Kendall; Kimberli R. H. Treadwell

    2007-01-01

    The authors investigated features of self-statements as predictors of anxiety in children with and without anxiety disorder (AD) and as a mediator of treatment of ADs in children. Children (N = 145) between the ages of 9 and 13 years participated (71 AD youth, 84 controls). Self-statements were classified by valence and content. Results indicated that children's anxious, but not

  2. Depression and Anxiety as Possible Mediators of the Association between Smoking and Attention Deficit Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Grunau, Gilat L.; Ratner, Pamela A.; Hossain, Shahadut; Johnson, Joy L.

    2010-01-01

    The objective of this study was to investigate the association between depression and anxiety and adolescents' smoking status, and to determine whether depression or anxiety mediate the association between Attention Deficit Hyperactivity Disorder (ADHD) and smoking. A cross-sectional survey of tobacco use was conducted in regional school districts…

  3. Effects of Naturalistic Benzodiazepine Use on Selective Attention to Threat Cues Among Anxiety Disorder Patients

    Microsoft Academic Search

    Sherry H. Stewart; Henny A. Westra; Carol E. Thompson; Brent E. Conrad

    2000-01-01

    The present study examined the effects of naturalistic benzodiazepine (BZ) use on selective attention to threat cues in 50 patients diagnosed with anxiety disorders, according to DSM-IV (APA, 1994) criteria. Patients provided information on their BZ use histories, demographics, and severity of anxiety symptomatology, and completed a computerized Stroop task involving color naming of social threat, physical threat, and matched

  4. Impact of early adolescent anxiety disorders on self-esteem development from adolescence to young adulthood

    PubMed Central

    Maldonado, Lizmarie; Huang, Yangxin; Chen, Ren; Kasen, Stephanie; Cohen, Patricia; Chen, Henian

    2013-01-01

    Purpose To examine the association between early adolescent anxiety disorders and self-esteem development from early adolescence to young adulthood. Methods Self-esteem was measured at mean ages 13, 16 and 22 for 821 participants from the Children in the Community Study, a population-based longitudinal cohort. Anxiety disorders were measured at mean age 13 years. Multilevel growth models were employed to analyze the change in self-esteem from early adolescence to young adulthood and to evaluate whether adolescent anxiety disorders predict both average and slope of self-esteem development. Results Self-esteem increased during adolescence and continued to increase in young adulthood. Girls had lower average self-esteem than boys, but this difference disappeared when examining the effect of anxiety. Adolescents with anxiety disorder had lower self-esteem, on average, compared with healthy adolescents (effect size (ES) =?0.35, p<0.01). Social phobia was found to have the greatest relative impact on average self-esteem (ES=?0.30, p<0.01), followed by overanxious disorder (ES=?0.17, p<0.05), and simple phobia (ES=?0.17, p<0.05). Obsessive compulsive-disorder (OCD) predicted a significant decline in self-esteem from adolescence to young-adulthood ( =?0.1, p<0.05). Separation anxiety disorder was not found to have any significant impact on self-esteem development. Conclusions All but one of the assessed adolescent anxiety disorders were related to lower self-esteem, with social phobia having the greatest impact. OCD predicted a decline in self-esteem trajectory with age. The importance of raising self-esteem in adolescents with anxiety and other mental disorders is discussed. PMID:23648133

  5. Relationship of genetically transmitted alpha EEG traits to anxiety disorders and alcoholism

    SciTech Connect

    Enoch, M.A.; Rohrbaugh, W.; Harris, C.R. [Washington School of Medicine, St. Louis, MO (United States)] [and others

    1995-10-09

    We tested the hypothesis that a heritable EEG trait, the low voltage alpha (LV), is associated with psychiatric disorders. Modest to moderate evidence for genetic linkage of both panic disorder and the low voltage alpha trait to the same region of chromosome 20q has recently been reported, raising the issue of whether there is a phenotypic correlation between these traits. A total of 124 subjects including 50 unrelated index subjects and 74 relatives were studied. Alpha EEG power was measured and EEG phenotypes were impressionistically classified. Subjects were psychiatrically interviewed using the SADS-L and blind-rated by RDC criteria. Alcoholics were four times more likely to be LV (including so-called borderline low voltage alpha) than were nonalcoholic, nonanxious subjects. Alcoholics with anxiety disorder are 10 times more likely to be LV. However, alcoholics without anxiety disorder were similar to nonalcoholics in alpha power. An anxiety disorder (panic disorder, phobia, or generalized anxiety) was found in 14/17 LV subjects as compared to 34/101 of the rest of the sample (P < 0.01). Support for these observations was found in the unrelated index subjects in whom no traits would be shared by familial clustering. Lower alpha power in anxiety disorders was not state-dependent, as indicated by the Spielberger Anxiety Scale. Familial covariance of alpha power was 0.25 (P < 0.01). These findings indicate there may be a shared factor underlying the transmissible low voltage alpha EEG variant and vulnerability to anxiety disorders with associated alcoholism. This factor is apparently not rare, because LV was found in approximately 10% of unrelated index subjects and 5% of subjects free of alcoholism and anxiety disorders. 43 refs., 1 fig., 3 tabs.

  6. Are Children with "Pure" Generalized Anxiety Disorder Impaired? A Comparison with Comorbid and Healthy Children

    ERIC Educational Resources Information Center

    Alfano, Candice A.

    2012-01-01

    Despite the approach of the "Diagnostic and Statistical Manual of Mental Disorders" (5th ed.), generalized anxiety disorder (GAD) of childhood continues to face questions as to whether it should be considered a distinct clinical disorder. A potentially critical issue embedded in this debate involves the role of functional impairment which has yet…

  7. Increased anxiety and other similarities in temperament of alcoholics with and without antisocial personality disorder across three diverse populations

    Microsoft Academic Search

    Francesca Ducci; Mary-Anne Enoch; Samuel Funt; Matti Virkkunen; Bernard Albaugh; David Goldman

    2007-01-01

    According to Cloninger's model, type I alcoholics are thought to be innately vulnerable to anxiety and depression. In contrast, type II alcoholics are thought to have increased likelihood of antisocial personality disorder (ASPD) and reduced anxiety. However, allostatic activations of stress, anxiety, and dysphoria may be a common thread in alcohol use disorders (AUDs). Our aim was to find commonalities

  8. Locus of Control Fails to Mediate between Stress and Anxiety and Depression in Parents of Children with a Developmental Disorder

    ERIC Educational Resources Information Center

    Hamlyn-Wright, Sarah; Draghi-Lorenz, Riccardo; Ellis, Jason

    2007-01-01

    Stress, anxiety and depression are raised amongst parents of children with a developmental disorder. However, the processes by which stress leads to depression and anxiety are poorly understood. In a cross-sectional survey, levels of parental stress, depression and anxiety were compared between parents of children with an autistic disorder,…

  9. Anxiety disorders and onset of cardiovascular disease: the differential impact of panic, phobias and worry.

    PubMed

    Batelaan, Neeltje M; ten Have, Margreet; van Balkom, Anton J L M; Tuithof, Marlous; de Graaf, Ron

    2014-03-01

    Anxiety has been linked to onset of cardiovascular disease. This study examines the differential impact of types of anxiety (panic, phobia and worry) on 3-year onset of non-fatal cardiovascular disease (CVD). By investigating anxiety disorders as opposed to anxiety symptoms and by using a reliable diagnostic instrument to assess anxiety, limitations of previous studies are considered. 5149 persons at risk for CVD were interviewed using the Composite International Diagnostic Interview. The panic-type included panic disorder and panic attacks; the phobic-type included agoraphobia and social phobia, and the worry-type included generalized anxiety disorder. CVD was self-reported and required treatment or monitoring by a doctor. Analyses were adjusted for sociodemographics, behavioral variables, and comorbid somatic and psychiatric disorders. During follow-up, 62 persons (1.2%) developed CVD. Baseline generalized anxiety disorder was strongly associated with onset of CVD (adjusted OR: 3.39). Further research should replicate findings and focus on biological underpinnings of this association. PMID:24513159

  10. Predicting Treatment Response in Social Anxiety Disorder From Functional Magnetic Resonance Imaging

    E-print Network

    Doehrmann, Oliver

    Context: Current behavioral measures poorly predict treatment outcome in social anxiety disorder (SAD). To our knowledge, this is the first study to examine neuroimaging-based treatment prediction in SAD.

  11. Hyper-Connectivity of Subcortical Resting-State Networks in Social Anxiety Disorder

    E-print Network

    Triantafyllou, Christina

    Social anxiety disorder–related alterations in basal ganglia regions, such as striatum and globus pallidus, though evident from metabolic imaging, remain to be explored using seed-based resting-state functional connectivity ...

  12. Anxiety Disorders and Rapid Cycling Data From a Cohort of 8129 Youths With Bipolar Disorder

    PubMed Central

    Castilla-Puentes, Ruby; Sala, Regina; Ng, Bernardo; Galvez, Juan; Camacho, Alvaro

    2014-01-01

    Anxiety disorders (ADs) are common in youths with bipolar disorder (BD). We examine psychiatric comorbidity, hospitalization, and treatment in youths with versus without AD and rapid cycling (four or more cycles per year). Data from the Integrated Healthcare Information Services cohort were used and included 8129 youths (ages ?18 years). Prevalence of AD, demographic, type of AD, hospitalization, and use of psychotropics were compared between rapid and nonrapid cycling. Overall, 51% of the youths met criteria for at least one comorbid AD; they were predominantly female and were between 12 and 17 years of age. The most common comorbid ADs were generalized ADs and separation ADs. In the patients with rapid cycling, 65.5%met criteria for comorbid AD. The BD youths with AD were more likely to have major depressive disorders and other comorbid ADs, to be given more psychotropics, and to be hospitalized for depression and medical conditions more often than were those without AD. PMID:24284641

  13. Continuity in features of anxiety and attention deficit/hyperactivity disorder in young preschool children.

    PubMed

    Overgaard, Kristin Romvig; Aase, Heidi; Torgersen, Svenn; Reichborn-Kjennerud, Ted; Oerbeck, Beate; Myhre, Anne; Zeiner, Pĺl

    2014-09-01

    Anxiety disorders and attention deficit/hyperactivity disorder (ADHD) develop before school age, but little is known about early developmental pathways. Here we test two hypotheses: first, that early signs of anxiety and ADHD at 18 months predict symptoms of anxiety and ADHD at age 3˝ years; second, that emotional dysregulation at 18 months predicts the outcome of co-occurring anxiety and ADHD at age 3˝ years. The study was part of the prospective Norwegian Mother and Child Cohort Study (MoBa) at the Norwegian Institute of Public Health. The 628 participants were clinically assessed at 3˝ years. Questionnaire data collected at 18 months were categorized into early behavioural scales of anxiety, ADHD, and emotional dysregulation. We investigated continuity in features of anxiety and ADHD from 18 months to 3˝ years of age through logistic regression analyses. Anxiety symptoms at 3˝ years were predicted by early signs of anxiety (Odds ratio (OR) = 1.41, CI = 1.15-1.73) and emotional dysregulation (OR = 1.33, CI = 1.15-1.54). ADHD symptoms at 3˝ years were predicted by early signs of ADHD (OR = 1.51, CI = 1.30-1.76) and emotional dysregulation (OR = 1.31, CI = 1.13-1.51). Co-occurring anxiety and ADHD symptoms at 3˝ years were predicted by early signs of anxiety (OR = 1.43, CI = 1.13-1.84), ADHD (OR = 1.30, CI = 1.11-1.54), and emotional dysregulation (OR = 1.34, CI = 1.13-1.58). We conclude that there were modest continuities in features of anxiety and ADHD through early preschool years, while emotional dysregulation at age 18 months was associated with symptoms of anxiety, ADHD, and co-occurring anxiety and ADHD at age 3˝ years. PMID:24687273

  14. Virtual Reality Exposure Therapy for Anxiety Disorders: The State of the Art

    Microsoft Academic Search

    Katharina Meyerbröker; Paul Emmelkamp

    \\u000a In the past 10 years virtual reality exposure therapy (VRET) has become a viable alternative for exposure in vivo, the gold\\u000a standard for the treatment of anxiety disorders. VRET is often regarded as a natural extension of the systematic exposure\\u000a component of (cognitive) behavior therapy. The objective of this chapter is to discuss the treatment of anxiety disorders\\u000a with VRET

  15. The Multiple Dimensions of the Social Anxiety Spectrum in Mood Disorders

    PubMed Central

    Fournier, Jay C.; Cyranowski, Jill M.; Rucci, Paola; Cassano, Giovanni B.; Frank, Ellen

    2012-01-01

    Major depressive disorder and bipolar spectrum disorders are debilitating conditions associated with severe impairment. The presence of co-occurring social phobia can make the clinical course of these disorders even more challenging. To better understand the nature of social anxiety in the context of ongoing mood disorders, we report the results of exploratory factor analyses of the Social Phobia Spectrum Self-Report Instrument (SHY), a 162-item measure designed to capture the full spectrum of manifestations and features associated with social anxiety experienced across the lifespan. We examined data from 359 adult outpatients diagnosed with major depressive disorder and 403 outpatients diagnosed with a bipolar spectrum disorder. The measure was divided into its two components: the SHY-General (SHY-G), reflecting general social anxiety features, and the SHY-Specific (SHY-S), reflecting anxiety in specific situations. Exploratory factor analyses were conducted for each using tetrachoric correlation matrices and an unweighted least squares estimator. Item invariance was evaluated for important patient subgroups. Five factors were identified for the SHY-G, representing general features of social anxiety: Fear of Social Disapproval, Childhood Social Anxiety, Somatic Social Anxiety, Excessive Agreeableness, and Behavioral Submission. Seven specific-situation factors were identified from the SHY-S: Writing in Public, Dating, Public Speaking, Eating in Public, Shopping Fears, Using Public Restrooms, and Unstructured Social Interactions. The identified dimensions provide clinically valuable information about the nature of the social fears experienced by individuals diagnosed with mood disorders and could help guide the development of tailored treatment strategies for individuals with co-occurring mood disorders and social anxiety. PMID:22771202

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

    PubMed Central

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

    2011-01-01

    As many as 9% of preschoolers suffer from an anxiety disorder, and earlier onset of disorder is associated with more intractable forms of psychopathology in later life. At present there is a relative dearth of empirical work examining the development of evidence-based treatments for anxiety disorders presenting in early childhood. Building on previous work supporting extensions of PCIT for separation anxiety disorder, the present study examines the preliminary feasibility and efficacy of an anxiety-based modification of PCIT (The CALM Program; Coaching Approach behavior and Leading by Modeling) for the treatment of youth between the ages of three and eight presenting with separation anxiety disorder, social anxiety disorder, generalized anxiety disorder, and/or specific phobias (N=9; Mage=5.4 years, ranging 4–8 years; 55.6% of families endorsing racial or ethnic minority status). Intent-to-treat (ITT; N=9) and treatment completer (N=7) analyses were conducted to evaluate diagnostic and functional response across participants. Pre- and posttreatment structured diagnostic interviews were conducted (ADIS-C/P), and clinical impression measures were completed (e.g., CGI, CGAS). Roughly 80% of the sample completed all treatment sessions. All treatment completers were categorized as global treatment responders by independent evaluators, with all but one showing full diagnostic improvements, and all but one showing meaningful functional improvements. These findings lend preliminary support for the promising role of live parent coaching for the treatment of a range of anxiety disorders that present in early childhood. Future work is needed to replicate the present findings in larger samples utilizing randomized controlled comparisons. PMID:21917417

  17. The Relationships Between Childhood Sexual Abuse, Social Anxiety, and Symptoms of Posttraumatic Stress Disorder in Women

    Microsoft Academic Search

    Margaret M. Feerick; Kyle L. Snow

    2005-01-01

    The relationships between childhood sexual abuse, social anxiety, and symptoms of posttraumatic stress disorder were examined\\u000a in a sample of 313 undergraduate women. Thirty-one percent of the women reported some form of sexual abuse in childhood. Women\\u000a with a history of sexual abuse reported more symptoms of anxiety, distress in social situations, and posttraumatic stress\\u000a disorder than other women. Women

  18. Self-Talk in Youth With Anxiety Disorders: States of Mind, Content Specificity, and Treatment Outcome

    Microsoft Academic Search

    Kimberli R. H. Treadwell; Philip C. Kendall

    1996-01-01

    This study investigated the relationship between childhood anxiety disorders, the valence and content of self-statements, and the impact of treatment on the internal dialogue. Participants (151 8- to 13-year-olds) included 71 youth with anxiety disorders and 80 control participants. Positive and negative self-statements and a states-of-mind (SOM) ratio were examined. Results indicated that the negative self-statements and SOM ratio (but

  19. Evaluation of therapist-supported parent-implemented CBT for anxiety disorders in rural children

    Microsoft Academic Search

    Heidi J. Lyneham; Ronald M. Rapee

    2006-01-01

    Supplementing bibliotherapy with therapist-client communication has been shown to be an effective way of providing services to under-resourced and isolated communities. The current study examined the efficacy of supplementing bibliotherapy for child anxiety disorders with therapist-initiated telephone or email sessions, or with client-initiated contact in a randomised trial using a waitlist control. Participants were 100 anxiety-disordered children and their parents

  20. School-Based Intervention for Adolescents with Social Anxiety Disorder: Results of a Controlled Study

    Microsoft Academic Search

    Carrie Masia-Warner; Rachel G. Klein; Heather C. Dent; Paige H. Fisher; Jose Alvir; Anne Marie Albano; Mary Guardino

    2005-01-01

    Social anxiety disorder, whose onset peaks in adolescence, is associated with significant impairment. Despite the availability\\u000a of effective treatments, few affected youth receive services. Transporting interventions into schools may circumvent barriers\\u000a to treatment. The efficacy of a school-based intervention for social anxiety disorder was examined in a randomized wait-list\\u000a control trial of 35 adolescents (26 females). Independent evaluators, blind to

  1. Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample

    Microsoft Academic Search

    Timothy A. Brown; Laura A. Campbell; Cassandra L. Lehman; Jessica R. Grisham; Richard B. Mancill

    2001-01-01

    The comorbidity of current and lifetime DSM-IV anxiety and mood disorders was examined in 1,127 outpatients who were assessed with the Anxiety Disorders Interview Schedule for DSM-IV: Lifetime version (ADIS-IV-L). The current and lifetime prevalence of additional Axis I disorders in principal anxiety and mood disorders was found to be 57% and 81%, respectively. The principal diagnostic categories associated with

  2. Prevalence of Psychiatric Disorders in Patients with a Diagnosis of Polycystic Ovary Syndrome in Kashmir

    PubMed Central

    Hussain, Arshad; Chandel, Rajesh Kumar; Ganie, Mohd Ashraf; Dar, Mansoor Ahmad; Rather, Yasir Hassan; Wani, Zaid Ahmad; Shiekh, Javid Ahmad; Shah, Majid Shafi

    2015-01-01

    Background: Polycystic ovary syndrome (PCOS) is one of the common endocrine disorders and is associated with reproductive, metabolic, and psychological disturbances affecting one in five women of reproductive age group. Objective: To investigate the prevalence of psychiatric disorders among women in ambulatory treatment with a diagnosis of PCOS. Materials and Methods: One hundred and ten patients of PCOS were evaluated using Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition criteria by means of Mini International Neuropsychiatric Interview, English version 5.0.0. Diagnosis of PCOS was confirmed according to the National Institute of Health/National Institute of Child Health and Human Development, 1990 consensus conference criteria. Forty subjects without PCOS who were matched for age and body mass index were taken as a comparison group. Results: About 23% of cases had major depressive disorder as compared to 7.5% of controls, 1.8% had dysthymia, 15.45% had panic disorder compared to 5% of controls, 6.36% had obsessive compulsive disorder compared to 2.5% of controls, 8% cases had suicidality, 2.72% of cases were bipolar affective disorder, and 15.45% had generalized anxiety disorder (GAD). Conclusion: A high prevalence of mental disorders was observed, especially major depression, panic disorder, and GAD in patients with PCOS in our study. The results suggest that screening and appropriate management for psychiatric disorders should be part of the routine evaluation of these patients. PMID:25722515

  3. Subtyping Social Anxiety Disorder in Developed and Developing Countries

    PubMed Central

    Stein, Dan J.; Ruscio, Ayelet Meron; Lee, Sing; Petukhova, Maria; Alonso, Jordi; Andrade, Laura Helena S.G.; Benjet, Corina; Bromet, Evelyn; Demyttenaere, Koen; Florescu, Silvia; de Girolamo, Giovanni; de Graaf, Ron; Gureje, Oye; He, Yanling; Hinkov, Hristo; Hu, Chiyi; Iwata, Noboru; Karam, Elie G; Lepine, Jean-Pierre; Matschinger, Herbert; Browne, Mark Oakley; Posada-Villa, Jose; Sagar, Rajesh; Williams, David R.; Kessler, Ronald C.

    2009-01-01

    BACKGROUND Although social anxiety disorder (SAD) is classified in DSM-IV into generalized and non-generalized subtypes, community surveys in Western countries find no evidence of disjunctions in the dose-response relationship between number of social fears and outcomes to support this distinction. We aimed to determine whether this holds across a broader set of developed and developing countries and whether subtyping according to number of performance versus interactional fears would be more useful. METHODS The WHO World Mental Health (WMH) Survey Initiative undertook population epidemiological surveys in 11 developing and 9 developed countries using the Composite International Diagnostic Interview (CIDI) to assess DSM-IV disorders. Fourteen performance and interactional fears were assessed. Associations between number of social fears in SAD and numerous outcomes (age-of-onset, persistence, severity, comorbidity, treatment) were examined. Additional analyses examined associations with number of performance fears versus number of interactional fears. RESULTS Lifetime social fears are quite common in both developed (15.9%) and developing (14.3%) countries, but lifetime SAD is much more common in the former (6.1%) than latter (2.1%) countries. Among those with SAD, persistence, severity, comorbidity, and treatment all have dose-response relationships with number of social fears, with no clear nonlinearity in relationships that would support a distinction between generalized and non-generalized SAD. The distinction between performance fears and interactional fears is generally not important in predicting these same outcomes. CONCLUSION No evidence is found to support subtyping SAD on the basis of either number of social fears or number of performance fears versus number of interactional fears. PMID:20037919

  4. Information-seeking bias in social anxiety disorder.

    PubMed

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

    2013-02-01

    In the present study, we sought to examine information seeking among individuals with social anxiety disorder (SAD, n = 31) and nonanxious controls (n = 32) during an impression-formation task. Participants were given an initial description of a protagonist that included polarized information on the social rank dimension (i.e., dominant or submissive) or on the affiliation dimension (i.e., friendly or unfriendly). Participants were told that their task was to rate the protagonist on social rank and affiliation traits and were given the opportunity to obtain additional information in order to make their decisions. Results indicated that compared to controls, individuals with SAD sought less information before making social rank ratings. In addition, individuals with SAD rated dominant protagonists as higher in social rank than did controls. These findings suggest that even in nonevaluative conditions, individuals with SAD may have an information-seeking bias. In addition, individuals with SAD may have a bias in forming impressions of dominant others. Implications for cognitive and interpersonal models of SAD are discussed. PMID:22905860

  5. Neurobiological correlates of social anxiety disorder: an update.

    PubMed

    Marazziti, Donatella; Abelli, Marianna; Baroni, Stefano; Carpita, Barbara; Ramacciotti, Carla E; Dell'Osso, Liliana

    2015-04-01

    Social anxiety disorder (SAD) is a condition characterized by pervasiveness and impairment in social functioning, with a prevalence in the general population between 1.9% and 12.1%. The most consistent findings on its neurobiological underpinnings involve a wide range of neurotransmitters (serotonin, norepinephrine, glutamate, and GABA) and neuropeptides (oxytocin), but no comprehensive hypothesis is yet available. In particular, oxytocin is becoming increasingly established as a "prosocial neuropeptide" and, as such, is a major focus of current research, with a great range of therapeutic applications including SAD treatment. Specifically, the amygdala plays a pivotal role in conditioning and processing of fear, and exaggerated amygdala responses in SAD patients have been observed during various social-emotional stimuli. In addition to the amygdala, other brain areas of interest in SAD-related circuitry are represented by the medial prefrontal cortex, dorsal raphe, striatum, locus coeruleus, prefrontal cortex, insular cortex, and anterior cingulate cortex. The aim of this review is to provide an update on neurobiological correlates of SAD, with a special focus on neurotransmitters and brain areas possibly involved, and suggestions for future research that could lead to more specific therapeutic interventions. PMID:24571962

  6. ADEQUACY OF TREATMENT RECEIVED BY PRIMARY CARE PATIENTS WITH ANXIETY DISORDERS

    PubMed Central

    Weisberg, Risa B.; Beard, Courtney; Moitra, Ethan; Dyck, Ingrid; Keller, Martin B.

    2014-01-01

    Background We examined the adequacy of pharmacotherapy and psychotherapy received by primary care patients with anxiety disorders over up to 5 years of follow-up. Method Five hundred thirty-four primary care patients at 15 US sites, who screened positive for anxiety symptoms, were assessed for anxiety disorders. Those meeting anxiety disorder criteria were offered participation and interviewed again at six and 12 months postintake, and yearly thereafter for up to 5 years. We utilized existing definitions of appropriate pharmacotherapy and created definitions of potentially adequate psychotherapy/cognitive-behavioral therapy (CBT). Results At intake, of 534 primary care participants with anxiety disorders, 19% reported receiving appropriate pharmacotherapy and 14% potentially adequate CBT. Overall, 28% of participants reported receiving potentially adequate anxiety treatment, whether pharmacotherapy, psychotherapy, or both. Over up to five years of follow-up, appropriate pharmacotherapy was received by 60% and potentially adequate CBT by 36% of the sample. Examined together, 69% of participants received any potentially adequate treatment during the follow-up period. Over the course of follow-up, primary care patients with MDD, panic disorder with agoraphobia, and with medicaid/medicare were more likely to receive appropriate anxiety treatment. Ethnic minority members were less likely to receive potentially adequate care. Conclusions Potentially adequate anxiety treatment was rarely received by primary care patients with anxiety disorders at intake. Encouragingly, rates improved over the course of the study. However, potentially adequate CBT remained much less utilized than pharmacotherapy and racial-ethnic minority members were less likely to received care, suggesting much room for improved dissemination of quality treatment. PMID:24190762

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

    PubMed

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

    2004-03-01

    As little is known about health-related quality of life (HRQoL) in Asians with anxiety disorders, we assessed HRQoL in Singaporeans with anxiety disorders and identified factors influencing their HRQoL. Outpatients with anxiety disorders (n = 119) attending a hospital psychiatric clinic completed the Short Form 36 Health Survey (SF-36), Beck Anxiety Inventory (BAI) and General Health Questionnaire (GHQ-12). SF-36 score reduction from population norms (quantified as the number of standard deviations below the mean) in these subjects was compared with existing data on Singaporeans with various medical conditions and Americans with panic disorder (PD). Factors influencing HRQoL were examined using stepwise multiple linear regression models. SF-36 score reduction in these subjects (0.3-1.4 SD) was greater than that in Singaporeans with systemic lupus erythematosus or thyroid cancer survivors for seven scales but similar to that in Americans with PD (0.5-1.7 SD). BAI and GHQ-12 scores, presence of PD/generalized anxiety disorder, presence of chronic medical conditions, being married or increasing age accounted for 19-61% of the variance in six selected SF-36 scales. In conclusion, it can be said that Singaporeans with anxiety disorders experience clinically important reductions in HRQoL; both clinical and socio-demographic factors influence HRQoL in such subjects. PMID:15085928

  8. Self and friend's differing views of social anxiety disorder's effects on friendships.

    PubMed

    Rodebaugh, Thomas L; Lim, Michelle H; Fernandez, Katya C; Langer, Julia K; Weisman, Jaclyn S; Tonge, Natasha; Levinson, Cheri A; Shumaker, Erik A

    2014-11-01

    Social anxiety disorder is known to be associated with self-report of global friendship quality. However, information about specific friendships, as well as information beyond self-report, is lacking. Such information is crucial, because known biases in information processing related to social anxiety disorder render global self-ratings particularly difficult to interpret. We examined these issues focusing on diagnosed participants (n = 77) compared with community control participants (n = 63). We examined self-report regarding global (i.e., overall) friendship quality and a specific friendship's quality; in addition, we examined friend-report of that friendship's quality. Results suggested that social anxiety disorder has a negative impact on self-perception of friendship quality for a specific friendship, but that this effect is less evident as reported by the friends. Specifically, social anxiety disorder was associated with a tendency to report worse friendship quality in comparison to friend-report, particularly in participants who were younger or had less long-lasting friendships. However, friend-report did show clear differences based on diagnostic group, with friends reporting participants with social anxiety disorder to be less dominant in the friendship and less well-adjusted. Overall, the findings are consistent with results of other studies indicating that social anxiety disorder has a strong association with self-ratings of impairment, but that these ratings appear out of proportion with the report of observers (in this case, friends). PMID:25314261

  9. Automatic Neural Processing of Disorder-Related Stimuli in Social Anxiety Disorder: Faces and More

    PubMed Central

    Schulz, Claudia; Mothes-Lasch, Martin; Straube, Thomas

    2013-01-01

    It has been proposed that social anxiety disorder (SAD) is associated with automatic information processing biases resulting in hypersensitivity to signals of social threat such as negative facial expressions. However, the nature and extent of automatic processes in SAD on the behavioral and neural level is not entirely clear yet. The present review summarizes neuroscientific findings on automatic processing of facial threat but also other disorder-related stimuli such as emotional prosody or negative words in SAD. We review initial evidence for automatic activation of the amygdala, insula, and sensory cortices as well as for automatic early electrophysiological components. However, findings vary depending on tasks, stimuli, and neuroscientific methods. Only few studies set out to examine automatic neural processes directly and systematic attempts are as yet lacking. We suggest that future studies should: (1) use different stimulus modalities, (2) examine different emotional expressions, (3) compare findings in SAD with other anxiety disorders, (4) use more sophisticated experimental designs to investigate features of automaticity systematically, and (5) combine different neuroscientific methods (such as functional neuroimaging and electrophysiology). Finally, the understanding of neural automatic processes could also provide hints for therapeutic approaches. PMID:23745116

  10. Rumination predicts heightened responding to stressful life events in major depressive disorder and generalized anxiety disorder.

    PubMed

    Ruscio, Ayelet Meron; Gentes, Emily L; Jones, Jason D; Hallion, Lauren S; Coleman, Elizabeth S; Swendsen, Joel

    2015-02-01

    Although studies have documented heightened stress sensitivity in major depressive disorder (MDD) and generalized anxiety disorder (GAD), the mechanisms involved are poorly understood. One possible mechanism is the tendency to ruminate in response to stress. We used ecological momentary assessment to study ruminative thoughts after stressful events in 145 adults with MDD, GAD, comorbid MDD-GAD, or no psychopathology. Diagnosed individuals reported more event-related rumination than controls, even after adjusting for event stressfulness. Rumination was equally common in MDD and GAD and was especially severe among comorbid cases. More rumination immediately after the event predicted poorer affect, more maladaptive behavior, and more MDD and GAD symptoms at the next signal, even when pre-event levels of these variables were controlled. Rumination mediated, but did not moderate, the association of stress with affect and with symptoms. Stress-related rumination was more deleterious for diagnosed than healthy individuals, more intense for more severe clinical cases, and more persistent for cases with a greater temperamental vulnerability for emotional disorders. These results implicate rumination as a mechanism of stress sensitivity and suggest pathways through which it may maintain depression and anxiety in everyday life. (PsycINFO Database Record (c) 2015 APA, all rights reserved). PMID:25688429

  11. Proteasome modulator 9 gene SNPs, responsible for anti-depressant response, are in linkage with generalized anxiety disorder.

    PubMed

    Gragnoli, Claudia

    2014-09-01

    Proteasome modulator 9 (PSMD9) gene single nucleotide polymorphism (SNP) rs1043307/rs2514259 (E197G) is associated with significant clinical response to the anti-depressant desipramine. PSMD9 SNP rs74421874 [intervening sequence (IVS) 3?+?nt460 G>A], rs3825172 (IVS3?+?nt437 C>T) and rs1043307/rs2514259 (E197G A>G) are all linked to type 2 diabetes (T2D), maturity-onset-diabetes-of the young 3 (MODY3), obesity and waist circumference, hypertension, hypercholesterolemia, T2D-macrovascular and T2D-microvascular disease, T2D-neuropathy, T2D-carpal tunnel syndrome, T2D-nephropathy, T2D-retinopathy, non-diabetic retinopathy and depression. PSMD9 rs149556654 rare SNP (N166S A>G) and the variant S143G A>G also contribute to T2D. PSMD9 is located in the chromosome 12q24 locus, which per se is in linkage with depression, bipolar disorder and anxiety. In the present study, we wanted to determine whether PSMD9 is linked to general anxiety disorder in Italian T2D families. Two-hundred Italian T2D families were phenotyped for generalized anxiety disorder, using the diagnostic criteria of DSM-IV. When the diagnosis was unavailable or unclear, the trait was reported as unknown. The 200 Italians families were tested for the PSMD9 T2D risk SNPs rs74421874 (IVS3?+?nt460 G>A), rs3825172 (IVS3?+nt437 T>C) and for the T2D risk and anti-depressant response SNP rs1043307/rs2514259 (E197G A>G) for evidence of linkage with generalized anxiety disorder. Non-parametric linkage analysis was executed via Merlin software. One-thousand simulation tests were performed to exclude results due to random chance. In our study, the PSMD9 gene SNPs rs74421874, rs3825172, and rs1043307/rs2514259 result in linkage to generalized anxiety disorder. This is the first report describing PSMD9 gene SNPs in linkage to generalized anxiety disorder in T2D families. PMID:24648162

  12. Diagnosis and management of post-traumatic stress disorder

    Microsoft Academic Search

    Bradley D. Grinage

    2003-01-01

    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

  13. Childhood trauma and current psychological functioning in adults with social anxiety disorder.

    PubMed

    Kuo, Janice R; Goldin, Philippe R; Werner, Kelly; Heimberg, Richard G; Gross, James J

    2011-05-01

    Etiological models of social anxiety disorder (SAD) suggest that early childhood trauma contributes to the development of this disorder. However, surprisingly little is known about the link between different forms of childhood trauma and adult clinical symptoms in SAD. This study (1) compared levels of childhood trauma in adults with generalized SAD versus healthy controls (HCs), and (2) examined the relationship between specific types of childhood trauma and adult clinical symptoms in SAD. Participants were 102 individuals with generalized SAD and 30 HCs who completed measures of childhood trauma, social anxiety, trait anxiety, depression, and self-esteem. Compared to HCs, individuals with SAD reported greater childhood emotional abuse and emotional neglect. Within the SAD group, childhood emotional abuse and neglect, but not sexual abuse, physical abuse, or physical neglect, were associated with the severity of social anxiety, trait anxiety, depression, and self-esteem. PMID:21183310

  14. Treating ethnic minority adults with anxiety disorders: Current status and future recommendations?

    PubMed Central

    Carter, Michele M; Mitchell, Frances E.; Sbrocco, Tracy

    2014-01-01

    The past three decades have witnessed an increase in the number of empirical investigations examining the phenomenology of anxiety and related conditions. There has also been an increase in efforts to understand differences that may exist between ethnic groups in the expression of the anxiety disorders. In addition, there is now substantial evidence that a variety of treatment approaches (most notably behavioral and cognitive behavioral) are efficacious in remediating anxiety. However, there continues to be comparatively few treatment outcome studies investigating the efficacy of anxiety treatments among minority populations. In this paper, we review the extant treatment outcome research for African American, Hispanic/Latino[a] American, Asian American, and Native Americans suffering with one of the anxiety disorders. We discuss some of the specific problems with the research in this area, and then provide specific recommendations for conducting treatment outcome research with minority populations in the future. PMID:22417877

  15. Exploring exercise as an avenue for the treatment of anxiety disorders

    PubMed Central

    DeBoer, Lindsey B; Powers, Mark B; Utschig, Angela C; Otto, Michael W; Smits, Jasper AJ

    2012-01-01

    Anxiety disorders constitute a significant public health problem. Current gold standard treatments are limited in their effectiveness, prompting the consideration of alternative approaches. In this review, we examine the evidence for exercise as an intervention for anxiety disorders. This evidence comes from population studies, studies of nonclinical anxiety reduction, as well as a limited number of studies of clinically anxious individuals. All of these studies provide converging evidence for consistent beneficial effects of exercise on anxiety, and are consistent with a variety of accounts of the mechanism of anxiety reduction with exercise. Further study of clinical populations is encouraged, as are studies of the mechanism of change of exercise interventions, which have the potential to help refine exercise intervention strategies. Likewise, studies that identify moderators of treatment efficacy will assist clinicians in deciding how and for whom to prescribe exercise. PMID:23002943

  16. Exploring exercise as an avenue for the treatment of anxiety disorders.

    PubMed

    DeBoer, Lindsey B; Powers, Mark B; Utschig, Angela C; Otto, Michael W; Smits, Jasper A J

    2012-08-01

    Anxiety disorders constitute a significant public health problem. Current gold standard treatments are limited in their effectiveness, prompting the consideration of alternative approaches. In this review, we examine the evidence for exercise as an intervention for anxiety disorders. This evidence comes from population studies, studies of nonclinical anxiety reduction, as well as a limited number of studies of clinically anxious individuals. All of these studies provide converging evidence for consistent beneficial effects of exercise on anxiety, and are consistent with a variety of accounts of the mechanism of anxiety reduction with exercise. Further study of clinical populations is encouraged, as are studies of the mechanism of change of exercise interventions, which have the potential to help refine exercise intervention strategies. Likewise, studies that identify moderators of treatment efficacy will assist clinicians in deciding how and for whom to prescribe exercise. PMID:23002943

  17. A systems neuroscience approach to the pathophysiology of pediatric mood and anxiety disorders.

    PubMed

    Tseng, Wan-Ling; Leibenluft, Ellen; Brotman, Melissa A

    2014-01-01

    Emotional dysregulation is a core feature of pediatric mood and anxiety disorders. Emerging evidence suggests that these disorders are mediated by abnormalities in the functions and structures of the developing brain. This chapter reviews recent behavioral and functional magnetic resonance imaging (fMRI) research on pediatric mood and anxiety disorders, focusing on the neural mechanisms underlying these disorders. Throughout the chapter, we highlight the relationship between neural and behavioral findings, and potential novel treatments. The chapter concludes with directions for future research. PMID:24281907

  18. An analysis of early developmental trauma in social anxiety disorder and posttraumatic stress disorder

    PubMed Central

    2014-01-01

    Background The early contributions of childhood trauma (emotional, physical, sexual, and general) have been hypothesized to play a significant role in the development of anxiety disorders, such as posttraumatic stress disorder (PTSD) and social anxiety disorder (SAD). The aim of this study was to assess childhood trauma differences between PTSD and SAD patients and healthy controls, as measured by the Early Trauma Inventory. Methods We examined individuals (N?=?109) with SAD with moderate/severe early developmental trauma (EDT) (n?=?32), individuals with SAD with low/no EDT (n?=?29), individuals with PTSD with EDT (n?=?17), and healthy controls (n?=?31). The mean age was 34 years (SD?=?11). Subjects were screened with the Mini-International Neuropsychiatric Interview (MINI), Liebowitz Social Anxiety Scale (LSAS), Clinician-Administered PTSD Scale (CAPS), and Childhood Trauma Questionnaire (CTQ). Analysis of variance was performed to assess group differences. Correlations were calculated between childhood traumas. Results Although not statistically significant, individuals with PTSD endorsed more physical and sexual childhood trauma compared with individuals with SAD with moderate/severe EDT who endorsed more emotional trauma. For all groups, physical and emotional abuse occurred between ages 6 and 11, while the occurrence of sexual abuse in individuals with PTSD was at 6–11 years and later (13–18 years) in individuals with SAD with moderate/severe EDT. For emotional abuse in all groups, the perpetrator was mostly a primary female caregiver; for sexual abuse, it was mostly a nonfamilial adult male, while for physical abuse, it was mostly a caregiver (male in PTSD and female in SAD with moderate/severe EDT). Conclusions The contribution of childhood abuse to the development of PTSD and SAD and the differences between these groups and other anxiety disorders should not be ignored and attention should be given to the frequency and severity of these events. The relationship of the perpetrator(s) and the age of onset of childhood abuse are also important considerations as they provide a useful starting point to assess impact over the life course. This can, in turn, guide clinicians on the optimal timing for the delivery of interventions for the prevention of PTSD and SAD. PMID:24920955

  19. Identification of emotional facial expressions among behaviorally inhibited adolescents with lifetime anxiety disorders.

    PubMed

    Reeb-Sutherland, Bethany C; Rankin Williams, Lela; Degnan, Kathryn A; Pérez-Edgar, Koraly; Chronis-Tuscano, Andrea; Leibenluft, Ellen; Pine, Daniel S; Pollak, Seth D; Fox, Nathan A

    2015-01-01

    The current study examined differences in emotion expression identification between adolescents characterised with behavioural inhibition (BI) in childhood with and without a lifetime history of anxiety disorder. Participants were originally assessed for BI during toddlerhood and for social reticence during childhood. During adolescence, participants returned to the laboratory and completed a facial emotion identification task and a clinical psychiatric interview. Results revealed that behaviorally inhibited adolescents with a lifetime history of anxiety disorder displayed a lower threshold for identifying fear relative to anger emotion expressions compared to non-anxious behaviorally inhibited adolescents and non-inhibited adolescents with or without anxiety. These findings were specific to behaviorally inhibited adolescents with a lifetime history of social anxiety disorder. Thus, adolescents with a history of both BI and anxiety, specifically social anxiety, are more likely to differ from other adolescents in their identification of fearful facial expressions. This offers further evidence that perturbations in the processing of emotional stimuli may underlie the aetiology of anxiety disorders. PMID:24800906

  20. Tryptophan Hydroxylase 2 Gene Polymorphism in Anxiety and Depressive Disorder in Kashmiri Population

    PubMed Central

    Shoib, Sheikh; Shah, Tabindah; Mushtaq, Sahil

    2014-01-01

    Background: The gene of tryptophan hydroxylase is widely recognized as a major candidate gene in many psychiatric disorders. However, no study has been done which investigates tryptophan hydroxylase 2 gene polymorphism in anxiety and depressive disorders in Kashmiri population (India). Objectives: To study tryptophan hydroxylase 2 (TPH2) C 11993 A gene polymorphism in anxiety and depressive disorders. Method: Sixty patients of depression disorder, 60 patients of anxiety disorder and 40 unrelated healthy volunteers (control) were studied in a case control design. Polymorphism was determined using polymerase chain reaction (PCR) and agarose gel electrophoresis after digestion with HAP II enzyme. Genotypes and allele frequencies were compared using Chi-square tests, Fischer’s exact test, odds ratio, 95% confidence interval (C.I) and p-value of <0.05 was considered to be statistical significant. Results: The mean age ± SD of anxiety, depression and control group was 32.73±10.99, 32.20±10 and 29.75±10.12 respectively and the difference was found to be statistically non significant (p=0.349).The mean HAM-A (Hamilton rating scale for anxiety) score and HAM-D (Hamilton rating scale for depression) score was high in both groups (anxiety and depression) and found to be statistically significant (p=0.001).Depression group had AA genotype (55.2%) than control (37.5%) and was found to be statistically non significant (p=0.890).Comparison of allelic frequency revealed no association of A allele in anxiety group (76.67%) compared with control (75.5%) and was found to be statistically non significant (p= 0.866), OR 1.09 (0.56-2.11). Conclusion: TPH2C 11993 A gene was not found to be associated with major depressive disorder (MDD) and anxiety disorder in Kashmiri population. PMID:25121048

  1. The Comorbidity of Major Depression and Anxiety Disorders: Recognition and Management in Primary Care

    PubMed Central

    Hirschfeld, Robert M. A.

    2001-01-01

    Background: Depressive and anxiety disorders commonly occur together in patients presenting in the primary care setting. Although recognition of individual depressive and anxiety disorders has increased substantially in the past decade, recognition of comorbidity still lags. The current report reviews the epidemiology, clinical implications, and management of comorbidity in the primary care setting. Method: Literature was reviewed by 2 methods: (1) a MEDLINE search (1980–2001) using the key words depression, depressive disorders, and anxiety disorders; comorbidity was also searched with individual anxiety diagnoses; and (2) direct search of psychiatry, primary care, and internal medicine journals over the past 5 years. Results: Between 10% and 20% of adults in any given 12-month period will visit their primary care physician during an anxiety or depressive disorder episode (although typically for a nonpsychiatric complaint); more than 50% of these patients suffer from a comorbid second depressive or anxiety disorder. The presence of depressive/anxiety comorbidity substantially increases medical utilization and is associated with greater chronicity, slower recovery, increased rates of recurrence, and greater psychosocial disability. Typically, long-term treatment is indicated, although far less research is available to guide treatment decisions. Selective serotonin reuptake inhibitor antidepressants are the preferred treatment based on efficacy, safety, and tolerability criteria. Knowledge of their differential clinical and pharmacokinetic profiles can assist in optimizing treatment. Conclusion: Increased recognition of the high prevalence and negative psychosocial impact of depression and anxiety disorder comorbidity will lead to more effective treatment. While it is hoped that early and effective intervention will yield long-term benefits, research is needed to confirm this. PMID:15014592

  2. 5-Hydroxy tryptamine transporter (5HTT) gene promoter region polymorphism in anxiety and depressive disorders

    PubMed Central

    Mushtaq, Raheel; Shoib, Sheikh; Shah, Tabindah; Mushtaq, Sahil

    2014-01-01

    Background: 5HTTLPR polymorphism (5- Hydroxy tryptamine transporter linked promoter region polymorphism) is the most widely studied genetic variant in psychiatry. The present study is a modest effort at ascertaining the role of 5HT transporter linked promoter region polymorphism (5HTTLPR) in anxiety and depressive disorders in Kashmir (India).The aim of this study was to examine 5-Hydroxy tryptamine transporter (5HTT) gene promoter region polymorphism in anxiety and depressive disorders. Methods: Thirty patients with unipolar depressive disorders, 30 patients with anxiety disorders and 40 healthy volunteers (controls) were studied on a case control design, using polymerase chain reaction (PCR) and agarose gel electrophoresis after digestion with endonuclease enzyme. Genotypes and allele frequencies were compared using chi square tests, and p value of < 0.05 was considered as statistically significant. Results: The mean (±sd) HAM-A (Hamilton rating scale for anxiety) scores for anxiety and depressive groups were 28.2±5.14 and 17±5.61, respectively (P < 0.001). The mean (±sd) HAM-D (Hamilton rating scale for depression) scores for depressive and anxiety groups were 25±5.58 and 15±6.13, respectively. (p< 0.001). The frequency of S allele was significantly high (83.3% vs 60%) in the group with anxiety (p< 0.05) compared to the control group (p> 0.05). Conclusion: The genetic studies are still evolving as pathogenesis of anxiety and depressive disorders and involve the interaction of environmental factors with various genes. Genetic variation in different populations and hence different environments is important for elucidation of the mechanisms of these disorders. However, the study concludes that the locus under study is not shared between the two disorders. PMID:25679006

  3. A Meta-Analysis on the Relationship between Self-Reported Presence and Anxiety in Virtual Reality Exposure Therapy for Anxiety Disorders

    PubMed Central

    Ling, Yun; Nefs, Harold T.; Morina, Nexhmedin; Heynderickx, Ingrid; Brinkman, Willem-Paul

    2014-01-01

    In virtual reality exposure therapy (VRET) for anxiety disorders, sense of presence in the virtual environment is considered the principal mechanism that enables anxiety to be felt. Existing studies on the relation between sense of presence and level of anxiety, however, have yielded mixed results on the correlation between the two. In this meta-analysis, we reviewed publications on VRET for anxiety that included self-reported presence and anxiety. The comprehensive search of the literature identified 33 publications with a total of 1196 participants. The correlation between self-reported sense of presence and anxiety was extracted and meta-analyzed. Potential moderators such as technology characteristics, sample characteristics including age, gender and clinical status, disorder characteristics and study design characteristics such as measurements were also examined. The random effects analysis showed a medium effect size for the correlation between sense of presence and anxiety (r?=?.28; 95% CI: 0.18–0.38). Moderation analyses revealed that the effect size of the correlation differed across different anxiety disorders, with a large effect size for fear of animals (r?=?.50; 95% CI: 0.30–0.66) and a no to small effect size for social anxiety disorder (r?=?.001; 95% CI: ?0.19–0.19). Further, the correlation between anxiety and presence was stronger in studies with participants who met criteria for an anxiety disorder than in studies with a non-clinical population. Trackers with six degrees of freedom and displays with a larger field of view resulted in higher effect sizes, compared to trackers with three degrees of freedom and displays with a smaller field of view. In addition, no difference in effect size was found for the type of presence measurement and the type of anxiety measurement. This meta-analysis confirms the positive relation between sense of presence and anxiety and demonstrates that this relation can be affected by various moderating factors. PMID:24801324

  4. Associations between sleep problems and attentional and behavioral functioning in children with anxiety disorders and ADHD.

    PubMed

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

    2014-01-01

    This study examined associations between sleep problems and attentional and behavioral functioning in 137 children aged 7 to 13 years with anxiety disorders (n = 39), attention deficit hyperactivity disorder (ADHD; n = 38), combined anxiety disorder and ADHD (n = 25), and 35 controls. Diagnoses were made using the semistructured diagnostic interview Schedule for Affective Disorders and Schizophrenia for School-age Children-Present and Lifetime Version. Sleep problems were assessed using the Children's Sleep Habits Questionnaire, attention was measured by the Attention Network Test, and behavioral problems were measured by teacher ratings on the Achenbach System of Empirically Based Assessment, Teacher Report Form. Sleep problems were associated with reduced efficiency of the alerting attention system for all children and with increased internalizing problems in children with anxiety disorders. PMID:23461477

  5. Validation of the social appearance anxiety scale in female eating disorder patients.

    PubMed

    Claes, Laurence; Hart, Trevor A; Smits, Dirk; Van den Eynde, Frederique; Mueller, Astrid; Mitchell, James E

    2012-09-01

    In the present study, we investigated the psychometric properties of the Social Appearance Anxiety Scale (SAAS) in a sample of 60 female eating disorder patients (M(age) = 27.82, SD = 9.76). The SAAS was developed to assess anxiety about being negatively evaluated for one's appearance. All patients completed the SAAS, the Eating Disorder Inventory-2, the Physical Health Questionnaire-9 Depression and the Dimensional Assessment of Personality Psychopathology. The SAAS demonstrated a one-factor structure and a high internal consistency. The SAAS was significantly positive in relation to body mass index, drive for thinness and body dissatisfaction. Concerning personality dimensions, the SAAS was positively related to emotional problems (e.g. depression, anxiety) and interpersonal problems (e.g. suspiciousness, submissiveness). Findings suggest that the SAAS is a psychometrically sound instrument to assess anxiety about being negatively evaluated about one's appearance in a sample of eating disorder patients. PMID:21805536

  6. A review of studies concerning treatment adherence of patients with anxiety disorders

    PubMed Central

    Santana, Lívia; Fontenelle, Leonardo F

    2011-01-01

    Objective This paper aimed at describing the most consistent correlates and/or predictors of nonadherence to treatment of patients with different anxiety disorders. Method The authors retrieved studies indexed in PubMed/MedLine, PsycINFO, and ISI Web of Knowledge using the following search terms: attrition OR dropout OR attrition rates OR patient dropouts OR treatment adherence AND anxiety disorders. Research was limited to articles published before January 2010. Results Sixteen studies were selected that investigated the impact of sociodemographic, clinical, or cognitive variables on adherence to treatment for anxiety disorders. While no consistent pattern of sociodemographic or clinical features associated with nonadherence emerged, all studies that investigated cognitive variables in panic disorder, social anxiety disorder, and obsessive-compulsive disorder found that expectations and opinions about treatment were related to adherence. Conclusion The findings of this study suggest that it is essential to consider anxiety disorder patients’ beliefs about illness and treatment strategies to increase their compliance with the therapeutic plan. PMID:21949606

  7. Cognitive-Behavioral Treatment of Late-Life Anxiety Disorders.

    ERIC Educational Resources Information Center

    Gorenstein, Ethan E.; Papp, Lazlo A.

    In the absence of data, pharmacotherapy with benzodiazepines has become the mainstay of anxiety management in the elderly population. However, the use of benzodiazepines in the elderly has many problems. Elderly persons are more sensitive to anti-anxiety medications and are subject to a variety of increased risks, including cognitive impairment,…

  8. Prioritization and Association Analysis of Murine-Derived Candidate Genes in Anxiety-Spectrum Disorders

    PubMed Central

    Hettema, John M.; Webb, Bradley T.; Guo, An-Yuan; Zhao, Zhongming; Maher, Brion S.; Chen, Xiangning; An, Seon-Sook; Sun, Cuie; Aggen, Steven H.; Kendler, Kenneth S.; Kuo, Po-Hsiu; Otowa, Takeshi; Flint, Jonathan; van den Oord, Edwin J.

    2011-01-01

    Background Anxiety disorders are common psychiatric conditions that are highly comorbid with each other and related phenotypes such as depression, likely due to a shared genetic basis. Fear-related behaviors in mice have long been investigated as potential models of anxiety disorders, making integration of information from both murine and human genetic data a powerful strategy for identifying potential susceptibility genes for these conditions. Methods We combined genome-wide association analysis of fear-related behaviours with strain distribution pattern analysis in heterogeneous stock mice to identify a preliminary list of 52 novel candidate genes. We ranked these according to three complementary sources of prior anxiety-related genetic data: (1) extant linkage and knock-out studies in mice, (2) a meta-analysis of human linkage scans, and (3) a preliminary human genomewide association study. We genotyped tagging SNPs covering the nine top-ranked regions in a two-stage association study of 1316 subjects from the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders chosen for high or low genetic loading for anxiety-spectrum phenotypes (anxiety disorders, neuroticism, and major depression). Results Multiple SNPs in the PPARGC1A gene demonstrated association in both stages that survived gene-wise correction for multiple testing. Conclusions Integration of genetic data across human and murine studies suggests PPARGC1A as a potential susceptibility gene for anxiety-related disorders. PMID:21871609

  9. Does D-Cycloserine Enhance Exposure Therapy for Anxiety Disorders in Humans? A Meta-Analysis

    PubMed Central

    Rodrigues, Helga; Figueira, Ivan; Lopes, Alessandra; Gonçalves, Raquel; Mendlowicz, Mauro Vitor; Coutinho, Evandro Silva Freire; Ventura, Paula

    2014-01-01

    The treatment of anxiety is on the edge of a new era of combinations of pharmacologic and psychosocial interventions. A new wave of translational research has focused on the use of pharmacological agents as psychotherapy adjuvants using neurobiological insights into the mechanism of the action of certain psychological treatments such as exposure therapy. Recently, d-cycloserine (DCS) an antibiotic used to treat tuberculosis has been applied to enhance exposure-based treatment for anxiety and has proved to be a promising, but as yet unproven intervention. The present study aimed to evaluate the efficacy of DCS in the enhancement of exposure therapy in anxiety disorders. A systematic review/meta-analysis was conducted. Electronic searches were conducted in the databases ISI-Web of Science, Pubmed and PsycINFO. We included only randomized, double-blind, placebo-controlled trials with humans, focusing on the role of DCS in enhancing the action of exposure therapy for anxiety disorders. We identified 328 references, 13 studies were included in our final sample: 4 on obsessive-compulsive disorder, 2 on panic disorder, 2 on social anxiety disorder, 2 on posttraumatic stress disorder, one on acrophobia, and 2 on snake phobia. The results of the present meta-analysis show that DCS enhances exposure therapy in the treatment of anxiety disorders (Cohen d?=? ?0.34; CI: ?0.54 to ?0.14), facilitating the specific process of extinction of fear. DCS seems to be effective when administered at a time close to the exposure therapy, at low doses and a limited number of times. DCS emerges as a potential new therapeutic approach for patients with refractory anxiety disorders that are unresponsive to the conventional treatments available. When administered correctly, DCS is a promising strategy for augmentation of CBT and could reduce health care costs, drop-out rates and bring faster relief to patients. PMID:24991926

  10. Pathophysiology, diagnosis, and treatment of mineralocorticoid disorders.

    PubMed

    Magill, Steven B

    2014-07-01

    The renin-angiotensin-aldosterone system (RAAS) is a major regulator of blood pressure control, fluid, and electrolyte balance in humans. Chronic activation of mineralocorticoid production leads to dysregulation of the cardiovascular system and to hypertension. The key mineralocorticoid is aldosterone. Hyperaldosteronism causes sodium and fluid retention in the kidney. Combined with the actions of angiotensin II, chronic elevation in aldosterone leads to detrimental effects in the vasculature, heart, and brain. The adverse effects of excess aldosterone are heavily dependent on increased dietary salt intake as has been demonstrated in animal models and in humans. Hypertension develops due to complex genetic influences combined with environmental factors. In the last two decades, primary aldosteronism has been found to occur in 5% to 13% of subjects with hypertension. In addition, patients with hyperaldosteronism have more end organ manifestations such as left ventricular hypertrophy and have significant cardiovascular complications including higher rates of heart failure and atrial fibrillation compared to similarly matched patients with essential hypertension. The pathophysiology, diagnosis, and treatment of primary aldosteronism will be extensively reviewed. There are many pitfalls in the diagnosis and confirmation of the disorder that will be discussed. Other rare forms of hyper- and hypo-aldosteronism and unusual disorders of hypertension will also be reviewed in this article. PMID:24944031

  11. Role of Comorbid Depression and Co-Occurring Depressive Symptoms in Outcomes for Anxiety-Disordered Youth Treated with Cognitive-Behavioral Therapy

    ERIC Educational Resources Information Center

    O'Neil, Kelly A.; Kendall, Philip C.

    2012-01-01

    This study examined the role of comorbid depressive disorders (major depressive disorder or dysthymic disorder) and co-occurring depressive symptoms in treatment outcome and maintenance for youth (N = 72, aged 7-14) treated with cognitive-behavioral therapy for a principal anxiety disorder (generalized anxiety disorder, separation anxiety

  12. Mood assessment via animated characters: a novel instrument to evaluate feelings in young children with anxiety disorders.

    PubMed

    Manassis, Katharina; Mendlowitz, Sandra; Kreindler, David; Lumsden, Charles; Sharpe, Jason; Simon, Mark D; Woolridge, Nicholas; Monga, Suneeta; Adler-Nevo, Gili

    2009-05-01

    We evaluated a novel, computerized feelings assessment instrument (MAAC) in 54 children with anxiety disorders and 35 nonanxious children ages 5 to 11. They rated their feelings relative to 16 feeling animations. Ratings of feelings, order of feeling selection, and correlations with standardized anxiety measures were examined. Positive emotions were rated more highly and visited earlier by nonanxious children. Children with anxiety disorders explored fewer emotions. MAAC ratings on several positive emotions showed inverse correlations with state anxiety. Although needing further evaluation, MAAC may facilitate feelings assessment in young children and may distinguish children with anxiety disorders from nonanxious children. PMID:19437298

  13. Preschool Anxiety Disorders Predict Different Patterns of Amygdala-Prefrontal Connectivity at School-Age

    PubMed Central

    Carpenter, Kimberly L. H.; Angold, Adrian; Chen, Nan-Kuei; Copeland, William E.; Gaur, Pooja; Pelphrey, Kevin; Song, Allen W.; Egger, Helen L.

    2015-01-01

    Objective In this prospective, longitudinal study of young children, we examined whether a history of preschool generalized anxiety, separation anxiety, and/or social phobia is associated with amygdala-prefrontal dysregulation at school-age. As an exploratory analysis, we investigated whether distinct anxiety disorders differ in the patterns of this amygdala-prefrontal dysregulation. Methods Participants were children taking part in a 5-year study of early childhood brain development and anxiety disorders. Preschool symptoms of generalized anxiety, separation anxiety, and social phobia were assessed with the Preschool Age Psychiatric Assessment (PAPA) in the first wave of the study when the children were between 2 and 5 years old. The PAPA was repeated at age 6. We conducted functional MRIs when the children were 5.5 to 9.5 year old to assess neural responses to viewing of angry and fearful faces. Results A history of preschool social phobia predicted less school-age functional connectivity between the amygdala and the ventral prefrontal cortices to angry faces. Preschool generalized anxiety predicted less functional connectivity between the amygdala and dorsal prefrontal cortices in response to fearful faces. Finally, a history of preschool separation anxiety predicted less school-age functional connectivity between the amygdala and the ventral prefrontal cortices to angry faces and greater school-age functional connectivity between the amygdala and dorsal prefrontal cortices to angry faces. Conclusions Our results suggest that there are enduring neurobiological effects associated with a history of preschool anxiety, which occur over-and-above the effect of subsequent emotional symptoms. Our results also provide preliminary evidence for the neurobiological differentiation of specific preschool anxiety disorders. PMID:25625285

  14. Dual Diagnosis: Adolescents with Co-Occurring Brain Disorders and Substance Abuse Disorders

    MedlinePLUS

    ... org ©2015 Dual Diagnosis: Adolescents with Co-occurring Brain Disorders & Substance Abuse Disorders Adolescents are often referred ... there is a period of convalescence with a brain disorder. There may be relapses and times of ...

  15. A Multitrait-Multimethod Analysis of the Construct Validity of Child Anxiety Disorders in a Clinical Sample

    ERIC Educational Resources Information Center

    Langer, David A.; Wood, Jeffrey J.; Bergman, R. Lindsey; Piacentini, John C.

    2010-01-01

    The present study examines the construct validity of separation anxiety disorder (SAD), social phobia (SoP), panic disorder (PD), and generalized anxiety disorder (GAD) in a clinical sample of children. Participants were 174 children, 6 to 17 years old (94 boys) who had undergone a diagnostic evaluation at a university hospital based clinic.…

  16. Anxiety disorders comorbidity in first-episode depressed patients: Personality differences based on the temperament and character inventory

    Microsoft Academic Search

    Omar Minaya; Ana Fresán

    2009-01-01

    Major depression and anxiety disorders are frequently comorbid diagnoses. Previous studies proposed that personality traits are relevant in the distinction of both disorders. The psychobiological model of personality might be a useful tool to address these differences. To examine personality differences in first-episode depressed adult outpatients with and without comorbidity with anxiety disorders and control subjects. We recruited 80 patients

  17. Content specificity of attention bias to threat in anxiety disorders: a meta-analysis.

    PubMed

    Pergamin-Hight, Lee; Naim, Reut; Bakermans-Kranenburg, Marian J; van IJzendoorn, Marinus H; Bar-Haim, Yair

    2015-02-01

    Despite the established evidence for threat-related attention bias in anxiety, the mechanisms underlying this bias remain unclear. One important unresolved question is whether disorder-congruent threats capture attention to a greater extent than do more general or disorder-incongruent threat stimuli. Evidence for attention bias specificity in anxiety would implicate involvement of previous learning and memory processes in threat-related attention bias, whereas lack of content specificity would point to perturbations in more generic attention processes. Enhanced clarity of mechanism could have clinical implications for the stimuli types used in Attention Bias Modification Treatments (ABMT). Content specificity of threat-related attention bias in anxiety and potential moderators of this effect were investigated. A systematic search identified 37 samples from 29 articles (N=866). Relevant data were extracted based on specific coding rules, and Cohen's d effect size was used to estimate bias specificity effects. The results indicate greater attention bias toward disorder-congruent relative to disorder-incongruent threat stimuli (d=0.28, p<0.0001). This effect was not moderated by age, type of anxiety disorder, visual attention tasks, or type of disorder-incongruent stimuli. No evidence of publication bias was observed. Implications for threat bias in anxiety and ABMT are discussed. PMID:25462110

  18. Rare Genomic Variants Link Bipolar Disorder with Anxiety Disorders to CREB-Regulated Intracellular Signaling Pathways

    PubMed Central

    Kerner, Berit; Rao, Aliz R.; Christensen, Bryce; Dandekar, Sugandha; Yourshaw, Michael; Nelson, Stanley F.

    2013-01-01

    Bipolar disorder is a common, complex, and severe psychiatric disorder with cyclical disturbances of mood and a high suicide rate. Here, we describe a family with four siblings, three affected females and one unaffected male. The disease course was characterized by early-onset bipolar disorder and co-morbid anxiety spectrum disorders that followed the onset of bipolar disorder. Genetic risk factors were suggested by the early onset of the disease, the severe disease course, including multiple suicide attempts, and lack of adverse prenatal or early life events. In particular, drug and alcohol abuse did not contribute to the disease onset. Exome sequencing identified very rare, heterozygous, and likely protein-damaging variants in eight brain-expressed genes: IQUB, JMJD1C, GADD45A, GOLGB1, PLSCR5, VRK2, MESDC2, and FGGY. The variants were shared among all three affected family members but absent in the unaffected sibling and in more than 200 controls. The genes encode proteins with significant regulatory roles in the ERK/MAPK and CREB-regulated intracellular signaling pathways. These pathways are central to neuronal and synaptic plasticity, cognition, affect regulation and response to chronic stress. In addition, proteins in these pathways are the target of commonly used mood-stabilizing drugs, such as tricyclic antidepressants, lithium, and valproic acid. The combination of multiple rare, damaging mutations in these central pathways could lead to reduced resilience and increased vulnerability to stressful life events. Our results support a new model for psychiatric disorders, in which multiple rare, damaging mutations in genes functionally related to a common signaling pathway contribute to the manifestation of bipolar disorder. PMID:24348429

  19. Co-morbidity between major depressive disorder and anxiety disorders: shared etiology or direct causation?

    PubMed Central

    Mathew, A. R.; Pettit, J. W.; Lewinsohn, P. M.; Seeley, J. R.; Roberts, R. E.

    2013-01-01

    Background Major depressive disorder (MDD) and anxiety disorders (ANX) are debilitating and prevalent conditions that often co-occur in adolescence and young adulthood. The leading theoretical models of their co-morbidity include the direct causation model and the shared etiology model. The present study compared these etiological models of MDD–ANX co-morbidity in a large, prospective, non-clinical sample of adolescents tracked through age 30. Method Logistic regression was used to examine cross-sectional associations between ANX and MDD at Time 1 (T1). In prospective analyses, Cox proportional hazards models were used to examine T1 predictors of subsequent disorder onset, including risk factors specific to each disorder or common to both disorders. Prospective predictive effect of a lifetime history of one disorder (e.g. MDD) on the subsequent onset of the second disorder (e.g. ANX) was then examined. This step was repeated while controlling for common risk factors. Results The findings supported relatively distinct profiles of risk between MDD and ANX depending on order of development. Whereas the shared etiology model best explained co-morbid cases in which MDD preceded ANX, direct causation was supported for co-morbid cases in which ANX preceded MDD. Conclusions Consistent with previous research, significant cross-sectional and prospective associations were found between MDD and ANX. The results of the present study suggest that different etiological models may characterize the co-morbidity between MDD and ANX based upon the temporal order of onset. Implications for classification and prevention efforts are discussed. PMID:21439108

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

    Microsoft Academic Search

    Heidi Gazelle; Jamie Olson Workman; Wesley Allan

    2010-01-01

    It was hypothesized that children identified by their peers at school as anxious solitary would report more symptoms of social\\u000a anxiety disorder on a self report questionnaire and, on the basis of child and parent clinical interviews, receive more diagnoses\\u000a of social anxiety disorder and additional anxiety and mood disorders. Participants were 192 children drawn from a community\\u000a sample of

  1. Development and evaluation of a new paradigm for the assessment of anxiety-disorder-specific interpretation bias using picture stimuli

    Microsoft Academic Search

    Tina In-Albon; Anke Klein; Mike Rinck; Eni Becker; Silvia Schneider

    2008-01-01

    An important factor in cognitive theories of anxiety disorders is the way in which information is processed. Findings support the existence of a biased information-processing style in anxious children. So far, cognitive biases in children with anxiety disorders are typically assessed as a general phenomenon. Thus, there is a lack of studies in children focusing on anxiety-disorder-specific interpretation bias. A

  2. Nonlinear relationships between anxiety and visual processing of own and others’ faces in body dysmorphic disorder

    PubMed Central

    Bohon, Cara; Hembacher, Emily; Moller, Hayley; Moody, Teena D.; Feusner, Jamie D.

    2012-01-01

    Individuals with body dysmorphic disorder (BDD) often experience anxiety, as well as perceptual distortions of appearance. Anxiety has previously been found to impact visual processing. This study therefore tested the relationship between anxiety and visual processing of faces in BDD. Medication-free participants with BDD (N=17) and healthy controls (N=16) viewed photographs of their face and a familiar face during functional magnetic resonance imaging. Blood-oxygen-level dependent signal changes in regions involved in anxiety (amygdala) and detailed visual processing (ventral visual stream – VVS) were regressed on anxiety scores. Significant linear relationships between activity in the amygdala and VVS were found in both healthy controls and individuals with BDD. There was a trend of a quadratic relationship between anxiety and activity in the right VVS and a linear relationship between anxiety and activity in the left VVS for the BDD sample, and this was stronger for own-face stimuli versus familiar-face. Results suggest that anxiety symptoms in BDD may be associated with activity in systems responsible for detailed visual processing. This may have clinical implications related to heightened perceptual distortions associated with anxiety. PMID:23137801

  3. The regional distribution of anxiety disorders: implications for the Global Burden of Disease Study, 2010.

    PubMed

    Baxter, Amanda J; Vos, Theo; Scott, Kate M; Norman, Rosana E; Flaxman, Abraham D; Blore, Jed; Whiteford, Harvey A

    2014-12-01

    Anxiety disorders are increasingly acknowledged as a global health issue however an accurate picture of prevalence across populations is lacking. Empirical data are incomplete and inconsistent so alternate means of estimating prevalence are required to inform estimates for the new Global Burden of Disease Study 2010. We used a Bayesian meta-regression approach which included empirical epidemiological data, expert prior information, study covariates and population characteristics. Reported are global and regional point prevalence for anxiety disorders in 2010. Point prevalence of anxiety disorders differed by up to three-fold across world regions, ranging between 2.1% (1.8-2.5%) in East Asia and 6.1% (5.1-7.4%) in North Africa/Middle East. Anxiety was more common in Latin America; high income regions; and regions with a history of recent conflict. There was considerable uncertainty around estimates, particularly for regions where no data were available. Future research is required to examine whether variations in regional distributions of anxiety disorders are substantive differences or an artefact of cultural or methodological differences. This is a particular imperative where anxiety is consistently reported to be less common, and where it appears to be elevated, but uncertainty prevents the reporting of conclusive estimates. PMID:25048296

  4. Anxiety sensitivity: Relations to psychopathy, DSM-IV personality disorder features, and personality traits

    Microsoft Academic Search

    Scott O Lilienfeld; Suzanne Penna

    2001-01-01

    Relatively few data are available concerning the relations between anxiety sensitivity (AS) and both abnormal and normal personality traits. In particular, little is known about the associations between AS and personality disorders, although Shostak and Peterson [Behav. Res. Ther. 28 (1990) 513.] hypothesized that AS would be negatively correlated with antisocial personality disorder (ASPD) and perhaps related conditions (e.g., psychopathy).

  5. Specificity of Treatment Effects: Cognitive Therapy and Relaxation for Generalized Anxiety and Panic Disorders

    ERIC Educational Resources Information Center

    Siev, Jedidiah; Chambless, Dianne L.

    2007-01-01

    The aim of this study was to address claims that among bona fide treatments no one is more efficacious than another by comparing the relative efficacy of cognitive therapy (CT) and relaxation therapy (RT) in the treatment of generalized anxiety disorder (GAD) and panic disorder without agoraphobia (PD). Two fixed-effects meta-analyses were…

  6. Pilot Study: Fluvoxamine Treatment for Depression and Anxiety Disorders in Children and Adolescents with Cancer

    ERIC Educational Resources Information Center

    Gothelf, Doron; Rubinstein, Maly; Shemesh, Eyal; Miller, Orit; Farbstein, Ilana; Klein, Anat; Weizman, Abraham; Apter, Alan; Yaniv, Isaac

    2005-01-01

    Objective: To evaluate the safety, tolerability, and benefit of fluvoxamine for the treatment of major depressive disorder or anxiety disorders in children and adolescents with cancer. Method: The study was conducted from 2001 to 2004 at a pediatric hematology-oncology center. Fifteen children and adolescents with cancer were treated with…

  7. Intrinsic Functional Connectivity of Amygdala-Based Networks in Adolescent Generalized Anxiety Disorder

    ERIC Educational Resources Information Center

    Roy, Amy K.; Fudge, Julie L.; Kelly, Clare; Perry, Justin S. A.; Daniele, Teresa; Carlisi, Christina; Benson, Brenda; Castellanos, F. Xavier; Milham, Michael P.; Pine, Daniel S.; Ernst, Monique

    2013-01-01

    Objective: Generalized anxiety disorder (GAD) typically begins during adolescence and can persist into adulthood. The pathophysiological mechanisms underlying this disorder remain unclear. Recent evidence from resting state functional magnetic resonance imaging (R-fMRI) studies in adults suggests disruptions in amygdala-based circuitry; the…

  8. Relationship of parental trauma exposure and PTSD to PTSD, depressive and anxiety disorders in offspring

    Microsoft Academic Search

    Rachel Yehuda; Sarah L Halligan; Linda M Bierer

    2001-01-01

    This study examined the relationship of parental trauma exposure and PTSD to the development of posttraumatic stress disorder (PTSD), depressive and anxiety disorders in the adult offspring of Holocaust survivors. One hundred and thirty-five subjects (55 men and 80 women) were divided into three groups according to parental trauma exposure and PTSD: 60 subjects were offspring of Holocaust survivors who

  9. Separation Anxiety Disorder in Childhood as a Risk Factor for Future Mental Illness

    ERIC Educational Resources Information Center

    Lewinsohn, Peter M.; Holm-Denoma, Jill M.; Small, Jason W.; Seeley, John R.; Joiner, Thomas E.

    2008-01-01

    A study to examine the association between childhood separation anxiety disorder (SAD) and the risk of the development of psychopathology during young adulthood was conducted. Results showed that SAD contributed to the risk for the development of internalizing disorders, which are panic and depression, but decreased the risk for externalizing…

  10. One Factor or Two Parallel Processes? Comorbidity and Development of Adolescent Anxiety and Depressive Disorder Symptoms

    ERIC Educational Resources Information Center

    Hale, William W., III; Raaijmakers, Quinten A. W.; Muris, Peter; van Hoof, Anne; Meeus, Wim H. J.

    2009-01-01

    Background: This study investigates whether anxiety and depressive disorder symptoms of adolescents from the general community are best described by a model that assumes they are indicative of one general factor or by a model that assumes they are two distinct disorders with parallel growth processes. Additional analyses were conducted to explore…

  11. The impact of co-occurring mood and anxiety disorders among substance-abusing youth

    Microsoft Academic Search

    Dan I. Lubman; Nicholas B. Allen; Nich Rogers; Enrico Cementon; Yvonne Bonomo

    2007-01-01

    BackgroundCo-occurring mood and anxiety disorders are highly prevalent amongst substance-using young adolescents, and have been associated with a range of adverse outcomes. Few studies however have examined the impact of affective disorders in samples of older adolescents and young adults attending youth drug treatment services.

  12. Persistence of Sleep Problems in Children with Anxiety and Attention Deficit Hyperactivity Disorders

    ERIC Educational Resources Information Center

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

    2013-01-01

    This study examines the persistence of sleep problems over 18 months in 76 referred children with anxiety disorders and/or attention deficit hyperactivity disorders (ADHD) and 31 nonreferred controls, and explores predictors of sleep problems at follow-up (T2) in the referred children. Diagnoses were assessed at initial assessment (T1) using the…

  13. Anxiety Disorders: Treatable regardless of the Severity of Comorbid Alcohol Dependence

    Microsoft Academic Search

    Annemiek Schadé; Loes A. Marquenie; Maarten W. J. Koeter; Edwin de Beurs; Richard van Dyck; Wim van den Brink

    2007-01-01

    Aims: Clinical and epidemiological research has shown that comorbidity is the rule rather than exception in the case of psychiatric disorders. Cognitive behavioral therapy (CBT) has been clearly demonstrated to be effective in treating anxiety and avoidance symptoms in patient samples of social phobia and agoraphobia without comorbid alcohol use disorders. It has recently been shown that treatment of comorbid

  14. Cognitive Behavioral Therapy for Anxiety in Children with Autism Spectrum Disorders: A Randomized, Controlled Trial

    ERIC Educational Resources Information Center

    Wood, Jeffrey J.; Drahota, Amy; Sze, Karen; Har, Kim; Chiu, Angela; Langer, David A.

    2009-01-01

    Background: Children with autism spectrum disorders often present with comorbid anxiety disorders that cause significant functional impairment. This study tested a modular cognitive behavioral therapy (CBT) program for children with this profile. A standard CBT program was augmented with multiple treatment components designed to accommodate or…

  15. Children with Anxiety Disorders: Use of a Cognitive Behavioral Therapy Model within a Social Milieu

    ERIC Educational Resources Information Center

    Kearny, Regina; Pawlukewicz, Justine; Guardino, Mary

    2014-01-01

    Because anxiety is the most common mental health disorder diagnosed in children, early intervention is crucial for fundamental coping. Although cognitive-behavioral therapy (CBT) is the preferred treatment method for this affective disorder, instruction for children needs to be specific for them to successfully acquire and implement essential CBT…

  16. Children With Prepubertal-Onset Major Depressive Disorder and Anxiety Grown Up

    Microsoft Academic Search

    Myrna M. Weissman; Susan Wolk; Priya Wickramaratne; Phillip Adams; Steven Greenwald; Neal D. Ryan; Ronald E. Dahl; David Steinberg

    1999-01-01

    Background: The continuity in adulthood of major de- pressive disorder (MDD) first arising before puberty is largely unknown. This information could guide early treat- ment and clarify the appropriateness of including chil- dren with MDD in genetic studies. Methods: Eighty-three subjects with onset of MDD, 44 subjects with anxiety disorder and no MDD, and 91 subjects with no evidence of

  17. Comparison of sleep problems in children with anxiety and attention deficit\\/hyperactivity disorders

    Microsoft Academic Search

    Berit Hjelde Hansen; Benedicte Skirbekk; Beate Oerbeck; Jorg Richter; Hanne Kristensen

    2011-01-01

    This cross-sectional case–control study compared sleep problems in consecutively referred children aged 7–13 years meeting\\u000a DSM-IV criteria for anxiety disorder, attention deficit\\/hyperactivity disorder (ADHD), comorbid anxiety disorder and ADHD,\\u000a and a group of control children of similar age and gender. Diagnoses were assessed with the Kiddie-SADS PL interview, parent\\u000a form, and the sleep problems with a standardized sleep questionnaire, the Children’s

  18. Treating Anxiety Disorders | NIH MedlinePlus the Magazine

    MedlinePLUS

    ... drugs block norepinephrine, the body's "fight-or-flight" stress hormone. This helps control the physical symptoms of anxiety, ... brain cells are more sensitive to a key stress hormone than male cells. "Although more research is necessary ...

  19. Is rTMS an effective therapeutic strategy that can be used to treat anxiety disorders?

    PubMed

    Machado, Sergio; Paes, Flávia; Velasques, Bruna; Teixeira, Silmar; Piedade, Roberto; Ribeiro, Pedro; Nardi, Antonio E; Arias-Carrión, Oscar

    2012-01-01

    Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive procedure whereby a pulsed magnetic field stimulates electrical activity in the brain. Anxiety disorders are the most common of all mental health problems for which effective, mechanism-based treatments remain elusive. Consequently, more advanced non-invasive therapeutic methods are required. A possible method to modulate brain activity and potentially viable for use in clinical practice is rTMS. Here, we focus on the main findings of rTMS from animal models of anxiety and the experimental advances of rTMS that may become a viable clinical application to treat anxiety disorders, one of the most common causes of disability in the workplace in the world. Key advances in combining rTMS with neuroimaging technology may aid such future developments. This article is part of a Special Issue entitled 'Anxiety and Depression'. PMID:21807002

  20. Animal models of anxiety disorders in rats and mice: some conceptual issues

    PubMed Central

    Steimer, Thierry

    2011-01-01

    Animal models can certainly be useful to find out more about the biological bases of anxiety disorders and develop new, more efficient pharmacological and/or behavioral treatments. However, many of the current “models of anxiety” in animals do not deal with pathology itself, but only with extreme forms of anxiety which are still in the normal, adaptive range. These models have certainly provided a lot of information on brain and behavioral mechanisms which could be involved in the etiology and physiopathology of anxiety disorders, but are usually not satisfactory when confronted directly with clinical syndromes. Further progress in this field will probably depend on the finding of endophenotypes which can be studied in both humans and animals with common methodological approaches. The emphasis should be on individual differences in vulnerability, which have to be included in animal models. Finally, progress will also depend on refining theoretical constructs from an interdisciplinary perspective, including psychiatry, psychology, behavioral sciences, genetics, and other neurosciences. PMID:22275854

  1. Internalizing disorders and leukocyte telomere erosion: a prospective study of depression, generalized anxiety disorder and post-traumatic stress disorder.

    PubMed

    Shalev, I; Moffitt, T E; Braithwaite, A W; Danese, A; Fleming, N I; Goldman-Mellor, S; Harrington, H L; Houts, R M; Israel, S; Poulton, R; Robertson, S P; Sugden, K; Williams, B; Caspi, A

    2014-11-01

    There is evidence that persistent psychiatric disorders lead to age-related disease and premature mortality. Telomere length has emerged as a promising biomarker in studies that test the hypothesis that internalizing psychiatric disorders are associated with accumulating cellular damage. We tested the association between the persistence of internalizing disorders (depression, generalized anxiety disorder and post-traumatic stress disorder) and leukocyte telomere length (LTL) in the prospective longitudinal Dunedin Study (n=1037). Analyses showed that the persistence of internalizing disorders across repeated assessments from ages 11 to 38 years predicted shorter LTL at age 38 years in a dose-response manner, specifically in men (?=-0.137, 95% confidence interval (CI): -0.232, -0.042, P=0.005). This association was not accounted for by alternative explanatory factors, including childhood maltreatment, tobacco smoking, substance dependence, psychiatric medication use, poor physical health or low socioeconomic status. Additional analyses using DNA from blood collected at two time points (ages 26 and 38 years) showed that LTL erosion was accelerated among men who were diagnosed with internalizing disorder in the interim (?=-0.111, 95% CI: -0.184, -0.037, P=0.003). No significant associations were found among women in any analysis, highlighting potential sex differences in internalizing-related telomere biology. These findings point to a potential mechanism linking internalizing disorders to accelerated biological aging in the first half of the life course, particularly in men. Because internalizing disorders are treatable, the findings suggest the hypothesis that treating psychiatric disorders in the first half of the life course may reduce the population burden of age-related disease and extend health expectancy. PMID:24419039

  2. The role of corticolimbic circuitry in the development of anxiety disorders in children and adolescents.

    PubMed

    Swartz, Johnna R; Monk, Christopher S

    2014-01-01

    Although most individuals progress through the periods of childhood and adolescence without significant disturbance, these developmental stages encompass the peak onset times for many forms of psychopathology related to altered emotion regulation, including anxiety disorders. Understanding the development of neural circuitry associated with emotion regulation may provide important insights into risk factors for psychopathology and how disturbances in function arise. The amygdala and ventral prefrontal cortex are two major nodes of a corticolimbic circuit involved in processing and regulating responses to emotional stimuli. We begin this chapter by reviewing evidence from diffusion tensor imaging and functional magnetic resonance imaging suggesting that changes in the structure and function of this circuitry occur during typical development in childhood and adolescence. Next, we discuss research on the function of this circuitry in pediatric anxiety disorder patients, and how abnormalities may be related to altered neural development. Finally, we illustrate a model for the role of corticolimbic circuitry in examining the development of anxiety disorders by discussing how the structure and function of this circuitry can serve as a neural mediator for linking genetic and environmental influences to the development of anxiety disorders. This model has the potential to inform our understanding of why anxiety disorders typically onset during childhood and adolescence and provides future directions for research that may allow us to better predict or prevent their development.. PMID:23950019

  3. Reduced Anterior Temporal and Hippocampal Functional Connectivity During Face Processing Discriminates Individuals with Social Anxiety Disorder from Healthy Controls and Panic Disorder, and Increases Following Treatment

    PubMed Central

    Pantazatos, Spiro P; Talati, Ardesheer; Schneier, Franklin R; Hirsch, Joy

    2014-01-01

    Group functional magnetic resonance imaging (fMRI) studies suggest that anxiety disorders are associated with anomalous brain activation and functional connectivity (FC). However, brain-based features sensitive enough to discriminate individual subjects with a specific anxiety disorder and that track symptom severity longitudinally, desirable qualities for putative disorder-specific biomarkers, remain to be identified. Blood oxygen level-dependent (BOLD) fMRI during emotional face perceptual tasks and a new, large-scale and condition-dependent FC and machine learning approach were used to identify features (pair-wise correlations) that discriminated patients with social anxiety disorder (SAD, N=16) from controls (N=19). We assessed whether these features discriminated SAD from panic disorder (PD, N=16), and SAD from controls in an independent replication sample that performed a similar task at baseline (N: SAD=15, controls=17) and following 8-weeks paroxetine treatment (N: SAD=12, untreated controls=7). High SAD vs HCs discrimination (area under the ROC curve, AUC, arithmetic mean of sensitivity and specificity) was achieved with two FC features during unattended neutral face perception (AUC=0.88, P<0.05 corrected). These features also discriminated SAD vs PD (AUC=0.82, P=0.0001) and SAD vs HCs in the independent replication sample (FC during unattended angry face perception, AUC=0.71, P=0.01). The most informative FC was left hippocampus-left temporal pole, which was reduced in both SAD samples (replication sample P=0.027), and this FC increased following the treatment (post>pre, t(11)=2.9, P=0.007). In conclusion, SAD is associated with reduced FC between left temporal pole and left hippocampus during face perception, and results suggest promise for emerging FC-based biomarkers for SAD diagnosis and treatment effects. PMID:24084831

  4. Is a gin and tonic more like gin or tonic? A comparison of comorbid and non-comorbid anxiety disorder diagnostic pairs.

    PubMed

    Norton, Peter J; Chase, Tannah E

    2015-01-30

    Despite findings indicating that anxiety disorders are more likely to co-occur with each other than occur in isolation, little research has explored precise areas of overlap and differentiation among comorbid pairs of anxiety disorders. Furthermore, many studies comparing phenomena across anxiety disorders define comparison groups based on principal diagnoses, with lesser regard for comorbid diagnoses, raising the question as to whether this is a valid approach to analyzing comparisons. To better understand the extent to which comparisons by principal diagnoses are valid, the current study investigated whether comorbid hierarchically opposing diagnostic pairs showed similarities and differences from their non-comorbid, or "pure", counterparts on measures of clinician-rated functioning, specific symptoms, vulnerability factors, and demographic characteristics. The study included a total of 353 participants with diagnoses of either Panic Disorder (PD) only, Social Phobia (SP) only, Generalized Anxiety Disorder (GAD) only, or some comorbid pair of the three. Consistent with hypotheses, results demonstrated that hierarchically opposing diagnostic pairs showed more overlap than differentiation with each other and with non-comorbid counterparts on measures of a given specific non-comorbid diagnosis, indicating that defining comparisons by principal diagnoses may be invalid and misleading. The implications regarding the nosological structure of the DSM and research practice will be discussed. PMID:25468640

  5. Group Cognitive Behavior Therapy for Children with High-Functioning Autism Spectrum Disorders and Anxiety: A Randomized Trial

    ERIC Educational Resources Information Center

    Reaven, Judy; Blakeley-Smith, Audrey; Culhane-Shelburne, Kathy; Hepburn, Susan

    2012-01-01

    Background: Children with high-functioning autism spectrum disorders (ASD) are at high risk for developing significant anxiety. Anxiety can adversely impact functioning across school, home and community environments. Cognitive behavioral therapies (CBT) are frequently used with success for children with anxiety symptoms. Modified CBT interventions…

  6. The impact of comorbid depressive and anxiety disorders on severity of anorexia nervosa in adolescent girls.

    PubMed

    Brand-Gothelf, Ayelet; Leor, Shani; Apter, Alan; Fennig, Silvana

    2014-10-01

    We examined the impact of comorbid depression and anxiety disorders on the severity of anorexia nervosa (AN) in adolescent girls. Adolescent girls with AN (N = 88) were divided into one group with and another group without comorbid disorders, and selected subjective and objective measures of illness severity were compared between the two groups. The comorbid group had significantly higher scores than the noncomorbid group for all four subscales and total scores of the Eating Disorders Examination as well as for all Eating Disorders Inventory-2 subscales, except for bulimia. The comorbid group also had significantly more suicide attempts and hospitalizations compared with the noncomorbid group. There were no significant group differences for the lowest ever body mass index, duration of AN symptoms, and age at AN onset. Our findings suggest that AN with comorbid depression and anxiety disorder is a more severe clinical variant of the disorder, especially with respect to severity of psychological symptoms and suicide risk. PMID:25265267

  7. Neurogenesis and generalization: a new approach to stratify and treat anxiety disorders

    PubMed Central

    Kheirbek, Mazen A; Klemenhagen, Kristen C; Sahay, Amar; Hen, René

    2013-01-01

    Although an influence of adult neurogenesis in mediating some of the effects of antidepressants has received considerable attention in recent years, much less is known about how alterations in this form of plasticity may contribute to psychiatric disorders such as anxiety and depression. One way to begin to address this question is to link the functions of adult-born hippocampal neurons with specific endophenotypes of these disorders. Recent studies have implicated adult-born hippocampal neurons in pattern separation, a process by which similar experiences or events are transformed into discrete, non-overlapping representations. Here we propose that impaired pattern separation underlies the overgeneralization often seen in anxiety disorders, specifically post-traumatic stress disorder and panic disorder, and therefore represents an endophenotype for these disorders. The development of new, pro-neurogenic compounds may therefore have therapeutic potential for patients who display pattern separation deficits. PMID:23187693

  8. Interpersonal Stress Regulation and the Development of Anxiety Disorders: An Attachment-Based Developmental Framework

    PubMed Central

    Nolte, Tobias; Guiney, Jo; Fonagy, Peter; Mayes, Linda C.; Luyten, Patrick

    2011-01-01

    Anxiety disorders represent a common but often debilitating form of psychopathology in both children and adults. While there is a growing understanding of the etiology and maintenance of these disorders across various research domains, only recently have integrative accounts been proposed. While classical attachment history has been a traditional core construct in psychological models of anxiety, contemporary attachment theory has the potential to integrate neurobiological and behavioral findings within a multidisciplinary developmental framework. The current paper proposes a modern attachment theory-based developmental model grounded in relevant literature from multiple disciplines including social neuroscience, genetics, neuroendocrinology, and the study of family factors involved in the development of anxiety disorders. Recent accounts of stress regulation have highlighted the interplay between stress, anxiety, and activation of the attachment system. This interplay directly affects the development of social–cognitive and mentalizing capacities that are acquired in the interpersonal context of early attachment relationships. Early attachment experiences are conceptualized as the key organizer of a complex interplay between genetic, environmental, and epigenetic contributions to the development of anxiety disorders – a multifactorial etiology resulting from dysfunctional co-regulation of fear and stress states. These risk-conferring processes are characterized by hyperactivation strategies in the face of anxiety. The cumulative allostatic load and subsequent “wear and tear” effects associated with hyperactivation strategies converge on the neural pathways of anxiety and stress. Attachment experiences further influence the development of anxiety as potential moderators of risk factors, differentially impacting on genetic vulnerability and relevant neurobiological pathways. Implications for further research and potential treatments are outlined. PMID:21960962

  9. Effects of Mindfulness-Based Stress Reduction (MBSR) on Emotion Regulation in Social Anxiety Disorder

    Microsoft Academic Search

    Philippe R. Goldin; James J. Gross

    2010-01-01

    Mindfulness-based stress reduction (MBSR) is an established program shown to reduce symptoms of stress, anxiety, and depression. MBSR is believed to alter emotional responding by modifying cognitive–affective processes. Given that social anxiety disorder (SAD) is characterized by emotional and attentional biases as well as distorted negative self-beliefs, we examined MBSR-related changes in the brain–behavior indices of emotional reactivity and regulation

  10. Prevalence of anxiety disorders comorbidity in bipolar depression, unipolar depression and dysthymia

    Microsoft Academic Search

    Stefano Pini; Giovanni B Cassano; Elisa Simonini; Mario Savino; Antonio Russo; Stuart A Montgomery

    1997-01-01

    Eighty-seven patients with current episode of depression were assessed by the SCID-P and subdivided in bipolar depressives (N=24), unipolar depressives (n=38) and dysthymics (n=25). Anxiety disorders comorbidity in these three groups was investigated by means of the SCID-P. Panic disorder comorbidity was found in 36.8% of bipolar depressives, 31.4% of unipolar depressives and 13% of dysthymics. Prevalence of obsessive–compulsive disorder

  11. Depression, Anxiety, Anger, and Somatic Symptoms in Patients with Body Dysmorphic Disorder

    Microsoft Academic Search

    Katharine A. Phillips; Jason M. Siniscalchi; Susan L. McElroy

    2004-01-01

    Body dysmorphic disorder (BDD) is a relatively common and impairing disorder. However, little is known about non-BDD symptoms and well-being in patients with this disorder. Seventy-five outpatients with DSM-IV BDD completed the Symptom Questionnaire, a validated self-report measure with four scales: depression, anxiety, somatic\\/somatization, and anger-hostility. Scores were compared to published norms for normal subjects and psychiatric outpatients. Participants in

  12. Effects of anxiety on the long-term course of depressive disorders

    PubMed Central

    Coryell, William; Fiedorowicz, Jess G.; Solomon, David; Leon, Andrew C.; Rice, John P.; Keller, Martin B.

    2012-01-01

    Background It is well established that the presence of prominent anxiety within depressive episodes portends poorer outcomes. Important questions remain as to which anxiety features are important to outcome and how sustained their prognostic effects are over time. Aims To examine the relative prognostic importance of specific anxiety features and to determine whether their effects persist over decades and apply to both unipolar and bipolar conditions. Method Participants with unipolar (n = 476) or bipolar (n = 335) depressive disorders were intensively followed for a mean of 16.7 years (s.d. = 8.5). Results The number and severity of anxiety symptoms, but not the presence of pre-existing anxiety disorders, showed a robust and continuous relationship to the subsequent time spent in depressive episodes in both unipolar and bipolar depressive disorder. The strength of this relationship changed little over five successive 5-year periods. Conclusions The severity of current anxiety symptoms within depressive episodes correlates strongly with the persistence of subsequent depressive symptoms and this relationship is stable over decades. PMID:21984801

  13. [Hyperhidrosis and social anxiety disorder--the same old thing under a different cloak?].

    PubMed

    Nahaloni, Elad; Iancu, Iulian

    2014-10-01

    Hyperhidrosis is a reason for treatment by many specialists in medicine, such as dermatologists, family medicine doctors, surgeons and also psychiatrists. Hyperhidrosis causes considerable distress and disability. Despite the fact that the condition has been known for thousands of years, it is yet unclear whether excessive sweating derives from emotional" activation of the central nervous system, whether the emotional symptoms evolve due to local dysfunction of the sweat glands, or a combination of the two problems. In this article, we will present two conditions: hyperhidrosis and Social Anxiety Disorder, a mental condition with anxiety and avoidanrce in social settings that is frequently accompanied by sweating. We will discuss the similarities and differences between these disorders and the various treatments available for these conditions. Research shows that social anxiety does not explain hyperhidrosis, but that excessive sweating reduces the threshold for social anxiety. Among people with hyperhidrosis, the functional disability and the emotional problems are mediated by the social anxiety. We propose treating the symptoms of hyperhidrosis and social anxiety disorder in combination in order to achieve maximal improvement in these patients. PMID:25518078

  14. Anxiety in youth with and without autism spectrum disorder: Examination of factorial equivalence

    PubMed Central

    White, Susan W.; Lerner, Matthew D.; McLeod, Bryce D.; Wood, Jeffrey J.; Ginsburg, Golda S.; Kerns, Connor; Ollendick, Thomas; Kendall, Philip C.; Piacentini, John; Walkup, John; Compton, Scott

    2014-01-01

    Although anxiety is frequently reported among children and adolescents with autism spectrum disorder (ASD), it has not been established that the manifest symptoms of anxiety in the context of ASD are the same as those seen in youth without ASD. This study sought to examine the metric and latent factor equivalence of anxiety as measured by the Multidimensional Anxiety Scale for Children, parent-report (MASC-P) and child-report (MASC-C), in youth with anxiety disorders and ASD with intact verbal ability (n = 109, Mage = 11.67 yrs, 99 male) and a gender-matched comparison group of typically developing (TD) children and adolescents with anxiety disorders but without ASD (n = 342, Mage = 11.25 yrs, 246 male). Multigroup factorial invariance (MFI) using structural equation modeling indicated equivalent latent factors in youth with and without ASD on the MASC-C (metric invariance). However, the item means and covariances along with the relations among the factor scores were different for the youth with ASD (i.e., lack of evidence for scalar or structural invariance). The MASC-P data did not fit the measure’s established structure for either the ASD or TD group, and post-hoc exploratory factor analysis revealed a different factor structure in the ASD group. Findings suggest that the MASC-C may not measure identical constructs in anxious youth with and without ASD. Further research on the structure of the MASC in clinical samples is warranted. PMID:25526834

  15. Mindfulness and Self-Compassion in Generalized Anxiety Disorder: Examining Predictors of Disability

    PubMed Central

    Hoge, Elizabeth A.; Hölzel, Britta K.; Marques, Luana; Metcalf, Christina A.; Lazar, Sara W.; Simon, Naomi M.

    2013-01-01

    Generalized anxiety disorder (GAD) is a condition characterized by worry and physiological arousal symptoms that causes significant disabilities in patients' lives. In order to improve psychotherapeutic interventions, a careful characterization of the deficiencies of this population as well as factors that ameliorate disability is crucial. Variables that have not traditionally been the focus of research should be considered, such as trait mindfulness and self-compassion. We investigated whether GAD patients would report lower mindfulness and self-compassion levels than healthy stressed individuals. Eighty-seven GAD patients and 49 healthy controls completed the Five Facet Mindfulness Questionnaire, the Self-Compassion Scale, and measures of anxiety. Patients with GAD also completed the Sheehan Disability Scale. Results showed that GAD patients had lower mindfulness and self-compassion than healthy stressed controls, and both were negatively correlated with levels of anxiety, worry, and anxiety sensitivity. In patients, mindfulness was a better predictor of disability than actual anxiety symptom scores. These findings highlight that in the presence of anxiety symptoms, mindfulness can be a factor that helps protect against feeling disabled by the disorder. The findings thereby add an important variable to the characterization of this disorder and should be taken into consideration for future treatment development. PMID:24174978

  16. Can the Components of a Cognitive Model Predict the Severity of Generalized Anxiety Disorder?

    PubMed Central

    Dugas, Michel J.; Savard, Pierre; Gaudet, Adrienne; Turcotte, Julie; Laugesen, Nina; Robichaud, Melisa; Francis, Kylie; Koerner, Naomi

    2010-01-01

    Over the past decade, a number of well-controlled studies have supported the validity of a cognitive model of generalized anxiety disorder (GAD) that has four main components: intolerance of uncertainty, positive beliefs about worry, negative problem orientation, and cognitive avoidance. Although these studies have shown that the model components are associated with high levels of worry in nonclinical samples and with a diagnosis of GAD in clinical samples, they have not addressed the question of whether the model components can predict the severity of GAD. Accordingly, the present study sought to determine if the model components are related to diagnostic severity, worry severity, and somatic symptom severity in a sample of 84 patients with a primary diagnosis of GAD. All model components were related to GAD severity, although positive beliefs about worry and cognitive avoidance were only modestly associated with the severity of the disorder. Intolerance of uncertainty and negative problem orientation had more robust relationships with the severity of GAD (and with worry severity, in particular). When participants were divided into Mild, Moderate, and Severe GAD groups, intolerance of uncertainty and negative problem orientation distinguished the Moderate and Severe GAD groups from the Mild GAD group, even when age, gender, and depressive symptoms were statistically controlled. Overall, the results lend further support to the validity of the model and suggest that intolerance of uncertainty and negative problem orientation are related to the severity of GAD, independently of sociodemographic and associated clinical factors. The theoretical and clinical implications of the findings are discussed. PMID:17499083

  17. Peer Victimization During Adolescence and Risk for Anxiety Disorders in Adulthood: A Prospective Cohort Study

    PubMed Central

    Stapinski, Lexine A; Bowes, Lucy; Wolke, Dieter; Pearson, Rebecca M; Mahedy, Liam; Button, Katherine S; Lewis, Glyn; Araya, Ricardo

    2014-01-01

    Background Peer victimization is ubiquitous across schools and cultures, and has been suggested as one developmental pathway to anxiety disorders. However, there is a dearth of prospective studies examining this relationship. The purpose of this cohort study was to examine the association between peer victimization during adolescence and subsequent anxiety diagnoses in adulthood. A secondary aim was to investigate whether victimization increases risk for severe anxiety presentations involving diagnostic comorbidity. Methods The sample comprised 6,208 adolescents from the Avon Longitudinal Study of Parents and Children who were interviewed about experiences of peer victimization at age 13. Maternal report of her child's victimization was also assessed. Anxiety disorders at age 18 were assessed with the Clinical Interview Schedule–Revised. Multivariable logistic regression was used to examine the association between victimization and anxiety diagnoses adjusted for potentially confounding individual and family factors. Sensitivity analyses explored whether the association was independent of diagnostic comorbidity with depression. Results Frequently victimized adolescents were two to three times more likely to develop an anxiety disorder than nonvictimized adolescents (OR = 2.49, 95% CI: 1.62–3.85). The association remained after adjustment for potentially confounding individual and family factors, and was not attributable to diagnostic overlap with depression. Frequently victimized adolescents were also more likely to develop multiple internalizing diagnoses in adulthood. Conclusions Victimized adolescents are at increased risk of anxiety disorders in later life. Interventions to reduce peer victimization and provide support for victims may be an effective strategy for reducing the burden associated with these disorders. PMID:24788688

  18. Childhood trauma and adult interpersonal relationship problems in patients with depression and anxiety disorders

    PubMed Central

    2014-01-01

    Introduction Although a plethora of studies have delineated the relationship between childhood trauma and onset, symptom severity, and course of depression and anxiety disorders, there has been little evidence that childhood trauma may lead to interpersonal problems among adult patients with depression and anxiety disorders. Given the lack of prior research in this area, we aimed to investigate characteristics of interpersonal problems in adult patients who had suffered various types of abuse and neglect in childhood. Methods A total of 325 outpatients diagnosed with depression and anxiety disorders completed questionnaires on socio-demographic variables, different forms of childhood trauma, and current interpersonal problems. The Childhood Trauma Questionnaire (CTQ) was used to measure five different forms of childhood trauma (emotional abuse, emotional neglect, physical abuse, physical neglect, and sexual abuse) and the short form of the Korean-Inventory of Interpersonal Problems Circumplex Scale (KIIP-SC) was used to assess current interpersonal problems. We dichotomized patients into two groups (abused and non-abused groups) based on CTQ score and investigated the relationship of five different types of childhood trauma and interpersonal problems in adult patients with depression and anxiety disorders using multiple regression analysis. Result Different types of childhood abuse and neglect appeared to have a significant influence on distinct symptom dimensions such as depression, state-trait anxiety, and anxiety sensitivity. In the final regression model, emotional abuse, emotional neglect, and sexual abuse during childhood were significantly associated with general interpersonal distress and several specific areas of interpersonal problems in adulthood. No association was found between childhood physical neglect and current general interpersonal distress. Conclusion Childhood emotional trauma has more influence on interpersonal problems in adult patients with depression and anxiety disorders than childhood physical trauma. A history of childhood physical abuse is related to dominant interpersonal patterns rather than submissive interpersonal patterns in adulthood. These findings provide preliminary evidence that childhood trauma might substantially contribute to interpersonal problems in adulthood. PMID:25648979

  19. Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder: a revision of the 2005 guidelines from the British Association for Psychopharmacology.

    PubMed

    Baldwin, David S; Anderson, Ian M; Nutt, David J; Allgulander, Christer; Bandelow, Borwin; den Boer, Johan A; Christmas, David M; Davies, Simon; Fineberg, Naomi; Lidbetter, Nicky; Malizia, Andrea; McCrone, Paul; Nabarro, Daniel; O'Neill, Catherine; Scott, Jan; van der Wee, Nic; Wittchen, Hans-Ulrich

    2014-05-01

    This revision of the 2005 British Association for Psychopharmacology guidelines for the evidence-based pharmacological treatment of anxiety disorders provides an update on key steps in diagnosis and clinical management, including recognition, acute treatment, longer-term treatment, combination treatment, and further approaches for patients who have not responded to first-line interventions. A consensus meeting involving international experts in anxiety disorders reviewed the main subject areas and considered the strength of supporting evidence and its clinical implications. The guidelines are based on available evidence, were constructed after extensive feedback from participants, and are presented as recommendations to aid clinical decision-making in primary, secondary and tertiary medical care. They may also serve as a source of information for patients, their carers, and medicines management and formulary committees. PMID:24713617

  20. A false sense of security: safety behaviors Erode objective speech performance in individuals with social anxiety disorder.

    PubMed

    Rowa, Karen; Paulitzki, Jeffrey R; Ierullo, Maria D; Chiang, Brenda; Antony, Martin M; McCabe, Randi E; Moscovitch, David A

    2015-05-01

    In the current study, 55 participants with a diagnosis of generalized social anxiety disorder (SAD), 23 participants with a diagnosis of an anxiety disorder other than SAD with no comorbid SAD, and 50 healthy controls completed a speech task as well as self-reported measures of safety behavior use. Speeches were videotaped and coded for global and specific indicators of performance by two raters who were blind to participants' diagnostic status. Results suggested that the objective performance of people with SAD was poorer than that of both control groups, who did not differ from each other. Moreover, self-reported use of safety behaviors during the speech strongly mediated the relationship between diagnostic group and observers' performance ratings. These results are consistent with contemporary cognitive-behavioral and interpersonal models of SAD and suggest that socially anxious individuals' performance skills may be undermined by the use of safety behaviors. These data provide further support for recommendations from previous studies that the elimination of safety behaviors ought to be a priority in cognitive behavioral therapy for SAD. PMID:25892167

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

    PubMed Central

    Le-Niculescu, H; Balaraman, Y; Patel, S D; Ayalew, M; Gupta, J; Kuczenski, R; Shekhar, A; Schork, N; Geyer, M A; Niculescu, A B

    2011-01-01

    Anxiety disorders are prevalent and disabling yet understudied from a genetic standpoint, compared with other major psychiatric disorders such as bipolar disorder and schizophrenia. The fact that they are more common, diverse and perceived as embedded in normal life may explain this relative oversight. In addition, as for other psychiatric disorders, there are technical challenges related to the identification and validation of candidate genes and peripheral biomarkers. Human studies, particularly genetic ones, are susceptible to the issue of being underpowered, because of genetic heterogeneity, the effect of variable environmental exposure on gene expression, and difficulty of accrual of large, well phenotyped cohorts. Animal model gene expression studies, in a genetically homogeneous and experimentally tractable setting, can avoid artifacts and provide sensitivity of detection. Subsequent translational integration of the animal model datasets with human genetic and gene expression datasets can ensure cross-validatory power and specificity for illness. We have used a pharmacogenomic mouse model (involving treatments with an anxiogenic drug—yohimbine, and an anti-anxiety drug—diazepam) as a discovery engine for identification of anxiety candidate genes as well as potential blood biomarkers. Gene expression changes in key brain regions for anxiety (prefrontal cortex, amygdala and hippocampus) and blood were analyzed using a convergent functional genomics (CFG) approach, which integrates our new data with published human and animal model data, as a translational strategy of cross-matching and prioritizing findings. Our work identifies top candidate genes (such as FOS, GABBR1, NR4A2, DRD1, ADORA2A, QKI, RGS2, PTGDS, HSPA1B, DYNLL2, CCKBR and DBP), brain–blood biomarkers (such as FOS, QKI and HSPA1B), pathways (such as cAMP signaling) and mechanisms for anxiety disorders—notably signal transduction and reactivity to environment, with a prominent role for the hippocampus. Overall, this work complements our previous similar work (on bipolar mood disorders and schizophrenia) conducted over the last decade. It concludes our programmatic first pass mapping of the genomic landscape of the triad of major psychiatric disorder domains using CFG, and permitted us to uncover the significant genetic overlap between anxiety and these other major psychiatric disorders, notably the under-appreciated overlap with schizophrenia. PDE10A, TAC1 and other genes uncovered by our work provide a molecular basis for the frequently observed clinical co-morbidity and interdependence between anxiety and other major psychiatric disorders, and suggest schizo-anxiety as a possible new nosological domain. PMID:22832404

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

    PubMed Central

    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). We therefore compared the interpersonal functioning of youth with GAD, SAD, and controls (6 to 13 years). Despite having relatively fewer friends overall, children with GAD did not differ from controls in terms of the likelihood of having a best friend, participation in groups/clubs, and parent ratings of social competence. In comparison, youth with SAD were less socially competent, had fewer friends and difficulty making new friends compared to controls. Findings suggest that peer difficulties are not a universal feature of all childhood AD and highlight a need to better understand the social experiences and functioning of children with GAD. PMID:21739298

  3. Anxious solitude and clinical disorder in middle childhood: bridging developmental and clinical approaches to childhood social anxiety.

    PubMed

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

    2010-01-01

    It was hypothesized that children identified by their peers at school as anxious solitary would report more symptoms of social anxiety disorder on a self report questionnaire and, on the basis of child and parent clinical interviews, receive more diagnoses of social anxiety disorder and additional anxiety and mood disorders. Participants were 192 children drawn from a community sample of 688 children attending public elementary schools. Half of these children were selected because they were identified as anxious solitary by peers and the other half were demographically-matched controls. 192 children provided self reports of social anxiety disorder symptoms on a questionnaire, and 76 of these children and their parent participated in clinical interviews. Results indicate that children identified by their peers as anxious solitary in the fall of 4th grade, compared to control children, were significantly more likely to receive diagnoses of social anxiety disorder, specific phobia, and selective mutism based on parent clinical interviews. Additionally, there was a tendency for these children to be diagnosed with generalized anxiety disorder and post traumatic stress disorder based on parent clinical interviews. Furthermore, children who had been identified as anxious solitary at any time in the 3rd or 4th grades were more likely than control children to report symptoms of social anxiety disorder that fell in the clinical range and to receive diagnoses of social anxiety disorder and dysthymia (both trends) and major depression (a significant effect) according to parental clinical interview. PMID:19707867

  4. Neural mechanisms of symptom improvements in generalized anxiety disorder following mindfulness training???

    PubMed Central

    Hölzel, Britta K.; Hoge, Elizabeth A.; Greve, Douglas N.; Gard, Tim; Creswell, J. David; Brown, Kirk Warren; Barrett, Lisa Feldman; Schwartz, Carl; Vaitl, Dieter; Lazar, Sara W.

    2013-01-01

    Mindfulness training aims to impact emotion regulation. Generalized anxiety disorder (GAD) symptoms can be successfully addressed through mindfulness-based interventions. This preliminary study is the first to investigate neural mechanisms of symptom improvements in GAD following mindfulness training. Furthermore, we compared brain activation between GAD patients and healthy participants at baseline. 26 patients with a current DSM-IV GAD diagnosis were randomized to an 8-week Mindfulness Based Stress Reduction (MBSR, N = 15) or a stress management education (SME, N = 11) active control program. 26 healthy participants were included for baseline comparisons. BOLD response was assessed with fMRI during affect labeling of angry and neutral facial expressions. At baseline, GAD patients showed higher amygdala activation than healthy participants in response to neutral, but not angry faces, suggesting that ambiguous stimuli reveal stronger reactivity in GAD patients. In patients, amygdala activation in response to neutral faces decreased following both interventions. BOLD response in ventrolateral prefrontal regions (VLPFC) showed greater increase in MBSR than SME participants. Functional connectivity between amygdala and PFC regions increased significantly pre- to post-intervention within the MBSR, but not SME group. Both, change in VLPFC activation and amygdala–prefrontal connectivity were correlated with change in Beck Anxiety Inventory (BAI) scores, suggesting clinical relevance of these changes. Amygdala–prefrontal connectivity turned from negative coupling (typically seen in down-regulation of emotions), to positive coupling; potentially suggesting a unique mechanism of mindfulness. Findings suggest that in GAD, mindfulness training leads to changes in fronto-limbic areas crucial for the regulation of emotion; these changes correspond with reported symptom improvements. PMID:24179799

  5. Complementary Medicine, Exercise, Meditation, Diet, and Lifestyle Modification for Anxiety Disorders: A Review of Current Evidence

    PubMed Central

    Sarris, J.; Moylan, S.; Camfield, D. A.; Pase, M. P.; Mischoulon, D.; Berk, M.; Jacka, F. N.; Schweitzer, I.

    2012-01-01

    Use of complementary medicines and therapies (CAM) and modification of lifestyle factors such as physical activity, exercise, and diet are being increasingly considered as potential therapeutic options for anxiety disorders. The objective of this metareview was to examine evidence across a broad range of CAM and lifestyle interventions in the treatment of anxiety disorders. In early 2012 we conducted a literature search of PubMed, Scopus, CINAHL, Web of Science, PsycInfo, and the Cochrane Library, for key studies, systematic reviews, and metaanalyses in the area. Our paper found that in respect to treatment of generalized anxiety or specific disorders, CAM evidence revealed current support for the herbal medicine Kava. One isolated study shows benefit for naturopathic medicine, whereas acupuncture, yoga, and Tai chi have tentative supportive evidence, which is hampered by overall poor methodology. The breadth of evidence does not support homeopathy for treating anxiety. Strong support exists for lifestyle modifications including adoption of moderate exercise and mindfulness meditation, whereas dietary improvement, avoidance of caffeine, alcohol, and nicotine offer encouraging preliminary data. In conclusion, certain lifestyle modifications and some CAMs may provide a beneficial role in the treatment of anxiety disorders. PMID:22969831

  6. Disseminating treatment for anxiety disorders: step 1: recognizing the problem as a precursor to seeking help.

    PubMed

    Coles, Meredith E; Schubert, Jessica R; Heimberg, Richard G; Weiss, Barry D

    2014-12-01

    Untreated mental illness is a substantial public health issue in the United States, with only approximately 1/3 of the estimated 46 million adults in the US with mental illness receiving treatment. Many of the individuals with mental illness suffer from excessive anxiety, as over 25% of Americans experience an anxiety disorder during their lifetime and most of these individuals remain untreated. Building from the premise that recognizing one's symptoms precedes requests for help, the current paper presents data from 577 adults (50% Caucasian, 50% African American) in the US regarding their ability to recognize anxiety disorders. Findings from a national survey showed that when presented with detailed vignettes portraying symptoms and their impact, 50% of respondents correctly recognized depression, whereas less than 20% correctly recognized the anxiety disorders. Recognition that the symptoms were a cause for concern was much more common, with 75% or more of the sample noting concern. Responses were surprisingly similar across the two races, and few consistent moderators were found. In conclusion, increasing recognition of anxiety disorders may be a useful first step toward increasing service utilization. PMID:25222497

  7. Complementary medicine, exercise, meditation, diet, and lifestyle modification for anxiety disorders: a review of current evidence.

    PubMed

    Sarris, J; Moylan, S; Camfield, D A; Pase, M P; Mischoulon, D; Berk, M; Jacka, F N; Schweitzer, I

    2012-01-01

    Use of complementary medicines and therapies (CAM) and modification of lifestyle factors such as physical activity, exercise, and diet are being increasingly considered as potential therapeutic options for anxiety disorders. The objective of this metareview was to examine evidence across a broad range of CAM and lifestyle interventions in the treatment of anxiety disorders. In early 2012 we conducted a literature search of PubMed, Scopus, CINAHL, Web of Science, PsycInfo, and the Cochrane Library, for key studies, systematic reviews, and metaanalyses in the area. Our paper found that in respect to treatment of generalized anxiety or specific disorders, CAM evidence revealed current support for the herbal medicine Kava. One isolated study shows benefit for naturopathic medicine, whereas acupuncture, yoga, and Tai chi have tentative supportive evidence, which is hampered by overall poor methodology. The breadth of evidence does not support homeopathy for treating anxiety. Strong support exists for lifestyle modifications including adoption of moderate exercise and mindfulness meditation, whereas dietary improvement, avoidance of caffeine, alcohol, and nicotine offer encouraging preliminary data. In conclusion, certain lifestyle modifications and some CAMs may provide a beneficial role in the treatment of anxiety disorders. PMID:22969831

  8. Post-traumatic stress disorder: Differential diagnosis and management

    Microsoft Academic Search

    Mark B. Hamner; Sophie Robert

    2004-01-01

    Post-traumatic stress disorder (PTSD) is an anxiety disorder that may develop after an individual experiences severe psychologic\\u000a trauma such as combat or rape. Characteristic symptoms of PTSD include re-experiencing symptoms, such as intrusive memories\\u000a or dreams of the event, avoidance of reminders of the event, and persistent symptoms of increased arousal such as insomnia\\u000a or hypervigilance. Chronic PTSD can result

  9. Let's get physical: a contemporary review of the anxiolytic effects of exercise for anxiety and its disorders.

    PubMed

    Asmundson, Gordon J G; Fetzner, Mathew G; Deboer, Lindsey B; Powers, Mark B; Otto, Michael W; Smits, Jasper A J

    2013-04-01

    Research over the past few decades has focused on the therapeutic effects of physical exercise among those affected by mood disorders. Only recently has attention turned to maladaptive and persistent expressions of anxiety, with a growing body of evidence indicating promise for exercise as an effective treatment for some of the anxiety disorders. The current review provides a comprehensive account of contemporary research examining the anxiolytic effects of exercise for anxiety disorders. We synthesize pertinent research regarding the effects of various types of exercise within the different anxiety disorders, consider impact of various types of exercise regimens on anxiety, and examine potential anxiolytic mechanisms responsible for positive mental health gains. We conclude with important considerations for implementing exercise as a treatment for clinically significant anxiety as well as future research directions. PMID:23300122

  10. Body dysmorphic disorder, social anxiety and depressive symptoms in Chinese medical students

    Microsoft Academic Search

    Yanhui Liao; Natalie P. Knoesen; Yunlong Deng; Jinsong Tang; David J. Castle; Riteesh Bookun; Wei Hao; Xiaogang Chen; Tieqiao Liu

    2010-01-01

    Aim  This cross-sectional study explored the prevalence of body image dissatisfaction, body dysmorphic disorder, social anxiety\\u000a and depressive symptoms in first-year medical students in China.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A self-report survey design was employed, using the Body Shape Questionnaire, Swansea Muscularity Attitudes Questionnaire,\\u000a Social Interaction Anxiety Scale, Dysmorphic Concern Questionnaire, Self-Rating Depression Scale and the Body Dysmorphic Disorder\\u000a Questionnaire. A total of 487 first-year

  11. [Treatment-resistant anxiety disorders: A literature review of drug therapy strategies.

    PubMed

    Ammar, G; Naja, W J; Pelissolo, A

    2014-11-14

    Anxiety disorders are widespread psychiatric conditions with significant social and professional disability, poor quality of life, an increased risk of suicide, and frequent attendance of medical services. Serotonin reuptake inhibitors (SRI) and serotonin and norepinephrine reuptake inhibitors (SNRI) have demonstrated a rather robust efficacy for the treatment of most of anxiety disorders. Nevertheless a substantial number of patients are resistant or still suffer from residual symptoms despite this first line treatment. The objective of our paper is to review relevant studies for the pharmacologic management of anxiety disorders resistant to the first line treatment. For this purpose, we conducted a pubmed/medline search for double-blind placebo-controlled trials of treatment-resistant anxiety disorders. An adequate trial for a SRI in the treatment of obsessive-compulsive disorder (OCD) should continue for at least 12 weeks. Special considerations of the comorbidities and symptom profile could help in the choice of an appropriate pharmacotherapy. Several trials have highlighted the efficacy of antipsychotics as an add-on to SRI in treatment-resistant OCD such as haloperidol more so when comorbid with a tic disorder, or risperidone that can reduce OCD as well as depressive symptoms. Aripiprazole has been shown efficacious in two placebo-controlled double-blind trials, while the efficacy of quetiapine and olanzapine remains controversial. Other trials showed some efficacy of anticonvulsants (lamotrigine, topiramate), pindolol, memantin and N-acetylcystein as an adjunctive treatment to SRI for resistant OCD. Few trials have investigated selective serotonin reuptake inhibitors (SSRI) or SNRI resistant generalized anxiety disorder showing a failure of adjunctive therapy with olanzapine, quetiapine, ziprasidone and risperidone. These studies were underpowered and very limited in number. Adjunctive risperidone for resistant post-traumatic stress disorder (PTSD) showed benefit in some but not all trials. Olanzapine was beneficial for the reduction of the CAPS score in addition to the improvement of sleep disturbances. Furthermore, prazosin was efficacious by reducing PTSD symptoms, sleep disturbances, nightmares, and psychological distress. One double-blind placebo-controlled study was conducted to investigate treatment-resistant social phobia showing no benefit of pindolol add-on paroxetine. Our results demonstrate that the pharmacological management of treatment-resistant anxiety disorders is not sufficiently investigated in double-blind placebo-controlled trials, despite a growing evidence in favor of antipsychotics and some other pharmacological agents in resistant OCD and, to a lesser extent, PTSD. Hence, there is a crucial need for larger double-blind placebo-controlled trials for resistant anxiety disorders. Finally, being out of the scope of our review, we omitted studies of non-pharmacologic therapies. PMID:25439852

  12. Adding psychotherapy to antidepressant medication in depression and anxiety disorders: a meta-analysis

    PubMed Central

    Cuijpers, Pim; Sijbrandij, Marit; Koole, Sander L; Andersson, Gerhard; Beekman, Aartjan T; Reynolds, Charles F

    2014-01-01

    We conducted a meta-analysis of randomized trials in which the effects of treatment with antidepressant medication were compared to the effects of combined pharmacotherapy and psychotherapy in adults with a diagnosed depressive or anxiety disorder. A total of 52 studies (with 3,623 patients) met inclusion criteria, 32 on depressive disorders and 21 on anxiety disorders (one on both depressive and anxiety disorders). The overall difference between pharmacotherapy and combined treatment was Hedges' g?=?0.43 (95% CI: 0.31-0.56), indicating a moderately large effect and clinically meaningful difference in favor of combined treatment, which corresponds to a number needed to treat (NNT) of 4.20. There was sufficient evidence that combined treatment is superior for major depression, panic disorder, and obsessive-compulsive disorder (OCD). The effects of combined treatment compared with placebo only were about twice as large as those of pharmacotherapy compared with placebo only, underscoring the clinical advantage of combined treatment. The results also suggest that the effects of pharmacotherapy and those of psychotherapy are largely independent from each other, with both contributing about equally to the effects of combined treatment. We conclude that combined treatment appears to be more effective than treatment with antidepressant medication alone in major depression, panic disorder, and OCD. These effects remain strong and significant up to two years after treatment. Monotherapy with psychotropic medication may not constitute optimal care for common mental disorders. PMID:24497254

  13. Randomized trial of a meditation-based stress reduction program and cognitive behavior therapy in generalized social anxiety disorder

    Microsoft Academic Search

    Diana Koszycki; Melodie Benger; Jakov Shlik; Jacques Bradwejn

    2007-01-01

    Mindfulness-based stress reduction (MBSR) has been reported to reduce anxiety in a broad range of clinical populations. However, its efficacy in alleviating core symptoms of specific anxiety disorders is not well established. We conducted a randomized trial to evaluate how well MBSR compared to a first-line psychological intervention for social anxiety disorder (SAD). Fifty-three patients with DSM-IV generalized SAD were

  14. Immediate effect of mind sound resonance technique on state anxiety and cognitive functions in patients suffering from generalized anxiety disorder: A self-controlled pilot study

    PubMed Central

    Dhansoia, Vipin; Bhargav, Hemant; Metri, Kashinath

    2015-01-01

    Objectives: To compare the immediate effect of mind sound resonance technique (MSRT) with supine rest (SR) on state anxiety and psychomotor performance in 15 (eight male and seven female) right-handed generalized anxiety disorder patients (GAD) with an age range of 34.8 ± 12.8 years. Materials and Methods: Self as control design was followed. Diagnosis of GAD was made by a psychiatrist using sections of the Mini International Neuropsychiatric Interview (MINI). Participants practiced MSRT or SR (as control intervention) for 30 min at the same time for two consecutive days. The sequence of intervention was assigned randomly to the participants. State anxiety was assessed using state trait anxiety inventory (STAI; Form X1). Digit letter substitution task (DLST) was used to assess psychomotor performance, which involves visual scanning, mental flexibility, sustained attention, psychomotor speed and speed of information processing. Intervention was given in a quiet dark room on an empty stomach. Subjects received a training of MSRT and SR for 1 week before the data were taken. A pre-recorded audiotape was used to administer the technique of MSRT. Difference in scores after baseline and intervention was used to check normality, and was found to be normally distributed by the Kolmogrov–Smirnov test. The changes in STAI, DLST and difference in scores before and after two interventions (MSRT and SR) were compared using the paired samples t test. Results: As compared with baseline, STAI scores reduced and DLST scores increased significantly (STAI; P < 0.01; DLST; P < 0.01) after MSRT. After SR, there was a significant reduction in STAI scores from baseline (STAI; P < 0.05), but there was no significant change in the DLST scores (P = 0.26). Comparison of the difference in scores for DLST and STAI before and after the two interventions (MSRT and SR) showed a significantly higher score for DLST (P < 0.05) and a significantly lower score for STAI (P < 0.01) for MSRT as compared with SR. Conclusion: This pilot study suggests that MSRT may have a potential role in reducing state anxiety and enhancing psychomotor performance in patients suffering from GAD immediately after the practice. These findings need confirmation from studies with a larger sample size and randomized controlled design, which are implicated in the future. PMID:25558137

  15. The Trauma of Peer Abuse: Effects of Relational Peer Victimization and Social Anxiety Disorder on Physiological and Affective Reactions to Social Exclusion

    PubMed Central

    Iffland, Benjamin; Sansen, Lisa Margareta; Catani, Claudia; Neuner, Frank

    2014-01-01

    Background: Social exclusion elicits emotional distress, negative mood, and physiological stress. Recent studies showed that these effects were more intense and persisting in socially anxious subjects. The present study examined whether the abnormal reactions of socially anxious subjects can be traced back to previous experiences of relational peer victimization during childhood and adolescence. Methods: Participants (N?=?74) were patients with a diagnosis of social anxiety disorder as well as healthy controls. The patient and control groups were subdivided into two subgroups according to the subject’s reports about previous relational peer victimization. Immediate and delayed physiological (skin conductance level and heart rate) and affective reactions to a simulated social exclusion in a ball-toss game (Cyberball) were recorded. Results: Overall, subjects’ immediate reactions to social exclusion were an increase in skin conductance and a reduction of positive affect. Regardless of the diagnostic status, subjects with a history of relational peer victimization showed a more intense self-reported affective change that was accompanied by a blunted skin conductance response. However, the mood of the subjects with a history of peer victimization recovered during a 15?min waiting period. A diagnosis of social anxiety disorder did not affect the reactions to social exclusion on any measure. Conclusion: Findings indicate that stress reactions to social exclusion depend more on previous experiences of peer victimization than on a diagnosis of social anxiety disorder. The findings indicate that memories of negative social experiences can determine the initial stress reaction to social threats. PMID:24672491

  16. Memory modification as an outcome variable in anxiety disorder treatment

    Microsoft Academic Search

    Warren W. Tryon; Dean McKay

    2009-01-01

    Learning and memory are interdependent processes. Memories are learned, and cumulative learning requires memory. It is generally accepted that learning contributes to psychopathology and consequently to pertinent memory formation. Neuroscience and psychological research have established that memory is an active reconstructive process that is influenced by thoughts, feelings, and behaviors including post-event information. Recent research on the treatment of anxiety

  17. Research Review: A Neuroscience Framework for Pediatric Anxiety Disorders

    ERIC Educational Resources Information Center

    Pine, Daniel S.

    2007-01-01

    Across a range of mammalian species, early developmental variations in fear-related behaviors constrain patterns of anxious behavior throughout life. Individual differences in anxiety among rodents and non-human primates have been shown to reflect early-life influences of genes and the environment on brain circuitry. However, in humans, the manner…

  18. Neuropsychopharmacological properties of neuroactive steroids in depression and anxiety disorders

    Microsoft Academic Search

    Daniela Eser; Cornelius Schüle; Elena Romeo; Thomas C. Baghai; Flavia di Michele; Augusto Pasini; Peter Zwanzger; Frank Padberg; Rainer Rupprecht

    2006-01-01

    Neuroactive steroids modulate neurotransmission through modulation of specific neurotransmitter receptors such as ?-aminobutyric acid type A (GABAA) receptors. Preclinical studies suggested that neuroactive steroids may modulate anxiety- and depression-related behaviour and may contribute to the therapeutical effects of antidepressant drugs. Attenuations of 3?-reduced neuroactive steroids have been observed during major depression. This disequilibrium can be corrected by successful treatment with

  19. Diagnostic Bias and Conduct Disorder: Improving Culturally Sensitive Diagnosis

    ERIC Educational Resources Information Center

    Mizock, Lauren; Harkins, Debra

    2011-01-01

    Disproportionately high rates of Conduct Disorder are diagnosed in African American and Latino youth of color. Diagnostic bias contributes to overdiagnosis of Conduct Disorder in these adolescents of color. Following a diagnosis of Conduct Disorder, adolescents of color face poorer outcomes than their White counterparts. These negative outcomes…

  20. Exploring the Relationship Between Anxiety and Insistence on Sameness in Autism Spectrum Disorders

    PubMed Central

    Gotham, Katherine; Bishop, Somer L.; Hus, Vanessa; Huerta, Marisela; Lund, Sabata; Buja, Andreas; Krieger, Abba; Lord, Catherine

    2015-01-01

    Elevated anxiety symptoms are one of the most common forms of psychopathology to co-occur with autism spectrum disorders (ASD). The purpose of this study was to explore the association between anxiety and ASD symptoms, particularly the degree to which the relationship is explained by Insistence on Sameness (IS) behaviors and/or cognitive ability. The sample included 1429 individuals aged 5:8 to 18:0 years who participated in the Simons Simplex Collection (SSC), a genetic consortium study of ASD. Child Behavior Checklist Anxiety Problems T-scores and Autism Diagnostic Interview-Revised “Insistence on Sameness” item raw totals were treated as both categorical and continuous measures of anxiety and IS respectively. Chronological age, verbal IQ, and a variety of ASD phenotype-related and other behavioral variables were assessed for potential association with anxiety and IS. Anxiety and IS continuous variables were minimally though significantly associated with each other and with chronological age and verbal IQ. Neither anxiety nor IS was associated with other core autism diagnostic scores. Anxiety was associated with a variety of other psychiatric and behavioral symptoms in ASD, including irritability, attention problems, and aggression, while IS was not. Anxiety and Insistence on Sameness appear to function as distinct constructs, each with a wide range of expression in children with ASD across age and IQ levels. Thus, both variables could be of use in ASD behavioral research or in dimensional approaches to genetic exploration. Unlike IS, however, anxiety is related to non-ASD-specific behavioral symptoms. PMID:23258569