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Sample records for adolescent anxiety disorders

  1. 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…

  2. [Anxiety disorders in children and adolescents].

    PubMed

    Rotberg, Benyamin; Schoen, Gila; Zalsman, Gil

    2008-07-01

    Anxiety disorders are the most common psychiatric illnesses in children and adolescents. They are associated with significant distress and impairment. Most of the children and adolescents with anxiety disorders are not detected and only a minority receives adequate treatment. Anxious children and adolescents often follow a chronic course of disease with elevated risk of depressive disorders, substance abuse and even suicide. Risk factors for anxiety disorders are complex and consist of intricate interplay of multiple factors, including genetic makeup and environmental risks. Effective, evidence-based treatments for anxiety disorders in children and adolescents consist of cognitive-behavioral therapy and pharmacotherapy with serotonin specific reuptake inhibitors. Further research is needed to design high-quality screening tools for anxiety disorders in the primary care setting.

  3. Beyond butterflies: generalized anxiety disorder in adolescents.

    PubMed

    McBride, Michon Elizabeth

    2015-03-12

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

  4. IRRITABILITY IN CHILD AND ADOLESCENT ANXIETY DISORDERS

    PubMed Central

    Stoddard, Joel; Stringaris, Argyris; Brotman, Melissa A; Montville, Daniel; Pine, Daniel S; Leibenluft, Ellen

    2014-01-01

    Background Our objective was to compare self- and parent-reported irritability in youths with anxiety disorders, healthy youths, and those with mood disorders characterized by irritability. Irritability is a common but relatively understudied psychiatric symptom in child and adolescent anxiety disorders. In anxious youths, little is known about the severity of irritability, its impact on functioning, or the effect of informant source on reports of irritability. Methods We compared parent- and self-report forms of the Affective Reactivity Index (ARI), a validated measure of irritability, in youths ages 8–17 years with no psychopathology (healthy comparison, HC; n = 38), anxiety disorders (ANX; n = 42), bipolar disorder (BD; n = 35), or severe mood dysregulation (SMD; n = 61; a phenotype characterized by chronic, severely impairing irritability). Results Irritability was significantly higher in ANX than HC youths by both parent and self-report (partial η2 = 0.24 and 0.22, respectively, P’s < 0.001). Informant effects differed among ANX, BD, and SMD. Overall, parent-reported irritability was higher in BD with comorbid anxiety disorders and SMD with or without comorbid anxiety disorders than ANX (P’s < 0.007), but self-reported irritability was not significantly different among the three patient groups. Discussion By both parent and self-report, youths with anxiety disorders exhibit significantly more irritability and associated impairment than healthy subjects. Self-reported irritability in youths with anxiety disorders is comparable to that observed in youths with severe mood disorders, although parental reports of irritability differ among the disorders. Future research should examine the pathophysiology of anxiety-associated irritability, as well as its prognostic and treatment implications. PMID:23818321

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

    PubMed Central

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

    2014-01-01

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

  6. Generalized Anxiety Disorder in Referred Children and Adolescents.

    ERIC Educational Resources Information Center

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

    2004-01-01

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

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

    PubMed

    Zimmermann, Peter; Iwanski, Alexandra; Çelik, Fatma

    2015-01-01

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

  8. 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 ...

  9. 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.

  10. Somatic Symptoms in Children and Adolescents with Anxiety Disorders

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  11. 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.

  12. 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…

  13. 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…

  14. 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

  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. Feasibility of Virtual Reality Environments for Adolescent Social Anxiety Disorder

    ERIC Educational Resources Information Center

    Parrish, Danielle E.; Oxhandler, Holly K.; Duron, Jacuelynn F.; Swank, Paul; Bordnick, Patrick

    2016-01-01

    Purpose: This study assessed the feasibility of virtual reality (VR) exposure as an assessment and treatment modality for youth with social anxiety disorder (SAD). Methods: Forty-one adolescents, 20 of which were identified as having SAD, were recruited from a community sample. Youth with and without SAD were exposed to two social virtual…

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

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

    PubMed

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

    2016-02-01

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

  19. External Validation of Comorbid Patterns of Anxiety Disorders in Children and Adolescents

    PubMed Central

    Franco, Ximena; Saavedra, Lissette; Silverman, Wendy K

    2009-01-01

    To evaluate the external validity of comorbid patterns of anxiety disorders among youth who presented to an anxiety disorders clinic, comorbid cases were compared to “pure” anxiety disorder cases. Children and adolescents (N = 329; mean age = 10.04 years) and parents were administered structured interviews and four groups were formed, Pure Anxiety, Anxiety + Anxiety, Anxiety + Externalizing, and Anxiety + Depressive, and compared along 4 external validation criteria: sociodemographics, clinical phenomenology, psychosocial, and family factors. All comorbid groups were more severe than the pure anxiety group on clinical phenomenology and psychosocial factors. The Anxiety + Depressive Disorders group was most severe on all criteria except sociodemographics. Results provide evidence for the external validity of comorbid diagnostic presentations among anxiety disorders, as there was differential meaningfulness in the diagnostic presentation of a pure anxiety disorder versus anxiety disorder comorbid with other disorders. Assessment and future research implications are discussed. PMID:17095184

  20. Social Skill Deficits and Anxiety in High-Functioning Adolescents with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Bellini, S.

    2004-01-01

    The present study examined the prevalence and types of anxiety exhibited by high-functioning adolescents with autism spectrum disorders and factors related to this anxiety. Results suggest that adolescents with autism spectrum disorders exhibit anxiety levels that are significantly higher than those of the general population. The study found a low…

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

    PubMed

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

    2013-09-01

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

  2. Adolescents' Perceptions of Parenting Behaviours and Its Relationship to Adolescent Generalized Anxiety Disorder Symptoms

    ERIC Educational Resources Information Center

    Hale, William W., III; Engels, Rutger; Meeus, Wim

    2006-01-01

    This study examined the relationship between how adolescents perceived parenting behaviours and adolescent Generalized Anxiety Disorder (GAD) symptom scores. The 1,106 junior high and high school students (12-19 years old; 49.6% males and 50.4% females) completed questionnaires regarding their perception of parenting behaviours and self-rated…

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

    PubMed

    Waite, Polly; Creswell, Cathy

    2015-08-01

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

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  5. Prediction of anxiety disorders using the state-trait anxiety inventory for multiethnic adolescents.

    PubMed

    Hishinuma, E S; Miyamoto, R H; Nishimura, S T; Goebert, D A; Yuen, N Y; Makini, G K; Andrade, N N; Johnson, R C; Carlton, B S

    2001-01-01

    The purpose of this study was to determine the validity of the State-Trait Anxiety Inventory (STAI) in predicting DSM-III-R anxiety disorders based on the Diagnostic Interview Schedule for Children (DISC, Version 2.3) and using Asian/Pacific Islander adolescents. An overall prevalence rate of 9.19% for generalized anxiety disorder, overanxious disorder, or social phobia was consistent with past studies. As hypothesized, STAI negatively worded (i.e., Factor 2) items were better predictors than positively stated (i.e., Factor 1) items. The STAI State mean was a better predictor of concurrent DISC anxiety disorders as compared to STAI State Factors I or 2. In contrast, the STAI Trait Factor 2 (negatively worded) composite was the best predictor for nonconcurrent DISC anxiety disorders as compared to STAI Trait Factor 1 or the overall STAI Trait subscale. Satisfactory predictive-validity values were obtained when using the STAI State mean and Trait Factor 2 composite. Implications of these findings are discussed, including using the STAI as a screening measure for ethnically diverse adolescents.

  6. Interpretation of ambiguity: Differences between children and adolescents with and without an anxiety disorder

    PubMed Central

    Waite, Polly; Codd, Jon; Creswell, Cathy

    2015-01-01

    Background Theory and treatment of anxiety disorders in young people are commonly based on the premise that interpretation biases found in anxious adults are also found in children and adolescents. Although there is some evidence that this may be the case, studies have not typically taken age into account, which is surprising given the normative changes in cognition that occur throughout childhood. The aim of the current study was to identify whether associations between anxiety disorder status and interpretation biases differed in children and adolescents. Methods The responses of children (7–10 years) and adolescents (13–16 years) with and without anxiety disorders (n=120) were compared on an ambiguous scenarios task. Results Children and adolescents with an anxiety disorder showed significantly higher levels of threat interpretation and avoidant strategies than non-anxious children and adolescents. However, age significantly moderated the effect of anxiety disorder status on interpretation of ambiguity, in that adolescents with anxiety disorders showed significantly higher levels of threat interpretation and associated negative emotion than non-anxious adolescents, but a similar relationship was not observed among children. Conclusions The findings suggest that theoretical accounts of interpretation biases in anxiety disorders in children and adolescents should distinguish between different developmental periods. For both ages, treatment that targets behavioral avoidance appears warranted. However, while adolescents are likely to benefit from treatment that addresses interpretation biases, there may be limited benefit for children under the age of ten. PMID:26363617

  7. Quality of Attachment Relationships and Peer Relationship Dysfunction Among Late Adolescents With and Without Anxiety Disorders

    PubMed Central

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

    2012-01-01

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

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

    PubMed

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

    2013-01-01

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

  9. Remission after Acute Treatment in Children and Adolescents with Anxiety Disorders: Findings from the CAMS

    ERIC Educational Resources Information Center

    Ginsburg, Golda S.; Kendall, Philip C.; Sakolsky, Dara; Compton, Scott N.; Piacentini, John; Albano, Anne Marie; Walkup, John T.; Sherrill, Joel; Coffey, Kimberly A.; Rynn, Moira A.; Keeton, Courtney P.; McCracken, James T.; Bergman, Lindsey; Iyengar, Satish; Birmaher, Boris; March, John

    2011-01-01

    Objective: To report on remission rates in anxious youth who participated in the Child/Adolescent Anxiety Multimodal Study (CAMS). The CAMS, a multisite clinical trial, randomized 488 children and adolescents (ages 7-17 years; 79% Caucasian; 50% female) with separation, social, and/or generalized anxiety disorder to a 12-week treatment of…

  10. Brief Report: The Assessment of Anxiety in High-Functioning Adolescents with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    White, Susan W.; Schry, Amie R.; Maddox, Brenna B.

    2012-01-01

    Anxiety may exacerbate interpersonal difficulties and contribute to secondary behavioral problems in adolescents with High-Functioning Autism Spectrum Disorder (HFASD). This study was conducted to assess the psychometric properties and construct validity of measures of anxiety with a sample (n = 30) of adolescents with HFASD and comorbid anxiety…

  11. Treating anxiety disorders in children and adolescents with epilepsy: what do we know?

    PubMed

    Jones, Jana E

    2014-10-01

    Children with epilepsy are at significant risk of psychiatric disorders, which can in turn negatively impact social skills development, academic achievement, and quality of life. The most commonly reported psychiatric comorbidities in pediatric epilepsy are ADHD, depression, and anxiety. The prevalence rates of anxiety disorders in pediatric epilepsy range from 5 to 49%, and in the general population, anxiety disorders are the most common psychiatric disorder in childhood. For the purposes of this review, anxiety disorders will be examined in order to 1) examine rates of anxiety disorders in children and adolescents with epilepsy, 2) review treatment options for anxiety disorders in children with epilepsy, and 3) identify future avenues for the development of evidence-based practices for the treatment of anxiety disorders in youth with epilepsy.

  12. The Relationship between Anxiety Disorders and Substance Use among Adolescents in the Community: Specificity and Gender Differences

    ERIC Educational Resources Information Center

    Wu, Ping; Goodwin, Renee D.; Fuller, Cordelia; Liu, Xinhua; Comer, Jonathan S.; Cohen, Patricia; Hoven, Christina W.

    2010-01-01

    Using a sample of 781 adolescents (ages 13-17, 52.8% male) from a community survey, this study examined gender differences in the co-occurrence of specific anxiety disorders with substance use in adolescents. The associations between anxiety disorders and substance use differed according to the particular anxiety disorders and forms of substance…

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

    ERIC Educational Resources Information Center

    Venta, Amanda; Sharp, Carla; Hart, John

    2012-01-01

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

  14. Empirically Derived Subtypes of Lifetime Anxiety Disorders: Developmental and Clinical Correlates in U.S. Adolescents

    ERIC Educational Resources Information Center

    Burstein, Marcy; Georgiades, Katholiki; Lamers, Femke; Swanson, Sonja A.; Cui, Lihong; He, Jian-Ping; Avenevoli, Shelli; Merikangas, Kathleen R.

    2012-01-01

    Objective: The current study examined the sex- and age-specific structure and comorbidity of lifetime anxiety disorders among U.S. adolescents. Method: The sample consisted of 2,539 adolescents (1,505 females and 1,034 males) from the National Comorbidity Survey-Adolescent Supplement who met criteria for "Diagnostic and Statistical Manual of…

  15. 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

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  18. Longitudinal Associations between Perceived Parent-Adolescent Attachment Relationship Quality and Generalized Anxiety Disorder Symptoms in Adolescence

    ERIC Educational Resources Information Center

    van Eijck, Fenna E. A. M.; Branje, Susan J. T.; Hale, William W., III; Meeus, Wim H. J.

    2012-01-01

    This longitudinal study examined the direction of effects between adolescents' generalized anxiety disorder (GAD) symptoms and perceived parent-adolescent attachment relationship quality, as well as the moderating role of gender and age. 1,313 Dutch adolescents (48.5% boys) from two age cohorts of early (n = 923, M[subscript age] = 12 at W1) and…

  19. Anxiety Disorders and Sleep in Children and Adolescents.

    PubMed

    Willis, Thomas A; Gregory, Alice M

    2015-06-01

    Sleep problems are common in children and adolescents. A growing body of research has explored the relationship between sleep problems and anxiety in youth. When reviewing the literature, methodologic inconsistencies need to be considered, such as variation in conceptualization of sleep problems, measurement of sleep, and the classification of anxiety. Despite this, there seems to be good evidence of concurrent and longitudinal associations between sleep difficulties and anxiety in community and clinical samples of young people. Potential mechanisms are proposed. There is a need for further exploration of these relationships, with the hope of aiding preventive capability and developing useful treatments.

  20. Anxiety Disorders

    MedlinePlus

    ... making life feel overwhelming or out of control. Obsessive compulsive disorder (OCD). For a person with OCD , anxiety takes ... For Kids For Parents MORE ON THIS TOPIC Obsessive-Compulsive Disorder Social Phobia 5 Ways to Deal With Anxiety ...

  1. Responses to Conflict and Cooperation in Adolescents with Anxiety and Mood Disorders

    ERIC Educational Resources Information Center

    McClure, Erin B.; Parrish, Jessica M.; Nelson, Eric E.; Easter, Joshua; Thorne, John F.; Rilling, James K.; Ernst, Monique; Pine, Daniel S.

    2007-01-01

    This study examined patterns of behavioral and emotional responses to conflict and cooperation in adolescents with anxiety/mood disorders and healthy peers. We compared performance on and emotional responses to the Prisoner's Dilemma (PD) game, an economic exchange task involving conflict and cooperation, between adolescents with…

  2. Implicit theories of intelligence and IQ test performance in adolescents with Generalized Anxiety Disorder.

    PubMed

    Da Fonseca, D; Cury, F; Fakra, E; Rufo, M; Poinso, F; Bounoua, L; Huguet, P

    2008-04-01

    During the past decade, several studies have reported positive effects of cognitive-behavioral therapy (CBT) in the treatment of children and adolescents with mental disorders. One of the most important CBT interventions is to teach children and adolescents to challenge negative thoughts that lead to maladjusted behaviors. Based on the implicit theories of intelligence framework, the main purpose of this study was to test whether an incremental theory manipulation could be used to affect IQ test performance in adolescents with Generalized Anxiety Disorder (GAD). Results showed that patients demonstrated enhanced IQ performance and experienced less state anxiety when they were exposed to an incremental theory of intelligence manipulation. Our findings suggest that incremental theory manipulation provides a useful cognitive strategy for addressing school-related anxiety in adolescents with mental disorders such as GAD.

  3. 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…

  4. Anxiety Disorders Comorbidity in Children and Adolescents with Attention Deficit Hyperactivity Disorder

    PubMed Central

    GÜMÜŞ, Yusuf Yasin; ÇAKIN MEMİK, Nursu; AĞAOĞLU, Belma

    2015-01-01

    Introduction Our aim is to investigate the prevalence of comorbidity of anxiety disorders (AD) among patients newly diagnosed with attention deficit hyperactivity disorder (ADHD) and to compare symptom severity of ADHD and sociodemographic parameters between patients with and without AD. Methods Among 1683 children and adolescents admitted to Kocaeli University Medical Faculty, Child and Adolescent Mental Health Outpatient Clinic, 447 children and adolescents, who were preliminarily diagnosed as ADHD by clinical interview based on Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), were invited to participate in the second phase of the study. Kiddie Schedule for Affective Disorder and Schizophrenia, Present and Lifetime-Turkish Version were applied to children and adolescents with ADHD and one of their parents to support the diagnoses of both ADHD and AD. Mothers, fathers, and teachers of the children were asked to complete DSM-IV-Based Child and Adolescent Behavior Disorders Screening and Rating Scale. Results Our study group comprised 170 children and adolescents diagnosed with ADHD of whom 19.4% were girls and 80.6% were boys; 27.6% of patients diagnosed with ADHD showed AD comorbidity. Age of the parents at birth of the patients with AD was significantly lower than that of patients without AD. Conclusion In line with the previous studies, the comorbidity rate of AD was found to be higher among patients with ADHD than general population and clinical sample without ADHD. The possibility of comorbidity of AD in patients with ADHD should be considered because higher rates of AD are observed in ADHD and comorbidities of AD.

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  7. Bullying Victimization, Parenting Stress, and Anxiety among Adolescents and Young Adults with Autism Spectrum Disorder.

    PubMed

    Weiss, Jonathan A; Cappadocia, M Catherine; Tint, Ami; Pepler, Debra

    2015-12-01

    Bullying victimization is commonly associated with anxiety among individuals with and without Autism Spectrum Disorder (ASD), and both bullying victimization and anxiety are more prevalent among youth with ASD than in the general population. We explored individual and contextual factors that relate to anxiety in adolescents and young adults with ASD who also experience bullying victimization. Participants included 101 mothers of adolescents and young adults diagnosed with ASD. Hierarchical multiple regression analyses were conducted to investigate the relationship between bullying victimization and anxiety in children with ASD, as well as parenting stress as a potential moderator of that relationship. Findings indicate that parenting stress moderates the association between bullying victimization and anxiety. The severity of anxiety was most strongly associated with bullying victimization when mothers reported high levels of stress. Implications for interventions that assist parents with coping and address bullying victimization are discussed.

  8. Open fluoxetine treatment of mixed anxiety disorders in children and adolescents.

    PubMed

    Fairbanks, J M; Pine, D S; Tancer, N K; Dummit, E S; Kentgen, L M; Martin, J; Asche, B K; Klein, R G

    1997-01-01

    An open-label pilot study examined fluoxetine treatment in 16 outpatients (9-18 years old) with mixed anxiety disorders. Following nonresponse to psychotherapy, fluoxetine monotherapy was started at 5 mg daily and was increased weekly by 5 or 10 mg daily for 6-9 weeks until improvement occurred or to a maximum of 40 mg (children under 12) or 80 mg (adolescents). Among patients on fluoxetine, severity of illness ratings were "much improved" (mean final Clinical Global Impression scale score 2.8 +/- 0.7). Clinical improvement occurred in 10 of 10 patients with current separation anxiety disorder, 8 of 10 with social phobia, 4 of 6 with specific phobia, 3 of 5 with panic disorder, and 1 of 7 with generalized anxiety disorder. Mean time to improvement was 5 weeks. Mean doses were 24 mg (0.7 mg/kg) for children and 40 mg (0.71 mg/kg) for adolescents. Side effects were transient and included drowsiness (31% of patients), sleep problems (19%), decreased appetite (13%), nausea (13%), abdominal pain (13%), and excitement (13%). No patient developed disinhibition, akathisia, or suicidality. These preliminary findings suggest fluoxetine effectiveness in separation anxiety disorder and social phobia. Youths with only one anxiety disorder appeared to respond to lower doses of fluoxetine than patients with multiple anxiety disorders (0.49 +/- 0.14 versus 0.80 +/- 0.28 mg/kg, p < 0.05).

  9. Anxiety and mood disorders in children and adolescents: A practice update

    PubMed Central

    Bradley, Susan J

    2001-01-01

    Anxiety and mood disorders are among the most common disorders in children and adolescents. They presage later emotional difficulties and disabilities. An understanding of the disorders’ presentation, common contributing factors and methods of intervention will enable paediatricians and family doctors to provide optimal support to these children and their families. The present paper briefly reviews the epidemiology of anxiety and mood disorders in children and adolescents. Phenomenology is referred to according to the major diagnostic categories for anxiety and depression. Contributing factors, including genetic and environmental components and their possible interaction, are discussed. The management of the disorders, including common strategies for encouraging coping responses, stress reduction and medication, is also described. PMID:20107554

  10. The Effect of Sertraline on the Quality of Life for Children and Adolescents with Anxiety Disorder

    PubMed Central

    ÇAKIN MEMİK, Nursu; KARAKAYA, Işık; YILDIZ, Özlem; ŞIŞMANLAR, Şahika; ÇAĞLAYAN, Çiğdem; AĞAOĞLU, Belma

    2014-01-01

    Introduction In this study, we aimed to determine the changes in quality of life of children/adolescents with anxiety disorders during six months of sertraline treatment, to investigate parent-child/adolescent concordance in perception of quality of life and to examine the effect of treatment on children/adolescents. Methods In this study, 30 patients with anxiety disorders according to criteria specified in Diagnostic and Statistical Manual of Mental Disorders, 4th. Edition (DSM-IV) were assigned to sertraline treatment. The patients were evaluated using the Pediatric Quality of Life Inventory (PedsQL), State-Trait Anxiety Inventory for Children, Clinical Global Impression Scale (CGI) and the Children’s Global Assessment Scale (CGAS) at 0th, 2nd and 6th months. Results PedsQL total scores increased significantly with the treatment in children and adolescents (p<.001), however, no differences were observed in parent proxy report (p=.326). The mean CGAS score was 59.85±7.73 at the beginning of treatment and 73.70±7.01 at the end of treatment (p<.001). The average CGI score decreased from 4.68±.96 to 2.27±.84. Conclusion It was observed that perception of quality of life in children and adolescents with anxiety disorders increased with the treatment.

  11. Anxiety Disorders

    MedlinePlus

    ... making life feel overwhelming or out of control. Obsessive compulsive disorder (OCD) . For a person with OCD, anxiety takes ... For Kids For Parents MORE ON THIS TOPIC Obsessive-Compulsive Disorder Taking Your Child to a Therapist Posttraumatic Stress ...

  12. 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…

  13. Adolescent Social Isolation as a Model of Heightened Vulnerability to Comorbid Alcoholism and Anxiety Disorders.

    PubMed

    Butler, Tracy R; Karkhanis, Anushree N; Jones, Sara R; Weiner, Jeffrey L

    2016-06-01

    Individuals diagnosed with anxiety-related illnesses are at increased risk of developing alcoholism, exhibit a telescoped progression of this disease and fare worse in recovery, relative to alcoholics that do not suffer from a comorbid anxiety disorder. Similarly, preclinical evidence supports the notion that stress and anxiety represent major risk factors for the development of alcohol use disorder (AUD). Despite the importance of understanding the link between anxiety and alcoholism, much remains unknown about the neurobiological substrates underlying this relationship. One stumbling block has been the lack of animal models that reliably reproduce the spectrum of behaviors associated with increased vulnerability to these diseases. Here, we review the literature that has examined the behavioral and neurobiological outcomes of a simple rodent adolescent social isolation procedure and discuss its validity as a model of vulnerability to comorbid anxiety disorders and alcoholism. Recent studies have provided strong evidence that adolescent social isolation of male rats leads to the expression of a variety of behaviors linked with increased vulnerability to anxiety and/or AUD, including deficits in sensory gating and fear extinction, and increases in anxiety measures and ethanol drinking. Neurobiological studies are beginning to identify mesolimbic adaptations that may contribute to the behavioral phenotype engendered by this model. Some of these changes include increased excitability of ventral tegmental area dopamine neurons and pyramidal cells in the basolateral amygdala and significant alterations in baseline and stimulated catecholamine signaling. A growing body of evidence suggests that adolescent social isolation may represent a reliable rodent model of heightened vulnerability to anxiety disorders and alcoholism in male rats. These studies provide initial support for the face, construct, and predictive validity of this model and highlight its utility in

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

    PubMed

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

    2012-07-01

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

  15. The Metacognitive Model of Generalized Anxiety Disorder in Children and Adolescents

    ERIC Educational Resources Information Center

    Ellis, Danielle M.; Hudson, Jennifer L.

    2010-01-01

    Worry is a common phenomenon in children and adolescents, with some experiencing excessive worries that cause significant distress and interference. The metacognitive model of generalized anxiety disorder (Wells 1995, 2009) was developed to explain cognitive processes associated with pathological worry in adults, particularly the role of positive…

  16. Concordance between Measures of Anxiety and Physiological Arousal Following Treatment of Panic Disorder in Adolescence

    ERIC Educational Resources Information Center

    Bacow, Terri Landon; May, Jill Ehrenreich; Choate-Summers, Molly; Pincus, Donna B.; Mattis, Sara G.

    2010-01-01

    This study examined the concordance (or synchrony/desynchrony) between adolescents' self-reports of anxiety and physiological measures of arousal (heart rate) both prior to and after treatment for panic disorder. Results indicated a decline in reported subjective units of distress (SUDS) for the treatment group only at the post-treatment…

  17. Heart rate variability (HRV) in adolescent females with anxiety disorders and major depressive disorder

    PubMed Central

    Henje Blom, E; Olsson, EM; Serlachius, E; Ericson, M; Ingvar, M

    2010-01-01

    Aim: The aim of this study was to investigate heart rate variability (HRV) in a clinical sample of female adolescents with anxiety disorders (AD) and/or major depressive disorder (MDD) compared with healthy controls and to assess the effect of selective serotonin reuptake inhibitors (SSRI) on HRV. Methods: Heart rate variability was measured in adolescent female psychiatric patients with AD and/or MDD (n = 69), mean age 16.8 years (range: 14.5–18.4), from 13 out-patient clinics and in healthy controls (n = 65), mean age 16.5 years (range: 15.9–17.7). HRV was registered in the sitting position during 4 min with no interventions. Results: Logarithmically transformed high frequency HRV (HF), low frequency HRV (LF) and standard deviation of inter beat intervals (SDNN) were lower in the clinical sample compared with the controls (Cohen’s d for HF = 0.57, LF = 0.55, SDNN = 0.60). This was not explained by body mass index, blood pressure or physical activity. Medication with SSRI explained 15.5% of the total variance of HF, 3.0% of LF and 6.5% of SDNN. Conclusions: Adolescent female psychiatric patients with AD and/or MDD show reduced HRV compared with healthy controls. Medication with SSRI explained a part of this difference. PMID:20121706

  18. The 12-Month Prevalence of DSM-IV Anxiety Disorders among Nigerian Secondary School Adolescents Aged 13-18 Years

    ERIC Educational Resources Information Center

    Adewuya, Abiodun O.; Ola, Bola A.; Adewumi, Tomi A.

    2007-01-01

    Aims: To estimate the 12-month prevalence of DSM-IV-specific anxiety disorders among Nigerian secondary school adolescents aged 13-18 years. Method: A representative sample of adolescents (n=1090) from senior secondary schools in a semi-urban town in Nigeria was assessed for the 12-month prevalence of DSM-IV-specific anxiety. Results: The 12-month…

  19. Randomized Controlled Trial: Multimodal Anxiety and Social Skill Intervention for Adolescents with Autism Spectrum Disorder

    PubMed Central

    White, Susan W.; Ollendick, Thomas; Albano, Anne Marie; Oswald, Donald; Johnson, Cynthia; Southam-Gerow, Michael A.; Kim, Inyoung; Scahill, Lawrence

    2012-01-01

    Anxiety is common among adolescents with autism spectrum disorders (ASD) and may amplify the core social disability, thus necessitating combined treatment approaches. This pilot, randomized controlled trial (RCT) evaluated the feasibility and preliminary outcomes of the Multimodal Anxiety and Social Skills Intervention (MASSI) program in a sample of 30 adolescents with ASD and anxiety symptoms of moderate or greater severity. The treatment was acceptable to families, subject adherence was high, and therapist fidelity was high. A 16% improvement in ASD social impairment (within-group effect size = 1.18) was observed on a parent-reported scale. Although anxiety symptoms declined by 26%, the change was not statistically significant. These findings suggest MASSI is a feasible treatment program and further evaluation is warranted. PMID:22735897

  20. Longitudinal associations between perceived parent-adolescent attachment relationship quality and generalized anxiety disorder symptoms in adolescence.

    PubMed

    van Eijck, Fenna E A M; Branje, Susan J T; Hale, William W; Meeus, Wim H J

    2012-08-01

    This longitudinal study examined the direction of effects between adolescents' generalized anxiety disorder (GAD) symptoms and perceived parent-adolescent attachment relationship quality, as well as the moderating role of gender and age. 1,313 Dutch adolescents (48.5% boys) from two age cohorts of early (n = 923, M(age) = 12 at W1) and middle (n = 390, M(age) = 16 at W1) adolescents completed questionnaires regarding their attachment relationship to parents and GAD symptoms in four waves. Cross-lagged path analyses demonstrated that adolescents' GAD symptoms and perceived father-adolescent attachment relationship quality bidirectionally negatively affected each other over time. For mothers, adolescents' GAD symptoms negatively predicted perceived mother-adolescent attachment relationship quality over time. The within-wave correlated residuals between perceived attachment relationship quality with fathers and GAD symptoms were stronger for boys than for girls and stronger for the cohort of middle adolescents than for the cohort of early adolescents. This study demonstrates that both the parents' and the adolescents' gender as well as the adolescents' age affects the relation between adolescents' GAD symptoms and perceived parent-adolescent attachment relationship quality.

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

    PubMed Central

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

    2015-01-01

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

  2. Exposure to maternal pre- and postnatal depression and anxiety symptoms: risk for major depression, anxiety disorders, and conduct disorder in adolescent offspring.

    PubMed

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

    2013-11-01

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

  3. Specificity in the Association of Anxiety, Depression, and Atopic Disorders in a Community Sample of Adolescents

    PubMed Central

    Slattery, Marcia J.; Essex, Marilyn J.

    2010-01-01

    The specificity of relationships between anxiety and depressive symptoms, with each of the major atopic disorders of asthma, allergic rhinitis (AR), and atopic dermatitis (AD) was systematically investigated within a single study sample. Participants included 367 adolescents who participated in a community, longitudinal study investigating risk factors for the development of psychiatric and physical health problems. Mental health symptoms were assessed at 7, 9, 11, and 13 years of age. Lifetime history of atopic disorders was assessed by parent report at age 13. Analysis of variance was used to investigate the specificity of the associations between anxiety and depression, and each of the atopic disorders. Results indicated that anxiety was associated with a lifetime history of atopic disorders as a group. The association was significantly strengthened when controlling for depression and externalizing psychiatric symptoms. Among atopic disorders, “pure” anxiety was associated with asthma and AR, and having both asthma and AR strengthened the association compared to having either disorder alone. The association of “pure” anxiety with asthma and AR is consistent with existing data suggesting a relationship between anxiety and respiratory disorders. Having both asthma and AR appeared to confer an additive “dose effect” on the strength of the association. The lack of an association with depression suggests that other factors may contribute to the differential expression of anxiety and depression with atopic disorders. Findings demonstrate the importance of assessing the impact of co-morbid psychiatric symptoms and atopic disorders within individual studies to determine the specificity of underlying relationships between these conditions. PMID:21111430

  4. High Magnitude of Social Anxiety Disorder in School Adolescents

    PubMed Central

    Mekuria, Kindie; Mulat, Haregwoin; Derajew, Habtamu; Yimer, Solomon; Legas, Getasew; Menberu, Melak; Getnet, Asmamaw; Kibret, Simegnew

    2017-01-01

    Introduction. Social phobia is the most prevalent and chronic type of anxiety disorder worldwide and it affects occupational, educational, and social affairs of the individual. Social phobia is also known for its association with depression and substance use disorder. Objective. The aim of this study was to assess the prevalence and associated factors of social phobia among high school students in Ethiopia. Methods. Cross-sectional study was conducted among 386 randomly selected students. Data were collected using pretested and self-administered questionnaire. Social phobia was assessed by using Social Phobia Inventory (SPIN). Logistic regression was used to analyze the data with 95% confidence interval and variables with p value less than 0.05 were considered as statistically significant. Results. From 386 study participants, 106 (27.5%) of them were positive for social phobia. Being female (AOR = 3.1; 95% CI: 1.82–5.27), current alcohol drinking (AOR = 1.75; 95% CI: 1.03–2.98), poor social support (AOR = 2.40; 95% CI: 1.17–4.92), and living with single parent (AOR = 5.72; 95% CI: 2.98–10.99) were significantly associated with social phobia. Conclusion. The proportion of social phobia was higher compared to previous evidences. School-based youth-friendly mental health services might be helpful to tackle this problem. PMID:28299314

  5. A Questionnaire for Screening a Broad Range of DSM-Defined Anxiety Disorder Symptoms in Clinically Referred Children and Adolescents

    ERIC Educational Resources Information Center

    Muris, Peter; Dreessen, Laura; Bogels, Susan; Weckx, Miryam; van Melick, Marion

    2004-01-01

    Objective: To examine the reliability and validity of the 66-item Screen for Child Anxiety Related Emotional Disorders-Revised (SCARED-R), a questionnaire for measuring a broad range of DSM-defined anxiety disorder symptoms, in a sample of clinically referred youths. Method: The SCARED-R was administered to children/adolescents and their parents…

  6. Self-esteem and social anxiety in an adolescent female eating disorder population: age and diagnostic effects.

    PubMed

    Obeid, Nicole; Buchholz, Annick; Boerner, Katelynn E; Henderson, Katherine A; Norris, Mark

    2013-01-01

    This study explored symptoms of social anxiety and multidimensional self-esteem in a clinical, adolescent female eating disorder population. Using self-report measures, data from 344 females revealed significant negative relationships between dimensions of self-esteem and social anxiety. A diagnostic difference emerged, with the restricting subgroup reporting significantly higher perceived physical appearance and global self-worth than those with binge/purge symptoms or bulimia nervosa. No significant age differences or age by diagnosis interaction effects emerged. These findings suggest that in clinical samples of adolescent eating disorders, self-esteem and social anxiety share a significant inverse relationship and seem to remain fairly constant across adolescence.

  7. 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…

  8. Sensory subtypes and anxiety in older children and adolescents with autism spectrum disorder.

    PubMed

    Uljarević, Mirko; Lane, Alison; Kelly, Amanda; Leekam, Susan

    2016-10-01

    This study aimed to identify sensory subtypes in older children and adolescents with Autism Spectrum Disorders (ASD) and examine the relationship of sensory subtypes with anxiety levels in this group. Mothers of 57 children and adolescents with ASD aged 11-17 years (Mean age = 14 years. 2.4 months, SD = 1.81) completed the short sensory profile and Spence anxiety scales. Model-based cluster analysis was applied to sensory profile scores to identify sensory subtypes. Three sensory subtypes, sensory adaptive (N = 19), sensory moderate (N = 29) and sensory severe (N = 9) were identified. The results indicated that the differences between the subtypes were well characterised by the severity of sensory symptoms and were not attributable to sensory modality or varying types of sensory-related behaviors. Children and adolescents from the adaptive subtype had significantly lower anxiety scores when compared with other two subtypes. There were no differences between subtypes based on chronological age, expressive language, or severity of autism diagnostic features as measured by the social communication questionnaire (SCQ total score). This is the first study to identify the existence of sensory subtypes among older children and adolescents with ASD and explore their association with anxiety levels. Autism Res 2016, 9: 1073-1078. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.

  9. Cognitive Behavior Therapy for Generalized Social Anxiety Disorder in Adolescents: A Randomized Controlled Trial

    PubMed Central

    Herbert, James D.; Gaudiano, Brandon A.; Rheingold, Alyssa A.; Moitra, Ethan; Myers, Valerie H.; Dalrymple, Kristy L.; Brandsma, Lynn L.

    2010-01-01

    Early identification and treatment of social anxiety disorder (SAD) is critical to prevent development of a chronic course of symptoms, persistent functional impairment, and progressive psychiatric comorbidity. A small but growing literature supports the effectiveness of cognitive behavior therapy (CBT) for anxiety disorders, including SAD, in adolescence. The present randomized controlled trial evaluated the efficacy of group vs. individual CBT for adolescents with generalized SAD in relation to an educational/supportive psychotherapy that did not contain specific CBT elements. All three treatments were associated with significant reductions in symptoms and functional impairment, and in improved social skills. No differences between treatments emerged on measures of symptoms, but the CBT conditions demonstrated greater gains on behavioral measures. The implications of the findings are discussed. PMID:18653310

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

    PubMed

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

    2014-08-01

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

  11. Evaluation of Depression, Anxiety, and Stress in Adolescents and Young Adults with Auditory Neuropathy Spectrum Disorder

    PubMed Central

    2016-01-01

    The aim of the present study was to determine the severity of stress, anxiety, and depression using Depression Anxiety Stress Scales (DASS) in adolescents and young adults with auditory neuropathy spectrum disorder (ANSD). DASS was administered to 20 individuals with auditory neuropathy spectrum disorder. The effect of gender on severity of anxiety, stress, and depression on DASS scores was determined. It was attempted to determine the correlation of severity of anxiety, stress, and depression with the reported onset of the problem, degree of hearing loss, and speech identification scores. The results of the study showed that individuals with ANSD had a moderate degree of depression and anxiety. The results also showed that the symptoms were more seen in females than in males. Correlation analysis revealed that DASS scores correlated with the reported onset of condition and speech identification scores (SIS) and the degree of hearing loss showed no correlation. The study concludes that individuals with ANSD experience depression and anxiety and this could be because of the inadequate management options available for individuals with ANSD. Thus, there is a need to develop appropriate management strategies for individuals with ANSD and provide appropriate referral for management of psychological issues. PMID:27579218

  12. Amygdala-based intrinsic functional connectivity and anxiety disorders in adolescents and young adults.

    PubMed

    Toazza, Rudineia; Franco, Alexandre Rosa; Buchweitz, Augusto; Molle, Roberta Dalle; Rodrigues, Danitsa Marcos; Reis, Roberta Sena; Mucellini, Amanda Brondani; Esper, Nathalia Bianchini; Aguzzoli, Cristiano; Silveira, Patrícia Pelufo; Salum, Giovanni Abrahão; Manfro, Gisele Gus

    2016-11-30

    Anxiety disorders (AD) are the most prevalent group of psychiatric disorders in adolescents and young adults. Nevertheless, the pathophysiology of anxiety disorders is still poorly understood. This study investigated differences in the functional connectivity of intrinsic amygdala-based networks of participants with and without AD. Resting state fMRI data were obtained from 18 participants with an AD and 19 healthy comparison individuals. Psychiatric diagnosis was assessed using standardized structured interviews. The comparison between groups was carried out using functional connectivity maps from six seed regions defined using probabilistic maps bilaterally within the amygdala (basolateral, superficial and centromedial amygdala). We found significant between-group differences in five clusters, which showed aberrant functional connectivity with the left basolateral amygdala: right precentral gyrus, right cingulate gyrus, bilateral precuneus, and right superior frontal gyrus in subjects with AD as compared with the comparison subjects. For the comparison subjects, the correlations between the amygdala and the five clusters were either non-significant, or negative. The present study suggests there is an intrinsic disruption in the communication between left basolateral amygdala and a network of brain regions involved with emotion regulation, and with the default mode network in adolescents and young adults with anxiety disorders.

  13. Remission After Acute Treatment in Children and Adolescents With Anxiety Disorders: Findings From the CAMS

    PubMed Central

    Ginsburg, Golda S.; Sakolsky, Dara; Piacentini, John; Walkup, John T.; Coffey, Kimberly A.; Keeton, Courtney P.; Iyengar, Satish; Kendall, Philip C.; Compton, Scott N.; Albano, Anne Marie; Sherrill, Joel; Rynn, Moira A.; McCracken, James T.; Bergman, Lindsey; Birmaher, Boris; March, John

    2012-01-01

    Objective To report on remission rates in anxious youth who participated in the Child/Adolescent Anxiety Multimodal Study (CAMS). The CAMS, a multisite clinical trial, randomized 488 children and adolescents (ages 7–17 years; 79% Caucasian; 50% female) with separation, social, and/or generalized anxiety disorder to a 12-week treatment of sertraline (SRT), cognitive behavioral therapy (CBT), their combination (COMB), or clinical management with pill placebo (PBO). Method The primary definition of remission was loss of all study-entry anxiety disorder diagnoses; additional definitions of remission were used. All outcomes were rated by independent evaluators blind to treatment assignment. Predictors of remission were also examined. Results Remission rates after 12 weeks of treatment ranged from 46% to 68% for COMB, 34% to 46% for SRT, 20% to 46% for CBT, and 15% to 27% for PBO. Rates of remission (i.e., achieving a nearly symptom-free state) were significantly lower than rates of response (i.e., achieving a clinically meaningful improvement relative to baseline) for the entire sample. Youth who received COMB had significantly higher rates of remission compared to all other treatment groups. Both monotherapies had higher remission rates compared to PBO, but rates were not different from each other. Predictors of remission were younger age, nonminority status, lower baseline anxiety severity, absence of other internalizing disorders (e.g., anxiety, depression), and absence of social phobia. Conclusions For the majority of children, some symptoms of anxiety persisted, even among those showing improvement after 12 weeks of treatment, suggesting a need to augment or extend current treatments for some children. PMID:22122292

  14. Anxiety and depression among adolescents with attention-deficit/hyperactivity disorder: The roles of behavioral temperamental traits, comorbid autism spectrum disorder, and bullying involvement.

    PubMed

    Hu, Huei-Fan; Chou, Wen-Jiun; Yen, Cheng-Fang

    2016-02-01

    The aim of this study was to examine the associations of behavioral temperamental traits, comorbid autism spectrum disorder (ASD), and bullying involvement with anxiety and depression among adolescents with attention-deficit/hyperactivity disorder (ADHD) in Taiwan. A total of 287 adolescents aged 11-18 years diagnosed with ADHD participated in this study. Their severities of anxiety and depression were assessed. Multiple regression analysis was used to examine the correlates of anxiety and depression. The results show that adolescents with ADHD who reported a higher behavioral inhibition system (BIS) score, had comorbid ASD, and were bullying victims, reported more severe anxiety and depressive symptoms. Adolescents with ADHD who bullied others reported more severe depressive symptoms than those who did not bully. The results of this study indicated that behavioral temperamental traits on the BIS, comorbid ASD, and bullying involvement were significantly associated with anxiety and depression among the adolescents with ADHD.

  15. The Youth Anxiety Measure for DSM-5 (YAM-5): Development and First Psychometric Evidence of a New Scale for Assessing Anxiety Disorders Symptoms of Children and Adolescents.

    PubMed

    Muris, Peter; Simon, Ellin; Lijphart, Hester; Bos, Arjan; Hale, William; Schmeitz, Kelly

    2017-02-01

    The Youth Anxiety Measure for DSM-5 (YAM-5) is a new self- and parent-report questionnaire to assess anxiety disorder symptoms in children and adolescents in terms of the contemporary classification system. International panels of childhood anxiety researchers and clinicians were used to construct a scale consisting of two parts: part one consists of 28 items and measures the major anxiety disorders including separation anxiety disorder, selective mutism, social anxiety disorder, panic disorder, and generalized anxiety disorder, whereas part two contains 22 items that focus on specific phobias and (given its overlap with situational phobias) agoraphobia. In general, the face validity of the new scale was good; most of its items were successfully linked to the intended anxiety disorders. Notable exceptions were the selective mutism items, which were frequently considered as symptoms of social anxiety disorder, and some specific phobia items especially of the natural environment, situational and other type, that were regularly assigned to an incorrect category. A preliminary investigation of the YAM-5 in non-clinical (N = 132) and clinically referred (N = 64) children and adolescents indicated that the measure was easy to complete by youngsters. In addition, support was found for the psychometric qualities of the measure: that is, the internal consistency was good for both parts, as well as for most of the subscales, the parent-child agreement appeared satisfactory, and there was also evidence for the validity of the scale. The YAM-5 holds promise as a tool for assessing anxiety disorder symptoms in children and adolescents.

  16. Estimating the Prevalence of Anxiety and Mood Disorders in an Adolescent General Population: An Evaluation of the GHQ12

    ERIC Educational Resources Information Center

    Mann, Robert E.; Paglia-Boak, Angela; Adlaf, Edward M.; Beitchman, Joseph; Wolfe, David; Wekerle, Christine; Hamilton, Hayley A.; Rehm, Jurgen

    2011-01-01

    Anxiety and mood disorders (AMD) may be more common among adolescents than previously thought, and epidemiological research would benefit from an easily-administered measure of AMD. We assessed the ability of the GHQ12 to estimate the prevalence of AMD in a representative sample of Ontario adolescents. Data were based on self-administered…

  17. The association between social cognition and executive functioning and symptoms of anxiety and depression in adolescents with autism spectrum disorders.

    PubMed

    Hollocks, Matthew J; Jones, Catherine R G; Pickles, Andrew; Baird, Gillian; Happé, Francesca; Charman, Tony; Simonoff, Emily

    2014-04-01

    While high levels of anxiety and depression are now recognized as major co-occurring problems in children and young people with an autism spectrum disorder (ASD), research examining possible associations with individual differences in neurocognitive functioning has been limited. This study included 90 adolescents with an ASD aged 14-16 years with a full-scale IQ > 50. Using structural equation modeling, we examined the independent relationships between multiple measures of executive functioning and social cognition on severity of anxiety or depressive symptoms. Results indicated a significant association between poorer executive functioning and higher levels of anxiety, but not depression. In contrast, social cognition ability was not associated with either anxiety or depression. This study is the first to report significant associations between executive functions and anxiety in ASD. This may suggest that poor executive functioning is one factor associated with the high prevalence of anxiety disorder in children and adolescents with ASD.

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

    PubMed Central

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

    2014-01-01

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

  19. Facing your fears in adolescence: cognitive-behavioral therapy for high-functioning autism spectrum disorders and anxiety.

    PubMed

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

    2012-01-01

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

  20. Childhood Anxiety Trajectories and Adolescent Disordered Eating: Findings from the NICHD Study of Early Child Care and Youth Development

    PubMed Central

    Zerwas, Stephanie; Von Holle, Ann; Watson, Hunna; Gottfredson, Nisha; Bulik, Cynthia M.

    2015-01-01

    Objective The goal of the present paper was to examine whether childhood anxiety trajectories predict eating psychopathology. We predicted that girls with trajectories of increasing anxiety across childhood would have significantly greater risk of disordered eating in adolescence in comparison to girls with stable or decreasing trajectories of anxiety over childhood. Method Data were collected as part of the prospective longitudinal NICHD Study of Early Child Care and Youth Development (N=450 girls). Childhood anxiety was assessed yearly (54 months through 6th grade) via maternal report on the Child Behavior Checklist. Disordered eating behaviors were assessed at age 15 via adolescent self-report on the Eating Attitudes Test (EAT-26). We conducted latent growth mixture modeling to define girls’ childhood anxiety trajectories. Maternal sensitivity, maternal postpartum depression, maternal anxiety, and child temperament were included as predictors of trajectory membership. Results The best fitting model included three trajectories of childhood anxiety, the low-decreasing class (22.9% of girls), the high-increasing class (35.4%), and the high-decreasing class (41.6%). Mothers with more symptoms of depression and separation anxiety had girls who were significantly more likely to belong to the high-increasing anxiety trajectory. There were no significant differences in adolescent disordered eating for girls across the three childhood anxiety trajectories. Conclusions Childhood anxiety, as captured by maternal report, may not be the most robust predictor of adolescent disordered eating and may be of limited utility for prevention programs that aim to identify children in the community at greatest risk for disordered eating. PMID:24938214

  1. The Role of Co-Occurring Disruptive Behavior in the Clinical Presentation of Children and Adolescents with Anxiety in the Context of Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Storch, Eric A.; Arnold, Elysse B.; Jones, Anna M.; Ale, Chelsea M.; Wood, Jeffrey J.; Ehrenreich-May, Jill; Lewin, Adam B.; Mutch, P. Jane; Murphy, Tanya K.

    2012-01-01

    This study explored the impact of disruptive behavior disorder (DBD) comorbidity on theoretically relevant correlates among 87 children and adolescents with autism spectrum disorders (ASD) and clinically significant anxiety. Relative to youth with ASD and anxiety alone, participants with ASD, anxiety, and DBD: (a) presented with significantly more…

  2. Amygdala Function and 5-HTT Gene Variants in Adolescent Anxiety and Major Depressive Disorder

    PubMed Central

    Lau, Jennifer Y. F.; Goldman, David; Buzas, Beata; Fromm, Stephen J.; Guyer, Amanda E.; Hodgkinson, Colin; Monk, Christopher S.; Nelson, Eric E.; Shen, Pei-Hong; Pine, Daniel S.; Ernst, Monique

    2009-01-01

    Background Associations between a functional polymorphism in the serotonin transporter gene and amygdala activation have been found in healthy, depressed, and anxious adults. This study explored these gene–brain associations in adolescents by examining predictive effects of serotonin transporter gene variants (S and LG allele carriers vs. LA allele homozygotes) and their interaction with diagnosis (healthy vs. patients) on amygdala responses to emotional faces. Methods Functional magnetic resonance data were collected from 33 healthy adolescents (mean age: 13.71, 55% female) and 31 medication-free adolescents with current anxiety or depressive disorders (or both; mean age: 13.58, 56% female) while viewing fearful, angry, happy, and neutral facial expressions under varying attention states. Results A significant three-way genotype-by-diagnosis-by-face-emotion interaction characterized right amygdala activity while subjects monitored internal fear levels. This interaction was decomposed to map differential gene–brain associations in healthy and affected adolescents. First, consistent with healthy adult data, healthy adolescents with at least one copy of the S or LG allele showed stronger amygdala responses to fearful faces than healthy adolescents without these alleles. Second, patients with two copies of the LA allele exhibited greater amygdala responses to fearful faces relative to patients with S or LG alleles. Third, although weaker, genotype differences on amygdala responses in patients extended to happy faces. All effects were restricted to the fear-monitoring attention state. Conclusions S/LG alleles in healthy adolescents, as in healthy adults, predict enhanced amygdala activation to fearful faces. Contrary findings of increased activation in patients with LALA relative to the S or LG alleles require further exploration. PMID:18950748

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

    ERIC Educational Resources Information Center

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

    2007-01-01

    Objective: The present study examined sleep-related problems (SRPs) among a large sample (n = 128) of youth with anxiety disorders (i.e., generalized, separation, and social). The frequency of eight specific SRPs was examined in relation to age, gender, type of anxiety disorder, anxiety severity, and functional impairment. The impact of…

  4. A risk-benefit assessment of pharmacotherapy for anxiety disorders in children and adolescents.

    PubMed

    Hawkridge, S M; Stein, D J

    1998-10-01

    Few pharmacotherapy trials have been undertaken in young people with anxiety disorders. Of those conducted, few are placebo-controlled or blinded, and often sample size is small, making interpretation of the data difficult. Case report and uncontrolled trial data generally support the efficacy of pharmacotherapy in many of the anxiety disorders seen in young people. However, most attempts to confirm these impressions in controlled trials have not been as encouraging. Further controlled studies in larger, diagnostically homogeneous samples are needed. At present, the decision as to whether or not to use medication in this patient population must be made on clinical grounds. Evidence is accumulating to suggest that anxiety disorders in young people can become chronic and cause at least moderate functional impairment in some individuals. This possibility has to be weighed against the potential for adverse effects of many of the drugs used clinically. Serious adverse effects appear only in a minority of patients; however, there does not seem to be a reliable method of predicting which patients might be at risk. Benzodiazepines are used to treat anxious children, notwithstanding concerns about dependence, behavioural disinhibition, cognitive impairment and mood changes. The tricyclic antidepressants (TCAs) are generally well tolerated, but their effects on cardiac conduction at higher plasma concentrations are well documented and there have been sporadic reports of sudden death associated with their use in children. Toxicity in overdose is an added concern. The use of selective serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors in children and adolescents is widespread, but few rigorous supportive trials have been conducted. The occurrence of both potentially serious adverse effects and other less serious, but troublesome, adverse effects and a possible discontinuation syndrome may complicate the use of these agents in younger patients. However, their relative

  5. Cognitive-Behavioral Psychotherapy for Anxiety and Depressive Disorders in Children and Adolescents: An Evidence-Based Medicine Review

    ERIC Educational Resources Information Center

    Compton, Scott N.; March, John S.; Brent, David; Albano, Anne Marie; Weersing, V. Robin; Curry, John

    2004-01-01

    Objective: To review the literature on the cognitive-behavioral treatment of children and adolescents with anxiety and depressive disorders within the conceptual framework of evidence-based medicine. Method: The psychiatric and psychological literature was systematically searched for controlled trials applying cognitive-behavioral treatment to…

  6. A Model of Therapist Competencies for the Empirically Supported Cognitive Behavioral Treatment of Child and Adolescent Anxiety and Depressive Disorders

    ERIC Educational Resources Information Center

    Sburlati, Elizabeth S.; Schniering, Carolyn A.; Lyneham, Heidi J.; Rapee, Ronald M.

    2011-01-01

    While a plethora of cognitive behavioral empirically supported treatments (ESTs) are available for treating child and adolescent anxiety and depressive disorders, research has shown that these are not as effective when implemented in routine practice settings. Research is now indicating that is partly due to ineffective EST training methods,…

  7. Cognitive behavioral therapy for early adolescents with autism spectrum disorders and clinical anxiety: a randomized, controlled trial.

    PubMed

    Wood, Jeffrey J; Ehrenreich-May, Jill; Alessandri, Michael; Fujii, Cori; Renno, Patricia; Laugeson, Elizabeth; Piacentini, John C; De Nadai, Alessandro S; Arnold, Elysse; Lewin, Adam B; Murphy, Tanya K; Storch, Eric A

    2015-01-01

    Clinically elevated anxiety is a common, impairing feature of autism spectrum disorders (ASD). A modular CBT program designed for preteens with ASD, Behavioral Interventions for Anxiety in Children with Autism (BIACA; Wood et al., 2009) was enhanced and modified to address the developmental needs of early adolescents with ASD and clinical anxiety. Thirty-three adolescents (11-15 years old) were randomly assigned to 16 sessions of CBT or an equivalent waitlist period. The CBT model emphasized exposure, challenging irrational beliefs, and behavioral supports provided by caregivers, as well as numerous ASD-specific treatment elements. Independent evaluators, parents, and adolescents rated symptom severity at baseline and posttreatment/postwaitlist. In intent-to-treat analyses, the CBT group outperformed the waitlist group on independent evaluators' ratings of anxiety severity on the Pediatric Anxiety Rating Scale (PARS) and 79% of the CBT group met Clinical Global Impressions-Improvement scale criteria for positive treatment response at posttreatment, as compared to only 28.6% of the waitlist group. Group differences were not found for diagnostic remission or questionnaire measures of anxiety. However, parent-report data indicated that there was a positive treatment effect of CBT on autism symptom severity. The CBT manual under investigation, enhanced for early adolescents with ASD, yielded meaningful treatment effects on the primary outcome measure (PARS), although additional developmental modifications to the manual are likely warranted. Future studies examining this protocol relative to an active control are needed.

  8. Cognitive Behavioral Therapy for Early Adolescents with Autism Spectrum Disorders and Clinical Anxiety: A Randomized, Controlled Trial

    PubMed Central

    Wood, Jeffrey J.; Ehrenreich-May, Jill; Alessandri, Michael; Fujii, Cori; Renno, Patricia; Laugeson, Elizabeth; Piacentini, John C.; De Nadai, Alessandro S.; Arnold, Elysse; Lewin, Adam B.; Murphy, Tanya K.; Storch, Eric A.

    2014-01-01

    Background Clinically elevated anxiety is a common, impairing feature of autism spectrum disorders (ASD). A modular CBT program designed for preteens with ASD, Behavioral Interventions for Anxiety in Children with Autism (BIACA; Wood et al., 2009), was enhanced and modified to address the developmental needs of early adolescents with ASD and clinical anxiety. Method Thirty-three adolescents (11–15 years old) were randomly assigned to 16 sessions of CBT or an equivalent waitlist period. The CBT model emphasized exposure, challenging irrational beliefs, and behavioral supports provided by caregivers, as well as numerous ASD-specific treatment elements. Independent evaluators, parents, and adolescents rated symptom severity at baseline and post-treatment/post-waitlist. Results In intent-to-treat analyses, the CBT group outperformed the waitlist group on independent evaluators’ ratings of anxiety severity on the Pediatric Anxiety Rating Scale (PARS) and 79% of the CBT group met Clinical Global Impressions-Improvement scale criteria for positive treatment response at posttreatment, as compared to only 28.6% of the waitlist group. Group differences were not found for diagnostic remission or questionnaire measures of anxiety. However, parent-report data indicated that there was a positive treatment effect of CBT on autism symptom severity. Conclusions The CBT manual under investigation, enhanced for early adolescents with ASD, yielded meaningful treatment effects on the primary outcome measure (PARS), although additional developmental modifications to the manual are likely warranted. Future studies examining this protocol relative to an active control are needed. PMID:25526831

  9. Depression and Anxiety Symptoms in Children and Adolescents with Autism Spectrum Disorders without Intellectual Disability

    ERIC Educational Resources Information Center

    Strang, John F.; Kenworthy, Lauren; Daniolos, Peter; Case, Laura; Wills, Meagan C.; Martin, Alex; Wallace, Gregory L.

    2012-01-01

    Recent studies have shown that rates of depression and anxiety symptoms are elevated among individuals with autism spectrum disorders (ASDs) of various ages and IQs and that depression/anxiety symptoms are associated with higher IQ and fewer ASD symptoms. In this study which examined correlates of depression and anxiety symptoms in the full…

  10. Examining the Relationship between Parental Anxiety and Treatment Response in Children and Adolescents with Autism Spectrum Disorder and Anxiety

    PubMed Central

    Reaven, Judy; Washington, Lindsay; Moody, Eric J.; Stern, Jessica A.; Hepburn, Susan L.; Blakeley-Smith, Audrey

    2015-01-01

    In response to the high co-occurrence of anxiety symptoms in youth with autism spectrum disorder (ASD), several interventions have been developed for this population. In spite of promising findings, some youth with ASD respond only minimally to anxiety interventions. The current study explores the role of parental anxiety in youth treatment outcome. Thirty-one youth with ASD, ages 7–18, and their parents participated in the study. Parents completed the State-Trait Anxiety Inventory pre- and post-treatment. Contrary to previous research, there was no correlation between parental anxiety and youth anxiety at baseline or post-treatment. However, parental trait anxiety significantly decreased from pre- to post-treatment for parents of treatment responders. The findings are consistent with previous research and suggest youth-to-parent influence. PMID:25778837

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  12. Generalized anxiety disorder - children

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/007687.htm Generalized anxiety disorder - children To use the sharing features on this page, please enable JavaScript. Generalized anxiety disorder (GAD) is a mental disorder in which a ...

  13. Generalized anxiety disorder

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/000917.htm Generalized anxiety disorder To use the sharing features on this page, please enable JavaScript. Generalized anxiety disorder (GAD) is a mental disorder in which a ...

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

    PubMed Central

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

    2013-01-01

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

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  16. 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 ...

  17. Examining the Relationship Between Parental Anxiety and Treatment Response in Children and Adolescents with Autism Spectrum Disorder and Anxiety.

    PubMed

    Reaven, Judy; Washington, Lindsay; Moody, Eric J; Stern, Jessica A; Hepburn, Susan L; Blakeley-Smith, Audrey

    2015-08-01

    In response to the high co-occurrence of anxiety symptoms in youth with autism spectrum disorder (ASD), several interventions have been developed for this population. In spite of promising findings, some youth with ASD respond only minimally to such interventions. To understand potential factors that may impact treatment response, the current study explores the role of parental anxiety in youth treatment outcome. Thirty-one youth with ASD, ages 7-18, and their parents participated in the study. Parents completed the State/Trait Anxiety Inventory pre- and post-treatment. Contrary to previous research, there was no correlation between parental anxiety and youth anxiety at baseline or post-treatment. However, parental trait anxiety significantly decreased from pre- to post-treatment for parents of treatment responders. The findings are consistent with previous research and suggest a youth-to-parent influence.

  18. Social anxiety disorder in Saudi adolescent boys: Prevalence, subtypes, and parenting style as a risk factor

    PubMed Central

    Ghazwani, Jaafar Y.; Khalil, Shamsun N.; Ahmed, Razia A.

    2016-01-01

    Background: Available information on social anxiety disorder (SAD) in adolescents in Saudi Arabia is limited. The objective of the study was to estimate the prevalence, severity, and subtypes of SAD, and parenting style risk factors associated with SAD in the adolescent. Materials and Methods: This cross-sectional study was conducted in two secondary schools for boys in Abha, Saudi Arabia during the Academic year 2013. To collect the data, a questionnaire eliciting information on background characteristics and parenting style as well as the Liebowitz Social Anxiety Scale Test (LSAS), for the evaluation of SAD, were used. Results: A total of 454 students participated in the study. The age of the participants ranged between 15 and 20 years with a mean of 17.4 years. The prevalence of SAD was 11.7%. Around 36% and 11.4% of the students respectively had severe and more severe forms of SAD. Parenting style such as parental anger, criticism particularly in front of others, exaggerated protection, maltreatment and family provocation emerged as a significant risk factor for SAD. The independent predictors of SAD were a parental provocation and physical or emotional maltreatment by the parent (odds ratio [OR] = 3.97, 95% confidence interval [CI]: 1.90–8.31 and OR = 2.67, 95% CI: 3.17–5.19, respectively). Conclusion: The prevalence of SAD in secondary school students at Abha is high. Parenting style risk factors for SAD are modifiable. In this context, a national program to improve mental health in this age group is crucial. PMID:26929726

  19. Do nightmares and generalized anxiety disorder in childhood and adolescence have a common genetic origin?

    PubMed

    Coolidge, Frederick L; Segal, Daniel L; Coolidge, Christa M; Spinath, Frank M; Gottschling, Juliana

    2010-05-01

    The present study investigated the prevalence and heritability of nightmares and their comorbidity with psychopathology in a sample (N = 1,318) of children, adolescents, and child and adolescent twins ranging in age from 4 to 17 years old. The prevalence of terrible nightmares was estimated to be 6.4%, which is similar to previous studies. There were marginal gender differences in this rate (7.7% for boys; 5.1% in girls), contrary to previous studies that purport higher rates for girls. There was little evidence for prevalence changes across age. Nightmares were highly heritable and attributed to an additive genetic influence (51%) and nonshared environmental effects (49%). There was little evidence for a shared genetic correlation for nightmares and generalized waking anxiety (Overanxious Disorder of Childhood). There was also a substantial and pervasive comorbid psychopathology for those parents who reported Strongly True on Item 59: My child has terrible nightmares on the 200-item parent-as-respondent, Coolidge Personality and Neuropsychological Inventory. Issues in estimating prevalence rates of nightmares were identified.

  20. The relationship between attentional bias and anxiety in children and adolescents with autism spectrum disorders.

    PubMed

    Hollocks, Matthew J; Ozsivadjian, Ann; Matthews, Claire E; Howlin, Patricia; Simonoff, Emily

    2013-08-01

    Young people with an autism spectrum disorder (ASD) are more likely to have heightened levels of anxiety compared with their typically developing (non-ASD) peers. The reasons for this are poorly understood, and there has been little research investigating the cognitive correlates of anxiety in individuals with ASD. Typically developing youth with anxiety disorders have frequently been found to show an attentional bias toward threatening information. In this study, we examined whether such a bias was also found in young people with ASD and anxiety symptoms. The protocol utilized two versions of the dot-probe paradigm, the first with emotional faces and the second with emotional words. Participants comprised 38 boys with an ASD and 41 typically developing controls aged 10-16 years of age. Those with an ASD displayed higher levels of parent- and child-rated anxiety (both P < 0.001) and depression (P < 0.001) compared with controls. However, there were no significant group differences in attentional bias scores and no significant relationship between anxiety and attentional bias in either the face or word tasks, for either group. Our findings suggest that, for young people with ASD, unlike non-ASD individuals with an anxiety disorder, high levels of anxiety may not be associated with attentional bias to threat. This may indicate that anxiety in ASD has different cognitive correlates from anxiety in the typically developing population. Further conclusions, study limitations, and future directions are discussed.

  1. Illness anxiety disorder

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/001236.htm Illness anxiety disorder To use the sharing features on this page, please enable JavaScript. Illness anxiety disorder (IAD) is a preoccupation that physical symptoms ...

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

  3. 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.

  4. Examining the Relationship between Parental Anxiety and Treatment Response in Children and Adolescents with Autism Spectrum Disorder and Anxiety

    ERIC Educational Resources Information Center

    Reaven, Judy; Washington, Lindsay; Moody, Eric J.; Stern, Jessica A.; Hepburn, Susan L.; Blakeley-Smith, Audrey

    2015-01-01

    In response to the high co-occurrence of anxiety symptoms in youth with autism spectrum disorder (ASD), several interventions have been developed for this population. In spite of promising findings, some youth with ASD respond only minimally to such interventions. To understand potential factors that may impact treatment response, the current…

  5. Quantitative EEG and neurofeedback in children and adolescents: anxiety disorders, depressive disorders, comorbid addiction and attention-deficit/hyperactivity disorder, and brain injury.

    PubMed

    Simkin, Deborah R; Thatcher, Robert W; Lubar, Joel

    2014-07-01

    This article explores the science surrounding neurofeedback. Both surface neurofeedback (using 2-4 electrodes) and newer interventions, such as real-time z-score neurofeedback (electroencephalogram [EEG] biofeedback) and low-resolution electromagnetic tomography neurofeedback, are reviewed. The limited literature on neurofeedback research in children and adolescents is discussed regarding treatment of anxiety, mood, addiction (with comorbid attention-deficit/hyperactivity disorder), and traumatic brain injury. Future potential applications, the use of quantitative EEG for determining which patients will be responsive to medications, the role of randomized controlled studies in neurofeedback research, and sensible clinical guidelines are considered.

  6. Anxiety in Medically Ill Children/Adolescents

    PubMed Central

    Pao, Maryland; Bosk, Abigail

    2010-01-01

    Anxiety disorders are thought to be one of the most common psychiatric diagnoses in children/adolescents. Chronic medical illness is a significant risk factor for the development of an anxiety disorder and the prevalence rate of anxiety disorders among youths with chronic medical illnesses is higher compared to their healthy counterparts. Anxiety disorders may develop secondary to predisposing biological mechanisms related to a child’s specific medical illness, as a response to being ill or in the hospital, a threatening environment, as a result of other genetic and psychological factors, or as a combination of all these factors. Additionally, exposure to physical pain early in one’s life and or frequent painful medical procedures are correlated with fear and anxiety during subsequent procedures and treatments and may lead to medical nonadherence and other comorbidities. Anxiety disorders can have serious consequences in children/adolescents with chronic and or life limiting medical illnesses. Therefore, proper identification and treatment of anxiety disorders is necessary and may improve not only psychiatric symptoms but also physical symptoms. Behavioral and cognitive methods as well as psychotropic medications are used to treat anxiety disorders in pediatric patients. We will review current treatments for anxiety in children/adolescents with medical illnesses and propose future research directions. PMID:20721908

  7. Examination of spatial working memory performance in children and adolescents with attention deficit hyperactivity disorder, combined type (ADHD-CT) and anxiety.

    PubMed

    Vance, Alasdair; Ferrin, Maite; Winther, Jo; Gomez, Rapson

    2013-08-01

    Spatial working memory (SWM) is known to be impaired in children with ADHD-CT, whether anxiety is present or not. Yet, it remains unclear whether anxiety disorders add to the SWM impairments evident in ADHD-CT and whether these findings extend into adolescents with ADHD-CT and anxiety. Further, it is not yet known whether children and adolescents with carefully defined anxiety disorders alone, demonstrate SWM deficits. This study explored the association of SWM and its strategy and spatial span components in carefully defined children and adolescents (age 6-16 years) with ADHD-CT alone (N = 163; 14 % female), ADHD-CT and anxiety (N = 243; 23 % female), anxiety disorders alone (N = 69; 25 % female) compared to age- and gender-matched healthy control participants (N = 116; 19 % female). The relationship between SWM and its strategy and span components and core ADHD-CT symptoms and anxiety symptoms were also examined. There was no evidence of an additive effect of ADHD and anxiety on SWM, strategy and spatial span deficits. But, anxiety disorders alone were associated with impaired SWM and span performance compared to healthy control participants. In contrast, strategy did not differ between children and adolescents with anxiety disorders alone and healthy control participants, suggesting that with anxiety span is the most affected component. Further, these findings were age-independent. This study concurs with and extends current influential models about the cognitive effects of anxiety on performance in the setting of ADHD-CT. Clinical implications and future research directions are discussed.

  8. Developmental trajectories of anxiety symptoms in early adolescence: the influence of anxiety sensitivity.

    PubMed

    Allan, Nicholas P; Capron, Daniel W; Lejuez, Carl W; Reynolds, Elizabeth K; MacPherson, Laura; Schmidt, Norman B

    2014-05-01

    Children and adolescents seem to suffer from anxiety disorders at rates similar to adults. Interestingly, anxiety symptoms appear to generally decline over time within children as evidenced by lower rates in early and middle adolescence. There is some evidence that there may be heterogeneous subpopulations of adolescent children with different trajectories of anxiety symptoms, including a class of adolescents with elevated levels of anxiety that do not dissipate over time. Anxiety sensitivity has been identified as an important risk factor in the development of anxiety psychopathology. This study prospectively examined the development of anxiety symptoms in a sample of 277 adolescents (M age = 11.52; 44 % female, 56 % male) over a 3 year period including the influence of anxiety sensitivity on this development. Further, this study investigated whether there were distinct classes of adolescents based on their anxiety symptom trajectories and including anxiety sensitivity as a predictor. Consistent with other reports, findings indicated an overall decline in anxiety symptoms over time in the sample. However, three classes of adolescents were found with distinct anxiety symptom trajectories and anxiety sensitivity was an important predictor of class membership. Adolescents with elevated anxiety sensitivity scores were more likely to be classified as having high and increasing anxiety symptoms over time versus having moderate to low and decreasing anxiety symptoms over time. There are important implications for identification of adolescents and children who are at risk for the development of an anxiety disorder.

  9. Stress sensitization and adolescent depressive severity as a function of childhood adversity: a link to anxiety disorders.

    PubMed

    Espejo, Emmanuel P; Hammen, Constance L; Connolly, Nicole P; Brennan, Patricia A; Najman, Jake M; Bor, William

    2007-04-01

    The goal of the present study was to determine whether exposure to adversity in childhood contributes to a differential threshold at which stressful life events provoke depressive reactions in adolescence. In addition, to address empirical and conceptual questions about stress effects, the moderating effect of anxiety disorder history was also explored. This examination was conducted in a sample of 816 children of depressed and nondepressed mothers, who were followed from birth to age 15. Information on adversities experienced in childhood was collected both from mothers during the first five years of their youth's life and from the youths themselves at age 15, and included information on the mother's relationship with her partner, maternal psychopathology, as well as youth-reported abuse. Results indicated that youths with both greater exposure to adversity in childhood and a history of an anxiety disorder displayed increased depressive severity following low levels of episodic stress compared to youths with only one or neither of these risk factors. The results are speculated to reflect the possibility that early anxiety disorders associated with exposure to adversity in childhood may be a marker of dysregulated stress responses, and may help to account for the comorbidity of depression and anxiety in some individuals.

  10. Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in Brazilian children and adolescents.

    PubMed

    Isolan, Luciano; Salum, Giovanni Abrahão; Osowski, Andrea Tochetto; Amaro, Estácio; Manfro, Gisele Gus

    2011-06-01

    The aim of this study was to evaluate the psychometric properties of the Brazilian-Portuguese version of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in a large community sample of Brazilian children and adolescents. A total of 2410 students completed the 41-item Brazilian-Portuguese version of the SCARED. The one-factor and the five-factor structure of the SCARED fit this sample well. However, the five-factor model had a significantly better fit than the one-factor model and an adequate fit for age and gender subgroups. Anxiety symptoms in Brazilian youth were reported at a moderate-high level as compared to other studies. Females were found to score significantly higher on the total score and on all of the subscales as compared to the males. The total score and each of the five factors for both children and adolescents showed good internal consistency, test-retest and construct validity. According to our findings the Brazilian-Portuguese version of the SCARED is a reliable and valid instrument to assess anxiety in Brazilian children and adolescents.

  11. Neuroimaging in anxiety disorders.

    PubMed

    Engel, Kirsten; Bandelow, Borwin; Gruber, Oliver; Wedekind, Dirk

    2009-06-01

    Neuroimaging studies have gained increasing importance in validating neurobiological network hypotheses for anxiety disorders. Functional imaging procedures and radioligand binding studies in healthy subjects and in patients with anxiety disorders provide growing evidence of the existence of a complex anxiety network, including limbic, brainstem, temporal, and prefrontal cortical regions. Obviously, "normal anxiety" does not equal "pathological anxiety" although many phenomena are evident in healthy subjects, however to a lower extent. Differential effects of distinct brain regions and lateralization phenomena in different anxiety disorders are mentioned. An overview of neuroimaging investigations in anxiety disorders is given after a brief summary of results from healthy volunteers. Concluding implications for future research are made by the authors.

  12. Evidence-Based Psychosocial Treatments for Phobic and Anxiety Disorders in Children and Adolescents

    ERIC Educational Resources Information Center

    Silverman, Wendy K.; Pina, Armando A.; Viswesvaran, Chockalingam

    2008-01-01

    The article reviews psychosocial treatments for phobic and anxiety disorders in youth. Using criteria from Nathan and Gorman (2002), 32 studies are evaluated along a continuum of methodological rigor. In addition, the treatments evaluated in each of the 32 studies are classified according to Chambless et al.'s (1996) and Chambless and Hollon's…

  13. 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…

  14. Betaxolol in anxiety disorders.

    PubMed

    Swartz, C M

    1998-03-01

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

  15. The Efficacy of Augment of D-Cycloserine and Cognitive-behavioral Therapy on Adolescent with one Type of Anxiety Disorders: A Double-blind Randomized Controlled Trial

    PubMed Central

    Arman, Soroor; Soheilimehr, Ali; Maracy, Mohammad Reza

    2017-01-01

    Background: This study was designed to investigating the effect of combining D-cycloserine (DCS) and cognitive-behavioral therapy (CBT) on adolescent with at least one type of anxiety disorders. Materials and Methods: The present study was conducted as a double-blind randomized controlled trial on 36 adolescent with anxiety disorders. Patients were assessed in two groups. In addition to 4 sessions of weekly CBT in both groups; case group, received a 50-mg DCS capsules, control group, received Placebo daily for a month. Patients received DCS capsules or placebo 1 h before sessions of CBT. Age, sex, kind of anxiety disorders “screen for child anxiety related disorders (SCARED)” and “cognitive abilities test (CATS)” scores were evaluated and compared between groups. Results: The mean age of the studied patients (29 females (80.6%) and 7 males (19.4%)) was 14.1 ± 1.8 years. The most frequent anxiety disorder among the study population was generalized social disorder (GAD) (77.7%). Age, sex and the frequency of anxiety disorders were not statistically significant between the study groups (P > 0.05). The mean score of “SCARED” and “CATS” at before starting the treatment, after treatment and three month after the treatment were not statistically significant between groups (P > 0.05). Also, decrease in values of “SCARED” and “CATS” during the evaluation time periods was not statistically significant between groups (P > 0.05). Conclusions: Findings of this study showed that there has been no difference in symptoms improvement in adolescent with anxiety disorder who received treatment protocol including 4 sessions of CBT, weekly, together with 50 mgs of DCS compared to the patients of the control group. PMID:28299303

  16. Are flatter diurnal cortisol rhythms associated with major depression and anxiety disorders in late adolescence? The role of life stress and daily negative emotion.

    PubMed

    Doane, Leah D; Mineka, Susan; Zinbarg, Richard E; Craske, Michelle; Griffith, James W; Adam, Emma K

    2013-08-01

    Alterations in hypothalamic-pituitary-adrenal (HPA) axis functioning have been associated with major depression disorder (MDD) and some anxiety disorders. Few researchers have tested the possibility that high levels of recent life stress or elevations in negative emotion may partially account for the HPA axis alterations observed in these disorders. In a sample of 300 adolescents from the Youth Emotion Project, we examined associations between MDD and anxiety disorders, dimensional measures of internalizing symptomatology, life stress, mood on the days of cortisol testing, and HPA axis functioning. Adolescents with a past MDD episode and those with a recent MDD episode comorbid with an anxiety disorder had flatter diurnal cortisol slopes than adolescents without a history of internalizing disorders. Higher reports of general distress, a dimension of internalizing symptomatology, were also associated with flatter slopes. Negative emotion, specifically sadness and loneliness, was associated with flatter slopes and partially accounted for the associations between comorbid MDD and anxiety disorders and cortisol. The associations between past MDD and cortisol slopes were not accounted for by negative emotion, dimensional variation in internalizing symptomatology, or levels of life stress, indicating that flatter cortisol slopes may also be a "scar" marker of past experiences of MDD.

  17. Evidence of association between Val66Met polymorphism at BDNF gene and anxiety disorders in a community sample of children and adolescents.

    PubMed

    Tocchetto, Andréa; Salum, Giovanni A; Blaya, Carolina; Teche, Stefania; Isolan, Luciano; Bortoluzzi, Andressa; Rebelo E Silva, Rafael; Becker, Juliana A; Bianchin, Marino M; Rohde, Luis Augusto; Leistner-Segal, Sandra; Manfro, Gisele G

    2011-09-20

    Different lines of evidence support BDNF as a candidate gene in mood and anxiety modulation. More recently, the Met allele of the BDNF Val66Met polymorphism has been implicated in anxiety in animal models and anxiety-traits in humans. The aim of this study is to evaluate the a priori hypothesis that the association between anxiety disorders and Val66Met polymorphism at the BDNF gene would be replicated in a community sample of children and adolescents. 240 subjects from a total sample of 2457 children and adolescents aged 10-17 years from the public schools in the catchment area of the primary care unit of a university hospital participated in this case-control study and were assessed for psychopathology using the K-SADS-PL. A sample of saliva was collected for DNA analysis of Val66Met polymorphism. BDNF was the single gene evaluated in this sample. We found a significant association between carrying one copy of the Met allele and higher chance of anxiety disorders in children and adolescents. The association remained positive even after the adjustment for potential confounders (228 subjects; OR=3.53 (CI95% 1.77-7.06; p<0.001)). Our results support the a priori hypothesis of an association between anxiety and the polymorphism Val66Met. To our knowledge, this is the first study documenting a potential role of this polymorphism in a community sample of anxious children and adolescents.

  18. Anxiety in adolescent epilepsy. A clinimetric analysis.

    PubMed

    Carrozzino, Danilo; Marchetti, Daniela; Laino, Daniela; Minna, Maria; Verrocchio, Maria Cristina; Fulcheri, Mario; Verrotti, Alberto; Bech, Per

    2016-08-01

    Background Anxiety and depression have been considered to be neglected disorders in epilepsy. Because panic disorder is one of the most important anxiety disorders, it has been problematic to use very comprehensive anxiety questionnaires in epilepsy patients, as panic attacks and epileptic seizures, although two distinct clinical entities from a diagnostic point of view, show a significant overlap of symptoms. Aims We have focused on single items for anxiety and depression as screening candidates in adolescent epilepsy. Methods The individual panic attack item in the Screen for Children Anxiety Related Emotional Disorders Scale (SCARED) and the single depression item in the Kellner Symptom Questionnaire were tested. Our samples consisted of adolescent patients with epilepsy and a matched control group with healthy participants, as well as two numerical groups acting as controls. Results The single panic attack item identified panic anxiety in 24.1% in the group of patients with epilepsy and 0.0% in the matched control group (p = 0.01). The single depression item identified 52.2% with depression in the epilepsy group and 6.2% in the matched control group (p = 0.001). Conclusion As screening instruments, single items of panic attack and depression are sufficient to screen for these affective states in adolescent epilepsy. The clinical implications are that it is important to be quite specific when screening for depression and panic attacks in adolescent patients with epilepsy.

  19. Treating Social Anxiety in Adolescents: Ten Group Therapy Lesson Plans

    ERIC Educational Resources Information Center

    Mazur-Elmer, Alison; McBride, Dawn

    2009-01-01

    This project provides a comprehensive overview of the research literature on social anxiety disorder (SAD) in adolescents and concludes by offering a set of 10 group therapy lesson plans for SAD that therapists can use in their practice. The overview includes a description of social anxiety disorder and highlights various theories of anxiety. The…

  20. Comparative efficacy and acceptability of psychotherapies for acute anxiety disorders in children and adolescents: study protocol for a network meta-analysis

    PubMed Central

    Zhang, Yuqing; Zhou, Xinyu; James, Anthony C; Qin, Bin; Whittington, Craig J; Cuijpers, Pim; Del Giovane, Cinzia; Liu, Yiyun; Cohen, David; Weisz, John R; Xie, Peng

    2015-01-01

    Introduction Anxiety disorders are associated with significant public health burden in young individuals. Cognitive-behavioural therapy (CBT) is the most commonly used psychotherapy for anxiety disorders in children and adolescents, but previous reviews were hindered by a limited number of trials with direct comparisons between different psychotherapies and their deliveries. Consequently, the main aim of this research was to investigate the comparative efficacy and acceptability of various types and deliveries of psychotherapies for anxiety disorders in children and adolescents. Methods and analysis We will systematically search PubMed, EMBASE, Cochrane, Web of Science, PsycINFO, CINAHL, ProQuest Dissertations and LiLACS for randomised controlled trials, regardless of whether participants received blinding or not, published from 1 January 1966 to 30 January 2015 (updated to 1 July 2015), that compared any psychotherapy with either a control condition or an active comparator with different types and/or different delivery formats for the acute treatment of anxiety disorders in children and adolescents. Data extraction, risk of bias and quality assessments will be independently extracted by two reviewers. The primary outcome for efficacy will be mean overall change scores in anxiety symptoms (self-rated or assessor-rated) from baseline to post-treatment between two groups. The acceptability of treatment will be measured as the proportion of patients who discontinued treatment during the acute phase of treatment. We will assess efficacy, based on the standardised mean difference (SMD), and acceptability, based on the OR, using a random-effects network meta-analysis within a Bayesian framework. Subgroup and sensitivity analyses will be conducted to assess the robustness of the findings. Ethics and dissemination No ethical issues are foreseen. The results will be published in a peer-reviewed journal and will be disseminated electronically and in print. The meta

  1. Recent developments in the treatment of anxiety disorders in children and adolescents.

    PubMed

    Creswell, Cathy; Waite, Polly

    2016-08-01

    Anxiety disorders are among the most common emotional difficulties experienced by children and young people. They cause significant disturbance to the lives of young people and their families and present a risk for lifelong psychological disturbance. Effective psychological (ie, cognitive-behaviour therapy (CBT)) and pharmacological interventions (eg, selective serotonin reuptake inhibitors (SSRIs)) have been established. However, the risk of adverse effects and unknown long-term effects of using SSRIs has led to recommendations that CBT is delivered as a first-line intervention. Recent innovations have included the development of low-intensity CBT programmes, delivered briefly via parents or online. These hold promise to increase access to psychological therapies for children and young people with these common and severe difficulties.

  2. The Social Appearance Anxiety Scale in Italian Adolescent Populations: Construct Validation and Group Discrimination in Community and Clinical Eating Disorders Samples.

    PubMed

    Dakanalis, Antonios; Carrà, Giuseppe; Calogero, Rachel; Zanetti, M Assunta; Volpato, Chiara; Riva, Giuseppe; Clerici, Massimo; Cipresso, Pietro

    2016-02-01

    Anxiety in situations where one's overall appearance (including body shape) may be negatively evaluated is hypothesized to play a central role in Eating Disorders (EDs) and in their co-occurrence with Social Anxiety Disorder (SAD). Three studies were conducted among community (N = 1995) and clinical (N = 703) ED samples of 11- to 18-year-old Italian girls and boys to (a) evaluate the psychometric qualities and measurement equivalence/invariance (ME/I) of the Social Appearance Anxiety (SAA) Scale (SAAS) and (b) determine to what extent SAA or other situational domains of social anxiety related to EDs distinguish adolescents with an ED only from those with SAD. Results upheld the one-factor structure and ME/I of the SAAS across samples, gender, age categories, and diagnostic status (i.e., ED participants with and without comorbid SAD). The SAAS demonstrated high internal consistency and 3-week test-retest reliability. The strength of the inter-relationships between SAAS and measures of body image, teasing about appearance, ED symptoms, depression, social anxiety, avoidance, and distress, as well as the ability of SAAS to discriminate community adolescents with high and low levels of ED symptoms and community participants from ED participants provided construct validity evidence. Only SAA strongly differentiated adolescents with any ED from those with comorbid SAD (23.2 %). Latent mean comparisons across all study groups were performed and discussed.

  3. [Separation anxiety and panic disorder].

    PubMed

    Seguí, J; Salvador, L; Canet, J; Márquez, M; Ortíz, M; García, L

    1998-01-01

    History od separation anxiety was investigated in several psychiatryc disorders and in 150 patients with panic disorder following DSM III-R criteria. Separation anxiety was reported by 15.3% of patients with panic disorder, 3.3% of the healthy control group, 13.3% of patients with major depression, 16.7% with dystymia, 13.3% with generalized anxiety and 33.3% with social phobia (p < 0.001). Separation anxiety is thus considered a common predisposing factor of anxiety and depressive disorders. Panic disorder patients with a history of separation anxiety had an earlier age at panic onset and greater comorbidity with social phobia and agoraphobia.

  4. Complete recovery from anxiety disorders following Cognitive Behavior Therapy in children and adolescents: A meta-analysis.

    PubMed

    Warwick, Helen; Reardon, Tessa; Cooper, Peter; Murayama, Kou; Reynolds, Shirley; Wilson, Charlotte; Creswell, Cathy

    2017-03-01

    Cognitive Behavior Therapy (CBT) is a well-established treatment for childhood anxiety disorders. Meta-analyses have concluded that approximately 60% of children recover following treatment, however these include studies using a broad range of diagnostic indices to assess outcomes including whether children are free of the one anxiety disorder that causes most interference (i.e. the primary anxiety disorder) or whether children are free of all anxiety disorders. We conducted a meta-analysis to establish the efficacy of CBT in terms of absence of all anxiety disorders. Where available we compared this rate to outcomes based on absence of primary disorder. Of 56 published randomized controlled trials, 19 provided data on recovery from all anxiety disorders (n=635 CBT, n=450 control participants). There was significant heterogeneity across those studies with available data and full recovery rates varied from 47.6 to 66.4% among children without autistic spectrum conditions (ASC) and 12.2 to 36.7% for children with ASC following treatment, compared to up to 20.6% and 21.3% recovery in waitlist and active treatment comparisons. The lack of consistency in diagnostic outcomes highlights the urgent need for consensus on reporting in future RCTs of childhood anxiety disorders for the meaningful synthesis of data going forwards.

  5. Psychometric Properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in a Non-Clinical Sample of Children and Adolescents in Saudi Arabia.

    PubMed

    Arab, Arwa; El Keshky, Mogeda; Hadwin, Julie A

    2016-08-01

    This paper examined the reliability, convergent validity and factor structure of the self-report Screen for Child Anxiety Disorders (SCARED; Birmaher et al. in J Am Acad Child Adolesc Psychiatry 36:545-553, 1997) in a large community sample of children and adolescents in Saudi Arabia. The questionnaire showed moderate to high internal consistency and satisfactory test-retest reliability over a 2 week period. In addition, there were significant positive correlations between reported anxiety symptoms with parent report behavioural difficulties. The five factor structure model of the SCARED also had a good model fit in this population. The results showed that self-report anxiety symptoms decreased with age (for boys and not girls) and were higher in adolescent girls. The results suggest that the SCARED could be useful in this population to identify individuals who are at risk of developing anxiety disorders in childhood with a view to implementing prevention and intervention methods to ensure positive developmental outcome over time.

  6. Rages and refusals. Managing the many faces of adolescent anxiety.

    PubMed Central

    Garland, E. J.

    2001-01-01

    OBJECTIVE: To provide family physicians with a practical approach to recognition, assessment, and treatment of adolescent anxiety disorders complicated by avoidance or oppositional behaviour. QUALITY OF EVIDENCE: Current literature was searched via MEDLINE using the MeSH headings Anxiety and Anxiety Disorders, focusing on epidemiology, clinical presentations in adolescence, and both pharmacologic and nonpharmacologic treatment. In addition, internationally accepted diagnostic criteria, current practice guidelines, and recent textbooks by recognized experts were reviewed. Research evidence and consensus recommendations were integrated with a practical approach developed in a provincial mood and anxiety disorders clinic. MAIN FINDINGS: Anxiety disorders are common in adolescents, with estimated prevalence of at least 10%. Substance abuse and avoiding school are common complications, and irritability with behavioural and rage problems can interfere with effective management. Current controlled research is examining the effectiveness of serotonergic medications known to benefit panic disorder, social phobia, and generalized anxiety in adults. While cognitive and behavioural treatments are effective for some child and adolescent anxiety disorders, they can be difficult to administer, and a supportive and psychoeducational approach could be as effective for those who refuse to go to school. CONCLUSION: Family physicians' awareness of the role of anxiety in adolescent school avoidance and in intense, oppositional emotional reactions at home can lead to more specific assessment and therapeutic intervention. Practical management strategies are recommended. PMID:11398717

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

    PubMed

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

    2014-07-01

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

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

  9. Striatum on the anxiety map: Small detours into adolescence

    PubMed Central

    Lago, Tiffany; Davis, Andrew; Grillon, Christian; Ernst, Monique

    2016-01-01

    Adolescence is the most sensitive period for the development of pathological anxiety. Moreover, specific neural changes associated with the striatum might be related to adolescent vulnerability to anxiety. Up to now, the study of anxiety has primarily focused on the amygdala, bed nucleus of the stria terminalis (BNST), hippocampus and ventromedial prefrontal cortex (vmPFC), while the striatum has typically not been considered as part of the anxiety system. This review proposes the addition of the striatum, a complex, multi-component structure, to the anxiety network by underscoring two lines of research. First, the co-occurrence of the adolescent striatal development with the peak vulnerability of adolescents to anxiety disorders might potentially reflect a causal relationship. Second, the recognition of the role of the striatum in fundamental behavioral processes that do affect anxiety supports the putative importance of the striatum in anxiety. These behavioral processes include (1) attention, (2) conditioning/prediction error, and (3) motivation. This review proposes a simplistic schematic representation of the anxiety circuitry that includes the striatum, and aims to promote further work in this direction, as the role of the striatum in shaping an anxiety phenotype during adolescence could have critical implications for understanding and preventing the peak onset of anxiety disorders during this period. PMID:27276526

  10. Social Anxiety Disorder (Social Phobia)

    MedlinePlus

    ... Substance abuse, such as drinking too much alcohol Suicide or suicide attempts Other anxiety disorders, major depressive disorder, substance ... disorder symptoms, your doctor may: Perform a physical exam to determine if there may be any physical ...

  11. Anxiety disorders in late life.

    PubMed Central

    Flint, A. J.

    1999-01-01

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

  12. Clinical decision making about child and adolescent anxiety disorders using the Achenbach system of empirically based assessment.

    PubMed

    Van Meter, Anna; Youngstrom, Eric; Youngstrom, Jennifer Kogos; Ollendick, Thomas; Demeter, Christine; Findling, Robert L

    2014-01-01

    Anxiety disorders are common among children but can be difficult to diagnose. An actuarial approach to the diagnosis of anxiety may improve the efficiency and accuracy of the process. The objectives of this study were to determine the clinical utility of the Achenbach Child Behavior Checklist (CBCL) and Youth Self Report (YSR), two widely used assessment tools, for diagnosing anxiety disorders in youth and to aid clinicians in incorporating scale scores into an actuarial approach to diagnosis through a clinical vignette. Demographically diverse youth, 5 to 18 years of age, were drawn from two samples; one (N = 1,084) was recruited from a research center, and the second (N = 651) was recruited from an urban community mental health center. Consensus diagnoses integrated information from semistructured interview, family history, treatment history, and clinical judgment. The CBCL and YSR internalizing problems T scores discriminated cases with any anxiety disorder or with generalized anxiety disorder from all other diagnoses in both samples (ps < .0005); the two scales had equivalent discriminative validity (ps > .05 for tests of difference). No other scales, nor any combination of scales, significantly improved on the performance of the Internalizing scale. In the highest risk group, Internalizing scores greater than 69 (CBCL) or greater than 63 (YSR) resulted in a Diagnostic Likelihood Ratio of 1.5; low scores reduced the likelihood of anxiety disorders by a factor of 4. Combined with other risk factor information in an actuarial approach to assessment and diagnosis, the CBCL and YSR Internalizing scales provide valuable information about whether a youth is likely suffering from an anxiety disorder.

  13. Anxiety Levels in Adolescents Who Stutter

    ERIC Educational Resources Information Center

    Blood, Gordon W.; Blood, Ingrid M.; Maloney, Kristy; Meyer, Crystal; Qualls, Constance Dean

    2007-01-01

    High levels of anxiety can negatively affect the lives of children and adolescents. Thirty-six adolescents who stutter and 36 adolescents who do not stutter were administered standardized scales for anxiety and self-esteem. Significant differences were found for the total T-scores for "Revised Children's Manifest Anxiety Scale" for the two groups,…

  14. Anxiety Disorders and Cardiovascular Disease.

    PubMed

    Celano, Christopher M; Daunis, Daniel J; Lokko, Hermioni N; Campbell, Kirsti A; Huffman, Jeff C

    2016-11-01

    Anxiety and its associated disorders are common in patients with cardiovascular disease and may significantly influence cardiac health. Anxiety disorders are associated with the onset and progression of cardiac disease, and in many instances have been linked to adverse cardiovascular outcomes, including mortality. Both physiologic (autonomic dysfunction, inflammation, endothelial dysfunction, changes in platelet aggregation) and health behavior mechanisms may help to explain the relationships between anxiety disorders and cardiovascular disease. Given the associations between anxiety disorders and poor cardiac health, the timely and accurate identification and treatment of these conditions is of the utmost importance. Fortunately, pharmacologic and psychotherapeutic interventions for the management of anxiety disorders are generally safe and effective. Further study is needed to determine whether interventions to treat anxiety disorders ultimately impact both psychiatric and cardiovascular health.

  15. [Anxiety and cognition disorders].

    PubMed

    Peretti, C S

    1998-01-01

    Anxious subjects present attentional disorders that are manifest with an increased bias towards threatening contents stimuli. In tasks derived from the Stroop task (such as emotional Stroop, a variant of the classic Stroop task) congruence between anxious themes or manifestations and stimuli content induces information processing changes leading to a slowness of response speed. In this case, results are similar to those obtained in signal detection tasks either when information is visually or auditorily presented. In anxious subjects an inconscious activation provoked by anxiogenic words is observed. Because such activation is independent from the semantic content of the words, an emotional priming has been hypothesized. Berck formulated an hypervigilance theory according to which anxiety provokes a selective distractibility regarding non pertinent stimuli. Such attentional selectivity would be responsible of a cognitive vulnerability in anxious subjects. State but not trait anxiety induces working memory performances deficit. On the bases of Baddeley's working memory framework, Eysenck proposed that anxiety uses part of the limited attentional capacity, placing the subject in a dual task situation. In that, he has to cope with pertinent information and anxiety generated information. If anxiety leads to better performance in simple tasks by recruiting motivational capacities, in tasks with high information content, anxious subjects performances are impaired. Changes in the long-term memory do not seem to fit with the theoretical models based on cognitive impairment observed in patients suffering from depressive states. Anxious subjects presented a memory bias towards anxiogenic information in implicit memory tasks. But experimental data are still too searce to describe implicit performance of anxious subjects and more systematic studies are therefore needed.

  16. The Developmental Course of Anxiety Symptoms during Adolescence: The TRAILS Study

    ERIC Educational Resources Information Center

    Van Oort, F. V. A.; Greaves-Lord, K.; Verhulst, F. C.; Ormel, J.; Huizink, A. C.

    2009-01-01

    Background: Little is known about the development of anxiety symptoms from late childhood to late adolescence. The present study determined developmental trajectories of symptoms of separation anxiety disorder (SAD), social phobia (SoPh), generalized anxiety disorder (GAD), panic disorder (PD), and obsessive-compulsive disorder (OCD) in a large…

  17. Treatment of pediatric anxiety disorders.

    PubMed

    Rapp, Amy; Dodds, Alice; Walkup, John T; Rynn, Moira

    2013-11-01

    This article provides a brief review of the current available data concerning present treatment and potential new treatment advances for pediatric anxiety disorders, such as generalized anxiety disorder, separation anxiety disorder, social phobia, obsessive-compulsive disorder, and posttraumatic stress disorder. Disorder-specific treatment methods and innovations, particularly computer-assisted methods of delivery for cognitive behavioral therapy (CBT) will be reviewed. Additionally, the paper will discuss novel psychopharmacological compounds (e.g., D-cycloserine, riluzole, memantine, and anticonvulsant medications). Available evidence for the efficacy of novel medication strategies in adult studies and implications for their use in pediatrics will be discussed.

  18. The role of the mother-child relationship for anxiety disorders and depression: results from a prospective-longitudinal study in adolescents and their mothers.

    PubMed

    Asselmann, Eva; Wittchen, Hans-Ulrich; Lieb, Roselind; Beesdo-Baum, Katja

    2015-04-01

    This study aims to examine whether (a) low child valence (emotional connectedness) within the mother-child relationship increases the risk for offspring depression, (b) low child potency (individual autonomy) increases the risk for offspring anxiety, and (c) maternal psychopathology pronounces these associations. We used data from a prospective-longitudinal study of adolescents (aged 14-17 at baseline) and their mothers (N = 1,015 mother-child dyads). Anxiety disorders and depression were assessed repeatedly over 10 years in adolescents (T0, T1, T2, T3) and their mothers (T1, T3) using the DSM-IV/M-CIDI. Valence and potency were assessed in mothers (T1) with the Subjective Family Image Questionnaire. Odds ratios (OR) from logistic regression were used to estimate associations between low child valence/potency and offspring psychopathology (cumulated lifetime incidences; adjusted for sex and age). In separate models (low valence or low potency as predictor), low child valence predicted offspring depression only (OR = 1.26 per SD), while low child potency predicted offspring anxiety (OR = 1.24) and depression (OR = 1.24). In multiple models (low valence and low potency as predictors), low child valence predicted offspring depression only (OR = 1.19), while low child potency predicted offspring anxiety only (OR = 1.22). Low child potency interacted with maternal anxiety on predicting offspring depression (OR = 1.49), i.e. low child potency predicted offspring depression only in the presence of maternal anxiety (OR = 1.33). These findings suggest that low child valence increases the risk for offspring depression, while low child potency increases the risk for offspring anxiety and depression and interacts with maternal psychopathology on predicting offspring depression.

  19. Mental, Emotional and Behavior Disorders in Children and Adolescents. Factsheet.

    ERIC Educational Resources Information Center

    Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Center for Mental Health Services.

    This factsheet describes the different mental, emotional, and behavior problems that can occur during childhood and adolescence. The incidence and symptoms of the following disorders are discussed: (1) anxiety disorders (including phobia, generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder);…

  20. Efficacy of three treatment protocols for adolescents with social anxiety disorder: a 5-year follow-up assessment.

    PubMed

    Garcia-Lopez, Luis-Joaquin; Olivares, Jose; Beidel, Deborah; Albano, Anne-Marie; Turner, Samuel; Rosa, Ana I

    2006-01-01

    Few studies have reported long-term follow-up data in adults and even fewer in adolescents. The purpose of this work is to report on the longest follow-up assessment in the literature on treatments for adolescents with social phobia. A 5-year follow-up assessment was conducted with subjects who originally received either Cognitive Behavioral Group Therapy for Adolescents (CBGT-A), Social Effectiveness Therapy for Adolescents--Spanish version (SET-Asv), or Intervención en Adolescentes con Fobia Social--Treatment for Adolescents with Social Phobia (IAFS) in a controlled clinical trial. Twenty-three subjects completing the treatment conditions were available for the 5-year follow-up. Results demonstrate that subjects treated either with CBGT-A, SET-Asv and IAFS continued to maintain their gains after treatments were terminated. Either the CBGT-A, SET-Asv and IAFS can provide lasting effects to the majority of adolescents with social anxiety. Issues that may contribute to future research and clinical implications are discussed.

  1. Anxiety disorders in primary care.

    PubMed

    Combs, Heidi; Markman, Jesse

    2014-09-01

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

  2. Cognitive Behavior Therapy in the Treatment of Anxiety for Adolescents and Adults with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Scattone, Dorothy; Mong, Michael

    2013-01-01

    Important areas of treatment for individuals with autism spectrum disorders (ASD) have only begun to be explored empirically in the last decade. Fortunately, there has been growing interest in identifying how to best adapt treatments that have been demonstrated to be efficacious with broader populations to individuals with ASD. This article…

  3. Perfectionism in pediatric anxiety and depressive disorders.

    PubMed

    Affrunti, Nicholas W; Woodruff-Borden, Janet

    2014-09-01

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

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

    ERIC Educational Resources Information Center

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

    2004-01-01

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

  5. The impact of smoking in adolescence on early adult anxiety symptoms and the relationship between infant vulnerability factors for anxiety and early adult anxiety symptoms: the TOPP Study.

    PubMed

    Moylan, Steven; Gustavson, Kristin; Karevold, Evalill; Øverland, Simon; Jacka, Felice N; Pasco, Julie A; Berk, Michael

    2013-01-01

    Cigarette smoking is increased in people with trait anxiety and anxiety disorders, however no longitudinal data exist illuminating whether smoking in adolescence can influence the developmental trajectory of anxiety symptoms from early vulnerability in infancy to adult anxiety expression. Using The Tracing Opportunities and Problems in Childhood and Adolescence (TOPP) Study, a community-based cohort of children and adolescents from Norway who were observed from the age of 18 months to age 18-19 years, we explored the relationship between adolescent smoking, early vulnerability for anxiety in infancy (e.g. shyness, internalizing behaviors, emotional temperaments) and reported early adult anxiety. Structural equation modeling demonstrated that adolescent active smoking was positively associated with increased early adulthood anxiety (β = 0.17, p<0.05), after controlling for maternal education (proxy for socioeconomic status). Adolescent anxiety did not predict early adult smoking. Adolescent active smoking was a significant effect modifier in the relationship between some infant vulnerability factors and later anxiety; smoking during adolescence moderated the relationship between infant internalizing behaviors (total sample: active smokers: β = 0.85, p<0.01, non-active smokers: ns) and highly emotional temperament (total sample: active smokers: β = 0.55, p<0.01,non-active smokers: ns), but not shyness, and anxiety in early adulthood. The results support a model where smoking acts as an exogenous risk factor in the development of anxiety, and smoking may alter the developmental trajectory of anxiety from infant vulnerability to early adult anxiety symptom expression. Although alternative non-mutually exclusive models may explain these findings, the results suggest that adolescent smoking may be a risk factor for adult anxiety, potentially by influencing anxiety developmental trajectories. Given the known adverse health effects of cigarette smoking and

  6. Genetic factors in anxiety disorders.

    PubMed

    Domschke, Katharina; Maron, Eduard

    2013-01-01

    Presently available clinical genetic studies point to a considerable heritability of anxiety disorders (30-67%), with multiple vulnerability genes such as 5-HT1A, 5-HTT, MAO-A, COMT, CCK-B, ADORA2A, CRHR1, FKBP5, ACE, RGS2/7 and NPSR1 suggested by molecular genetic association studies. These genes have been shown to partially interact with each other as well as with environmental factors to shape the overall disease risk in a complex genetic model. Additionally, recent studies have pointed out the crucial role of epigenetic signatures such as methylation patterns in modifying environmental influences as well as in driving the functional impact of anxiety disorder risk genes. On a systems level, vulnerability genes of anxiety disorders seem to confer some of the disease risk via intermediate phenotypes like behavioral inhibition, anxiety sensitivity or several neurobiological traits such as increased startle reactivity or dysfunctional corticolimbic activity during emotional processing. Finally, first pharmaco- and psychotherapy-genetic studies provide evidence for certain risk genes to confer interindividual variability in response to a pharmacological or psychotherapeutic intervention in anxiety disorders. Genetic research in anxiety disorders will be discussed regarding its potential to foster innovative and individually tailored therapeutic approaches for patients with anxiety disorders.

  7. Treatment for Anxiety Disorders

    MedlinePlus

    ... Disorder Specific Phobias Obsessive-Compulsive Disorder (OCD) Posttraumatic Stress Disorder (PTSD) Depression Bipolar Disorder Suicide and Prevention Stress Related Illnesses Myth-Conceptions Find ...

  8. 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

  9. Can autism spectrum disorders and social anxiety disorders be differentiated by the social responsiveness scale in children and adolescents?

    PubMed

    Cholemkery, Hannah; Mojica, Laura; Rohrmann, Sonja; Gensthaler, Angelika; Freitag, Christine M

    2014-05-01

    Autism spectrum disorder (ASD) as well as social phobia (SP), and selective mutism (SM) are characterised by impaired social interaction. We assessed the validity of the Social Responsiveness Scale (SRS) to differentiate between ASD, and SP/SM. Raw scores were compared in 6-18 year old individuals with ASD (N = 60), SP (N = 38), SM (N = 43), and typically developed (N = 42). Sensitivity and specificity were examined. The three disorders showed overlapping SRS scores. Especially in boys with SM (ROC-AUC = .81), presence of ASD was overestimated by the SRS. A combination of three disorder specific questionnaires resulted in marginally improved diagnostic accuracy. For the clinically very relevant differential diagnosis of SP/SM, SRS results must be interpreted with caution.

  10. Cognitive Enhancers for Anxiety Disorders

    PubMed Central

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

    2010-01-01

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

  11. Can Autism Spectrum Disorders and Social Anxiety Disorders Be Differentiated by the Social Responsiveness Scale in Children and Adolescents?

    ERIC Educational Resources Information Center

    Cholemkery, Hannah; Mojica, Laura; Rohrmann, Sonja; Gensthaler, Angelika; Freitag, Christine M.

    2014-01-01

    Autism spectrum disorder (ASD) as well as social phobia (SP), and selective mutism (SM) are characterised by impaired social interaction. We assessed the validity of the Social Responsiveness Scale (SRS) to differentiate between ASD, and SP/SM. Raw scores were compared in 6-18 year old individuals with ASD (N = 60), SP (N = 38), SM (N = 43), and…

  12. 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

  13. 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…

  14. Socialization of Social Anxiety in Adolescent Crowds

    ERIC Educational Resources Information Center

    Van Zalk, Nejra; Van Zalk, Maarten Herman Walter; Kerr, Margaret

    2011-01-01

    In this study, we looked at whether social anxiety is socialized, or influenced by peers' social anxiety, more in some peer crowds than others. Adolescents in crowds with eye-catching appearances such as Goths and Punks (here termed "Radical"), were compared with three comparison groups. Using data from 796 adolescents (353 girls and 443 boys; M…

  15. Treatments for generalized anxiety disorder.

    PubMed

    Struzik, Lukasz; Vermani, Monica; Coonerty-Femiano, Aimee; Katzman, Martin A

    2004-03-01

    Generalized anxiety disorder is characterized by excessive chronic anxiety in association with many somatic symptoms. The disorder has pervasive effects on quality of life, including work, social and educational aspects and requires long-term therapy. Available studies in patients are the Diagnostic and Statistical Manual of Mental Disorders, third edition-revised and fourth edition, which have defined generalized anxiety disorder and demonstrate the efficacy of benzodiazepines, azapirones, some antidepressants and psychotherapy. Benzodiazepines are effective anxiolytics for short-term use but are accompanied by many adverse events. The antidepressants, paroxetine and venlafaxine (Efexor), have demonstrated efficacy in patients with generalized anxiety disorder with mild side-effect profiles. They have the additional benefit of efficacy in depression, which frequently occurs comorbidly in these patients. Long-term efficacy has been shown with venlafaxine in the treatment of this chronic condition, confirming that as in depression, the goal must not just be remission beyond simple symptom resolution but also on to improved functioning and quality of life. Psychotherapy with applied relaxation, cognitive therapy and cognitive behavioral therapy show the most promise in resolving and maintaining treatment gains in the long-term. These approaches may be useful alone or in combination with adjunctive pharmacotherapy to achieve remission. Based on current evidence, the recommended approach to achieving long-term benefits for patients with generalized anxiety disorder is antidepressant therapy with paroxetine or venlafaxine in combination with cognitive behavioral therapy.

  16. 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…

  17. Generalized Anxiety Disorder

    MedlinePlus

    ... serve as an "alarm system," alerting you to danger. For example, imagine coming home and finding a ... extra spark to help you get out of danger. In more normal but busy situations, anxiety can ...

  18. Oxidative Imbalance and Anxiety Disorders

    PubMed Central

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

    2014-01-01

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

  19. [Anxiety disorders in DSM-5].

    PubMed

    Márquez, Miguel

    2014-01-01

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

  20. Nonpharmacological treatments for anxiety disorders.

    PubMed

    Cottraux, Jean

    2002-09-01

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

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

    PubMed

    Craske, Michelle G; Waters, Allison M

    2005-01-01

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

  2. Differential associations between Social Anxiety Disorder, family cohesion, and suicidality across racial/ethnic groups: Findings from the National Comorbidity Survey-Adolescent (NCS-A).

    PubMed

    Rapp, Amy M; Lau, Anna; Chavira, Denise A

    2016-09-20

    The proposed research seeks to introduce a novel model relating Social Anxiety Disorder (SAD) and suicide outcomes (i.e., passive suicidal ideation, active suicidal ideation, and suicide attempts) in diverse adolescents. This model posits that family cohesion is one pathway by which suicide risk is increased for socially anxious youth, and predicts that the relationships between these variables may be of different strength in Latino and White subgroups and across gender. Data from a sample of Latino (n=1922) and non-Hispanic White (hereafter referred to as White throughout) (n=5648) male and female adolescents who participated in the National Comorbidity Survey-Adolescent were used for this study. Analyses were conducted using generalized structural equation modeling. Results showed that the mediation model held for White females. Further examination of direct pathways highlighted SAD as a risk factor unique to Latinos for active suicidal ideation and suicide attempt, over and above comorbid depression and other relevant contextual factors. Additionally, family cohesion showed a strong association with suicide outcomes across groups, with some inconsistent findings for White males. Overall, it appears that the mechanism by which SAD increases risk for suicidality is different across groups, indicating further need to identify relevant mediators, especially for racial/ethnic minority youth.

  3. Comorbid depressive disorders in anxiety-disordered youth: demographic, clinical, and family characteristics.

    PubMed

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

    2010-06-01

    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 adolescents (aged 7-17) with and without comorbid depressive disorders (major depressive disorder or dysthymic disorder), seeking treatment at a university-based anxiety clinic. All participants met DSM-IV diagnostic criteria for a principal anxiety disorder (generalized anxiety disorder, separation anxiety disorder, or social phobia). Of these, twelve percent (n = 24) also met criteria for a comorbid depressive disorder. Results suggest that anxiety-disordered youth with comorbid depressive disorders (AD-DD) were older at intake, had more severe anxious and depressive symptomatology, and were more impaired than anxiety-disordered youth without comorbid depressive disorders (AD-NDD). AD-DD youth also reported significantly more family dysfunction than AD-NDD youth. Future research should examine how this diagnostic and family profile may impact treatment for AD-DD youth.

  4. 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…

  5. Stability of childhood anxiety disorder diagnoses: a follow-up naturalistic study in psychiatric care.

    PubMed

    Carballo, Juan J; Baca-Garcia, Enrique; Blanco, Carlos; Perez-Rodriguez, M Mercedes; Arriero, Miguel A Jimenez; Artes-Rodriguez, Antonio; Rynn, Moira; Shaffer, David; Oquendo, Maria A

    2010-04-01

    Few studies have examined the stability of major psychiatric disorders in pediatric psychiatric clinical populations. The objective of this study was to examine the long-term stability of anxiety diagnoses starting with pre-school age children through adolescence evaluated at multiple time points. Prospective cohort study was conducted of all children and adolescents receiving psychiatric care at all pediatric psychiatric clinics belonging to two catchment areas in Madrid, Spain, between 1 January, 1992 and 30 April, 2006. Patients were selected from among 24,163 children and adolescents who received psychiatric care. Patients had to have a diagnosis of an ICD-10 anxiety disorder during at least one of the consultations and had to have received psychiatric care for the anxiety disorder. We grouped anxiety disorder diagnoses according to the following categories: phobic disorders, social anxiety disorders, obsessive-compulsive disorder (OCD), stress-related disorders, and "other" anxiety disorders which, among others, included generalized anxiety disorder, and panic disorder. Complementary indices of diagnostic stability were calculated. As much as 1,869 subjects were included and had 27,945 psychiatric/psychological consultations. The stability of all ICD-10 anxiety disorder categories studied was high regardless of the measure of diagnostic stability used. Phobic and social anxiety disorders showed the highest diagnostic stability, whereas OCD and "other" anxiety disorders showed the lowest diagnostic stability. No significant sex differences were observed on the diagnostic stability of the anxiety disorder categories studied. Diagnostic stability measures for phobic, social anxiety, and "other" anxiety disorder diagnoses varied depending on the age at first evaluation. In this clinical pediatric outpatient sample it appears that phobic, social anxiety, and stress-related disorder diagnoses in children and adolescents treated in community outpatient services may

  6. Examining the Latent Structure of Anxiety Sensitivity in Adolescents using Factor Mixture Modeling

    PubMed Central

    Allan, Nicholas P.; MacPherson, Laura; Young, Kevin C.; Lejuez, Carl W.; Schmidt, Norman B.

    2014-01-01

    Anxiety sensitivity has been implicated as an important risk factor, generalizable to most anxiety disorders. In adults, factor mixture modeling has been used to demonstrate that anxiety sensitivity is best conceptualized as categorical between individuals. That is, whereas most adults appear to possess normative levels of anxiety sensitivity, a small subset of the population appears to possess abnormally high levels of anxiety sensitivity. Further, those in the high anxiety sensitivity group are at increased risk of having high levels of anxiety and of having an anxiety disorder. This study was designed to determine whether these findings extend to adolescents. Factor mixture modeling was used to examine the best fitting model of anxiety sensitivity in a sample of 277 adolescents (M age = 11.0, SD = .81). Consistent with research in adults, the best fitting model consisted of two classes, one containing adolescents with high levels of anxiety sensitivity (n = 25), and another containing adolescents with normative levels of anxiety sensitivity (n = 252). Examination of anxiety sensitivity subscales revealed that the social concerns subscale was not important for classification of individuals. Convergent and discriminant validity of anxiety sensitivity classes were found in that membership in the high anxiety sensitivity class was associated with higher mean levels of anxiety symptoms, controlling for depression and externalizing problems, and was not associated with higher mean levels of depression or externalizing symptoms controlling for anxiety problems. PMID:24749756

  7. Does the Revised Child Anxiety and Depression Scale (RCADS) measure anxiety symptoms consistently across adolescence? The TRAILS study.

    PubMed

    Mathyssek, Christina M; Olino, Thomas M; Hartman, Catharina A; Ormel, Johan; Verhulst, Frank C; Van Oort, Floor V A

    2013-03-01

    We assessed if the Revised Child Anxiety and Depression Scale (RCADS) measures anxiety symptoms similarly across age groups within adolescence. This is crucial for valid comparison of anxiety levels between different age groups. Anxiety symptoms were assessed biennially in a representative population sample (n = 2226) at three time points (age range 10-17 years) using the RCADS anxiety subscales (generalized anxiety disorder [GAD], obsessive-compulsive disorder [OCD], panic disorder [PD], separation anxiety [SA], social phobia [SP]). We examined longitudinal measurement invariance of the RCADS, using longitudinal confirmatory factor analysis, by examining the factor structure (configural invariance), factor loadings (metric invariance) and thresholds (strong invariance). We found that all anxiety subtypes were configural invariant. Metric invariance held for items on the GAD, OCD, PD and SA subscales; yet, for the SP subscale three items showed modest longitudinal variation at age 10-12. Model fit decreased modestly when enforcing additional constraints across time; however, model fit for these models was still adequate to excellent. We conclude that the RCADS measures anxiety symptoms similarly across time in a general population sample of adolescents; hence, measured changes in anxiety symptoms very likely reflect true changes in anxiety levels. We consider the instrument suitable to assess anxiety levels across adolescence.

  8. [Attachment Patterns and their Relation to the Development of Anxiety Symptoms in Childhood and Adolescence].

    PubMed

    Achtergarde, Sandra; Müller, Jörg Michael; Postert, Christian; Wessing, Ida; Mayer, Andreas; Romer, Georg

    2015-01-01

    From the perspective of attachment theory, insecure attachment can be seen as a key risk factor for the development of anxiety symptoms and anxiety disorders. This systematic review addresses the current state of empirical research on the relationship between attachment status and anxiety symptoms respective anxiety disorders in childhood and adolescence. 21 current international studies published between 2010 and 2014 were included in this systematic review. These studies were heterogeneous in target populations, methods and study design. The majority of studies supported the assumed correlation between insecure attachment and anxiety symptoms or anxiety disorders. These findings are more evident in studies with school-age children than with preschool children or adolescents. Furthermore, the disorganized-disoriented type of attachment seems to be a particular risk factor for the development of anxiety symptoms and anxiety disorders. Results were discussed in relation to attachment theory and with reference to the results of previous relevant reviews.

  9. Generalized anxiety disorder -- self-care

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000685.htm Generalized anxiety disorder - self-care To use the sharing features on this page, please enable JavaScript. Generalized anxiety disorder (GAD) is a mental condition in which you ...

  10. Clinical and autonomic functions: a study of childhood anxiety disorders

    PubMed Central

    Sharma, Rajiv Kumar; Sagar, Rajesh; Deepak, K. K.; Mehta, Manju; Balhara, Yatan Pal Singh

    2011-01-01

    BACKGROUND AND OBJECTIVES: Childhood and adolescent anxiety is generally associated with a varied somatic symptom pattern thought to reflect autonomic system activity. Few studies have examined the autonomic characteristics of generalized anxiety disorder (GAD). This omission is at odds with contemporary models of autonomic cardiovascular control. The current study aimed to find differences in autonomic functions between children with a diagnosis of childhood anxiety disorder and a control group using a case-control design. DESIGN AND SETTING: A cross sectional experimental study conducted in the years 2004-2005 in the psycho-physiology lab of a tertiary care multi-speciality teaching hospital. METHODS: Assessments were carried out using a semistructured interview, K-SADS (Schedule for Affective Disorders and Schizophrenia for Children and Adolescents); STAIC (State and Trait Anxiety Inventory for Children); CDRS (Childhood Depression Rating Scales); SCARED (Self-Report for Childhood Anxiety–Related Disorders). Autonomic reactivity was tested using the standard battery of tests. RESULTS: There were differences between 34 children and adolescents (age range, 8-18 years) with a diagnosis of childhood anxiety disorder and a control group of 30 age- and sex-matched subjects from a nearby school in autonomic activity and reactivity between individuals with anxiety disorder and non-anxious control subjects. Our finding is suggestive of autonomic rigidity or diminished physiologic flexibility in children with anxiety disorder CONCLUSIONS: The study is probably the first of its kind to look into the issue in detail using a detailed battery of the autonomic function tests, and the results are of help in better understanding the condition. The result of the present experiment supports differences in autonomic activity and reactivity between individuals with anxiety disorder and non-anxious control subjects. PMID:21623053

  11. Psychometric Properties of the Spence Children's Anxiety Scale (SCAS) in Cypriot Children and Adolescents

    ERIC Educational Resources Information Center

    Essau, Cecilia A.; Anastassiou-Hadjicharalambous, Xenia; Munoz, Luna C.

    2011-01-01

    The Spence Children's Anxiety Scale (SCAS) is a 38-item self-report questionnaire which measures symptoms of DSM-IV anxiety disorders in children and adolescents. This study examined the psychometric properties of the Greek translation of SCAS in a large community sample of children and adolescents (N = 1,072), aged 12-17 years, in the…

  12. 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…

  13. Anxiety response and restraint-induced stress differentially affect ethanol intake in female adolescent rats.

    PubMed

    Acevedo, María Belén; Fabio, Maria Carolina; Fernández, Macarena Soledad; Pautassi, Ricardo Marcos

    2016-10-15

    Anxiety disorders are more likely to occur in women than in men, usually emerge during adolescence and exhibit high comorbidity with alcohol use disorders (AUD). Adolescents with high levels of anxiety or heightened reactivity to stress may be at-risk for developing AUD. An approach to analyze if high levels of inborn anxiety predict greater ethanol drinking is to assess the latter variable in subjects classified as high- or low-anxiety responders. The present study assessed ethanol drinking in adolescent, female Wistar, rats classified as high-, low- or average-anxiety responders and exposed or not to restraint stress (RS, Exp. 1). Classification was made through a multivariate index derived from testing anxiety responses in an elevated plus maze and a light-dark box tests. RS was applied after animals had been initiated to ethanol drinking. Intake of sweetened ethanol was unaffected by level of anxiety response. Adolescents with high levels of inborn anxiety exhibited significantly higher intake of unsweetened ethanol than counterparts with standard levels of anxiety, yet this effect was inhibited by RS exposure. Experiment 2 assessed FOS immunoreactivity after RS. Stress induced a significant increase in FOS immunoreactivity at the paraventricular nucleus, yet this effect was unaffected by level of anxiety response. Female adolescents with high levels of basal anxiety may be at-risk for exhibiting increased predisposition for ethanol intake and preference. The study also indicates that stress may exert differential effects on adolescent ethanol intake as a function of the level of anxiety response.

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

    PubMed Central

    Johnco, Carly; Storch, Eric A.

    2016-01-01

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

  15. Psychotherapy for Anxiety in Children With Autism Spectrum Disorder

    ClinicalTrials.gov

    2016-11-28

    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

  16. Antisocial personality disorder and anxiety disorder: a diagnostic variant?

    PubMed

    Coid, Jeremy; Ullrich, Simone

    2010-06-01

    Antisocial personality disorder (ASPD) with co-morbid anxiety disorder may be a variant of ASPD with different etiology and treatment requirements. We investigated diagnostic co-morbidity, ASPD criteria, and anxiety/affective symptoms of ASPD/anxiety disorder. Weighted analyses were carried out using survey data from a representative British household sample. ASPD/anxiety disorder demonstrated differing patterns of antisocial criteria, co-morbidity with clinical syndromes, psychotic symptoms, and other personality disorders compared to ASPD alone. ASPD criteria demonstrated specific associations with CIS-R scores of anxiety and affective symptoms. Findings suggest ASPD/anxiety disorder is a variant of ASPD, determined by symptoms of anxiety. Although co-morbid anxiety and affective symptoms are the same as in anxiety disorder alone, associations with psychotic symptoms require further investigation.

  17. 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

  18. Over-generalization in youth with anxiety disorders.

    PubMed

    El-Bar, Nurit; Laufer, Offir; Yoran-Hegesh, Roni; Paz, Rony

    2017-02-01

    Over-generalization of dangerous stimuli is a possible etiological account of anxiety. Recently, we demonstrated it could result from alterations in early perceptual mechanisms, i.e., a fundamental change in the way the stimulus is perceived. Yet it is still unclear if these mechanisms already exist in youth, or develop only later. The purpose of this study was therefore to explore the mechanism of generalization in youth suffering from anxiety disorders. Children and adolescents with anxiety disorders and age-matched control participants underwent a conditioning task where a loss or gain outcome was associated with two well-separated tones. A generalization probe then followed in which different surrounding tones were presented and classified. Generalization curves and changes in discrimination abilities were compared between groups and according to the background variables. We found that patients had lower perceptual discrimination thresholds after conditioning, and tended to have wider generalization curve. Relative enhanced generalization was observed in adolescents with anxiety, in males, and as the level of anxiety rose. Our results suggest that over-generalization in anxiety can start already during adolescence, and may suggest that an early perceptual source can give rise to later more cognitive over-generalization during adult anxiety.

  19. Social Anxiety Scale for Adolescents (SAS-A): Measuring Social Anxiety among Finnish Adolescents

    ERIC Educational Resources Information Center

    Ranta, Klaus; Junttila, Niina; Laakkonen, Eero; Uhmavaara, Anni; La Greca, Annette M.; Niemi, Paivi M.

    2012-01-01

    The aim of this study was to investigate symptoms of social anxiety and the psychometric properties of the "Social Anxiety Scale for Adolescents" (SAS-A) among Finnish adolescents, 13-16 years of age. Study 1 (n = 867) examined the distribution of SAS-A scores according to gender and age, and the internal consistency and factor structure…

  20. Recent developments in anxiety disorders.

    PubMed

    Christmas, David M; Hood, Sean D

    2006-11-01

    Anxiety disorders are common and debilitating mental illnesses. Current pharmacological treatments are beset by problems of poor efficacy and side effect profiles. Increasing understanding of novel neurotransmitter systems and the interplay between these systems is broadening the scope of anxiolytic drug treatment. This article aims to describe the areas of current interest and possible future development of anxiolytic drugs by outlining recent patents in this field. A patent database was searched for 17 neurotransmitters and their synonyms as well as 23 compounds of recent known interest from May 2003 to May 2005. The internet resources Pubmed and Google Scholar were searched for peer reviewed literature using the same search parameters. Results were grouped into neurotransmitter systems to present an overview of recent developments in the neuropharmacology of anxiety disorders.

  1. A Randomized Controlled Trial of Online versus Clinic-Based CBT for Adolescent Anxiety

    ERIC Educational Resources Information Center

    Spence, Susan H.; Donovan, Caroline L.; March, Sonja; Gamble, Amanda; Anderson, Renee E.; Prosser, Samantha; Kenardy, Justin

    2011-01-01

    Objective: The study examined the relative efficacy of online (NET) versus clinic (CLIN) delivery of cognitive behavior therapy (CBT) in the treatment of anxiety disorders in adolescents. Method: Participants included 115 clinically anxious adolescents aged 12 to 18 years and their parent(s). Adolescents were randomly assigned to NET, CLIN, or…

  2. 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…

  3. Anxiety in adolescence. Can we prevent it?

    PubMed Central

    Malonda, Elisabeth; Samper, Paula

    2017-01-01

    Background Emotions are potent modulators and motivators of the behaviour that the individual displays in the different situations they have to live and they can act as a protection factor or vulnerability of the adapted or maladaptive behaviour. This study focuses on anxiety in adolescence. Objectives. The objective is, through a longitudinal study, to analyse the psychological processes and emotions that facilitate the symptoms of anxiety and those which protect the adolescent from these symptoms. Material and Methods 417 adolescents (192 boys and 225 girls) participated in a three-wave longitudinal study in Valencia, Spain. In the first wave, adolescents were either in the third year of secondary school (81 boys and 85 girls) or the fourth year of secondary school (111 boys and 140 girls). The mean age was 14.70 (SD = 0.68; range = 13-17 years). This study monitored participating adolescents for three years. Results The results indicate a differential profile in the evaluated emotions according to sex, with the girls being the ones to experiment more anxiety and more empathy, while the boys show more emotional instability and aggression. Conclusions It is concluded that the best predictors for anxiety are anger state, aggressive behaviour, empathic concern together with the lack of coping mechanisms focused on problem solving and the perception of stress as a threat. Key words:Adolescence, anxiety, emotions, coping, stress. PMID:27988785

  4. Eating Disordered Adolescent Males.

    ERIC Educational Resources Information Center

    Eliot, Alexandra O.; Baker, Christina Wood

    2001-01-01

    Described a sample of eating disordered adolescent males who were seen for treatment at Boston Children's Hospital Outpatient Eating Disorders Clinic. Findings suggest the idea that clinicians, coaches, peers, and family should encourage young men to share concerns about body image and weight at an earlier, less severe juncture, with the assurance…

  5. An examination of the tripartite model of anxiety and depression in an outpatient sample of adolescents.

    PubMed

    Dia, David A; Harrington, Donna; Silverman, Wendy K

    2010-07-01

    Anxiety and depressive disorders are the most common mental health problems for adolescents; understanding their etiology and course is necessary for developing effective prevention and treatment programs. The tripartite model of anxiety and depression was evaluated in a random, clinical sample of 185 adolescents, with an average age of 15.09 years (SD = 1.9), with 58.4% males (n = 108). Survey packets were mailed to participants (61% response rate). Two models were evaluated: (a) Model one fit adequately, however, modification indices and prior research and theory suggested adding paths between anxiety and depression. (b) Model two tested paths between anxiety and depression; this revised model fit the data well, suggesting a relationship from anxiety to depression. Further, physiological hyperarousal may be a distinct component for anxiety and negative affectivity may be a general risk factor for anxiety and depression in adolescents. The findings that different factors contribute to the cause of anxiety and depression have implications for practice.

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  7. Post-Traumatic Stress Disorder, Depression, and Anxiety among Gaza Strip Adolescents in the Wake of the Second Uprising (Intifada)

    ERIC Educational Resources Information Center

    Elbedour, Salman; Onwuegbuzie, Anthony J.; Ghannam, Jess; Whitcome, Janine A.; Hein, Fadel A.

    2007-01-01

    Objective: Children and adolescents of the Gaza Strip have been subjected to continuous violence since the eruption of the second Intifada (Uprising). Little is known, however, about the psychological effects of this violence on children and adolescents of Gaza. Thus, the purpose of the present investigation was to evaluate and describe the…

  8. Cognitive-Behavioral Treatment versus an Active Control for Children and Adolescents with Anxiety Disorders: A Randomized Trial

    ERIC Educational Resources Information Center

    Hudson, Jennifer L.; Rapee, Ronald M.; Deveney, Charise; Schniering, Carolyn A.; Lyneham, Heidi J.; Bavopoulos, Nataly

    2009-01-01

    Specific delivery of cognitive-behavioral skills is more effective in treating childhood anxiety compared to treatment that contains only nonspecific therapy factors. The findings are based on a randomized trial involving 112 children aged 7-16 years.

  9. 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.

  10. 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

  11. Homotypic versus Heterotypic Continuity of Anxiety Symptoms in Young Adolescents: Evidence for Distinctions between DSM-IV Subtypes

    ERIC Educational Resources Information Center

    Ferdinand, Robert F.; Dieleman, Gwen; Ormel, Johan; Verhulst, Frank C.

    2007-01-01

    Objective: To investigate homotypic and heterotypic longitudinal patterns of symptoms of separation anxiety disorder (SAD), generalized anxiety disorder (GAD), social phobia (SoPh), panic disorder (PD), and obsessive compulsive disorder (OCD) in young adolescents from the Dutch general population. Method: 2,067 individuals (51.4% girls) from a…

  12. Anxious and aggressive: the co-occurrence of IED with anxiety disorders

    PubMed Central

    Keyes, Katherine M.; McLaughlin, Katie A.; Vo, Thomas; Galbraith, Todd; Heimberg, Richard G.

    2015-01-01

    Background Evidence suggests that impulsive aggression and explosive anger are common among individuals with anxiety disorders; yet, the influence of IED on the onset, course, consequences, and patterns of comorbidity among those with anxiety disorders is unknown. Methods Data were drawn from the National Comorbidity Survey Replication (N=9,282) and Adolescent Supplement (N=9,632), nationally representative surveys conducted between 2001–2004. Diagnoses were based on structured lay-administered interviews. Lifetime diagnoses assessed with structured instruments. Outcomes included comorbidity, functional and role impairment, and treatment utilization. Results Adolescents with a lifetime anxiety disorder had a higher prevalence of a lifetime anger attacks (68.5%) and IED (22.9%) than adolescents without a lifetime anxiety disorder (48.6% and 7.8%, respectively), especially social phobia and panic disorders. Similar elevation was found for adults. Age of onset and course of anxiety disorders did not differ by IED. Severe functional impairment associated with anxiety was higher among adolescents (39.3%) and adults (45.7%) with IED than those without IED (29.2% and 28.2%, respectively). Comorbidity for all other disorders was elevated. However, individuals with anxiety disorders and IED were no more likely to use treatment services than those with anxiety disorders without IED. Conclusions Individuals with IED concomitant to anxiety disorder, especially social phobia and panic, are at marked risk for worse functional impairment and a higher burden of comorbidity, but onset and course of anxiety disorder do not differ, and those with anxiety and IED are no more likely to utilize treatment services. Assessment, identification, and specialized treatment of anger in the context of anxiety disorders are critical to reducing burden. PMID:26422701

  13. Eating Disorders in Adolescent Males

    ERIC Educational Resources Information Center

    Ray, Shannon L.

    2004-01-01

    Research indicates that the primary onset of eating disorders occurs in adolescence and that there is a growing prevalence of adolescent males with eating disorders. This article describes the eating disorders of anorexia nervosa and bulimia nervosa as they relate to adolescent males. Diagnostic criteria, at-risk groups, and implications for…

  14. Consultants’ Perceptions of School Counselors’ Ability to Implement an Empirically-Based Intervention for Adolescent Social Anxiety Disorder

    PubMed Central

    Warner, Carrie Masia; Brice, Chad; Esseling, Petra G.; Stewart, Catherine E.; Mufson, Laura; Herzig, Kathleen

    2013-01-01

    Social anxiety is highly prevalent but goes untreated. Although school-based CBT programs are efficacious when delivered by specialized psychologists, it is unclear whether school counselors can implement these interventions effectively, which is essential to promote sustainable school programs. We present an initial consultation strategy to support school counselor implementation of group CBT for social anxiety and an evaluation of counselors’ treatment fidelity. Counselors were highly adherent to the treatment, but competence varied based on measurement. Counselors and consultants demonstrated good agreement for adherence, but relatively modest correspondence in competence ratings. We discuss future directions for school-based implementation efforts informed by these initial findings. PMID:23716144

  15. 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.

  16. Testing the specificity between social anxiety disorder and drinking motives.

    PubMed

    Windle, Michael; Windle, Rebecca C

    2012-09-01

    This study tested the specificity of the relationship between social anxiety disorder (SAD) and coping drinking motives (versus enhancement drinking motives and social drinking motives) within the context of a range of potentially confounding variables measured during adolescence (e.g., quantity and frequency of alcohol use, coping drinking motives) and substantively important variables assessed during young adulthood (e.g., other anxiety disorders and major depressive disorder). A sample of high school sophomores and juniors (n=717) completed measures of substance use and risk factors during adolescence and were then prospectively followed-up in early- and middle-young adulthood, and psychiatric diagnoses and drinking motives (i.e., coping, enhancement, and social) were assessed each time. Findings indicated that SAD was specifically related to coping motives (measured during early-to-middle young adulthood) after controlling for the effects of a range of alcohol and mental health variables. In addition, adolescent variables predicted young adult drinking motives as did major depressive disorder and other anxiety disorders. These findings are discussed within a conceptual framework of the functional role (e.g., self-medication) that drinking motives, and especially coping drinking motives, may play in the etiology of alcohol problems and disorders. Implications for prevention and treatment interventions are discussed.

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  18. 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…

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  20. The Pathogenesis of Childhood Anxiety Disorders: Considerations from a Developmental Psychopathology Perspective

    ERIC Educational Resources Information Center

    Muris, Peter

    2006-01-01

    Anxiety disorders are among the most prevalent psychiatric problems in children and adolescents. The present article summarizes the main evidence that has accumulated on the pathogenesis of childhood anxiety disorders during the past two decades. Various risk and vulnerability factors (e.g., genetics, behavioral inhibition, disgust sensitivity,…

  1. Anxiety symptoms in Chinese and German adolescents: their relationship with early learning experiences, perfectionism, and learning motivation.

    PubMed

    Essau, Cecilia A; Leung, Patrick W L; Conradt, Judith; Cheng, Halina; Wong, Tiffany

    2008-01-01

    The main aim of this study was to compare the frequency and correlates of DSM-IV anxiety disorder symptoms among non-referred adolescents in Germany and in Hong Kong. A total of 1,022 adolescents (594 from Germany and 428 from Hong Kong) between the ages of 12 and 17 years were investigated. Results showed that adolescents in Hong Kong reported significantly higher levels of anxiety symptoms than adolescents in Germany. Anxiety symptoms showed different correlates in different cultures. Specifically, academic motivational goals to compete to get good grades and to be rewarded for their performance correlated significantly with anxiety symptoms in Hong Kong. In Germany, anxiety symptoms correlated significantly with reinforcement received for anxiety-related problems (i.e., instrumental learning) and with parental verbal transmission about the danger of anxiety (i.e., informational learning). The findings underscore the importance of cultural factors on adolescent's anxiety.

  2. Factor Structure of the Screen for Child Anxiety-Related Emotional Disorders (SCARED) in a Community Sample of Hong Kong Chinese Adolescents.

    PubMed

    Chan, Siu Mui; Leung, Chi Hung

    2015-10-01

    The current study tested the factor structure of the 41-item SCARED in assessing anxiety in a sample of Hong Kong adolescents. Data were collected from 5,226 youths (54.5 % boys) aged 12-18. Results showed that the scale and the five subscales had high internal consistency. However, confirmatory factor analyses showed that the original five-factor model did not fit the data collected in this sample. Instead, the results revealed a seven-factor model consisting of one second-order factor of anxiety and seven first-order factors: the four original factors of General Anxiety, Panic/Somatic Syndromes, Social Anxiety, and School Phobia and three new factors representing different aspects of Separation Anxiety. Group invariance in the Boys and Girls models was found. It is recommended that the three new factors (Fear of Loneliness, Separation Fear, Worry about Harm) be further developed by adding new items so as to enhance the content and construct validities of the SCARED when used with Hong Kong adolescents.

  3. Common comorbidities seen in adolescents with attention-deficit/hyperactivity disorder.

    PubMed

    Young, Joel

    2008-08-01

    This article provides an overview of key research on significant comorbidities that occur among adolescents with attention-deficit/hyperactivity disorder, including disruptive behaviors. Such comorbidities include oppositional defiant disorder and conduct disorder, as well as depressive disorders, anxiety disorders, personality disorders, suicidality, eating disorders, sleep disorders, learning disabilities, Internet "addiction," tic disorders, new-onset pediatric epilepsy, and celiac disease.

  4. 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…

  5. 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

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

    PubMed Central

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  8. Vitamin D in anxiety and affective disorders.

    PubMed

    Bičíková, M; Dušková, M; Vítků, J; Kalvachová, B; Řípová, D; Mohr, P; Stárka, L

    2015-01-01

    Reduced levels of vitamin or its metabolites have been reported in various psychiatric disorders. Insufficient levels of vitamin D in depressive patients have been confirmed by many authors, but there have been conflicting results in subjects with anxiety disorders. In the present cross-sectional study, levels of calcidiol were determined in groups of depressive men and women and in men and women with anxiety disorders and compared with age matched controls. Significantly lower levels of calcidiol were found in men and women with depression as well as in age matched patients with anxiety disorders.

  9. Generalized Anxiety Symptoms and Identity Processes in Cross-Cultural Samples of Adolescents from the General Population

    ERIC Educational Resources Information Center

    Crocetti, Elisabetta; Hale, William W., III.; Dimitrova, Radosveta; Abubakar, Amina; Gao, Cheng-Hai; Agaloos Pesigan, Ivan Jacob

    2015-01-01

    Background: Approximately 20% of adolescents around the world experience mental health problems, most commonly depression or anxiety. High levels of anxiety disorder symptoms can hinder adolescent development, persist into adulthood, and predict negative mental outcomes, such as suicidal ideation and attempts. Objectives: We analyzed generalized…

  10. Positive thinking in anxiety disordered children reconsidered.

    PubMed

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

    2012-01-01

    Negatively valenced thoughts are assumed to play a central role in the development and maintenance of anxiety. However, the role of positive thoughts in anxiety is rather unclear. In the current study we examined the role of negative and positive self-statements in the anxiety level of anxious and non-anxious children. Participants were 139 anxiety disordered children and 293 non-anxious children (8-18 years). Compared to non-anxious children, anxious children reported more negative thoughts, less positive thoughts and lower State of Mind (SOM) ratios (ratio of positive to negative thoughts). Negative thoughts and SOM ratios were the strongest predictors of anxiety level in anxious children; whereas both negative and positive thoughts were the strongest predictors of anxiety level in non-anxious children. To conclude, a lack of positive thoughts might be more than just an epiphenomenon of anxiety level and might deserve a place in the cognitive model of anxiety.

  11. Screening utility of the social anxiety screening scale in Spanish speaking adolescents.

    PubMed

    Piqueras, José Antonio; Olivares, José; Hidalgo, María Dolores

    2012-07-01

    The aim of this study was to analyse the screening utility of the Social Anxiety Screening Scale (SASS/EDAS) in a sample of 227 adolescents with social anxiety disorder and 156 Without it (14-17 years). Results showed that the EDAS subscales (Avoidance, Distress and Interference) scores were reliable in terms of internal consistency (alpha > .80). All the subscales discriminated between adolescents with and without the disorder. They also showed a positive and significant correlation with other empirically validated measures of social anxiety. The three subscales indicated relevant sensitivity (69.16-84.14%), specificity (63.46-66.03%) and areas under the curve (.74-.81%). Binary logistic regression analyses indicated the adequate predictive utility of EDAS subscales, with the Distress subscale as the best diagnostic predictor. The data provide empirical evidence of the usefulness of EDAS as a screener for adolescent social anxiety disorder in terms of reliability, convergent and discriminant validity, diagnostic accuracy and clinical usefulness.

  12. Preventing Adolescent Social Anxiety and Depression and Reducing Peer Victimization: Intervention Development and Open Trial

    ERIC Educational Resources Information Center

    La Greca, Annette M.; Ehrenreich-May, Jill; Mufson, Laura; Chan, Sherilynn

    2016-01-01

    Background: Social anxiety disorder (SAD) and depression are common among adolescents, frequently comorbid, and resistant to change. Prevention programs for adolescent SAD are scant, and depression prevention programs do not fully address peer-risk factors. One critical peer-risk factor for SAD and depression is peer victimization. We describe the…

  13. Psychiatric Disorders Associated with the Onset and Persistence of Bulimia Nervosa and Binge Eating Disorder during Adolescence.

    ERIC Educational Resources Information Center

    Zaider, Talia I.; Johnson, Jeffrey G.; Cockell, Sarah J.

    2002-01-01

    Conducted a prospective longitudinal study to investigate whether anxiety, depressive, personality, or substance abuse disorders increase risk for onset of bulimia nervosa (BN) or binge eating disorder (BED) during adolescence. Findings for 201 adolescents suggest that adolescents with chronic depressive symptoms may be at elevated risk for the…

  14. 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

  15. Depression, anxiety and suicidal behaviour in children and adolescents with Haemophilia.

    PubMed

    Ghanizadeh, A; Baligh-Jahromi, P

    2009-03-01

    It was aimed to study the prevalence of major depressive disorder, separation anxiety disorder and suicidal behaviour in the children and adolescents with haemophilia. A total of 83 children and adolescents with haemophilia A or B aged 5-19 years old were randomly selected using systematic random sampling method. They were interviewed using the Farsi (Persian) version of Kiddie Schedule for Affective Disorders and Schizophrenia by face-to-face interview with the subjects and their primary caregivers, according to the DSM-IV diagnostic criteria. Major depressive disorder, separation anxiety disorder and suicidal behaviour were surveyed. The rate of major depressive disorder was 6.0%. Approximately 2.4% of the patients were suffering from at least five symptoms of major depression, and 4.8% were suffering from more than five symptoms of major depressive disorder. One-third of the children and adolescents were suffering from irritability. Approximately 36% of the subjects wished to die at least once during the last 6 months. Also, 6% of the subjects had thought about suicidal attempt. Approximately 4.8% of them met the criteria of separation anxiety disorder. The incidences of major depressive disorder and separation anxiety disorder were comparable to that prevalent in the thalassaemic patients. The proportion of patients with death wish was very high. The proportion of patients with suicidal thought and attempt was much lower than that in the children and adolescents with thalassaemia. Therefore, psychiatric consultation needs to be included in the management of these children.

  16. High anxieties: the social construction of anxiety disorders.

    PubMed

    Dowbiggin, Ian R

    2009-07-01

    Anxiety has always been part of the human condition, with accounts of its various manifestations, including acute shyness and stage fright, dating back to classical antiquity. Nonetheless, since the end of the Second World War, reported levels of anxiety have risen alarmingly. At the beginning of the 21st century, anxiety disorders constitute the most prevalent mental health problem around the globe, afflicting millions of people. What social factors account for this stunning development in the mental health field during the past half century? Some observers target the ever increasing pace and demands of modern life. Nonetheless, a larger body of evidence suggests that the prevalence of anxiety is due less to these pressures themselves than to a prevailing social ethos that teaches people that anxiety-related symptoms are a socially and medically legitimate response to life in the modern age.

  17. Recognizing and treating anxiety disorders in children.

    PubMed

    Kelly, Maria N

    2005-02-01

    Anxiety disorders are a common group of disorders that must be recognized more frequently by pediatricians. Outcomes can be very successful with prompt recognition and early treatment. For this reason, it is important that pediatricians recognize their central role in integrating sociological, psychological, and biological approaches to treatment. Pediatricians are vital for initial assessment, interventions, management of psychotherapeutic and pharmacotherapeutic treatments, and referral to psychiatrists and psychologists when necessary. An improved understanding of anxiety disorders by pediatricians will lead to improved diagnosis and improved quality of life for many undiagnosed pediatric patients suffering from anxiety.

  18. The trajectories of adolescent anxiety and depressive symptoms over the course of a transdiagnostic treatment.

    PubMed

    Queen, Alexander H; Barlow, David H; Ehrenreich-May, Jill

    2014-08-01

    Anxiety and depressive disorders commonly co-occur during adolescence, share multiple vulnerability factors, and respond to similar psychosocial and pharmacological interventions. However, anxiety and depression may also be considered distinct constructs and differ on some underlying properties. Prior research efforts on evidence-based treatments for youth have been unable to examine the concurrent trajectories of primary anxiety and depressive concerns across the course of treatment. The advent of transdiagnostic approaches for these emotional disorders in youth allows for such examination. The present study examined the separate trajectories of adolescent anxiety and depressive symptoms over the course of a transdiagnostic intervention, the Unified Protocol for the Treatment of Emotional Disorders in Adolescence (UP-A; Ehrenreich et al., 2008), as well as up to six months following treatment. The sample included 59 adolescents ages 12-17 years old (M=15.42, SD=1.71) who completed at least eight sessions of the UP-A as part of an open trial or randomized, controlled trial across two treatment sites. Piecewise latent growth curve analyses found adolescent self-rated anxiety and depressive symptoms showed similar rates of improvement during treatment, but while anxiety symptoms continued to improve during follow-up, depressive symptoms showed non-significant improvement after treatment. Parent-rated symptoms also showed similar rates of improvement for anxiety and depression during the UP-A to those observed for adolescent self-report, but little improvement after treatment across either anxiety or depressive symptoms. To a certain degree, the results mirror those observed among other evidence-based treatments for youth with anxiety and depression, though results hold implications for future iterations of transdiagnostic treatments regarding optimization of outcomes for adolescents with depressive symptoms.

  19. Animal defense strategies and anxiety disorders.

    PubMed

    Shuhama, Rosana; Del-Ben, Cristina M; Loureiro, Sônia R; Graeff, Frederico G

    2007-03-01

    Anxiety disorders are classified according to symptoms, time course and therapeutic response. Concurrently, the experimental analysis of defensive behavior has identified three strategies of defense that are shared by different animal species, triggered by situations of potential, distal and proximal predatory threat, respectively. The first one consists of cautious exploration of the environment for risk assessment. The associated emotion is supposed to be anxiety and its pathology, Generalized Anxiety Disorder. The second is manifested by oriented escape or by behavioral inhibition, being related to normal fear and to Specific Phobias, as disorders. The third consists of disorganized flight or complete immobility, associated to dread and Panic Disorder. Among conspecific interactions lies a forth defense strategy, submission, that has been related to normal social anxiety (shyness) and to Social Anxiety Disorder. In turn, Posttraumatic Stress Disorder and Obsessive-Compulsive Disorder do not seem to be directly related to innate defense reactions. Such evolutionary approach offers a reliable theoretical framework for the study of the biological determinants of anxiety disorders, and a sound basis for psychiatric classification.

  20. Failure Is Not an Option: Risk-Taking Is Moderated by Anxiety and Also by Cognitive Ability in Children and Adolescents Diagnosed with an Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    South, Mikle; Dana, Julianne; White, Sarah E.; Crowley, Michael J.

    2011-01-01

    Understanding hetereogeneity in symptom expression across the autism spectrum disorders (ASD) is a major challenge for identifying causes and effective treatments. In 40 children and adolescents diagnosed with ASD and 37 IQ--and age-matched comparison participants (the TYP group), we found no differences in summary measures on an experimental…

  1. A Replication and Extension of the PEERS Intervention: Examining Effects on Social Skills and Social Anxiety in Adolescents with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Schohl, Kirsten A.; Van Hecke, Amy V.; Carson, Audrey Meyer; Dolan, Bridget; Karst, Jeffrey; Stevens, Sheryl

    2014-01-01

    This study aimed to evaluate the Program for the Education and Enrichment of Relational Skills (PEERS: Laugeson et al. in "J Autism Dev Disord" 39(4):596-606, 2009). PEERS focuses on improving friendship quality and social skills among adolescents with higher-functioning ASD. 58 participants aged 11-16 years-old were randomly assigned to…

  2. Perceived Family Impact of Preschool Anxiety Disorders

    PubMed Central

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

    2014-01-01

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

  3. 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…

  4. Social Anxiety Scale for Adolescents (SAS-A): measuring social anxiety among Finnish adolescents.

    PubMed

    Ranta, Klaus; Junttila, Niina; Laakkonen, Eero; Uhmavaara, Anni; La Greca, Annette M; Niemi, Päivi M

    2012-08-01

    The aim of this study was to investigate symptoms of social anxiety and the psychometric properties of the Social Anxiety Scale for Adolescents (SAS-A) among Finnish adolescents, 13-16 years of age. Study 1 (n = 867) examined the distribution of SAS-A scores according to gender and age, and the internal consistency and factor structure of the SAS-A. In a subsample (n = 563; Study 2) concurrent and discriminant validity of the SAS-A were examined relative to the Social Phobia Inventory and the Beck Depression Inventory. Test-retest stability was examined over a 30-month period by repeated measures every 6 months in another subsample (n = 377; Study 3). Results mostly revealed no gender differences in social anxiety, except that boys reported more general social avoidance and distress than girls. Older adolescents (14-16-year-olds) reported higher social anxiety than younger adolescents (12-13-year-olds). Internal consistency for the SAS-A was acceptable for both genders and for all three SAS-A subscales. Confirmatory factor analysis replicated the original 18-item three-factor structure of the SAS-A, accounting for 61% of the variance between items. Evidence for concurrent and discriminant validity was found. Test-retest stability over 6 months was satisfactory. Results support the reliability and validity of the Finnish adaptation of the SAS-A, and further indicate that gender differences in adolescents' social anxiety may vary across Western countries.

  5. 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.

  6. 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

  7. Study of Anxiety in Parents and Children with Attention Deficit with Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Sánchez, Jose Juan Castro; Bermúdez, M. Olga Escandell; Sevilla, M. del Sol Fortea; Hernán-Pérez, Alejandra Sanjuán

    2015-01-01

    The identification of factors that influence attention deficit/hyperactivity disorder (ADHD) will help to develop intervention strategies for the personal and social adjustment of these individuals. The goal of the study is to assess the perception of anxiety in a group of children and adolescents with ADHD and the anxiety that their parents…

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  9. Child/Adolescent Anxiety Multimodal Study: Evaluating Safety

    PubMed Central

    Rynn, Moira A.; Walkup, John T.; Compton, Scott N.; Sakolsky, Dara J.; Sherrill, Joel T.; Shen, Sa; Kendall, Philip C.; McCracken, James; Albano, Anne Marie; Piacentini, John; Riddle, Mark A.; Keeton, Courtney; Waslick, Bruce; Chrisman, Allan; Iyengar, Satish; March, John S.; Birmaher, Boris

    2015-01-01

    Objective To evaluate the frequency of adverse events (AEs) across four treatment conditions in the Child/Adolescent Anxiety Multimodal Study (CAMS), and to compare the frequency of AEs between children and adolescents. Method Participants ages 7-17 years (M=10.7) meeting the DSM-IV criteria for one or more of the following disorders: separation anxiety disorder, generalized anxiety disorder, or social phobia were randomized (2:2:2:1) to cognitive-behavioral therapy (CBT, n=139), sertraline (SRT, n=133), combination of both (COMB, n=140), or pill placebo (PBO, n=76). AEs were collected via a standardized inquiry method plus a self-report Physical Symptom Checklist (PSC). Results There were no differences between the double-blinded conditions (SRT vs. PBO) for total physical and psychiatric AEs or any individual physical or psychiatric AEs. The rates of total physical AEs were greater in the SRT-alone treatment condition when compared to CBT (p<.01) and COMB (p<.01). Moreover, those who received SRT alone reported higher rates of several physical AEs when compared to COMB and CBT. The rate of total psychiatric AEs was higher in children (≤12 years) across all arms (31.7% vs. 23.1%, p<.05). Total PSC scores decreased over time with no significant differences between treatment groups. Conclusion The results support the tolerability/safety of selective serotonin reuptake inhibitor (SSRI) treatment for anxiety disorders even after adjusting for the number of reporting opportunities leading to no differences in overall rates of AEs. Few differences occurred on specific items. Additional monitoring of psychiatric AEs is recommended in children (≤12 years). PMID:25721183

  10. 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

  11. Social Anxiety Scale for Adolescents: factorial invariance across gender and age in Hispanic American adolescents.

    PubMed

    La Greca, Annette M; Ingles, Candido J; Lai, Betty S; Marzo, Juan C

    2015-04-01

    Social anxiety is a common psychological disorder that often emerges during adolescence and is associated with significant impairment. Efforts to prevent social anxiety disorder require sound assessment measures for identifying anxious youth, especially those from minority backgrounds. We examined the factorial invariance and latent mean differences of the Social Anxiety Scale for Adolescents (SAS-A) across gender and age groups in Hispanic American adolescents (N = 1,191; 56% girls; 15-18 years) using multigroup confirmatory factor analyses. Results indicated that the factorial configuration of the correlated three-factor model of the SAS-A was invariant across gender and age. Analyses of latent mean differences revealed that boys exhibited higher structured means than girls on the Social Avoidance and Distress-General (SAD-General) subscale. On all SAS-A subscales, Fear of Negative Evaluation, Social Avoidance and Distress-New, and SAD-General, estimates of the structured means decreased with adolescent age. Implications for further research and clinical practice are discussed.

  12. Generalized anxiety disorder and medical illness.

    PubMed

    Culpepper, Larry

    2009-01-01

    Patients with generalized anxiety disorder (GAD) often have multiple medical comorbidities. The adrenal system and genetic and environmental factors are intermediaries between anxiety and medical illnesses such as chronic pain conditions and gastrointestinal, cardiovascular, endocrine, and respiratory disorders. Medical disorders associated with anxiety include migraine, rheumatoid arthritis, peptic ulcer disease, irritable bowel syndrome, coronary heart disease, hyperthyroidism, diabetes, asthma, and chronic obstructive pulmonary disorder. Compared to people with pain conditions without GAD, individuals with pain conditions and GAD experience and register pain differently; they also have increased awareness of symptoms. Comorbid medical illnesses may influence treatment choice for GAD. Treatment of anxiety in young patients with GAD needs to be long-term to decrease vulnerability to medical conditions.

  13. Developmental pathways of social avoidance across adolescence: the role of social anxiety and negative cognition.

    PubMed

    Miers, Anne C; Blöte, Anke W; Heyne, David A; Westenberg, P Michiel

    2014-12-01

    It is argued that the adolescent onset of social anxiety disorder (SAD) may be partly attributable to an increase in avoidance of social situations across this period. The current cohort-sequential study investigated developmental pathways of social avoidance in adolescence and examined the explanatory role of social anxiety and negative cognitive processes. A community sample of youth (9-21 years, N=331) participated in a four-wave study. Trajectory analyses revealed two pathways: an increased avoidance pathway and a low avoidance pathway. The pathways were hardly distinguishable at age 9 and they steadily diverged across adolescence. Logistic regression analyses showed that social anxiety and post-event rumination were significantly related to the increased avoidance pathway; anticipatory processing and self-focused attention were not. The findings suggest that adolescence is a key developmental period for the progression of social avoidance among youth who show relatively high levels of social anxiety and post-event rumination.

  14. Core dimensions of anxiety and depression change independently during adolescence.

    PubMed

    Conway, Christopher C; Zinbarg, Richard E; Mineka, Susan; Craske, Michelle G

    2017-02-01

    The developmental trajectories of emotional disorder symptoms during adolescence remain elusive, owing in part to a shortage of intensive longitudinal data. In the present study, we charted the temporal course of the tripartite model of anxiety and depression-which posits an overarching negative affect dimension and specific anhedonia and anxious arousal dimensions-over adolescence and emerging adulthood to construct a developmental map of the core dimensions of emotional disorders. We recruited 604 high school juniors, overselecting those at high risk for emotional disorders, and assessed the tripartite symptom domains 5 times annually. Latent curve modeling revealed that negative affect and anxious arousal declined over follow up, whereas anhedonia did not. Moreover, the correlation in rate of change varied across pairs of symptom domains. Change in negative affect was moderately correlated with change in anxious arousal, but change in anhedonia was not significantly related to change in any other domain. Symptom trajectories, and the pattern of covariation among trajectories, were equivalent across gender and comorbidity status. We discuss implications of these findings for developmental models of anxiety and depression, as well as transdiagnostic frameworks for emotional disorders. (PsycINFO Database Record

  15. Advances in psychotherapy for generalized anxiety disorder.

    PubMed

    Garfinkle, Eric J; Behar, Evelyn

    2012-06-01

    Since the introduction of generalized anxiety disorder into the diagnostic system for psychiatric conditions, scientists have worked to develop effective treatments for the amelioration of chronic, excessive worry. In addition to traditional cognitive-behavioral therapy, more recent advances have focused on treatments targeting intolerance of uncertainty, meta-cognitions, emotion dysregulation, lack of acceptance of internal experiences, and emotional contrasts. This article reviews these therapeutic approaches and summarizes recent publications relevant to the psychological treatment of worry and generalized anxiety disorder.

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

    PubMed

    Ströhle, Andreas

    2009-06-01

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

  17. [Irrational anxiety: obsessive-compulsive disorder].

    PubMed

    Vera, Luis

    2010-06-20

    Obsessive-compulsive disorder is an exemplar of an anxiety disorder where irrational thoughts and compulsive behaviors succeed each other in a mental system where every negative outcome can occur. Affects like doubt and guilt reinforce the need to prevent catastrophic consequences from occurring. Magical thinking replaces logical thoughts. The risk of suicide becomes high when compulsive acts cannot control anxiety. Behavior and cognitive therapy is the most frequent type of psychological help: the principal target is the change of emotional reactions.

  18. Fear of Negative Evaluation Influences Eye Gaze in Adolescents with Autism Spectrum Disorder: A Pilot Study

    ERIC Educational Resources Information Center

    White, Susan W.; Maddox, Brenna B.; Panneton, Robin K.

    2015-01-01

    Social anxiety is common among adolescents with Autism Spectrum Disorder (ASD). In this modest-sized pilot study, we examined the relationship between social worries and gaze patterns to static social stimuli in adolescents with ASD (n = 15) and gender-matched adolescents without ASD (control; n = 18). Among cognitively unimpaired adolescents with…

  19. Chronic unpredictable stress during adolescence causes long-term anxiety.

    PubMed

    Chaby, L E; Cavigelli, S A; Hirrlinger, A M; Caruso, M J; Braithwaite, V A

    2015-02-01

    Exposure to stress during adolescence can cause long-term changes in behavior and cognition. Anxiety diagnoses rise during adolescence and are increased by adverse experiences. Currently, it is unknown how long stress during adolescence alters anxiety in adulthood. We found that rats exposed to chronic unpredictable stress during adolescence expressed altered behavior 6.5 months later; showing increased anxiety in a feeding test in a novel environment. Although behavioral changes indicative of anxiety were detected in late adulthood, the basal levels of fecal corticoid metabolites in prior-stressed rats did not differ from unstressed, control rats.

  20. A Unified, Transdiagnostic Treatment for Adolescents with Chronic Pain and Comorbid Anxiety and Depression

    ERIC Educational Resources Information Center

    Allen, Laura B.; Tsao, Jennie C. I.; Seidman, Laura C.; Ehrenreich-May, Jill; Zeltzer, Lonnie K.

    2012-01-01

    Chronic pain disorders represent a significant public health concern, particularly for children and adolescents. High rates of comorbid anxiety and unipolar mood disorders often complicate psychological interventions for chronic pain. Unified treatment approaches, based on emotion regulation skills, are applicable to a broad range of emotional…

  1. Treatment of anxiety in children and adolescents: using child and adolescent anxiety psychodynamic psychotherapy.

    PubMed

    Silver, Gabrielle; Shapiro, Theodore; Milrod, Barbara

    2013-01-01

    This article presents information on child and adolescent psychodynamic psychotherapy (CAPP). Following a definition of anxiety, the authors present study outcomes of nonpsychodynamic treatment approaches, alone and in combination with psychopharmacologic treatment, then explore psychodynamic approaches. A detailed overview of psychodynamic psychotherapy is presented, along with 2 cases illustrating the use of CAPP in young patients with anxiety. Also presented are tables and boxes summarizing CAPP therapeutic processes and strategies as intervention for anxious youth.

  2. 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.

  3. Cannabis Use Disorder in Adolescence.

    PubMed

    Simpson, Annabelle K; Magid, Viktoriya

    2016-07-01

    Cannabis use in the adolescent population poses a significant threat of addiction potential resulting in altered neurodevelopment. There are multiple mechanisms of treatment of cannabis use disorder including behavioral therapy management and emerging data on treatment via pharmacotherapy. Recognizing the diagnostic criteria for cannabis use disorder, cannabis withdrawal syndrome, and mitigating factors that influence adolescent engagement in cannabis use allows for comprehensive assessment and management in the adolescent population.

  4. Anxiety and depression in children and adolescents with sickle cell disease.

    PubMed

    Benton, Tami D; Ifeagwu, Judith A; Smith-Whitley, Kim

    2007-04-01

    A growing body of evidence suggests that depressive disorders and anxiety disorders are much more prevalent among medically ill children and adolescents when compared with the general population, and that the presence of comorbidity may adversely affect medical outcomes and quality of life. Whereas the prevalence and impact of anxiety and depressive disorders have been described in chronic conditions such as asthma, diabetes, and epilepsy, much less is known about sickle cell disease (SCD), a disorder that affects more than 70,000 Americans, primarily those of African and Mediterranean descent. A hallmark of this disorder is recurrent, acute, and chronic pain that often requires emergency management and hospitalization. Medical advances in the treatment of this illness have transformed SCD from a condition associated with very early morbidity and mortality into a chronic condition of adulthood. This article reviews the evidence describing our knowledge of anxiety and depression in children and adolescents with SCD, its clinical impact, and effectiveness of interventions.

  5. Cross-cultural aspects of anxiety disorders.

    PubMed

    Hofmann, Stefan G; Hinton, Devon E

    2014-06-01

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

  6. 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

  7. 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

  8. Panic Disorder in Children and Adolescents

    MedlinePlus

    ... for Families Guide Panic Disorder In Children And Adolescents No. 50; Updated July 2013 Panic disorder is a common and treatable disorder. Children and adolescents with panic disorder have unexpected and repeated periods ...

  9. Health anxiety symptoms in children and adolescents diagnosed with OCD.

    PubMed

    Villadsen, Anna; Thorgaard, Mette V; Hybel, Katja A; Jensen, Jens Søndergaard; Thomsen, Per H; Rask, Charlotte U

    2017-02-01

    Health anxiety (HA) is an overlooked area in paediatric research. Little is known about the occurrence of HA symptoms in a child and adolescent psychiatric setting, and there are no age-appropriate diagnostic criteria and only limited number of assessment tools. It is therefore likely that HA is seen as part of obsessive-compulsive disorder (OCD) due to construct overlap and the diagnostic uncertainty of HA in this age group. In the present study, the extent of HA symptoms was investigated in 94 children and adolescents with a primary ICD-10 diagnosis of OCD. Self-reported HA symptoms were assessed using the Childhood Illness Attitude Scales. Clinician-rated OCD symptoms and severity were measured using the Children's Yale Brown Obsessive Compulsive Scale. Information on socio-demographics was obtained from the child's/adolescent's medical record. The distribution of HA symptoms resembled a normal curve shifted to the right compared with a normal population of Danish children, and 30 % presented with high HA symptoms. Chi-squared tests were used to examine the proportion of children and adolescents with high HA symptoms in relation to various clinical characteristics. Clinician-rated illness worries and comorbid anxiety disorder were associated with high self-reported HA symptoms. The results contribute to the understanding of how HA and OCD overlap conceptually in young patients and bring attention to the need for improved recognition of OCD patients dominated by illness worries. Further research in the description of childhood HA is important in order to understand whether HA is a distinct disorder early in life.

  10. 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…

  11. Anxiety status affects nicotine- and baclofen-induced locomotor activity, anxiety, and single-trial conditioned place preference in male adolescent rats.

    PubMed

    Falco, Adriana M; McDonald, Craig G; Smith, Robert F

    2014-09-01

    Adolescents have an increased vulnerability to nicotine and anxiety may play a role in the development of nicotine abuse. One possible treatment for anxiety disorders and substance abuse is the GABAB agonist, baclofen. The aim of the present study was to determine the effect of anxiety-like behavior on single-trial nicotine conditioned place preference in adolescent rats, and to assess the action of baclofen. Baclofen was shown to have effects on locomotor and anxiety-like behavior in rats divided into high-anxiety and low-anxiety groups. Baclofen decreased locomotor behavior in high-anxiety rats. Baclofen alone failed to produce differences in anxiety-like behavior, but nicotine and baclofen + nicotine administration were anxiolytic. High- and low-anxiety groups also showed differences in single-trial nicotine-induced place preference. Only high-anxiety rats formed place preference to nicotine, while rats in the low-anxiety group formed no conditioned place preference. These results suggest that among adolescents, high-anxiety individuals are more likely to show preference for nicotine than low-anxiety individuals.

  12. 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.…

  13. Beta-blockers in anxiety disorders.

    PubMed

    Hayes, P E; Schulz, S C

    1987-01-01

    Studies evaluating the antianxiety and antipanic properties of beta-blockers do not support their routine use in treating either generalized anxiety disorder or panic disorder. The use of propranolol for anxiety disorders accompanied by physical symptoms, especially cardiovascular complaints, may be effective in some patients when combined with benzodiazepines or perhaps in some non-responders to conventional treatment. Better designed studies are needed to evaluate the exact role of beta-blocking agents in treating anxiety. The efficacy of propranolol in patients with panic disorder has not been widely researched, but preliminary results have not been encouraging. Propranolol may provide symptomatic relief in some patients with residual somatic complaints (i.e., palpitations and tachycardia), when combined with the patient's ongoing drug regimen. Because beta-blockers may induce depression, they should be used cautiously--if at all--in panic patients with concurrent depressive illness.

  14. Evidence Base Update: 50 Years of Research on Treatment for Child and Adolescent Anxiety.

    PubMed

    Higa-McMillan, Charmaine K; Francis, Sarah E; Rith-Najarian, Leslie; Chorpita, Bruce F

    2016-01-01

    Anxiety disorders are the most common mental health disorder among children and adolescents. We examined 111 treatment outcome studies testing 204 treatment conditions for child and adolescent anxiety published between 1967 and mid-2013. Studies were selected for inclusion in this review using the PracticeWise Evidence-Based Services database. Using guidelines identified by this journal (Southam-Gerow & Prinstein, 2014), studies were included if they were conducted with children and/or adolescents (ages 1-19) with anxiety and/or avoidance problems. In addition to reviewing the strength of the evidence, the review also examined indicators of effectiveness, common practices across treatment families, and mediators and moderators of treatment outcome. Six treatments reached well-established status for child and adolescent anxiety, 8 were identified as probably efficacious, 2 were identified as possibly efficacious, 6 treatments were deemed experimental, and 8 treatments of questionable efficacy emerged. Findings from this review suggest substantial support for cognitive-behavioral therapy (CBT) as an effective and appropriate first-line treatment for youth with anxiety disorders. Several other treatment approaches emerged as probably efficacious that are not primarily CBT based, suggesting that there are alternative evidence-based treatments that practitioners can turn to for children and adolescents who do not respond well to CBT. The review concludes with a discussion of treatments that improve functioning in addition to reducing symptoms, common practices derived from evidence-based treatments, mediators and moderators of treatment outcomes, recommendations for best practice, and suggestions for future research.

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

    PubMed

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

    2014-01-01

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

  16. Irrational Beliefs and Test Anxiety in Turkish School Adolescents

    ERIC Educational Resources Information Center

    Boyacioglu, Nur; Kucuk, Leyla

    2011-01-01

    The purpose of this descriptive and correlational study was to determine the extent to which irrational beliefs of students in early adolescents predict test anxiety. The study sample consisted of 557 students recruited from primary schools in Turkey. The Irrational Beliefs Scale for Adolescents (IBS-A) and the Test Anxiety scale were used as…

  17. Psychometric properties and clinical cut-off scores of the Spanish version of the Social Anxiety Scale for Adolescents.

    PubMed

    Garcia-Lopez, Luis J; Inglés, Cándido J; García-Fernández, José M; Hidalgo, María D; Bermejo, Rosa; Puklek Levpušček, Melita

    2011-01-01

    This study examined the reliability and validity evidence drawn from the scores of the Spanish version of the Slovenian-developed Social Anxiety Scale for Adolescents (SASA; Puklek, 1997; Puklek & Vidmar, 2000) using a community sample (Study 1) and a clinical sample (Study 2). Confirmatory factor analysis in Study 1 replicated the 2-factor structure found by the original authors in a sample of Slovenian adolescents. Test-retest reliability was adequate. Furthermore, the SASA correlated significantly with other social anxiety scales, supporting concurrent validity evidence in Spanish adolescents. The results of Study 2 confirmed the correlations between the SASA and other social anxiety measures in a clinical sample. In addition, findings revealed that the SASA can effectively discriminate between adolescents with a clinical diagnosis of social anxiety disorder (SAD) and those without this disorder. Finally, cut-off scores for the SASA are provided for Spanish adolescents.

  18. Social Anxiety, Stress Type, and Conformity among Adolescents

    PubMed Central

    Zhang, Peng; Deng, Yanhe; Yu, Xue; Zhao, Xin; Liu, Xiangping

    2016-01-01

    Social anxiety and stress type can influence strong conformity among adolescents; however, the interaction between them is not clear. In this study, 152 adolescents were recruited and assigned one of two conditions: an interaction and a judgment condition. In the interaction condition, adolescents with high social anxiety (HSA) were less likely to conform when completing a modified Asch task, compared to adolescents who had low social anxiety. In the judgment condition, adolescents with HSA were more likely to conform to the opinions from the unanimous majority. The results suggest that adolescents with HSA may show different styles of strong conformity with the change of stress type. We believe that socially anxious adolescents avoid potential social situations with weaker conformity, while avoiding negative evaluations from others with stronger conformity. These findings contribute to a better understanding of the social dysfunctions among adolescents with HSA and provide a new direction for clinical interventions. PMID:27242649

  19. Social Anxiety, Stress Type, and Conformity among Adolescents.

    PubMed

    Zhang, Peng; Deng, Yanhe; Yu, Xue; Zhao, Xin; Liu, Xiangping

    2016-01-01

    Social anxiety and stress type can influence strong conformity among adolescents; however, the interaction between them is not clear. In this study, 152 adolescents were recruited and assigned one of two conditions: an interaction and a judgment condition. In the interaction condition, adolescents with high social anxiety (HSA) were less likely to conform when completing a modified Asch task, compared to adolescents who had low social anxiety. In the judgment condition, adolescents with HSA were more likely to conform to the opinions from the unanimous majority. The results suggest that adolescents with HSA may show different styles of strong conformity with the change of stress type. We believe that socially anxious adolescents avoid potential social situations with weaker conformity, while avoiding negative evaluations from others with stronger conformity. These findings contribute to a better understanding of the social dysfunctions among adolescents with HSA and provide a new direction for clinical interventions.

  20. 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

  1. "Social Anxiety Disorder Carved at its Joints": evidence for the taxonicity of social anxiety disorder.

    PubMed

    Weeks, Justin W; Carleton, R Nicholas; Asmundson, Gordon J G; McCabe, Randi E; Antony, Martin M

    2010-10-01

    Previous findings suggest that social anxiety disorder may be best characterized as having a dimensional latent structure (Kollman et al., 2006; Weeks et al., 2009). We attempted to extend previous taxometric investigations of social anxiety by examining the latent structure of social anxiety disorder symptoms in a large sample comprised of social anxiety disorder patients (i.e., putative taxon members) and community residents/undergraduate respondents (i.e., putative complement class members). MAXEIG and MAMBAC were performed with indicator sets drawn from a self-report measure of social anxiety symptoms, the Social Interaction Phobia Scale (Carleton et al., 2009). MAXEIG and MAMBAC analyses, as well as comparison analyses utilizing simulated taxonic and dimensional datasets, yielded converging evidence that social anxiety disorder has a taxonic latent structure. Moreover, 100% of the confirmed social anxiety disorder patients in our overall sample were correctly assigned to the identified taxon class, providing strong support for the external validity of the identified taxon; and k-means cluster analysis results corroborated our taxometric base-rate estimates. Implications regarding the conceptualization, diagnosis, and assessment of social anxiety disorder are discussed.

  2. A Parent-Child Interactional Model of Social Anxiety Disorder in Youth

    ERIC Educational Resources Information Center

    Ollendick, Thomas H.; Benoit, Kristy E.

    2012-01-01

    In this paper, one of the most common disorders of childhood and adolescence, social anxiety disorder (SAD), is examined to illustrate the complex and delicate interplay between parent and child factors that can result in normal development gone awry. Our parent-child model of SAD posits a host of variables that converge to occasion the onset and…

  3. Brain activation during anticipatory anxiety in social anxiety disorder.

    PubMed

    Boehme, Stephanie; Ritter, Viktoria; Tefikow, Susan; Stangier, Ulrich; Strauss, Bernhard; Miltner, Wolfgang H R; Straube, Thomas

    2014-09-01

    Exaggerated anticipatory anxiety during expectation of performance-related situations is an important feature of the psychopathology of social anxiety disorder (SAD). The neural basis of anticipatory anxiety in SAD has not been investigated in controlled studies. The current study used functional magnetic resonance imaging (fMRI) to investigate the neural correlates during the anticipation of public and evaluated speaking vs a control condition in 17 SAD patients and 17 healthy control subjects. FMRI results show increased activation of the insula and decreased activation of the ventral striatum in SAD patients, compared to control subjects during anticipation of a speech vs the control condition. In addition, an activation of the amygdala in SAD patients during the first half of the anticipation phase in the speech condition was observed. Finally, the amount of anticipatory anxiety of SAD patients was negatively correlated to the activation of the ventral striatum. This suggests an association between incentive function, motivation and anticipatory anxiety when SAD patients expect a performance situation.

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

  5. 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.

  6. Epidemiology and management of anxiety in patients with bipolar disorder.

    PubMed

    Kauer-Sant'Anna, Marcia; Kapczinski, Flavio; Vieta, Eduard

    2009-11-01

    Epidemiological and clinical studies have reported a high prevalence of anxiety symptoms in bipolar disorder, either in manic or depressive episodes, although these symptoms do not always meet criteria for a specific anxiety disorder. In addition to anxiety symptoms, bipolar disorder frequently presents with co-morbid axis I conditions, with anxiety disorders being the most common co-morbidity. Therefore, the objective of this article is to review clinical and epidemiological studies that have investigated the association between bipolar disorder and anxiety. Available data on the efficacy of treatments for bipolar disorder and co-morbid anxiety disorders are also reviewed. Existing guidelines do recognize that co-morbid anxiety has a negative impact on the course and outcome of bipolar disorder; however, there have been very few double-blind, controlled trials examining the treatment response of patients with bipolar disorder and co-occurring anxiety disorders. There is some positive evidence for quetiapine, olanzapine in combination with fluoxetine or lithium, and lamotrigine with lithium, and negative evidence for risperidone. Other therapies used for bipolar disorder, including several mood stabilizers, antidepressants, atypical antipsychotics and benzodiazepines, have been shown to reduce anxiety symptoms, but specific data for their effects in patients with anxiety symptoms co-morbid with bipolar disorder are not available. The co-occurrence of anxiety and bipolar disorder has implications for diagnosis, clinical outcome, treatment and prognosis. Careful screening for co-morbid anxiety symptoms and disorders is warranted when diagnosing and treating patients with bipolar disorder.

  7. Eating Disorder Not Otherwise Specified in Adolescents

    ERIC Educational Resources Information Center

    Eddy, Kamryn T.; Doyle, Angela Celio; Hoste, Renee Rienecke; Herzog, David B.; Le Grange, Daniel

    2008-01-01

    A study to examine the kind of eating disorders not otherwise specified (EDNOS) among adolescents encountered during treatment at an outpatient eating disorder clinic is conducted. Results indicate that EDNOS is more predominant among adolescents seeking treatment for eating disorders.

  8. Eating Disorders in Adolescent Athletes.

    ERIC Educational Resources Information Center

    Patel, Dilip R.; Greydanus, Donald E.; Pratt, Helen D.; Phillips, Elaine L.

    2003-01-01

    Reviews research on eating disorders in adolescent athletes, including prevalence, its uncommonness among male athletes, risk factors, medical complications, prevention strategies, and implications for sport and exercise participation, management, and prognosis. (EV)

  9. Interpretation bias modification for youth and their parents: a novel treatment for early adolescent social anxiety.

    PubMed

    Reuland, Meg M; Teachman, Bethany A

    2014-12-01

    Social anxiety is the most prevalent anxiety disorder of late adolescence, yet current treatments reach only a minority of youth with the disorder. Effective and easy-to-disseminate treatments are needed. This study pilot tested the efficacy of a novel, online cognitive bias modification for interpretation (CBM-I) intervention for socially anxious youth and their parents. The CBM-I intervention targeted cognitive biases associated with early adolescents' maladaptive beliefs regarding social situations, and with parents' intrusive behavior, both of which have been theoretically linked with the maintenance of social anxiety in youth. To investigate the efficacy of intervening with parents and/or children, clinically diagnosed early adolescents (ages 10-15; N=18) and their mothers were randomly assigned to one of three conditions: the first targeted early adolescents' cognitive biases related to social anxiety (Child-only condition); the second targeted parents' biases associated with intrusive behavior (Parent-only condition); and the third targeted both youth and parents' biases in tandem (Combo condition). The use of a multiple baseline design allowed for the efficient assessment of causal links between the intervention and reduction in social anxiety symptoms in youth. Results provided converging evidence indicating modest support for the efficacy of CBM-I, with no reliable differences across conditions. Taken together, results suggest that online CBM-I with anxious youth and/or their parents holds promise as an effective and easily administered component of treatment for child social anxiety that deserves further evaluation in a larger trial.

  10. A Meta-Analysis of the Cross-Cultural Psychometric Properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED)

    ERIC Educational Resources Information Center

    Hale, William W.; Crocetti, Elisabetta; Raaijmakers, Quinten A. W.; Meeus, Wim H. J.

    2011-01-01

    Background: Accumulating studies have demonstrated that the Screen for Child Anxiety Related Emotional Disorders (SCARED), a modern youth anxiety questionnaire with scales explicitly designed to map onto specific DSM-IV-TR anxiety disorders, has good psychometric properties for children and adolescents from various countries. However, no study has…

  11. Social Support Seeking and Early Adolescent Depression and Anxiety Symptoms

    ERIC Educational Resources Information Center

    Vélez, Clorinda E.; Krause, Elizabeth D.; McKinnon, Allison; Brunwasser, Steven M.; Freres, Derek R.; Abenavoli, Rachel M.; Gillham, Jane E.

    2016-01-01

    This study examined how social support seeking and rumination interacted to predict depression and anxiety symptoms 6 months later in early adolescents (N = 118; 11-14 years at baseline). We expected social support seeking would be more helpful for adolescents engaging in low rather than high levels of rumination. Adolescents self-reported on all…

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

    PubMed Central

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

    2013-01-01

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

  13. Parenting behaviors in parents with anxiety disorders.

    PubMed

    Turner, Samuel M; Beidel, Deborah C; Roberson-Nay, Roxann; Tervo, Kari

    2003-05-01

    Anxiety disorders are familial, and although considerable evidence supports the role of genetic/biological parameters in their development, these alone do not entirely explain their etiology. In this study, the role of parenting behavior as a possible factor in the transmission of anxiety from parent to child was examined. Using interview, self-report, and direct behavioral observation, behaviors of parents with an anxiety disorder were compared to those of parents without an anxiety disorder on a number of dimensions, but particularly with respect to whether anxious parents actively inhibited their children from engaging in normal age appropriate activities. These behaviors were assessed during routine activities and in a structured non-conflictual play task. Although anxious parents did not overtly restrict their child's behavior in either type of activity, they reported higher levels of distress when their children were engaged in these activities. Similarly, the "emotional climate" in families with an anxious parent differed significantly from families without an anxious parent. The results are discussed in terms of how parenting behaviors might influence the development of maladaptive anxiety via social learning and information transfer, and their heuristic implications.

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

    MedlinePlus

    ... health, money, or family problems. But people with generalized anxiety disorder (GAD) feel extremely worried or feel nervous about ... I find more information? To learn more about generalized anxiety disorder, visit: MedlinePlus (National Library of Medicine) http: / / medlineplus. ...

  15. Generalized Anxiety Disorder: When Worry Gets Out of Control

    MedlinePlus

    ... GAD? Where can I find more information? Share Generalized Anxiety Disorder: When Worry Gets Out of Control Download PDF ... health, money, or family problems. But people with generalized anxiety disorder (GAD) feel extremely worried or feel nervous about ...

  16. Studying Anxiety Disorders | NIH MedlinePlus the Magazine

    MedlinePlus

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

  17. Longitudinal associations between social anxiety symptoms and cannabis use throughout adolescence: the role of peer involvement.

    PubMed

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

    2016-05-01

    There appear to be contradicting theories and empirical findings on the association between adolescent Social Anxiety Disorder (SAD) symptoms and cannabis use, suggesting potential risk as well as protective pathways. The aim of this six-year longitudinal study was to further examine associations between SAD symptoms and cannabis use over time in adolescents from the general population, specifically focusing on the potential role that adolescents' involvement with their peers may have in these associations. Participants were 497 Dutch adolescents (57 % boys; M age = 13.03 at T1), who completed annual self-report questionnaires for 6 successive years. Cross-lagged panel analysis suggested that adolescent SAD symptoms were associated with less peer involvement 1 year later. Less adolescent peer involvement was in turn associated with lower probabilities of cannabis use as well as lower frequency of cannabis use 1 year later. Most importantly, results suggested significant longitudinal indirect paths from adolescent SAD symptoms to cannabis use via adolescents' peer involvement. Overall, these results provide support for a protective function of SAD symptoms in association with cannabis use in adolescents from the general population. This association is partially explained by less peer involvement (suggesting increased social isolation) for those adolescents with higher levels of SAD symptoms. Future research should aim to gain more insight into the exact nature of the relationship between anxiety and cannabis use in adolescents from the general population, especially regarding potential risk and protective processes that may explain this relationship.

  18. 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…

  19. Pharmacotherapy of anxiety disorders: a critical review

    PubMed Central

    Koen, Nastassja; Stein, Dan J.

    2011-01-01

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

  20. Anxiety Disorders in Children: Family Matters

    ERIC Educational Resources Information Center

    Ginsburg, Golda S.; Siqueland, Lynne; Masia-Warner, Carrie; Hedtke, Kristina A.

    2004-01-01

    Accumulating evidence indicates that family/parenting behaviors are associated with the etiology of anxiety disorders in children. This article critically reviews what is known about how family/parenting behaviors have been measured in this literature and presents findings from studies examining the relation between family/parenting constructs and…

  1. A Randomized Controlled Trial of the "Cool Teens" CD-ROM Computerized Program for Adolescent Anxiety

    ERIC Educational Resources Information Center

    Wuthrich, Viviana M.; Rapee, Ronald M.; Cunningham, Michael J.; Lyneham, Heidi J.; Hudson, Jennifer L.; Schniering, Carolyn A.

    2012-01-01

    Objective: Computerized cognitive behavioral interventions for anxiety disorders in adults have been shown to be efficacious, but limited data are available on the use of computerized interventions with young persons. Adolescents in particular are difficult to engage in treatment and may be especially suited to computerized technologies. This…

  2. The Role of Exercise in Reducing Childhood and Adolescent PTSD, Anxiety, and Depression

    ERIC Educational Resources Information Center

    Motta, Robert W.; McWilliams, Meredith E.; Schwartz, Jennifer T.; Cavera, Robert S.

    2012-01-01

    The authors review the role of physical exercise in reducing childhood and adolescent posttraumatic stress disorder, anxiety, and depression. A good deal of the existing research on the influence of exercise in reducing negative emotional states and enhancing perceptions of self-efficacy has been conducted with adult samples. Comparatively few…

  3. 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…

  4. Parent and child agreement on anxiety disorder symptoms using the DISC predictive scales.

    PubMed

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

    2011-06-01

    Growing recognition of the negative impact of anxiety disorders in the lives of youth has made their identification an important clinical task. Multiple perspective assessment (e.g., parents, children) is generally considered a preferred method in the assessment of anxiety disorder symptoms, although it has been generally thought that disagreement between parent and youth ratings of the child's emotions is common. This study examined parent and child reports of the child's anxiety disorder symptoms using the Diagnostic Interview Schedule for Children-Predictive Scales (DISC-PS) in a clinic-referred sample of substance using adolescents. Parents and adolescents (N = 480) who were referred for substance abuse treatment were screened for anxiety disorder symptoms using the DISC-PS at pretreatment. Results suggest similar (low) levels of agreement between the parent report and child report versions as found with other anxiety symptom and anxiety disorder measures. Findings provide data on multi-informant agreement and highlight issues in the use of the DISC-PS to identify anxiety problems in youth.

  5. Differentiating Anxiety and Depression in Relation to the Social Functioning of Young Adolescents With ADHD.

    PubMed

    Becker, Stephen P; Langberg, Joshua M; Evans, Steven W; Girio-Herrera, Erin; Vaughn, Aaron J

    2015-01-01

    The present study examined anxiety and depressive symptoms in relation to the social functioning of young adolescents with attention-deficit/hyperactivity disorder (ADHD) and builds upon prior work by incorporating youths' self-reports of internalizing symptoms and examining distinct anxiety and depression dimensions to increase specificity. Participants were 310 young adolescents (ages 10-14; 71% male, 78% Caucasian) diagnosed with ADHD. Youth provided ratings of anxiety/depression, and parents provided ratings of their own depression. Parents and youth both reported on youths' social skills and perceived social acceptance. Path analyses indicated that above and beyond child demographics, ADHD and oppositional defiant disorder symptom severity, and parents' own depression, self-reported social anxiety and anhedonia were both associated with lower youth-reported social skills and both parent- and youth-reported social acceptance. Negative self-evaluation was associated with poorer parent-reported social skills. Finally, harm avoidance was positively associated with both youth- and parent-reported social skills. A path analysis using comorbid diagnoses (rather than symptom dimensions) indicated that that having a comorbid disruptive behavior disorder or depression diagnosis (but not a comorbid anxiety diagnosis) was associated with poorer parent-reported social functioning. Results demonstrate that the relation between internalizing symptoms and social functioning among young adolescents with ADHD is nuanced, with social anxiety and anhedonia symptoms associated with lower social skills and social acceptance in contrast to harm avoidance being associated with higher ratings of social skills (and unrelated to social acceptance). In terms of comorbid diagnoses, depression is more clearly related than anxiety to poorer social functioning among young adolescents with ADHD. These results point to the importance of attending to specific facets of anxiety and depression in

  6. Intolerance of uncertainty, fear of anxiety, and adolescent worry.

    PubMed

    Dugas, Michel J; Laugesen, Nina; Bukowski, William M

    2012-08-01

    A 5 year, ten wave longitudinal study of 338 adolescents assessed the association between two forms of cognitive vulnerability (intolerance of uncertainty and fear of anxiety) and worry. Multilevel mediational analyses revealed a bidirectional and reciprocal relation between intolerance of uncertainty and worry in which change in one variable partially explained change in the other. Fear of anxiety and worry also showed evidence of a bidirectional relation, although change in fear of anxiety had a much weaker mediational effect on change in worry than vice versa. The findings show that relative to fear of anxiety, intolerance of uncertainty may play a greater role in the etiology of worry in adolescents.

  7. Childhood history of anxiety in adults with panic disorder: association with anxiety sensitivity and comorbidity.

    PubMed

    Otto, M W; Pollack, M H; Rosenbaum, J F; Sachs, G S; Asher, R H

    1994-01-01

    Converging lines of evidence indicate a nonspecific link between childhood anxiety disorders and adult panic disorder. Anxiety sensitivity, defined as the fear of anxiety symptoms, was hypothesized to be a potential mediating variable in this link. This study examined the association among childhood history of anxiety disorders, current anxiety symptoms, and anxiety sensitivity in a sample of 100 patients with panic disorder undergoing treatment. Fifty-five percent of the patients had histories of one or more childhood anxiety disorders. Despite the heterogeneity of symptoms and treatment interventions among these patients, a childhood history of anxiety was associated with comorbid anxiety conditions, agoraphobic avoidance, and anxiety sensitivity scores. Anxiety sensitivity was itself a significant predictor of current severity of illness, but a childhood history of anxiety was not. These findings are consistent with the hypothesis that having an anxiety disorder during childhood is linked with patterns of anxiety and phobic avoidance in adulthood, including the level of anxiety sensitivity in patients with panic disorder.

  8. Psychometric properties and factorial structure of the Spence Children's Anxiety Scale (SCAS) in Spanish adolescents.

    PubMed

    Orgilés, Mireia; Spence, Susan H; Marzo, Juan C; Méndez, Xavier; Espada, José P

    2014-01-01

    The Spence Children's Anxiety Scale is an instrument widely applied in the assessment of the most common anxiety disorders in children and adolescents. This study examines its psychometric properties and the factorial structure in a large community sample of Spanish-speaking adolescents (N = 1,374) aged 13 to 17 years. The scale demonstrated strong internal consistency and good convergent and discriminant validity. Factor analysis confirmed the 6-factor original model, providing a good fit of the data for the Spanish sample. The good psychometric properties support its use by clinicians and researchers, adding evidence to the international empirical support for this measure.

  9. Depression and Anxiety among Transitioning Adolescents and College Students with ADHD, Dyslexia, or Comorbid ADHD/Dyslexia

    ERIC Educational Resources Information Center

    Nelson, Jason M.; Gregg, Noel

    2012-01-01

    Objective: To investigate depressive and anxious symptomatology among transitioning adolescents and college students with ADHD, dyslexia, or comorbid ADHD/dyslexia. Method: Transitioning adolescents and college students with these disorders along with a non-ADHD/dyslexia college sample completed self-report measures of depression and anxiety.…

  10. Interpersonal predictors of early therapeutic alliance in a transdiagnostic cognitive-behavioral treatment for adolescents with anxiety and depression.

    PubMed

    Levin, Laura; Henderson, Heather A; Ehrenreich-May, Jill

    2012-06-01

    The importance of therapeutic alliance in predicting treatment success is well established, but less is known about client characteristics that predict alliance. This study examined alliance predictors in adolescents with anxiety and/or depressive disorders (n=31) who received a transdiagnostic cognitive-behavioral treatment, the Unified Protocol for the Treatment of Emotional Disorders in Youth (Ehrenreich, Buzzella, Trosper, Bennett, & Barlow, 2008) in the context of a larger randomized controlled trial. Alliance was assessed at session three by therapists, clients, and independent observers. Results indicated that alliance ratings across the three informant perspectives were significantly associated with one another, but that pretreatment interpersonal variables (e.g., social support, attachment security, and social functioning in current family and peer relationships) were differentially associated with varying informant perspectives. Adolescent and observer ratings of alliance were both predicted by adolescent self-reports on measures reflecting how they perceive their interpersonal relationships. In addition, adolescent-reported symptom severity at pretreatment predicted observer ratings of alliance such that adolescents who indicated greater anxiety and depressive symptoms were rated as having stronger early alliances by independent observers. Therapists perceived having weaker early alliances with adolescents evidencing clinically significant depression at intake as compared with adolescents diagnosed with anxiety disorders alone. Future research is needed to examine whether identification of relevant interpersonal factors at intake can help improve initial therapeutic engagement and resulting outcomes for the psychosocial treatment of adolescents with anxiety and depressive disorders.

  11. Sex Differences in Internalizing Problems during Adolescence in Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Oswald, Tasha M.; Winter-Messiers, Mary Ann; Gibson, Brandon; Schmidt, Alexandra M.; Herr, Cynthia M.; Solomon, Marjorie

    2016-01-01

    We hypothesized that the double hit conferred by sex and diagnosis increases the risk for internalizing disorders in adolescent females with autism spectrum disorder (ASD). In a sample of 32 adolescents with ASD and 32 controls, we examined the effects of sex, diagnostic factors, and developmental stages on depression and anxiety. A 3-way…

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

    PubMed

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

    2010-02-01

    Interoceptive sensitivity, particularly regarding heartbeat, has been suggested to play a pivotal role in the pathogenesis of anxiety and anxiety disorders. This review provides an overview of methods which are frequently used to assess heartbeat perception in clinical studies and summarizes presently available results referring to interoceptive sensitivity with respect to heartbeat in anxiety-related traits (anxiety sensitivity, state/trait anxiety), panic disorder and other anxiety disorders. In addition, recent neurobiological studies of neuronal activation correlates of heartbeat perception using positron emission tomography (PET), functional magnetic resonance imaging (fMRI) or electroencephalographic (EEG) techniques are presented. Finally, possible clinical and therapeutic implications (e.g., beta-blockers, biofeedback therapy, cognitive interventions and interoceptive exposure) of the effects of heartbeat perception on anxiety and the anxiety disorders and the potential use of interoceptive sensitivity as an intermediate phenotype of anxiety disorders in future neurobiological and genetic studies are discussed.

  13. Psychometric properties of the state-trait anxiety inventory for Asian/Pacific-islander adolescents.

    PubMed

    Hishinuma, E S; Miyamoto, R H; Nishimura, S T; Nahulu, L B; Andrade, N N; Makini, G K; Yuen, N Y; Johnson, R C; Kim, S P; Goebert, D A; Guerrero, A P

    2000-03-01

    Anxiety disorders are said to be universal across all cultures and recent reviews have found relatively high prevalence rates across different countries. However, the experience and interpretation of anxiety are strongly influenced by cultural factors. Demonstrating cross-cultural equivalence of measures of anxiety is essential to assure that comparisons between cultures will result in meaningful interpretations. Despite the State-Trait Anxiety Inventory being the most researched of anxiety measures from a cross-cultural basis, there is a lack of empirical studies on the psychometric properties of the STAI with adolescent Asian/Pacific Islanders. The present study examined the STAI using a large sample of ethnically diverse high school students in Hawaii. In general, a four-factor model (State-Anxiety Absent, State-Anxiety Present, Trait-Anxiety Absent, and Trait-Anxiety Present) provided the best fit based on a series of confirmatory factor analyses. Indicators of internal consistency supported the reliability of the factors and subscales, and the inter-factor correlations reflected positively on the concurrent validity of the different STAI factor and subscale measures. This study suggested cautious use and interpretation of one particular item (Trait Item 14 = I try to avoid facing a crisis or difficulty ), and cautious application of the STAI to Filipino adolescents (particularly Filipino males). Domains for further research are discussed.

  14. Emotion regulation in children with anxiety disorders.

    PubMed

    Suveg, Cynthia; Zeman, Janice

    2004-12-01

    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 Interview (ERI), and mothers reported on their children's emotion regulation using the Emotion Regulation Checklist (ERC). Results indicated that children who met Diagnostic and Statistical Manual for Mental Disorders (4th ed., American Psychiatric Association, 1994) criteria for an anxiety disorder had difficulty managing worried, sad, and anger experiences, potentially due to their report of experiencing emotions with high intensity and having little confidence in their ability to regulate this arousal. These findings indicate that emotion regulation needs to be considered centrally in research with anxious populations.

  15. Pediatric generalized anxiety disorder: epidemiology, diagnosis, and management.

    PubMed

    Keeton, Courtney Pierce; Kolos, Amie C; Walkup, John T

    2009-01-01

    Pediatric generalized anxiety disorder (GAD) is characterized by excessive and uncontrollable worry about a variety of events and is accompanied by physical symptoms such as headaches, tension, restlessness, gastrointestinal distress, and heart palpitations. Symptoms impose marked distress and interfere with social, emotional, and educational functioning. GAD occurs in over 10% of children and adolescents, has an average age of onset of 8.5 years, and is more often reported in girls. Common co-occurring conditions include separation anxiety disorder and social phobia. Assessment involves a multi-informant, multi-method approach involving the child, parents, and school teachers. A clinical interview should be conducted to assess for the three primary ways anxiety presents: behaviors, thoughts, and somatic symptoms. Several semi-structured diagnostic interviews are available, and the Anxiety Disorders Interview Schedule is increasingly used. Rating scales completed by the patient, caregivers, and teachers provide useful information for diagnosis and symptom monitoring. Several scales are available to assess patients for the Diagnostic and Statistical Manual of Mental Disorders (4th Edition) GAD diagnosis; however, instruments generally cannot distinguish children with GAD from children with similar anxiety disorders. Both cognitive-behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs) have demonstrated efficacy for the treatment of pediatric anxiety disorders including GAD. Evidence suggests that the combination of CBT plus sertraline offers additional benefit compared with either treatment alone. With pharmacotherapy, systematic tracking of treatment-emergent adverse events such as headaches, stomach aches, behavioral activation, worsening symptoms, and emerging suicidal thoughts is important. Recommended starting doses are fluvoxamine 25 mg/day, fluoxetine 10 mg/day, and sertraline 25 mg/day, though lower starting doses are possible. Dosing

  16. 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.

  17. Gaining insight into adolescent vulnerability for social anxiety from developmental cognitive neuroscience.

    PubMed

    Caouette, Justin D; Guyer, Amanda E

    2014-04-01

    Social anxiety disorder (SAD) markedly impairs daily functioning. For adolescents, SAD can constrain typical development precisely when social experiences broaden, peers' opinions are highly salient, and social approval is actively sought. Individuals with extreme, impairing social anxiety fear evaluation from others, avoid social interactions, and interpret ambiguous social cues as threatening. Yet some degree of social anxiety can be normative and non-impairing. Furthermore, a temperament of behavioral inhibition increases risk for SAD for some, but not all adolescents with this temperament. One fruitful approach taken to understand the mechanisms of social anxiety has been to use neuroimaging to link affect and cognition with neural networks implicated in the neurodevelopmental social reorientation of adolescence. Although initial neuroimaging studies of adolescent SAD and risk for SAD underscored the role of fear-processing circuits (e.g., the amygdala and ventral prefrontal cortex), recent work has expanded these circuits to include reward-processing structures in the basal ganglia. A growing focus on reward-related neural circuitry holds promise for innovative translational research needed to differentiate impairing from normative social anxiety and for novel ways to treat adolescent SAD that focus on both social avoidance and social approach.

  18. Chronic pain in adolescence and internalizing mental health disorders: a nationally representative study.

    PubMed

    Noel, Melanie; Groenewald, Cornelius B; Beals-Erickson, Sarah E; Gebert, J Thomas; Palermo, Tonya M

    2016-06-01

    Chronic pain in childhood and adolescence has been shown to heighten the risk for depressive and anxiety disorders in specific samples in adulthood; however, little is known about the association between a wider variety of chronic pains and internalizing mental health disorders. Using nationally representative data, the objectives of this study were to establish prevalence rates of internalizing mental health disorders (anxiety and depressive disorders) among cohorts with or without adolescent chronic pain, and to examine whether chronic pain in adolescence is associated with lifetime history of internalizing mental health disorders reported in adulthood. Data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) was used (N = 14,790). Individuals who had chronic pain in adolescence subsequently reported higher rates of lifetime anxiety disorders (21.1% vs 12.4%) and depressive disorders (24.5% vs 14.1%) in adulthood as compared with individuals without a history of adolescent chronic pain. Multivariate logistic regression confirmed that chronic pain in adolescence was associated with an increased likelihood of lifetime history of anxiety disorders (odds ratio: 1.33; 95% confidence interval: 1.09-1.63, P = 0.005) and depressive disorders (odds ratio: 1.38; confidence interval: 1.16-1.64, P < 0.001) reported in adulthood. Future research is needed to examine neurobiological and psychological mechanisms underlying these comorbidities.

  19. Anxiety disorders in fragile X premutation carriers: Preliminary characterization of probands and non-probands

    PubMed Central

    Cordeiro, Lisa; Abucayan, Floridette; Hagerman, Randi; Tassone, Flora; Hessl, David

    2015-01-01

    Summary A very high proportion of individuals with fragile X syndrome (FXS) (FMR1 full mutation, > 200 CGG repeats) experience clinically significant anxiety. Recent evidence suggests that adult fragile X premutation carriers (55–200 CGG repeats) also are at risk for anxiety disorders, and they demonstrate limbic system alterations mediated by FMRP and/or elevated FMR1 mRNA that may explain this heightened risk. However, less is known about psychiatric symptoms including anxiety among children and adolescents with the premutation. We completed structured DSM-IV based diagnostic interviews focused on current anxiety in 35 children, adolescents or young adults with the premutation (ages 5–23 years, M = 11.3 ± 4.3; 27 male; 20 probands and 15 non-probands) and 31 controls (ages 5–18 years, M = 9.9 ± 3.6; 22 males). Among premutation carriers, 70.6% met criteria for at least one anxiety disorder (most frequently generalized anxiety disorder, specific phobia, social phobia, or obsessive compulsive disorder), compared to 22.6% of controls and 9.8% of the general population in this age range. Premutation carriers with intellectual disability, male gender, and proband status were associated with the highest rates of anxiety disorders. However, non-probands did have higher rates of having any anxiety disorder (40.0%) compared to general population norms. Although the results implicate anxiety as a target of screening and intervention among youth with the premutation, larger studies of unselected samples from the population of premutation carriers are needed to confirm and specify the degree and extent of psychiatric disorders in this condition. PMID:26361563

  20. Adolescent caffeine consumption increases adulthood anxiety-related behavior and modifies neuroendocrine signaling.

    PubMed

    O'Neill, Casey E; Newsom, Ryan J; Stafford, Jacob; Scott, Talia; Archuleta, Solana; Levis, Sophia C; Spencer, Robert L; Campeau, Serge; Bachtell, Ryan K

    2016-05-01

    basal Crf mRNA in the central nucleus of the amygdala, but no additional effects of stress or caffeine consumption were observed in other brain regions. Together these findings suggest that adolescent caffeine consumption may increase vulnerability to psychiatric disorders including anxiety-related disorders, and this vulnerability may result from dysregulation of the neuroendocrine stress response system.

  1. Defense Mechanisms in "Pure" Anxiety and "Pure" Depressive Disorders.

    PubMed

    Colovic, Olga; Lecic Tosevski, Dusica; Perunicic Mladenovic, Ivana; Milosavljevic, Maja; Munjiza, Ana

    2016-10-01

    Our study was intended to test whether there are any differences in the way defense mechanisms are used by patients suffering from pure anxiety and those with pure depressive disorders. The sample size was as follows: depressive disorders without psychotic symptoms 30, anxiety disorders 30, and the healthy control group 30. The assessment of defense mechanisms was made using the DSQ-40 questionnaire. Our findings show that "pure" anxiety disorders differ from "pure" depressive disorders only in the use of immature defense mechanisms. The group with depressive disorders was significantly more prone to use immature defense mechanisms than the group with anxiety disorders (p = 0.005), primarily projection (p = 0.001) and devaluation (p = 0.003). These defense mechanisms may therefore be used both to differentiate between anxiety and depressive disorders and also to determine which symptoms (anxiety or depressive disorders) are dominant at any given stage of treatment.

  2. 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

  3. Social Anxiety Scale for Adolescents (SAS-A) Short Form.

    PubMed

    Nelemans, Stefanie A; Meeus, Wim H J; Branje, Susan J T; Van Leeuwen, Karla; Colpin, Hilde; Verschueren, Karine; Goossens, Luc

    2017-01-01

    In this study, we examined the longitudinal measurement invariance of a 12-item short version of the Social Anxiety Scale for Adolescents (SAS-A) in two 4-year longitudinal community samples ( Nsample 1 = 815, Mage T1 = 13.38 years; Nsample 2 = 551, Mage T1 = 14.82 years). Using confirmatory factor analyses, we found strict longitudinal measurement invariance for the three-factor structure of the SAS-A across adolescence, across samples, and across gender. Some developmental changes in social anxiety were found from early to mid-adolescence, as well as gender differences across adolescence. These findings suggest that the short version of the SAS-A is a developmentally appropriate instrument that can be used effectively to examine adolescent social anxiety development.

  4. 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…

  5. Gender Role Orientation and Anxiety Symptoms among African American Adolescents

    ERIC Educational Resources Information Center

    Palapattu, Anuradha G.; Kingery, Julie Newman; Ginsburg, Golda S.

    2006-01-01

    The present study evaluated gender role theory as an explanation for the observed gender differences in anxiety symptoms among adolescents. Specifically, the relation between gender, gender role orientation (i.e., masculinity and femininity), self-esteem, and anxiety symptoms was examined in a community sample of 114 African Americans aged 14 to…

  6. Social Anxiety and Adolescents' Friendships: The Role of Social Withdrawal

    ERIC Educational Resources Information Center

    Biggs, Bridget K.; Vernberg, Eric M.; Wu, Yelena P.

    2012-01-01

    Research indicates social anxiety is associated with lower friendship quality, but little is known about the underlying mechanisms. This 2-month longitudinal study examined social withdrawal as a mediator of the social anxiety-friendship quality link in a sample of 214 adolescents (M[subscript age] = 13.1 years, SD = 0.73) that included an…

  7. Social Anxiety and Onset of Drinking in Early Adolescence

    ERIC Educational Resources Information Center

    Tomlinson, Kristin L.; Cummins, Kevin M.; Brown, Sandra A.

    2013-01-01

    The present study examines several types of social anxiety that may be associated with the onset of alcohol use in middle school students, and whether the relationship differs by sex and grade. Students in the seventh and eighth grades (N = 2,621) completed the Social Anxiety Scale for Adolescents and a measure of lifetime drinking via schoolwide…

  8. The Development of a Transdiagnostic, Cognitive Behavioral Group Intervention for Childhood Anxiety Disorders and Co-Occurring Depression Symptoms

    ERIC Educational Resources Information Center

    Ehrenreich-May, Jill; Bilek, Emily L.

    2012-01-01

    Anxiety and depression are highly prevalent and frequently comorbid classes of disorder associated with significant impairment in youth. While current transdiagnostic protocols address a range of potential anxiety and depression symptoms among adult and adolescent populations, there are few similar treatment options for school-aged children with…

  9. Emotional reasoning and anxiety sensitivity: Associations with social anxiety disorder in childhood☆

    PubMed Central

    Alkozei, Anna; Cooper, Peter J.; Creswell, Cathy

    2014-01-01

    Background Two specific cognitive constructs that have been implicated in the development and maintenance of anxiety symptoms are anxiety sensitivity and emotional reasoning, both of which relate to the experience and meaning of physical symptoms of arousal or anxiety. The interpretation of physical symptoms has been particularly implicated in theories of social anxiety disorder, where internal physical symptoms are hypothesized to influence the individual's appraisals of the self as a social object. Method The current study compared 75 children on measures of anxiety sensitivity and emotional reasoning: 25 with social anxiety disorder, 25 with other anxiety disorders, and 25 nonanxious children (aged 7–12 years). Results Children with social anxiety disorder reported higher levels of anxiety sensitivity and were more likely than both other groups to view ambiguous situations as anxiety provoking, whether physical information was present or not. There were no group differences in the extent to which physical information altered children's interpretation of hypothetical scenarios. Limitations This study is the first to investigate emotional reasoning in clinically anxious children and therefore replication is needed. In addition, those in both anxious groups commonly had comorbid conditions and, consequently, specific conclusions about social anxiety disorder need to be treated with caution. Conclusion The findings highlight cognitive characteristics that may be particularly pertinent in the context of social anxiety disorder in childhood and which may be potential targets for treatment. Furthermore, the findings suggest that strategies to modify these particular cognitive constructs may not be necessary in treatments of some other childhood anxiety disorders. PMID:24120086

  10. Pediatric-Onset and Adult-Onset Separation Anxiety Disorder Across Countries in the World Mental Health Survey

    PubMed Central

    Silove, Derrick; Alonso, Jordi; Bromet, Evelyn; Gruber, Mike; Sampson, Nancy; Scott, Kate; Andrade, Laura; Benjet, Corina; de Almeida, Jose Miguel Caldas; De Girolamo, Giovanni; de Jonge, Peter; Demyttenaere, Koen; Fiestas, Fabian; Florescu, Silvia; Gureje, Oye; He, Yanling; Karam, Elie; Lepine, Jean-Pierre; Murphy, Sam; Villa-Posada, Jose; Zarkov, Zahari; Kessler, Ronald C.

    2016-01-01

    Objective The age-at-onset criterion for separation anxiety disorder was removed in DSM-5, making it timely to examine the epidemiology of separation anxiety disorder as a disorder with onsets spanning the life course, using cross-country data. Method The sample included 38,993 adults in 18 countries in the World Health Organization (WHO) World Mental Health Surveys. The WHO Composite International Diagnostic Interview was used to assess a range of DSM-IV disorders that included an expanded definition of separation anxiety disorder allowing onsets in adulthood. Analyses focused on prevalence, age at onset, comorbidity, predictors of onset and persistence, and separation anxiety-related role impairment. Results Lifetime separation anxiety disorder prevalence averaged 4.8% across countries (interquartile range [25th–75th percentiles]=1.4%–6.4%), with 43.1% of lifetime onsets occurring after age 18. Significant time-lagged associations were found between earlier separation anxiety disorder and subsequent onset of internalizing and externalizing DSM-IV disorders and conversely between these disorders and subsequent onset of separation anxiety disorder. Other consistently significant predictors of lifetime separation anxiety disorder included female gender, retrospectively reported childhood adversities, and lifetime traumatic events. These predictors were largely comparable for separation anxiety disorder onsets in childhood, adolescence, and adulthood and across country income groups. Twelve-month separation anxiety disorder prevalence was considerably lower than lifetime prevalence (1.0% of the total sample; interquartile range=0.2%–1.2%). Severe separation anxiety-related 12-month role impairment was significantly more common in the presence (42.4%) than absence (18.3%) of 12-month comorbidity. Conclusions Separation anxiety disorder is a common and highly comorbid disorder that can have onset across the lifespan. Childhood adversity and lifetime trauma are

  11. 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…

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

    ERIC Educational Resources Information Center

    Naragon-Gainey, Kristin

    2010-01-01

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

  13. 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.

  14. Dysthymic disorder in adolescents with intellectual disability.

    PubMed

    Masi, G; Mucci, M; Favilla, L; Poli, P

    1999-04-01

    The present report examines the clinical features of dysthymic disorder in a sample of adolescents with mild intellectual disability (ID). Frequency of symptoms, comorbidity, agreement between reports of subjects and parents, comparison between the frequency of depressive symptoms in subjects with ID and in two different groups of normal IQ dysthymic subjects (aged 7-11, 11 and 12-18 years) are described. The sample consisted of 12 subjects (age range = 12-25.6 years; mean age = 16.3 years) screened from unselected consecutively referred patients with mild ID. All the subjects were comprehensively diagnosed with a structured diagnostic interview, the Kiddie-Schedule for Affective Disorder and Schizophrenia (K-SADS), according to DSM-IV criteria. A symptomatic profile in the group with ID showed that intrapsychic and cognitive symptoms, such as depressed mood, irritability, pathological guilt and low self-image, were frequently reported in people with ID. Parents were less aware of depressed mood, but they reported high rates of low self-esteem; the agreement between the depressive reports of ID subjects and their parents was higher than in previous findings in normal IQ children. The symptomatic profile of subjects with ID was more comparable to that of prepubertal dysthymic children than that of dysthymic adolescents, but more significant are the analogies between dysthymic disorder in ID and normal IQ subjects. High rates of comorbidity with generalized anxiety disorder were evident in the group with ID. According to the present data, dysthymic disorder can be diagnosed in adolescents with mild ID. The K-SADS clinical interview seems to be a reliable instrument for the diagnosis and clinical definition of depressive symptomatology in this special population.

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

    PubMed

    Akiyoshi, Jotaro

    2012-01-01

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

  16. 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

  17. [Impact of DSM-5: Application and Problems Based on Clinical and Research Viewpoints on Anxiety Disorders].

    PubMed

    Shioiri, Toshiki

    2015-01-01

    In Japan, the impact of DSM-5 has been greater than we had imagined. The Japanese Society of Psychiatry and Neurology organized a group for translation and the members spent many hours in this volunteer effort over a 2-year period. This highlights the significance of and expectations for DSM-5 in clinical practice in Japan. Regarding anxiety disorders, the highlights of changes from DSM-IV-TR to DSM-5 are as follows. Firstly, the DSM-5 chapter on anxiety disorder no longer includes obsessive-compulsive disorder (which is included with obsessive-compulsive and related disorders) or posttraumatic stress disorder and acute stress disorder(which are included with trauma- and stressor-related disorders). However, the sequential order of these chapters in DSM-5 reflects the close relationships among them. Secondly, in DSM-IV, selective mutism and separation anxiety disorder were classified in the section "Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence." They are now classified as an anxiety disorder. Through these two changes, at the beginning of the chapter, it can be clearly noted that anxiety disorders include disorders that share features of excessive fear and anxiety and related behavioral disturbances. Thirdly, panic disorder and agoraphobia are not associated in DSM-5. Thus, the former DSM-IV diagnoses of panic disorder with agoraphobia, panic disorder without agoraphobia, and agoraphobia without a history of panic disorder are now replaced by two diagnoses, panic disorder and agoraphobia, each with separate criteria. The co-occurrence of panic disorder and agoraphobia is now coded with two diagnoses. This change recognizes that a marked number of individuals with agoraphobia do not experience panic symptoms. For the present, this change ends the. controversy over the hierarchy between panic disorder and agoraphobia. The diagnostic criteria for agoraphobia are derived from the DSM-IV descriptors for agoraphobia, although the clarification

  18. Pre-Sleep Arousal and Sleep Problems of Anxiety-Disordered Youth

    ERIC Educational Resources Information Center

    Alfano, Candice A.; Pina, Armando A.; Zerr, Argero A.; Villalta, Ian K.

    2010-01-01

    The current study examined sleep problems and pre-sleep arousal among 52 anxious children and adolescents, aged 7-14 years, in relation to age, sex, ethnicity, and primary anxiety disorder. Assessment included structured diagnostic interviews and parent and child completed measures of sleep problems and pre-sleep arousal. Overall, 85% of parents…

  19. Somatic Complaints in Children with Anxiety Disorders and Their Unique Prediction of Poorer Academic Performance

    ERIC Educational Resources Information Center

    Hughes, Alicia A.; Lourea-Waddell, Brittany; Kendall, Philip C.

    2008-01-01

    The present study aimed to examine somatic complaints in children with anxiety disorders compared to non-anxious control children and whether somatic complaints predict poorer academic performance. The sample consisted of 108 children and adolescents (aged 8-14 years) assessed by a structured diagnostic interview: 69 with a principal (i.e., most…

  20. Sociodemographic Variables in Relation to Social Appearance Anxiety in Adolescents

    ERIC Educational Resources Information Center

    Sahin, Ertugrul; Barut, Yasar; Ersanli, Ercüment

    2013-01-01

    This study examined the effects of gender, age, grade level, and the educational level of the mother and father on social appearance anxiety in Turkish adolescents. This was a cross-sectional study in which a simple random sampling method was used. Participants were 2,219 adolescents (1089 boys, 1130 girls) with a mean age of 12.76 years old (SD =…

  1. Factors Predicting Rural Chinese Adolescents' Anxieties, Fears and Depression

    ERIC Educational Resources Information Center

    Li, Huijun; Zhang, Ying

    2008-01-01

    This study examined age, gender, birth order and self-perceived level of achievement and popularity, as predictors of anxieties, fears and depression in Chinese adolescents. A sample of 398 rural Chinese adolescents participated in this study. Gender, academic performance and popularity have been found to make the greatest contributions to the…

  2. Social Physique Anxiety and Physical Activity among Adolescents.

    ERIC Educational Resources Information Center

    Eklund, Robert C.; Bianco, Theresa

    2000-01-01

    This article examines the potential impact of adolescent social physique anxiety on behavior and physical activity settings. Offers that an awareness and consideration of the self-presentational sensitivities that adolescents may experience in physical activity settings provide important avenues for understanding and addressing certain types of…

  3. What's the Worry with Social Anxiety? Comparing Cognitive Processes in Children with Generalized Anxiety Disorder and Social Anxiety Disorder.

    PubMed

    Hearn, Cate S; Donovan, Caroline L; Spence, Susan H; March, Sonja; Holmes, Monique C

    2016-12-05

    Social anxiety disorder (SAD) in children is often comorbid with generalized anxiety disorder (GAD). We investigated whether worry, intolerance of uncertainty, beliefs about worry, negative problem orientation and cognitive avoidance, that are typically associated with GAD, are present in children with SAD. Participants included 60 children (8-12 years), matched on age and gender. Groups included children: with primary GAD and without SAD (GAD); with primary SAD and without GAD (SAD); and without an anxiety disorder (NAD). GAD and SAD groups scored significantly higher than the NAD group on worry, intolerance of uncertainty, negative beliefs about worry and negative problem orientation, however, they did not score differently from each other. Only the GAD group scored significantly higher than the NAD group on cognitive avoidance. These findings further understanding of the structure of SAD and suggest that the high comorbidity between SAD and GAD may be due to similar underlying processes within the disorders.

  4. Pharmacologic treatment of anxiety disorders in Parkinson's disease

    PubMed Central

    Pontone, Gregory M.; Williams, James R.; Anderson, Karen E.; Chase, Gary; Goldstein, Susanne R.; Grill, Stephen; Hirsch, Elaina S.; Lehmann, Susan; Little, John T.; Margolis, Russell L.; Palanci, Justin; Rabins, Peter V.; Weiss, Howard D.; Marsh, Laura

    2012-01-01

    Objective Neither best practices nor an evidence-base for the pharmacologic treatment of anxiety in Parkinson's disease has been established. This study investigated pharmacologic treatment of anxiety disorders in idiopathic Parkinson's disease and the associated clinical features. Design Cross-sectional. Setting Three community-based movement disorder neurology practices Participants 250 subjects with Parkinson's disease. Measurements Anxiety disorder diagnoses were established by consensus using a panel of six psychiatrists with expertise in geriatric psychiatry and movement disorders. Current medications were provided by the treating neurologists at the time of interview. Results Amongst subjects with anxiety disorders only, 53% were untreated with medications. However, when anxious subjects with comorbid depressive disorders were included, 70.8% were on medications effective for treatment of anxiety. Subjects with anxiety and comorbid depressive disorders were more likely to be treated for their psychiatric disturbances than subjects with anxiety disorders alone (Odds Ratio 8.33) as were subjects with comorbid motor fluctuations (Odds Ratio, 3.65). There were no differences in the types of anti-anxiety medications used in regard to the presence of depression or motor fluctuations. Conclusions These findings suggest that over half of non-depressed Parkinson's disease patients with clinically significant anxiety are untreated with medication. A better understanding of the role of clinical features associated with anxiety in PD, such as depression and motor fluctuations, may improve the recognition and treatment of anxiety disorders in this population. PMID:23567419

  5. 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

  6. Outcome of depression and anxiety after war: a prospective epidemiologic study of children and adolescents.

    PubMed

    Karam, Elie G; Fayyad, John; Karam, Aimee N; Melhem, Nadine; Mneimneh, Zeina; Dimassi, Hani; Tabet, Caroline Cordahi

    2014-04-01

    Prospective studies of children exposed to war have not investigated disorders other than posttraumatic stress disorder (PTSD) and have methodological limitations. From a stratified random sample of 386 children and adolescents who had been interviewed 3 weeks after war exposure (Phase 1) a random subsample (N = 143) was interviewed a year later (Phase 2). PTSD, major depressive disorder (MDD), separation anxiety disorder (SAD), overanxious disorder (OAD), and psychosocial stressors were assessed using structured interviews administered to both children and adolescents and their parents. The prevalence of disorders among the 143 at Phase 1 was MDD 25.9%, SAD 16.1%, OAD 28.0%, and PTSD 26.0%, with 44.1% having any disorder. At Phase 2 the prevalence was MDD, 5.6%; SAD, 4.2%; OAD, 0%; and PTSD, 1.4%, with 9.2% having any disorder. Occurrence of disorders at Phase 1 was associated with older age, prewar disorders, financial problems, fear of being beaten, and witnessing any war event (ORs ranged from 2.5 to 28.6). Persistence of disorders to Phase 2 was associated with prewar disorders (OR = 6.0) and witnessing any war event (OR = 14.3). There are implications for detection of at-risk cases following wars by screening for adolescents exposed to family violence, those with prewar disorders, and those who directly witnessed war events to target them for specific interventions.

  7. Normative data for the Multidimensional Anxiety Scale for Children (MASC) in Swedish adolescents.

    PubMed

    Ivarsson, Tord

    2006-01-01

    The Swedish translation of a new scale developed for childhood and adolescent anxiety, the Multidimensional Anxiety Scale for Children (MASC), was studied regarding reliability and convergent validity and to obtain norms in a general population. Four hundred and five adolescents, reasonably representative of Swedish adolescents, were asked to rate their anxiety symptoms on the MASC. In order to study the convergent validity, they also rated their depressive symptoms on the Children's Depression Inventory (CDI), their attitude to their body on the Body Esteem Scale for Adolescents and Adults (BESAA) and filled in demographical data on themselves. The MASC showed adequate internal consistency both for the whole scale (alpha = 0.87) and for subscales (range 0.64-0.84). The scale showed convergent validity through a moderate correlation with the CDI (r=0.400, P=0.0001) and the BESAA (r= - 0.29, P=0001). Girls scored higher (mean = 38.9) than boys (mean = 31.9) on the MASC total score (t(385) = 5.14, P=0.0001) and on the subscales, except Harm avoidance. Using the MASC as a general screen for anxiety, scores of 48 for boys and 56 for girls using MASC total scores, or scores of 15 for boys and 17 for girls using the Anxiety Disorders Index could be employed (both representing the 90th percentiles). The MASC appears to be a reliable and valid scale both on the global and on the subscale level.

  8. Sleep and Anxiety in Late Childhood and Early Adolescence

    PubMed Central

    McMakin, Dana L.; Alfano, Candice A.

    2015-01-01

    Purpose of review Adolescence is a period of dynamic change in both sleep and emotional systems, with related increases in problems controlling emotion and behavior. Youth with anxiety enter adolescence with pre-existing vulnerabilities in systems of sleep and emotion that may place them at heightened risk. This review summarizes recent research on sleep and anxiety during the transition to adolescence, and highlights emerging themes. Recent findings Prospective studies support that sleep predicts anxiety symptoms in early adolescence. Notably, robust evidence for subjective sleep problems in anxious youth is not well-corroborated by objective assessments. Longitudinal designs and methodology that carefully examine dimensions of anxiety and sleep may clarify inconsistencies. Preliminary evidence suggests that late childhood to early adolescence may be a sensitive period for escalating problems with sleep and anxiety. Recent advances in the neuroscience of sleep can further refine integrative mechanistic models of developmental psychopathology—the role of sleep in emotional learning and memory is provided as an example. Summary Sleep problems are common and prospectively predict escalating anxiety symptoms. Precision is needed regarding the nature of sleep disruption, and how and when sleep impacts various aspects of developmental trajectories. This precision, along with advances in the neuroscience of sleep, may lead to developmentally-informed translational interventions. PMID:26382163

  9. Anxiety

    MedlinePlus

    ... include Panic disorder Obsessive-compulsive disorder Post-traumatic stress disorder Phobias Generalized anxiety disorder Treatment can involve medicines, therapy or both. NIH: National Institute of Mental Health

  10. Adolescent Eating Disorder: Anorexia Nervosa.

    ERIC Educational Resources Information Center

    Muuss, Rolf E.

    1985-01-01

    Examines anorexia nervosa, an eating disorder seen with increasing frequency, especially among adolescent girls. Presents five theories about causation, discusses early characteristics, typical family patterns, physical and medical characteristics, social adjustment problems, and society's contribution to anorexia. Describes course of the…

  11. 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.

  12. Examining the Factor Structure of Anxiety and Depression Symptom Items Among Adolescents in Santiago, Chile.

    PubMed

    Bares, Cristina B; Andrade, Fernando; Delva, Jorge; Grogan-Kaylor, Andrew

    2011-01-01

    The co-occurrence of emotional disorders among adolescents has received considerable empirical attention. This study aims to contribute to the understanding of co-occurring anxiety and depression by examining the factor structure of the Youth Self-Report used with a sample of low-income adolescents from Santiago, Chile. Data from two independent, randomly selected subsamples were analyzed using exploratory and confirmatory factor analyses. Results indicate the best fit for the data is a two-factor model of anxiety and depression symptoms, which factors anxiety and depression into separate latent constructs. Because the findings show that anxiety and depression are not measured by the same factor in this international sample, the results imply that a valid and useful distinction exists between these constructs. That these constructs are found to be separate factors suggests that anxiety and depression may have separate etiologies and consequences, which might be best addressed by separate intervention components. These findings are consistent with the viewpoint that anxiety and depression constructs have similar emotional features and, despite sharing a common underlying internalizing disorder, distinct items capture aspects of each construct.

  13. Cognitive conflict adaptation in generalized anxiety disorder.

    PubMed

    Larson, Michael J; Clawson, Ann; Clayson, Peter E; Baldwin, Scott A

    2013-10-01

    Individuals with generalized anxiety disorder (GAD) display poor emotional conflict adaptation, a cognitive control process requiring the adjustment of performance based on previous-trial conflict. It is unclear whether GAD-related conflict adaptation difficulties are present during tasks without emotionally-salient stimuli. We examined conflict adaptation using the N2 component of the event-related potential (ERP) and behavioral responses on a Flanker task from 35 individuals with GAD and 35 controls. Groups did not differ on conflict adaptation accuracy; individuals with GAD also displayed intact RT conflict adaptation. In contrast, individuals with GAD showed decreased amplitude N2 principal component for conflict adaptation. Correlations showed increased anxiety and depressive symptoms were associated with longer RT conflict adaptation effects and lower ERP amplitudes, but not when separated by group. We conclude that individuals with GAD show reduced conflict-related component processes that may be influenced by compensatory activity, even in the absence of emotionally-salient stimuli.

  14. 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.

  15. Effects of psychotherapy for anxiety in children and adolescents: a meta-analytic review.

    PubMed

    Reynolds, Shirley; Wilson, Charlotte; Austin, Joanne; Hooper, Lee

    2012-06-01

    This paper provides a comprehensive quantitative review of high quality randomized controlled trials of psychological therapies for anxiety disorders in children and young people. Using a systematic search for randomized controlled trials which included a control condition and reported data suitable for meta-analysis, 55 studies were included. Eligible studies were rated for methodological quality and outcome data were extracted and analyzed using standard methods. Trial quality was variable, many studies were underpowered and adverse effects were rarely assessed; however, quality ratings were higher for more recently published studies. Most trials evaluated cognitive behavior therapy or behavior therapy and most recruited both children and adolescents. Psychological therapy for anxiety in children and young people was moderately effective overall, but effect sizes were small to medium when psychological therapy was compared to an active control condition. The effect size for non-CBT interventions was not significant. Parental involvement in therapy was not associated with differential effectiveness. Treatment targeted at specific anxiety disorders, individual psychotherapy, and psychotherapy with older children and adolescents had effect sizes which were larger than effect sizes for treatments targeting a range of anxiety disorders, group psychotherapy, and psychotherapy with younger children. Few studies included an effective follow-up. Future studies should follow CONSORT reporting standards, be adequately powered, and assess follow-up. Research trials are unlikely to address all important clinical questions around treatment delivery. Thus, careful assessment and formulation will remain an essential part of successful psychological treatment for anxiety in children and young people.

  16. Familial and Temperamental Risk Factors for Social Anxiety Disorder

    ERIC Educational Resources Information Center

    Hirshfeld-Becker, Dina R.

    2010-01-01

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

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

    PubMed Central

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

    2013-01-01

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

  18. Bullying at School--An Indicator of Adolescents at Risk for Mental Disorders.

    ERIC Educational Resources Information Center

    Kaltiala-Heino, Riittakerttu; Rimpela, Matti; Rantanen, Paivi; Rimpela, Arja

    2000-01-01

    Surveys Finnish adolescents about bullying and victimization in relations to psychosomatic symptoms, depression, anxiety, eating disorders and substance use. Anxiety, depression, and psychosomatic symptoms were most frequent among bully-victims and equally common among bullies and victims. Argues that bullying should be seen as an indicator of…

  19. Subthreshold Depressive Disorder in Adolescents: Predictors of Escalation to Full-Syndrome

    ERIC Educational Resources Information Center

    Klein, Daniel N.; Shankman, Stewart A.; Lewinsohn, Peter M.; Seeley, John R.

    2009-01-01

    The risk for the onset of full-syndrome depressive disorders from the subtreshold depressive disorder in adolescents is found to be at 67 percent. The variables that predict the progression to the full onset are: severity of depressive symptoms, medical conditions/ symptoms, history of suicidal ideation, history of anxiety disorder, and familial…

  20. 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.

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

    PubMed

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

    2016-04-01

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

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

    PubMed

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

    2014-01-01

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

  3. The measurement of mathematics anxiety: the Mathematics Anxiety Rating Scale for Adolescents--MARS-A.

    PubMed

    Suinn, R M; Edwards, R

    1982-07-01

    Describes the Mathematics Anxiety Rating Scale for Adolescents (MARS-A). Normative data on over 1,200 junior high and senior high students are reported. In addition, psychometric data that relate to reliability and construct validity for the MARS-A scale are discussed. Two factors were identified in the scale, a factor of numerical anxiety that appeared in 91% of the items and a factor of mathematics test anxiety that appeared in the remaining items. Results that show the association between high mathematics anxiety scale scores and low grade average in mathematics courses are reported on two samples of students.

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

    PubMed

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

    2013-02-01

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

  5. Anxiety, stress, depression, and psychosocial functioning of Indian adolescents

    PubMed Central

    Singh, Kamlesh; Junnarkar, Mohita; Sharma, Soumya

    2015-01-01

    Background: Lifetime prevalence of depression and anxiety increases from 1% of the population under age 12 years to ~17%-25% of the population by the end of adolescence. The greatest increase in new cases occurs between 15-18 years. Indian empirical studies have reported a prevalence of psychiatric morbidity in the range between 14.4% and 31.7%; thus, affecting psychosocial functioning. Aims: The objectives of the current study were to (i) examine the psychometric properties of the DASS and SDQ on Indian adolescents, (ii) explore the role of socio- demographic variablesand (iii) examine if there was any difference between school going and school dropouts. Methodology: Data from 1812 students, aged 12-19 years was collected with mean age = 15.67 years (SD =1.41 years). The participants were administered a booklet containing demographic questionnaire and psychometric scales such as DASS-21 (Henry & Crawford, 2005; Lovibond & Lovibond, 1999) and Strengths and Difficulties Questionnaire (Goodman, 1997). Statistical Analysis: Structure validation, correlational analysis and multivariate analysis. Results and Conclusions: The results of validation indicated that English and Hindi version of 3 factor model of DASS and 2 factor model of SDQ was an acceptable model fit. It was noted that early adolescents were high on prosocial behaviour whereas late adolescents were high on difficulties score. Females were higher than males on prosocial behaviour. Adolescents residing in rural areas differed from their urban counterparts on prosocial behaviour and anxiety. Government school going adolescents differed from private school going adolescents on prosocial behaviour, stress and anxiety. Negative perception of relationship with family affected adolescents difficulties score, depression and stress. Similarly, negative perception of self-concept leads to higher difficulties score and lower prosocial behaviour score. The school going adolescents differed from non-school going

  6. Developmental Risk Factors in Generalized Anxiety Disorder and Panic Disorder

    PubMed Central

    Newman, Michelle G.; Shin, Ki Eun; Zuellig, Andrea R.

    2016-01-01

    Background There is a lack of clarity regarding specific risk factors discriminating generalized anxiety disorder (GAD) from panic disorder (PD). Goal This study investigated whether GAD and PD could be discriminated through differences in developmental etiological factors including childhood parental loss/separation, psychological disorders, and maternal and paternal attachment. Method Twenty people with adult generalized anxiety disorder (GAD), 20 with adult panic disorder (PD), 11 with adult comorbid GAD and PD, and 21 adult non-anxious controls completed diagnostic interviews to assess symptoms of mental disorders in adulthood and childhood. Participants also reported on parental attachment, loss, and separation. Results Childhood diagnoses of GAD and PD differentiated clinical groups from controls as well as from each other, suggesting greater likelihood for homotypic over heterotypic continuity. Compared to controls, specific phobia was associated with all three clinical groups, and childhood depression, social phobia, and PTSD were uniquely associated with adult GAD. Both maternal and paternal attachment also differentiated clinical groups from controls. However, higher levels of subscales reflecting maternal insecure avoidant attachment (e.g., no memory of early childhood experiences and balancing/forgiving current state of mind) emerged as more predictive of GAD relative to PD. There were no group differences in parental loss or separation. Conclusions These results support differentiation of GAD and PD based on developmental risk factors. Recommendations for future research and implications of the findings for understanding the etiology and symptomatology of GAD and PD are discussed. PMID:27466747

  7. Nicotine Modulation of Fear Memories and Anxiety: Implications for Learning and Anxiety Disorders

    PubMed Central

    Kutlu, Munir Gunes; Gould, Thomas J.

    2015-01-01

    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), anxiety disorders 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

  8. 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

  9. 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

  10. Generalized anxiety disorder: some biochemical aspects.

    PubMed

    Munjack, D J; Baltazar, P L; DeQuattro, V; Sobin, P; Palmer, R; Zulueta, A; Crocker, B; Usigli, R; Buckwalter, G; Leonard, M

    1990-04-01

    Fifty-one patients who met DSM-III criteria for generalized anxiety disorder, and who were recruited to participate in a drug outcome study, filled out a variety of rating scales and had blood samples drawn for plasma norepinephrine, epinephrine, and free 3-methoxy-4-hydroxyphenylglycol (MHPG) after a 20-min rest period. This group was compared to 15 normal controls who also had their blood drawn after a 20-min rest period. While the two groups were initially found to have significantly different levels of plasma free MHPG through the use of t tests, this finding was not confirmed by subsequent discriminant analysis.

  11. [Virtual reality therapy in anxiety disorders].

    PubMed

    Mitrousia, V; Giotakos, O

    2016-01-01

    During the last decade a number of studies have been conducted in order to examine if virtual reality exposure therapy can be an alternative form of therapy for the treatment of mental disorders and particularly for the treatment of anxiety disorders. Imaginal exposure therapy, which is one of the components of Cognitive Behavioral Therapy, cannot be easily applied to all patients and in cases like those virtual reality can be used as an alternative or a supportive psychotherapeutic technique. Most studies using virtual reality have focused on anxiety disorders, mainly in specific phobias, but some extend to other disorders such as eating disorders, drug dependence, pain control and palliative care and rehabilitation. Main characteristics of virtual reality therapy are: "interaction", "immersion", and "presence". High levels of "immersion" and "presence" are associated with increased response to exposure therapy in virtual environments, as well as better therapeutic outcomes and sustained therapeutic gains. Typical devices that are used in order patient's immersion to be achieved are the Head-Mounted Displays (HMD), which are only for individual use, and the computer automatic virtual environment (CAVE), which is a multiuser. Virtual reality therapy's disadvantages lie in the difficulties that arise due to the demanded specialized technology skills, devices' cost and side effects. Therapists' training is necessary in order for them to be able to manipulate the software and the hardware and to adjust it to each case's needs. Devices' cost is high but as technology continuously improves it constantly decreases. Immersion during virtual reality therapy can induce mild and temporary side effects such as nausea, dizziness or headache. Until today, however, experience shows that virtual reality offers several advantages. Patient's avoidance to be exposed in phobic stimuli is reduced via the use of virtual reality since the patient is exposed to them as many times as he

  12. Reported early separation anxiety symptoms in patients with panic and generalised anxiety disorders.

    PubMed

    Silove, D; Manicavasagar, V; O'Connell, D; Blaszczynski, A

    1993-09-01

    Attachment theory has proposed that early separation anxiety is a risk factor for adult anxiety disorder, with the recent focus being particularly on panic disorder. The results of empirical studies examining this link are, however, contradictory, possibly because of inconsistencies across studies in measuring memories of early separation anxiety. In the present study, a psychometrically sound measure, the Separation Anxiety Symptom Inventory (SASI) was used to compare memories of such early symptoms in panic disorder (including those with mild phobic-avoidance), generalised anxiety disorder and control subjects. Anxiety patients as a group returned higher SASI scores (p < 0.001) with a non-significant trend for panic disorder patients to score higher than those with generalised anxiety. These results suggest that early separation anxiety may be a harbinger of adult anxiety and that risk of panic disorder may be higher in the most severely affected youngsters. As a risk factor, early separation anxiety does not however appear to be uniquely related to adult panic disorder.

  13. Amygdala habituation to emotional faces in adolescents with internalizing disorders, adolescents with childhood sexual abuse related PTSD and healthy adolescents.

    PubMed

    van den Bulk, Bianca G; Somerville, Leah H; van Hoof, Marie-José; van Lang, Natasja D J; van der Wee, Nic J A; Crone, Eveline A; Vermeiren, Robert R J M

    2016-10-01

    Adolescents with internalizing disorders and adolescents with childhood sexual abuse related post-traumatic stress disorder (CSA-related PTSD) show a large overlap in symptomatology. In addition, brain research indicated hyper-responsiveness and sustained activation instead of habituation of amygdala activation to emotional faces in both groups. Little is known, however, about whether the same patterns of amygdala habituation are present in these two groups. The current study examined habituation patterns of amygdala activity to emotional faces (fearful, happy and neutral) in adolescents with a DSM-IV depressive and/or anxiety disorder (N=25), adolescents with CSA-related PTSD (N=19) and healthy controls (N=26). Behaviourally, the adolescents from the internalizing and CSA-related PTSD group reported more anxiety to fearful and neutral faces than adolescents from the control group and adolescents from the CSA-related PTSD group reacted slower compared to the internalizing group. At the whole brain level, there was a significant interaction between time and group within the left amygdala. Follow-up ROI analysis showed elevated initial activity in the amygdala and rapid habituation in the CSA-related PTSD group compared to the internalizing group. These findings suggest that habituation patterns of amygdala activation provide additional information on problems with emotional face processing. Furthermore, the results suggest there are differences in the underlying neurobiological mechanisms related to emotional face processing for adolescents with internalizing disorders and adolescents with CSA-related PTSD. Possibly CSA-related PTSD is characterized by a stronger primary emotional response driven by the amygdala.

  14. Combining and sequencing medication and cognitive-behaviour therapy for childhood anxiety disorders.

    PubMed

    Keeton, Courtney P; Ginsburg, Golda S

    2008-04-01

    Despite the absence of data on the efficacy of combination therapy (i.e., psychosocial and medication) for the treatment of anxiety disorders in youths, clinicians in clinical practice often utilize this treatment approach. This paper discusses issues related to sequencing, combining, and integrating cognitive behavioural and pharmacological interventions for anxiety disorders in children and adolescents. We briefly summarize the empirical evidence for mono and combination therapy and raise a variety of issues that should be considered when making treatment decisions. Finally, we present an integrated treatment model to facilitate the delivery of a comprehensive treatment approach across care providers. These suggestions are geared toward optimizing clinical outcomes for anxious youths.

  15. Self-compassion and social anxiety disorder.

    PubMed

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

    2012-01-01

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

  16. Anxiety Sensitivity in Children of Panic Disorder Patients

    ERIC Educational Resources Information Center

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

    2005-01-01

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

  17. Eating-related anxiety in individuals with eating disorders.

    PubMed

    Webb, C M; Thuras, P; Peterson, C B; Lampert, J; Miller, D; Crow, S J

    2011-12-01

    Although previous research has supported the importance of anxiety as an etiological and maintenance factor for eating disorders, the specific mechanisms are not well understood. The role of anxiety in the context of eating behavior is especially unclear. The purpose of this study was to identify anxiety-eliciting eating situations and anxiety management strategies patients use to mitigate anxiety experienced in the context of eating as determined by diagnostic groups and symptom patterns. Fifty-three eating disorder outpatients were administered the Eating and Anxiety Questionnaire (EAQ) and the Eating Disorder Diagnostic Scale. Ratings indicated significant anxiety in most eating situations, whereas management strategies were more limited yet regularly employed. Factor analysis of the EAQ revealed a 6-factor solution for anxiety management strategies and a 4-factor solution for anxiety-eliciting situations. These results indicate patients with eating disorders report high levels of anxiety associated with eating behaviors but utilize limited yet consistent anxiety management strategies. Effective intervention strategies for managing eating-related anxiety should be incorporated into treatment and may need to be specified for different diagnostic subgroups.

  18. Relations among religiosity, health, happiness, and anxiety for Kuwaiti adolescents.

    PubMed

    Baroun, Khader A

    2006-12-01

    The present study investigated correlations among religiosity, health, happiness, and anxiety for 941 Kuwaiti adolescents. A convenience sample of male (n=408) and female (n=533) students (M age = 16.5, SD = 1.2 yr.) was randomly selected from secondary school students of different districts of the State of Kuwait. The Intrinsic Religious Motivation scale, the Kuwait University Anxiety Scale, and six self-rating scales assessing religiosity, strength of religious belief, physical health, mental health, happiness, and life satisfaction were applied to assess correlations among Kuwaiti adolescents. Analysis showed boys had significantly higher mean scores than girls on all measures except anxiety, on which girls scored significantly higher than boys. There also were significant and positive correlations among the variables, except for anxiety, which was significant and negative.

  19. 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.

  20. 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

  1. Emotion Regulation Therapy for Generalized Anxiety Disorder.

    PubMed

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

    2013-08-01

    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.

  2. 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

  3. Variation in the Profile of Anxiety Disorders in Boys with an ASD According to Method and Source of Assessment

    ERIC Educational Resources Information Center

    Bitsika, Vicki; Sharpley, Christopher F.

    2015-01-01

    To determine any variation that might occur due to the type of assessment and source used to assess them, the prevalence of 7 anxiety disorders were investigated in a sample of 140 boys with an Autism spectrum disorder (ASD) and 50 non-ASD (NASD) boys via the Child and Adolescent Symptom Inventory and the KIDSCID Clinical Interview. Boys with an…

  4. 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.

  5. Prevention of Disordered Eating among Adolescents.

    ERIC Educational Resources Information Center

    Massey-Stokes, Marilyn S.

    2000-01-01

    Discusses unhealthy dieting behaviors that can lead to eating disorders during adolescence. Outlines ways middle school and high school teachers and administrators can aid in the prevention of disordered eating among adolescents. Lists resources for eating disorders awareness and prevention. (SR)

  6. Threat perception bias and anxiety among Chinese school children and adolescents.

    PubMed

    Lu, Weili; Daleiden, Eric; Lu, Shou-En

    2007-01-01

    This study evaluated the relationship between threat perception bias and anxiety among children and adolescents in China. A sample of 1,004 elementary, middle and high school students aged 9 to 19 years listened to stories containing themes of generalized anxiety, social anxiety and separation anxiety in either an ambiguous or non-ambiguous context. The story content included topics such as upset stomach, teacher-student interaction, and parents who are late to return home. Multiple threat perception indices were derived from children's responses. Children's level of anxiety was assessed by means of self-report questionnaires and parental reports. Higher levels of anxiety were related to higher frequencies of threat perception and interpretation, lower thresholds to detect threat and more negative feelings and cognitions. Age and gender were also related to some indices of threat perception bias. Threat perception bias was related to anxious symptomatology in general and was not content specific to particular anxiety disorders. The findings were consistent with studies conducted in Western culture and suggest that cognitive processing theories of childhood anxiety may generalize beyond Western society.

  7. 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.

  8. Interaction between perceived maternal care, anxiety symptoms, and the neurobehavioral response to palatable foods in adolescents.

    PubMed

    Machado, Tania Diniz; Dalle Molle, Roberta; Reis, Roberta Sena; Rodrigues, Danitsa Marcos; Mucellini, Amanda Brondani; Minuzzi, Luciano; Franco, Alexandre Rosa; Buchweitz, Augusto; Toazza, Rudineia; Ergang, Bárbara Cristina; Cunha, Ana Carla de Araújo; Salum, Giovanni Abrahão; Manfro, Gisele Gus; Silveira, Patrícia Pelufo

    2016-05-01

    Studies in rodents have shown that early life trauma leads to anxiety, increased stress responses to threatening situations, and modifies food intake in a new environment. However, these associations are still to be tested in humans. This study aimed to verify complex interactions among anxiety diagnosis, maternal care, and baseline cortisol on food intake in a new environment in humans. A community sample of 32 adolescents and young adults was evaluated for: psychiatric diagnosis using standardized interviews, maternal care using the Parental Bonding Inventory (PBI), caloric consumption in a new environment (meal choice at a snack bar), and salivary cortisol. They also performed a brain fMRI task including the visualization of palatable foods vs. neutral items. The study found a three-way interaction between anxiety diagnosis, maternal care, and baseline cortisol levels on the total calories consumed (snacks) in a new environment. This interaction means that for those with high maternal care, there were no significant associations between cortisol levels and food intake in a new environment. However, for those with low maternal care and who have an anxiety disorder (affected), cortisol was associated with higher food intake; whereas for those with low maternal care and who did not have an anxiety disorder (resilient), cortisol was negatively associated with lower food intake. In addition, higher anxiety symptoms were associated with decreased activation in the superior and middle frontal gyrus when visualizing palatable vs. neutral items in those reporting high maternal care. These results in humans mimic experimental research findings and demonstrate that a combination of anxiety diagnosis and maternal care moderate the relationship between the HPA axis functioning, anxiety, and feeding behavior in adolescents and young adults.

  9. 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…

  10. Biological predictors of pharmacological therapy in anxiety disorders.

    PubMed

    Maron, Eduard; Nutt, David

    2015-09-01

    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.

  11. Adolescents with Internet Gaming Disorder (IGD): profiles and treatment response.

    PubMed

    Martín-Fernández, María; Matalí, Josep Lluís; García-Sánchez, Sara; Pardo, Marta; Lleras, María; Castellano-Tejedor, Carmina

    2016-10-07

    Demand for treatment for problems related to the use of video games have increased significantly in adolescents. Most cases have a comorbid mental disorder that jeopardises both pathologies. The aim of this study is to describe profiles of adolescents with Internet Gaming Disorder (IGD) according to comorbidity and analyze treatment response at 3 and 6 months. A sample of 86 patients which consulted in the Addictive Behavior Unit of a hospital was assessed with diagnostic criteria for IGD, the interview K-SADS-PL for mental disorders and the Clinical Global Impression (CGI) to treatment progress. Of the initial sample, 68,6% (n = 59) met diagnostic criteria for IGD. Of these, the 45,76% matched an internalizing profile, presenting comorbidity with Mood Disorders (44,4%), Anxiety Disorders (44,4%) and Personality Disorders (11,1%). The externalizing profile would comprise 52,54% of the sample presenting Disruptive Behavior Disorder (48,4%=, ADHD (29%) and Disruptive Behavior Disorders not otherwise specified (22,6%). Unlike externalizing, the internalizing patients had a family history of psychiatric problems (63%), difficulties in social relationships (77,8%) and seemed to use video games preferably to escape discomfort (66,7%). After 3 months the externalizing profile showed improvements. Comorbid disorders allow the discrimination of two IGD profiles in adolescents and these could influence treatment response. Therefore, it is important to assess comorbidities to design a more accurate intervention focused on the specificities of each profile.

  12. Parent and child perspectives on the nature of anxiety in children and young people with autism spectrum disorders: a focus group study.

    PubMed

    Ozsivadjian, Ann; Knott, Fiona; Magiati, Iliana

    2012-03-01

    Anxiety disorders are common among children and young people with autism spectrum disorders (ASD). Despite growing knowledge about the prevalence, phenomenology and treatment of anxiety disorders, relatively little is understood about the nature and impact of anxiety in this group and little is known about autism-specific factors that may have a role in the increased prevalence of anxiety disorders. In this exploratory study, we report on a series of five focus groups with 17 parents of children and adolescents with ASD and anxiety. Across groups, parents gave strikingly similar descriptions of the triggers and behavioural signs associated with anxiety. Another consistent finding was that many parents reported that their children had great difficulty expressing their worries verbally and most showed their anxiety through changes in their behaviour. The impact of anxiety was reported to often be more substantial than the impact of ASD itself. The implications of the focus group findings are discussed in relation to existing literature.

  13. [Sociodemographic, clinical and outcome differences among anxiety disorders].

    PubMed

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

    2012-01-01

    The aims of this paper are to analyze differences in sociodemographic and clinical characteristics among the various anxiety disorders treated in a Psychology Clinic, and the results of treatment in each anxiety disorder. Data from 282 patients of University Psychology Clinic at the Complutense University of Madrid, who had at least one diagnosis of anxiety according to DMS-IV-TR criteria, were analyzed. The most frequent anxiety disorders were nonspecific anxiety disorder (19.1%) and social phobia (18.8%). Significant differences were observed according to sex (in all disorders, the percentage of women was significantly higher than that of men, except for obsessive-compulsive disorder). Unspecific anxiety disorder required a smaller number of assessment and treatment sessions, whereas obsessive-compulsive disorder required a greater number of sessions. There were no significant differences between the percentage of patients who completed treatment and dropout rates in specific phobia, general anxiety disorder and obsessive-compulsive disorder. Differences between epidemiological and clinical data are discussed.

  14. 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…

  15. 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…

  16. Anxiety Disorders in Childhood: Casting a Nomological Net

    ERIC Educational Resources Information Center

    Weems, Carl F.; Stickle, Timothy R.

    2005-01-01

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

  17. 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…

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

    PubMed

    Kutlu, Munir Gunes; Gould, Thomas J

    2015-10-15

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

  19. 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.

  20. 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

  1. Anxiety- and depressive-like profiles during early- and mid-adolescence in the female Wistar Kyoto rat.

    PubMed

    D'Souza, Deepthi; Sadananda, Monika

    2017-02-01

    Approaches for the development of preclinical models of depression extensively use adult and male animals owing to the discrepancies arising out of the hormonal flux in adult females and adolescents during attainment of puberty. Thus the increased vulnerability of females towards clinical depression and anxiety-related disorders remains incompletely understood. Development of clinical models of depression in adolescent females is essential in order to evolve effective treatment strategies for adolescent depression. In the present study, we have examined the anxiety and depressive-like profiles in a putative animal model of childhood depression, the Wistar Kyoto (WKY) rat, during early adolescence (∼postnatal day 30) and mid-adolescence (∼postnatal day 40). Female adolescent WKY rats, tested on a series of behavioural tests modelling anxiety- and depressive-like behaviours with age-matched Wistars as controls, demonstrated marked differences during early adolescence in a strain- and age-specific manner. Anxiety indices were obtained from exposure to the elevated plus maze, where social communication vide 50-kHz ultrasonic vocalizations was also assessed, while immobility and other parameters in the forced swim test were screened for depressive-like profiles. Sucrose preference, used as a measure of anhedonia in animals, was lower in WKYs at both ages tested and decreased with age. Anxiety-related behaviours were prominent in WKY rats only during early adolescence. WKY female rats are anxious during early adolescence and exhibit anhedonia as a core symptom of depression during early- and mid-adolescence, thus indicating that inclusion of female animals in preclinical trials is essential and will contribute to gender-based approaches to diagnosis and treatment of adolescent depression in females.

  2. Effects of juvenile exposure to predator odor on adolescent and adult anxiety and pain nociception.

    PubMed

    Post, Ryan J; Dahlborg, Kaitlyn M; O'Loughlin, Lauren E; Bloom, Christopher M

    2014-05-28

    Clinical researchers have tracked patients with early life trauma and noted generalized anxiety disorder, unipolar depression, and risk-taking behaviors developing in late adolescence and into early adulthood. Animal models provide an opportunity to investigate the neural and developmental processes that underlie the relationship between early stress and later abnormal behavior. The present model used repeated exposure to 2,3,5-trimethyl-3-thiazoline (TMT), a component of fox feces, as an unconditioned fear-eliciting stimulus in order to induce stress in juvenile rats aged postnatal day (PND) 23 through 27. After further physical maturation characteristic of the adolescent stage (PND 42), animals were tested using an elevated plus maze (EPM) for anxiety and plantar test (Hargreaves method) for pain to assess any lingering effects of the juvenile stress. To assess how an additional stress later in life affects anxiety and pain nociception, PND 43 rats were exposed to inescapable shock (0.8mA) and again tested on EPM and plantar test. A final testing period was conducted in the adult (PND 63) rats to assess resulting changes in adult behaviors. TMT-exposed rats were significantly more anxious in adolescence than controls, but this difference disappeared after exposure to the secondary stressor. In adulthood, but not in adolescence, TMT-exposed rats demonstrated lower pain sensitivity than controls. These results suggest that early life stress can play a significant role in later anxiety and pain nociception, and offer insight into the development and manifestation of anxiety- and trauma-related disorders.

  3. Somatic complaints in children with anxiety disorders and their unique prediction of poorer academic performance.

    PubMed

    Hughes, Alicia A; Lourea-Waddell, Brittany; Kendall, Philip C

    2008-06-01

    The present study aimed to examine somatic complaints in children with anxiety disorders compared to non-anxious control children and whether somatic complaints predict poorer academic performance. The sample consisted of 108 children and adolescents (aged 8-14 years) assessed by a structured diagnostic interview: 69 with a principal (i.e., most severe and/or interfering) anxiety disorder diagnosis and 39 non-anxious community controls. Established child and parent report measure of somatic complaints, anxiety, and internalizing symptoms were completed. The participants' primary teacher was used to assess academic performance. Findings indicated that children with anxiety disorders reported more somatic complaints than the non-anxious community controls. Furthermore, a greater frequency of somatic complaints uniquely predicted poorer academic performance beyond that accounted for by anxiety and internalizing symptoms based on both child and parent report measures. Knowledge about somatic complaints in children with anxiety disorders and their relation to academic functioning may allow for early identification and prevent academic problems.

  4. Body Dysmorphic Disorder and Other Clinically Significant Body Image Concerns in Adolescent Psychiatric Inpatients: Prevalence and Clinical Characteristics

    ERIC Educational Resources Information Center

    Dyl, Jennifer; Kittler, Jennifer; Phillips, Katharine A.; Hunt, Jeffrey I.

    2006-01-01

    Background: This study assessed prevalence and clinical correlates of body dysmorphic disorder (BDD), eating disorders (ED), and other clinically significant body image concerns in 208 consecutively admitted adolescent inpatients. It was hypothesized that adolescents with BDD would have higher levels of depression, anxiety, and suicidality.…

  5. The Role of Stress Reactivity in the Long-term Persistence of Adolescent Social Anxiety Symptoms.

    PubMed

    Nelemans, S A; Hale, W W; Branje, S J T; van Lier, P A C; Koot, H M; Meeus, W H J

    2017-03-05

    Social Anxiety Disorder (SAD) symptoms demonstrate a marked persistence over time, but little is known empirically about short-term processes that may account for this long-term persistence. In this study, we examined how self-reported and physiological stress reactivity were associated with persistence of SAD symptoms from early to late adolescence. A community sample of 327 adolescents (56% boys, Mage=13.01 at T1) reported their SAD symptoms for 6 successive years and participated in a public speaking task, during which self-reported (i.e., perceived nervousness and heart rate) and physiological (i.e., cortisol and heart rate) measures of stress were taken. Overall, our results point to a developmental process in which adolescents with a developmental history of higher SAD symptoms show both heightened perceived stress reactivity and heart rate reactivity, which, in turn, predict higher SAD symptoms into late adolescence.

  6. Children with social anxiety and other anxiety disorders show similar deficits in habitual emotional regulation: evidence for a transdiagnostic phenomenon.

    PubMed

    Keil, Verena; Asbrand, Julia; Tuschen-Caffier, Brunna; Schmitz, Julian

    2017-01-11

    Deficits in emotion regulation (ER) are an important factor in maintaining social anxiety disorder (SAD) in adults. As SAD and ER problems typically develop during childhood and adolescence, and are maintained dynamically within the parent-child dyad, research on families can help to reveal the role ER plays in the early development of SAD. The current study assessed self-reported habitual ER in dyads of children with SAD (n = 31), children with mixed anxiety disorders (MAD; n = 41) and healthy control children (HC; n = 36), and their parents. Results indicate a transdiagnostic quality of ER in that, children with SAD and children with MAD similarly reported less adaptive and more maladaptive ER strategies than HC children, whereas no group differences in parental ER strategies emerged. Furthermore, children's ER strategies aggressive action, withdrawal and self-devaluation and the parental ER strategy reappraisal were associated with social anxiety symptoms. These results suggest that there may be deficits in ER which generalize across childhood anxiety disorders. Our results are discussed in relation to current theories and their implications for treatment of childhood SAD.

  7. Genetics of Anxiety and Trauma-Related Disorders

    PubMed Central

    Norrholm, Seth D.; Ressler, Kerry J.

    2009-01-01

    Anxiety disorders are the most common psychiatric illnesses in the U.S. with approximately 30% of the population experiencing anxiety-related symptoms in their lifetime (Kessler et al., 2005). Notably, a variety of studies have demonstrated that 30−40% of the variance contributing to these disorders is heritable. In the present review, we discuss the latest findings regarding the genetic and environmental influences on the development and symptomatology of anxiety disorders. Specific emphasis is placed on posttraumatic stress disorder (PTSD) due to its uniqueness as an anxiety disorder; its diagnosis is dependent on a precipitating traumatic event and its development appears to be mediated by both genetic and environmental contributions. The co-morbidity of anxiety disorders and the potential reclassification of anxiety disorders as part of DSM-V are reviewed given the potential impact on the interpretation and design of genetic investigations. Lastly, several keys to future genetic studies are highlighted. Thorough analyses of the gene by environment (GxE) interactions that govern one's vulnerability to anxiety disorder(s), the effectiveness of individual treatment strategies, and the severity of symptoms may lead to more effective prophylactic (e.g., social support) and treatment strategies. PMID:19540311

  8. An association of early puberty with disordered eating and anxiety in a population of undergraduate women and men

    PubMed Central

    Zehr, Julia L.; Culbert, Kristen M.; Sisk, Cheryl L.; Klump, Kelly L.

    2007-01-01

    Eating and anxiety disorders are more prevalent in females, increase during adolescence, and are associated with early pubertal development. This study examined whether timing of puberty onset is associated with disordered eating and anxiety in a large sample of post-pubertal male and female undergraduate students. Self-report questionnaires assessed timing of puberty, disordered eating, anxiety, alcohol use, personality, and sensation seeking. Females scored significantly higher on measures of disordered eating (binge eating, dietary restraint, eating concerns, and weight and shape concerns) and anxiety (state and trait anxiety) than did males. In addition, early maturing women and men scored significantly higher on measures of disordered eating and anxiety than on-time or late maturing women and men. Measures of alcohol use, sensation seeking, and personality characteristics differed in males and females but did not vary with pubertal timing. Findings suggest that early puberty is associated with disordered eating and anxiety, and this association may be due to an organizational effect of pubertal hormones. Despite important differences in body fat composition, both males and females experiencing early puberty had an increased incidence of disordered eating. The fact that early puberty was associated with increased eating and anxiety symptoms in both sexes suggests that puberty may influence these symptoms through both biological and psychosocial mechanisms. PMID:17707381

  9. An association of early puberty with disordered eating and anxiety in a population of undergraduate women and men.

    PubMed

    Zehr, Julia L; Culbert, Kristen M; Sisk, Cheryl L; Klump, Kelly L

    2007-11-01

    Eating and anxiety disorders are more prevalent in females, increase during adolescence, and are associated with early pubertal development. This study examined whether timing of puberty onset is associated with disordered eating and anxiety in a large sample of postpubertal male and female undergraduate students. Self-report questionnaires assessed timing of puberty, disordered eating, anxiety, alcohol use, personality, and sensation seeking. Females scored significantly higher on measures of disordered eating (binge eating, dietary restraint, eating concerns, and weight and shape concerns) and anxiety (state and trait anxiety) than did males. In addition, early maturing women and men scored significantly higher on measures of disordered eating and anxiety than on time or late maturing women and men. Measures of alcohol use, sensation seeking, and personality characteristics differed in males and females but did not vary with pubertal timing. Findings suggest that early puberty is associated with disordered eating and anxiety, and this association may be due to an organizational effect of pubertal hormones. Despite important differences in body fat composition, both males and females experiencing early puberty had an increased incidence of disordered eating. The fact that early puberty was associated with increased eating and anxiety symptoms in both sexes suggests that puberty may influence these symptoms through both biological and psychosocial mechanisms.

  10. Long term therapy of generalized anxiety disorder.

    PubMed

    Rouillon, Frédéric

    2004-04-01

    Generalized anxiety disorder (GAD) is a common (lifetime prevalence: 5.1%), recurrent condition, which often heralds other psychiatric disorders, notably depression. As by definition it is a disorder progressing over months, treatment should be designed on a long term basis. And yet, few studies have been conducted beyond the classical 6-8 weeks characterizing the acute treatment phase. This is especially true of anxiolytics, but also of antidepressants, with the exception of paroxetine and venlafaxine, which are the only drugs approved in this indication in Western countries. The efficacy of psychotherapy, notably relaxation and cognitive-behavioral therapy, is established in the treatment of GAD, but its preferred indications and possible combination with antidepressants are still to be specified. Long term, not to say very long term studies of GAD, as well as depression, will still be required in the future to improve its management and specify therapeutic modalities (combination treatment, optimal duration, continuous or intermittent therapy, choice of psychotherapeutic techniques or agents, em leader ). Early and adequately prolonged treatment should not only result in more numerous remission periods, but also in decreased frequency of co-morbidities whether depressive, addictive, or of another nature, and should also reduce the social impact of GAD.

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

    PubMed Central

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

    2014-01-01

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

  12. Mediators of Change in the Child/Adolescent Anxiety Multimodal Treatment Study

    PubMed Central

    Kendall, Philip C.; Cummings, Colleen M.; Villabø, Marianne A.; Narayanan, Martina K.; Treadwell, Kimberli; Birmaher, Boris; Compton, Scott; Piacentini, John; Sherrill, Joel; Walkup, John; Gosch, Elizabeth; Keeton, Courtney; Ginsburg, Golda; Suveg, Cindy; Albano, Anne Marie

    2015-01-01

    Objective Test changes in (a) coping efficacy and (b) anxious self-talk as potential mediators of treatment gains at 3-month follow-up in the Child/Adolescent Anxiety Multimodal Treatment Study (CAMS). Method Participants were 488 youth (ages 7-17; 50.4% male) randomized to cognitive-behavioral therapy (CBT; Coping cat program), pharmacotherapy (sertraline), their combination, or pill placebo. Participants met DSM-IV criteria for generalized anxiety disorder, social phobia, and/or separation anxiety disorder. Coping efficacy (reported ability to manage anxiety provoking situations) was measured by youth and parent reports on the Coping Questionnaire, and anxious self-talk was measured by youth report on the Negative Affectivity Self-Statement Questionnaire. Outcome was measured using the Pediatric Anxiety Rating Scale (completed by Independent Evaluators blind to condition). For temporal precedence, residualized treatment gains were assessed at 3-month follow-up. Results Residualized gains in coping efficacy mediated gains in the CBT, sertraline, and combination conditions. In the combination condition, some unique effect of treatment remained. Treatment assignment was not associated with a reduction in anxious self-talk, nor did anxious self-talk predict changes in anxiety symptoms. Conclusions The findings suggest that improvements in coping efficacy are a mediator of treatment gains. Anxious self-talk did not emerge as a mediator. PMID:26460572

  13. Intolerance of Uncertainty, Fear of Anxiety, and Adolescent Worry

    ERIC Educational Resources Information Center

    Dugas, Michel J.; Laugesen, Nina; Bukowski, William M.

    2012-01-01

    A 5 year, ten wave longitudinal study of 338 adolescents assessed the association between two forms of cognitive vulnerability (intolerance of uncertainty and fear of anxiety) and worry. Multilevel mediational analyses revealed a bidirectional and reciprocal relation between intolerance of uncertainty and worry in which change in one variable…

  14. Childhood and Adolescent Anxiety and Depression: Beyond Heritability

    ERIC Educational Resources Information Center

    Franic, Sanja; Middeldorp, Christel M.; Dolan, Conor V.; Ligthart, Lannie; Boomsma, Dorret I.

    2010-01-01

    Objective: To review the methodology of behavior genetics studies addressing research questions that go beyond simple heritability estimation and illustrate these using representative research on childhood and adolescent anxiety and depression. Method: The classic twin design and its extensions may be used to examine age and gender differences in…

  15. Prospective Links between Social Anxiety and Adolescent Peer Relations

    ERIC Educational Resources Information Center

    Tillfors, Maria; Persson, Stefan; Willen, Maria; Burk, William J.

    2012-01-01

    This study examines bi-directional links between social anxiety and multiple aspects of peer relations (peer acceptance, peer victimization, and relationship quality) in a longitudinal sample of 1528 adolescents assessed twice with one year between (754 females and 774 males; M = 14.7 years of age). Lower levels of peer acceptance predicted…

  16. Social Anxiety Disorder: More Than Just a Little Shyness.

    PubMed

    Jefferson, James W.

    2001-02-01

    Social anxiety is defined as a "marked and persistent fear of social or performance situations" and includes such symptoms as sweating, palpitations, shaking, and respiratory distress. Social anxiety is fairly common, occurring in as much as 13% of the population, and can be extremely disabling. It can be either specific (confined to 1 or 2 performance situations) or generalized, and can be diagnosed with a scale-based questionnaire. Social anxiety may coexist with other disorders, such as depression and dysthymia. The differential diagnosis for social anxiety includes panic disorder, agoraphobia, atypical depression, and body dysmorphic disorder. Treatment for social anxiety can be quite effective and consists of psychotherapy, pharmacotherapy (including such medications as beta-blockers, anxiolytics, antidepressants, and anticonvulsants), or a combination. This article details the prevalence, onset, disease impact, and etiology of social anxiety. Specific treatments, including both psychotherapy and pharmacotherapy, are presented in detail, along with other treatment considerations, such as comorbidity.

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  18. Family Correlates of Comorbid Anxiety Disorders in Children with Attention Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Pfiffner, Linda J.; McBurnett, Keith

    2006-01-01

    This study evaluated parental anxiety and parenting practices associated with comorbid Anxiety Disorders among children with Attention Deficit/Hyperactivity Disorder. Clinic-referred families (n = 143) were diagnosed using DSM criteria. Parents and children completed measures of parenting practices. Comorbid anxiety in children was significantly…

  19. What Is the Threshold of Teachers' Recognition and Report of Concerns about Anxiety and Depression in Students? An Exploratory Study with Teachers of Adolescents in Regional Australia

    ERIC Educational Resources Information Center

    Trudgen, Michelle; Lawn, Sharon

    2011-01-01

    Introduction: Anxiety and depression in adolescence is prevalent but often unrecognised and untreated. This can lead to serious disorders in later life. This study explored how teachers recognise anxiety and depression in secondary school students and act on their concerns. Method: Twenty teachers from four secondary colleges in regional Victoria,…

  20. Family Accommodation of Child and Adolescent Anxiety: Mechanisms, Assessment, and Treatment

    PubMed Central

    Norman, Kaila R.; Silverman, Wendy K.

    2016-01-01

    TOPIC Anxiety disorders are the most common mental health concern for youth. Unfortunately, a substantial number of children and adolescents do not respond positively to current evidence-based interventions and/or relapse. As pediatric anxiety disorders are fundamentally a systemic phenomenon, focusing on the ways in which parents become involved in their children’s anxiety symptoms may be a promising alternative approach to treatment. PURPOSE To inform psychiatric mental health nurse practitioners (PMHNPs) about the phenomenology, associated neurobiology, and assessment of family accommodation (FA) as well as clinical interventions targeting FA. FA refers to ways that parents adapt their own behaviors to reduce their children’s anxiety-related distress. SOURCES USED A literature search was performed using Psyc-INFO and PubMed. CONCLUSIONS Current findings indicate a high prevalence of FA associated with pediatric anxiety disorders. FA has a potentially deleterious impact on course of illness and treatment response and is associated with greater caregiver burden. Potential neurobiological underpinnings of FA include dysregulation of parent cortico-limbic circuitry and the oxytocinergic system. PMHNPs are in a unique position to identify families engaged in problematic FA, educate their clientele, provide psychotherapy services with the goal of reducing FA, and consult with multidisciplinary team members. PMID:26238937

  1. 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.

  2. 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

  3. Long-term pharmacological treatment of generalized anxiety disorder.

    PubMed

    Mahe, V; Balogh, A

    2000-03-01

    Generalized anxiety disorder (GAD) is one of the most common anxiety disorders and has a poor prognosis, although it is often thought to be a minor complaint. This disorder has a chronic course of 5-15 years and longer. Long-term treatment with the commonly used benzodiazepines is controversial because of concerns over tolerance and dependence. We performed a thorough search of the literature for clinical trials of a duration of over 2 months conducted in patients with generalized anxiety disorder in order to identify any successful long-term treatment of this disorder. Only eight long-term reports of studies conducted in well-defined homogeneous groups of patients diagnosed with generalized anxiety disorder were found with the methodology of these studies presenting a number of limiting factors. The results are inconclusive and no reference drug could be identified. In addition, an adequate evaluation of the long-term treatment of GAD has not yet been performed.

  4. Maternal Over-Control Moderates the Association between Early Childhood Behavioral Inhibition and Adolescent Social Anxiety Symptoms

    ERIC Educational Resources Information Center

    Lewis-Morrarty, Erin; Degnan, Kathryn A.; Chronis-Tuscano, Andrea; Rubin, Kenneth H.; Cheah, Charissa S. L.; Pine, Daniel S.; Henderon, Heather A.; Fox, Nathan A.

    2012-01-01

    Behavioral inhibition (BI) and maternal over-control are early risk factors for later childhood internalizing problems, particularly social anxiety disorder (SAD). Consistently high BI across childhood appears to confer risk for the onset of SAD by adolescence. However, no prior studies have prospectively examined observed maternal over-control as…

  5. Child/Adolescent Anxiety Multimodal Study (CAMS): rationale, design, and methods

    PubMed Central

    2010-01-01

    Objective To present the design, methods, and rationale of the Child/Adolescent Anxiety Multimodal Study (CAMS), a recently completed federally-funded, multi-site, randomized placebo-controlled trial that examined the relative efficacy of cognitive-behavior therapy (CBT), sertraline (SRT), and their combination (COMB) against pill placebo (PBO) for the treatment of separation anxiety disorder (SAD), generalized anxiety disorder (GAD) and social phobia (SoP) in children and adolescents. Methods Following a brief review of the acute outcomes of the CAMS trial, as well as the psychosocial and pharmacologic treatment literature for pediatric anxiety disorders, the design and methods of the CAMS trial are described. Results CAMS was a six-year, six-site, randomized controlled trial. Four hundred eighty-eight (N = 488) children and adolescents (ages 7-17 years) with DSM-IV-TR diagnoses of SAD, GAD, or SoP were randomly assigned to one of four treatment conditions: CBT, SRT, COMB, or PBO. Assessments of anxiety symptoms, safety, and functional outcomes, as well as putative mediators and moderators of treatment response were completed in a multi-measure, multi-informant fashion. Manual-based therapies, trained clinicians and independent evaluators were used to ensure treatment and assessment fidelity. A multi-layered administrative structure with representation from all sites facilitated cross-site coordination of the entire trial, study protocols and quality assurance. Conclusions CAMS offers a model for clinical trials methods applicable to psychosocial and psychopharmacological comparative treatment trials by using state-of-the-art methods and rigorous cross-site quality controls. CAMS also provided a large-scale examination of the relative and combined efficacy and safety of the best evidenced-based psychosocial (CBT) and pharmacologic (SSRI) treatments to date for the most commonly occurring pediatric anxiety disorders. Primary and secondary results of CAMS will hold

  6. Power spectrum analysis and cardiovascular morbidity in anxiety disorders.

    PubMed

    Cohen, Hagit; Benjamin, Jonathan

    2006-07-30

    Spectral analysis of heart rate variability (HRV) and related measures has been shown to be a reliable noninvasive technique enabling quantitative assessment of cardiovascular autonomic regulatory responses to autonomic regulatory mechanisms; it provides a dynamic probe of sympathetic and parasympathetic tone, reflecting the interactions between the two. Over 20 studies reported abnormalities of HRV in anxiety, and patients with heart disease and anxiety are at increased risk for morbidity and mortality. Psychiatric drugs partly correct abnormalities of HRV and, recently, autonomic drugs (beta-blockers) have been studied in anxiety disorders. The authors call for further studies, especially in patients with co-existing anxiety disorders and heart disease, incorporating assessment of HRV.

  7. Cognitive bias modification of interpretations: a viable treatment for child and adolescent anxiety?

    PubMed

    Lau, Jennifer Y F

    2013-10-01

    Anxiety disorders in children and adolescents are common and impairing. As many patients do not benefit from - or have difficulties accessing - frontline treatments, novel, effective and easy-to-deliver interventions are needed. Cognitive Bias Modification of Interpretations (CBM-I) training has been used to treat adult anxiety disorders. CBM-I methods train individuals to endorse benign rather than negative resolutions of ambiguous cues. Developmental extensions of CBM-I are important for several reasons. First, implementing CBM-I in symptomatic children and adolescents may facilitate early preventative gains. Second, as training uses simple learning mechanisms, CBM-I may reflect a developmentally-suitable strategy for shaping adaptive processing styles. Third, as this age range involves protracted neurocognitive maturation and associated plasticity, administering CBM-I early could drive powerful, long-lasting benefits for emotional development. Finally, data from CBM-I studies could inform the cognitive mechanisms involved in the genesis of early-emerging anxiety. This paper provides the first organised review of CBM-I studies conducted in children and adolescents, and contains suggestions for future research that may help realise the therapeutic potential of early CBM-I interventions.

  8. The Unexpected Effects of Beneficial and Adverse Social Experiences during Adolescence on Anxiety and Aggression and Their Modulation by Genotype

    PubMed Central

    Meyer, Neele; Richter, S. Helene; Schreiber, Rebecca S.; Kloke, Vanessa; Kaiser, Sylvia; Lesch, Klaus-Peter; Sachser, Norbert

    2016-01-01

    Anxiety and aggression are part of the behavioral repertoire of humans and animals. However, in their exaggerated form both can become maladaptive and result in psychiatric disorders. On the one hand, genetic predisposition has been shown to play a crucial modulatory role in anxiety and aggression. On the other hand, social experiences have been implicated in the modulation of these traits. However, so far, mainly experiences in early life phases have been considered crucial for shaping anxiety-like and aggressive behavior, while the phase of adolescence has largely been neglected. Therefore, the aim of the present study was to elucidate how levels of anxiety-like and aggressive behavior are shaped by social experiences during adolescence and serotonin transporter (5-HTT) genotype. For this purpose, male mice of a 5-HTT knockout mouse model including all three genotypes (wildtype, heterozygous and homozygous 5-HTT knockout mice) were either exposed to an adverse social situation or a beneficial social environment during adolescence. This was accomplished in a custom-made cage system where mice experiencing the adverse environment were repeatedly introduced to the territory of a dominant opponent but had the possibility to escape to a refuge cage. Mice encountering beneficial social conditions had free access to a female mating partner. Afterwards, anxiety-like and aggressive behavior was assessed in a battery of tests. Surprisingly, unfavorable conditions during adolescence led to a decrease in anxiety-like behavior and an increase in exploratory locomotion. Additionally, aggressive behavior was augmented in animals that experienced social adversity. Concerning genotype, homozygous 5-HTT knockout mice were more anxious and less aggressive than heterozygous 5-HTT knockout and wildtype mice. In summary, adolescence is clearly an important phase in which anxiety-like and aggressive behavior can be shaped. Furthermore, it seems that having to cope with challenge during

  9. 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

  10. Dynamic associations among alcohol use and anxiety symptoms in early adolescence.

    PubMed

    Pardee, Carolyn Speidel; Colder, Craig R; Bowker, Julie C

    2014-12-01

    The relationship between anxiety and alcohol use in adolescence remains unclear, with evidence for no association and for risk and protective effects of anxiety. Considering developmental trajectories may be important for understanding the association between anxiety and alcohol use and may help clarify prior mixed findings. The present study examined trajectories of alcohol use, social anxiety symptoms, and general anxiety symptoms in early to middle adolescence through the use of univariate and parallel process growth models. Social anxiety and general anxiety symptoms declined, while alcohol use increased with age. Parallel process growth models suggested that less rapid declines in social anxiety and general anxiety symptoms were associated with more rapid escalation in alcohol use. These results suggest that young adolescents who do not show normative declines in social anxiety or general anxiety symptoms may be at risk for more rapid increases in alcohol use.

  11. Dynamic associations among alcohol use and anxiety symptoms in early adolescence

    PubMed Central

    Pardee, Carolyn Speidel; Colder, Craig R.; Bowker, Julie C.

    2014-01-01

    The relationship between anxiety and alcohol use in adolescence remains unclear, with evidence for no association, as well as risk and protective effects of anxiety. Considering developmental trajectories may be important for understanding the association between anxiety and alcohol use, and may help clarify prior mixed findings. The present study examined trajectories of alcohol use, social anxiety and general anxiety symptoms in early to middle adolescence using univariate and parallel process growth models. Social anxiety and general anxiety symptoms declined, while alcohol use increased with age. Parallel process growth models suggested that less rapid declines in social anxiety and general anxiety symptoms were associated with more rapid escalation in alcohol use. These results suggest that young adolescents who do not show normative declines in social anxiety or general anxiety symptoms may be at risk for more rapid increases in alcohol use. PMID:25528052

  12. Relations of tripartite dimensions of emotion to childhood anxiety and mood disorders.

    PubMed

    Chorpita, B F; Plummer, C M; Moffitt, C E

    2000-06-01

    This study examined preliminary higher-order models relating tripartite dimensions of emotion to severity of anxiety and depressive disorders in 100 clinically referred children and adolescents. In light of the accumulating support for multifactor models of vulnerability and negative emotion in children, the present investigation was designed to establish preliminary estimates of the structure and magnitude of the relations of three emotion factors with dimensions of social anxiety, depression, panic, generalized anxiety, obsessions/compulsions, and separation anxiety. Results were consistent with structures that minimally specified two higher-order emotion factors, yet only some parameter estimates were consistent with theory regarding the tripartite model. Problems with the measurement of tripartite factors and possibilities for further research are outlined.

  13. The LAOM Multidimensional Anxiety Scale for Measuring Anxiety in Children and Adolescents: Addressing the Psychometric Properties of the Scale

    ERIC Educational Resources Information Center

    Kozina, Ana

    2012-01-01

    The article introduces a new anxiety scale, called the LAOM (Lestvica anksioznosti za otroke in mladostnike [The anxiety scale for children and adolescents]) for measuring self-reported multidimensional anxiety. The scale has been developed with a special focus on the school setting, using one sample from an elementary school which is…

  14. The nuclear receptor Tlx regulates motor, cognitive and anxiety-related behaviours during adolescence and adulthood.

    PubMed

    O'Leary, James D; Kozareva, Danka A; Hueston, Cara M; O'Leary, Olivia F; Cryan, John F; Nolan, Yvonne M

    2016-06-01

    The nuclear receptor Tlx is a key regulator of embryonic and adult hippocampal neurogenesis and has been genetically linked to bipolar disorder. Mice lacking Tlx (Nr2e1(-/-)) display deficits in adult hippocampal neurogenesis and behavioural abnormalities. However, whether Tlx regulates behaviour during adolescence or in a sex-dependent manner remains unexplored. Therefore, we investigated the role of Tlx in a series of behavioural tasks in adolescent male and female mice with a spontaneous deletion of Tlx (Nr2e1(-/-) mice). Testing commenced at adolescence (postnatal day 28) and continued until adulthood (postnatal day 67). Adolescent male and female Nr2e1(-/-) mice were hyperactive in an open field, an effect that persisted in adulthood. Male but not female Nr2e1(-/-) mice exhibited reduced thigmotaxis during adolescence and adulthood. Impairments in rotarod motor performance developed in male and female Nr2e1(-/-) mice at the onset of adulthood. Spontaneous alternation in the Y-maze, a hippocampus-dependent task, was impaired in adolescent but not adult male and female Nr2e1(-/-) mice. Contextual fear conditioning was impaired in adolescent male Nr2e1(-/-) mice only, but both male and female adolescent Nr2e1(-/-) mice showed impaired cued fear conditioning, a hippocampal-amygdala dependent cognitive process. These deficits persisted into adulthood in males but not females. In conclusion, deletion of Tlx impairs motor, cognitive and anxiety-related behaviours during adolescence and adulthood in male and female mice with most effects occurring during adolescence rather than adulthood, independent of housing conditions. This suggests that Tlx has functions beyond regulation of adult hippocampal neurogenesis, and may be an important target in understanding neurobiological disorders.

  15. Impact of Treatments for Depression on Comorbid Anxiety, Attentional, and Behavioral Symptoms in Adolescents with Selective Serotonin Reuptake Inhibitor-Resistant Depression

    ERIC Educational Resources Information Center

    Hilton, Robert C.; Rengasamy, Manivel; Mansoor, Brandon; He, Jiayan; Mayes, Taryn; Emslie, Graham J.; Porta, Giovanna; Clarke, Greg N.; Wagner, Karen Dineen; Birmaher, Boris; Keller, Martin B.; Ryan, Neal; Shamseddeen, Wael; Asarnow, Joan Rosenbaum; Brent, David A.

    2013-01-01

    Objective: To assess the relative efficacy of antidepressant medication, alone and in combination with cognitive behavioral therapy (CBT), on comorbid symptoms of anxiety, attention, and disruptive behavior disorders in participants in the Treatment of Resistant Depression in Adolescents (TORDIA) trial. Method: Adolescents with selective serotonin…

  16. Variants of girls and boys with conduct disorder: anxiety symptoms and callous-unemotional traits.

    PubMed

    Euler, Felix; Jenkel, Nils; Stadler, Christina; Schmeck, Klaus; Fegert, Jörg M; Kölch, Michael; Schmid, Marc

    2015-05-01

    Recent research suggests that among the group of aggressive and antisocial adolescents, there are distinct variants who exhibit different levels of anxiety symptoms and callous-unemotional traits (CU traits). The purpose of the present study was to examine whether such variants are also present in male and female adolescents diagnosed with conduct disorder (CD). We used model-based cluster analysis to disaggregate data of 158 adolescents with CD (109 boys, 49 girls; mean age =15.61 years) living in child welfare and juvenile justice institutions. Three variants were identified: (1) CD only, (2) CD with moderate CU traits and anxiety symptoms, and (3) CD with severe CU traits. Variants differed in external validation measures assessing anger and irritability, externalizing behavior, traumatic experiences, and substance use. The CD variant with moderate CU traits and anxiety symptoms had the most severe pattern of psychopathology. Our results also indicated distinct profiles of personality development for all three variants. Gender-specific comparisons revealed differences between girls and boys with CD on clustering and external validation measures and a gender-specific cluster affiliation. The present results extend previously published findings on variants among aggressive and antisocial adolescents to male and female adolescents diagnosed with CD.

  17. The Effectiveness of Mindfulness-Based Cognitive Therapy on Iranian Female Adolescents Suffering From Social Anxiety

    PubMed Central

    Ebrahiminejad, Shima; Poursharifi, Hamid; Bakhshiour Roodsari, Abbas; Zeinodini, Zahra; Noorbakhsh, Simasadat

    2016-01-01

    Background Social anxiety is one of the most common psychological disorders that exists among children and adolescents, and it has profound effects on their psychological states and academic achievements. Objectives The aim of this study was to determine the effectiveness of mindfulness-based cognitive therapy (MBCT) on diminishing social anxiety disorder symptoms and improving the self-esteem of female adolescents suffering from social anxiety. Patients and Methods Semi-experimental research was conducted on 30 female students diagnosed with social anxiety. From the population of female students who were studying in Tehran’s high schools in the academic year of 2013 - 2014, 30 students fulfilling the DSM-5 criteria were selected using the convenience sampling method and were randomly assigned to control and experimental groups. The experimental group received eight sessions of MBCT treatment. The control group received no treatment. All participants completed the social phobia inventory (SPIN) and Rosenberg self-esteem scale (RSES) twice as pre- and post-treatment tests. Results The results from the experimental group indicated a statistically reliable difference between the mean scores from SPIN (t (11) = 5.246, P = 0.000) and RSES (t (11) = -2.326, P = 0.040) pre-treatment and post-treatment. On the other hand, the results of the control group failed to reveal a statistically reliable difference between the mean scores from SPIN (t (12) = 1.089, P = 0.297) and RSES pre-treatment and post-treatment (t (12) = 1.089, P = 0.000). Conclusions The results indicate that MBCT is effective on both the improvement of self-esteem and the decrease of social anxiety. The results are in accordance with prior studies performed on adolescents. PMID:28191335

  18. Escitalopram in the treatment of generalized anxiety disorder.

    PubMed

    Baldwin, David S; Nair, Rajesh V

    2005-07-01

    The selective serotonin reuptake inhibitor escitalopram is the active enantiomer of citalopram and has proven efficacy in the treatment of major depression, panic disorder and social phobia. Accumulating data indicate that it is also efficacious in the treatment of patients with generalized anxiety disorder. This drug profile summarizes the current evidence-base for the treatment of generalized anxiety disorder, describes the findings of a series of randomized placebo-controlled and comparator-controlled trials of escitalopram, examines the strengths and weaknesses of current treatment approaches and considers potential new therapies for the treatment of this common, chronic and impairing anxiety disorder. In summary, escitalopram is effective and well tolerated in both the short- and long-term treatment of generalized anxiety disorder, and has advantages over benzodiazepines and the selective serotonin reuptake inhibitor paroxetine.

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

    PubMed

    Chambless, Dianne L

    2012-05-01

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

  20. Intimate relationship involvement, intimate relationship quality, and psychiatric disorders in adolescents.

    PubMed

    Whisman, Mark A; Johnson, Daniel P; Li, Angela; Robustelli, Briana L

    2014-12-01

    Prior research has shown that poor relationship quality in marriage and other intimate relationships demonstrates cross-sectional and longitudinal associations with a variety of psychiatric disorders in adults. In comparison, there has been less research on the covariation between relationship quality and psychiatric disorders in adolescents, a developmental period that is associated with elevated risk of incidence of several disorders and that is important for the acquisition and maintenance of intimate relationships. The present study was conducted to examine the associations between intimate relationship involvement, intimate relationship quality, and psychiatric disorders in a population-based sample of adolescents. The associations between relationship involvement, positive and negative relationship quality, and 12-month prevalence of mood, anxiety, and substance use disorders were evaluated in adolescents from the National Comorbidity Survey-Adolescent Supplement. Participants completed an interview-based assessment of psychiatric disorders and a self-report measure of relationship quality. Results indicated that the prevalence of broad categories of mood, anxiety, and substance use disorders, and several specific disorders were significantly associated with (a) being married, cohabiting, or involved in a serious relationship; and (b) reporting more negative (but not less positive) relationship quality. For several disorders, the association between the disorder and relationship involvement was moderated by age, wherein the strength of the association decreased in magnitude with increasing age. Findings suggest that being in an intimate relationship and reporting higher levels of negative relationship quality are associated with the prevalence of several common psychiatric disorders in adolescents.

  1. [Treatment of generalized anxiety disorder in terms of cognitive behavioral].

    PubMed

    Kamrowska, Anna; Gmitrowicz, Agnieszka

    2016-02-01

    Risk of generalized anxiety disorder (GAD) within life is estimated at 2.6-5.1%. Amongst etiological factors that affect the development of the disorder are: biological and psychological problems, including cognitive models. There are known several cognitive models: metacognitive, Borkovec'c model and the model developed in Quebec. Key cognitive contents that occur with generalized anxiety disorder are focused on two aspects: metacognitive beliefs and intolerance of uncertainty. A primary purpose of cognitive-behavioural therapy (CBT) is the modification of dysfunctional beliefs about worry. Cognitive behavioural therapy is effective in reducing anxiety, makes it easier to operate in the professional sphere and improves the quality of life.

  2. Reliability and Validity of Borderline Personality Disorder in Hospitalized Adolescents

    PubMed Central

    Glenn, Catherine R.; Klonsky, E. David

    2013-01-01

    Objective: Although the DSM-IV suggests that dysfunctional personality patterns can be traced back to adolescence, there is continued debate about whether borderline personality disorder (BPD) can be reliably and validly diagnosed before age 18. The current study examined the reliability and validity of BPD in a large sample of adolescent psychiatric patients. Method: BPD and Axis I disorders were assessed with validated structured interviews and a series of clinical, emotion, and personality correlates were assessed with validated self-report questionnaires. Results: Consistent with previous studies in adolescent clinical samples, approximately 30% of patients in the current sample met criteria for BPD. The nine BPD criteria demonstrated good internal consistency, equivalent to rates reported in adult samples. In addition, BPD was related to greater clinical severity and impairment as indexed by strong associations with all major Axis I disorders, as well as with dimensional measures of depression, anxiety, difficulties with emotion regulation, and impulsiveness. Notably, reliability and validity remained satisfactory even when analyses were limited to younger adolescents between the ages of 12 and 14. Conclusions: Overall, findings suggest that BPD can be reliably and validly diagnosed in adolescents as young as 12–14 years old. PMID:23970909

  3. Suicidal behavior in adolescents with post-traumatic stress disorder.

    PubMed

    Ganz, D; Sher, L

    2010-08-01

    Recently, the prevalence of post-traumatic stress disorder (PTSD) in adolescence is higher than the prevalence of PTSD in adult populations. PTSD and suicidality are often found in populations of adolescents presenting with other emotional disorders (particularly mood disorders), traumatic grief, childhood abuse, and/or a family or peer history of suicide. The reasons and developments of the association between PTSD and suicidality in adolescence, however, remain unclear. Core psychobiological changes contributing to PTSD affect emotion, arousal, perception of the self and the world, irritability, impulsivity, anger, aggression and depression. There is evidence that the aforementioned factors, as well as alcohol and other drug use may act to moderate the influence of stressful life events and lead to eventual suicidality. Both PTSD and suicidality in adolescents have also been hypothesized to be a result of exposure to violence and negative coping styles. There are many treatment challenges for these populations, yet the most promising prevention and treatments include suicide risk screenings, suicide education, Dialectical Behavioral Therapy, addressing associated coping mechanisms and prescribing anti-depressant and anti-anxiety medications. However, when prescribing medications, physicians do need to be careful to consider the weaknesses and strengths of each of the pharmacological options as they apply to adolescents presenting with PTSD and suicidality.

  4. Social Anxiety and the Severity and Typography of Stuttering in Adolescents

    ERIC Educational Resources Information Center

    Mulcahy, Kylie; Hennessey, Neville; Beilby, Janet; Byrnes, Michelle

    2008-01-01

    The present study examined the relationship between anxiety, attitude toward daily communication, and stuttering symptomatology in adolescent stuttering. Adolescents who stuttered (n = 19) showed significantly higher levels of trait, state and social anxiety than fluent speaking controls (n = 18). Trait and state anxiety was significantly…

  5. The Adolescent Mattering Experience: Gender Variations in Perceived Mattering, Anxiety, and Depression

    ERIC Educational Resources Information Center

    Dixon, Andrea L.; Scheidegger, Corey; McWhirter, J. Jeffries

    2009-01-01

    Individuals who perceive that they matter to others are likely to experience lower anxiety and depression levels. The effects of young adolescents' perceived mattering on their anxiety and depression levels were examined. Results indicated that female adolescents reported lower anxiety levels but greater depression levels than did male…

  6. Career Exploration in Adolescents: The Role of Anxiety, Attachment, and Parenting Style

    ERIC Educational Resources Information Center

    Vignoli, Emmanuelle; Croity-Belz, Sandrine; Chapeland, Valerie; de Fillipis, Anne; Garcia, Martine

    2005-01-01

    The aim of the study was to examine the role of parent-adolescent attachment, adolescent anxiety and parenting style in the career exploration process and in career satisfaction. Three kinds of anxiety were considered: general trait anxiety, fear of failing in one's career and fear of disappointing one's parents. The participants were 283 French…

  7. Anxiety trajectories and identity development in adolescence: a five-wave longitudinal study.

    PubMed

    Crocetti, Elisabetta; Klimstra, Theo; Keijsers, Loes; Hale, William W; Meeus, Wim

    2009-07-01

    The aim of this five-wave longitudinal study was to investigate the relationship between anxiety and adolescent identity development. Participants were 1,313 adolescents who annually completed measures of anxiety and identity. Growth Mixture Modeling (GMM) analyses demonstrated that the adolescent population was best typified by two latent growth trajectory classes: a low anxiety class (n = 1,199) characterized by a low initial level of anxiety that decreased over time and a high anxiety class (n = 114) characterized by a higher initial level of anxiety that increased over time. To answer our research question, we tested a model in which the anxiety classes predicted initial levels and rates of change of three identity dimensions: commitment, in-depth exploration, and reconsideration of commitment. Findings indicated that the high anxiety adolescents displayed a more troublesome identity development than their low anxiety peers, since their commitments became weaker with age, and they reconsidered them intensively.

  8. Sex Differences in Internalizing Problems During Adolescence in Autism Spectrum Disorder.

    PubMed

    Oswald, Tasha M; Winter-Messiers, Mary Ann; Gibson, Brandon; Schmidt, Alexandra M; Herr, Cynthia M; Solomon, Marjorie

    2016-02-01

    We hypothesized that the double hit conferred by sex and diagnosis increases the risk for internalizing disorders in adolescent females with autism spectrum disorder (ASD). In a sample of 32 adolescents with ASD and 32 controls, we examined the effects of sex, diagnostic factors, and developmental stages on depression and anxiety. A 3-way interaction revealed that females with ASD exhibited greater depressive symptoms than males with ASD and female controls particularly during early adolescence; therefore, females with ASD might have a unique combination of genetic, hormonal, and psychosocial vulnerabilities that heighten their risk for depression during early adolescence. Additionally, the ASD group reported high levels of separation anxiety and panic in late adolescence, possibly indicating atypical development of independence.

  9. Social Anxiety Disorders and Alcohol Abuse

    MedlinePlus

    ... Disorder Specific Phobias Obsessive-Compulsive Disorder (OCD) Posttraumatic Stress Disorder (PTSD) Depression Bipolar Disorder Suicide and Prevention Stress Related Illnesses Myth-Conceptions Find ...

  10. 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.

  11. Interpersonal Callousness and Co-Occurring Anxiety: Developmental Validity of an Adolescent Taxonomy

    PubMed Central

    2016-01-01

    Growing evidence suggests heterogeneity within interpersonal-callous (IC) youth based on co-occurring anxiety. The developmental validity of this proposed taxonomy remains unclear however, as most previous research is cross-sectional and/or limited to adolescence. We aimed to identify low-anxiety (IC/ANX−) and high-anxiety (IC/ANX+) IC variants, and compare these groups on (a) early risk exposures, (b) psychiatric symptoms from midchildhood to early adolescence, and (c) school-based functioning. Using the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective epidemiological birth cohort, model-based cluster analysis was performed on children with complete age-13 IC and anxiety scores (n = 6,791). Analysis of variance was used to compare resulting clusters on (a) prenatal and postnatal family adversity and maternal psychopathology, and harsh parenting; (b) developmental differences in attention-deficit/hyperactivity disorder (ADHD), conduct disorder (CD), oppositional defiant disorder (ODD), emotional difficulties, and low pro-social behavior at 7, 10, and 13 years; and (c) teacher-reported discipline problems, along with standardized test performance. We identified a 4-cluster solution: “typical,” “low,” “IC/ANX−”, and “IC/ANX+.” IC/ANX+ youth showed the highest prenatal and postnatal levels of family adversity and maternal psychopathology, highest levels of ADHD, CD, ODD, and emotional difficulties, greatest discipline problems, and lowest national test scores (all p < .001). IC/ANX+ also showed a distinct pattern of increasing psychopathology from age 7 to 13 years. Adolescent IC subtypes were successfully validated in ALSPAC across multiple raters using prenatal and early postnatal risk, repeated measures of psychopathology, and school-based outcomes. Greater prenatal environmental risk among IC/ANX+ youth suggests an important target for early intervention. PMID:27977232

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

    MedlinePlus

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

  13. The effects of media violence on anxiety in late adolescence.

    PubMed

    Madan, Anjana; Mrug, Sylvie; Wright, Rex A

    2014-01-01

    Exposure to media violence is related to anxiety in youth, but the causality of the effect has not been established. This experimental study examined the effects of media violence on anxiety, blood pressure, and heart rate in late adolescents. We also examined whether these responses varied by previous exposure to media and real-life violence. College students (N = 209; M age = 18.74; 75 % female; 50 % Caucasian, 34 % African American, 9 % Asian, 3 % Hispanic, and 3 % other racial minorities) were randomized to view either violent or nonviolent high-action movie clips. Participants reported on their anxiety before and after watching the clips, as well as their previous exposure to violence. Measures of blood pressure and heart rate were taken at baseline and during movie viewing. Participants watching violent movie clips showed a greater anxiety increase than those watching nonviolent clips. Both groups experienced increased blood pressure and reduced heart rate during movie watching compared to baseline. Prior exposure to media violence was associated with diminished heart rate response. Additionally, students previously exposed to high levels of real-life violence showed lower blood pressure increases when watching violent clips compared to nonviolent clips. Thus, relatively brief exposure to violent movie clips increased anxiety among late adolescents. Prior exposure to media and real-life violence were associated with lower physiological reactivity to high-action and violent movies, respectively, possibly indicating desensitization. Future studies should investigate long-term anxiety and physiological consequences of regular exposure to media violence in adolescence.

  14. Interpretation Bias Modification for Youth and their Parents: A Novel Treatment for Early Adolescent Social Anxiety

    PubMed Central

    Reuland, Meg M.; Teachman, Bethany A.

    2014-01-01

    Social anxiety is the most prevalent anxiety disorder of late adolescence, yet current treatments reach only a minority of youth with the disorder. Effective and easy-to-disseminate treatments are needed. This study pilot tested the efficacy of a novel, online cognitive bias modification for interpretation (CBM-I) intervention for socially anxious youth and their parents. The CBM-I intervention targeted cognitive biases associated with early adolescents’ maladaptive beliefs regarding social situations, and with parents’ intrusive behavior, both of which have been theoretically linked with the maintenance of social anxiety in youth. To investigate the efficacy of intervening with parents and/or children, clinically diagnosed early adolescents (ages 10–15; N = 18) and their mothers were randomly assigned to one of three conditions: the first targeted early adolescents’ cognitive biases related to social anxiety (Child-only condition); the second targeted parents’ biases associated with intrusive behavior (Parent-only condition); and the third targeted both youth and parents’ biases in tandem (Combo condition). The use of a multiple baseline design allowed for the efficient assessment of causal links between the intervention and reduction in social anxiety symptoms in youth. Results provided converging evidence indicating modest support for the efficacy of CBM-I, with no reliable differences across conditions. Taken together, results suggest that online CBM-I with anxious youth and/or their parents holds promise as an effective and easily administered component of treatment for child social anxiety that deserves further evaluation in a larger trial. PMID:25445075

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

    ERIC Educational Resources Information Center

    Gadow, Kenneth D.; Nolan, Edith E.

    2011-01-01

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

  16. Is Separation Anxiety in Adolescents and Parents Related to Parental Differentiation of Self?

    ERIC Educational Resources Information Center

    Peleg, Ora; Miller, Paul; Yitzhak, Meital

    2015-01-01

    The current study examined the relationship between separation anxiety in adolescents after their transition to middle school, on the one hand, and differentiation of self and separation anxiety in their parents, on the other hand. The sample included 88 adolescents from northern Israel, together with their biological parents. Adolescents'…

  17. Early Learning Experience and Adolescent Anxiety: A Cross-Cultural Comparison between Japan and England

    ERIC Educational Resources Information Center

    Essau, Cecilia A.; Ishikawa, Shin-ichi; Sasagawa, Satoko

    2011-01-01

    The main aim of this study was to compare the frequency of anxiety symptoms among adolescents in Japan and England, and to examine the association between early learning experiences and anxiety symptoms. A total of 299 adolescents (147 from England and 152 from Japan), aged 12 to 17 years were investigated. Results showed that adolescents in…

  18. An Evaluation of the Applicability of the Tripartite Constructs to Social Anxiety in Adolescents

    ERIC Educational Resources Information Center

    Anderson, Emily R.; Veed, Glen J.; Inderbitzen-Nolan, Heidi M.; Hansen, David J.

    2010-01-01

    The current study examined the tripartite model of anxiety and depression in relation to social phobia in a nonclinical sample of adolescents (ages 13-17). Adolescent/parent dyads participated in a semistructured interview and completed self-report measures of the tripartite constructs and social anxiety. Adolescents gave an impromptu speech, and…

  19. 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).…

  20. 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…

  1. 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…

  2. 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…

  3. Validation of the Social Interaction Anxiety Scale and the Social Phobia Scale across the Anxiety Disorders.

    ERIC Educational Resources Information Center

    Brown, Elissa J.; And Others

    1997-01-01

    The psychometric adequacy of the Social Interaction Scale and the Social Phobia Scale (both by R. P. Mattick and J. C. Clark, 1989) was studied with 165 patients with anxiety disorders and 21 people without anxiety. Results support the usefulness of the scales for screening and treatment design and evaluation. (SLD)

  4. 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,…

  5. A Rorschach comparison of psychopathic and nonpsychopathic conduct disordered adolescents.

    PubMed

    Smith, A M; Gacono, C B; Kaufman, L

    1997-06-01

    Forty-eight male subjects who met the DSM-IV (APA, 1994) criteria for conduct disorder (CD) were assessed for psychopathy level using a modified version of the Psychopathy Checklist-Revised (PCL-R, Forth, Hart, & Hare, 1990). Rorschach variables associated with self-perception, affects, and object relations, early behavioral problems and history of violence were compared between psychopathic and nonpsychopathic CD adolescents. Psychopathic CD subjects were significantly more self-centered and violent than nonpsychopathic CD subjects. Decreased attachment and anxiety were found in both CD groups. Our study adds empirical support to the heterogeneity noted among CD adolescents (PCL-R), supports the utility of the Rorschach for detecting individual differences among CD subjects, and extends the empirical work of Gacono and Meloy (1994) to adolescent psychopathy.

  6. Enhanced anger superiority effect in generalized anxiety disorder and panic disorder.

    PubMed

    Ashwin, Chris; Holas, Pawel; Broadhurst, Shanna; Kokoszka, Andrzej; Georgiou, George A; Fox, Elaine

    2012-03-01

    People are typically faster and more accurate to detect angry compared to happy faces, which is known as the anger superiority effect. Many cognitive models of anxiety suggest anxiety disorders involve attentional biases towards threat, although the nature of these biases remains unclear. The present study used a Face-in-the-Crowd task to investigate the anger superiority effect in a control group and patients diagnosed with either generalized anxiety disorder (GAD) or panic disorder (PD). The main finding was that both anxiety groups showed an enhanced anger superiority effect compared to controls, which is consistent with key theories of anxiety. Furthermore, both anxiety groups showed a differential pattern of enhanced bias towards threat depending on the crowd in the displays. The different attentional bias patterns between the GAD and PD groups may be related to the diverse symptoms in these disorders. These findings have implications for the diagnosis and treatment of anxiety.

  7. Commentary: Transdiagnostic neuroscience of child and adolescent mental disorders--differentiating decision-making in attention-deficit/hyperactivity disorder, conduct disorder, depression and anxiety. A commentary on Sonuga-Barke et al. (2016).

    PubMed

    Rohde, Luis Augusto

    2016-03-01

    Sonuga-Barke, Cortese, Fairchild, and Stringaris offer us new insights not only on the neuropsychological processes and neurobiological mechanisms involved in the decision-making process but also how some of the most relevant child mental disorders might impact this process through a very comprehensive review of the pertinent literature. Although it is difficult to select specific points for discussing in a so dense review, I would like to highlight some aspects for 'whetting readers appetite' and seduce them to be in contact with the fascinating neurobiology behind an essential aspect of our lives.

  8. 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.

  9. 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

  10. The psychosocial treatments interview for anxiety disorders. A method for assessing psychotherapeutic procedures in anxiety disorders

    PubMed Central

    Steketee, G; Perry, JC; Goisman, RM; Warshaw, MG; Massion, AO; Peterson, LG; Langford, L; Weinshenker, N; Farreras , IG; Keller , MB

    1997-01-01

    The authors report on development, reliability, and findings of the Psychosocial Treatments Interview (PTI) to assess treatments reported by patients in a naturalistic study of the longitudinal course of anxiety disorders. The PTI ascertains frequency of different types of psychosocial treatments, based on patients' reports. The PTI showed good internal consistency and very good interrater reliability. At first 6-month follow-up, the most common modalities were supportive, medication discussion, and dynamic intervention. Combinations were common. Delivery of treatments differed by site. Overall, the PTI fills a methodological need for the assessment of the treatments reported by patients in naturalistic follow-up studies. PMID:9185065

  11. The psychosocial treatments interview for anxiety disorders. A method for assessing psychotherapeutic procedures in anxiety disorders.

    PubMed

    Steketee, G; Perry, J C; Goisman, R M; Warshaw, M G; Massion, A O; Peterson, L G; Langford, L; Weinshenker, N; Farreras, I G; Keller, M B

    1997-01-01

    The authors report on development, reliability, and findings of the Psychosocial Treatments Interview (PTI) to assess treatments reported by patients in a naturalistic study of the longitudinal course of anxiety disorders. The PTI ascertains frequency of different types of psychosocial treatments, based on patients' reports. The PTI showed good internal consistency and very good interrater reliability. At first 6-month follow-up, the most common modalities were supportive, medication discussion, and dynamic intervention. Combinations were common. Delivery of treatments differed by site. Overall, the PTI fills a methodological need for the assessment of the treatments reported by patients in naturalistic follow-up studies.

  12. Prospective community study of family stress and anxiety in (pre)adolescents: the TRAILS study.

    PubMed

    van Oort, Floor V A; Verhulst, Frank C; Ormel, Johan; Huizink, Anja C

    2010-06-01

    For prevention of anxiety in children and adolescents, it is important to know whether family stress is a predictor of anxiety. We studied this in 1,875 adolescents from the Tracking Adolescents' Individual Lives Survey (TRAILS) who were followed up for 2 years, from age 10-12 to 12-14 years. Adolescents reported anxiety and depression symptoms at both assessments, and parents reported family stress (family dysfunction and parenting stress) at the first assessment. Family dysfunction was not associated with future anxiety, whereas high parenting stress was. Furthermore, family dysfunction was more strongly associated with anxiety than with depression, whereas parenting stress was more strongly associated with depression. Level of parental psychopathology explained part of the association of family stress with anxiety. The associations were modest and the understanding of the origins of adolescents' anxiety will require identifying other factors than family stress that account for more of the variance.

  13. Psychometric properties of the Spence Children's Anxiety Scale (SCAS) in Mainland Chinese children and adolescents.

    PubMed

    Zhao, Jinxia; Xing, Xiaopei; Wang, Meifang

    2012-10-01

    This study examined the psychometric properties of the Spence Children's Anxiety Scale (SCAS) in a Mainland Chinese community sample. The 38-item Chinese version of SCAS was administered to 1878 children and adolescents. Multiple group confirmatory factor analyses supported a common 6-factor model of SCAS for children and adolescents, and for boys and girls. The internal consistency and test-retest reliability of SCAS were satisfactory. Convergent and divergent validity of SCAS were supported by significant correlations with a measure of anxiety to a greater extent than with a measure of depression. Adolescents reported higher anxiety levels than children, and girls reported higher anxiety levels than boys. Compared to other studies, anxiety symptoms of Chinese children were found at a moderate level, but anxiety symptoms of Chinese adolescents were found at a high level. Our findings suggest that the SCAS is suitable for assessing anxiety symptoms in Mainland Chinese children and adolescents.

  14. Health functioning impairments associated with posttraumatic stress disorder, anxiety disorders, and depression.

    PubMed

    Zayfert, Claudia; Dums, Aricca R; Ferguson, Robert J; Hegel, Mark T

    2002-04-01

    Although anxiety disorders have been associated with impairments in self-reported health functioning, the relative effect of various anxiety disorders has not been studied. We compared health functioning of patients with a principal diagnosis of posttraumatic stress disorder (PTSD), panic disorder (PD), generalized anxiety disorder (GAD), and major depressive disorder (MDD). Patients with PTSD and MDD were equally impaired on overall mental health functioning, and both were significantly worse than patients with PD and GAD. PTSD was associated with significantly worse physical health functioning relative to PD, GAD, and MDD. Hierarchical regression showed that the association of PTSD with physical health functioning was unique and was not caused by the effects of age, depression, or comorbid anxiety disorders. Both PTSD and comorbid anxiety accounted for unique variance in mental functioning. These results highlight the association of PTSD with impaired physical and mental functioning and suggest that effective treatment of PTSD may affect overall health.

  15. Threat Perception Bias and Anxiety among Chinese School Children and Adolescents

    ERIC Educational Resources Information Center

    Lu, Weili; Daleiden, Eric; Lu, Shou-En

    2007-01-01

    This study evaluated the relationship between threat perception bias and anxiety among children and adolescents in China. A sample of 1,004 elementary, middle and high school students aged 9 to 19 years listened to stories containing themes of generalized anxiety, social anxiety and separation anxiety in either an ambiguous or non-ambiguous…

  16. Interpersonal Psychotherapy-Adolescent Skills Training: Anxiety Outcomes and Impact of Comorbidity

    ERIC Educational Resources Information Center

    Young, Jami F.; Makover, Heather B.; Cohen, Joseph R.; Mufson, Laura; Gallop, Robert J.; Benas, Jessica S.

    2012-01-01

    Given the frequent comorbidity of anxiety and depression, it is important to study the effects of depression interventions on anxiety and the impact of comorbid anxiety on depression outcomes. This article reports on pooled anxiety and depression data from two randomized trials of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), a…

  17. Anxiety sensitivity mediates relations between emotional disorders and smoking.

    PubMed

    Zvolensky, Michael J; Farris, Samantha G; Leventhal, Adam M; Schmidt, Norman B

    2014-09-01

    Research has documented consistent and robust relations between emotional disorders (i.e., depressive and anxiety disorders) and smoking. Yet, it is presently unclear whether anxiety sensitivity--the fear of aversive internal anxiety states--accounts for the relations between emotional disorders and various smoking processes, including nicotine dependence, perceived barriers to smoking cessation, and severity of problematic symptoms during past cessation attempts. Participants (N = 465) were treatment-seeking daily tobacco smokers recruited as part of a larger tobacco-cessation study. Baseline (pretreatment) data were utilized. Emotional disorders were assessed via clinical diagnostic interview; self-report measures were used to assess anxiety sensitivity and 3 criterion variables: nicotine dependence, barriers to smoking cessation, and severity of problematic symptoms while quitting in past attempts. Emotional disorders were predictive of higher levels of nicotine dependence, greater perceived barriers to cessation, and greater severity of problematic symptoms while attempting to quit in the past; each of these relations were accounted for by the indirect effect of anxiety sensitivity. The present findings suggest that anxiety sensitivity may be an important transdiagnostic construct in explicating the nature of the relations between emotional disorders and various smoking processes.

  18. Psychiatric Disorders and Sexual Risk among Adolescents in Mental Health Treatment

    PubMed Central

    Brown, Larry K.; Hadley, Wendy; Stewart, Angela; Lescano, Celia; Whiteley, Laura; Donenberg, Geri; DiClemente, Ralph

    2010-01-01

    Objective To examine the relationship between psychiatric disorders and sexual behaviors among adolescents receiving mental health treatment. Adolescents in mental health treatment have been found to have higher rates of HIV risk behavior than their peers, but data concerning the relationship between psychopathology and risk are inconsistent and limited. Method Eight hundred and forty adolescents (56% female, 58% African American, mean age 14.9 years) and their parents completed computerized assessments of psychiatric symptoms via the Computerized Diagnostic Interview Schedule for Children (C-DISC). Adolescents also reported on sexual risk behaviors (vaginal/anal sex, condom use at last sex) and completed urine screens for a sexually transmitted infection (STI). Results Adolescents meeting criteria for Mania, externalizing disorder (Oppositional Defiant, Conduct, and Attention Deficit Hyperactivity Disorders) or comorbid internalizing (Major Depressive, Generalized Anxiety, and Post-Traumatic Stress Disorders) and externalizing disorders were significantly more likely to report a lifetime history of vaginal or anal sex than those who did not meet criteria for any psychiatric disorder (OR = 2.0, 2.3 and 1.9, respectively). Adolescents meeting criteria for Mania were significantly more likely to have two or more partners in the past 90 days (OR= 3.2) and test positive for a STI (OR = 4.3) relative to adolescents who did not meet criteria for a psychiatric disorder. Conclusions The presence of internalizing and externalizing disorders, especially Mania, suggests the need for careful screening and targeting of adolescent sexual behavior during psychiatric treatment. PMID:20658815

  19. A parent-child interactional model of social anxiety disorder in youth.

    PubMed

    Ollendick, Thomas H; Benoit, Kristy E

    2012-03-01

    In this paper, one of the most common disorders of childhood and adolescence, social anxiety disorder (SAD), is examined to illustrate the complex and delicate interplay between parent and child factors that can result in normal development gone awry. Our parent-child model of SAD posits a host of variables that converge to occasion the onset and maintenance of this disorder. Specifically, five risk factors--temperamental characteristics of the child, parental anxiety, attachment processes in the parent-child dyad, information processing biases, and parenting practices--will be highlighted. While it is acknowledged that other factors including genetic influences and peer relationships may also be important, they are simply not the focus of this paper. Within these constraints, the implications of our parent-child interaction model for prevention, treatment, research, and practice will be explored.

  20. Serum cytokines and anxiety in adolescent depression patients: Gender effect.

    PubMed

    Pallavi, Pooja; Sagar, Rajesh; Mehta, Manju; Sharma, Subhadra; Subramanium, Arulselvi; Shamshi, Farah; Sengupta, Utpal; Pandey, Ravindra M; Mukhopadhyay, Asok K

    2015-09-30

    The present study compares the serum cytokine levels between adolescent depression patients and healthy controls and assesses correlation between depression, anxiety scores and serum levels of eight cytokines. Study also checked the variation in serum levels with medication status (medication free/naïve vs. patients on medication). Following clinical and psychometric assessment of 77 adolescent (aged 13-18 years) depression patients (49 males and 28 females; 56 medication free/naïve) and 54 healthy controls (25 males, 29 females), eight cytokines (IL-1β, IL-2, IL-6, IL-10, TNF-α, IFN-γ, TGF-β1 and IL-17A {denoted IL-17 throughout}) were measured in serum using ELISA. Depressed adolescents had significantly high levels of IL-2 (p<0.001) and IL-6 (p=0.03) as compared to controls. The female population skewed the result of one cytokine (IL-6) in patients. Anxiety scores showed positive correlation (only in female patients) with IL-1β, IL-10 and negative correlation with TGF-β1 and IL-17. The gender effect in relationship between anxiety and cytokines was not straightforward. On comparing study groups on the medication/naïve status, IL-2 and TGF-β1 showed significant difference between the groups (p<0.001, p=0.007 higher in medicated). Depression in adolescents was associated with elevation of proinflammatory serum cytokines with a gender bias for females. Anxiety scores correlated negatively with TGF-β1 and IL-17.

  1. Attention Deficit Hyperactivity Disorder and Anxiety in Children With Malignancy.

    PubMed

    Yousefi Chaijan, Parsa; Sharafkhah, Mojtaba; Abdolrazaghnejad, Ali; Amiri, Mohammad; Ebrahimi Monfared, Mohsen; Fatemi Tabaei, Saghi

    2016-11-01

    Attention deficit hyperactivity disorder (ADHD) and Anxiety is the most common childhood psychiatric disorder. Based on studies, these disorders are more prevalent in some chronic disease. This study aimed at investigating the prevalence of ADHD and anxiety in children with malignancy and anxiety in their parents and comparing the results with those of the control group. One hundred, 3-15-year-old children with malignancy and 100 healthy children without malignancy or any chronic disease were included in this case-control study as case and control groups, respectively. Subjects were selected from children who were referred to the pediatric ward of Amir Kabir Hospital of Arak, Iran, in the form of simple probability and based on inclusion and exclusion criteria. ADHD and Anxiety were diagnosed by Conner's Parent Rating Scale-48 (CPRS-48) and Hamilton Anxiety Rating Scale (HARS) and were confirmed by psychologist consult. Data were analyzed by Student t-test in SPSS18. ADHD was observed in 23 cases (23%) with malignancy and 5 controls (5%) (P=0.001). In the case group, 57 children (57%) and 45 of their parents (45%) were suffering from anxiety while in the control group the figure was observed in 12 children (12%) and 11 of their parents (11%) (P=0.001). ADHD and anxiety are more common in children with malignancy as compared with children without malignancy and anxiety is also more common in their parents. Therefore, implementing interventions and psychiatric counseling are recommended for these children and their parents.

  2. Safe enough to sleep: sleep disruptions associated with trauma, posttraumatic stress, and anxiety in children and adolescents.

    PubMed

    Charuvastra, Anthony; Cloitre, Marylene

    2009-10-01

    Sleep disturbance is an essential symptom of posttraumatic stress disorder, and recent evidence suggests that disrupted sleep may play an important role in the development of posttraumatic stress disorder following traumatic stress. The authors review several aspects of sleep as it relates to posttraumatic stress disorder. First, there is an association between traumatic stress and different components of disrupted sleep in children and adolescents. Second, sleep disruption appears to be a core feature of other pediatric anxiety disorders, and the authors consider if this preexisting sleep vulnerability may explain in part why preexisting anxiety disorders are a risk factor for developing posttraumatic stress disorder following a traumatic event. Third, the authors consider attachment theory and the social context of trauma and sleep disruption. This article concludes with a consideration of the therapeutic implications of these findings.

  3. Interpersonal psychotherapy-adolescent skills training: anxiety outcomes and impact of comorbidity.

    PubMed

    Young, Jami F; Makover, Heather B; Cohen, Joseph R; Mufson, Laura; Gallop, Robert J; Benas, Jessica S

    2012-01-01

    Given the frequent comorbidity of anxiety and depression, it is important to study the effects of depression interventions on anxiety and the impact of comorbid anxiety on depression outcomes. This article reports on pooled anxiety and depression data from two randomized trials of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), a depression prevention program. Ninety-eight adolescents were randomized to receive IPT-AST or school counseling (SC). Outcome and predictor analyses were performed utilizing hierarchical linear models. IPT-AST adolescents had significantly greater reductions in anxiety and depressive symptoms than SC adolescents during the intervention. Baseline anxiety symptoms predicted change in depressive symptoms for adolescents in both intervention conditions, with adolescents low in baseline anxiety demonstrating more rapid change in depressive symptoms than adolescents high in baseline anxiety. These findings indicate that IPT-AST is effective at decreasing both depressive and anxiety symptoms. For adolescents with comorbid symptoms of anxiety, there may be slower rates of change in depressive symptoms following prevention programs.

  4. Short health anxiety inventory: factor structure and psychometric properties in Spanish adolescents.

    PubMed

    Morales, Alexandra; Espada, José P; Carballo, José L; Piqueras, José A; Orgilés, Mireia

    2015-02-01

    The Short Health Anxiety Inventory is a common screening tool for assessing health anxiety among adolescents; however, its psychometric properties and internal structure have not been evaluated within a Spanish-speaking population. The goodness of fit of four models of the latent structure of the Short Health Anxiety Inventory was tested by using confirmatory factor analysis in a sample of 832 Spanish secondary school adolescents. Based on these results, the reliability of the original two-factor model was tested. Differences in health anxiety by gender and age were also examined. The results support use of the Spanish version of the Short Health Anxiety Inventory by researchers and clinicians among Spanish adolescents.

  5. Metacognitive therapy for generalized anxiety disorder: an open trial.

    PubMed

    Wells, Adrian; King, Paul

    2006-09-01

    Generalized anxiety disorder (GAD) responds only modestly to existing cognitive-behavioural treatments. This study investigated a new treatment based on an empirically supported metacognitive model [Wells, (1995). Metacognition and worry: A cognitive model of generalized anxiety disorder. Behavioural and Cognitive Psychotherapy, 23, 301-320; Wells, (1997). Cognitive therapy of anxiety disorders: A practice manual and conceptual guide. Chichester, UK: Wiley]. Ten consecutive patients fulfilling DSM-IV criteria for GAD were assessed before and after metacognitive therapy, and at 6, and 12-month follow-up. Patients were significantly improved at post-treatment, with large improvements in worry, anxiety, and depression (ESs ranging from 1.04-2.78). In all but one case these were lasting changes. Recovery rates were 87.5% at post treatment and 75% at 6 and 12 months. The treatment appears promising and controlled evaluation is clearly indicated.

  6. Adolescent offenders with mental disorders.

    PubMed

    Grisso, Thomas

    2008-01-01

    Thomas Grisso points out that youth with mental disorders make up a significant subgroup of youth who appear in U.S. juvenile courts. And he notes that juvenile justice systems today are struggling to determine how best to respond to those youths' needs, both to safeguard their own welfare and to reduce re-offending and its consequences for the community. In this article, Grisso examines research and clinical evidence that may help in shaping a public policy that addresses that question. Clinical science, says Grisso, offers a perspective that explains why the symptoms of mental disorders in adolescence can increase the risk of impulsive and aggressive behaviors. Research on delinquent populations suggests that youth with mental disorders are, indeed, at increased risk for engaging in behaviors that bring them to the attention of the juvenile justice system. Nevertheless, evidence indicates that most youth arrested for delinquencies do not have serious mental disorders. Grisso explains that a number of social phenomena of the past decade, such as changes in juvenile law and deficiencies in the child mental health system, appear to have been responsible for bringing far more youth with mental disorders into the juvenile justice system. Research shows that almost two-thirds of youth in juvenile justice detention centers and correctional facilities today meet criteria for one or more mental disorders. Calls for a greater emphasis on mental health treatment services in juvenile justice, however, may not be the best answer. Increasing such services in juvenile justice could simply mean that youth would need to be arrested in order to get mental health services. Moreover, many of the most effective treatment methods work best when applied in the community, while youth are with their families rather than removed from them. A more promising approach, argues Grisso, could be to develop community systems of care that create a network of services cutting across public child

  7. 24- and 36-Week Outcomes for the Child/Adolescent Anxiety Multimodal Study (CAMS)

    PubMed Central

    Piacentini, John; Bennett, Shannon; Compton, Scott; Kendall, Phillip; Birmaher, Boris; Albano, Anne Marie; March, John; Sherrill, Joel; Sakolsky, Dara; Ginsburg, Golda; Rynn, Moira; Bergman, R. Lindsey; Gosch, Elizabeth; Waslick, Bruce; Iyengar, Satish; McCracken, James; Walkup, John

    2014-01-01

    Objective We report active treatment group differences on response and remission rates and changes in anxiety severity at weeks 24 and 36 for the Child/Adolescent Anxiety Multimodal Study (CAMS). Method CAMS youth (N=488; 74%≤12 years) with DSM-IV separation, generalized, or social anxiety disorder were randomized to 12 weeks of cognitive behavior therapy (CBT), sertraline (SRT), CBT+SRT (COMB), or medication management/pill placebo (PBO). Responders attended 6 monthly booster sessions in their assigned treatment arm; youth in COMB and SRT continued on their medication throughout this period. Efficacy of COMB, SRT, and CBT (N=412) was assessed at 24 and 36 weeks postrandomization. Youth randomized to PBO (n=76) were offered active CAMS treatment if nonresponsive at week 12 or over follow-up and were not included here. Independent evaluators blind to study condition assessed anxiety severity, functioning, and treatment response. Concomitant treatments were allowed but monitored over follow-up. Results Most (>80%) acute responders maintained positive response at both weeks 24 and 36. Consistent with acute outcomes, COMB maintained advantage over CBT and SRT, which did not differ, on dimensional outcomes; the 3 treatments did not differ on most categorical outcomes over follow-up. Compared to COMB and CBT, youth in SRT obtained more concomitant psychosocial treatments, while those in SRT and CBT obtained more concomitant combined (medication plus psychosocial) treatment. Discussion COMB maintained advantage over CBT and SRT on some measures over follow-up, while the 2 monotherapies remained indistinguishable. The observed convergence of COMB and monotherapy may be related to greater use of concomitant treatment during follow-up among youth receiving the monotherapies, although other explanations are possible. While outcomes were variable, most CAMS-treated youth enjoyed sustained treatment benefit. Clinical trial registration information— Child and Adolescent

  8. A multidimensional anxiety assessment of adolescents after Typhoon Morakot-associated mudslides.

    PubMed

    Yen, Cheng-Fang; Tang, Tze-Chun; Yang, Pinchen; Chen, Cheng-Sheng; Cheng, Chung-Ping; Yang, Rei-Cheng; Huang, Ming-Shyan; Jong, Yuh-Jyh; Yu, Hsin-Su

    2011-01-01

    The aims of this study were to examine the factor structure, reliability and validity of the Taiwanese version of the Multidimensional Anxiety Scale for Children (MASC-T) in a group of adolescents in mountainous regions worst affected by Typhoon Morakot-associated mudslides. In total, 271 adolescents in grades 7-9 completed the MASC-T and the Chinese version of the Impact of Events Scale-Revised (C-IES-R). They also received a diagnostic interview to determine whether they had post-traumatic stress disorder (PTSD). We examined adequacy of the original four-factor structure of the MASC-T using confirmatory factor analysis, as well as its internal reliability, discriminant and predictive validities for PTSD, and convergent validity with the C-IES-R. Results support adequacy of the four-factor structure and internal reliability of the MASC-T in adolescents affected by Typhoon Morakot. Scores for the total MASC-T and subscales significantly discriminated adolescents with PTSD from those without PTSD. However, levels of predictive values for PTSD and the convergent validity with the C-IES-R differed among the MASC-T subscales and the total scale. The physical symptoms and harm avoidance subscales had the highest and lowest predictive accuracies for presence of PTSD, respectively. The MASC-T combined with diagnostic interviews for PTSD and self-report measures for assessing PTSD-specific symptoms can be used to evaluate a broad range of anxiety symptoms.

  9. 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…

  10. Childhood stressful events, HPA axis and anxiety disorders.

    PubMed

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

    2012-02-22

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

  11. The long-term clinical course of generalized anxiety disorder.

    PubMed

    Keller, Martin B

    2002-01-01

    Although generalized anxiety disorder (GAD) is a common disorder associated with significant levels of morbidity, little is known of its long-term course and outcomes. During the first 5 years, GAD follows a chronic course with low rates of remission and moderate rates of relapse/recurrence following remission. Retrospective studies suggest that this chronic pattern may last up to 20 years. It is hoped that, as with depression, long-term prospective studies in GAD will provide insight into the course, nature, and outcomes of the disorder over time. The studies will also identify any changes in the duration and severity of episodes of GAD over time, enabling treatments to effectively reflect the course of the disorder. Studies of other anxiety disorders and depression suggest that the course and outcome of the disorder may be influenced by certain factors such as stressful life events, anxiety sensitivity/negative affect, gender, subsyndromal symptoms, and comorbid disorders. Currently, studies are underway to determine the effects of these factors on the risk of relapse/recurrence, maintenance of full symptoms, and development of subsyndromal symptoms in GAD. GAD is currently underrecognized and undertreated, but it is hoped that this will change with the ever-increasing awareness of anxiety disorders. As treatment for GAD becomes more common, future prospective studies will identify the effect of therapy on the course and nature of the disorder, leading to increased understanding of GAD and the development of effective treatment strategies tailored for individual patients.

  12. [Bipolar disorder in children and adolescents].

    PubMed

    Dame, C; Casper, P

    2006-01-01

    Bipolar disorder affects all age categories, included children and adolescents (in this case, prepubertal and early adolescent or PEA-BP). Its diagnosis at this age is difficult for two reasons: first, clinical symptoms are different from these encountered by adults and second, an important psychiatric comorbidity is often observed (especially with attention-deficit/hyperactivity disorder or ADHD). This review presents the clinical presentation, the differential diagnosis, the familial antecedents, the comorbidity and the treatment of the PEA-BP.

  13. [Anxiety and fear in children and adolescents].

    PubMed

    Chutko, L S; Surushkina, S Yu; Anisimova, T I

    2016-01-01

    The article presents an overview of scientific publication devoted to the study of epidemiology, etiology, pathogenesis, clinical manifestation and basic approaches to treatment of anxious-phobic disorders in children.

  14. Social Anxiety and Peer Helping in Adolescent Addiction Treatment

    ERIC Educational Resources Information Center

    Pagano, Maria E.; Wang, Alexandra R.; Rowles, Brieana M.; Lee, Matthew T.; Johnson, Byron R.

    2015-01-01

    The developmental need to fit in may lead to higher alcohol and other drug use among socially anxious youths which exacerbates the drink/trouble cycle. In treatment, youths with social anxiety disorder (SAD) may avoid participating in therapeutic activities with risk of negative peer appraisal. Peer-helping is a low-intensity, social activity in…

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

    ERIC Educational Resources Information Center

    Drake, Kelly L.; Ginsburg, Golda S.

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  18. Psychiatric comorbidity distribution and diversities in children and adolescents with attention deficit/hyperactivity disorder: a study from Turkey

    PubMed Central

    Yüce, Murat; Zoroglu, Süleyman Salih; Ceylan, Mehmet Fatih; Kandemir, Hasan; Karabekiroglu, Koray

    2013-01-01

    Objective We aimed to determine distribution and diversities of psychiatric comorbidities in children and adolescents with attention deficit/hyperactivity disorder (ADHD) in terms of age groups, sex, and ADHD subtype. Materials and methods The sample included 6–18 year old children and adolescents from Turkey (N=108; 83 boys, 25 girls) diagnosed with ADHD. All comorbid diagnoses were determined based on the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version assessment. Results 96.3% of the cases were found to have at least one psychiatric comorbid diagnosis. The most frequent psychiatric comorbid disorder was oppositional defiant disorder (69.4%) followed by anxiety disorders (49%) and elimination disorders (27.8%). Disruptive behavior disorders were more common in ADHD-combined type. Depression and anxiety disorders were more common in girls. Separation anxiety disorder and elimination disorder were more common in children, whereas depression, bipolar disorder, obsessive–compulsive disorder, and social phobia were more common in the adolescents. Conclusion According to our results, when a diagnostic tool was used to assess the presence of comorbid psychiatric disorders in children and adolescents diagnosed with ADHD, almost all cases had at least one comorbid diagnosis. Therefore, especially in the clinical sample, ADHD cases should not be solely interpreted with ADHD symptom domains, instead they should be investigated properly in terms of accompanying psychiatric disorders. PMID:24265552

  19. Individual differences in frontolimbic circuitry and anxiety emerge with adolescent changes in endocannabinoid signaling across species

    PubMed Central

    Gee, Dylan G.; Fetcho, Robert N.; Jing, Deqiang; Li, Anfei; Glatt, Charles E.; Drysdale, Andrew T.; Cohen, Alexandra O.; Dellarco, Danielle V.; Yang, Rui R.; Dale, Anders M.; Jernigan, Terry L.; Lee, Francis S.; Casey, B.J.

    2016-01-01

    Anxiety disorders peak in incidence during adolescence, a developmental window that is marked by dynamic changes in gene expression, endocannabinoid signaling, and frontolimbic circuitry. We tested whether genetic alterations in endocannabinoid signaling related to a common polymorphism in fatty acid amide hydrolase (FAAH), which alters endocannabinoid anandamide (AEA) levels, would impact the development of frontolimbic circuitry implicated in anxiety disorders. In a pediatric imaging sample of over 1,000 3- to 21-y-olds, we show effects of the FAAH genotype specific to frontolimbic connectivity that emerge by ∼12 y of age and are paralleled by changes in anxiety-related behavior. Using a knock-in mouse model of the FAAH polymorphism that controls for genetic and environmental backgrounds, we confirm phenotypic differences in frontoamygdala circuitry and anxiety-related behavior by postnatal day 45 (P45), when AEA levels begin to decrease, and also, at P75 but not before. These results, which converge across species and level of analysis, highlight the importance of underlying developmental neurobiology in the emergence of genetic effects on brain circuitry and function. Moreover, the results have important implications for the identification of risk for disease and precise targeting of treatments to the biological state of the developing brain as a function of developmental changes in gene expression and neural circuit maturation. PMID:27001846

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  1. Emotion dysregulation and sleep difficulties in generalized anxiety disorder.

    PubMed

    Tsypes, Aliona; Aldao, Amelia; Mennin, Douglas S

    2013-03-01

    Diagnostic criteria for generalized anxiety disorder (GAD) include sleep problems, which often persist even after successful treatment of the disorder. The purpose of this study was to examine emotion dysregulation as a potential contributor to sleep problems in GAD patients. Participants comprised two groups: 59 individuals diagnosed with GAD and 66 healthy controls. They were assessed for the presence of mood and anxiety disorders and then completed self-report questionnaires assessing problems with sleep and emotion regulation. Participants in the GAD group scored significantly higher on a number of sleep outcomes than did the control group. Importantly, difficulties with emotion regulation statistically mediated the relationship between GAD and a wide range of outcomes of sleep dysfunction independently of the effects of depression and secondary anxiety diagnoses. Emotion regulation difficulties that characterize GAD mediate the relationship between symptoms of this disorder and a wide range of sleep problems. Implications for treatment and future research directions are discussed.

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

    PubMed Central

    Goodwin, Guy M.

    2015-01-01

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

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

    PubMed

    Goodwin, Guy M

    2015-09-01

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

  4. Subthreshold body dysmorphic disorder in adolescents: Prevalence and impact.

    PubMed

    Schneider, Sophie C; Mond, Jonathan; Turner, Cynthia M; Hudson, Jennifer L

    2017-05-01

    The aim of the current study was to establish the prevalence of subthreshold body dysmorphic disorder (subthreshold-BDD) in a community sample of adolescents, and to compare disorder correlates in individuals with subthreshold-BDD to those with probable full-syndrome BDD (probable-BDD) and those without BDD (non-BDD). Self-report questionnaires assessing DSM-IV BDD criteria, past mental health service use, and symptoms of body dysmorphic disorder, anxiety, depression, obsessive-compulsive disorder and eating disorders, were completed by 3149 Australian high school students (mean age =14.6 years, 63.5% male). Male participants also completed measures assessing quality of life, muscularity concerns, emotional symptoms, conduct problems, hyperactivity, and peer problems. The prevalence of subthreshold-BDD was 3.4%, and probable-BDD was 1.7%. Compared to the non-BDD group, subthreshold-BDD was associated with elevated symptoms of comorbid psychopathology and greater past mental health service use, and in male-only measures, with poorer quality of life and elevated muscularity concerns. Subthreshold-BDD participants reported significantly lower mental health service use, and fewer symptoms of depression, eating disorders, and hyperactivity than probable-BDD participants, however, other comorbid symptoms did not differ significantly between these groups. These findings indicate that subthreshold-BDD is associated with substantial difficulties for adolescents in the general community. BDD screening should include subthreshold presentations, as these may be an important target for early intervention programs.

  5. Anxiety and selective attention in obsessive-compulsive disorder.

    PubMed

    Cohen, Yoav; Lachenmeyer, Juliana Rasic; Springer, Craig

    2003-11-01

    Recently, there has been increasing evidence for information-processing deficits in individuals with obsessive-compulsive disorder (OCD). While impairments in selective attention have been identified to be central to the symptomatology of OCD, the role that situational anxiety plays in attentional processes has not been fully explored. Previous research findings were limited to tasks containing anxiety-relevant materials, only permitting for the evaluation of the impact of anxiety on simultaneous cognitive processing. Furthermore, it has not yet been determined whether the impact of anxiety is limited to selective attention or is indicative of a more general cognitive impairment. This study was designed to examine the role that situational anxiety plays in selective attention impairments. OCD participants and controls were presented with an anxiety producing statement and a neutral statement, followed by the Stroop Task. Results indicated that situational anxiety plays a significant role in the performance of tasks that require selective attention in OCD. A significant deterioration was detected in performance on selective attention tasks for the OCD participants after confronting anxiety-provoking scenarios, as compared to neutral scenarios. Anxiety did not impair performance on simple reading tasks. Possible explanations are discussed.

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

    NASA Astrophysics Data System (ADS)

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

    2010-04-01

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

  7. Relationship between anxiety and medical disorders among compulsory military service candidates between the years 1998-2013.

    PubMed

    Shelef, Leah; Dotan, Shron; Kaminsky, Dan; Kedem, Ron; Margulis, Alexander; Hassidim, Ayal

    2016-10-30

    One of the most common psychiatric diagnoses among adolescents is anxiety disorder. Many of the anxiety symptoms are expressed physiologically, and therefore can mimic other medical conditions. The aim of this study was to examine the association between anxiety disorders and other medical conditions sharing common symptoms with anxiety (MDSCSA: Irritable Bowel Syndrome, asthma, migraine and hyperhidrosis). The study was based on the national database of the candidates for military service in Israel. Data for the years 1998-2013 was retrieved to create the study dataset. The final cohort population was comprised of 1,229,461 military service candidates. Anxiety prevalence and its association with other medical conditions sharing the same symptoms was examined in the cohort. The results showed significant statistical association between anxiety and IBS, asthma, migraine and hyperhidrosis. These findings support the fact that there is a clear association between anxiety disorder and the examined medical conditions. Moreover, in the military setting, the primary care physician has an important role in giving a correct diagnosis for soldiers presenting with symptoms that can be regarded both to anxiety and to other physical illnesses.

  8. An examination of the MASC Social Anxiety Scale in a non-referred sample of adolescents.

    PubMed

    Anderson, Emily R; Jordan, Judith A; Smith, Ashley J; Inderbitzen-Nolan, Heidi M

    2009-12-01

    Social phobia is prevalent during adolescence and is associated with negative outcomes. Two self-report instruments are empirically validated to specifically assess social phobia symptomatology in youth: the Social Phobia and Anxiety Inventory for Children and the Social Anxiety Scale for Adolescents. The Multidimensional Anxiety Scale for Children is a broad-band measure of anxiety containing a scale assessing the social phobia construct. The present study investigated the MASC Social Anxiety Scale in relation to other well-established measures of social phobia and depression in a non-referred sample of adolescents. Results support the convergent validity of the MASC Social Anxiety Scale and provide some support for its discriminant validity, suggesting its utility in the initial assessment of social phobia. Receiver Operating Characteristics (ROCs) calculated the sensitivity and specificity of the MASC Social Anxiety Scale. Binary logistic regression analyses determined the predictive utility of the MASC Social Anxiety Scale. Implications for assessment are discussed.

  9. Text anxiety in adolescents: the role of self-criticism and acceptance and mindfulness skills.

    PubMed

    Cunha, Marina; Paiva, Maria Jacinta

    2012-07-01

    The current study sets out to explore test anxiety in adolescent students. The effect of sociodemographic variables on test anxiety was controlled for and the relationship between test anxiety and other psychological constructs, such as self-criticism, social anxiety, acceptance and mindfulness, was examined. In addition, the predictive effect/power of these variables was analyzed and a comparative study between high and low test anxiety adolescents was conducted. Participants in this study were 449 high school students, 211 boys and 238 girls, with a mean age of 16.28 years. These participants completed a battery of self-report questionnaires composed by the Portuguese versions of Test Anxiety Inventory (TAI), Child Acceptance and Mindfulness Measure (CAMM), Forms of Self-Criticizing/Attacking and Self-Reassuring Scale (FSCRS), and the Social Anxiety and Avoidance Scale for Adolescents (SAASA). Results showed that gender, self-criticism and competencies for acceptance and mindfulness had a significant and an independent contribution on the prediction of test anxiety. The comparative study revealed that adolescents with high test anxiety score significantly higher in negative forms of self-criticism, social anxiety and lower in self-reassurance, acceptance and mindfulness, when compared to those with low test anxiety. Despite its exploratory nature, the current study adds to the existing knowledge on the influence of psychological processes, such as self-criticism and acceptance, on test anxiety. These findings might constitute a relevant contribution to psychological intervention with adolescents.

  10. Bullying involvement in relation to personality disorders: a prospective follow-up of 508 inpatient adolescents.

    PubMed

    Antila, Henna; Arola, Riikka; Hakko, Helinä; Riala, Kaisa; Riipinen, Pirkko; Kantojärvi, Liisa

    2017-01-24

    We examined the association of bullying behavior in adolescence to personality disorder (PD) diagnosed in early adulthood. The study sample consisted of 508 adolescents (300 girls, 208 boys) who were admitted to psychiatric inpatient treatment between April 2001 and March 2006. Data were based on semi-structured K-SADSPL-interviews and hospital treatments extracted from the Care Register for Health Care (CRHC). At the end of 2013, details of psychiatric diagnoses recorded on hospital discharges and outpatient visits were extracted from the CRHC. This study showed that female victims of bullying have an almost fourfold likelihood of developing a PD later in life compared to adolescents with no involvement in bullying behavior. Most of the females had Borderline PD. Female adolescents diagnosed with anxiety disorder during adolescence had an over threefold risk of developing a PD during late adolescence or early adulthood. Conversely, we found no associations between bullying involvement among men in adolescence and subsequent PDs. Bullying victimization may influence the development of PDs among females. Adolescent services should pay particular attention to female victims of bullying and those displaying symptoms of anxiety disorders.

  11. Child Abuse and Mental Disorders in Iranian Adolescents

    PubMed Central

    Pirdehghan, Azar; Vakili, Mahmood; Rajabzadeh, Yavar; Puyandehpour, Mohammad; Aghakoochak, Arezoo

    2016-01-01

    Background Child abuse is a serious social health problem all over the world with important adverse effects. Objectives The aim of this study was to extend our understanding of the relation between mental disorders and child abuse. Materials and Methods The study was designed as a cross-sectional survey on 700 students in secondary schools using multiple cluster sampling in Yazd, Iran in 2013. We applied 2 self reported questionnaires: DASS (depression anxiety stress scales)-42 for assessing mental disorders (anxiety, stress and depression) and a standard self-reported valid and reliable questionnaire for recording child abuse information in neglect, psychological, physical and sexual domains. The collected data was analyzed using SPSS software. P-values < 0.05 were considered as significant. Results There was a statically significant correlation between mental disorder and child abuse score (Spearman rho: 0.2; P-value < 0.001). The highest correlations between mental disorders and child abuse were found in psychological domain, Spearman’s rho coefficients were 0.46, 0.41 and 0.36 for depression, anxiety and stress respectively (P-value < 0.001). Based on the results of logistic regression for mental disorder, females, last born adolescents and subjects with drug or alcohol abuser parents had mental disorder odds of 3, 0.4 and 1.9 times compared to others; and severe psychological abuse, being severely neglected and having sexual abuse had odds 90, 1.6 and 1.5 respectively in another model. Conclusions Programming for mandatory reporting of child abuse by physicians and all health care givers e.g. those attending schools or health centers, in order to prevent or reduce its detrimental effects is useful and success in preventing child abuse could lead to reductions in the prevalence of mental disorders. PMID:27437096

  12. Retrospective reports of parenting in depressed adults with and without comorbid panic disorder and social anxiety disorder.

    PubMed

    Torpey, Dana C; Olino, Thomas M; Klein, Daniel N

    2007-09-01

    Previous research has examined the role of parenting in the development of depression and anxiety disorders using retrospective reports of parenting behaviors. However, most studies have not considered comorbidity; the few that have did not differentially examine individual anxiety disorders and yielded inconsistent results. The present study compared retrospective parenting reports given by depressed individuals with no comorbid anxiety disorder, comorbid panic disorder, and comorbid social anxiety disorder. Results indicated that depressed men with panic disorder reported significantly greater maternal and nonsignificantly greater paternal protectiveness than depressed men without panic disorder but not than depressed women with and without panic disorder. No differences were found for the retrospective parenting reports given by depressed participants with or without social anxiety disorder. This work highlights the importance of examining specific anxiety disorders rather than grouping all depressed patients with any anxiety disorder together, as well as examining males and females separately when investigating the influence of parental behavior.

  13. Adolescent Coping Profiles Differentiate Reports of Depression and Anxiety Symptoms

    PubMed Central

    Herres, Joanna; Ohannessian, Christine McCauley

    2015-01-01

    The purpose of the study was to identify groups of adolescents based on their reported use of different coping strategies and compare levels of depression and anxiety symptoms across the groups. Tenth and eleventh grade public school students (N = 982; 51% girls; 66% Caucasian; M age =16.04, SD = .73) completed a battery of self-report measures that assessed their use of different coping strategies, depressive symptoms, and anxiety symptoms. Latent profile analysis (LPA) classified the participants into four distinct groups based on their responses on subscales of the COPE inventory (Carver, Scheier, & Weintraub, 1989). Groups differed in amount of coping with participants in each group showing relative preference for engaging in certain strategies over others. Disengaged copers reported the lowest amounts of coping with a preference for avoidance strategies. Independent copers reported moderate levels of coping with relatively less use of support-seeking. Social support-seeking copers and active copers reported the highest levels of coping with a particular preference for support-seeking strategies. The independent copers reported the lowest levels of depressive symptoms compared to the three other groups. The Social Support Seeking and Active Coping Groups reported the highest levels of anxiety. Although distinct coping profiles were observed, findings showed that adolescents between the ages of 14 and 16 engage in multiple coping strategies and are more likely to vary in their amount of coping than in their use of specific strategies. PMID:26275359

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

    PubMed

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

    2015-01-01

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

  15. Mechanisms of Selective Attention in Generalized Anxiety Disorder

    PubMed Central

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

    2015-01-01

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

  16. The genetic basis of panic and phobic anxiety disorders.

    PubMed

    Smoller, Jordan W; Gardner-Schuster, Erica; Covino, Jennifer

    2008-05-15

    Panic disorder and phobic anxiety disorders are common disorders that are often chronic and disabling. Genetic epidemiologic studies have documented that these disorders are familial and moderately heritable. Linkage studies have implicated several chromosomal regions that may harbor susceptibility genes; however, candidate gene association studies have not established a role for any specific loci to date. Increasing evidence from family and genetic studies suggests that genes underlying these disorders overlap and transcend diagnostic boundaries. Heritable forms of anxious temperament, anxiety-related personality traits and neuroimaging assays of fear circuitry may represent intermediate phenotypes that predispose to panic and phobic disorders. The identification of specific susceptibility variants will likely require much larger sample sizes and the integration of insights from genetic analyses of animal models and intermediate phenotypes.

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

    PubMed Central

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

    2014-01-01

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

  18. DSM-III personality disorders in generalized anxiety, panic/agoraphobia, and obsessive-compulsive disorders.

    PubMed

    Mavissakalian, M R; Hamann, M S; Abou Haidar, S; de Groot, C M

    1993-01-01

    In an earlier report, we stated that personality profiles of patients with panic disorder/agoraphobia (n = 187) and obsessive-compulsive disorder ([ODC] n = 51) were similar, albeit more pronounced in OCD, suggesting that the link between panic disorder/agoraphobia and DSM-III personality disorders (PDs) or traits may be nonspecific. The present report extends the comparative study of DSM-III PDs/traits, as assessed by the Personality Diagnostic Questionnaire (PDQ), by adding a third diagnostic group of 39 patients with generalized anxiety disorder (GAD). The personality assessment of panic disorder/agoraphobia and GAD patients yielded virtually identical results on the PDQ and Eysenck Personality Inventory (EPI). Because GAD lacks the prominent panic, phobic, and obsessive-compulsive symptoms of other anxiety disorders, the present findings provide strong support for a nonspecific link between panic disorder/agoraphobia and DSM-III PDs/traits and for the presence of common personality characteristics in anxiety disorders.

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

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

    2012-01-01

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