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Sample records for anxiety disorder diagnosis

  1. Current Diagnosis and Treatment of Anxiety Disorders

    PubMed Central

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

    2013-01-01

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

  2. [Dual diagnosis in anxiety disorders: pharmacologic treatment recommendations].

    PubMed

    Sáiz Martínez, Pilar Alejandra; Jimenez Treviño, Luis; Díaz Mesa, Eva M; García-Portilla González, M Paz; Marina González, Pedro; Al-Halabí, Susana; Szerman, Néstor; Bobes García, Julio; Ruiz, Pedro

    2014-01-01

    Anxiety disorders and substance use disorders are highly comorbid (between 18% and 37%), and such comorbidity complicates treatment and worsens prognosis (including higher suicide risk). There are not many research works on the specific pharmacologic treatment of dual comorbid anxiety disorders. Most authors recommend a simultaneous approach of both, anxiety and substance use, disorders. Research data on pharmacotherapy suggest that psychotropics used in the treatment of anxiety disorders are also effective in dual diagnosis. SSRIs are considered first-line therapy in the treatment of dual anxiety while benzodiacepines should be avoided. New generation antiepileptic have shown efficacy in case series and open label studies in the latest years, thus being a promising treatment option for dual comorbid anxiety disorders, specially pregabalin in generalized anxiety disorder. PMID:25314041

  3. [Diagnosis and Treatment of Social Anxiety Disorder].

    PubMed

    Asakura, Satoshi

    2015-01-01

    Many studies of social anxiety disorder (SAD) have been conducted because diagnostic criteria are defined as social phobia in DSM-III in the West. In Japan, several studies have examined pathological conditions similar to SAD, known as taijin-kyofu (TK). This highly remarkable disorder involves a convincing fear of giving another person discomfort from one's physical faults (e.g. feeling that neighboring people detect an unpleasant smell from one's body, "jikoshu-kyofu", or feeling that neighboring people feel unpleasant because of one's appearance,"shukei-kyofu") termed "convinced subtype of TK" (c-TK; also known as offensive subtype of TK). In DSM-5, the definitions of feeling rejection and offense of others are added to a fear of humiliating or embarrassing oneself. Moreover, TK is a sufficient criterion for SAD. However, it is confusing that body dysmorphic disorder is not in category of somatoform disorders but in that of obsessive-compulsive disorder and related disorders and that the Japanese terms of "jikoshu-kyofu" and "shubo-kyofu" are categorized as other specified obsessive-compulsive disorder and related disorders. The efficacy and tolerability of selective serotonin reuptake inhibitors (SSRIs) for the treatment of SAD has been reported in many controlled studies. Recently, SSRIs are regarded as first line pharmacotherapy for SAD. Cognitive behavioral therapy is also effective for SAD treatment. High rates of co-occurring SAD and other psychiatric disorders can be found in clinical samples and in the general population. Additional research must be conducted for these patients and for the management of treatment-refractory SAD patients. PMID:26524867

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

    PubMed

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

    2013-02-01

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

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

    PubMed Central

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

    1994-01-01

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

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

    PubMed

    Silove, Derrick; Rees, Susan

    2014-10-01

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

  7. Primary Versus Secondary Diagnosis of Generalized Anxiety Disorder in Youth: Is the Distinction an Important One?

    PubMed

    Ollendick, Thomas H; Jarrett, Matthew A; White, Bradley A; White, Susan W; Grills, Amie E

    2016-08-01

    Examine whether children with a primary diagnosis of generalized anxiety disorder (GAD) differ from children with a secondary diagnosis of GAD on clinician, parent, teacher, and youth-report measures. Based on consensus diagnoses, 64 youth referred to a general outpatient assessment clinic were categorized as having either a primary or secondary diagnosis of GAD. A semi-structured diagnostic interview was used to guide diagnostic decisions and assign primary versus secondary diagnostic status. We predicted that youth with a primary GAD diagnosis would present with greater anxiety symptomatology and symptom impairment on a variety of anxiety-related measures than youth with a secondary GAD diagnosis. Contrary to our hypotheses, no differences were found between those with primary versus secondary GAD diagnoses on measures of symptom severity and clinical impairment, comorbid diagnoses, or youth and teacher-report measures. Our findings have potential implications for the current practice of requiring primary anxiety diagnostic status as an inclusion criterion in clinical research and treatment outcome studies. Assuming our findings are confirmed in larger samples and with other anxiety disorders, future clinical trials and basic psychopathology research might not exclude youth based on absence of a particular anxiety disorder as the primary disorder but rather include individuals for whom that anxiety disorder is secondary as well. PMID:26386700

  8. Anxiety Disorders

    ERIC Educational Resources Information Center

    Klein, Rachel G.

    2009-01-01

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

  9. 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,"…

  10. Anxiety Disorders

    MedlinePlus

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

  11. The latent structure of social anxiety disorder: consequences of shifting to a dimensional diagnosis.

    PubMed

    Ruscio, Ayelet Meron

    2010-11-01

    Despite longstanding debate over the nature of the boundary between social anxiety disorder (SAD) and less severe social anxiety, no study has tested directly whether the defining features of the disorder correspond to a latent category or dimension. The present study examined this question using data from the National Comorbidity Survey Replication (NCS-R), a nationally representative survey of the U.S. household population. Indicators representing the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) criteria for SAD were submitted to taxometric analyses in a subsample of adults (n = 2,166) who reported excessive social fear in their lifetime. Multiple taxometric procedures and consistency tests converged on a dimensional solution, suggesting that SAD is continuous with milder social anxiety. In follow-up analyses, a dimensional SAD diagnosis outperformed the DSM-IV diagnosis in predicting the subsequent onset of a range of clinically important outcomes. Large differences in associations with comorbid mood disorders, suicidality, and treatment seeking in particular favored the prognostic value of dimensional over categorical diagnosis. These findings support the validity and potential utility of a dimensional conceptualization of SAD that may inform efforts to revise the diagnosis for DSM-V. PMID:20853918

  12. Anxiety Disorders: Support Groups

    MedlinePlus

    ... Anxiety Disorder Treating Anxiety Disorders: Educational Videos Clinical Practice Review for Major Depressive Disorder Meetings & Events Mental Health Apps Announcements Awards Alies Muskin Career Development ...

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

    PubMed Central

    Norton, Peter J.; Barrera, Terri L.

    2012-01-01

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

  14. Social anxiety disorder

    MedlinePlus

    Phobia - social; Anxiety disorder - social; Social phobia; SAD - social anxiety disorder ... People with social anxiety disorder fear and avoid situations in which they may be judged by others. It may begin in the teens ...

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

    PubMed Central

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

    2016-01-01

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

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

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

    PubMed Central

    Furmark, Tomas; Henningsson, Susanne; Appel, Lieuwe; Åhs, 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

  18. Anxiety Disorders

    MedlinePlus

    ... fearful to talk at all in certain situations. Panic attacks. These episodes of anxiety can occur for no apparent reason. During a panic attack, a child typically has sudden and intense physical ...

  19. Generalized Anxiety Disorder

    MedlinePlus

    MENU Return to Web version Generalized Anxiety Disorder Overview What is anxiety? Anxiety is a word that describes feelings of worry, nervousness, fear, apprehension, concern or restlessness. Normal feelings ...

  20. Illness anxiety disorder

    MedlinePlus

    Somatic symptom disorder; Somatic symptom and related disorders; Hypochondriasis ... Illness anxiety disorder is different from somatic symptom disorder. With somatic symptom disorder, the person has physical pain or other ...

  1. Generalized anxiety disorder

    MedlinePlus

    GAD; Anxiety disorder ... you can help yourself get better by: Reducing caffeine Not using street drugs or large amounts of ... a helpful addition. Resources for more information include: Anxiety and Depression Association of America: www.adaa.org ...

  2. Anxiety Disorders Information: Helping Others

    MedlinePlus

    ... Anxiety Disorder Treating Anxiety Disorders: Educational Videos Clinical Practice Review for Major Depressive Disorder Meetings & Events Mental Health Apps Announcements Awards Alies Muskin Career Development ...

  3. 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

  4. [Pharmacotherapy of Anxiety Disorders].

    PubMed

    Zwanzger, P

    2016-05-01

    Anxiety disorders belong to the most frequent psychiatric disorders according to epidemiological studies and are associated with a high economic burden. Panic disorder, generalized anxiety disorder, social anxiety disorder, and specific phobia belong to the most important clinical disorders. The etiology is complex, including genetic, neurobiological as well as psychosocial factors. With regard to treatment, both psychotherapy and medication can be employed according to current treatment guidelines. With regard to psychotherapy, cognitive behavioral therapy (CBT) represents the treatment of choice. As for pharmacological treatment, in particular modern antidepressants and pregabalin are recommended. However, several recommendations have to be considered in daily clinical practice. PMID:27299791

  5. 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…

  6. Social anxiety disorder

    MedlinePlus

    Social anxiety disorder is a persistent and irrational fear of situations that may involve scrutiny or judgment ... People with social anxiety disorder fear and avoid situations in which they may be judged by others. It may begin in adolescence and may have to do ...

  7. Clinical Diagnosis of Anxiety

    PubMed Central

    Ghadirian, A. M.

    1981-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  9. Anxiety disorders in plastic surgery.

    PubMed

    Rankin, M; Borah, G L

    1997-08-01

    Surgery is a stressful event, with the potential for profound disturbance to the patient's psychological and physiologic homeostasis. Cosmetic surgery is a particularly intense psychological experience because, in addition to the usual concerns about surgical side effects, cosmetic patients bring their hopes and expectations for improved self-image, putting them at risk for the added anxiety of disappointment. High levels of anxiety coupled with the perception of vulnerability or threat to self can cause significant psychological reactions complicating care for the plastic surgical patient. This paper outlines the diagnostic features of the common types of anxiety disorders seen in plastic surgical patients, and it offers treatment strategies for the practitioner, delineating when referral to a mental health expert is advised. Specific clinical case studies of panic attack, posttraumatic stress disorder, and acute stress disorder are presented to illustrate the variety of abnormal anxiety responses that may be encountered in the perioperative setting. Interventions for the anxious patient are part science and part art. Careful questioning and psychosocial assessment can identify those patients who are at greater risk for psychological problems after surgery. However, some patients may mask or keep secret their concerns, which can be manifested with resulting anger and hostility. Plastic surgeons must use appropriate indicators of psychological anxiety and measure a specific patient's reactions to surgery to make the diagnosis of abnormal anxiety. Close follow-up by the plastic surgical team is an essential part of the anxiety disorder patient's psychological treatment, but it is imperative that these problematic patients be referred promptly to a qualified mental health professional to limit their adverse experience and promote their well-being. Patients who are less anxious during the perioperative period report less emotional distress and fewer defensive

  10. Predictors of Generalized Anxiety Disorder stigma.

    PubMed

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

    2013-04-30

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

  11. 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.…

  12. 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

  13. The separation of adult separation anxiety disorder.

    PubMed

    Baldwin, David S; Gordon, Robert; Abelli, Marianna; Pini, Stefano

    2016-08-01

    The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) categorization of mental disorders places "separation anxiety disorder" within the broad group of anxiety disorders, and its diagnosis no longer rests on establishing an onset during childhood or adolescence. In previous editions of DSM, it was included within the disorders usually first diagnosed in infancy, childhood, or adolescence, with the requirement for an onset of symptoms before the age of 18 years: symptomatic adults could only receive a retrospective diagnosis, based on establishing this early onset. The new position of separation anxiety disorder is based upon the findings of epidemiological studies that revealed the unexpectedly high prevalence of the condition in adults, often in individuals with an onset of symptoms after the teenage years; its prominent place within the DSM-5 group of anxiety disorders should encourage further research into its epidemiology, etiology, and treatment. This review examines the clinical features and boundaries of the condition, and offers guidance on how it can be distinguished from other anxiety disorders and other mental disorders in which "separation anxiety" may be apparent. PMID:27503572

  14. Clinical characteristics of anxiety disordered youth

    PubMed Central

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

    2010-01-01

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

  15. Screening for Generalized Anxiety Disorder (GAD)

    MedlinePlus

    ... Anxiety Disorder Treating Anxiety Disorders: Educational Videos Clinical Practice Review for Major Depressive Disorder Meetings & Events Mental Health Apps Announcements Awards Alies Muskin Career Development ...

  16. Anxiety Disorders in Primary Care.

    PubMed

    Metzler, Danielle H; Mahoney, David; Freedy, John R

    2016-06-01

    Investigation for a possible anxiety disorder should be considered in patients with multiple or persistent anxiety symptoms or multiple somatic complaints without a clear somatic etiology. The ideal treatment for anxiety disorders is a combination of pharmacologic and behavioral strategies. As primary care health care evolves, it is expected that the management of mental health disorders (including anxiety disorders) will largely occur in the context of collaborative care models in which patients and primary care clinicians are assisted by trained case managers who help facilitate a more comprehensive, holistic treatment plan between primary care and mental health providers. PMID:27262005

  17. Auditory Neuropathy Spectrum Disorder Masquerading as Social Anxiety

    PubMed Central

    Rao, Mukund G.; Mishra, Shree; Varambally, Shivarama; Nagarajarao, Shivashankar; Gangadhar, Bangalore N.

    2015-01-01

    The authors report a case of a 47-year-old man who presented with treatment-resistant anxiety disorder. Behavioral observation raised clinical suspicion of auditory neuropathy spectrum disorder. The presence of auditory neuropathy spectrum disorder was confirmed on audiological investigations. The patient was experiencing extreme symptoms of anxiety, which initially masked the underlying diagnosis of auditory neuropathy spectrum disorder. Challenges in diagnosis and treatment of auditory neuropathy spectrum disorder are discussed. PMID:26351622

  18. Diagnosis and Treatment of Anxiety in the Aging Woman.

    PubMed

    Siegel, Andrew M; Mathews, Sarah B

    2015-12-01

    The peri- and postmenopausal periods represent a window of vulnerability for emergence of anxiety symptoms and disorders in the life cycle of adult women. Compared to depression, anxiety symptoms and disorders remain largely unexplored during this phase of a woman's life, despite the significant impact on quality of life if not diagnosed and treated. Here, we review the literature to present our current understanding of the epidemiology, causal factors, diagnosis, and treatment of anxiety in the aging woman. PMID:26458819

  19. The structure of feared social situations among individuals with a lifetime diagnosis of social anxiety disorder in two independent nationally representative mental health surveys.

    PubMed

    Cox, Brian J; Clara, Ian P; Sareen, Jitender; Stein, Murray B

    2008-04-01

    The present study employed both exploratory and confirmatory factor analytic approaches with nationally representative samples of individuals with a lifetime diagnosis of social anxiety disorder (n=1123; n=3091, respectively) using split-halves of the National Comorbidity Replication Survey (n=9282) and cross-validated with the Canadian Community Health Survey on Mental Health and Wellbeing (n=36,984). Strong support was found for a three-factor solution. This model was obtained from exploratory factor analysis and was further evaluated using two confirmatory factor analytic investigations in the two national samples. The three social situational domains reflected (1) Social Interaction Fears, (2) Observation Fears, and (3) Public Speaking Fears. Individuals with generalized social anxiety disorder (i.e., those who endorsed 7 or more of 13 feared social situations assessed in the survey) were significantly more likely to report Social Interaction Fears and Observation Fears compared to individuals with non-generalized social anxiety disorder (i.e., those who endorsed only 6 or fewer of 13 feared social situations). Individuals with generalized social anxiety were particularly characterized by combinations of Public Speaking Fears plus Social Interaction Fears and Observation Fears. The clinical and classification implications of our study for DSM-V are discussed. PMID:18313030

  20. Neuroimaging in anxiety disorders.

    PubMed

    Fredrikson, Mats; Faria, Vanda

    2013-01-01

    Neuroimaging studies using functional magnetic resonance imaging (fMRI), positron emission tomography (PET) and single-photon emission computed tomography (SPECT) to evaluate neurofunctional and neurochemical alterations related to the generation and control of affect in patients with anxiety disorders are reviewed. We performed a meta-analysis of symptom provocation studies, where neural activity was measured using fMRI, PET or SPECT to test the hypothesis that prefrontal regions modulate amygdala activity. Data revealed that reactivity in the amygdala was enhanced in patients with phobia as well as posttraumatic stress disorder (PTSD). The dorsal anterior cingulate cortex was activated in concert with the amygdala, both in PTSD and in phobic states, suggesting a role in fear expression, rather than emotional control. Activity in emotion-regulating areas in the ventromedial prefrontal cortex including the subgenual anterior cingulate cortex and the medial orbitofrontal cortex was compromised in the symptomatic state in PTSD and phobic disorders, respectively. Increased amygdala reactivity was restored with psychological treatment. Treatment effects across different modalities including pharmacological and psychological interventions as well as with placebo regimens support that reduction of neural activity in the amygdala may be a final common pathway for successful therapeutic interventions irrespective of method, thereby linking neurotransmission to plasticity in a pivotal node of the core fear network of the brain. PMID:25225017

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  3. Pregnancy complications associated with childhood anxiety disorders.

    PubMed

    Hirshfeld-Becker, Dina R; Biederman, Joseph; Faraone, Stephen V; Robin, Joanna A; Friedman, Deborah; Rosenthal, Jessica M; Rosenbaum, Jerrold F

    2004-01-01

    To determine whether perinatal complications predict childhood anxiety disorders independently of parental psychopathology, we systematically assessed pregnancy and delivery complications and psychopathology in a sample of children (mean age=6.8 years) at high risk for anxiety disorders whose parents had panic disorder with (n=138) or without (n=26) major depression, and in contrast groups of offspring of parents with major depression alone (n=47), or no mood or anxiety disorders (n=95; total N=306). Psychopathology in the children was assessed by structured diagnostic interviews (K-SADS), and pregnancy and delivery complications were assessed using the developmental history module of the DICA-P. Number of pregnancy complications predicted multiple childhood anxiety disorders independently of parental diagnosis (odds ratio=1.6 [1.4-2.0]). This effect was accounted for by heavy bleeding requiring bed-rest, hypertension, illness requiring medical attention, and serious family problems. Associations remained significant when lifetime child mood and disruptive behavior disorders were covaried. Results suggest that prenatal stressors may increase a child's risk for anxiety disorders beyond the risk conferred by parental psychopathology alone. PMID:15129417

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

    PubMed

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

    2015-01-01

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

  5. [Social Anxiety Disorder].

    PubMed

    Nagata, Toshihiko

    2015-01-01

    Social Anxiety Disorder (SAD) is not a rare psychiatric disorder, and the recent World Mental Health Japan Survey, Second (WMHJ2) reported the possibility that the twelve-month prevalence of SAD has increased from 0.7 to 2.3% over the last ten years. However, ten years have already passed since selective serotonin reuptake inhibitors (SSRI) were approved for the treatment of SAD in Japan, and not only laypersons but also mental health professionals still misunderstand SAD as public speech phobia. As a result, the boundary between normal shyness and SAD and threshold to start pharmacotherapy have been debated. Participants in most double-blind studies of SSRI were limited to those with a generalized subtype of SAD. While benzodiazepine led to a significantly more favorable response and symptom improvement and the effect size of benzodiazepine was larger than those of SSRI, it did not lead to a "cure" and is sometimes deleterious for atypical SAD patients. To sum up, a psychotherapeutic approach including cognitive behavioral therapy is suggested as first-line treatment for non-generalized SAD according to the NICE guidelines. On the other hand, patients with generalized SAD and secondary depression are still misunderstood (and under-recognized) as those with "treatment-resistant depression", and they suffer from severe impairment of the psycho-social function, including absences or withdrawal from working or schooling. They need more effective combination treatment of SSRI and cognitive behavioral therapy as generalized SAD patients. PMID:26524840

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

    MedlinePlus

    ... phobia? For More Information Share Social Phobia (Social Anxiety Disorder): Always Embarrassed Download PDF Download ePub Order ... If so, you may have a type of anxiety disorder called social phobia, also called social anxiety ...

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

    PubMed Central

    Mathew, Roy J.

    1994-01-01

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

  8. 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…

  9. Early intervention crucial in anxiety disorders in children.

    PubMed

    Griffiths, Helen; Fazel, Mina

    2016-06-01

    Anxiety disorders are among the most common mental health disorders of childhood. Three quarters of anxiety disorders have their origins in childhood, with presentation often chronic in nature. Children with an anxiety disorder are 3.5 times more likely to experience depression or anxiety in adulthood, highlighting the importance of early diagnosis and appropriate treatment. Making a diagnosis can often prove difficult. It is important for clinicians to distinguish between normal anxiety and anxiety disorders. In the latter, symptoms may impair function and/or cause marked avoidance behaviour and significant distress. Younger children, who are less able to verbalise their anxiety, may show symptoms of regression of physical abilities (e.g. toileting, requiring carrying); increased attachment seeking behaviours (e.g. becoming more clingy); or increased physical symptoms (e.g. stomach aches). NICE quality standards recommend the need for an accurate assessment of which specific anxiety disorder the individual is experiencing, its severity, and the impact on functioning. NICE guidance for assessment of social anxiety disorder may be extrapolated to the assessment of other anxiety disorders: e.g. giving the child the opportunity to provide information on their own, and conducting a risk assessment. Where the child is experiencing significant distress or functional impairment (e.g. missing school, not taking part in age-appropriate activity), then specialist input is likely to be needed. PMID:27552796

  10. Studying Anxiety Disorders | NIH MedlinePlus the Magazine

    MedlinePlus

    ... page please turn Javascript on. Feature: Phobias and Anxiety Disorders Studying Anxiety Disorders Past Issues / Fall 2010 Table of Contents ... physical and psychological stress, and diet. 5 Major Anxiety Disorders Generalized Anxiety Disorder (GAD) : chronic anxiety, exaggerated ...

  11. 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…

  12. Suicidal Ideation in Anxiety-Disordered Youth

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  13. Cognitive Therapy of Anxiety Disorders.

    ERIC Educational Resources Information Center

    Chambless, Dianne L.; Gillis, Martha M.

    1993-01-01

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

  14. 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

  15. 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

  16. Generalized anxiety disorder

    MedlinePlus

    ... disorder References American Psychiatric Association. Diagnostic and statistical manual of mental disorders . 5th ed. Arlington, VA: American Psychiatric Publishing. 2013. Calkins AW, Bui E, Taylor CT, Pollack ...

  17. Imaging genetics of anxiety disorders.

    PubMed

    Domschke, Katharina; Dannlowski, Udo

    2010-11-15

    Anxiety disorders are frequent and burdensome psychiatric diseases. Despite their moderate to strong heritabilities, the search for candidate genes has been limited by methodological shortcomings hitherto, e.g., the use of clinically defined, but neurobiologically heterogeneous categorical phenotypes. Investigating neurobiological response patterns associated with fear processing as an intermediate phenotype might aid in overcoming these difficulties. The existing imaging literature on the neurobiological correlates of fear processing and anxiety disorders points to a pivotal role of the amygdala in the human fear circuit. Therefore, amygdala responsiveness to anxiety-related stimuli was suggested as an intermediate phenotype for anxiety disorders. The present article provides an overview of imaging genetic studies investigating genetic effects on amygdala responsiveness with particular emphasis on recent imaging genetic findings in anxiety-related traits, panic disorder and social phobia. The existing studies consistently reveal strong genetic effects on the responsiveness of the fear circuit, particularly of genetic variants previously discussed as potential susceptibility variants for anxiety, e.g., the COMT 158val allele or the 5-HTTLPR short allele. Further research will be necessary involving larger sample sizes to allow for investigating gene-gene and gene-environment interactions. More evolved statistical and neuroimaging methods such as effective connectivity measures could lead to a better understanding of imaging endophenotypes and the nature of gene-brain relationships. Longitudinal studies in patient samples will be required to elucidate how genetically influenced neurobiological intermediate phenotypes are associated with subtype, severity and the course of anxiety disorders, thereby having the potential for developing individualized therapy regimes derived from neurobiological research. PMID:19944771

  18. 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…

  19. Screening for Generalized Anxiety Disorder (GAD)

    MedlinePlus

    ... Screening for Posttraumatic Stress Disorder (PTSD) Screening for Social Anxiety Disorder Screening for Specific Phobias Screening for an Anxiety Disorder: Children Screening for an Anxiety Disorder: Family Member Self-Help Strategies: Webinars to Calm Anxious Minds "Triumph" E-News ...

  20. Anxiety in the medically ill: nosology and principles of differential diagnosis.

    PubMed

    Skodol, A E

    1999-04-01

    Anxiety and anxiety disorder have been estimated to occur in 5% to 20% of medical inpatients and 4% to 14% of medical outpatients. These estimates do not distinguish between anxiety symptoms and anxiety disorders, nor between the various causes of anxiety in the medically ill. This article reviews the epidemiology, nosology, disorders in the differential diagnosis, and principles of differential diagnosis of anxiety in the medically ill. A widely endorsed nosology for anxiety disorders caused by medical illness and its treatments is a relatively recent development. General guidelines for differentiating between specific diagnoses in the differential diagnosis of anxiety in the medically ill are now provided in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, but, as is often the case, it is easier to describe the distinctions in theory than it is to make them in actual practice. PMID:10378950

  1. Pharmacotherapy of social anxiety disorder.

    PubMed

    Ganasen, Keith A; Stein, Dan J

    2010-01-01

    A range of medications have been shown effective for the treatment of social anxiety disorder. The largest trials to date have been with various selective serotonin reuptake inhibitors (SSRIs). Several of these agents have been registered for the treatment of social anxiety disorder with agencies such as the FDA or EMEA, meta-analyses confirm their efficacy and safety, and expert consensus guidelines have often recommended them as a first-line pharmacotherapy of choice. Despite such advances, there are many unanswered questions in the pharmacotherapy of social anxiety disorder, including the optimal pharmacotherapy of patients refractory to first-line intervention, and the optimal sequencing of pharmacotherapy and psychotherapy. Translational research has already had an impact on concepts of treatment, and may ultimately lead to novel interventions. PMID:21309123

  2. Generalized anxiety disorder - self-care

    MedlinePlus

    ... G, Delong H, Vasconcelos e Sa D, Simon NM. The pharmacotherapy of anxiety disorders. In: Stern TA, ... E, Taylor CT, Pollack MH, LeBeau RT, Simon NM. Anxiety disorders. In: Stern TA, Fava M, Wilens ...

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

    PubMed Central

    Anderson, Christina; Tauch, Deborah; Quante, Arnim

    2015-01-01

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

  4. Generalized anxiety disorder: What are we missing?

    PubMed

    Allgulander, Christer

    2006-07-01

    One of the most prevalent anxiety conditions seen in primary care is generalized anxiety disorder (GAD). Numerous physical ailments frequently accompany the psychic symptoms of anxiety, which often drive patients to ask for help. In spite of the high incidence of GAD, only 30% of sufferers are diagnosed. Furthermore, very few patients are prescribed medication or referred to a psychiatrist. The key aim is to ensure the early detection and management of these patients. Developing physician education programs may improve the identification of GAD. The use of simple diagnostic tools would also aid the early detection of sufferers. Physicians require more long-term data, including that on the influence of ethnicity and genetics, to assist them to better understand and more effectively manage GAD. By achieving early diagnosis and treatment of GAD, physicians can ensure that a lesser burden is inflicted upon sufferers, thus improving their quality of life. PMID:16730165

  5. Autism Spectrum Traits in Children with Anxiety Disorders

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  6. 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…

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

    PubMed

    Beidel, D C

    1998-01-01

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

  8. Illness anxiety disorder

    MedlinePlus

    ... Hypochondriasis References American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing, 2013. Feinstein RE, deGruy FV. Difficult patients: personality ...

  9. Diagnosis, Phenomenology, Differential Diagnosis, and Comorbidity of Pediatric Bipolar Disorder.

    PubMed

    Kowatch, Robert A

    2016-01-01

    Diagnosing a pediatric patient with bipolar disorder can pose a challenge for clinicians. Children typically do not present with the full criteria for a mood episode and may have symptoms of other disorders such as attention-deficit/hyperactivity disorder, oppositional defiant disorder, anxiety disorders, and other mood disorders, which may complicate the diagnostic process. By diligently interviewing parents and children about behaviors, thoroughly reviewing family histories, and systematically ruling out other disorders, clinicians can provide an accurate diagnosis for their pediatric patients. PMID:27570927

  10. Psychotherapy for Anxiety in Children With Autism Spectrum Disorder

    ClinicalTrials.gov

    2016-02-22

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

  11. Psychotherapy for Anxiety in Children With Autism Spectrum Disorder

    ClinicalTrials.gov

    2016-03-07

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

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

    PubMed

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

    2015-11-01

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

  13. Personality disorder diagnosis

    PubMed Central

    WIDIGER, THOMAS A

    2003-01-01

    Every person has a characteristic manner of thinking, feeling, and relating to others. Some of these personality traits can be so dysfunctional as to warrant a diagnosis of personality disorder. The World Health Organization's International Classification of Diseases (ICD- 10) includes ten personality disorder diagnoses. Three issues of particular importance for the diagnosis of personality disorders are their differentiation from other mental disorders, from general personality functioning, and from each other. Each of these issues is discussed in turn, and it is suggested that personality disorders are more accurately and effectively diagnosed as maladaptive variants of common personality traits. PMID:16946918

  14. A lifespan view of anxiety disorders

    PubMed Central

    Lenze, Eric J.; Wetherell, Julie Loebach

    2011-01-01

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

  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. 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…

  17. Cognitive Coping in Anxiety-Disordered Adolescents

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  18. Social anxiety disorder in DSM-5.

    PubMed

    Heimberg, Richard G; Hofmann, Stefan G; Liebowitz, Michael R; Schneier, Franklin R; Smits, Jasper A J; Stein, Murray B; Hinton, Devon E; Craske, Michelle G

    2014-06-01

    With the publication of DSM-5, the diagnostic criteria for social anxiety disorder (SAD, also known as social phobia) have undergone several changes, which have important conceptual and clinical implications. In this paper, we first provide a brief history of the diagnosis. We then review a number of these changes, including (1) the primary name of the disorder, (2) the increased emphasis on fear of negative evaluation, (3) the importance of sociocultural context in determining whether an anxious response to a social situation is out of proportion to the actual threat, (4) the diagnosis of SAD in the context of a medical condition, and (5) the way in which we think about variations in the presentation of SAD (the specifier issue). We then consider the clinical implications of changes in DSM-5 related to these issues. PMID:24395386

  19. 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, ...

  20. Managing anxiety associated with neurodegenerative disorders

    PubMed Central

    Kumar, Anand

    2015-01-01

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

  1. The epidemiology of anxiety disorders: a review

    PubMed Central

    Martin, Patrick

    2003-01-01

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

  2. Generalized anxiety disorder: A comorbid disease.

    PubMed

    Nutt, David; Argyropoulos, Spilos; Hood, Sean; Potokar, John

    2006-07-01

    Generalized anxiety disorder (GAD) frequently occurs comorbidly with other conditions, including depression and somatic complaints. Comorbid GAD sufferers have increased psychologic and social impairment, request additional treatment, and have an extended course and poorer outcome than those with GAD alone; therapy should alleviate both the psychic and somatic symptoms of GAD without negatively affecting the comorbid condition. The ideal treatment would provide relief from both GAD and the comorbid condition, reducing the need for polypharmacy. Physicians need suitable tools to assist them in the detection and monitoring of GAD patients-the GADI, a new, self-rating scale, may meet this requirement. Clinical data have shown that various neurobiologic irregularities (e.g., in the GABA and serotonin systems) are associated with the development of anxiety. Prescribing physicians must take into account these abnormalities when choosing a drug. Effective diagnosis and treatment should improve patients' quality of life and their prognosis for recovery. PMID:16737802

  3. Attachment and Parenting in Adult Patients with Anxiety Disorders

    PubMed Central

    Picardi, Angelo; Caroppo, Emanuele; Fabi, Elisa; Proietti, Serena; Gennaro, Giancarlo Di; Meldolesi, Giulio Nicolò; 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

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

    PubMed

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

    2016-01-01

    Despite the ubiquity of sleep complaints among individuals with anxiety disorders, few prior studies have examined whether sleep quality improves during anxiety treatment. The current study examined pre- to posttreatment sleep quality improvement during cognitive behavioral therapy (CBT) for panic disorder (PD; n = 26) or generalized anxiety disorder (GAD; n = 24). Among sleep quality indices, only global sleep quality and sleep latency improved significantly (but modestly) during CBT. Sleep quality improvement was greater for treatment responders, but did not vary by diagnosis. Additionally, poor baseline sleep quality was independently associated with worse anxiety treatment outcome, as measured by higher intolerance of uncertainty. Additional intervention targeting sleep prior to or during CBT for anxiety may be beneficial for poor sleepers. PMID:26244485

  5. Prevalence of depressive and anxiety disorders in Chinese gastroenterological outpatients

    PubMed Central

    Li, Xiao-Jing; He, Yan-Ling; Ma, Hong; Liu, Zhe-Ning; Jia, Fu-Jun; Zhang, Ling; Zhang, Lan

    2012-01-01

    AIM: To investigate the prevalence and physicians’ detection rate of depressive and anxiety disorders in gastrointestinal (GI) outpatients across China. METHODS: A hospital-based cross-sectional survey was conducted in the GI outpatient departments of 13 general hospitals. A total of 1995 GI outpatients were recruited and screened with the Hospital Anxiety and Depression Scale (HADS). The physicians of the GI departments performed routine clinical diagnosis and management without knowing the HADS score results. Subjects with HADS scores ≥ 8 were subsequently interviewed by psychiatrists using the Mini International Neuropsychiatric Interview (MINI) to make further diagnoses. RESULTS: There were 1059 patients with HADS score ≥ 8 and 674 (63.64%) of them undertook the MINI interview by psychiatrists. Based on the criteria of Diagnostic and Statistical Manual of Mental Disorders (4th edition), the adjusted current prevalence for depressive disorders, anxiety disorders, and comorbidity of both disorders in the GI outpatients was 14.39%, 9.42% and 4.66%, respectively. Prevalence of depressive disorders with suicidal problems [suicide attempt or suicide-related ideation prior or current; module C (suicide) of MINI score ≥ 1] was 5.84% in women and 1.64% in men. The GI physicians’ detection rate of depressive and anxiety disorders accounted for 4.14%. CONCLUSION: While the prevalence of depressive and anxiety disorders is high in Chinese GI outpatients, the detection rate of depressive and anxiety disorders by physicians is low. PMID:22654455

  6. Treating Anxiety Disorders in a School Setting

    ERIC Educational Resources Information Center

    McLoone, Jordana; Hudson, Jennifer L.; Rapee, Ronald M.

    2006-01-01

    Anxiety disorders are among the most prevalent childhood psychological disorders. In addition to causing acute distress to the child, parent and school staff, anxiety disorders may also have a significant impact on a child's educational and social development and persist chronically into adulthood. Recent work has begun to identify the school as…

  7. Caring for the Patient with an Anxiety Disorder.

    PubMed

    Antai-Otong, Deborah

    2016-06-01

    Anxiety disorders are among the most prevalent and disabling psychiatric disorders. Patients and their families have a plethora of evidence-based treatment options to manage these potentially incapacitating and costly disorders. Nurses in various settings can assess symptoms of anxiety disorder and initiate or refer patients for treatment. Families play a critical role in treatment planning and must be part of the health care team. Primary nursing interventions must be person centered and recovery based to ensure accurate diagnosis, initiation of appropriate person-centered treatment, and facilitate an optimal level of functioning and quality of life. PMID:27229274

  8. Anxiety disorders in people with epilepsy.

    PubMed

    Brandt, Christian; Mula, Marco

    2016-06-01

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

  9. Social Anxiety Disorders and Alcohol Abuse

    MedlinePlus

    ... Council Special Interest Groups Child & Adolescent Anxiety SIG Peer Consultation OCD & Related Disorders SIG Peer Consultation Professional Opportunities: Jobs and Fellowships Journal & Multimedia ...

  10. Peer Perceptions and Liking of Children with Anxiety Disorders

    ERIC Educational Resources Information Center

    Verduin, Timothy L.; Kendall, Philip C.

    2008-01-01

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

  11. Negative Generalization and Symptoms of Anxiety Disorders

    PubMed Central

    Fulford, Daniel; Rosen, Rebecca K.; Johnson, Sheri L.; Carver, Charles S.

    2013-01-01

    The tendency to generalize from a single failure to one's entire self-worth is an important correlate and predictor of depression. Despite conceptual overlap between cognitive biases in anxiety and depression, little research has examined whether negative generalization relates to anxiety symptoms. We examined associations of negative generalization with symptoms of several anxiety disorders, above and beyond its association with lifetime symptoms of depression, among 248 undergraduates. After controlling for lifetime symptoms of major depression, negative generalization was significantly correlated with symptoms of each anxiety disorder tested, most notably generalized anxiety and social phobia. PMID:24340170

  12. Perinatal Generalized Anxiety Disorder: Assessment and Treatment

    PubMed Central

    Abizadeh, Jasmin; Sanders, Shawn; Swift, Elena

    2015-01-01

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

  13. Perinatal Generalized Anxiety Disorder: Assessment and Treatment.

    PubMed

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

    2015-09-01

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

  14. Childhood anxiety disorders. Approach to intervention.

    PubMed Central

    Manassis, Katharina

    2004-01-01

    OBJECTIVE: To present an approach to intervention in childhood anxiety disorders. SOURCES OF INFORMATION: This paper is based on selected findings from a MEDLINE search for recent literature on childhood anxiety disorders and on my experience as a child psychiatrist and researcher in a specialized anxiety disorders clinic. MAIN MESSAGE: Children with symptoms of high sympathetic arousal; persistent worries or intrusive thoughts; and extreme clinging, avoidance, or repetitive behaviours that interfere with daily functioning should be investigated for anxiety disorders. Counseling parents, relaxation techniques, and incentives for "brave" behaviour can often return children with mild disorders to age-appropriate functioning. Children who are severely impaired or fail to respond to these simple interventions might require medication or referral for cognitive-behavioural therapy. CONCLUSION: Family physicians can play an important role in recognizing and intervening early in childhood anxiety disorders. PMID:15318675

  15. 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

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

    MedlinePlus

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

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

    MedlinePlus

    ... link, please review our exit disclaimer . Subscribe Understanding Anxiety Disorders When Panic, Fear, and Worries Overwhelm Many ... or help us focus. But for people with anxiety disorders, they can be overwhelming. Anxiety disorders affect ...

  18. Treating Anxiety Disorders | NIH MedlinePlus the Magazine

    MedlinePlus

    ... page please turn Javascript on. Feature: Phobias and Anxiety Disorders Treating Anxiety Disorders Past Issues / Fall 2010 Table of Contents Anxiety disorders are generally treated with medication, specific types ...

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

    MedlinePlus

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

  20. Symptoms: Personal Snapshots of Anxiety Disorders

    MedlinePlus

    ... of these conditions: Panic Disorder: "For me, a panic attack is almost a violent experience. I feel disconnected from reality. I feel like I'm losing control in a very extreme way. My heart ... / Studying Anxiety Disorders / Symptoms: Personal snapshots of anxiety ...

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  3. 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.…

  4. 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

  5. The effect of comorbid substance use disorders on treatment outcome for anxiety disorders.

    PubMed

    McEvoy, Peter M; Shand, Fiona

    2008-08-01

    This study examined the impact of concurrent substance use disorders (SUDs) on outcomes for psychotherapy targeting anxiety disorders. Study 1 (N=484) sought to determine the prevalence of SUDs in a sample referred to a community anxiety disorders clinic, as well as the impact of comorbid SUDs on outcomes for a subsample (n=200) completing cognitive behavior therapy (CBT). Around one-quarter (22-29%) of patients with one or two anxiety disorders met criteria for at least one SUD, but this rate was substantially higher (46%) for patients with three anxiety disorders. Concurrent SUDs were associated with higher levels of anxiety but not depression or stress, compared to those without a SUD. However, concurrent SUDs did not moderate treatment outcomes. Study 2 (N=103) focused on the impact of alcohol use on diagnosis-specific symptom measures and generic measures of distress and disability, following a course of CBT for panic disorder or social phobia. Pre-treatment alcohol use did not predict changes in panic symptoms, performance anxiety, distress, or disability, but it did predict changes in social interaction anxiety. Problem drinking per se did not have any predictive utility in terms of treatment outcome. These findings suggest that clinicians treating patients for a primary anxiety disorder and concurrent SUD can be relatively optimistic about treatment outcomes. PMID:18164585

  6. 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

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

    PubMed Central

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

    2015-01-01

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

  8. Novel treatment approaches for refractory anxiety disorders.

    PubMed

    Pollack, Mark H; Otto, Michael W; Roy-Byrne, Peter P; Coplan, Jeremy D; Rothbaum, Barbara O; Simon, Naomi M; Gorman, Jack M

    2008-01-01

    The Anxiety Disorders Association of America convened a conference of experts to address treatment-resistant anxiety disorders and review promising novel approaches to the treatment of refractory anxiety disorders. Workgroup leaders and other participants reviewed the literature and considered the presentations and discussions from the conference. Authors placed the emerging literature on new therapeutic approaches into clinical perspective and identified unmet needs and priority areas for future research. There is a relative paucity of efforts addressing inadequate response to anxiety disorder treatment. Systematic efforts to exhaust all therapeutic options and overcome barriers to effective treatment delivery are needed before patients can be considered treatment refractory. Cognitive behavioral therapy, especially in combination with pharmacotherapy, must be tailored to accommodate the effects of clinical context on treatment response. The literature on pharmacologic treatment of refractory anxiety disorders is small but growing and includes studies of augmentation strategies and non-traditional anxiolytics. Research efforts to discover new pharmacologic targets are focusing on neuronal systems that mediate responses to stress and fear. A number of clinical and basic science studies were proposed that would advance the research agenda and improve treatment of patients with anxiety disorders. Significant advances have been made in the development of psychotherapeutic and pharmacologic treatments for anxiety disorders. Unfortunately, many patients remain symptomatic and functionally impaired. Progress in the development of new treatments has great promise, but will only succeed through a concerted research effort that systematically evaluates potential areas of importance and properly uses scarce resources. PMID:17437259

  9. Anxiety

    MedlinePlus

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

  10. Treating Anxiety Disorders | NIH MedlinePlus the Magazine

    MedlinePlus

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

  11. Disorder-specific cognitive profiles in major depressive disorder and generalized anxiety disorder

    PubMed Central

    2014-01-01

    Background This investigation examines differences in cognitive profiles in subjects with major depressive disorder (MDD) and generalized anxiety disorder (GAD). Methods Data were used from subjects with current MDD (n = 655), GAD (n = 107) and comorbid MDD/GAD (n = 266) diagnosis from the Netherlands Study of Depression and Anxiety (NESDA). The Composite Interview Diagnostic Instrument was used to diagnose MDD and GAD. Cognitive profiles were measured using the Leiden Index of Depression Sensitivity, the Anxiety Sensitivity Index, and the Penn State Worry Questionnaire. Results Results showed that differences in cognitive profiles between single MDD and single GAD subjects were present: scores on hopelessness/suicidality and rumination were significantly higher in MDD than GAD, whereas anxiety sensitivity for physical concerns and pathological worry were higher in GAD than MDD. The cognitive profile of comorbid MDD/GAD showed more extreme depression cognitions compared to single disorders, and a similar anxiety profile compared to single GAD subjects. Conclusions Despite the commonalities in cognitive profiles in MDD and GAD, there are differences suggesting that MDD and GAD have disorder-specific cognitive profiles. Findings of this investigation give support for models like the cognitive content-specificity model and the tripartite model and could provide useful handles for treatment focus. PMID:24690413

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

    ERIC Educational Resources Information Center

    Maddox, Brenna B.; White, Susan W.

    2015-01-01

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

  13. 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.

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

    PubMed

    Bandelow, Borwin; Michaelis, Sophie

    2015-09-01

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

  15. Epidemiology of anxiety disorders in the 21st century

    PubMed Central

    Bandelow, Borwin; Michaelis, Sophie

    2015-01-01

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

  16. Assessment of anxiety disorders in asthmatic children.

    PubMed

    Vila, G; Nollet-Clémençon, C; de Blic, J; Falissard, B; Mouren-Simeoni, M C; Scheinmann, P

    1999-01-01

    The study's objective was to determine whether the State Trait Anxiety Inventory for Children, Trait version (STAIC), is suitable for the assessment of DSM-IV anxiety disorders in asthmatic children and adolescents. Ninety-two outpatients were given a semistructured diagnostic interview. They completed STAIC; another questionnaire about anxiety, the Echelle Comportementale d'Anxiété et de Peurs (ECAP); and the Child Depression Inventory. The parents filled in the Child Behavior Check-List (CBCL) and the Conners Parent Rating Scale (CPRS). A group of healthy children was assessed with STAIC. Thirty asthmatic children had anxiety disorders. They had significantly higher STAIC scores than the nonanxious asthmatic and the nonasthmatic children. STAIC scores were independent of age and sex and were correlated with ECAP, CPRS anxiety subscore, CBCL total score, internalizing score, and CBCL anxiety-depression subscore. Internal consistency was 0.75. With a threshold value of 34 for anxiety disorders, this method had a sensitivity of 73% and a specificity of 70%. STAIC was thus a useful method for anxiety disorder screening in a pediatric population. PMID:10479945

  17. Toward an application to psychological disorders diagnosis.

    PubMed

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

    2011-01-01

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

  18. Your Adolescent: Anxiety and Avoidant Disorders

    MedlinePlus

    ... of uneasiness. At other times, it develops into panic attacks and phobias. Identifying the Signs Anxiety disorders vary ... specific situations, in which case they are called panic attacks. A panic attack is an abrupt episode of ...

  19. Primary care perspectives on generalized anxiety disorder.

    PubMed

    Roy-Byrne, Peter P; Wagner, Amy

    2004-01-01

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

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

    PubMed

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

    2016-04-01

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

  1. [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

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

    PubMed Central

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

    2014-01-01

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

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  5. Cultural aspects in social anxiety and social anxiety disorder.

    PubMed

    Hofmann, Stefan G; Anu Asnaani, M A; Hinton, Devon E

    2010-12-01

    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 SAD. This has direct relevance for the upcoming DSM-V. PMID:21132847

  6. Functional impairment in social anxiety disorder.

    PubMed

    Aderka, Idan M; Hofmann, Stefan G; Nickerson, Angela; Hermesh, Haggai; Gilboa-Schechtman, Eva; Marom, Sofi

    2012-04-01

    The present study examined functional impairment among treatment seekers with social anxiety disorder (SAD). We investigated the effects of diagnostic subtypes of SAD and comorbidity with mood and anxiety disorders on impairment. In addition, we used cluster analysis procedures to empirically identify subgroups of individuals with distinct patterns of impairment. Participants were 216 treatment-seeking individuals with SAD. Clinical interviews were undertaken to determine diagnoses of anxiety disorders and major depressive disorder, and a battery of self-report measures was administered to index symptoms of social anxiety, depression and extent of impairment. Results indicated that individuals with the generalized subtype of SAD had greater impairment in all three life domains compared to individuals with the nongeneralized subtype. Comorbidity with mood disorders was associated with greater impairment than SAD alone, but comorbidity with anxiety disorders was not. Four distinct impairment profiles emerged from the cluster analysis: primary work/studies impairment, primary social life impairment, both work/studies and social impairment, and impairment in all domains. Findings from this study suggest that SAD is associated with substantial impairment across multiple domains, and that individuals with SAD present diverse impairment profiles. These profiles may inform subtyping of the disorder as well as therapeutic interventions. PMID:22306132

  7. Supplementary dimensional assessment in anxiety disorders.

    PubMed

    Shear, M Katherine; Bjelland, Ingvar; Beesdo, Katja; Gloster, Andrew T; Wittchen, Hans-Ulrich

    2007-01-01

    Anxiety disorders, as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), comprise a relatively heterogeneous group of clinical conditions that range from specific phobias to obsessive compulsive disorder (OCD) and post-traumatic stress disorder (PTSD). The grouping under one heading refers to the fact that these seemingly heterogeneous disorders share a number of common psychopathological features and also share at least some common principles in treatment. Among the shared elements are broadly defined prototypical anxiety reactions, panic attacks, anticipatory anxiety, avoidance behaviour, a predominantly early onset, and relatively high persistence rates over time. Many of the shared diagnostic features of anxiety disorders are by their nature dimensional, and hundreds of psychometric scales have been developed to measure these diagnostic constructs across anxiety disorder and for specific diagnostic classes. This paper explores different types of dimensional approaches used in the literature and discusses how an integrated categorical/dimensional strategy might enhance the usefulness of the DSM-V. We suggest the use of cross-cutting dimensional ratings that might ultimately lead to an improved classification model. We also suggest that a staging approach to illness, based upon supplementary dimensional rating could provide useful information for clinical and research purposes. PMID:17623395

  8. Cross-Cultural Aspects of Anxiety Disorders

    PubMed Central

    Hofmann, Stefan G.; Hinton, Devon E.

    2014-01-01

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

  9. The many faces of social anxiety disorder.

    PubMed

    Wittchen, H U

    2000-07-01

    Social anxiety disorder, also known as social phobia, is one of the most prevalent anxiety disorders, affecting 7-13% of subjects in the community at some time in their lives. Despite being eminently treatable, it remains largely under-recognised and, therefore, undertreated. The disorder is characterized by a fear of scrutiny by others, with sufferers experiencing excessive anxiety in social and performance situations. This excessive anxiety usually leads to avoidance behaviour that can severely affect normal daily living. With onset commonly occurring during childhood or adolescence, social anxiety disorder may disrupt normal patterns of development of social and personal relationships, often having a long-term impact on emotional stability in social or working life. If left untreated, the course of social anxiety disorder is frequently complicated with comorbid conditions, particularly major depression or substance abuse. This review assesses the size of the clinical problem by evaluating current and lifetime prevalence estimates, age of onset, risk factors and evolution of the clinical course; thereby providing the rationale for early recognition and prompt treatment. PMID:10994677

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

    PubMed Central

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

    2015-01-01

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

  11. Anxiety

    MedlinePlus

    ... R S T U V W X Y Z Anxiety Share: © Thinkstock Anxiety disorders affect about 40 million Americans age 18 ... in a given year. Effective conventional treatments for anxiety disorders are available, and research is uncovering new ...

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

    PubMed

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

    2012-09-01

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

  13. 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…

  14. Toddler Anxiety Disorders: A Pilot Study

    ERIC Educational Resources Information Center

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

    2006-01-01

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

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

    PubMed

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

    2009-08-01

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

  16. The moderated effects of video feedback for social anxiety disorder.

    PubMed

    Rodebaugh, Thomas L; Heimberg, Richard G; Schultz, Luke T; Blackmore, Michelle

    2010-10-01

    Despite initially positive results, video feedback for social anxiety has never been shown to reduce social anxiety in a controlled experiment with diagnosed participants, and only once with undiagnosed participants. Previous studies arguably did not detect such an effect because of limited assessment of anxiety and potential moderators. We tested video feedback with cognitive preparation among treatment-seeking participants with a primary diagnosis of social anxiety disorder. In Session 1, participants gave an extemporaneous speech and either received the intervention or not. In Session 2, 6-14 days later, participants gave a second extemporaneous speech. The intervention improved self-perception of performance, particularly for those participants with the most unrealistically negative impressions of their performance (i.e., high self-observer discrepancy). In addition, the intervention reduced anticipatory anxiety for the second speech for participants with high self-observer discrepancy. These findings extend previous results regarding video feedback and suggest that the intervention may be useful for people with social anxiety disorder and higher self-observer discrepancies for a specific task. PMID:20471783

  17. Immune system. Relationship to anxiety disorders.

    PubMed

    Stein, M; Keller, S E; Schleifer, S J

    1988-06-01

    The demonstration that behavioral states and CNS processes are associated with immune function suggests that there may be a relationship between anxiety and the immune system. Stress and immunity have been studied extensively, but there have been relatively few studies of anxiety and immunity. Many of the neurobiologic processes associated with stress and with depression have been observed in anxiety and are known to influence the immune system. A review of the immune response to stress and of immune alterations in depression has been presented in an effort to provide further understanding of the biology of anxiety. It appears that a variety of factors such as age; sex; nature, intensity, and chronicity of a stressful life events; and psychologic response to life stress need to be considered in the investigation of behavior and immunity. The biologic effects of stress on immunity are multifaceted, including complex neuroendocrine and neurotransmitter interactions. Further investigation is required of anxiety and immunity in clearly delineated and diagnosed anxiety states and disorders. Such studies may help to elucidate the pathophysiology of anxiety disorders. PMID:3047704

  18. 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

  19. 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

  20. Advances in pharmacotherapy for pediatric anxiety disorders.

    PubMed

    Rynn, Moira; Puliafico, Anthony; Heleniak, Charlotte; Rikhi, Pranav; Ghalib, Kareem; Vidair, Hilary

    2011-01-01

    Pediatric anxiety disorders are prevalent, chronic, and often lead to significant impaired functioning that impacts both short- and long-term outcomes for children and adolescents. Treatment options include pharmacotherapy and psychosocial interventions. This presentation will review treatment advances specifically for pharmacotherapy. Current research supports serotonin reuptake inhibitors as the medication class to be the first-line treatment option for pediatric anxiety disorders. Available evidence for the efficacy of other classes of medications will be reviewed, along with the available approaches to manage partial responders and nonresponders. The risks and benefits of pharmacotherapy will also be reviewed. In addition, recent research has shown the potential promise of novel agents that act upon other neural systems implicated in the development of pediatric anxiety disorders. Novel compounds that affect the glutamate system will be discussed. PMID:21225851

  1. Depression and anxiety among patients with somatoform disorders, panic disorder, and other depressive/anxiety disorders in Taiwan.

    PubMed

    Huang, Wei-Lieh; Chen, Tzu-Ting; Chen, I-Ming; Ma, Huei-Mei; Lee, Ming-Tzu; Liao, Shih-Cheng; Gau, Shur-Fen

    2016-07-30

    The aim of this study is to compare the severity of depression and anxiety in individuals with somatoform disorders, panic disorder, other depressive/anxiety disorders, and healthy controls in a Han Chinese population. According to the DSM-IV-TR-based diagnostic interviews, we recruited 152 subjects with somatoform disorders (SG), 56 with panic disorder (PG), 85 with other depressive/anxiety disorders (OG), and 179 without any psychiatric disorder (NG). The four groups reported on the Beck Depression Inventory-II (BDI-II) and Beck Anxiety Inventory (BAI) for depressive and anxiety symptoms, respectively. Correlation analysis and multivariate regression analysis were used to determine the effects of demographic factors and psychiatric diagnoses on depressive and anxiety symptoms separately. BDI-II scores were not significantly different in SG, PG, and OG but were higher than NG. SG and PG had the highest BAI scores, whereas NG had the lowest. Multiple linear regression analyses revealed that the associated factors for BDI-II were gender, residential location, somatoform disorders, panic disorder, major depressive disorder (MDD), and generalized anxiety disorder, whereas BAI was significantly associated with somatoform disorders, panic disorder, and MDD. Our results strongly suggest the inclusion of clinical assessment of depressive and anxious symptoms in patients with somatoform disorders. PMID:27179181

  2. 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

  3. Studying Anxiety Disorders | NIH MedlinePlus the Magazine

    MedlinePlus

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

  4. Is obsessive-compulsive disorder an anxiety disorder?

    PubMed

    Bartz, Jennifer A; Hollander, Eric

    2006-05-01

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

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  6. 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…

  7. 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…

  8. 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

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

    PubMed

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

    2016-03-01

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

  10. Anxiety.

    PubMed

    Dean, Erin

    2016-07-13

    Essential facts Anxiety is the feeling of fear that occurs when faced with threatening or stressful situations. It is a normal response when confronted with danger, but, if it is overwhelming or the feeling persists, it could be regarded as an anxiety disorder. The Royal College of Psychiatrists says anxiety disorders, including panic disorder, post-traumatic stress disorder and social anxiety disorder, affect about one in ten. PMID:27406490

  11. Fluvoxamine in the treatment of anxiety disorders.

    PubMed

    Irons, Jane

    2005-12-01

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

  12. Generalized anxiety disorder in the classroom.

    PubMed

    Manassis, Katharina

    2012-01-01

    Interventions for students with generalized anxiety disorder require attention to contextual factors both within and outside the classroom. They often are based on the principles of increasing environmental predictability and increasing the student’s sense of self-efficacy. Good judgment is sometimes needed to determine which strategies constitute reasonable accommodations to the student’s anxiety and which constitute an excessive deviation from usual school expectations. The latter can single out students unnecessarily or limit their academic progress. Working closely with parents and mental health professionals involved in the student’s care is most likely to ensure a consistently helpful approach. PMID:22137814

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

    PubMed Central

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

    2016-01-01

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

  14. 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

  15. 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…

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

    PubMed Central

    2012-01-01

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

  17. 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…

  18. 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…

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

    PubMed

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

    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

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

    PubMed

    Maddox, Brenna B; White, Susan W

    2015-12-01

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

  1. Neuroenhancement of Exposure Therapy in Anxiety Disorders

    PubMed Central

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

    2015-01-01

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

  2. Psychological treatment of social anxiety disorder improves body dysmorphic concerns.

    PubMed

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

    2013-10-01

    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

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

    PubMed

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

    2012-08-01

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

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

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

    PubMed Central

    Gallagher, Matthew W.; Brown, Timothy A.

    2014-01-01

    Although posttraumatic stress disorder (PTSD) is no longer considered an anxiety disorder in DSM-5, previous research has indicated high rates of comorbid anxiety and mood disorders in individuals with PTSD. The goal of the present study was to build upon previous examinations of diagnostic comorbidity by using Bayesian methods of estimating current and lifetime comorbidity rates to determine more precise estimates of the proportion of individuals in a clinical sample with PTSD that also meet criteria for various emotional disorders. Two hundred and fifty three individuals with a current or lifetime diagnosis of PTSD underwent a comprehensive assessment of current and lifetime emotional disorders. Bayesian statistical techniques were then used to calculate credibility intervals for the current and lifetime comorbidity rates of emotional disorders. The Bayesian analyses used informative priors based on previous comorbidity findings. The median number of current emotional disorders was two and the median number of lifetime comorbid emotional disorders was three. Credibility intervals indicated that social phobia and major depressive disorder were the most common current and lifetime comorbid emotional disorders. The proportion of individuals with lifetime comorbidity rates were very high for both any lifetime anxiety disorder (.91, 95% CI .88: .94) and any lifetime depressive disorder (.90, 95% CI .86: .93). Together these results indicate that despite the separation from the anxiety disorders in DSM-5, the vast majority of individuals with PTSD will present with one or more emotional disorders. Implications for the assessment and treatment of PTSD are discussed. PMID:26166944

  6. Obsessive-compulsive disorder: diagnosis and treatment.

    PubMed

    Goodman, W K

    1999-01-01

    Obsessive-compulsive disorder (OCD) is a chronic, disabling anxiety disorder that is characterized by recurrent obsessions and uncontrolled compulsions such as repetitive behavioral or mental acts that are performed in response to an obsession. OCD often occurs comorbidly with a number of depressive and anxiety disorders. In addition, patients with OCD suffer significant personal and social morbidity and may have difficulty maintaining a job, finishing school, and developing relationships. The backbone of pharmacologic treatment for OCD is a 10- to 12-week trial with a selective serotonin reuptake inhibitor (SSRI) in adequate doses. In most cases, treatment should be initiated with an SSRI because of the superior safety, tolerability, and equivalent efficacy of this class of drugs compared with clomipramine. When dealing with patients who do not respond to one SSRI, effective alternatives include switching to a different SSRI, combining another medication or behavioral therapy with SSRI therapy, considering novel or experimental drug treatments, or employing nonpharmacologic biological approaches, such as electroconvulsive therapy, neurosurgery, or repetitive transcranial magnetic stimulation. This article provides an update on the diagnosis and medical management of OCD and will discuss guidelines for the use of SSRIs and novel approaches for managing treatment-refractory patients. PMID:10487253

  7. Gaze perception in social anxiety and social anxiety disorder

    PubMed Central

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

    2013-01-01

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

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

    PubMed

    Gieler, T; Brähler, E

    2016-05-01

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

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

    PubMed

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

    2015-12-01

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

  10. 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

  11. Social anxiety disorder: psychobiological and evolutionary underpinnings.

    PubMed

    Stein, Dan J; Vythilingum, Bavanisha

    2007-11-01

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

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

    PubMed

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

    2006-01-01

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

  13. A trans-diagnostic review of anxiety disorder comorbidity and the impact of multiple exclusion criteria on studying clinical outcomes in anxiety disorders

    PubMed Central

    Goldstein-Piekarski, A N; Williams, L M; Humphreys, K

    2016-01-01

    Anxiety disorders are highly comorbid with each other and with other serious mental disorders. As our field progresses, we have the opportunity to pursue treatment study designs that consider these comorbidities. In this perspective review, we first characterized the prevalence of multiple anxiety disorder comorbidity by reanalyzing national survey data, then conducted an English-language PubMed search of studies analyzing the impact of exclusion criteria on treatment outcome data. In the prevalence data, 60% of people with an anxiety disorder had one or more additional anxiety or depression diagnosis. Because our commonly applied exclusion criteria focus on a single diagnosis and do not consider a multiple comorbidity profile, the impact of the criteria may be to exclude up to 92% of anxiety disorder treatment seekers. Moreover, the findings do not suggest a consistent relationship between the number of exclusion criteria and the effect size of treatment outcomes. Thus, future studies might consider a more trans-diagnostic rationale for determining exclusion criteria, one that is generalizable to real-world settings in which multiple diagnoses commonly co-occur. The findings also encourage a more systematic reporting of rationales for the choice of—and the implications of—each exclusion criterion. PMID:27351601

  14. A trans-diagnostic review of anxiety disorder comorbidity and the impact of multiple exclusion criteria on studying clinical outcomes in anxiety disorders.

    PubMed

    Goldstein-Piekarski, A N; Williams, L M; Humphreys, K

    2016-01-01

    Anxiety disorders are highly comorbid with each other and with other serious mental disorders. As our field progresses, we have the opportunity to pursue treatment study designs that consider these comorbidities. In this perspective review, we first characterized the prevalence of multiple anxiety disorder comorbidity by reanalyzing national survey data, then conducted an English-language PubMed search of studies analyzing the impact of exclusion criteria on treatment outcome data. In the prevalence data, 60% of people with an anxiety disorder had one or more additional anxiety or depression diagnosis. Because our commonly applied exclusion criteria focus on a single diagnosis and do not consider a multiple comorbidity profile, the impact of the criteria may be to exclude up to 92% of anxiety disorder treatment seekers. Moreover, the findings do not suggest a consistent relationship between the number of exclusion criteria and the effect size of treatment outcomes. Thus, future studies might consider a more trans-diagnostic rationale for determining exclusion criteria, one that is generalizable to real-world settings in which multiple diagnoses commonly co-occur. The findings also encourage a more systematic reporting of rationales for the choice of-and the implications of-each exclusion criterion. PMID:27351601

  15. 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…

  16. Diagnosis of Copper Transport Disorders

    PubMed Central

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

    2011-01-01

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

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

    PubMed Central

    Apetroaia, Adela; Hill, Claire; Creswell, Cathy

    2015-01-01

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

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

    PubMed

    Allilaire, Jean-François

    2012-10-01

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

  19. Update on Anxiety Disorders in Childhood and Adolescence.

    PubMed

    McGuinness, Teena M; Durand, Simone C

    2016-06-01

    Despite significant progress in understanding anxiety disorders in youth, affected children are often unrecognized and never receive adequate treatment recognition. Although common among children and adolescents, many parents and health care providers do not realize anxiety disorders in youth predict anxiety disorders in adulthood. The history of anxiety disorders in childhood and their continuity into adolescence and adulthood are discussed. Treatment options and best practices for psychiatric nurses are also explored. [Journal of Psychosocial Nursing and Mental Health Services, 54 (6), 25-28.]. PMID:27245249

  20. Proportional differences in emergency room adult patients with PTSD, mood disorders, and anxiety for a large ethnically diverse geographic sample.

    PubMed

    Onoye, Jane; Helm, Susana; Koyanagi, Chad; Fukuda, Michael; Hishinuma, Earl; Takeshita, Junji; Ona, Celia

    2013-05-01

    Underserved populations often utilize the emergency room in place of primary care, particularly for short term behavioral health services. This study examined emergency department (ED) utilization rates for rurality, insurance, sex, and ethnicity in a large sample of adult patients in Hawai'i hospitals from 2000-2010 with a diagnosis of post-traumatic stress disorder (PTSD), mood disorder, or other anxiety disorder. Findings showed a higher rate of use by rural and suburban residents with a diagnosis of PTSD or other anxiety than by urban residents. Utilization of EDs by African Americans and Other Pacific Islanders with PTSD was proportionally higher than for those with mood disorders or other anxiety disorders. Military ED visits were also proportionally higher for individuals with PTSD than for those with mood or other anxiety disorders. Limited economic resources and increasingly costly mental health disorders such as PTSD highlight the importance of better understanding the needs for behavioral health services for underserved populations. PMID:23728057

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

    PubMed

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

    2014-07-01

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

  2. Self-Compassion and Social Anxiety Disorder

    PubMed Central

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

    2014-01-01

    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 (Neff, 2003b). 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. Episodic Memories in Anxiety Disorders: Clinical Implications

    PubMed Central

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

    2014-01-01

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

  5. Episodic future thinking in generalized anxiety disorder.

    PubMed

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

    2015-12-01

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

  6. Emotion Regulation Therapy for Generalized Anxiety Disorder

    PubMed Central

    Fresco, David M.; Mennin, Douglas S.; Heimberg, Richard G.; Ritter, Michael

    2016-01-01

    Despite the success of cognitive behavioral therapies (CBT) for emotional disorders, a sizable subgroup of patients with complex clinical presentations, such as patients with generalized anxiety disorder, fails to evidence adequate treatment response. Emotion Regulation Therapy (ERT) integrates facets of traditional and contemporary CBTs, mindfulness, and emotion-focused interventions within a framework that reflects basic and translational findings in affect science. Specifically, ERT is a mechanism-targeted intervention focusing on patterns of motivational dysfunction while cultivating emotion regulation skills. Open and randomized controlled psychotherapy trials have demonstrated considerable preliminary evidence for the utility of this approach as well as for the underlying proposed mechanisms. This article provides an illustration of ERT through the case of “William.” In particular, this article includes a case-conceptualization of William from an ERT perspective while describing the flow and progression of the ERT treatment approach. PMID:27499606

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

    PubMed Central

    2014-01-01

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

  8. Neuroendocrine models of social anxiety disorder.

    PubMed

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

    2015-09-01

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

  9. Anxiety disorders in ancient Indian literature

    PubMed Central

    Sheth, Hitesh C.; Gandhi, Zindadil; Vankar, G. K.

    2010-01-01

    In western literature, the oldest description of symptoms of PTSD, an anxiety group of disorder, is seen in Homer’s Iliad written around 720 BC. According to Shay, Achilles was suffering from symptoms of PTSD. However, in the Indian literature it was mentioned around 5000 BC. The description of a PTSD-like syndrome is seen in the Ramayana, although it was not described as PTSD or by any other similar name. Ravana’s brother Marrich was having symptoms of PTSD after he was grievously hurt by Lord Rama’s arrow and was almost dead. This traumatic event threatened his physical integrity. He developed all the symptoms of PTSD, like hyper-arousal, re-experiencing the events and avoidance. He also gave up his natural work of harassing the monk and got engaged in meditation and austerities. His symptoms lasted for many years till Lord Rama killed him, while he was masquerading as a golden deer to deceive Sita. In another ancient epic Shrimad Bhagavatam, Maharshi Ved Vyasa described the symptoms of Generalized Anxiety Disorder (GAD). The demon King Kansha developed GAD-like symptoms, when Lord Krishna killed all his demons and threatened to kill him. He developed symptoms of GAD, like excessive worry about the attack from his arch foe Krishna, difficulty in concentration and difficulty in falling asleep. Like Marrich, the symptoms of Kansha also lasted until Lord Krishna killed him. PMID:21180424

  10. Neuroendocrine models of social anxiety disorder

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  12. 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

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

    PubMed

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

    2010-01-01

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

  14. Cannabidiol as a Potential Treatment for Anxiety Disorders.

    PubMed

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

    2015-10-01

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

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

    PubMed

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

    2009-01-01

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

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  17. Biological predictors of pharmacological therapy in anxiety disorders

    PubMed Central

    Maron, Eduard; Nutt, David

    2015-01-01

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

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

    PubMed

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

    2015-10-01

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

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

    PubMed

    Kutlu, Munir Gunes; Gould, Thomas J

    2015-10-15

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  1. 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…

  2. Generalized Anxiety Disorder in Referred Children and Adolescents.

    ERIC Educational Resources Information Center

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

    2004-01-01

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

  3. 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…

  4. Conceptual Relations between Anxiety Disorder and Fearful Temperament

    ERIC Educational Resources Information Center

    Rapee, Ronald M.; Coplan, Robert J.

    2010-01-01

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

  5. Lack of a Benign Interpretation Bias in Social Anxiety Disorder

    PubMed Central

    Amir, Nader; Prouvost, Caroline; Kuckertz, Jennie M.

    2013-01-01

    Cognitive models of social anxiety posit that recurrent interpretation of ambiguous information as threatening maintains symptoms (e.g. Clark & Wells, 1995, pp. 69–93, Social phobia: Diagnosis, assessment, and treatment. New York: Guilford Press; Rapee & Heimberg, 1997, pp. 741–756, Behavior Research and Therapy, 35). However, biased interpretation may also be represented as a failure to make a benign interpretation of the ambiguous event. Furthermore, interpretation bias can be characterized by both an online (automatic) component and an offline (effortful) component (Hirsch & Clark, 2004, pp. 799–825, Clinical Psychology Review, 24). To measure both benign and threat biases, as well as examine the effect of social anxiety on offline versus online interpretations, Beard and Amir (2009, pp. 1135–1141, Behaviour Research and Therapy, 46) developed the Word Sentence Association Paradigm (WSAP). In the current study, we administered the WSAP to a group of participants diagnosed with social anxiety disorder (SAD) as well as to a group of non-anxious control (NAC) participants. We found that participants with SAD demonstrated a lack of benign online bias, but not an online threat bias when compared to NACs. However, when examining offline biases, SAD patients endorsed social threat interpretations and rejected benign social interpretations to a greater degree than non-anxious individuals. Our results, when taken together, clearly implicate the role of reduced bias toward benign information in SAD. PMID:22545788

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

    PubMed

    Boyd, Rhonda C; Tervo-Clemmens, Brenden

    2013-06-01

    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

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

    PubMed

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

    2015-09-30

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

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

    PubMed Central

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

    2014-01-01

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

  9. MicroRNA Regulators of Anxiety and Metabolic Disorders.

    PubMed

    Meydan, Chanan; Shenhar-Tsarfaty, Shani; Soreq, Hermona

    2016-09-01

    Anxiety-related and metabolic disorders are under intense research focus. Anxiety-induced microRNAs (miRNAs) are emerging as regulators that are not only capable of suppressing inflammation but can also induce metabolic syndrome-related processes. We summarize here evidence linking miRNA pathways which share regulatory networks in metabolic and anxiety-related conditions. In particular, miRNAs involved in these disorders include regulators of acetylcholine signaling in the nervous system and their accompanying molecular machinery. These have been associated with anxiety-prone states in individuals, while also acting as inflammatory suppressors. In peripheral tissues, altered miRNA pathways can lead to dysregulated metabolism. Common pathways in metabolic and anxiety-related phenomena might offer an opportunity to reclassify 'healthy' and 'unhealthy', as well as metabolic and anxiety-prone biological states, and inform putative strategies to treat these disorders. PMID:27496210

  10. Anger profiles in social anxiety disorder.

    PubMed

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

    2016-01-01

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

  11. Differentiating the subtypes of social anxiety disorder.

    PubMed

    Dalrymple, Kristy; D'Avanzato, Catherine

    2013-11-01

    Since the inclusion of subtypes of social anxiety disorder (SAD) in the DSM-III-R, the most studied have been generalized versus specific subtypes. Previous research indicated that the generalized subtype was associated with greater severity, comorbidity and functional impairment compared to the specific subtype, but more recent evidence supports a dimensional conceptualization of SAD. Earlier studies also possessed limitations, such as heterogeneity in definitions of generalized SAD. Based on the more recent findings and the limitations of the earlier studies, the DSM-5 eliminated the generalized specifier. However, it also retained a categorical system by including a performance-based fear specifier, thus leaving an open debate on whether or not a dimensional or categorical system best describes SAD. Future research could examine other, more recent concepts as potential subtypes (e.g., attentional biases), or perhaps the larger question of the overall utility in subtyping SAD. PMID:24175725

  12. Delineation of differential temporal relations between specific eating and anxiety disorders.

    PubMed

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

    2010-09-01

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

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  14. Generalized Anxiety Disorder and Social Anxiety Disorder, but Not Panic Anxiety Disorder, Are Associated with Higher Sensitivity to Learning from Negative Feedback: Behavioral and Computational Investigation

    PubMed Central

    Khdour, Hussain Y.; Abushalbaq, Oday M.; Mughrabi, Ibrahim T.; Imam, Aya F.; Gluck, Mark A.; Herzallah, Mohammad M.; Moustafa, Ahmed A.

    2016-01-01

    Anxiety disorders, including generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic anxiety disorder (PAD), are a group of common psychiatric conditions. They are characterized by excessive worrying, uneasiness, and fear of future events, such that they affect social and occupational functioning. Anxiety disorders can alter behavior and cognition as well, yet little is known about the particular domains they affect. In this study, we tested the cognitive correlates of medication-free patients with GAD, SAD, and PAD, along with matched healthy participants using a probabilistic category-learning task that allows the dissociation between positive and negative feedback learning. We also fitted all participants' data to a Q-learning model and various actor-critic models that examine learning rate parameters from positive and negative feedback to investigate effects of valence vs. action on performance. SAD and GAD patients were more sensitive to negative feedback than either PAD patients or healthy participants. PAD, SAD, and GAD patients did not differ in positive-feedback learning compared to healthy participants. We found that Q-learning models provide the simplest fit of the data in comparison to other models. However, computational analysis revealed that groups did not differ in terms of learning rate or exploration values. These findings argue that (a) not all anxiety spectrum disorders share similar cognitive correlates, but are rather different in ways that do not link them to the hallmark of anxiety (higher sensitivity to negative feedback); and (b) perception of negative consequences is the core feature of GAD and SAD, but not PAD. Further research is needed to examine the similarities and differences between anxiety spectrum disorders in other cognitive domains and potential implementation of behavioral therapy to remediate cognitive deficits. PMID:27445719

  15. Generalized Anxiety Disorder and Social Anxiety Disorder, but Not Panic Anxiety Disorder, Are Associated with Higher Sensitivity to Learning from Negative Feedback: Behavioral and Computational Investigation.

    PubMed

    Khdour, Hussain Y; Abushalbaq, Oday M; Mughrabi, Ibrahim T; Imam, Aya F; Gluck, Mark A; Herzallah, Mohammad M; Moustafa, Ahmed A

    2016-01-01

    Anxiety disorders, including generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic anxiety disorder (PAD), are a group of common psychiatric conditions. They are characterized by excessive worrying, uneasiness, and fear of future events, such that they affect social and occupational functioning. Anxiety disorders can alter behavior and cognition as well, yet little is known about the particular domains they affect. In this study, we tested the cognitive correlates of medication-free patients with GAD, SAD, and PAD, along with matched healthy participants using a probabilistic category-learning task that allows the dissociation between positive and negative feedback learning. We also fitted all participants' data to a Q-learning model and various actor-critic models that examine learning rate parameters from positive and negative feedback to investigate effects of valence vs. action on performance. SAD and GAD patients were more sensitive to negative feedback than either PAD patients or healthy participants. PAD, SAD, and GAD patients did not differ in positive-feedback learning compared to healthy participants. We found that Q-learning models provide the simplest fit of the data in comparison to other models. However, computational analysis revealed that groups did not differ in terms of learning rate or exploration values. These findings argue that (a) not all anxiety spectrum disorders share similar cognitive correlates, but are rather different in ways that do not link them to the hallmark of anxiety (higher sensitivity to negative feedback); and (b) perception of negative consequences is the core feature of GAD and SAD, but not PAD. Further research is needed to examine the similarities and differences between anxiety spectrum disorders in other cognitive domains and potential implementation of behavioral therapy to remediate cognitive deficits. PMID:27445719

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

    PubMed

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

    1998-12-01

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

  17. Pharmacotherapy for anxiety disorders in children and adolescents

    PubMed Central

    Kodish, Ian; Rockhill, Carol; Varley, Chris

    2011-01-01

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

  18. 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…

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

    PubMed

    Bernstein, G A; Borchardt, C M

    1991-07-01

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

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

    PubMed

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

    2010-09-01

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

  1. 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

  2. Relationship between Social Anxiety Disorder and Body Dysmorphic Disorder

    PubMed Central

    Fang, Angela; Hofmann, Stefan G.

    2010-01-01

    Social anxiety disorder (SAD) and body dysmorphic disorder (BDD) are two separate, but conceptually overlapping nosological entities. In this review, we examine similarities between SAD and BDD in comorbidity, phenomenology, cognitive biases, treatment outcome, and cross-cultural aspects. Our review suggests that SAD and BDD are highly comorbid, show a similar age of onset, share a chronic trajectory, and show similar cognitive biases for interpreting ambiguous social information in a negative manner. Furthermore, research from treatment outcome studies have demonstrated that improvements in SAD were significantly correlated with improvements in BDD. Findings from cross-cultural research suggest that BDD may be conceived as a subtype of SAD in some Eastern cultures. Directions for future research and clinical implications of these findings are discussed. PMID:20817336

  3. 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

  4. [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

  5. Social anxiety disorder in the primary care setting.

    PubMed

    Culpepper, Larry

    2006-01-01

    Generalized social anxiety disorder (SAD) is a disabling yet unrecognized condition for many individuals visiting primary care physicians. Social anxiety disorder carries a high risk of developing additional anxiety and mood disorders, including those with suicidal behaviors, as comorbidities, leading to a severe course. Screening and case-finding tools are available and can lead to the recognition of affected individuals. Once symptoms are recognized, an initial assessment will help to differentiate from other anxiety disorders and conditions that can be misdiagnosed as SAD. The primary care physician can manage treatment of SAD, which might require involving mental health professionals. Both pharmacotherapy, involving selective serotonin reuptake inhibitors, and psychotherapy, preferably with cognitive-behavioral therapy, can be effective. Long-term support strategies to monitor relapses or the development of additional psychiatric disorders or to provide anticipatory guidance at times of significant life transitions are additional primary care-based activities that can be helpful to the patient with SAD. PMID:17092194

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

    MedlinePlus

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

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

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

    ERIC Educational Resources Information Center

    Gadow, Kenneth D.; Nolan, Edith E.

    2011-01-01

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

  9. 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,…

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Rapee, Ronald M.

    2012-01-01

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

  12. 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,…

  13. 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…

  14. [Symptoms profile of mixed anxiety and depressive disorder].

    PubMed

    Małyszczak, K; Sidorowicz, S; Łaczmański, T

    2001-01-01

    The paper describes symptoms of mixed depressive and anxiety disorder (ICD-10). The study was carried out in three medical dispensaries: two psychiatric (42 persons) and one primary care (62 persons). Patients with or without anxiety and depressive symptoms were included. Exclusion criteria was: psychoactive substance abuse, physical diseases affecting mental state, and mental disorders other than anxiety or mood disorders. A total of 104 patients (65 women and 39 men in mean age of 41.1 years) were inquired with General Health Questionnaire (GHQ-30), Global Assessment of Functioning (GAF) and diagnostic questionnaire based on Schedules for Clinical Assessment in Neuropsychiatry, Version 2.0. There was no pattern of symptoms specific for mixed disorder that could be a basis for operational criteria. The most frequent were symptoms of generalised anxiety disorder (GAD), depression and dysthymia. The most specific symptoms, selected using discriminant analysis were: (1) difficulty in concentrating, (2) feeling mentally tense, (3) feeling of hopelessness or despair, (4) shortening of breath, (5) lowered mood, (6) feeling dizzy, unsteady, faint, or light headed; (7) early waking up, (8) nightmares, (9) dry mouth, (10) hot flushes or cold chills, (11) frequent tearfulness. The results contribute to the concept that mixed depression and anxiety disorder is closely related to generalised anxiety disorder (GAD). PMID:11842606

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-07-01

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

  17. 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

  18. 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

  19. Childhood Language Disorder and Social Anxiety in Early Adulthood.

    PubMed

    Brownlie, E B; Bao, Lin; Beitchman, Joseph

    2016-08-01

    Language disorder is associated with anxiety and with social problems in childhood and adolescence. However, the relation between language disorder and adult social anxiety is not well known. This study examines social anxiety in early adulthood in a 26-year prospective longitudinal study following individuals identified with a communication disorder at age 5 and a control group. Social anxiety diagnoses and subthreshold symptoms were examined at ages 19, 25, and 31 using a structured diagnostic interview; social anxiety symptoms related to social interaction and social performance were also assessed dimensionally at age 31. Multiple imputation was used to address attrition. Compared to controls, participants with childhood language disorder had higher rates of subthreshold social phobia at ages 19 and 25 and endorsed higher levels of social interaction anxiety symptoms at age 31, with particular difficulty talking to others and asserting their perspectives. Childhood language disorder is a specific risk factor for a circumscribed set of social anxiety symptoms in adulthood, which are likely associated with communication challenges. PMID:26530522

  20. Anxiety in Children and Adolescents with Autism Spectrum Disorders

    PubMed Central

    White, Susan W.; Oswald, Donald; Ollendick, Thomas; Scahill, Lawrence

    2009-01-01

    Anxiety and poor stress management are common concerns in clinical samples of children with autism spectrum disorders (ASD). Anxiety may worsen during adolescence, as young people face an increasingly complex social milieu and often become more aware of their differences and interpersonal difficulties. This review summarizes the state of research on the prevalence, phenomenology, and treatment of anxiety in youth with autism and related conditions such as Asperger’s disorder. Using search words autism, asperger(s), or pervasive developmental disorder and anxiety or anxious to find reports published between 1990 and 2008, this review identified 40 papers. The results of the review suggest that anxiety, whether measured categorically or dimensionally, is indeed common in children and adolescents with autism spectrum disorders and may be a source of additional morbidity. The assessment of anxiety disorders in ASD should be conducted using multiple informants and modalities, as children with ASD often do not display age-typical symptoms of anxiety. To date, relatively few controlled intervention studies using well-characterized samples have been conducted despite preliminary evidence for efficacy of select pharmacological and psychosocial approaches. Recommendations for future applied research are presented and clinical implications are explored. PMID:19223098

  1. 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

  2. Withdrawing Benzodiazepines in Patients With Anxiety Disorders.

    PubMed

    Lader, Malcolm; Kyriacou, Andri

    2016-01-01

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

  3. 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

  4. 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

  5. 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

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

    PubMed

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

    2016-01-01

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

  7. Space and motion discomfort and abnormal balance control in patients with anxiety disorders

    PubMed Central

    Jacob, R G; Redfern, M S; Furman, J M

    2016-01-01

    Objective Previous research suggested that panic disorder with agoraphobia is associated with abnormalities on vestibular and balance function tests. The purpose of this study was to further examine psychiatric correlates of vestibular/balance dysfunction in patients with anxiety disorders and the specific nature of the correlated vestibular abnormalities. The psychiatric variables considered included anxiety disorder versus normal control status, panic disorder versus non-panic anxiety disorder diagnosis, presence or absence of comorbid fear of heights, and degree of space and motion discomfort (SMD). The role of anxiety responses to vestibular testing was also re-examined. Methods 104 subjects were recruited: 29 psychiatrically normal individuals and 75 psychiatric patients with anxiety disorders. Anxiety patients were assigned to four subgroups depending on whether or not they had panic disorder and comorbid fear of heights. SMD and anxiety responses were measured by questionnaires. Subjects were examined for abnormal unilateral vestibular hypofunction on caloric testing indicative of peripheral vestibular dysfunction, asymmetric responses on rotational testing as an indicator of an ongoing vestibular imbalance and balance function using Equitest dynamic posturography as an indicator of balance control. Logistic regression was used to establish the association between the psychiatric variables and vestibular or balance test abnormalities. Results Rotational test results were not significantly related to any of the psychiatric variables. The presence of either panic attacks or fear of heights increased the probability of having caloric hypofunction in a non-additive fashion. SMD and anxiety responses were independently associated with abnormal balance. Among specific posturography conditions, the association with SMD was significant for a condition that involved the balance platform tilting codirectionally with body sway, suggesting an abnormal dependence on

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

    PubMed

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

    2016-04-01

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

  9. Neurocircuitry underlying risk and resilience to social anxiety disorder

    PubMed Central

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

    2015-01-01

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

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

    PubMed

    Roth, Walton T

    2005-01-01

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