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Sample records for adolescent panic disorder

  1. Panic Disorder in Children and Adolescents

    MedlinePlus

    ... Skip breadcrumb navigation Panic Disorder In Children And Adolescents Quick Links Facts For Families Guide Facts For ... is a common and treatable disorder. Children and adolescents with panic disorder have unexpected and repeated periods ...

  2. Panic Disorder in Clinically Referred Children and Adolescents

    ERIC Educational Resources Information Center

    Doerfler, Leonard A.; Connor, Daniel F.; Volungis, Adam M.; Toscano, Peter F., Jr.

    2007-01-01

    The present study examined the frequency and characteristics of panic disorder in children and adolescents who had been referred to a pediatric psychopharmacology clinic. Of the 280 children and adolescents evaluated in this clinic, 35 were diagnosed with panic disorder using a semi-structured clinical interview (K-SADS) and other objective…

  3. Panic Disorder

    MedlinePlus

    ... panic disorder? Panic disorder is characterized by recurrent panic attacks—an uncontrollable and terrifying response to ordinary, nonthreatening ... is also persistent anxiety or fear about the panic attacks and changes in behavior in an attempt to ...

  4. Panic Disorder

    MedlinePlus

    ... by recurrent episodes of paralyzing fear, known as panic attacks. Panic disorder, which affects three million to six ... Americans, typically surfaces between ages fifteen and nineteen. Panic attacks may be precipitated by specific events, but they ...

  5. Panic Disorder

    MedlinePlus

    ... is a type of anxiety disorder. It causes panic attacks, which are sudden feelings of terror when there ... or a cold chill Tingly or numb hands Panic attacks can happen anytime, anywhere, and without warning. You ...

  6. Psychopathology in the Adolescent Offspring of Parents with Panic Disorder and Depression

    ERIC Educational Resources Information Center

    Bhat, Amritha S.; Srinivasan, K.

    2006-01-01

    Aim: To study the prevalence of psychiatric diagnosis and psychopathology in adolescent offspring of parents with panic disorder, depression and normal controls. Methods: Adolescent offspring (11-16 years) of parents with a diagnosis of panic disorder and major depression, and normal controls were interviewed using Missouri Assessment of Genetics…

  7. Treatment of Adolescent Panic Disorder: A Nonrandomized Comparison of Intensive versus Weekly CBT

    ERIC Educational Resources Information Center

    Chase, Rhea M.; Whitton, Sarah W.; Pincus, Donna B.

    2012-01-01

    This study compared the relative efficacy of intensive versus weekly panic control treatment (PCT) for adolescent panic disorder with agoraphobia (PDA). Twenty-six adolescents participated in weekly sessions and 25 received intensive treatment involving daily sessions. Both groups demonstrated significant and comparable reductions in panic…

  8. Cognitive-Behavioral Treatment of Panic Disorder in Adolescence

    ERIC Educational Resources Information Center

    Pincus, Donna B.; May, Jill Ehrenreich; Whitton, Sarah W.; Mattis, Sara G.; Barlow, David H.

    2010-01-01

    This investigation represents the first randomized controlled trial to evaluate the feasibility and efficacy of Panic Control Treatment for Adolescents (PCT-A). Thirteen adolescents, ages 14 to 17, were randomized to 11 weekly sessions of PCT-A treatment, whereas 13 were randomized to a self-monitoring control group. Results indicate that…

  9. Panic Disorder

    MedlinePlus

    ... your head? No. Most likely, you had a panic attack. Panic attacks can last from minutes to hours. They may ... made after a person experiences at least 2 panic attacks that occur without reason and are followed by ...

  10. Panic Disorder and Women

    MedlinePlus

    ... in your state. Panic Attacks, Panic Disorder, and Agoraphobia (Copyright © American Academy of Family Physicians) - This online ... and examples of co-existing conditions. Panic Disorder & Agoraphobia (Copyright © Anxiety Disorders Association of America) - This web ...

  11. 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…

  12. Preliminary Validation of a Screening Tool for Adolescent Panic Disorder in Pediatric Primary Care Clinics

    ERIC Educational Resources Information Center

    Queen, Alexander H.; Ehrenreich-May, Jill; Hershorin, Eugene R.

    2012-01-01

    This study examines the validity of a brief screening tool for adolescent panic disorder (PD) in a primary care setting. A total of 165 participants (ages 12-17 years) seen in two pediatric primary care clinics completed the Autonomic Nervous System Questionnaire (ANS; Stein et al. in Psychosomatic Med 61:359-364, 40). A subset of those screening…

  13. Neurobiology of panic disorder.

    PubMed

    Bourin, M; Baker, G B; Bradwejn, J

    1998-01-01

    Various provocative agents, including sodium lactate, carbon dioxide (CO2), caffeine, yohimbine, serotoninergic agents, and cholecystokinin (CCK), have been utilized as panicogenics in studies on healthy volunteers as well as in panic disorder patients. An overview of the utilization of these agents to study the neurobiology of panic disorder is presented. The possible roles of several neurotransmitters and neuromodulators in the etiology of panic disorder and in the actions of drugs used in its treatment are also discussed.

  14. A Psychometric Evaluation of the Panic Disorder Severity Scale for Children and Adolescents

    PubMed Central

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

    2014-01-01

    The Panic Disorder Severity Scale (PDSS; Shear et al., 1997) is a well-validated measure that assesses symptoms of panic disorder and agoraphobia (PDA) in adults. The Panic Disorder Severity Scale for Children (PDSS-C) is an adaptation of the PDSS for youth ages 11 to 17. The current study evaluated the psychometric properties of the PDSS-C. Participants included sixty adolescents from an RCT investigating the efficacy of an intensive cognitive behavioral treatment for adolescent PDA. Convergent and discriminant validity of PDSS-C scores were evaluated via observed associations between the PDSS-C and the Childhood Anxiety Sensitivity Index (CASI; Silverman et al., 1991), Multidimensional Anxiety Scale for Children (MASC; March et al., 1997), and Children’s Depression Inventory (CDI; Kovacs, 2003). Baseline and post-treatment data afforded the opportunity to evaluate the measure’s sensitivity to treatment-related change. PDSS-C scores demonstrated acceptable internal consistency (α = 0.82) and adequate 1-day test-retest reliability (r = 0.79). Convergent and discriminant validity of the PDSS-C scores were supported through significant associations with the CASI and the MASC, and non-significant associations with the CDI, respectively. Linear regression analysis demonstrated sensitivity to treatment-related changes—i.e., greater PDSS-C change scores were significantly associated with assignment to CBT versus waitlist condition. Clinical utility was further established through significant associations between PDSS-C change scores and MASC and CASI change scores, and through non-significant associations with CDI change scores. Results support the use of PDSS-C scores as reliable, valid, and clinically useful for the assessment of youth panic disorder in research and clinical settings. PMID:24295237

  15. Understanding Panic Disorder.

    ERIC Educational Resources Information Center

    Hendrix, Mary Lynn

    This booklet is part of the National Institute of Mental Health's efforts to educate the public and health care professionals about panic disorder. Discussed here are the causes, definition, and symptoms of the disorder. Panic attacks, which can seriously interfere with a person's life, may strike more than three million U.S. citizens at some time…

  16. Behavioral inhibition in childhood predicts smaller hippocampal volume in adolescent offspring of parents with panic disorder

    PubMed Central

    Schwartz, C E; Kunwar, P S; Hirshfeld-Becker, D R; Henin, A; Vangel, M G; Rauch, S L; Biederman, J; Rosenbaum, J F

    2015-01-01

    Behavioral inhibition (BI) is a genetically influenced behavioral profile seen in 15–20% of 2-year-old children. Children with BI are timid with people, objects and situations that are novel or unfamiliar, and are more reactive physiologically to these challenges as evidenced by higher heart rate, pupillary dilation, vocal cord tension and higher levels of cortisol. BI predisposes to the later development of anxiety, depression and substance abuse. Reduced hippocampal volumes have been observed in anxiety disorders, depression and posttraumatic stress disorder. Animal models have demonstrated that chronic stress can damage the hippocampal formation and implicated cortisol in these effects. We, therefore, hypothesized that the hippocampi of late adolescents who had been behaviorally inhibited as children would be smaller compared with those who had not been inhibited. Hippocampal volume was measured with high-resolution structural magnetic resonance imaging in 43 females and 40 males at 17 years of age who were determined to be BI+ or BI− based on behaviors observed in the laboratory as young children. BI in childhood predicted reduced hippocampal volumes in the adolescents who were offspring of parents with panic disorder, or panic disorder with comorbid major depression. We discuss genetic and environmental factors emanating from both child and parent that may explain these findings. To the best of our knowledge, this is the first study to demonstrate a relationship between the most extensively studied form of temperamentally based human trait anxiety, BI, and hippocampal structure. The reduction in hippocampal volume, as reported by us, suggests a role for the hippocampus in human trait anxiety and anxiety disorder that warrants further investigation. PMID:26196438

  17. Behavioral inhibition in childhood predicts smaller hippocampal volume in adolescent offspring of parents with panic disorder.

    PubMed

    Schwartz, C E; Kunwar, P S; Hirshfeld-Becker, D R; Henin, A; Vangel, M G; Rauch, S L; Biederman, J; Rosenbaum, J F

    2015-01-01

    Behavioral inhibition (BI) is a genetically influenced behavioral profile seen in 15-20% of 2-year-old children. Children with BI are timid with people, objects and situations that are novel or unfamiliar, and are more reactive physiologically to these challenges as evidenced by higher heart rate, pupillary dilation, vocal cord tension and higher levels of cortisol. BI predisposes to the later development of anxiety, depression and substance abuse. Reduced hippocampal volumes have been observed in anxiety disorders, depression and posttraumatic stress disorder. Animal models have demonstrated that chronic stress can damage the hippocampal formation and implicated cortisol in these effects. We, therefore, hypothesized that the hippocampi of late adolescents who had been behaviorally inhibited as children would be smaller compared with those who had not been inhibited. Hippocampal volume was measured with high-resolution structural magnetic resonance imaging in 43 females and 40 males at 17 years of age who were determined to be BI+ or BI- based on behaviors observed in the laboratory as young children. BI in childhood predicted reduced hippocampal volumes in the adolescents who were offspring of parents with panic disorder, or panic disorder with comorbid major depression. We discuss genetic and environmental factors emanating from both child and parent that may explain these findings. To the best of our knowledge, this is the first study to demonstrate a relationship between the most extensively studied form of temperamentally based human trait anxiety, BI, and hippocampal structure. The reduction in hippocampal volume, as reported by us, suggests a role for the hippocampus in human trait anxiety and anxiety disorder that warrants further investigation. PMID:26196438

  18. Cholecystokinin and panic disorder.

    PubMed

    Bourin, Michel; Dailly, Eric

    2004-04-01

    Evidence for implication of cholecystokinin (CCK) in the neurobiology of panic disorder is reviewed through animal and human pharmacological studies. The results of these investigations raise two issues: (i) selectivity of action of CCK-2 agonists in anxiety disorders; and (ii) aberrations of the CCK system in anxiety disorders, both of which are discussed.

  19. Panic disorder and locomotor activity

    PubMed Central

    Sakamoto, Noriyuki; Yoshiuchi, Kazuhiro; Kikuchi, Hiroe; Takimoto, Yoshiyuki; Kaiya, Hisanobu; Kumano, Hiroaki; Yamamoto, Yoshiharu; Akabayashi, Akira

    2008-01-01

    Background Panic disorder is one of the anxiety disorders, and anxiety is associated with some locomotor activity changes such as "restlessness". However, there have been few studies on locomotor activity in panic disorder using actigraphy, although many studies on other psychiatric disorders have been reported using actigraphy. Therefore, the aim of the present study was to investigate the relationship between panic disorder and locomotor activity pattern using a wrist-worn activity monitor. In addition, an ecological momentary assessment technique was used to record panic attacks in natural settings. Methods Sixteen patients with panic disorder were asked to wear a watch-type computer as an electronic diary for recording panic attacks for two weeks. In addition, locomotor activity was measured and recorded continuously in an accelerometer equipped in the watch-type computer. Locomotor activity data were analyzed using double cosinor analysis to calculate mesor and the amplitude and acrophase of each of the circadian rhythm and 12-hour harmonic component. Correlations between panic disorder symptoms and locomotor activity were investigated. Results There were significant positive correlations between the frequency of panic attacks and mesor calculated from double cosinor analysis of locomotor activity (r = 0.55) and between HAM-A scores and mesor calculated from double cosinor analysis of locomotor activity (r = 0.62). Conclusion Panic disorder patients with more panic attacks and more anxiety have greater objectively assessed locomotor activity, which may reflect the "restlessness" of anxiety disorders. PMID:19017383

  20. The impact of an 8-day intensive treatment for adolescent panic disorder and agoraphobia on comorbid diagnoses.

    PubMed

    Gallo, Kaitlin P; Chan, Priscilla T; Buzzella, Brian A; Whitton, Sarah W; Pincus, Donna B

    2012-03-01

    Previous research findings have shown positive effects of cognitive-behavioral therapy for primary anxiety disorders as well as for nonprimary, co-occurring anxiety disorders. In this study, we analyzed data from an existing randomized controlled trial of intensive treatment for panic disorder with or without agoraphobia (PDA) to examine the effects of the treatment on comorbid psychiatric diagnoses. The overall frequency and severity of aggregated comorbid diagnoses decreased in a group of adolescents who received an 8-day treatment for PDA. Results suggest that an 8-day treatment for PDA can alleviate the symptoms of some specific comorbid clinical diagnoses; in particular specific phobias, generalized anxiety disorder, and social phobia. These findings suggest that an intensive treatment for PDA is associated with reductions in comorbid symptoms even though disorders other than PDA are not specific treatment targets.

  1. [Panic disorder and atrial fibrillation].

    PubMed

    Olazabal Eizaguirre, N; Chavez, R; González-Torres, M A; Gaviria, M

    2013-10-01

    This paper studies the relationship between atrial fibrillation and panic disorder. There are often doubts on the differential diagnosis in emergency services and general medical settings. Panic disorder prevalence rates have been found to be high in patients suffering from atrial fibrillation. Various studies have observed that patients diagnosed with anxiety disorders frequently have higher cardiovascular disease rates compared to the general population. Usually, patients suffering from panic disorder exhibit somatic complaints suggesting coronary disease, such as chest pain or palpitations. The aim is to make the correct diagnosis and treatment for these different illnesses, and to decrease the costs due to misdiagnosis.

  2. Pharmacotherapy of panic disorder

    PubMed Central

    Pull, Charles B; Damsa, Cristian

    2008-01-01

    Panic disorder (PD) is a common, persistent and disabling mental disorder. It is often associated with agoraphobia. The present article reviews the current status of pharmacotherapy for PD with or without agoraphobia as well as the current status of treatments combing pharmacotherapy with cognitive behavior therapy (CBT). The review has been written with a focus on randomized controlled trials, meta-analyses, and reviews that have been published over the past few years. Effective pharmacological treatments include tricyclic antidepressants, monoamine oxidase inhibitors, selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, and various benzodiazepines. Treatment results obtained with CBT compare well with pharmacotherapy, with evidence that CBT is at least as effective as pharmacotherapy. Combining pharmacotherapy with CBT has been found to be superior to antidepressant pharmacotherapy or CBT alone, but only in the acute-phase treatment. Long term studies on treatments combining pharmacotherapy and CBT for PD with or without agoraphobia have found little benefit, however, for combination therapies versus monotherapies. New investigations explore the potential additional value of sequential versus concomitant treatments, of cognitive enhancers and virtual reality exposure therapy, and of education, self management and Internet-based interventions. PMID:19043522

  3. Panic attacks and panic disorder: the great neurologic imposters.

    PubMed

    Stahl, S M; Soefje, S

    1995-06-01

    Patients who experience panic attacks, panic disorder, or agoraphobia have significant impairment associated with their disorders. The cost to society in health care costs as well as the human suffering and mortality is high and may be even higher than necessary because of misdiagnosis and inadequate treatment of these patients. Although we do not have many answers in the areas of pathophysiology or neurochemistry of panic disorder, we do have effective treatments for panic disorder and agoraphobia. If these are conceptualized as distinct disorders with specific symptoms, making a diagnosis of panic disorder or agoraphobia is relatively easy. Making the correct diagnosis may save the patient many months or years of suffering and many inappropriate tests or treatments. PMID:7481132

  4. Panic Disorder among Adults

    MedlinePlus

    ... Hyperactivity Disorder Among Children Autism Spectrum Disorder (ASD) Eating Disorders Among Adults - Anorexia Nervosa Eating Disorders Among Adults - Binge Eating Disorder Eating Disorders Among ...

  5. [From inducers of panic attack to neurobiology of panic disorder].

    PubMed

    Bourin, M

    1996-12-01

    Various provocative agents, including sodium lactate, carbon dioxide (CO2), caffeine, yohimbine and cholecystokinin (CCK), have been utilized as panicogenics in studies on healthy volunteers as well as in panic disorder patients. Most provocative agents are lacking in specificity, limiting their use in identifying neurotransmitter systems involved in panic attacks. CCK appears to offer several advantages over other challenge strategies since it is a putative neurotransmitter in the CNS, with its own neuronal pathways and receptors, and reliably provokes panic attacks in a dose-dependent manner. It is important to clarify the relationships between CCK and other neurotransmitter systems in order to further understand the neurobiology of panic disorder. The possible roles of some of these neurotransmitters in panic disorder are discussed in this review.

  6. Screening for Panic Disorder

    MedlinePlus

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

  7. Panic Disorder: When Fear Overwhelms

    MedlinePlus

    ... for several minutes or longer. These are called panic attacks . Panic attacks are characterized by a fear of disaster or ... also have a strong physical reaction during a panic attack. It may feel like having a heart attack. ...

  8. Charles Darwin and panic disorder.

    PubMed

    Barloon, T J; Noyes, R

    1997-01-01

    Charles Darwin (1809-1882) suffered from a chronic illness that, throughout much of his adult life, impaired his functioning and severely limited his activities. The writings of this famous scientist as well as biographical materials indicate that he probably suffered from an anxiety disorder. His symptoms, when considered individually, suggest a variety of conditions, but taken together they point toward panic disorder with agoraphobia. This diagnosis brings coherence to Darwin's activities and explains his secluded lifestyle, including difficulty in speaking before groups and meeting with colleagues.

  9. The genetic basis of panic disorder.

    PubMed

    Na, Hae-Ran; Kang, Eun-Ho; Lee, Jae-Hon; Yu, Bum-Hee

    2011-06-01

    Panic disorder is one of the chronic and disabling anxiety disorders. There has been evidence for either genetic heterogeneity or complex inheritance, with environmental factor interactions and multiple single genes, in panic disorder's etiology. Linkage studies have implicated several chromosomal regions, but no research has replicated evidence for major genes involved in panic disorder. Researchers have suggested several neurotransmitter systems are related to panic disorder. However, to date no candidate gene association studies have established specific loci. Recently, researchers have emphasized genome-wide association studies. Results of two genome-wide association studies on panic disorder failed to show significant associations. Evidence exists for differences regarding gender and ethnicity in panic disorder. Increasing evidence suggests genes underlying panic disorder overlap, transcending current diagnostic boundaries. In addition, an anxious temperament and anxiety-related personality traits may represent intermediate phenotypes that predispose to panic disorder. Future research should focus on broad phenotypes, defined by comorbidity or intermediate phenotypes. Genome-wide association studies in large samples, studies of gene-gene and gene-environment interactions, and pharmacogenetic studies are needed.

  10. Anchoring the Panic Disorder Severity Scale

    ERIC Educational Resources Information Center

    Keough, Meghan E.; Porter, Eliora; Kredlow, M. Alexandra; Worthington, John J.; Hoge, Elizabeth A.; Pollack, Mark H.; Shear, M. Katherine; Simon, Naomi M.

    2012-01-01

    The Panic Disorder Severity Scale (PDSS) is a clinician-administered measure of panic disorder symptom severity widely used in clinical research. This investigation sought to provide clinically meaningful anchor points for the PDSS both in terms of clinical severity as measured by the Clinical Global Impression-Severity Scale (CGI-S) and to extend…

  11. Identifying Efficacious Treatment Components of Panic Control Treatment for Adolescents: A Preliminary Examination

    ERIC Educational Resources Information Center

    Micco, Jamie A.; Choate-Summers, Molly L.; Ehrenreich, Jill T.; Pincus, Donna B.; Mattis, Sara G.

    2007-01-01

    Panic Control Treatment for Adolescents (PCT-A) is a developmentally sensitive and efficacious treatment for adolescents with panic disorder. The present study is a preliminary examination of the relative efficacy of individual treatment components in PCT-A in a sample of treatment completers; the study identified when rapid improvements in panic…

  12. Sleep Apnea and Risk of Panic Disorder

    PubMed Central

    Su, Vincent Yi-Fong; Chen, Yung-Tai; Lin, Wei-Chen; Wu, Li-An; Chang, Shi-Chuan; Perng, Diahn-Warng; Su, Wei-Juin; Chen, Yuh-Min; Chen, Tzeng-Ji; Lee, Yu-Chin; Chou, Kun-Ta

    2015-01-01

    PURPOSE Epidemiological studies have identified a trend in the development of depressive and anxiety disorders following a diagnosis of sleep apnea. The relationship between sleep apnea and subsequent panic disorder, however, remains unclear. METHODS Using a nationwide database, the Taiwan National Health Insurance Research Database, patients with sleep apnea and age-, sex-, income-, and urbanization-matched control patients who did not have sleep apnea were enrolled between 2000 and 2010. Patients with a prior diagnosis of panic disorder before enrollment were excluded. The 2 cohorts were observed until December 31, 2010. The primary endpoint was occurrence of newly diagnosed panic disorder. RESULTS A total of 8,704 sleep apnea patients and 34,792 control patients were enrolled. Of the 43,496 patients, 263 (0.60%) suffered from panic disorder during a mean follow-up period of 3.92 years, including 117 (1.34%) from the sleep apnea cohort and 146 (0.42%) from the control group. The Kaplan-Meier analysis revealed a predisposition of patients with sleep apnea to develop panic disorder (log-rank test, P <.001). After multivariate adjustment, the hazard ratio for subsequent panic disorder among the sleep apnea patients was 2.17 (95% confidence interval, 1.68–2.81; P <.001). CONCLUSIONS Sleep apnea appears to confer a higher risk for future development of panic disorder. PMID:26195676

  13. Treatment of Panic Disorder: A Clinical Update.

    ERIC Educational Resources Information Center

    Beamish, Patricia M.; Belcastro, Amy L.; Granello, Darcy Haag

    This article presents specific, practical information to guide mental health counselors in treating individuals who meet the criteria for panic disorder. It delineates the specific strategies identified in the research literature for use by mental health counselors. Full resolution of panic attacks by one form of treatment may not always be…

  14. Cued Panic Attacks in Body Dysmorphic Disorder

    PubMed Central

    Phillips, Katharine A.; Menard, William; Bjornsson, Andri S.

    2013-01-01

    Background Body dysmorphic disorder (BDD) is a common and often severe disorder. Clinical observations suggest that panic attacks triggered by BDD symptoms may be common. However, to our knowledge, no study has examined such panic attacks in BDD. We investigated the prevalence, clinical features, and correlates of BDD-triggered panic attacks in individuals with this disorder. Methods Panic attacks and other variables were assessed using reliable and valid measures in 76 individuals with lifetime DSM-IV BDD. Results 28.9% (95% CI, 18.5%–39.4%) of participants reported lifetime panic attacks triggered by BDD symptoms. The most common triggers of such attacks were feeling that others were looking at or scrutinizing the perceived appearance defects (61.9%), looking in the mirror at perceived defects (38.1%), and being in bright light where perceived defects would be more visible (23.8%). The most common panic attack symptoms were palpitations (86.4%), sweating (66.7%), shortness of breath (63.6%), trembling or shaking (63.6%), and fear of losing control or going crazy (63.6%). Compared to participants without such panic attacks, those with BDD-triggered panic attacks had more severe lifetime BDD, social anxiety, and depressive symptoms, as well as poorer functioning and quality of life on a number of measures. They were also less likely to be employed and more likely to have been psychiatrically hospitalized and to have had suicidal ideation due to BDD. Conclusions Panic attacks triggered by BDD-related situations appear common in individuals with this disorder. BDD-triggered panic attacks were associated with greater symptom severity and morbidity. PMID:23653076

  15. Implementation of an Intensive Treatment Protocol for Adolescents with Panic Disorder and Agoraphobia

    ERIC Educational Resources Information Center

    Angelosante, Aleta G.; Pincus, Donna B.; Whitton, Sarah W.; Cheron, Daniel; Pian, Jessica

    2009-01-01

    New and innovative ways of implementing cognitive-behavioral therapy (CBT) are required to address the varied needs of youth with anxiety disorders. Brief treatment formats may be useful in assisting teens to return to healthy functioning quickly and can make treatment more accessible for those who may not have local access to providers of CBT.…

  16. [Personality in patients with panic disorder].

    PubMed

    Sanz-Carrillo, C; García-Campayo, J J; Sánchez Blanque, A

    1993-01-01

    Fourty-five patients diagnosed ad Panic Disorder and forty-five control patients are studied. Personality traits are assessed by Cattel's 16 PF. Test and several subscales derived from MMPI (dependence, repression, hypersensibility, etc.). Anxiety is measured by Zung's Anxiety Scale. Panic disorder patients show higher "dependence", "inferiority", "hypersensibility", low "ego strength", "parmia", "shrewdness", "self-sentiment integration" and high "ergic tension". In addition, male patients show significative differences in "affectothymia", "self-sufficiency", "self-sentiment integration" and "invia". PMID:8172011

  17. Learning Processes Associated with Panic-Related Symptoms in Families with and without Panic Disordered Mothers

    ERIC Educational Resources Information Center

    de Albuquerque, Jiske E. G.; Munsch, Simone; Margraf, Jurgen; Schneider, Silvia

    2013-01-01

    The present study compared learning processes associated with panic-related symptoms in families with and without panic disordered mothers. Using a multi-informant approach, 86 mothers [of whom 58 had a primary diagnosis of panic disorder (PD)], their partners and teenage children (mean age, 16.67 years) reported about parents' behavior (modeling…

  18. Treating Comorbid Panic Disorder in Veterans With Posttraumatic Stress Disorder

    ERIC Educational Resources Information Center

    Teng, Ellen J.; Bailey, Sara D.; Chaison, Angelic D.; Petersen, Nancy J.; Hamilton, Joseph D.; Dunn, Nancy Jo

    2008-01-01

    This study compares the effectiveness of panic control treatment (PCT) with that of a psychoeducational supportive treatment (PE-SUP) in treating panic disorder among a veteran sample with a primary diagnosis of chronic posttraumatic stress disorder (PTSD). Thirty-five patients randomized to receive 10 individual sessions of either PCT or PE-SUP…

  19. Outcome Studies in the Treatment of Panic Disorder: A Review.

    ERIC Educational Resources Information Center

    Beamish, Patricia M.; And Others

    1996-01-01

    Reviews outcome studies in the treatment of panic disorder without agoraphobia for adults. Presents evidence supporting the efficacy of psychopharmacological and cognitive-behavioral interventions. Addresses the need for standards of care in counseling persons with panic disorder. (RB)

  20. The cholecystokinin hypothesis of panic and anxiety disorders: a review.

    PubMed

    Bradwejn, J; Koszycki, D; du Tertre, A C; Bourin, M; Palmour, R; Ervin, F

    1992-01-01

    It has been suggested that cholecystokinin, a neurotransmitter found in high density in mammalian brain, might be implicated in the neurobiology of panic and anxiety disorders. Cholecystokinin-tetrapeptide induces panic attacks analogous to spontaneous panic attacks in patients suffering from panic disorder and to a much lesser degree in healthy volunteers, suggesting an enhanced sensitivity to cholecystokinin-tetrapeptide in panic disorder. In animal models of anxiety, pre-treatment with cholecystokinin antagonists significantly decreases the anxiogenic effects of cholecystokinin agonists. This paper reviews clinical and basic studies supporting an involvement for cholecystokinin in panic and anxiety disorders.

  1. Provocative agents in panic disorder.

    PubMed

    Bourin, M; Malinge, M; Guitton, B

    1995-01-01

    The pharmacological challenge strategy involves giving a provoking agent under controlled rules to clarify some aspect of behavioural or biological function. Various agents such as sodium lactate, carbon dioxide, caffeine, yohimbine, isoprenaline and now cholecystokinin have been used as provoking agents in healthy volunteers as well as in panic patients. Results obtained in this field are updated, with emphasis on the potential mechanisms of action. It is concluded that there may be a final pathway between carbon dioxide, sodium lactate, and cholecystokinin inducing panic attacks.

  2. Simultaneous prepubertal onset of panic disorder, night terrors, and somnambulism.

    PubMed

    Garland, E J; Smith, D H

    1991-07-01

    Concurrent acute onset of night terrors, somnambulism, and spontaneous daytime panic attacks meeting the criteria for panic disorder is reported in a 10-year-old boy with a family history of panic disorder. Both the parasomnias and the panic disorder were fully responsive to therapeutic doses of imipramine. A second case of night terrors and infrequent full symptom panic attacks is noted in another 10-year-old boy whose mother has panic disorder with agoraphobia. The clinical resemblance and reported differences between night terrors and panic attacks are described. The absence of previous reports of this comorbidity is notable. It is hypothesized that night terror disorder and panic disorder involve a similar constitutional vulnerability to dysregulation of brainstem altering systems. PMID:1890087

  3. The effects of tianeptine or paroxetine on 35% CO2 provoked panic in panic disorder.

    PubMed

    Schruers, Koen; Griez, Eric

    2004-12-01

    Antidepressants that inhibit the reuptake of serotonin (5-HT) are particularly effective in the treatment of panic disorder. Evidence suggests that increased 5-HT availability is important for the anti-panic effect of serotonergic drugs and in maintaining the response to selective serotonin reuptake inhibitors (SSRIs). Tianeptine is an antidepressant with 5-HT reuptake enhancing properties (i.e. the opposite pharmacological profile to that of SSRIs). Therefore, no effect would be expected in panic disorder. The aim of the present study was to compare the effect of tianeptine with that of paroxetine, a selective 5-HT reuptake inhibitor with demonstrated efficacy in panic disorder, on the vulnerability to a laboratory panic challenge in panic disorder patients. Twenty panic disorder patients were treated with either tianeptine or paroxetine for a period of 6 weeks, in a randomized, double-blind, separate group design. The reaction to a 35% CO(2) panic challenge was assessed at baseline and after treatment. Improvement on several clinical scales was also monitored. Tianeptine, as well as paroxetine, showed a significant reduction in vulnerability to the 35% CO(2) panic challenge. In spite of their opposite influence on 5-HT uptake, both tianeptine and paroxetine appeared to reduce the reaction to the panic challenge. These results raise questions about the necessity of 5-HT uptake for the therapeutic efficacy of anti-panic drugs.

  4. Parent-Reported Predictors of Adolescent Panic Attacks.

    ERIC Educational Resources Information Center

    Hayward, Chris; Wilson, Kimberly A.; Lagle, Kristy; Killen, Joel D.; Taylor, C. Barr

    2004-01-01

    Objective: To identify parent-reported risk factors for adolescent panic attacks. Method: Structured diagnostic interviews were obtained from 770 parents of participants in a school-based risk factor study for adolescent panic. Parent-reported risk factors assessed included characteristics of the child (negative affect, separation anxiety disorder…

  5. Don't panic: interpretation bias is predictive of new onsets of panic disorder.

    PubMed

    Woud, Marcella L; Zhang, Xiao Chi; Becker, Eni S; McNally, Richard J; Margraf, Jürgen

    2014-01-01

    Psychological models of panic disorder postulate that interpretation of ambiguous material as threatening is an important maintaining factor for the disorder. However, demonstrations of whether such a bias predicts onset of panic disorder are missing. In the present study, we used data from the Dresden Prediction Study, in which a epidemiologic sample of young German women was tested at two time points approximately 17 months apart, allowing the study of biased interpretation as a potential risk factor. At time point one, participants completed an Interpretation Questionnaire including two types of ambiguous scenarios: panic-related and general threat-related. Analyses revealed that a panic-related interpretation bias predicted onset of panic disorder, even after controlling for two established risk factors: anxiety sensitivity and fear of bodily sensations. This is the first prospective study demonstrating the incremental validity of interpretation bias as a predictor of panic disorder onset.

  6. [Panic disorders in the emergency room].

    PubMed

    Langewitz, W; Kiss, A; Saner, R

    1995-03-01

    Patients with panic disorder perceive physical symptoms which they interpret as dangerous phenomena; therefore, they normally seek help from physicians in somatic medicine and do not consult with a psychotherapist or psychiatrist. The combination of physical symptoms and catastrophic thinking induces such an intense feeling of anxiety that patients often visit an emergency unit. Thus, the prevalence of panic disorder is high among patients who seek help for heart symptoms within the setting of an emergency department (18%); in other clinical populations it may even be higher (patients with negative coronary angiography 33 to 59%, with irritable bowel syndrome 29 to 38%, with migraine headache 5 to 15%). Already in the emergency department it is possible to establish with the patient an understanding of the impact such catastrophic interpretations of basically benign physical changes have on the development of panic. This helps to avoid long-standing and expensive patient careers that have often been described in the literature. The present review includes a description of the cognitive model of the origin and the treatment of panic disorder as well as an overview of drug treatments with benzodiazepines and antidepressive drugs.

  7. The acute phase response in panic disorder.

    PubMed

    Herrán, Andrés; Sierra-Biddle, Deirdre; García-Unzueta, Maria Teresa; Puente, Jesús; Vázquez-Barquero, José Luis; Antonio Amado, José

    2005-12-01

    An acute-phase response (APR), manifested as an increase of acute-phase proteins has been shown in major depression. Panic disorder (PD) may share some aetiopathogenic mechanisms with depression, but APR has not been studied in this disorder. Forty-one panic patients in the first stages of their illness were compared with 32 healthy subjects of comparable sex, age, and body mass index. Clinical diagnosis was established with the mini international neuropsychiatric interview, and severity with the panic disorder severity scale and the CGI scale. Laboratory determinations included four acute phase proteins (APPs) [albumin, gammaglobulins, fibrinogen, C-reactive-protein (CRP)] and basal cortisol level. Patients were studied after 8-wk follow-up taking selective serotonin reuptake inhibitors (SSRIs) to assess the evolution of the APPs. Gammaglobulin levels were lower, and both cortisol and CRP levels were higher in PD patients than in controls. APP did not differ between patients with or without agoraphobia. At follow-up, patients who responded to SSRIs presented a decrease in albumin levels, and a trend towards a decrease in cortisol and CRP compared with levels at intake. The conclusions of this study are that there is an APR in patients suffering from PD, and this APR tends to diminish after a successful treatment with SSRIs. PMID:15927091

  8. Cognitive-behavioral treatment for panic disorder: current status.

    PubMed

    Landon, Terri M; Barlow, David H

    2004-07-01

    Is cognitive behavioral treatment (CBT) appropriate for panic disorder with or without agoraphobia (PDA) in children, adolescents, and adults? Are its effects durable? In this review, we survey various psychological approaches to the treatment of PDA and examine the relative efficacy and clinical utility of each. A growing body of research demonstrates that CBT is well-tolerated, cost-effective, and produces substantial treatment gains for individuals with PDA over the short- and long-term. Nevertheless, not everyone benefits and there is room for improvement among those who do. We address these shortcomings and consider recent developments. PMID:15552543

  9. Cognitive-behavioral treatment for panic disorder: current status.

    PubMed

    Landon, Terri M; Barlow, David H

    2004-07-01

    Is cognitive behavioral treatment (CBT) appropriate for panic disorder with or without agoraphobia (PDA) in children, adolescents, and adults? Are its effects durable? In this review, we survey various psychological approaches to the treatment of PDA and examine the relative efficacy and clinical utility of each. A growing body of research demonstrates that CBT is well-tolerated, cost-effective, and produces substantial treatment gains for individuals with PDA over the short- and long-term. Nevertheless, not everyone benefits and there is room for improvement among those who do. We address these shortcomings and consider recent developments.

  10. Panic disorder: the psychobiology of external treat and introceptive distress.

    PubMed

    Stein, Dan J

    2008-01-01

    Panic disorder seems to be mediated by the neuronal circuitry and neurochemical systems that have evolved to respond to external threatening stimuli. Distant threats activate prefrontal cortex (involved in complex planning of avoidance strategies), while immediate threats activate midbrain structures (involved in fast reflexive behaviors). Panic disorder may, however, also involve more specific interoceptive mechanisms. For example, the association between respiratory dysfunction and panic disorder has bolstered a false suffocation alarm hypothesis. Genetic and environmental contributors to panic disorder are beginning to be delineated. Effective pharmacotherapy and psychotherapy are able to normalize the relevant psychobiology.

  11. Ambulatory Assessment in Panic Disorder and Specific Phobia

    ERIC Educational Resources Information Center

    Alpers, Georg W.

    2009-01-01

    Anxiety disorders are among the most prevalent mental disorders. In panic disorder, panic attacks often occur at unpredictable times, making it difficult to study these episodes in the laboratory. In specific phobias, symptoms occur in very circumscribed situations and specific triggers are sometimes difficult to reproduce in the laboratory.…

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

    MedlinePlus

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

  13. New segregation analysis of panic disorder

    SciTech Connect

    Vieland, V.J.; Fyer, A.J.; Chapman, T.

    1996-04-09

    We performed simple segregation analyses of panic disorder using 126 families of probands with DSM-III-R panic disorder who were ascertained for a family study of anxiety disorders at an anxiety disorders research clinic. We present parameter estimates for dominant, recessive, and arbitrary single major locus models without sex effects, as well as for a nongenetic transmission model, and compare these models to each other and to models obtained by other investigators. We rejected the nongenetic transmission model when comparing it to the recessive model. Consistent with some previous reports, we find comparable support for dominant and recessive models, and in both cases estimate nonzero phenocopy rates. The effect of restricting the analysis to families of probands without any lifetime history of comorbid major depression (MDD) was also examined. No notable differences in parameter estimates were found in that subsample, although the power of that analysis was low. Consistency between the findings in our sample and in another independently collected sample suggests the possibility of pooling such samples in the future in order to achieve the necessary power for more complex analyses. 32 refs., 4 tabs.

  14. Panic disorder: a review of DSM-IV panic disorder and proposals for DSM-V.

    PubMed

    Craske, Michelle G; Kircanski, Katharina; Epstein, Alyssa; Wittchen, Hans-Ulrich; Pine, Danny S; Lewis-Fernández, Roberto; Hinton, Devon

    2010-02-01

    This review covers the literature since the publication of DSM-IV on the diagnostic criteria for panic attacks (PAs) and panic disorder (PD). Specific recommendations are made based on the evidence available. In particular, slight changes are proposed for the wording of the diagnostic criteria for PAs to ease the differentiation between panic and surrounding anxiety; simplification and clarification of the operationalization of types of PAs (expected vs. unexpected) is proposed; and consideration is given to the value of PAs as a specifier for all DSM diagnoses and to the cultural validity of certain symptom profiles. In addition, slight changes are proposed for the wording of the diagnostic criteria to increase clarity and parsimony of the criteria. Finally, based on the available evidence, no changes are proposed with regard to the developmental expression of PAs or PD. This review presents a number of options and preliminary recommendations to be considered for DSM-V.

  15. Empirically supported treatments for panic disorder.

    PubMed

    McHugh, R Kathryn; Smits, Jasper A J; Otto, Michael W

    2009-09-01

    This article provides an empirical review of the elements and efficacy of both pharmacologic and psychosocial treatments for panic disorder. Both monotherapies and combination treatment strategies are considered. The available evidence suggests that both cognitive behavioral therapy (CBT) and pharmacotherapy (prominently, selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors) are effective first-line agents and that CBT offers particular cost efficacy relative to both pharmacotherapy alone and combined pharmacotherapy and CBT. Predictors of non-response and mechanisms of action are considered, as are novel treatment strategies, including the use of memory enhancers to improve CBT outcome.

  16. Caffeine challenge test and panic disorder: a systematic literature review.

    PubMed

    Vilarim, Marina Machado; Rocha Araujo, Daniele Marano; Nardi, Antonio Egidio

    2011-08-01

    This systematic review aimed to examine the results of studies that have investigated the induction of panic attacks and/or the anxiogenic effect of the caffeine challenge test in patients with panic disorder. The literature search was performed in PubMed, Biblioteca Virtual em Saúde and the ISI Web of Knowledge. The words used for the search were caffeine, caffeine challenge test, panic disorder, panic attacks and anxiety disorder. In total, we selected eight randomized, double-blind studies where caffeine was administered orally, and none of them controlled for confounding factors in the analysis. The percentage of loss during follow-up ranged between 14.3% and 73.1%. The eight studies all showed a positive association between caffeine and anxiogenic effects and/or panic disorder.

  17. Differential familial liability of panic disorder and agoraphobia.

    PubMed

    Nocon, A; Wittchen, H-U; Beesdo, K; Brückl, T; Hofler, M; Pfister, H; Zimmermann, P; Lieb, R

    2008-01-01

    To examine the familial liability of panic disorder (PD) and agoraphobia (AG) in a community sample, namely the effect of parental PD and AG on the offspring's risk to develop either or both conditions in adolescence or adulthood. A representative community sample of N=3,021 adolescents and young adults aged 14-24 years at baseline was followed up over a period of 10 years in up to four waves. Family information was assessed by either direct interviews with at least one parent or by using subjects' family history information at either wave (N=3,014). Diagnoses and selected symptoms were assessed in both, parents and subjects, by using a standardized diagnostic interview (DSM-IV M-CIDI) with its respective family history module. (1) Parental panic attacks (PA), PD, and AG were all shown to be associated with an increased risk of offspring to also develop PA, PD, and AG. (2) Associations of parental PD were present irrespective of parental AG, whereas parental AG without PD was not associated with an increased offspring risk. (3) Outcome risk was particularly elevated in offspring of parents with PD+AG. (4) Parental PD or AG was not associated with an earlier age of onset of any syndrome in the offspring. We confirmed and expanded previous results from clinical samples that comorbid PD and AG aggregate in families. AG without PD is not familial, but it might enhance the familial transmission of PD.

  18. A Laboratory-Based Test of the Relation between Adolescent Alcohol Use and Panic-Relevant Responding

    PubMed Central

    Blumenthal, Heidemarie; Cloutier, Renee M.; Zamboanga, Byron L.; Bunaciu, Liviu; Knapp, Ashley A.

    2015-01-01

    A burgeoning literature supports a link between alcohol use and panic-spectrum problems (e.g., panic attacks, disorder) among adolescents, but the direction of influence has yet to be properly examined. From a theoretical perspective, panic-spectrum problems may increase risk for problematic drinking via affect regulation efforts (e.g., self-medication), and problematic consumption also may increase or initiate panic-relevant responding (e.g., learning or kindling models). The objective of the current investigation was to examine the role of prior alcohol use in predicting panic-relevant responding, as well as panic symptom history in predicting the desire to consume alcohol, in the context of either a voluntary hyperventilation or a low-arousal task. Participants were community-recruited adolescents aged 12-17 years (n = 92, Mage = 15.42, SD = 1.51; 39.1% girls). Results indicated that prior alcohol use predicted panic-relevant responding among those undergoing the hyperventilation task (but not the low-arousal task), and that this finding was robust to the inclusion of theoretically-relevant covariates (i.e. age, sex, negative affectivity). However, panic symptom history did not predict the desire to consume alcohol as a function of either the hyperventilation or low-arousal condition. This work sheds further light on the nature of the relation between panic-spectrum problems and problematic alcohol use in adolescence. Specifically, the current findings suggest that frequent alcohol use may increase panic vulnerability among adolescents, whereas acute panic symptoms may not elicit the immediate (self-reported) desire to drink. PMID:26053320

  19. A laboratory-based test of the relation between adolescent alcohol use and panic-relevant responding.

    PubMed

    Blumenthal, Heidemarie; Cloutier, Renee M; Zamboanga, Byron L; Bunaciu, Liviu; Knapp, Ashley A

    2015-10-01

    A burgeoning literature supports a link between alcohol use and panic-spectrum problems (e.g., panic attacks, disorder) among adolescents, but the direction of influence has yet to be properly examined. From a theoretical perspective, panic-spectrum problems may increase risk for problematic drinking via affect regulation efforts (e.g., self-medication), and problematic consumption also may increase or initiate panic-relevant responding (e.g., learning or kindling models). The objective of the current investigation was to examine the role of prior alcohol use in predicting panic-relevant responding, as well as panic symptom history in predicting the desire to consume alcohol, in the context of either a voluntary hyperventilation or a low-arousal task. Participants were community-recruited adolescents aged 12-17 years (n = 92, Mage = 15.42, SD = 1.51; 39.1% girls). Results indicated that prior alcohol use predicted panic-relevant responding among those undergoing the hyperventilation task (but not the low-arousal task), and that this finding was robust to the inclusion of theoretically relevant covariates (i.e., age, sex, negative affectivity). However, panic symptom history did not predict the desire to consume alcohol as a function of either the hyperventilation or low-arousal condition. This work sheds further light on the nature of the relation between panic-spectrum problems and problematic alcohol use in adolescence. Specifically, the current findings suggest that frequent alcohol use may increase panic vulnerability among adolescents, whereas acute panic symptoms may not elicit the immediate (self-reported) desire to drink.

  20. Sleep paralysis in African Americans with panic disorder.

    PubMed

    Paradis, Cheryl M; Friedman, Steven

    2005-03-01

    Studies have reported a wide range in lifetime prevalence of sleep paralysis (SP). This variation may stem from cultural factors, stressful life events and genetic differences in studied populations. We found that recurrent SP was more common among African-American participants, especially those with panic disorder. Recurrent SP was reported by 59% of African Americans with panic disorder, 7% of whites with panic disorder, 23% of African-American community volunteers and 6% of white community volunteers. Significantly more early life stressors were reported by African Americans than whites. Higher levels of psychosocial stressors, including poverty, racism and acculturation, may contribute to the higher rates of SP experienced by African Americans.

  1. Agoraphobia Related to Unassertiveness in Panic Disorder.

    PubMed

    Levitan, Michelle Nigri; Simoes, Pedro; Sardinha, Aline G; Nardi, Antonio E

    2016-05-01

    Despite developments in panic disorder (PD) research, a significant percentage of patients do not benefit from conventional treatments. Interpersonal factors have been identified as potential predictors of treatment failures. We aimed to evaluate assertiveness in a sample of patients with PD and its implications for treatment. Forty-six symptomatic patients with PD and 46 college students responded to assessment scales regarding assertiveness and clinical data. Seventy-five percent of the patients had a secondary diagnosis of agoraphobia. We found that the PD group was characterized as nonassertive and slightly less assertive than control subjects. Furthermore, the deficit in the level of assertiveness correlated with the severity of the PD. The diagnosis of agoraphobia was correlated with unassertiveness (p < 0.05). Agoraphobia predisposes individuals to dependency and insecurity about their ability to overcome anxiogenic situations. These data demonstrate the importance of managing assertiveness in patients with PD accompanied by agoraphobia. PMID:26915016

  2. Panic attack symptom dimensions and their relationship to illness characteristics in panic disorder.

    PubMed

    Meuret, Alicia E; White, Kamila S; Ritz, Thomas; Roth, Walton T; Hofmann, Stefan G; Brown, Timothy A

    2006-09-01

    Subtyping panic disorder by predominant symptom constellations, such as cognitive or respiratory, has been done for some time, but criteria have varied considerably between studies. We sought to identify statistically symptom dimensions from intensity ratings of 13 DSM-IV panic symptoms in 343 panic patients interviewed with the Anxiety Disorders Interview Schedule for DSM-IV Lifetime Version. We then explored the relation of symptom dimensions to selected illness characteristics. Ratings were submitted to exploratory maximum likelihood factor analysis with a Promax rotation. A three-factor solution was found to account best for the variance. Symptoms loading highest on the first factor were palpitations, shortness of breath, choking, chest pain, and numbness, which define a cardio-respiratory type (with fear of dying). Symptoms loading highest on the second factor were sweating, trembling, nausea, chills/hot flashes, and dizziness, which defines a mixed somatic subtype. Symptoms loading highest on the third factor were feeling of unreality, fear of going crazy, and fear of losing control, which defines a cognitive subtype. Subscales based on these factors showed moderate intercorrelations. In a series of hierarchical multiple regression analyses, the cardio-respiratory subscale was a strong predictor of panic severity, frequency of panic attacks, and agoraphobic avoidance, while the cognitive subscale mostly predicted worry due to panic. In addition, patients with comorbid asthma had higher scores on the cardio-respiratory subscale. We conclude that partly independent panic symptom dimensions can be identified that have different implications for severity and control of panic disorder. PMID:16293263

  3. [Diagnosis and management of panic disorder in psychiatry (PANDA Study)].

    PubMed

    Servant, D; Parquet, P J

    2000-01-01

    Panic disorder is a genuine public health problem given by their frequency and the various and repeated consultations that they involve. PD is underdiagnosed in primary care and in medical specialist. A public campaign might lead to improved diagnosis and better treatment of panic disorder, with a beneficial effect on medico-economic indicators. Intervention by the psychiatrist is of key importance, although it has not been evaluated to any great extend. The objective of the PANDA study was to look at the prevalence and diagnostic of panic disorder, the conditions of access to and use of care, as well as the method of treatment. Four hundred and twenty three psychiatrists participated in the study and 8,137 patients seen consecutively were included. The prevalence of actual panic disorder evaluated using the Mini International Neuropsychiatric Interview (MINI) systematic is 9%. In two third of cases coexisted agoraphobia and in one third a depression. Eighty six percent of patients with actual panic disorder were treated by the psychiatrists. The diagnosis and suitable treatment of panic disorder would appear to be a significant objective in term of public health, leading to a reduction in medical and social cost of this disorder. PMID:10858913

  4. Medications for Panic Disorder and Generalized Anxiety Disorder During Pregnancy

    PubMed Central

    Rubinchik, Sofya M.; Kablinger, Anita S.; Gardner, J. Suzette

    2005-01-01

    Objective: Approximately 30% of women experience some type of anxiety disorder during their lifetime. In addition, some evidence exists that anxiety disorders can affect pregnancy outcomes. This article reviews the literature on the course of generalized anxiety disorder (GAD) and panic disorder during pregnancy and the postpartum period and presents guidelines for management. Data Sources and Study Selection: An English language electronic search of relevant studies using PubMed (January 1, 1985–January 2004) was performed using the search terms anxiety and pregnancy, maternal mental illness, panic and pregnancy, psychotropic medications in pregnancy, and treatment options in pregnancy. Review articles and primary pharmacologic treatment articles were selected for discussion. Data Extraction and Synthesis: Despite the extensive use of psychotropic drugs such as antidepressants during pregnancy, there is a scarcity of information regarding the effect of such exposure on the developing fetus. Review articles and primary pharmacologic treatment trials were analyzed and incorporated into the review based on adequate methodology, completeness of data, and information on pregnancy outcome. Conclusion: It is important that physicians understand the course of these disorders during pregnancy and available treatments so they appropriately counsel women who are or intend to become pregnant. The goal of treatment during pregnancy and lactation is sufficient treatment for syndrome remission. To minimize the potential for neonatal withdrawal and maternal toxicity after delivery, vigilant monitoring of side effects is indicated. Also, if possible, nonpharmacologic treatment, such as cognitive-behavioral therapy, should be first-line treatment in pregnant women with GAD or panic disorder. PMID:16027764

  5. Current pharmacological interventions in panic disorder.

    PubMed

    Freire, Rafael C; Machado, Sergio; Arias-Carrión, Oscar; Nardi, Antonio E

    2014-01-01

    The aim of this review was to summarize the recent evidences regarding the pharmacological treatment of panic disorder (PD). The authors performed a review of the literature regarding the pharmacological treatment of PD since the year 2000. The research done in the last decade brought strong evidences of effectiveness for paroxetine, venlafaxine, sertraline, fluvoxamine, citalopram, fluoxetine, clonazepam, and the relatively novel agent escitalopram. There are evidences indicating that the other new compounds inositol, duloxetine, mirtazapine, milnacipran, and nefazodone have antipanic properties and may be effective compounds in the treatment of PD. The effectiveness of reboxetine and anticonvulsants is a subject of controversy. In addition to selective serotonin reuptake inhibitors and serotonin and noradrenaline reuptake inhibitors, tricyclic antidepressants, monoamine oxidase inhibitors, benzodiazepines and atypical antipsychotics may be valid alternatives in the treatment of PD. Recent data indicate that augmentation strategies with aripiprazole, olanzapine, pindolol or clonazepam may be effective. D-cycloserine is a promising agent in the augmentation of cognitive behavioral therapy. PMID:24923349

  6. Decreased mean platelet volume in panic disorder

    PubMed Central

    Göğçegöz Gül, Işıl; Eryılmaz, Gül; Özten, Eylem; Hızlı Sayar, Gökben

    2014-01-01

    Aim The relationship between psychological stress and platelet activation has been widely studied. It is well known that platelets may reflect certain biochemical changes that occur in the brain when different mental conditions occur. Platelet 5-hydroxytryptamine (5-HT) is also extensively studied in psychiatry. The mean platelet volume (MPV), the accurate measure of platelet size, has been considered a marker and determinant of platelet function. The aim of the present study was to search for any probable difference in the MPV of subjects with panic disorder (PD). Methods A total of 37 drug-free subjects, aged 18 to 65 years, diagnosed with PD, with or without agoraphobia, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth edition (DSM-IV) criteria and 45 healthy control subjects were included in the study. Platelet count and MPV were measured and recorded for each subject. Results There were no statistically significant differences between groups in terms of female/male ratio, age, or body mass index between the PD group and control group (P=0.91, P=0.82, and P=0.93, respectively). The MPV was found to be significantly lower in the PD group compared with the control group (8.8±0.9 fL vs 9.2±0.8 fL; P=0.02). All the participants had MPV values in the standard range of 6.9–10.8 fL. Conclusion We concluded that abnormalities of the 5-HT1A receptor function in the central nervous system of subjects with a diagnosis of PD are also mirrored in as an alteration in platelet activity. Measurements of platelet activity may be used as a tool for neuropsychiatric and psychopharmacological research and for studying how certain mental diseases and medications affect the central nervous system. PMID:25214790

  7. A case of panic disorder induced by oral contraceptive.

    PubMed

    Ushiroyama, T; Okamoto, Y; Toyoda, K; Sugimoto, O

    1992-01-01

    A 27-year-old woman experienced feelings of unreality and fear after taking an oral contraceptive in the form of birth control pills. She subsequently experienced a panic attack just after she had stopped taking the pills. This was characterized by palpitation, general fatigue, trembling of the whole body, and dyspnea. The panic disorder experienced by the patient could have been due to the drug's potentiating of the sympathoadrenal response to simple physiological stimuli, or possibly to a disorder in psychological functioning caused by an anxiotropic effect of rapid endocrinological change. PMID:1315108

  8. Interoceptive Assessment and Exposure in Panic Disorder: A Descriptive Study

    ERIC Educational Resources Information Center

    Schmidt, Norman B.; Trakowski, Jack

    2004-01-01

    Cognitive behavioral treatment (CBT) protocols for panic disorder (PD) typically include some form of interoceptive exposure (IE)--repeated exposure to internal sensations. Despite the widespread clinical use of IE, there is a notable absence of empirical reports about the nature of interoceptive assessments and IE. The present study was designed…

  9. A Meta-Analysis of Treatments for Panic Disorder.

    ERIC Educational Resources Information Center

    Clum, George A.; And Others

    1993-01-01

    Used metanalysis to compare effectiveness of psychological and pharmacological treatments for panic disorder. Percentage of agoraphobic subjects in sample and duration of illness were unrelated to effect size (ES). Psychological coping strategies involving relaxation training, cognitive restructuring, and exposure yielded most consistent ESs;…

  10. Increased Opioid Dependence in a Mouse Model of Panic Disorder

    PubMed Central

    Gallego, Xavier; Murtra, Patricia; Zamalloa, Teresa; Canals, Josep Maria; Pineda, Joseba; Amador-Arjona, Alejandro; Maldonado, Rafael; Dierssen, Mara

    2009-01-01

    Panic disorder is a highly prevalent neuropsychiatric disorder that shows co-occurrence with substance abuse. Here, we demonstrate that TrkC, the high-affinity receptor for neurotrophin-3, is a key molecule involved in panic disorder and opiate dependence, using a transgenic mouse model (TgNTRK3). Constitutive TrkC overexpression in TgNTRK3 mice dramatically alters spontaneous firing rates of locus coeruleus (LC) neurons and the response of the noradrenergic system to chronic opiate exposure, possibly related to the altered regulation of neurotrophic peptides observed. Notably, TgNTRK3 LC neurons showed an increased firing rate in saline-treated conditions and profound abnormalities in their response to met5-enkephalin. Behaviorally, chronic morphine administration induced a significantly increased withdrawal syndrome in TgNTRK3 mice. In conclusion, we show here that the NT-3/TrkC system is an important regulator of neuronal firing in LC and could contribute to the adaptations of the noradrenergic system in response to chronic opiate exposure. Moreover, our results indicate that TrkC is involved in the molecular and cellular changes in noradrenergic neurons underlying both panic attacks and opiate dependence and support a functional endogenous opioid deficit in panic disorder patients. PMID:20204153

  11. 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);…

  12. A Comparison of Alprazolam and Behavior Therapy in Treatment of Panic Disorder.

    ERIC Educational Resources Information Center

    Klosko, Janet S.; And Others

    1990-01-01

    Compared panic control treatment (PCT), behavior therapy for panic disorders, with alprazolam medication, placebo, and waiting-list control groups. Percentage of clients (N=57) completing study who were free of panic attacks following PCT was 87 percent, compared with 50 percent for alprazolam, 36 percent for placebo, and 33 percent for…

  13. Replication of action of cholecystokinin tetrapeptide in panic disorder: clinical and behavioral findings.

    PubMed

    Bradwejn, J; Koszycki, D; Payeur, R; Bourin, M; Borthwick, H

    1992-07-01

    Eleven patients with panic disorder were challenged with cholecystokinin tetrapeptide (CCK-4) on two occasions. The effects of CCK-4 were consistent except symptom onset was more rapid with the second injection. Demonstrating that the effects of CCK-4 are reproducible in panic patients opens the doors for studies of the effects of drug treatment on CCK-4-induced panic.

  14. Milnacipran in panic disorder with agoraphobia and major depressive disorder: a case report.

    PubMed

    Chen, Mu-Hong; Liou, Ying-Jay

    2011-01-01

    A 51-year-old woman had panic disorder with agoraphobia and major depressive disorder sequentially. The aforementioned symptoms subsided significantly after treatment with milnacipran, 125 mg, administered daily for 2 months. However, panic attacks with agoraphobia were noted frequently when she tapered down milnacipran to 50 mg daily. She consequently experienced depression that gradually increased in degree, with poor energy, poor sleep, thoughts of helplessness, and ideas of death. After administration of a daily dose of 125 mg of milnacipran for 1 month, her panic attacks with agoraphobia and depressed mood were again alleviated. The present report shows significant effects of milnacipran on the comorbidity of panic disorder with agoraphobia and major depressive disorder. PMID:21926486

  15. Perceived parental characteristics of patients with obsessive compulsive disorder, depression, and panic disorder.

    PubMed

    Merkel, W T; Pollard, C A; Wiener, R L; Staebler, C R

    1993-01-01

    It has been hypothesized that parents of patients with obsessive compulsive disorder exhibit specific traits. 320 consecutive inpatient admissions who met criteria for OCD, depression, and panic disorder checked a list of adjectives to describe their parents. Patients with OCD were 1) less likely to perceive their mothers as disorganized than depressives, 2) more likely to perceive their mothers as overprotective than depressives and 3) less likely to perceive their fathers as demanding than patients with panic. PMID:8404245

  16. 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 ...

  17. Emerging Standards of Care for the Diagnosis and Treatment of Panic Disorder.

    ERIC Educational Resources Information Center

    Beamish, Patrica M.; Granello, Darcy Haag; Granello, Paul F.; McSteen, Patricia B.; Stone, David A.

    1997-01-01

    Proposes eight emerging standards of care, based on a literature review, for the diagnosis and treatment of panic disorder without agoraphobia in adults. The diagnostic criteria were particularly analyzed in terms of comorbid psychological disorders, medical disorders, and substances that mimic panic symptoms. Defines minimal professional conduct.…

  18. Impact of Mindfulness-Based Cognitive Therapy on Intolerance of Uncertainty in Patients with Panic Disorder

    PubMed Central

    Kim, Min Kuk; Lee, Kang Soo; Kim, Borah; Choi, Tai Kiu

    2016-01-01

    Objective Intolerance of uncertainty (IU) is a transdiagnostic construct in various anxiety and depressive disorders. However, the relationship between IU and panic symptom severity is not yet fully understood. We examined the relationship between IU, panic, and depressive symptoms during mindfulness-based cognitive therapy (MBCT) in patients with panic disorder. Methods We screened 83 patients with panic disorder and subsequently enrolled 69 of them in the present study. Patients participating in MBCT for panic disorder were evaluated at baseline and at 8 weeks using the Intolerance of Uncertainty Scale (IUS), Panic Disorder Severity Scale-Self Report (PDSS-SR), and Beck Depression Inventory (BDI). Results There was a significant decrease in scores on the IUS (p<0.001), PDSS (p<0.001), and BDI (p<0.001) following MBCT for panic disorder. Pre-treatment IUS scores significantly correlated with pre-treatment PDSS (p=0.003) and BDI (p=0.003) scores. We also found a significant association between the reduction in IU and PDSS after controlling for the reduction in the BDI score (p<0.001). Conclusion IU may play a critical role in the diagnosis and treatment of panic disorder. MBCT is effective in lowering IU in patients with panic disorder. PMID:27081380

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  20. Brief cognitive therapy for panic disorder: a randomized controlled trial.

    PubMed

    Clark, D M; Salkovskis, P M; Hackmann, A; Wells, A; Ludgate, J; Gelder, M

    1999-08-01

    Cognitive therapy (CT) is a specific and highly effective treatment for panic disorder (PD). Treatment normally involves 12-15 1-hr sessions. In an attempt to produce a more cost-effective version, a briefer treatment that made extensive use of between-sessions patient self-study modules was created. Forty-three PD patients were randomly allocated to full CT (FCT), brief CT (BCT), or a 3-month wait list. FCT and BCT were superior to wait list on all measures, and the gains obtained in treatment were maintained at 12-month follow-up. There were no significant differences between FCT and BCT. Both treatments had large (approximately 3.0) and essentially identical effect sizes. BCT required 6.5 hr of therapist time, including booster sessions. Patients' initial expectation of therapy success was negatively correlated with posttreatment panic-anxiety. Cognitive measures at the end of treatment predicted panic-anxiety at 12-month follow-up. PMID:10450630

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

    PubMed

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

    2014-12-01

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

  2. Missense mutation of the cholecystokinin B receptor gene: Lack of association with panic disorder

    SciTech Connect

    Kato, Tadafumi; Wang, Zhe Wu; Crowe, R.R.; Zoega, T.

    1996-07-26

    Cholecystokinin tetrapeptide (CCK{sub 4}) is known to induce panic attacks in patients with panic disorder at a lower dose than in normal controls. Therefore, the cholecystokinin B (CCK{sub B}) receptor gene is a candidate gene for panic disorder. We searched for mutations in the CCK{sub B} gene in 22 probands of panic disorder pedigrees, using single-strand conformation polymorphism (SSCP) analysis. Two polymorphisms were detected. A polymorphism in an intron (2491 C{yields}A) between exons 4 and 5 was observed in 10 of 22 probands. A missense mutation in the extracellular loop of exon 2 (1550 G{yields}A, Val{sup 125}{yields}Ile) was found in only one proband. This mutation was also examined in additional 34 unrelated patients with panic disorder and 112 controls. The prevalence rate of this mutation was 8.8% in patients with panic disorder (3/34) and 4.4% in controls (5/112). The mutation did not segregate with panic disorder in two families where this could be tested. These results suggest no pathophysiological significance of this mutation in panic disorder. 21 refs., 4 figs., 1 tab.

  3. Automatic associations and panic disorder: Trajectories of change over the course of treatment

    PubMed Central

    Teachman, Bethany A.; Marker, Craig D.; Smith-Janik, Shannan B.

    2008-01-01

    Cognitive models of anxiety and panic suggest that symptom reduction during treatment should be preceded by changes in cognitive processing, including modifying the anxious schema. The current study tests these hypotheses by using a repeated measures design to evaluate whether the trajectory of change in automatic panic associations over the course of 12-week cognitive behavior therapy (CBT) is related to the trajectory of change in panic symptoms. Individuals with panic disorder (N=43) completed a measure of automatic panic associations (the Implicit Association Test, which reflects elements of the schema construct) every three weeks over the course of therapy, and measures of panic symptoms each week. Dynamic bivariate latent difference score modeling indicated that automatic panic associations not only changed over the course of CBT for panic disorder, but showed these changes were correlated with symptom reduction. Moreover, change in automatic panic associations was a significant predictor of change in panic symptom severity. These findings permit inferences about the temporality of change, suggesting that cognitive change does in fact precede and contribute to symptom change. PMID:19045967

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  5. Functional MRI activation in response to panic-specific, non-panic aversive, and neutral pictures in patients with panic disorder and healthy controls.

    PubMed

    Engel, K R; Obst, K; Bandelow, B; Dechent, P; Gruber, O; Zerr, I; Ulrich, K; Wedekind, D

    2016-09-01

    There is evidence that besides limbic brain structures, prefrontal and insular cortical activations and deactivations are involved in the pathophysiology of panic disorder. This study investigated activation response patterns to stimulation with individually selected panic-specific pictures in patients with panic disorder with agoraphobia (PDA) and healthy control subjects using functional magnetic resonance imaging (fMRI). Structures of interest were the prefrontal, cingulate, and insular cortex, and the amygdalo-hippocampal complex. Nineteen PDA subjects (10 females, 9 males) and 21 healthy matched controls were investigated using a Siemens 3-Tesla scanner. First, PDA subjects gave Self-Assessment Manikin (SAM) ratings on 120 pictures showing characteristic panic/agoraphobia situations, of which 20 pictures with the individually highest SAM ratings were selected. Twenty matched pictures showing aversive but not panic-specific stimuli and 80 neutral pictures from the International Affective Picture System were chosen for each subject as controls. Each picture was shown twice in each of four subsequent blocks. Anxiety and depression ratings were recorded before and after the experiment. Group comparisons revealed a significantly greater activation in PDA patients than control subjects in the insular cortices, left inferior frontal gyrus, dorsomedial prefrontal cortex, the left hippocampal formation, and left caudatum, when PA and N responses were compared. Comparisons for stimulation with unspecific aversive pictures showed activation of similar brain regions in both groups. Results indicate region-specific activations to panic-specific picture stimulation in PDA patients. They also imply dysfunctionality in the processing of interoceptive cues in PDA and the regulation of negative emotionality. Therefore, differences in the functional networks between PDA patients and control subjects should be further investigated. PMID:26585457

  6. "But it might be a heart attack": intolerance of uncertainty and panic disorder symptoms.

    PubMed

    Carleton, R Nicholas; Duranceau, Sophie; Freeston, Mark H; Boelen, Paul A; McCabe, Randi E; Antony, Martin M

    2014-06-01

    Panic disorder models describe interactions between feared anxiety-related physical sensations (i.e., anxiety sensitivity; AS) and catastrophic interpretations therein. Intolerance of uncertainty (IU) has been implicated as necessary for catastrophic interpretations in community samples. The current study examined relationships between IU, AS, and panic disorder symptoms in a clinical sample. Participants had a principal diagnosis of panic disorder, with or without agoraphobia (n=132; 66% women). IU was expected to account for significant variance in panic symptoms controlling for AS. AS was expected to mediate the relationship between IU and panic symptoms, whereas IU was expected to moderate the relationship between AS and panic symptoms. Hierarchical linear regressions indicated that IU accounted for significant unique variance in panic symptoms relative to AS, with comparable part correlations. Mediation and moderation models were also tested and suggested direct and indirect effects of IU on panic symptoms through AS; however, an interaction effect was not supported. The current cross-sectional evidence supports a role for IU in panic symptoms, independent of AS.

  7. Paranoid personality traits in a panic disorder population: a pilot study.

    PubMed

    Reich, J; Braginsky, Y

    1994-01-01

    To better understand the relationship between panic disorder and paranoid personality, panic disorder patients (N = 28) who were referred to an anxiety disorder clinic in a community mental health center were evaluated for paranoid personality traits on a standardized personality self-report instrument. Paranoid personality disorder was found in 54% of subjects. Paranoid subjects were found to have an earlier age of onset, longer duration of illness, and more psychopathology. Possible etiologies and implications for treatment of these findings are discussed.

  8. Quality of Smartphone Apps Related to Panic Disorder

    PubMed Central

    Van Singer, Mathias; Chatton, Anne; Khazaal, Yasser

    2015-01-01

    Quality of smartphone apps related to panic: smartphone apps have a growing role in health care. This study assessed the quality of English-language apps for panic disorder (PD) and compared paid and free apps. Keywords related to PD were entered into the Google Play Store search engine. Apps were assessed using the following quality indicators: accountability, interactivity, self-help score (the potential of smartphone apps to help users in daily life), and evidence-based content quality. The Brief DISCERN score and the criteria of the “Health on the Net” label were also used as content quality indicators as well as the number of downloads. Of 247 apps identified, 52 met all inclusion criteria. The content quality and self-help scores of these PD apps were poor. None of the assessed indicators were associated with payment status or number of downloads. Multiple linear regressions showed that the Brief DISCERN score significantly predicted the content quality and self-help scores. Poor content quality and self-help scores of PD smartphone apps highlight the gap between their technological potential and the overall quality of available products. PMID:26236242

  9. Virtual Reality Exposure in the Treatment of Panic Disorder with Agoraphobia: A Case Study

    ERIC Educational Resources Information Center

    Martin, Helena Villa; Botella, Cristina; Garcia-Palacios, Azucena; Osma, Jorge

    2007-01-01

    In this work we present a case example of the use of virtual reality exposure for the treatment of panic disorder with agoraphobia. The assessment protocol and procedure (including a baseline period) and the cognitive-behavioral treatment program are described. The clinical measures were categorized into target behaviors, panic and agoraphobia…

  10. Acceptability of Virtual Reality Interoceptive Exposure for the Treatment of Panic Disorder with Agoraphobia

    ERIC Educational Resources Information Center

    Quero, Soledad; Pérez-Ara, M. Ángeles; Bretón-López, Juana; García-Palacios, Azucena; Baños, Rosa M.; Botella, Cristina

    2014-01-01

    Interoceptive exposure (IE) is a standard component of cognitive-behavioural therapy (CBT) for panic disorder and agoraphobia. The virtual reality (VR) program "Panic-Agoraphobia" has several virtual scenarios designed for applying exposure to agoraphobic situations; it can also simulate physical sensations. This work examines…

  11. Treatment of internet addiction in patient with panic disorder and obsessive compulsive disorder: a case report.

    PubMed

    Santos, Veruska; Nardi, Antonio Egidio; King, Anna Lucia Spear

    2015-01-01

    Problematic Internet use is a worldwide social issue and it can be found in any age, social, educational, or economic range. In some countries like China and South Korea internet addiction (IA) is considered a public health condition and this governments support research, education and treatment. Internet addiction has been associated with others psychiatric disorders. Panic disorder (PD) and Obsessive Compulsive Disorder (OCD) are anxiety disorders that involve a lot of damages in patient's life. We report a treatment of a patient with Panic Disorder and Obsessive Compulsive Disorder and internet addition involving pharmacotherapy and Cognitive Behavioral Therapy (CBT). The Cognitive Behavioral Therapy was conducted 1 time per week during 10 weeks and results suggest that the treatment was an effective treatment for the anxiety and for the internet addiction.

  12. Panic disorder and migraine: comorbidity, mechanisms, and clinical implications.

    PubMed

    Smitherman, Todd A; Kolivas, Elizabeth D; Bailey, Jennifer R

    2013-01-01

    A growing body of literature suggests that comorbid anxiety disorders are more common and more prognostically relevant among migraine sufferers than comorbid depression. Panic disorder (PD) appears to be more strongly associated with migraine than most other anxiety disorders. PD and migraine are both chronic diseases with episodic manifestations, involving significant functional impairment and shared symptoms during attacks, interictal anxiety concerning future attacks, and an absence of identifiable secondary pathology. A meta-analysis of high-quality epidemiologic study data from 1990 to 2012 indicates that the odds of PD are 3.76 times greater among individuals with migraine than those without. This association remains significant even after controlling for demographic variables and comorbid depression. Other less-rigorous community and clinical studies confirm these findings. The highest rates of PD are found among migraine with aura patients and those presenting to specialty clinics. Presence of PD is associated with greater negative impact of migraine, including more frequent attacks, increased disability, and risk for chronification and medication overuse. The mechanisms underlying this common comorbidity are poorly understood, but both pathophysiological (eg, serotonergic dysfunction, hormonal influences, dysregulation of the hypothalamic-pituitary-adrenal axis) and psychological (eg, interoceptive conditioning, fear of pain, anxiety sensitivity, avoidance behavior) factors are implicated. Means of assessing comorbid PD among treatment-seeking migraineurs are reviewed, including verbal screening for core PD symptoms, ruling out medical conditions with panic-like features, and administering validated self-report measures. Finally, evidence-based strategies for both pharmacologic and behavioral management are outlined. The first-line migraine prophylactics are not indicated for PD, and the selective serotonin re-uptake inhibitors used to treat PD are not

  13. 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.

  14. Serum biomarkers predictive of depressive episodes in panic disorder.

    PubMed

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

    2016-02-01

    Panic disorder with or without comorbid agoraphobia (PD/PDA) has been linked to an increased risk to develop subsequent depressive episodes, yet the underlying pathophysiology of these disorders remains poorly understood. We aimed to identify a biomarker panel predictive for the development of a depressive disorder (major depressive disorder and/or dysthymia) within a 2-year-follow-up period. Blood serum concentrations of 165 analytes were evaluated in 120 PD/PDA patients without depressive disorder baseline diagnosis (6-month-recency) in the Netherlands Study of Depression and Anxiety (NESDA). We assessed the predictive performance of serum biomarkers, clinical, and self-report variables using receiver operating characteristics curves (ROC) and the area under the ROC curve (AUC). False-discovery-rate corrected logistic regression model selection of serum analytes and covariates identified an optimal predictive panel comprised of tetranectin and creatine kinase MB along with patient gender and scores from the Inventory of Depressive Symptomatology (IDS) rating scale. Combined, an AUC of 0.87 was reached for identifying the PD/PDA patients who developed a depressive disorder within 2 years (n = 44). The addition of biomarkers represented a significant (p = 0.010) improvement over using gender and IDS alone as predictors (AUC = 0.78). For the first time, we report on a combination of biological serum markers, clinical variables and self-report inventories that can detect PD/PDA patients at increased risk of developing subsequent depressive disorders with good predictive performance in a naturalistic cohort design. After an independent validation our proposed biomarkers could prove useful in the detection of at-risk PD/PDA patients, allowing for early therapeutic interventions and improving clinical outcome.

  15. Serum biomarkers predictive of depressive episodes in panic disorder.

    PubMed

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

    2016-02-01

    Panic disorder with or without comorbid agoraphobia (PD/PDA) has been linked to an increased risk to develop subsequent depressive episodes, yet the underlying pathophysiology of these disorders remains poorly understood. We aimed to identify a biomarker panel predictive for the development of a depressive disorder (major depressive disorder and/or dysthymia) within a 2-year-follow-up period. Blood serum concentrations of 165 analytes were evaluated in 120 PD/PDA patients without depressive disorder baseline diagnosis (6-month-recency) in the Netherlands Study of Depression and Anxiety (NESDA). We assessed the predictive performance of serum biomarkers, clinical, and self-report variables using receiver operating characteristics curves (ROC) and the area under the ROC curve (AUC). False-discovery-rate corrected logistic regression model selection of serum analytes and covariates identified an optimal predictive panel comprised of tetranectin and creatine kinase MB along with patient gender and scores from the Inventory of Depressive Symptomatology (IDS) rating scale. Combined, an AUC of 0.87 was reached for identifying the PD/PDA patients who developed a depressive disorder within 2 years (n = 44). The addition of biomarkers represented a significant (p = 0.010) improvement over using gender and IDS alone as predictors (AUC = 0.78). For the first time, we report on a combination of biological serum markers, clinical variables and self-report inventories that can detect PD/PDA patients at increased risk of developing subsequent depressive disorders with good predictive performance in a naturalistic cohort design. After an independent validation our proposed biomarkers could prove useful in the detection of at-risk PD/PDA patients, allowing for early therapeutic interventions and improving clinical outcome. PMID:26687614

  16. Internet Administration of Three Commonly Used Questionnaires in Panic Research: Equivalence to Paper Administration in Australian and Swedish Samples of People With Panic Disorder

    ERIC Educational Resources Information Center

    Austin, David W.; Carlbring, Per; Richards, Jeffrey C.; Andersson, Gerhard

    2006-01-01

    This study assessed the degree of equivalence between paper and Internet administration of three measures of panic and agoraphobia-related cognition and behavior: Body Sensations Questionnaire (BSQ), Agoraphobic Cognitions Questionnaire (ACQ), and Mobility Inventory (MI). Participants were 110 people with panic disorder who had registered for an…

  17. Healthcare utilization following cognitive-behavioral treatment for panic disorder with agoraphobia.

    PubMed

    Roberge, Pasquale; Marchand, André; Reinharz, Daniel; Cloutier, Karine; Mainguy, Nicole; Miller, Jean-Marc; Bégin, Jean; Turcotte, Julie

    2005-01-01

    The aim of this study was to examine the overall changes in healthcare services utilization after providing an empirically supported cognitive-behavioral treatment for panic disorder with agoraphobia. Data on healthcare utilization were collected for a total of 84 adults meeting DSM-IV criteria. Participants were completers of a cognitive-behavioral treatment for panic disorder with agoraphobia. Data on utilization of healthcare services and medication were obtained from semi-structured interviews from baseline to 1-year after treatment. Results of the Friedman non-parametric analysis reveal a significant decrease in overall and mental health-related costs following treatment. This study shows a significant reduction in healthcare costs following cognitive behavior therapy for panic disorder with agoraphobia. More studies are needed to examine the potential long-term cost-offset effect of empirically supported treatments for panic disorder. PMID:15986784

  18. Behavioral, Cognitive, and Pharmacological Treatments of Panic Disorder with Agoraphobia: Critique and Synthesis.

    ERIC Educational Resources Information Center

    Michelson, Larry K.; Marchione, Karen

    1991-01-01

    Examines theoretical, methodologic, and research issues as well as strengths, limitations, and possible interactions pertaining to behavioral, cognitive, and pharmacological treatments of panic disorder with agoraphobia. Compares attrition, outcome, and maintenance effects and presents composite indices of significant improvement, endstate…

  19. Does 'fear of dying' indicate a more severe presentation of panic disorder?

    PubMed

    Gazarian, Douglas; Multach, Matthew D; Ellison, William D; Chelminski, Iwona; Dalrymple, Kristy; Zimmerman, Mark

    2016-05-01

    Research suggests a relationship between the presence of fearful cognitions and panic disorder (PD) severity. With little existing evidence addressing the clinical significance of individual panic-cognitions, the current study examined presentation and impairment differences among 331 outpatients with PD according to whether they experience "fear of dying" (FOD) during panic attacks. Patients reporting FOD (n=153) were compared to patients denying FOD (n=178) on variables indicating PD severity (e.g., number of symptoms) and psychiatric impairment (e.g., hospitalizations). PD patients with FOD reported a greater number of panic symptoms, agoraphobia diagnoses, and were more likely to be seeking treatment primarily for PD. We found no clinical impairment or comorbidity differences between groups. Results suggest that panic attacks with FOD are related to a more acute presentation of PD. Such results substantiate past research connecting cognitive distress and PD severity and further suggest that FOD may be particularly relevant to this relationship. PMID:27105467

  20. Subregional Shape Alterations in the Amygdala in Patients with Panic Disorder

    PubMed Central

    Kim, Geon Ha; Kang, Hee Jin; Kim, Bori R.; Jeon, Saerom; Im, Jooyeon Jamie; Hyun, Heejung; Moon, Sohyeon; Lim, Soo Mee; Lyoo, In Kyoon

    2016-01-01

    Background The amygdala has been known to play a pivotal role in mediating fear-related responses including panic attacks. Given the functionally distinct role of the amygdalar subregions, morphometric measurements of the amygdala may point to the pathophysiological mechanisms underlying panic disorder. The current study aimed to determine the global and local morphometric alterations of the amygdala related to panic disorder. Methods Volumetric and surface-based morphometric approach to high-resolution three-dimensional T1-weighted images was used to examine the structural variations of the amygdala, with respect to extent and location, in 23 patients with panic disorder and 31 matched healthy individuals. Results There were no significant differences in bilateral amygdalar volumes between patients with panic disorder and healthy individuals despite a trend-level right amygdalar volume reduction related to panic disorder (right, β = -0.23, p = 0.09, Cohen's d = 0.51; left, β = -0.18, p = 0.19, Cohen's d = 0.45). Amygdalar subregions were localized into three groups including the superficial, centromedial, and laterobasal groups based on the cytoarchitectonically defined probability map. Surface-based morphometric analysis revealed shape alterations in the laterobasal and centromedial groups of the right amygdala in patients with panic disorder (false discovery rate corrected p < 0.05). Conclusions The current findings suggest that subregion-specific shape alterations in the right amygdala may be involved in the development and maintenance of panic disorder, which may be attributed to the cause or effects of amygdalar hyperactivation. PMID:27336300

  1. Gender Differences in Associations of Glutamate Decarboxylase 1 Gene (GAD1) Variants with Panic Disorder

    PubMed Central

    Weber, Heike; Scholz, Claus Jürgen; Domschke, Katharina; Baumann, Christian; Klauke, Benedikt; Jacob, Christian P.; Maier, Wolfgang; Fritze, Jürgen; Bandelow, Borwin; Zwanzger, Peter Michael; Lang, Thomas; Fehm, Lydia; Ströhle, Andreas; Hamm, Alfons; Gerlach, Alexander L.; Alpers, Georg W.; Kircher, Tilo; Wittchen, Hans-Ulrich; Arolt, Volker; Pauli, Paul; Deckert, Jürgen; Reif, Andreas

    2012-01-01

    Background Panic disorder is common (5% prevalence) and females are twice as likely to be affected as males. The heritable component of panic disorder is estimated at 48%. Glutamic acid dehydrogenase GAD1, the key enzyme for the synthesis of the inhibitory and anxiolytic neurotransmitter GABA, is supposed to influence various mental disorders, including mood and anxiety disorders. In a recent association study in depression, which is highly comorbid with panic disorder, GAD1 risk allele associations were restricted to females. Methodology/Principal Findings Nineteen single nucleotide polymorphisms (SNPs) tagging the common variation in GAD1 were genotyped in two independent gender and age matched case-control samples (discovery sample n = 478; replication sample n = 584). Thirteen SNPs passed quality control and were examined for gender-specific enrichment of risk alleles associated with panic disorder by using logistic regression including a genotype×gender interaction term. The latter was found to be nominally significant for four SNPs (rs1978340, rs3762555, rs3749034, rs2241165) in the discovery sample; of note, the respective minor/risk alleles were associated with panic disorder only in females. These findings were not confirmed in the replication sample; however, the genotype×gender interaction of rs3749034 remained significant in the combined sample. Furthermore, this polymorphism showed a nominally significant association with the Agoraphobic Cognitions Questionnaire sum score. Conclusions/Significance The present study represents the first systematic evaluation of gender-specific enrichment of risk alleles of the common SNP variation in the panic disorder candidate gene GAD1. Our tentative results provide a possible explanation for the higher susceptibility of females to panic disorder. PMID:22662185

  2. Newly diagnosed panic disorder and the risk of erectile dysfunction: A population-based cohort study in Taiwan.

    PubMed

    Wang, Yao-Ting; Chen, Hsi-Han; Lin, Ching-Heng; Lee, Shih-Hsiung; Chan, Chin-Hong; Huang, Shiau-Shian

    2016-10-30

    Previous studies indicated that panic disorder is correlated with erectile dysfunction (ED). The primary aim of this study was to explore the incidence rate of ED among panic disorder patients in an Asian country. The secondary aim was to compare the risk of ED in panic disorder patients that were treated with different kinds of antidepressants, and to explore the possible mechanism between these two disorders. We identified 1393 male patients with newly diagnosed panic disorder from the Taiwan's National Health Insurance Database. Four matched controls per case were selected for the study group by propensity score. After adjusting for age, obesity and comorbidities, the panic disorder patients had a higher hazard ratio of ED diagnosis than the controls, especially among the untreated panic disorder patients. This retrospective dynamic cohort study supports the link between ED and prior panic disorder in a large sample of panic disorder patients. This study points out the need of early antidepressant treatment for panic disorder to prevent further ED. PMID:27497294

  3. Preliminary Evidence for Cognitive Mediation During Cognitive–Behavioral Therapy of Panic Disorder

    PubMed Central

    Hofmann, Stefan G.; Suvak, Michael K.; Barlow, David H.; Shear, M. Katherine; Meuret, Alicia E.; Rosenfield, David; Gorman, Jack M.; Woods, Scott W.

    2007-01-01

    Cognitive–behavioral therapy (CBT) and pharmacotherapy are similarly effective for treating panic disorder with mild or no agoraphobia, but little is known about the mechanism through which these treatments work. The present study examined some of the criteria for cognitive mediation of treatment change in CBT alone, imipramine alone, CBT plus imipramine, and CBT plus placebo. Ninety-one individuals who received 1 of these interventions were assessed before and after acute treatment, and after a 6-month maintenance period. Multilevel moderated mediation analyses provided preliminary support for the notion that changes in panic-related cognitions mediate changes in panic severity only in treatments that include CBT. PMID:17563154

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

    PubMed

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

    2009-06-01

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

  5. Face-Emotion Processing in Offspring at Risk for Panic Disorder.

    ERIC Educational Resources Information Center

    Pine, Daniel S.; Klein, Rachel G.; Mannuzza, Salvatore; Moulton, John L., III; Lissek, Shmuel; Guardino, Mary; Woldehawariat, Girma

    2005-01-01

    Objective: Panic disorder (PD) has been linked to perturbed processing of threats. This study tested the hypotheses that offspring of parents with PD and offspring with anxiety disorders display relatively greater sensitivity and attention allocation to fear provocation. Method: Offspring of adults with PD, major depressive disorder (MDD), or no…

  6. Increased brain serotonin turnover in panic disorder patients in the absence of a panic attack: reduction by a selective serotonin reuptake inhibitor.

    PubMed

    Esler, Murray; Lambert, Elisabeth; Alvarenga, Marlies; Socratous, Florentia; Richards, Jeff; Barton, David; Pier, Ciaran; Brenchley, Celia; Dawood, Tye; Hastings, Jacqueline; Guo, Ling; Haikerwal, Deepak; Kaye, David; Jennings, Garry; Kalff, Victor; Kelly, Michael; Wiesner, Glen; Lambert, Gavin

    2007-08-01

    Since the brain neurotransmitter changes characterising panic disorder remain uncertain, we quantified brain noradrenaline and serotonin turnover in patients with panic disorder, in the absence of a panic attack. Thirty-four untreated patients with panic disorder and 24 matched healthy volunteers were studied. A novel method utilising internal jugular venous sampling, with thermodilution measurement of jugular blood flow, was used to directly quantify brain monoamine turnover, by measuring the overflow of noradrenaline and serotonin metabolites from the brain. Radiographic depiction of brain venous sinuses allowed differential venous sampling from cortical and subcortical regions. The relation of brain serotonin turnover to serotonin transporter genotype and panic disorder severity were evaluated, and the influence of an SSRI drug, citalopram, on serotonin turnover investigated. Brain noradrenaline turnover in panic disorder patients was similar to that in healthy subjects. In contrast, brain serotonin turnover, estimated from jugular venous overflow of the metabolite, 5-hydroxyindole acetic acid, was increased approximately 4-fold in subcortical brain regions and in the cerebral cortex (P < 0.01). Serotonin turnover was highest in patients with the most severe disease, was unrelated to serotonin transporter genotype, and was reduced by citalopram (P < 0.01). Normal brain noradrenaline turnover in panic disorder patients argues against primary importance of the locus coeruleus in this condition. The marked increase in serotonin turnover, in the absence of a panic attack, possibly represents an important underlying neurotransmitter substrate for the disorder, although this point remains uncertain. Support for this interpretation comes from the direct relationship which existed between serotonin turnover and illness severity, and the finding that SSRI administration reduced serotonin turnover. Serotonin transporter genotyping suggested that increased whole brain

  7. Translating Empirically Supported Strategies into Accessible Interventions: The Potential Utility of Exercise for the Treatment of Panic Disorder

    ERIC Educational Resources Information Center

    Smits, Jasper A. J.; Powers, Mark B.; Berry, Angela C.; Otto, Michael W.

    2007-01-01

    Many patients suffering from panic disorder do not receive adequate care. Advances in the conceptualization and treatment of panic disorder encourage innovative strategies for targeting core fears (fears of anxiety sensations) that underlie this disorder. In this article, we discuss the use of exercise as a potential strategy for therapeutic…

  8. Predictors of comorbid personality disorders in patients with panic disorder with agoraphobia.

    PubMed

    Latas, M; Starcevic, V; Trajkovic, G; Bogojevic, G

    2000-01-01

    The aim of this study was to ascertain predictors of comorbid personality disorders in patients with panic disorder with agoraphobia (PDAG). Sixty consecutive outpatients with PDAG were administered the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) for the purpose of diagnosing personality disorders. Logistic regressions were used to identify predictors of any comorbid personality disorder, any DSM-IV cluster A, cluster B, and cluster C personality disorder. Independent variables in these regressions were gender, age, duration of panic disorder (PD), severity of PDAG, and scores on self-report instruments that assess the patient's perception of their parents, childhood separation anxiety, and traumatic experiences. High levels of parental protection on the Parental Bonding Instrument (PBI), indicating a perception of the parents as overprotective and controlling, emerged as the only statistically significant predictor of any comorbid personality disorder. This finding was attributed to the association between parental overprotection and cluster B personality disorders, particularly borderline personality disorder. The duration of PD was a significant predictor of any cluster B and any cluster C personality disorder, suggesting that some of the cluster B and cluster C personality disorders may be a consequence of the long-lasting PDAG. Any cluster B personality disorder was also associated with younger age. In conclusion, despite a generally nonspecific nature of the relationship between parental overprotection in childhood and adult psychopathology, the findings of this study suggest some specificity for the association between parental overprotection in childhood and personality disturbance in PDAG patients, particularly cluster B personality disorders. PMID:10646616

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

    PubMed

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

    2016-04-01

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

  10. Quality of Life Impairment in Generalized Anxiety Disorder, Social Phobia, and Panic Disorder

    PubMed Central

    Barrera, Terri L.; Norton, Peter J.

    2009-01-01

    Interest in the assessment of quality of life in the anxiety disorders is growing. The present study examined quality of life impairments in individuals with Generalized Anxiety Disorder (GAD), Social Phobia, and Panic Disorder. Results showed that individuals with these disorders reported less satisfaction with their quality of life than non-anxious adults in the community. However, the degree of quality of life impairment is similar across these three disorders. Additionally, comorbid depression, but not anxiety, was found to negatively impact quality of life in these individuals. Finally, diagnostic symptom severity was not found to influence quality of life, indicating that subjective measures of quality of life offer unique information on the effects of anxiety disorders. PMID:19640675

  11. Neuropeptide S receptor gene -- converging evidence for a role in panic disorder.

    PubMed

    Domschke, K; Reif, A; Weber, H; Richter, J; Hohoff, C; Ohrmann, P; Pedersen, A; Bauer, J; Suslow, T; Kugel, H; Heindel, W; Baumann, C; Klauke, B; Jacob, C; Maier, W; Fritze, J; Bandelow, B; Krakowitzky, P; Rothermundt, M; Erhardt, A; Binder, E B; Holsboer, F; Gerlach, A L; Kircher, T; Lang, T; Alpers, G W; Ströhle, A; Fehm, L; Gloster, A T; Wittchen, H-U; Arolt, V; Pauli, P; Hamm, A; Deckert, J

    2011-09-01

    Animal studies have suggested neuropeptide S (NPS) and its receptor (NPSR) to be involved in the pathogenesis of anxiety-related behavior. In this study, a multilevel approach was applied to further elucidate the role of NPS in the etiology of human anxiety. The functional NPSR A/T (Asn¹⁰⁷Ile) variant (rs324981) was investigated for association with (1) panic disorder with and without agoraphobia in two large, independent case-control studies, (2) dimensional anxiety traits, (3) autonomic arousal level during a behavioral avoidance test and (4) brain activation correlates of anxiety-related emotional processing in panic disorder. The more active NPSR rs324981 T allele was found to be associated with panic disorder in the female subgroup of patients in both samples as well as in a meta-analytic approach. The T risk allele was further related to elevated anxiety sensitivity, increased heart rate and higher symptom reports during a behavioral avoidance test as well as decreased activity in the dorsolateral prefrontal, lateral orbitofrontal and anterior cingulate cortex during processing of fearful faces in patients with panic disorder. The present results provide converging evidence for a female-dominant role of NPSR gene variation in panic disorder potentially through heightened autonomic arousal and distorted processing of anxiety-relevant emotional stimuli.

  12. Cognitive-Behavior Therapy (CBT) for Panic Disorder: Relationship of Anxiety and Depression Comorbidity with Treatment Outcome

    PubMed Central

    White, Kamila S.; Barlow, David H.; Shear, M. Katherine; Gorman, Jack M.; Woods, Scott W.

    2009-01-01

    Research evaluating the relationship of comorbidity to treatment outcome for panic disorder has produced mixed results. The current study examined the relationship of comorbid depression and anxiety to treatment outcome in a large-scale, multi-site clinical trial for cognitive-behavior therapy (CBT) for panic disorder. Comorbidity was associated with more severe panic disorder symptoms, although comorbid diagnoses were not associated with treatment response. Comorbid generalized anxiety disorder (GAD) and major depressive disorder (MDD) were not associated with differential improvement on a measure of panic disorder severity, although only rates of comorbid GAD were significantly lower at posttreatment. Treatment responders showed greater reductions on measures of anxiety and depressive symptoms. These data suggest that comorbid anxiety and depression are not an impediment to treatment response, and successful treatment of panic disorder is associated with reductions of comorbid anxiety and depressive symptoms. Implications for treatment specificity and conceptual understandings of comorbidity are discussed. PMID:20421906

  13. A Structural Equation Model of Perievent Panic and Posttraumatic Stress Disorder After a Community Disaster

    PubMed Central

    Adams, Richard E.; Boscarino, Joseph A.

    2012-01-01

    Studies suggest that perievent panic attacks are predictive of future posttraumatic stress disorder (PTSD). Using a population of New York City residents interviewed after the World Trade Center Disaster, the authors measured event exposure, perievent panic, potential confounding, mediating variables, and PTSD. When they estimated a structural equation model, with other stressor events, psychological resources, and Year 1 and Year 2 PTSD as latent variables and adjusted for confounders, the association between perievent panic and Year 2 PTSD was not significant. Results revealed that perievent panic was predictive of Year 1 PTSD, but not Year 2 PTSD. Year 2 stressors and Year 2 psychosocial resources were the best predictors of Year 2 PTSD. PMID:21351165

  14. Parental Bonds in Children at High and Low Familial Risk for Panic Disorder

    ERIC Educational Resources Information Center

    Koszycki, Diana; Bilodeau, Cynthia; Zwanzger, Peter; Schneider, Barry H.; Flament, Martine F.; Bradwejn, Jacques

    2013-01-01

    A rejecting and overprotective parenting style is considered to be an important risk factor for the development of anxiety disorders. This study examined the role of perceived parental bonding as a potential environmental risk factor for panic disorder (PD) in unaffected offspring with parental PD. Children with a biological parent with PD (n =…

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

    ERIC Educational Resources Information Center

    Siev, Jedidiah; Chambless, Dianne L.

    2007-01-01

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

  16. An Internet-based investigation of the catastrophic misinterpretation model of panic disorder.

    PubMed

    Austin, David; Kiropoulos, Litza

    2008-01-01

    The catastrophic misinterpretation (CM) model of panic disorder proposes that spontaneous panic attacks are the result of interpretation of harmless autonomic arousal as precursors to physical (e.g., heart attack) or psychological (e.g., insanity) emergency. Mixed research findings to date have provided equivocal support. The body sensations interpretation questionnaire-modified was administered via Internet to investigate core assumptions of the model among 30 people with panic disorder (PD), 28 with social anxiety disorder (SAD), and 30 non-anxious controls. The PD group gave more harm-related interpretations of ambiguous internal stimuli than both other groups, and this tendency to interpret ambiguous stimuli catastrophically was not also apparent for external/general events. Furthermore, people with PD rated harm and anxiety outcomes as more catastrophic than non-anxious controls. Results substantially support the CM model although a modification is proposed.

  17. Cognitive Behavioral Treatment of Panic Disorder and Agoraphobia in a Multiethnic Urban Outpatient Clinic: Initial Presentation and Treatment Outcome

    ERIC Educational Resources Information Center

    Friedman, Steven; Braunstein, Jeffrey W.; Halpern, Beth

    2006-01-01

    Few studies examine the effectiveness of panic control treatment across diverse ethnic groups. In this paper we present data on 40 patients (African American, n = 24; Caucasian, n = 16) with panic disorder and comorbid agoraphobia who presented at an anxiety disorder clinic in an inner-city area. On initial assessment both groups were similar on…

  18. Addressing Relapse in Cognitive Behavioral Therapy for Panic Disorder: Methods for Optimizing Long-Term Treatment Outcomes

    ERIC Educational Resources Information Center

    Arch, Joanna J.; Craske, Michelle G.

    2011-01-01

    In this paper, we present a client with panic disorder and agoraphobia who relapses following a full course of cognitive behavioral therapy (CBT). To frame the client's treatment, the major components of CBT for panic disorder with or without agoraphobia (PD/A) are reviewed. Likely reasons for the treatment's failure and strategies for improving…

  19. The Interaction of Motivation and Therapist Adherence Predicts Outcome in Cognitive Behavioral Therapy for Panic Disorder: Preliminary Findings

    ERIC Educational Resources Information Center

    Huppert, Jonathan D.; Barlow, David H.; Gorman, Jack M.; Shear, M. Katherine; Woods, Scott W.

    2006-01-01

    This report is a post-hoc, exploratory examination of the relationships among patient motivation, therapist protocol adherence, and panic disorder outcome in patients treated with cognitive behavioral therapy within the context of a randomized clinical trial for the treatment of panic disorder (Barlow, Gorman, Shear, & Woods, 2000). Results…

  20. Long-Term Outcome in Cognitive-Behavioral Treatment of Panic Disorder: Clinical Predictors and Alternative Strategies for Assessment.

    ERIC Educational Resources Information Center

    Brown, Timothy A.; Barlow, David H.

    1995-01-01

    Examines long-term outcome of cognitive-behavioral treatment in 63 patients with panic disorder. Many patients (27%) sought further treatment for panic during follow-up because of less-than-adequate response to treatment; nevertheless, additional treatment did not result in further clinical improvement. Pretreatment severity of disorder and the…

  1. An examination of the relation between traumatic event exposure and panic-relevant biological challenge responding among adolescents.

    PubMed

    Hawks, Erin; Blumenthal, Heidemarie; Feldner, Matthew T; Leen-Feldner, Ellen W; Jones, Rachel

    2011-09-01

    The current study uniquely extended research that has linked traumatic event exposure to panic-spectrum problems among adolescents. It was hypothesized that among 127 adolescents (age range: 10 to 17 years; M = 14.63, SD = 2.24), those who endorsed a history of traumatic event exposure would evidence significantly greater anxious and fearful reactivity to a well-established 3-min voluntary hyperventilation procedure compared to nonexposed individuals. Results were consistent with hypotheses, suggesting traumatic event exposure is associated with anxious and fearful reactivity to abrupt increases in bodily arousal among adolescents. Moreover, consistent with hypotheses, anxiety sensitivity significantly mediated the relations between traumatic event exposure and both self-reported panic symptoms and panic symptoms elicited by the challenge. Future prospective research is now needed to better understand temporal relations between traumatic event exposure and indices of panic and related vulnerability.

  2. Life events in panic disorder-an update on "candidate stressors".

    PubMed

    Klauke, Benedikt; Deckert, Jürgen; Reif, Andreas; Pauli, Paul; Domschke, Katharina

    2010-08-01

    Studies on gene-environment interactions in mental disorders are characterized by powerful genetic techniques and well defined "candidate genes," whereas a definition of "candidate stressors," in most cases assessed in the form of life events (LEs), is inconsistent or not even provided. This review addresses this problem, with particular attention to the clinical phenotype of panic disorder (PD), by providing an overview and critical discussion for which life events are known to contribute to the etiology of the disease and how they may be conceptualized. There is converging evidence for a significant impact of cumulative as well as specific life events, such as threat, interpersonal and health-related events in adulthood, and abuse or loss/separation experiences in childhood, respectively, on the pathogenesis of panic disorder with some overlapping effect across the anxiety disorder spectrum as well as on comorbid major depression. Besides genetic vulnerability factors, personality and behavioral characteristics, such as anxiety sensitivity, neuroticism, and cognitive appraisal might moderate the influence of LEs on the development of panic disorder. The present state of knowledge regarding the specification and conceptualization of LEs in PD within a more complex multifactorial model, involving mediating and moderating factors in between genes and the clinical phenotype, is hoped to aid in informing future gene-environment interaction studies in panic disorder.

  3. [Comorbidity of panic disorder and alcoholism in a sample of 100 alcoholic patients].

    PubMed

    Segui, J; Salvador, L; Canet, J; Herrera, C; Aragón, C

    1994-01-01

    Among one hundred patients with alcohol dependence (DSM-III-R) studied in a drug abuse center in the "Bajo Llobregat" area (Barcelona industrial belt it was detected that 27% had life time rate of panic disorder. The age of onset of alcoholism was earlier than the one for panic disorder. In 78.8% of these patients alcoholismo appeared first. 70.4% refer worsening of the panic attacks when drinking large amounts of alcohol. Patients with Panic Disorder: a) are younger (p < 0.05); b) have attended school longer and have higher education (p < 0.01); c) have more alcoholism family history (p < 0.05); d) have more major depressive disorders (0.05) and dysthimic disorder (p < 0.01); e) Worse social functioning according to the GAS (p < 0.01); f) higher score for the Psychological disorders Scale (p < 0.001) and a lower performance at work (p < 0.001) measured by the ASI. The clinical significance of these findings is discussed. PMID:7484297

  4. Combined pharmacotherapy and cognitive behavior therapy in the treatment of panic disorder.

    PubMed

    Gelder, M G

    1998-12-01

    Cognitive behavior therapy (CBT) has been combined with pharmacotherapy in the treatment of panic disorder in three ways: (1) to treat agoraphobic symptoms in the condition of panic with agoraphobia; (2) to reduce withdrawal effects during drug taper; and (3) to treat panic attacks. Exposure treatment and pharmacotherapy have a modest additive effect, although more patients drop out of exposure therapy combined with imipramine treatment compared with exposure therapy alone. CBT reduces symptoms of withdrawal from alprazolam and other benzodiazepines and improves the outcome of drug treatment. At present, sufficient data are not available to determine whether the effects of CBT combined with drug therapy are additive in treating panic disorder. The results of a large trial are awaited. Current CBT consists of 12 sessions and is not widely offered to patients because of cost considerations. Efforts are being made to decrease the number of sessions necessary by improving cognitive techniques. One of these models is the subject of an ongoing trial. Finally, efforts to educate and counsel patients in the clinical setting regarding the psychopathology of panic attacks may improve the outcome of pharmacotherapy. PMID:9872706

  5. A Comparison of Alprazolam and Behavior Therapy in Treatment of Panic Disorder

    PubMed Central

    KLOSKO, JANET S.; BARLOW, DAVID H.; TASSINARI, ROBIN; CERNY, JEROME A.

    1994-01-01

    The results of a clinical outcome study (N = 57) comparing behavior therapy directed at panic disorder (panic control treatment [PCT]) with alprazolam were reported. These conditions were compared with a medication placebo and a waiting-list control group. Patterns of results on measures of panic attacks, generalized anxiety, and global clinical ratings reveal that PCT was significantly more effective than placebo and waiting-list conditions on most measures. The alprazolam group differed significantly from neither PCT nor placebo. The percentage of clients completing the study who were free of panic attacks following PCT was 87%, compared with 50% for alprazolam, 36% for placebo, and 33% for the waiting-list group. Since alprazolam may work more quickly than PCT but may also interfere with the effects of behavioral treatment, these data suggest a series of studies on the feasibility of integrating these treatments and on the precise patterns and mechanisms of action of various successful treatment approaches to panic disorder. PMID:22700189

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

    PubMed

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

    2014-03-01

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

  7. Efficacy of CBT for benzodiazepine discontinuation in patients with panic disorder: Further evaluation.

    PubMed

    Otto, Michael W; McHugh, R Kathryn; Simon, Naomi M; Farach, Frank J; Worthington, John J; Pollack, Mark H

    2010-08-01

    Despite its acute efficacy for the treatment of panic disorder, benzodiazepines (BZs) are associated with a withdrawal syndrome that closely mimics anxiety sensations, leading to difficulty with treatment discontinuation and often disorder relapse. An exposure-based cognitive-behavioral treatment for BZ discontinuation, Panic Control Treatment for BZ Discontinuation (CBT) targets the fear of these sensations and has demonstrated efficacy in preventing disorder relapse and facilitating successful BZ discontinuation among patients with panic disorder. In this randomized controlled trial, CBT was compared to taper alone and a taper plus a relaxation condition to control for the effect of therapist contact and support among 47 patients with panic disorder seeking taper from BZs. Based on the primary outcome of successful discontinuation of BZ use, results indicate that adjunctive CBT provided additive benefits above both taper alone and taper plus relaxation, with consistently medium and large effect sizes over time that reached significance at the six month follow-up evaluation. The efficacy of CBT relative to either of the other taper conditions reflected very large and significant effect sizes at that time. These findings suggest that CBT provides specific efficacy for the successful discontinuation from BZs, even when controlling for therapist contact and relaxation training.

  8. Monoamine oxidase A gene DNA hypomethylation - a risk factor for panic disorder?

    PubMed

    Domschke, Katharina; Tidow, Nicola; Kuithan, Henriette; Schwarte, Kathrin; Klauke, Benedikt; Ambrée, Oliver; Reif, Andreas; Schmidt, Hartmut; Arolt, Volker; Kersting, Anette; Zwanzger, Peter; Deckert, Jürgen

    2012-10-01

    The monoamine oxidase A (MAOA) gene has been suggested as a prime candidate in the pathogenesis of panic disorder. In the present study, DNA methylation patterns in the MAOA regulatory and exon 1/intron 1 region were investigated for association with panic disorder with particular attention to possible effects of gender and environmental factors. Sixty-five patients with panic disorder (44 females, 21 males) and 65 healthy controls were analysed for DNA methylation status at 42 MAOA CpG sites via direct sequencing of sodium bisulfate treated DNA extracted from blood cells. The occurrence of recent positive and negative life events was ascertained. Male subjects showed no or only very minor methylation with some evidence for relative hypomethylation at one CpG site in intron 1 in patients compared to controls. Female patients exhibited significantly lower methylation than healthy controls at 10 MAOA CpG sites in the promoter as well as in exon/intron 1, with significance surviving correction for multiple testing at four CpG sites (p≤0.001). Furthermore, in female subjects the occurrence of negative life events was associated with relatively decreased methylation, while positive life events were associated with increased methylation. The present pilot data suggest a potential role of MAOA gene hypomethylation in the pathogenesis of panic disorder particularly in female patients, possibly mediating a detrimental influence of negative life events. Future studies are warranted to replicate the present finding in independent samples, preferably in a longitudinal design.

  9. Two-Day, Intensive Cognitive-Behavioral Therapy for Panic Disorder: A Case Study

    ERIC Educational Resources Information Center

    Deacon, Brett

    2007-01-01

    Cognitive-behavioral therapy (CBT) is a highly effective treatment for panic disorder. However, few patients have access to this treatment, particularly those living in rural areas. In a pilot study, the author previously described the efficacy of a 2-day, intensive, exposure-based CBT intervention that was developed for the purpose of delivering…

  10. Impact of Cognitive-Behavioral Treatment on Quality of Life in Panic Disorder Patients.

    ERIC Educational Resources Information Center

    Telch, Michael J.; And Others

    1995-01-01

    Patients (n=156) meeting criteria for panic disorder with agoraphobia were randomly assigned to group cognitive-behavioral treatment (CBT) or a delayed-treatment control. Compared with the control group, CBT-treated patients showed significant reductions in impairment that were maintained at follow-up. Anxiety and phobic avoidance were…

  11. Sensation-Focused Intensive Treatment for Panic Disorder with Moderate to Severe Agoraphobia

    ERIC Educational Resources Information Center

    Morissette, Sandra Baker; Spiegel, David A.; Heinrichs, Nina

    2005-01-01

    The current article presents a detailed description of an intensive treatment program for panic disorder with moderate to severe levels of agoraphobia (PDA), called Sensation-Focused Intensive Treatment (SFIT). Although the efficacy of traditional CBT treatment programs has been well established for the treatment of PDA, patients with moderate to…

  12. Causes and Management of Treatment-Resistant Panic Disorder and Agoraphobia: A Survey of Expert Therapists

    ERIC Educational Resources Information Center

    Sanderson, William C.; Bruce, Timothy J.

    2007-01-01

    Cognitive behavior therapy (CBT) is recognized as an effective psychological treatment for panic disorder (PD). Despite its efficacy, some clients do not respond optimally to this treatment. Unfortunately, literatures on the prediction, prevention, and management of suboptimal response are not well developed. Considering this lack of empirical…

  13. Catastrophic Misinterpretations as a Predictor of Symptom Change during Treatment for Panic Disorder

    ERIC Educational Resources Information Center

    Teachman, Bethany A.; Marker, Craig D.; Clerkin, Elise M.

    2010-01-01

    Objective: Cognitive models of panic disorder suggest that change in catastrophic misinterpretations of bodily sensations will predict symptom reduction. To examine change processes, we used a repeated measures design to evaluate whether the trajectory of change in misinterpretations over the course of 12-week cognitive behavior therapy is related…

  14. Preliminary Evidence for Cognitive Mediation during Cognitive-Behavioral Therapy of Panic Disorder

    ERIC Educational Resources Information Center

    Hofmann, Stefan G.; Meuret, Alicia E.; Rosenfield, David; Suvak, Michael K.; Barlow, David H.; Gorman, Jack M.; Shear, M. Katherine; Woods, Scott W.

    2007-01-01

    Cognitive-behavioral therapy (CBT) and pharmacotherapy are similarly effective for treating panic disorder with mild or no agoraphobia, but little is known about the mechanism through which these treatments work. The present study examined some of the criteria for cognitive mediation of treatment change in CBT alone, imipramine alone, CBT plus…

  15. Respiratory and Cognitive Mediators of Treatment Change in Panic Disorder: Evidence for Intervention Specificity

    ERIC Educational Resources Information Center

    Meuret, Alicia E.; Rosenfield, David; Seidel, Anke; Bhaskara, Lavanya; Hofmann, Stefan G.

    2010-01-01

    Objective: There are numerous theories of panic disorder, each proposing a unique pathway of change leading to treatment success. However, little is known about whether improvements in proposed mediators are indeed associated with treatment outcomes and whether these mediators are specific to particular treatment modalities. Our purpose in this…

  16. Human sympathetic nerve biology: parallel influences of stress and epigenetics in essential hypertension and panic disorder.

    PubMed

    Esler, Murray; Eikelis, Nina; Schlaich, Markus; Lambert, Gavin; Alvarenga, Marlies; Kaye, David; El-Osta, Assam; Guo, Ling; Barton, David; Pier, Ciaran; Brenchley, Celia; Dawood, Tye; Jennings, Garry; Lambert, Elisabeth

    2008-12-01

    Patients with panic disorder provide a clinical model of stress. On a "good day," free from a panic attack, they show persistent stress-related changes in sympathetic nerve biology, including abnormal sympathetic nerve single-fiber firing ("salvos" of multiple firing within a cardiac cycle) and release of epinephrine as a cotransmitter. The coreleased epinephrine perhaps originates from in situ synthesis by phenylethanolamine N-methyltransferase (PNMT). In searching for biological evidence that essential hypertension is caused by mental stress--a disputed proposition--we note parallels with panic disorder, which provides an explicit clinical model of stress: (1) There is clinical comorbidity; panic disorder prevalence is increased threefold in essential hypertension. (2) For both, epinephrine cotransmission is present in sympathetic nerves. (3) In panic disorder and essential hypertension, but not in health, single-fiber sympathetic nerve firing salvos occur. (4) Tissue nerve growth factor is increased in both conditions (nerve growth factor is a stress reactant). (5) There is induction of PNMT in sympathetic nerves. Essential hypertension exhibits a further manifestation of mental stress: there is activation of noradrenergic brain stem neurons projecting to the hypothalamus and amygdala. These pathophysiological findings strongly support the view that chronic mental stress is important in the pathogenesis of essential hypertension. A hypothesis now under test is whether in both disorders, under prevailing conditions of ongoing stress, PNMT induced in sympathetic nerves acts as a DNA methylase, causing the norepinephrine transporter (NET) gene silencing that is present in both conditions. PNMT can have an intranuclear distribution, binding to DNA. We have demonstrated that the reduced neuronal noradrenaline reuptake present in both disorders does have an epigenetic mechanism, with demonstrable reduction in the abundance of the transporter protein, the NET gene

  17. Internet Cognitive Behavioural Therapy for Panic Disorder: Does the Inclusion of Stress Management Information Improve End-State Functioning?

    ERIC Educational Resources Information Center

    Richards, Jeffrey C.; Klein, Britt; Austin, David W.

    2006-01-01

    Previous research has established Internet-based cognitive behavioural therapy (CBT) for panic disorder (PD) as effective in reducing panic severity and frequency. There is evidence, however, that such programs are less effective at improving overall end-state functioning, defined by a PD clinician severity rating of [less than or equal to] 2 and…

  18. Experiential cognitive therapy in the treatment of panic disorders with agoraphobia: a controlled study.

    PubMed

    Vincelli, F; Anolli, L; Bouchard, S; Wiederhold, B K; Zurloni, V; Riva, G

    2003-06-01

    The use of a multicomponent cognitive-behavioral treatment strategy for panic disorder with agoraphobia is actually one of the preferred therapeutic approaches for this disturbance. This method involves a mixture of cognitive and behavioral techniques that are intended to help patients identify and modify their dysfunctional anxiety-related thoughts, beliefs and behavior. The paper presents a new treatment protocol for Panic Disorder and Agoraphobia, named Experiential-Cognitive Therapy (ECT) that integrates the use of virtual reality (VR) in a multicomponent cognitive-behavioral treatment strategy. The VR software used for the trial is freely downloadable: www.cyberpsychology.info/try.htm. Moreover, the paper presents the result of a controlled study involving 12 consecutive patients aged 35-53. The selected subjects were randomly divided in three groups: ECT group, that experienced the Cognitive Behavioral Therapy-Virtual Reality assisted treatment (eight sessions), a CBT group that experienced the traditional Cognitive Behavioral approach (12 sessions) and a waiting list control group. The data showed that both CBT and ECT could significantly reduce the number of panic attacks, the level of depression and both state and trait anxiety. However, ECT procured these results using 33% fewer sessions than CBT. This datum suggests that ECT could be better than CBT in relation to the "cost of administration," justifying the added use of VR equipment in the treatment of panic disorders. PMID:12855090

  19. Childhood Traumatic Experiences, Dissociative Symptoms, and Dissociative Disorder Comorbidity Among Patients With Panic Disorder: A Preliminary Study.

    PubMed

    Ural, Cenk; Belli, Hasan; Akbudak, Mahir; Tabo, Abdulkadir

    2015-01-01

    This study assessed childhood trauma history, dissociative symptoms, and dissociative disorder comorbidity in patients with panic disorder (PD). A total of 92 psychotropic drug-naive patients with PD, recruited from outpatient clinics in the psychiatry department of a Turkish hospital, were involved in the study. Participants were assessed using the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D), Dissociation Questionnaire, Panic and Agoraphobia Scale, Panic Disorder Severity Scale, and Childhood Trauma Questionnaire. Of the patients with PD, 18 (19%) had a comorbid dissociative disorder diagnosis on screening with the SCID-D. The most prevalent disorders were dissociative disorder not otherwise specified, dissociative amnesia, and depersonalization disorders. Patients with a high degree of dissociation symptoms and dissociative disorder comorbidity had more severe PD than those without (p < .05). All of the childhood trauma subscales used were correlated with the severity of symptoms of dissociation and PD. Among all of the subscales, the strongest relationship was with childhood emotional abuse. Logistic regression analysis showed that emotional abuse and severity of PD were independently associated with dissociative disorder. In our study, a significant proportion of the patients with PD had concurrent diagnoses of dissociative disorder. We conclude that the predominance of PD symptoms at admission should not lead the clinician to overlook the underlying dissociative process and associated traumatic experiences among these patients.

  20. Atomoxetine Augmentation in a Case of Treatment Resistant Panic Disorder with Multiple Augments Failure: A Case Report.

    PubMed

    Ram, Dushad; Patil, Shwetha; Gowdappa, Basavana; Rajalakshmi, Iyshwarya

    2015-12-31

    Atomoxetine, a selective norepinephrine inhibitor, is effective in comorbid anxiety and attention deficit hyperactivity disorder, however its role in panic disorder is unknown. We are presenting a case of panic disorder, who initially partially responded to clonazepam. When clonazepam was added with sertraline, escitalopram, desvenlafaxin, she did not improve significantly until paroxetine was added. When clonazepam-paroxetine combination was added with propranolol, etizolam, olanzepine, risperidone and amisulpride the symptom remission did not occur until a trial of Atomoxetine was done. PMID:26598594

  1. Atomoxetine Augmentation in a Case of Treatment Resistant Panic Disorder with Multiple Augments Failure: A Case Report

    PubMed Central

    Ram, Dushad; Patil, Shwetha; Gowdappa, Basavana; Rajalakshmi, Iyshwarya

    2015-01-01

    Atomoxetine, a selective norepinephrine inhibitor, is effective in comorbid anxiety and attention deficit hyperactivity disorder, however its role in panic disorder is unknown. We are presenting a case of panic disorder, who initially partially responded to clonazepam. When clonazepam was added with sertraline, escitalopram, desvenlafaxin, she did not improve significantly until paroxetine was added. When clonazepam-paroxetine combination was added with propranolol, etizolam, olanzepine, risperidone and amisulpride the symptom remission did not occur until a trial of Atomoxetine was done. PMID:26598594

  2. The role of "interoceptive" fear conditioning in the development of panic disorder.

    PubMed

    De Cort, Klara; Griez, Eric; Büchler, Marjolein; Schruers, Koen

    2012-03-01

    More than 20% of the general population experience a panic attack at least once in their lives; however, only a minority goes on to develop panic disorder (PD). Conditioning mechanisms have been proposed to explain this evolution in persons who are susceptible to developing panic disorder upon a "traumatic" panic attack. According to preparedness theory, some cues are more likely to condition than others, namely, those referring to internal, bodily signals of danger. The aim of the present study was to test this theory in a differential conditioning paradigm, making use of scripts referring to different internal, bodily sensations as conditioned stimulus (CS) and inhalation of 35% CO(2) as unconditioned stimulus (UCS). Thirty-three healthy volunteers were assigned to three scripts conditions: "suffocation," "neutral," or "urgency." During acquisition, one of two versions of a particular script was always followed by an inhalation of 35% CO(2) (CS+) and the other by room air (CS-). Acquisition was followed by a test phase, where only inhalations of room air were administered. In line with our hypothesis, only participants in the suffocation condition exhibited a selective conditioning effect. They were more fearful and showed a significantly higher increase in tidal volume than participants in the two control conditions. Results are discussed with relation to interoceptive conditioning, preparedness, and the possible role of tidal volume in PD.

  3. Internet-based treatment for panic disorder: does frequency of therapist contact make a difference?

    PubMed

    Klein, Britt; Austin, David; Pier, Ciaran; Kiropoulos, Litza; Shandley, Kerrie; Mitchell, Joanna; Gilson, Kathryn; Ciechomski, Lisa

    2009-01-01

    Internet-based interventions with therapist support have proven effective for treating a range of mental health conditions. This study examined whether frequency of therapist contact affected treatment outcomes. Fifty-seven people with panic disorder (including 32 with agoraphobia) were randomly allocated to an 8-week Internet-based cognitive behavioural treatment intervention (Panic Online) with either frequent (three e-mails per week) or infrequent (one e-mail per week) support from a psychologist. Posttreatment, intention-to-treat analyses revealed that both treatments were effective at improving panic disorder and agoraphobia severity ratings, panic-related cognitions, negative affect, and psychological and physical quality of life domains, with no differences between conditions. High end-state functioning was achieved by 28.6% of the frequent and infrequent participants, respectively. Therapist alliance, treatment credibility, and satisfaction also did not differ between groups, despite significantly greater therapist time invested in the frequent contact condition. The results provide evidence that the effectiveness of Internet-based mental health interventions may be independent of the frequency of therapist support and may, therefore, be more cost-effective than previously reported. PMID:19306149

  4. Parental representations of patients with panic disorder and generalised anxiety disorder.

    PubMed

    Silove, D; Parker, G; Hadzi-Pavlovic, D; Manicavasagar, V; Blaszczynski, A

    1991-12-01

    Previous studies using the Parental Bonding Instrument have shown a general trend for neurotic subjects to score their parents as less caring and more protective. Such a finding was broadly replicated in a study of 80 clinically anxious subjects and age- and sex-matched controls. Although direct comparisons of PBI scores failed to reveal clear-cut differences between generalised anxiety (GA) and panic disorder (PD) subgroups, logistic regression analyses revealed higher odds ratios for parental assignment to aberrant categories in the GA group, with PD patients reporting a more limited pattern of overprotective parenting only. Our findings suggest that adverse parental behaviour may be relevant to the pathogenesis of GA, while parental 'affectionate constraint' may be a parental response to early manifestations of PD. PMID:1790454

  5. The Neuroanatomical Basis of Panic Disorder and Social Phobia in Schizophrenia: A Voxel Based Morphometric Study

    PubMed Central

    Picado, Marisol; Carmona, Susanna; Hoekzema, Elseline; Pailhez, Guillem; Bergé, Daniel; Mané, Anna; Fauquet, Jordi; Hilferty, Joseph; Moreno, Ana; Cortizo, Romina; Vilarroya, Oscar; Bulbena, Antoni

    2015-01-01

    Objective It is known that there is a high prevalence of certain anxiety disorders among schizophrenic patients, especially panic disorder and social phobia. However, the neural underpinnings of the comorbidity of such anxiety disorders and schizophrenia remain unclear. Our study aims to determine the neuroanatomical basis of the co-occurrence of schizophrenia with panic disorder and social phobia. Methods Voxel-based morphometry was used in order to examine brain structure and to measure between-group differences, comparing magnetic resonance images of 20 anxious patients, 20 schizophrenic patients, 20 schizophrenic patients with comorbid anxiety, and 20 healthy control subjects. Results Compared to the schizophrenic patients, we observed smaller grey-matter volume (GMV) decreases in the dorsolateral prefrontal cortex and precentral gyrus in the schizophrenic-anxiety group. Additionally, the schizophrenic group showed significantly reduced GMV in the dorsolateral prefrontal cortex, precentral gyrus, orbitofrontal cortex, temporal gyrus and angular/inferior parietal gyrus when compared to the control group. Conclusions Our findings suggest that the comorbidity of schizophrenia with panic disorder and social phobia might be characterized by specific neuroanatomical and clinical alterations that may be related to maladaptive emotion regulation related to anxiety. Even thought our findings need to be replicated, our study suggests that the identification of neural abnormalities involved in anxiety, schizophrenia and schizophrenia-anxiety may lead to an improved diagnosis and management of these conditions. PMID:25774979

  6. A polymorphic genomic duplication on human chromosome 15 is a susceptibility factor for panic and phobic disorders.

    PubMed

    Gratacòs, M; Nadal, M; Martín-Santos, R; Pujana, M A; Gago, J; Peral, B; Armengol, L; Ponsa, I; Miró, R; Bulbena, A; Estivill, X

    2001-08-10

    Anxiety disorders are complex and common psychiatric illnesses associated with considerable morbidity and social cost. We have studied the molecular basis of the cooccurrence of panic and phobic disorders with joint laxity. We have identified an interstitial duplication of human chromosome 15q24-26 (named DUP25), which is significantly associated with panic/agoraphobia/social phobia/joint laxity in families, and with panic disorder in nonfamilial cases. Mosaicism, different forms of DUP25 within the same family, and absence of segregation of 15q24-26 markers with DUP25 and the psychiatric phenotypes suggest a non-Mendelian mechanism of disease-causing mutation. We propose that DUP25, which is present in 7% control subjects, is a susceptibility factor for a clinical phenotype that includes panic and phobic disorders and joint laxity. PMID:11509185

  7. Epigenetic signature of panic disorder: a role of glutamate decarboxylase 1 (GAD1) DNA hypomethylation?

    PubMed

    Domschke, Katharina; Tidow, Nicola; Schrempf, Marie; Schwarte, Kathrin; Klauke, Benedikt; Reif, Andreas; Kersting, Anette; Arolt, Volker; Zwanzger, Peter; Deckert, Jürgen

    2013-10-01

    Glutamate decarboxylases (GAD67/65; GAD1/GAD2) are crucially involved in gamma-aminobutyric acid (GABA) synthesis and thus were repeatedly suggested to play an important role in the pathogenesis of anxiety disorders. In the present study, DNA methylation patterns in the GAD1 and GAD2 promoter and GAD1 intron 2 regions were investigated for association with panic disorder, with particular attention to possible effects of environmental factors. Sixty-five patients with panic disorder (f=44, m=21) and 65 matched healthy controls were analyzed for DNA methylation status at 38 GAD1 promoter/intron2 and 10 GAD2 promoter CpG sites via direct sequencing of sodium bisulfate treated DNA extracted from blood cells. Recent positive and negative life events were ascertained. Patients and controls were genotyped for GAD1 rs3762556, rs3791878 and rs3762555, all of which are located in the analyzed promoter region. Patients with panic disorder exhibited significantly lower average GAD1 methylation than healthy controls (p<0.001), particularly at three CpG sites in the promoter as well as in intron 2. The occurrence of negative life events was correlated with relatively decreased average methylation mainly in the female subsample (p=0.01). GAD1 SNP rs3762555 conferred a significantly lower methylation at three GAD1 intron 2 CpG sites (p<0.001). No differential methylation was observed in the GAD2 gene. The present pilot data suggest a potentially compensatory role of GAD1 gene hypomethylation in panic disorder possibly mediating the influence of negative life events and depending on genetic variation. Future studies are warranted to replicate the present finding in independent samples, preferably in a longitudinal design.

  8. Reactivity to 35% carbon dioxide in bulimia nervosa and panic disorder.

    PubMed

    Woznica, Andrea; Vickers, Kristin; Koerner, Naomi; Fracalanza, Katie

    2015-08-30

    The inhalation of 35% carbon dioxide (CO₂) induces panic and anxiety in people with panic disorder (PD) and in people with various other psychiatric disorders. The anxiogenic effect of CO₂ in people with eating disorders has received sparse attention despite the fact that PD and bulimia nervosa (BN) have several common psychological and neurobiological features. This study compared CO₂-reactivity across three groups of participants: females with BN, females with PD, and female controls without known risk factors for enhanced CO₂-reactivity (e.g., social anxiety disorder, first degree relatives with PD). Reactivity was measured by self-reported ratings of panic symptomatology and subjective anxiety, analyzed as both continuous variables (change from room-air to CO₂) and dichotomous variables (positive versus negative responses to CO₂). Analyses of each outcome measure demonstrated that CO₂-reactivity was similar across the BN and PD groups, and reactivity within each of these two groups was significantly stronger than that in the control group. This is the first study to demonstrate CO₂-hyperreactivity in individuals with BN, supporting the hypothesis that reactivity to this biological paradigm is not specific to PD. Further research would benefit from examining transdiagnostic mechanisms in CO₂-hyperreactivity, such as anxiety sensitivity, which may account for this study's results.

  9. [Eczematous disorders in adolescents].

    PubMed

    Fölster-Holst, R

    2016-04-01

    Eczematous disorders in adolescence (definition WHO: the period between 10 and 20 years) are common and include mainly atopic dermatitis, contact eczema, and seborrheic dermatitis. They all share the similarity of inflammatory reactions which mainly affect the epidermis and can take a chronic course, depending on the underlying dermatosis. In the following article, the particularities of eczematous diseases in adolescents are discussed. PMID:26857132

  10. Effectiveness of a mindfulness-based cognitive therapy program as an adjunct to pharmacotherapy in patients with panic disorder.

    PubMed

    Kim, Borah; Lee, Sang-Hyuk; Kim, Yong Woo; Choi, Tai Kiu; Yook, Keunyoung; Suh, Shin Young; Cho, Sung Joon; Yook, Ki-Hwan

    2010-08-01

    Mindfulness-based cognitive therapy (MBCT) has been studied to treat patients with depressive or anxiety disorders. The aim of this study was to examine whether MBCT is effective as an adjunct to pharmacotherapy in the treatment of patients with panic disorder. Twenty-three patients with panic disorder were included in a MBCT program for a period of 8 weeks. The Hamilton Anxiety Rating Scale (HAM-A), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Anxiety Sensitivity Index-Revised (ASI-R), Albany Panic and Phobia Questionnaire (APPQ), and Panic Disorder Severity Scale (PDSS) were used to assess the patients during the MBCT program. Both HAM-A and PDSS scores were significantly decreased at the 2nd, 4th and 8th weeks compared to baseline in the patients with panic disorder (HAM-A, p<0.01; PDSS, p<0.01). Also, BAI, APPQ and ASI-R were improved significantly after MBCT program (BAI, p<0.01; APPQ, p<0.01; ASI-R, p<0.01). In addition, all subscale scores of ASI-R decreased significantly. MBCT could be effective as an adjunct to pharmacotherapy in patients with panic disorder. However, randomized controlled trials are needed.

  11. 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…

  12. Evidence-based Guidelines for Interpretation of the Panic Disorder Severity Scale

    PubMed Central

    Furukawa, Toshi A.; Shear, M. Katherine; Barlow, David H.; Gorman, Jack M.; Woods, Scott W.; Money, Roy; Etschel, Eva; Engel, Rolf R.; Leucht, Stefan

    2008-01-01

    Background The Panic Disorder Severity Scale (PDSS) is promising to be a standard global rating scale for panic disorder. In order for a clinical scale to be useful, we need a guideline for interpreting its scores and their changes, and for defining clinical change points such as response and remission. Methods We used individual patient data from two large randomized controlled trials of panic disorder (total n=568). Study participants were administered the PDSS and the Clinical Global Impression (CGI)-Severity and -Improvement. We applied equipercentile linking technique to draw correspondences between PDSS and CGI-Severity, numeric changes in PDSS and CGI-Improvement, and percent changes in PDSS and CGI-Improvement. Results The interpretation of the PDSS total score differed according to the presence or absence of agoraphobia. When the patients were not agoraphobic, score ranges 0–1 corresponded with “Normal,” 2–5 with “Borderline”, 6–9 with “Slightly ill”, 10–13 with “Moderately ill”, and 14 and above with “Markedly ill.” When the patients were agoraphobic, score ranges 3–7 meant “Borderline ill,” 8–10 “Slightly ill,” 11–15 “Moderately ill,” and 16 and above “Markedly ill.” The relationship between PDSS change and CGI-Improvement was more linear when measured as percentile change than as numeric changes, and was indistinguishable for those with or without agoraphobia. The decrease by 75–100% was considered “Very much improved,” that by 40–74% “Much improved,” and that by 10–39% “Minimally improved.” Conclusion We propose that “remission” of panic disorder be defined by PDSS scores of 5 or less and its “response” by 40% or greater reduction. PMID:19006198

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

    PubMed

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

    2014-01-28

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

  14. Citalopram controls phobic symptoms in patients with panic disorder: randomized controlled trial.

    PubMed Central

    Leinonen, E; Lepola, U; Koponen, H; Turtonen, J; Wade, A; Lehto, H

    2000-01-01

    OBJECTIVE: To examine the effects of long-term treatment with citalopram or clomipramine on subjective phobic symptoms in patients with panic disorder. DESIGN: Double-blind, parallel-group, five-arm study. PATIENTS: Patients aged 18 to 65 years with panic disorder (DMS-III-R diagnosis) and with no major depressive symptoms. INTERVENTIONS: Four hundred and seventy-five patients were randomized to 8 weeks of treatment with either citalopram (10 to 15 mg per day; 20 to 30 mg per day; or 40 to 60 mg per day), clomipramine (60 to 90 mg per day) or placebo. Two hundred and seventy-nine patients continued treatment after the 8-week acute phase. OUTCOME MEASURES: Phobic symptoms were assessed using the Phobia Scale and the Symptom Checklist's (SCL-90) phobia-related factors. RESULTS: At all dosages, citalopram was more efficacious than placebo, with 20 to 30 mg generally being the most effective dosage. Citalopram (20 to 30 mg) generally decreased phobic symptoms significantly more than placebo after Month 3. Interpersonal sensitivity decreased when measured on the respective SCL-90 sub-scale. Alleviation of phobic symptoms generally continued to increase towards the end of the treatment. The effect of clomipramine was not as consistent. CONCLUSIONS: All active treatment groups, especially the group receiving 20 to 30 mg per day of citalopram, effectively controlled phobic symptoms in patients with panic disorder. Long-term treatment with citalopram further decreased phobic symptoms. PMID:10721681

  15. Hypermethylation of FOXP3 Promoter and Premature Aging of the Immune System in Female Patients with Panic Disorder?

    PubMed Central

    Prelog, Martina; Hilligardt, Deborah; Schmidt, Christian A.; Przybylski, Grzegorz K.; Leierer, Johannes; Almanzar, Giovanni; El Hajj, Nady; Lesch, Klaus-Peter; Arolt, Volker; Zwanzger, Peter; Haaf, Thomas; Domschke, Katharina

    2016-01-01

    Immunological abnormalities associated with pathological conditions, such as higher infection rates, inflammatory diseases, cancer or cardiovascular events are common in patients with panic disorder. In the present study, T cell receptor excision circles (TRECs), Forkhead-Box-Protein P3 gene (FOXP3) methylation of regulatory T cells (Tregs) and relative telomere lengths (RTLs) were investigated in a total and subsamples of 131 patients with panic disorder as compared to 131 age- and sex-matched healthy controls in order to test for a potential dysfunction and premature aging of the immune system in anxiety disorders. Significantly lower TRECs (p = 0.004) as well as significant hypermethylation of the FOXP3 promoter region (p = 0.005) were observed in female (but not in male) patients with panic disorder as compared to healthy controls. No difference in relative telomere length was discerned between patients and controls, but significantly shorter telomeres in females, smokers and older persons within the patient group. The presently observed reduced TRECs in panic disorder patients and FOXP3 hypermethylation in female patients with panic disorder potentially reflect impaired thymus and immunosuppressive Treg function, which might partly account for the known increased morbidity and mortality of anxiety disorders conferred by e.g. cancer and cardiovascular disorders. PMID:27362416

  16. A comparative study of early maladaptive schemas in obsessive-compulsive disorder and panic disorder.

    PubMed

    Kwak, Kyung-Hwa; Lee, Seung Jae

    2015-12-30

    Schema theory and therapy may be an additional therapeutic approach to identify and treat chronic psychological problems, namely early maladaptive schemas (EMSs), in patients with obsessive-compulsive disorder (OCD) and panic disorder (PAD). In the current study, we investigated the characteristics in EMSs between patients with OCD and PAD. Fifty-one patients with OCD, 46 patients with PAD, and 70 normal controls participated in this study. EMSs and depressive symptoms were measured using the Young Schema Questionnaire and the Beck Depression Inventory (BDI), respectively. Analysis of covariance was conducted with age, sex, BDI score, and education level as covariates to assess group differences. Direct comparisons among the three groups revealed that the defectiveness/shame and social isolation/alienation schemas were prominently activated in patients with OCD, whereas the vulnerability to harm or illness and self-sacrifice were activated in patients with PAD. In subgroup analysis, these differences were observed between subgroups with lower BDI scores, but not between the patient subgroups with higher BDI scores. However, the differences between the patient groups in the defectiveness/shame and vulnerability to harm or illness schemas almost reached significance. Patients with OCD and PAD differed in particular EMS characteristics, which could have potential therapeutic implications. PMID:26599390

  17. Generalized anxiety disorder versus panic disorder: participation in controlled efficacy trials.

    PubMed

    Mavissakalian, M R; Zamar, N

    2000-01-01

    Seventy-one patients with panic disorder (PD) and 46 patients with generalized anxiety disorder (GAD) were studied in relation to their behavior before, during, and after participation in two contemporaneous and procedurally similar double-blind drug efficacy trials. The two groups were administered a battery of assessments aimed at comparing them on the nature and intensity of various symptom domains, social and work-related disability, personality, life events, and previous treatments. The results yielded few significant differences that were not due to definitional factors, most notably a more prevalent history of depression and treatment for depression in the GAD group and a higher rate of pharmacological treatment in the PD group. On the other hand, the two groups behaved in a comparable way in the screening, experimental, and postexperimental phases of the trials. The findings are in support of more similarities than differences between the groups. In addition, the comparable behavior of the two groups throughout the three phases of the trial suggests that differential pretreatment attrition and compliance with placebo-controlled trials may not present major confounding problems in comparative treatment effectiveness studies between GAD and PD diagnostic groups.

  18. A comparative study of early maladaptive schemas in obsessive-compulsive disorder and panic disorder.

    PubMed

    Kwak, Kyung-Hwa; Lee, Seung Jae

    2015-12-30

    Schema theory and therapy may be an additional therapeutic approach to identify and treat chronic psychological problems, namely early maladaptive schemas (EMSs), in patients with obsessive-compulsive disorder (OCD) and panic disorder (PAD). In the current study, we investigated the characteristics in EMSs between patients with OCD and PAD. Fifty-one patients with OCD, 46 patients with PAD, and 70 normal controls participated in this study. EMSs and depressive symptoms were measured using the Young Schema Questionnaire and the Beck Depression Inventory (BDI), respectively. Analysis of covariance was conducted with age, sex, BDI score, and education level as covariates to assess group differences. Direct comparisons among the three groups revealed that the defectiveness/shame and social isolation/alienation schemas were prominently activated in patients with OCD, whereas the vulnerability to harm or illness and self-sacrifice were activated in patients with PAD. In subgroup analysis, these differences were observed between subgroups with lower BDI scores, but not between the patient subgroups with higher BDI scores. However, the differences between the patient groups in the defectiveness/shame and vulnerability to harm or illness schemas almost reached significance. Patients with OCD and PAD differed in particular EMS characteristics, which could have potential therapeutic implications.

  19. A risk-benefit assessment of pharmacological treatments for panic disorder.

    PubMed

    Bennett, J A; Moioffer, M; Stanton, S P; Dwight, M; Keck, P E

    1998-06-01

    Panic disorder, a psychiatric disorder characterised by frequent panic attacks, is the most common anxiety disorder, affecting 2 to 6% of the general population. No one line of treatment has been found to be superior, making a risk-benefit assessment of the treatments available useful for treating patients. Choice of treatment depends on a number of issues, including the adverse effect profile, efficacy and the presence of concomitant syndromes. Tricyclic antidepressants (TCAs) are beneficial in the treatment of panic disorder. They have a proven efficacy, are affordable and are conveniently administered. Adverse effects, including jitteriness syndrome, bodyweight gain, anticholinergic effects and orthostatic hypotension are commonly associated with TCAs, but can be managed successfully. Selective serotonin (5-hydroxytryptamine; 5HT) reuptake inhibitors are also potential first line agents and are well tolerated and effective, with a favourable adverse effects profile. There is little risk in overdose or of anticholinergic effects. Adverse effects include sedation, dyspepsia and headache early in treatment, and sexual dysfunction and increased anxiety, but these can be effectively managed with proper dosage escalation and management. Benzodiazepines are an effective treatment, providing short-term relief of panic-related symptoms. Patients respond to treatment quickly, providing rapid relief of symptoms. Adverse effects include ataxia and drowsiness, and cognitive and psycho-motor impairment. There are reservations over their first-line use because of concerns regarding abuse and dependence. Monoamine oxidase inhibitors, because of their adverse effects profile, potential drug interactions, dietary restrictions, gradual onset of effect and overdose risk, are not considered to be first-line agents. They are effective however, and should be considered for patients with refractory disease. Valproic acid (valproate sodium), while not intensively studied, shows

  20. Plasma anti-serotonin and serotonin anti-idiotypic antibodies are elevated in panic disorder.

    PubMed

    Coplan, J D; Tamir, H; Calaprice, D; DeJesus, M; de la Nuez, M; Pine, D; Papp, L A; Klein, D F; Gorman, J M

    1999-04-01

    The psychoneuroimmunology of panic disorder is relatively unexplored. Alterations within brain stress systems that secondarily influence the immune system have been documented. A recent report indicated elevations of serotonin (5-HT) and ganglioside antibodies in patients with primary fibromyalgia, a condition with documented associations with panic disorder. In line with our interest in dysregulated 5-HT systems in panic disorder (PD), we wished to assess if antibodies directed at the 5-HT system were elevated in patients with PD in comparison to healthy volunteers. Sixty-three patients with panic disorder and 26 healthy volunteers were diagnosed by the SCID. Employing ELISA, we measured anti-5-HT and 5-HT anti-idiotypic antibodies (which are directed at 5-HT receptors). To include all subjects in one experiment, three different batches were run during the ELISA. Plasma serotonin anti-idiotypic antibodies: there was a significant group effect [patients > controls (p = .007)] and batch effect but no interaction. The mean effect size for the three batches was .76. Following Z-score transformation of each separate batch and then combining all scores, patients demonstrated significantly elevated levels of plasma serotonin anti-idiotypic antibodies. Neither sex nor age as covariates affected the significance of the results. There was a strong correlation between anti-serotonin antibody and serotonin anti-idiotypic antibody measures. Plasma anti-serotonin antibodies: there was a significant diagnosis effect [patients > controls (p = .037)]. Mean effect size for the three batches was .52. Upon Z-score transformation, there was a diagnosis effect with antibody elevations in patients. Covaried for sex and age, the result falls below significance to trend levels. The data raise the possibility that psychoimmune dysfunction, specifically related to the 5-HT system, may be present in PD. Potential interruption of 5-HT neurotransmission through autoimmune mechanisms may be of

  1. Frontoparietal Cortical Thinning in Respiratory-Type Panic Disorder: A Preliminary Report

    PubMed Central

    Yoon, Ho-Kyoung; Kang, June; Ham, Byung-Joo

    2016-01-01

    Objective Many evidences raise the possibility that the panic disorder (PD) patients with respiratory subtype (RS) may have characteristic structural abnormalities. We aimed to explore the structural differences between PD patients with and without the respiratory symptoms. Methods Patients with PD were recruited from the Department of Psychiatry at Korea University Anam Hospital. Respiratory subtype (RS) was diagnosed when at least 4 out of 5 of the following respiratory symptoms were present during the panic attack: fear of dying, chest pain/discomfort, shortness of breath, paresthesias, and a choking sensation. We acquired high-resolution MRI scans and used FreeSurfer to obtain a measure of cortical thickness for each patient. Results Cluster based analysis revealed significantly decreased cortical thickness in the left hemisphere in the caudal-middle-frontal, superior frontal, and posterior parietal areas in the RS group. No significant difference was observed in any of the limbic areas. Conclusion Respiratory symptoms of panic disorder were associated with a reduction in cortical thickness in the left frontal and parietal areas. This finding leads to the assumption that the frontoparietal network is the crucial component in a larger cortical network underlying the perception of dyspnea in RS. PMID:26766957

  2. Reaction time to threat stimuli in panic disorder and social phobia.

    PubMed

    Cloitre, M; Heimberg, R G; Holt, C S; Liebowitz, M R

    1992-11-01

    Two studies assessed response time among clinically anxious subjects and normal controls when presented with threat, positive and neutral stimuli under perceptual (lexical decision) and semantic (category decision) task conditions. In Study 1, panic disorder subjects' (n = 14) performance was compared to that of matched normal controls (n = 14) while in Study 2 social phobic subjects (n = 24) were compared to matched normal controls (n = 24). Relative to matched normal controls, panic disorder subjects but not social phobics tended to show greater slowing in performance on the more cognitively complex (category) task. A second finding, consistent across both studies was that, compared to the normal control groups, both panic and social phobic groups showed significantly slowed responses to threat words in both the perceptual and semantic tasks. Such findings are directly counter to the predictions of a mood congruence hypothesis. This apparent contradiction is resolved by a review of the literature which indicates that mood-related facilitation effects are obtained only in tasks which tap awareness of threat information rather than speed of response. It is suggested that while anxiety may produce enhanced awareness of threat, it may inhibit responsiveness to it. The results of these studies are seen as consistent with ethological theories of inhibited motoric responses under certain threat conditions. Furthermore, the findings suggest that caution is indicated in interpreting slowed reaction time to threat stimuli in tasks such as the Stroop color naming task as purely the result of attentional processes. PMID:1417686

  3. Virtual reality assisted cognitive behavioral therapy for the treatment of Panic Disorders with Agoraphobia.

    PubMed

    Vincelli, F; Choi, H; Molinari, E; Wiederhold, B K; Bouchard, S; Riva, G

    2002-01-01

    The chapter describes the characteristics of the Experiential-Cognitive Therapy (ECT) protocol for Panic Disorder and Agoraphobia. The goal of ECT is to decondition fear reactions, to modify misinterpretational cognition related to panic symptoms and to reduce anxiety symptoms. This is possible in an average of eight sessions of treatment plus an assessment phase and booster sessions, through the integration of Virtual Experience and traditional cognitive-behavioral techniques. We decided to employ the techniques included in the cognitive-behavioral approach because they showed high levels of efficacy. Through virtual environments we can gradually expose the patient to feared situation: virtual reality consent to re-create in our clinical office a real experiential world. The patient faces the feared stimuli in a context that is nearer to reality than imagination. For ECT we developed the Virtual Environments for Panic Disorders--VEPD--virtual reality system. VEPD is a 4-zone virtual environment developed using the Superscape VRT 5.6 toolkit. The four zones reproduce different potentially fearful situations--an elevator, a supermarket, a subway ride, and large square. In each zone the characteristics of the anxiety-related experience are defined by the therapist through a setup menu.

  4. Evidence that variation in the peripheral benzodiazepine receptor (PBR) gene influences susceptibility to panic disorder.

    PubMed

    Nakamura, Kazuhiko; Yamada, Kazuo; Iwayama, Yoshimi; Toyota, Tomoko; Furukawa, Aizou; Takimoto, Takahiro; Terayama, Hayato; Iwahashi, Kazuhiko; Takei, Nori; Minabe, Yoshio; Sekine, Yoshimoto; Suzuki, Katsuaki; Iwata, Yasuhide; Pillai, Anitha; Nakamoto, Yurie; Ikeda, Kazutaka; Yoshii, Mitsunobu; Fukunishi, Isao; Yoshikawa, Takeo; Mori, Norio

    2006-04-01

    Panic disorder (PD) is the repeated sudden occurrence of panic attacks, episodes characterized by psychological symptoms. Peripheral benzodiazepine receptor (PBR) is closely associated with personality traits for anxiety tolerance, and that it holds promise as a biological marker of stressful conditions. We have performed association analyses using the polymorphism to determine the PBR in PD. We screened the subjects for sequence variations within the 5' region, the coding region (exons 2-4), and the 3' noncoding region. One novel missense variant in exon 4, derived from the nucleotide transition in codon 162 (CGT --> CAT:485G > A) resulting in an arginine-to-histidine (Arg --> His) change, was detected in these subjects. The 485G > polymorphism of the PBR gene was analyzed in 91 PD patients and 178 controls. The genotypic and allelic analyses of the 485G > A revealed significant differences between the panic patients and the comparison subjects (P = 0.021 and 0.014, respectively). The present study provides new and important evidence that variation in the PBR gene influences susceptibility to PD.

  5. Hippocampal hyperexcitability underlies enhanced fear memories in TgNTRK3, a panic disorder mouse model.

    PubMed

    Santos, Mónica; D'Amico, Davide; Spadoni, Ornella; Amador-Arjona, Alejandro; Stork, Oliver; Dierssen, Mara

    2013-09-18

    Panic attacks are a hallmark in panic disorder (PAND). During the panic attack, a strong association with the surrounding context is established suggesting that the hippocampus may be critically involved in the pathophysiology of PAND, given its role in contextual processing. We previously showed that variation in the expression of the neurotrophin tyrosine kinase receptor type 3 (NTRK3) in both PAND patients and a transgenic mouse model (TgNTRK3) may have a role in PAND pathophysiology. Our study examines hippocampal function and activation of the brain fear network in TgNTRK3 mice. TgNTRK3 mice showed increased fear memories accompanied by impaired extinction, congruent with an altered activation pattern of the amygdala-hippocampus-medial prefrontal cortex fear circuit. Moreover, TgNTRK3 mice also showed an unbalanced excitation-to-inhibition ratio in the hippocampal cornu ammonis 3 (CA3)-CA1 subcircuit toward hyperexcitability. The resulting hippocampal hyperexcitability underlies the enhanced fear memories, as supported by the efficacy of tiagabine, a GABA reuptake inhibitor, to rescue fear response. The fearful phenotype appears to be the result of hippocampal hyperexcitability and aberrant fear circuit activation. We conclude that NTRK3 plays a role in PAND by regulating hippocampus-dependent fear memories. PMID:24048855

  6. Panic Disorder and Agoraphobia: Considerations for DSM-V

    ERIC Educational Resources Information Center

    Schmidt, Norman B.; Norr, Aaron M.; Korte, Kristina J.

    2014-01-01

    With the upcoming release of the fifth edition of the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-V) there has been a necessary critique of the DSM-IV including questions regarding how to best improve the next iteration of the DSM classification system. The aim of this article is to provide commentary on the probable…

  7. Combination of psychotherapy and benzodiazepines versus either therapy alone for panic disorder: a systematic review

    PubMed Central

    Watanabe, Norio; Churchill, Rachel; Furukawa, Toshi A

    2007-01-01

    Background: The efficacy of combined psychotherapy and benzodiazepine treatment for panic disorder is still unclear despite its widespread use. The present systematic review aims to examine its efficacy compared with either monotherapy alone. Methods: All randomised trials comparing combined psychotherapy and benzodiazepine for panic disorder with either therapy alone were identified by comprehensive electronic search on the Cochrane Registers, by checking references of relevant studies and of other reviews, and by contacting experts in the field. Two reviewers independently checked eligibility of trials, assessed quality of trials and extracted data from eligible trials using a standardized data extraction form. Our primary outcome was "response" defined by global judgement. Authors of the original trials were contacted for further unpublished data. Meta-analyses were undertaken synthesizing data from all relevant trials. Results: Only two studies, which compared the combination with behaviour (exposure) therapy, met our eligibility criteria. Both studies had a 16-week intervention. Unpublished data were retrieved for one study. The relative risk for response for the combination was 1.25 (95%CI: 0.78 to 2.03) during acute phase treatment, 0.78 (0.45 to 1.35) at the end of treatment, and 0.62 (0.36 to 1.07) at 6–12 months follow-up. Some secondary outcomes hinted at superiority of the combination during acute phase treatment. One study was identified comparing the combination to benzodiazepine. The relative risk for response was 1.57 (0.83 to 2.98), 3.39 (1.03 to 11.21, statistically significant) and 2.31 (0.79 to 6.74) respectively. The superiority of the combination was observed on secondary outcomes at all the time points. No sub-group analyses were conducted due to the limited number of included trials. Conclusion: Unlike some narrative reviews in the literature, our systematic search established the paucity of high quality evidence for or against the

  8. A Pilot Study of Sensation-Focused Intensive Treatment for Panic Disorder with Moderate to Severe Agoraphobia: Preliminary Outcome and Benchmarking Data

    ERIC Educational Resources Information Center

    Bitran, Stella; Morissette, Sandra B.; Spiegel, David A.; Barlow, David H.

    2008-01-01

    This report presents results of a treatment for panic disorder with moderate to severe agoraphobia (PDA-MS) called sensation-focused intensive treatment (SFIT). SFIT is an 8-day intensive treatment that combines features of cognitive-behavioral treatment for panic disorder, such as interoceptive exposure and cognitive restructuring with ungraded…

  9. Interoceptive fear conditioning and panic disorder: the role of conditioned stimulus-unconditioned stimulus predictability.

    PubMed

    Acheson, Dean T; Forsyth, John P; Moses, Erica

    2012-03-01

    Interoceptive fear conditioning is at the core of contemporary behavioral accounts of panic disorder. Yet, to date only one study has attempted to evaluate interoceptive fear conditioning in humans (see Acheson, Forsyth, Prenoveau, & Bouton, 2007). That study used brief (physiologically inert) and longer-duration (panicogenic) inhalations of 20% CO(2)-enriched air as an interoceptive conditioned (CS) and unconditioned (US) stimulus and evaluated fear learning in three conditions: CS only, CS-US paired, and CS-US unpaired. Results showed fear conditioning in the paired condition, and fearful responding and resistance to extinction in an unpaired condition. The authors speculated that such effects may be due to difficulty discriminating between the CS and the US. The aims of the present study are to (a) replicate and expand this line of work using an improved methodology, and (b) clarify the role of CS-US discrimination difficulties in either potentiating or depotentiating fear learning. Healthy participants (N=104) were randomly assigned to one of four conditions: (a) CS only, (b) contingent CS-US pairings, (c) unpaired CS and US presentations, or (d) an unpaired "discrimination" contingency, which included an exteroceptive discrimination cue concurrently with CS onset. Electrodermal and self-report ratings served as indices of conditioned responding. Consistent with expectation, the paired contingency and unpaired contingencies yielded elevated fearful responding to the CS alone. Moreover, adding a discrimination cue to the unpaired contingency effectively attenuated fearful responding. Overall, findings are consistent with modern learning theory accounts of panic and highlight the role of interoceptive conditioning and unpredictability in the etiology of panic disorder.

  10. Interoceptive fear conditioning and panic disorder: the role of conditioned stimulus-unconditioned stimulus predictability.

    PubMed

    Acheson, Dean T; Forsyth, John P; Moses, Erica

    2012-03-01

    Interoceptive fear conditioning is at the core of contemporary behavioral accounts of panic disorder. Yet, to date only one study has attempted to evaluate interoceptive fear conditioning in humans (see Acheson, Forsyth, Prenoveau, & Bouton, 2007). That study used brief (physiologically inert) and longer-duration (panicogenic) inhalations of 20% CO(2)-enriched air as an interoceptive conditioned (CS) and unconditioned (US) stimulus and evaluated fear learning in three conditions: CS only, CS-US paired, and CS-US unpaired. Results showed fear conditioning in the paired condition, and fearful responding and resistance to extinction in an unpaired condition. The authors speculated that such effects may be due to difficulty discriminating between the CS and the US. The aims of the present study are to (a) replicate and expand this line of work using an improved methodology, and (b) clarify the role of CS-US discrimination difficulties in either potentiating or depotentiating fear learning. Healthy participants (N=104) were randomly assigned to one of four conditions: (a) CS only, (b) contingent CS-US pairings, (c) unpaired CS and US presentations, or (d) an unpaired "discrimination" contingency, which included an exteroceptive discrimination cue concurrently with CS onset. Electrodermal and self-report ratings served as indices of conditioned responding. Consistent with expectation, the paired contingency and unpaired contingencies yielded elevated fearful responding to the CS alone. Moreover, adding a discrimination cue to the unpaired contingency effectively attenuated fearful responding. Overall, findings are consistent with modern learning theory accounts of panic and highlight the role of interoceptive conditioning and unpredictability in the etiology of panic disorder. PMID:22304889

  11. Patient Characteristics and Variability in Adherence and Competence in Cognitive-Behavioral Therapy for Panic Disorder

    PubMed Central

    Boswell, James F.; Gallagher, Matthew W.; Sauer-Zavala, Shannon E.; Bullis, Jacqueline; Gorman, Jack M.; Shear, M. Katherine; Woods, Scott; Barlow, David H.

    2013-01-01

    Although associations with outcome have been inconsistent, therapist adherence and competence continues to garner attention, particularly within the context of increasing interest in the dissemination, implementation, and sustainability of evidence-based treatments. To date, research on therapist adherence and competence has focused on average levels across therapists. With a few exceptions, research has failed to address multiple sources of variability in adherence and competence, identify important factors that might account for variability, or take these sources of variability into account when examining associations with symptom change. Objective (a) statistically demonstrate between- and within-therapist variability in adherence and competence ratings and examine patient characteristics as predictors of this variability and (b) examine the relationship between adherence/competence and symptom change. Method Randomly selected audiotaped sessions from a randomized controlled trial of cognitive-behavioral therapy for panic disorder were rated for therapist adherence and competence. Patients completed a self-report measure of panic symptom severity prior to each session and the Inventory of Interpersonal Problems-Personality Disorder Scale prior to the start of treatment. Results Significant between- and within-therapist variability in adherence and competence were observed. Adherence and competence deteriorated significantly over the course of treatment. Higher patient interpersonal aggression was associated with decrements in both adherence and competence. Neither adherence nor competence predicted subsequent panic severity. Conclusions Variability and “drift” in adherence and competence can be observed in controlled trials. Training and implementation efforts should involve continued consultation over multiple cases in order to account for relevant patient factors and promote sustainability across sessions and patients. PMID:23339537

  12. The Effects of Aggression on Symptom Severity and Treatment Response in a Trial of Cognitive Behavioral Therapy for Panic Disorder

    PubMed Central

    Cassiello-Robbins, Clair; Conklin, Laren R.; Anakwenze, Ujunwa; Gorman, Jack M.; Woods, Scott W.; Shear, M. Katherine; Barlow, David H.

    2015-01-01

    Background Previous research suggests that patients with panic disorder exhibit higher levels of aggression than patients with other anxiety disorders. This aggression is associated with more severe symptomatology and interpersonal problems. However, few studies have examined whether higher levels of aggression are associated with a worse treatment response in this population. Methods The present study sought to examine the association of aggression with panic disorder symptom severity in a sample of 379 patients who participated in a trial examining long-term strategies for the treatment of panic disorder. Results We found that aggression was significantly associated with higher baseline levels of panic disorder symptoms, anxiety, depression, and functional impairment. Further, we found that patients higher in aggression did not achieve the same level of improvement in general anxiety symptoms during treatment compared to patients lower in aggression, even when controlling for baseline anxiety symptom severity. Conclusion These results suggest that more research is needed concerning patients with anxiety disorders with higher aggression, as they may be a group in need of additional treatment considerations. PMID:25987198

  13. A usability assessment on a virtual reality system for panic disorder treatment

    NASA Astrophysics Data System (ADS)

    Lee, Jaelin; Kawai, Takashi; Yoshida, Nahoko; Izawa, Shuhei; Nomura, Shinobu; Eames, Douglas; Kaiya, Hisanobu

    2008-02-01

    The authors have developed a virtual reality exposure system that reflects the Japanese culture and environment. Concretely, the system focuses on the subway environment, which is the environment most patients receiving treatment for panic disorder at hospitals in Tokyo, Japan tend to avoid. The system is PC based and features realistic video images and highly interactive functionality. In particular, the system enables instant transformation of the virtual space and allows situations to be freely customized according to the condition and symptoms expressed by each patient. Positive results achieved in therapy assessments aimed at patients with panic disorder accompanying agoraphobia indicate the possibility of indoor treatment. Full utilization of the functionality available requires that the interactive functions be easily operable. Accordingly, there appears to be a need for usability testing aimed at determining whether or not a therapist can operate the system naturally while focusing fully on treatment. In this paper, the configuration of the virtual reality exposure system focusing on the subway environment is outlined. Further, the results of usability tests aimed at assessing how naturally it can be operated while focusing fully on treatment are described.

  14. Anxiety sensitivity, the menstrual cycle, and panic disorder: a putative neuroendocrine and psychological interaction.

    PubMed

    Nillni, Yael I; Toufexis, Donna J; Rohan, Kelly J

    2011-11-01

    The 2:1 female-to-male sex difference in the prevalence of panic disorder (PD) suggests that there is a sex-specific vulnerability involved in the etiology and/or maintenance of this disorder. The purpose of this paper is to present a new conceptual model, which emphasizes the interaction between a cognitive vulnerability for PD, anxiety sensitivity, and the effects of progesterone and its metabolite, allopregnanolone, on behavioral and physiological responses to stress during the premenstrual phase. This interaction is proposed to be a potential sex-specific pathway that may initiate and/or maintain panic and anxiety symptoms in women. This review paper presents preliminary evidence from both the human and animal literatures to support this new model. Specific topics reviewed include: psychopathology related to the menstrual cycle, anxiety sensitivity and its relationship to the menstrual cycle, PMS, and PMDD, anxiety-modulating effects of progesterone and its neuroactive metabolite, allopregnanolone, and how results from the neuroendocrine literature relate to psychopathology or symptoms associated with the menstrual cycle.

  15. Symptoms of Generalised Anxiety disorder but not Panic Disorder at age 15 increase the risk of depression at 18 in the ALSPAC cohort study

    PubMed Central

    Davies, Simon J C; Pearson, Rebecca; Stapinski, Lexine; Bould, Helen; Christmas, David M; Button, Katherine S; Skapinakis, Petros; Lewis, Glyn; Evans, Jonathan

    2016-01-01

    Background Generalised Anxiety Disorder (GAD) and Panic Disorder (PD) differ in their biology and co-morbidities. We hypothesised that GAD but not PD symptoms at 15 are associated with depression diagnosis at 18. Methods Using longitudinal data from the ALSPAC birth cohort we examined relations of GAD and PD symptoms (measured by DAWBA) at 15 to depression at 18 (by CIS-R) using logistic regression. We excluded adolescents already depressed at 15 and adjusted for social class, maternal education, birth order, gender, alcohol intake and smoking. We repeated these analyses following multiple imputation for missing data. Results In the sample with complete data (n=2835), high and moderate GAD symptoms in adolescents not depressed at 15, were associated with increased risk of depression at 18 both in unadjusted analyses and adjusting for PD symptoms at 15 and the above potential confounders. The adjusted OR for depression at 18 in adolescents with high relative to low GAD scores was 5.2 [95% C.I. 3.0 - 9.1; overall p<0.0001]. There were no associations between PD symptoms and depression at 18 in any model (high relative to low PD scores, adjusted OR= 1.3 [95% C.I. 0.3 - 4.8], overall p=0.737). Missing data imputation strengthened the relations of GAD symptoms with depression (high relative to low GAD scores, OR= 6.2, [95% C.I. 3.9 - 9.9]) but those for PD became weaker. Conclusion Symptoms of GAD but not PD at 15 are associated with depression at 18. Clinicians should be aware that adolescents with GAD symptoms may develop depression. PMID:26315278

  16. Black Monday on stock markets throughout the world - a new phenomenon of collective panic disorder? A psychiatric approach.

    PubMed

    Sperling, Wolfgang; Bleich, Stefan; Reulbach, Udo

    2008-12-01

    Drastic losses on the stock markets within short periods have been the subject of numerous investigations in view of the fact that they are often irrational. Stock exchanges around the world suffered dramatic losses on Monday 21 January 2008, and again recently on Monday 17 March 2008. Regardless of cultural affiliation, public reporting of the global collapse in stock prices on Monday was striking in its almost unified mood of panic, anxiety and general fear of further partially arbitrary trading losses. These partly irrational mechanisms of an international financial crisis seem to fulfil several criteria of typical panic disorders according to classification systems like ICD-10 or DSM-IV. The new phenomenon affects international stock markets in the sense of a global panic disorder (GPD).

  17. 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.

  18. 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. PMID:27338965

  19. An association analysis of Per2 with panic disorder in the Japanese population.

    PubMed

    Otowa, Takeshi; Tochigi, Mamoru; Kawamura, Yoshiya; Sugaya, Nagisa; Yoshida, Eiji; Inoue, Ken; Yasuda, Shin; Umekage, Tadashi; Ebisawa, Takashi; Tanii, Hisashi; Kaiya, Hisanobu; Okazaki, Yuji; Kato, Nobumasa; Sasaki, Tsukasa

    2011-10-01

    Panic disorder (PD) is a severe and chronic psychiatric disorder, with genetic components underlying in its etiology. The PERIOD2 (Per2) gene has been reported to be associated with familial advanced sleep phase syndrome. Considering the high frequency of sleep disturbance in PD, Per2 may be a candidate gene for PD. Therefore, we conducted a two-stage case-control association study in the Japanese population. In the first screening sample of 203 patients and 409 controls, we investigated three single-nucleotide polymorphisms in Per2. We found a potential association in the screening sample (rs2304672, genotype P=0.046, uncorrected), whereas we could not replicate the association in the second sample of 460 patients and 460 controls. Our results suggest that Per2 may not have a major role in the pathogenesis of PD in the Japanese population. PMID:21814225

  20. Efficacy of telephone-administered behavioral therapy for panic disorder with agoraphobia.

    PubMed

    Swinson, R P; Fergus, K D; Cox, B J; Wickwire, K

    1995-05-01

    The purpose of this study was to determine the efficacy of a structured exposure-based behavior therapy program delivered by telephone to agoraphobic individuals who were isolated from specialized treatment centres. Forty-two individuals with a DSM-III-R diagnosis of panic disorder with agoraphobia who were living in rural areas of Ontario were assigned to either an eight-session telephone behavior therapy program or wait-list control condition. There were significant treatment x time interaction effects on several outcome variables. Patients originally in the wait-list group then received the same type of therapy and they also significantly improved. All treatment gains were maintained at three-month and six-month follow-up. Telephone behavior therapy appears to be a cost-effective and efficacious treatment for agoraphobics living in remote regions where specialized anxiety disorder services are not readily available. PMID:7755536

  1. Parental bonds in children at high and low familial risk for panic disorder.

    PubMed

    Koszycki, Diana; Bilodeau, Cynthia; Zwanzger, Peter; Schneider, Barry H; Flament, Martine F; Bradwejn, Jacques

    2013-04-01

    A rejecting and overprotective parenting style is considered to be an important risk factor for the development of anxiety disorders. This study examined the role of perceived parental bonding as a potential environmental risk factor for panic disorder (PD) in unaffected offspring with parental PD. Children with a biological parent with PD (n = 71) and children of parents with no psychiatric history (n = 80) participated in the study. Results indicate that high risk children do not perceive their parents as being more protective and less caring than low risk controls. The optimal bonding type (high care, low protection) was the most frequently reported parenting style across groups. The constraining type of maternal bonding (high care, high protection) was less frequently reported by high risk children (p < 0.05). Overall, these data suggest that parental PD does not compromise the parent-child bonds in never-ill offspring. PMID:22837072

  2. The PHQ-PD as a Screening Tool for Panic Disorder in the Primary Care Setting in Spain

    PubMed Central

    Wood, Cristina Mae; Ruíz-Rodríguez, Paloma; Tomás-Tomás, Patricia; Gracia-Gracia, Irene; Dongil-Collado, Esperanza; Iruarrizaga, M. Iciar

    2016-01-01

    Introduction Panic disorder is a common anxiety disorder and is highly prevalent in Spanish primary care centres. The use of validated tools can improve the detection of panic disorder in primary care populations, thus enabling referral for specialized treatment. The aim of this study is to determine the accuracy of the Patient Health Questionnaire-Panic Disorder (PHQ-PD) as a screening and diagnostic tool for panic disorder in Spanish primary care centres. Method We compared the psychometric properties of the PHQ-PD to the reference standard, the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) interview. General practitioners referred 178 patients who completed the entire PHQ test, including the PHQ-PD, to undergo the SCID-I. The sensitivity, specificity, positive and negative predictive values and positive and negative likelihood ratios of the PHQ-PD were assessed. Results The operating characteristics of the PHQ-PD are moderate. The best cut-off score was 5 (sensitivity .77, specificity .72). Modifications to the questionnaire's algorithms improved test characteristics (sensitivity .77, specificity .72) compared to the original algorithm. The screening question alone yielded the highest sensitivity score (.83). Conclusion Although the modified algorithm of the PHQ-PD only yielded moderate results as a diagnostic test for panic disorder, it was better than the original. Using only the first question of the PHQ-PD showed the best psychometric properties (sensitivity). Based on these findings, we suggest the use of the screening questions for screening purposes and the modified algorithm for diagnostic purposes. PMID:27525977

  3. Cognitive-Behavioral Therapy of Panic Disorder with Secondary Major Depression: A Preliminary Investigation.

    ERIC Educational Resources Information Center

    Laberge, Benoit; And Others

    1993-01-01

    Investigated extent to which cognitive-behavioral therapy can be used successfully in treatment of secondary depressed panic patients. Findings from eight panic patients with major depression and seven panic patients without major depression showed that cognitive-behavioral therapy was significantly superior to information-based therapy in…

  4. Panic disorder

    MedlinePlus

    ... drink alcohol while on this medicine. Talk therapy (cognitive-behavioral therapy, or CBT) helps you understand your behaviors and ... addition. Resources for more information include: Anxiety and Depression Association of America: www.adaa.org National Institute ...

  5. Internet cognitive–behavioural treatment for panic disorder: randomised controlled trial and evidence of effectiveness in primary care

    PubMed Central

    Newby, Jill M.; Mackenzie, Anna; Smith, Jessica; Boulton, Matthew; Loughnan, Siobhan A.; Andrews, Gavin

    2016-01-01

    Background Internet cognitive–behavioural therapy (iCBT) for panic disorder of up to 10 lessons is well established. The utility of briefer programmes is unknown. Aims To determine the efficacy and effectiveness of a five-lesson iCBT programme for panic disorder. Method Study 1 (efficacy): Randomised controlled trial comparing active iCBT (n=27) and waiting list control participants (n=36) on measures of panic severity and comorbid symptoms. Study 2 (effectiveness): 330 primary care patients completed the iCBT programme under the supervision of primary care practitioners. Results iCBT was significantly more effective than waiting list control in reducing panic (g=0.97, 95% CI 0.34 to 1.61), distress (g=0.92, 95% CI 0.28 to 1.55), disability (g=0.81, 95% CI 0.19 to 1.44) and depression (g=0.79, 95% CI 0.17 to 1.41), and gains were maintained at 3 months post-treatment (iCBT group). iCBT remained effective in primary care, but lower completion rates were found (56.1% in study 2 v. 63% in study 1). Adherence appeared to be related to therapist contact. Conclusions The five-lesson Panic Program has utility for treating panic disorder, which translates to primary care. Adherence may be enhanced with therapist contact. Declaration of interest None. Copyright and usage © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence. PMID:27703768

  6. More "C" Please: Commentary on Arch and Craske's (2011) "Addressing Relapse in Cognitive Behavioral Therapy for Panic Disorder"

    ERIC Educational Resources Information Center

    Nadler, Wayne P.

    2012-01-01

    Comments are offered to clarify the learning model proposed by Arch and Craske (2011) based on extensive clinical experience with the CBT model for treating panic disorder developed by Barlow and Craske (1990). Suggestions are made regarding treatment targets and several cases are offered as examples of how choice of treatment target can make a…

  7. Cognitive-Behavioral Treatment for Panic Disorder with Agoraphobia: A Randomized, Controlled Trial and Cost-Effectiveness Analysis

    ERIC Educational Resources Information Center

    Roberge, Pasquale; Marchand, Andre; Reinharz, Daniel; Savard, Pierre

    2008-01-01

    A randomized, controlled trial was conducted to examine the cost-effectiveness of cognitive-behavioral treatment (CBT) for panic disorder with agoraphobia. A total of 100 participants were randomly assigned to standard (n = 33), group (n = 35), and brief (n = 32) treatment conditions. Results show significant clinical and statistical improvement…

  8. Mechanism of Change in Cognitive-Behavioral Treatment of Panic Disorder: Evidence for the Fear of Fear Mediational Hypothesis

    ERIC Educational Resources Information Center

    Smits, Jasper A. J.; Powers, Mark B.; Cho, Yongrae; Telch, Michael J.

    2004-01-01

    Numerous clinical trials have demonstrated the efficacy of cognitive-behavioral treatment (CBT) for panic disorder. However, studies investigating the mechanisms responsible for improvement with CBT are lacking. The authors used regression analyses outlined by R. M. Baron and D. A. Kenny (1986) to test whether a reduction in fear of fear (FOF)…

  9. Multiple Channel Exposure Therapy: Combining Cognitive-Behavioral Therapies for the Treatment of Posttraumatic Stress Disorder with Panic Attacks

    ERIC Educational Resources Information Center

    Falsetti, Sherry A.; Resnick, Heidi S.; Davis, Joanne

    2005-01-01

    A large proportion of patients who present for treatment of posttraumatic stress disorder (PTSD) experience comorbid panic attacks, yet it is unclear to what extent currently available PTSD treatment programs address this problem. Here we describe a newly developed treatment, multiple-channel exposure therapy (M-CET), for comorbid PTSD and panic…

  10. Physical, Mental, and Social Catastrophic Cognitions as Prognostic Factors in Cognitive-Behavioral and Pharmacological Treatments for Panic Disorder

    ERIC Educational Resources Information Center

    Hicks, Thomas V.; Leitenberg, Harold; Barlow, David H.; Gorman, Jack M.; Shear, Katherine M.; Woods, Scott W.

    2005-01-01

    The authors explored the prognostic value of 3 different types of catastrophic cognitions in the treatment of panic disorder with and without mild-to-moderate agoraphobia using a sample of 143 participants who received either cognitive-behavioral therapy (CBT) or imipramine in a randomized controlled trial. Stronger fears of social catastrophes…

  11. Effectiveness of Cognitive-Behavioral Treatment for Panic Disorder versus Treatment as Usual in a Managed Care Setting

    ERIC Educational Resources Information Center

    Addis, Michael E.; Hatgis, Christina; Krasnow, Aaron D.; Jacob, Karen; Bourne, Leslie; Mansfield, Abigail

    2004-01-01

    Eighty clients enrolled in a managed care health plan who identified panic disorder as their primary presenting problem were randomly assigned to treatment by a therapist recently trained in a manual-based empirically supported psychotherapy (M. G. Craske, E. Meadows, & D. H. Barlow, 1994) or a therapist conducting treatment as usual (TAU).…

  12. Cortisol awakening response in drug-naïve panic disorder

    PubMed Central

    Jakuszkowiak-Wojten, Katarzyna; Landowski, Jerzy; Wiglusz, Mariusz S; Cubała, Wiesław Jerzy

    2016-01-01

    Background It is unclear whether hypothalamic–pituitary–adrenal axis is involved in the pathophysiology of panic disorder (PD). The findings remain inconsistent. Cortisol awakening response (CAR) is a noninvasive biomarker of stress system activity. We designed the study to assess CAR in drug-naïve PD patients. Materials and methods We assessed CAR in 14 psychotropic drug-naïve outpatients with PD and 14 healthy controls. The severity of PD was assessed with Panic and Agoraphobia Scale. The severity of anxiety and depression was screened with Hospital Anxiety and Depression Scale. Results No significant difference in CAR between PD patients and control group was found. No correlations were observed between CAR and anxiety severity measures in PD patients and controls. Limitations The number of participating subjects was relatively small, and the study results apply to nonsuicidal drug-naïve PD patients without agoraphobia and with short-illness duration. There was a lack of control on subjects’ compliance with the sampling instructions. Conclusion The study provides no support for elevated CAR levels in drug-naïve PD patients without agoraphobia. PMID:27390521

  13. Effectiveness of Cognitive-Behavioral Treatment for Panic Disorder Versus Treatment as Usual in a Managed Care Setting: 2-Year Follow-Up

    ERIC Educational Resources Information Center

    Addis, Michael E.; Hatgis, Christina; Cardemil, Esteban; Jacob, Karen; Krasnow, Aaron D.; Mansfield, Abigail

    2006-01-01

    Eighty clients meeting criteria for panic disorder and receiving either panic control therapy (PCT; M. G. Craske, E. Meadows, & D. H. Barlow, 1994) or treatment as usual (TAU) in a managed care setting were assessed 1 and 2 years following acute treatment. PCT was provided by therapists with little or no previous exposure to cognitive-behavioral…

  14. Response to Nadler's Commentary on Arch and Craske's (2011) "Addressing Relapse in Cognitive Behavioral Therapy for Panic Disorder: Methods for Optimizing Long-Term Treatment Outcomes"

    ERIC Educational Resources Information Center

    Arch, Joanna J.; Craske, Michelle G.

    2012-01-01

    Nadler (this issue), in his commentary of our article, "Addressing Relapse in Cognitive Behavioral Therapy for Panic Disorder: Methods for Optimizing Long-Term Treatment Outcomes" (Arch & Craske, 2011), argues that we misrepresent the role of panic attacks within learning theory and overlook cognitive treatment targets. He presents several case…

  15. Mechanisms of change in cognitive behavioral therapy for panic disorder: The unique effects of self-efficacy and anxiety sensitivity

    PubMed Central

    Gallagher, Matthew W.; Payne, Laura A.; White, Kamila S.; Shear, Katherine M.; Woods, Scott W.; Gorman, Jack M.; Barlow, David H.

    2013-01-01

    The present study examined temporal dependencies of change of panic symptoms and two promising mechanisms of change (self-efficacy and anxiety sensitivity) during an 11-session course of cognitive-behavior therapy (CBT) for Panic Disorder (PD). 361 individuals with a principal diagnosis of PD completed measures of self-efficacy, anxiety sensitivity, and PD symptoms at each session during treatment. Effect size analyses indicated that the greatest changes in anxiety sensitivity occurred early in treatment, whereas the greatest changes in self-efficacy occurred later in treatment. Results of parallel process latent growth curve models indicated that changes in self-efficacy and anxiety sensitivity across treatment uniquely predicted changes in PD symptoms. Bivariate and multivariate latent difference score models indicated, as expected, that changes in anxiety sensitivity and self-efficacy temporally preceded changes in panic symptoms, and that intraindividual changes in anxiety sensitivity and self-efficacy independently predicted subsequent intraindividual changes in panic symptoms. These results provide strong evidence that changes in self-efficacy and anxiety sensitivity during CBT influence subsequent changes in panic symptoms, and that self-efficacy and anxiety sensitivity may therefore be two distinct mechanisms of change of CBT for PD that have their greatest impact at different stages of treatment. PMID:24095901

  16. Sequential combination of imipramine and self-directed exposure in the treatment of panic disorder with agoraphobia.

    PubMed

    Mavissakalian, M

    1990-05-01

    Thirty-eight patients who had panic disorder with agoraphobia completed 8 weeks of treatment with imipramine followed by 8 weeks of treatment with imipramine combined with behavior therapy consisting of self-directed exposure. Sixty-three percent (24) of the patients responded markedly to this cost-effective combined pharmacologic and behavioral approach. Results also revealed that most of the improvement in panic occurred during the first 8 weeks of treatment when imipramine treatment alone was used, whereas improvement in severity, anxiety, depression, and phobias, in particular, continued to be significant between midtreatment and end of study. Further analysis revealed that improvement in phobic anxiety and avoidance in the first 8 weeks of treatment, rather than improvement in panic, predicted final outcome. Implications of these findings on the complex issue of differential antipanic and antiphobic effects of imipramine are briefly discussed. PMID:2335493

  17. Insula response to unpredictable and predictable aversiveness in individuals with panic disorder and comorbid depression

    PubMed Central

    2014-01-01

    Background Prior studies suggest that hyperactive insula responding to unpredictable aversiveness is a core feature of anxiety disorders. However, no study to date has investigated the neural correlates of unpredictable aversiveness in those with panic disorder (PD) with comorbid major depressive disorder (MDD). The aim of the current study was to examine group differences in neural responses to unpredictable and predictable aversiveness in 41 adults with either 1) current PD with comorbid MDD (PD-MDD), 2) current MDD with no lifetime diagnosis of an anxiety disorder (MDD-only), or 3) no lifetime diagnosis of psychopathology. All participants completed a functional magnetic resonance imaging (fMRI) scan while viewing temporally predictable or unpredictable negative or neutral images. Findings The results indicated that individuals with PD-MDD exhibited greater bilateral insula activation to unpredictable aversiveness compared with controls and individuals with MDD-only (who did not differ). There were no group differences in insula activation to predictable aversiveness. Conclusions These findings add to a growing literature highlighting the role of the insula in the pathophysiology of anxiety disorders. PMID:25337388

  18. Imipramine and alprazolam effects on stress test reactivity in panic disorder.

    PubMed

    Roth, W T; Margraf, J; Ehlers, A; Haddad, J M; Maddock, R J; Agras, W S; Taylor, C B

    1992-01-01

    The reactivity of 40 panic disorder patients on mental arithmetic, cold pressor, and 5% CO2 inhalation stressors was tested before and after 8 weeks of treatment with imipramine, alprazolam, or placebo. Mean levels of subjective and physiological stress measures were compared during a baseline before any stressors were given, and at anticipation, stressor, and recovery periods for each stressor. After treatment, imipramine patients differed from the other two treatment groups on the prestressor baseline in showing higher systolic blood pressure (mean difference about 10 mmHg), higher diastolic blood pressure (10 mm Hg), higher heart rate (15 bpm), less respiratory sinus arrhythmia, shorter pulse transit time, and lower T-wave amplitude. Respiratory measures, electrodermal measures, body movement, and self-reported anxiety and excitement did not distinguish the groups. Reactivity to the stress tests was unaffected by the medications, but tonic differences present in the baseline persisted.

  19. 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.

  20. 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)

  1. Changes in cerebral blood flow after cognitive behavior therapy in patients with panic disorder: a SPECT study

    PubMed Central

    Seo, Ho-Jun; Choi, Young Hee; Chung, Yong-An; Rho, Wangku; Chae, Jeong-Ho

    2014-01-01

    Aim Inconsistent results continue to be reported in studies that examine the neural correlates of cognitive behavioral therapy (CBT) in patients with panic disorder. We examined the changes in regional cerebral blood flow (rCBF) associated with the alleviation of anxiety by CBT in panic patients. Methods The change in rCBF and clinical symptoms before and after CBT were assessed using single photon emission computed tomography and various clinical measures were analyzed. Results Fourteen subjects who completed CBT showed significant improvements in symptoms on clinical measures, including the Panic and Agoraphobic Scale and the Anxiety Sensitivity Index-Revised. After CBT, increased rCBF was detected in the left postcentral gyrus (BA 43), left precentral gyrus (BA 4), and left inferior frontal gyrus (BA 9 and BA 47), whereas decreased rCBF was detected in the left pons. Correlation analysis of the association between the changes in rCBF and changes in each clinical measure did not show significant results. Conclusion We found changes in the rCBF associated with the successful completion of CBT. The present findings may help clarify the effects of CBT on changes in brain activity in panic disorder. PMID:24790449

  2. Automatic Associations and Panic Disorder: Trajectories of Change over the Course of Treatment

    ERIC Educational Resources Information Center

    Teachman, Bethany A.; Marker, Craig D.; Smith-Janik, Shannan B.

    2008-01-01

    Cognitive models of anxiety and panic suggest that symptom reduction during treatment should be preceded by changes in cognitive processing, including modifying the anxious schema. The current study tested these hypotheses by using a repeated measures design to evaluate whether the trajectory of change in automatic panic associations over a…

  3. Treatment modality preferences and adherence to group treatment for panic disorder with agoraphobia.

    PubMed

    Perreault, Michel; Julien, Dominic; White, Noé Djawn; Bélanger, Claude; Marchand, André; Katerelos, Theodora; Milton, Diana

    2014-06-01

    To examine the relationship between preference for group psychotherapy and adherence to group cognitive-behavioral therapy (CBT) for clients with panic disorder with agoraphobia (PDA), 109 participants experiencing PDA completed a questionnaire measuring preference for group treatment (PGTQ) before beginning CBT groups. A t test was used to compare preference scores for group treatment to investigate whether participants who completed treatment differed from those who abandoned treatment. Participants who completed group therapy expressed higher preference for group treatment than participants who dropped out of treatment (t[107] = 1.99; p < 0.05). The PGTQ-4 presented adequate psychometric properties. Reliability analyses of the items retained after factorization demonstrated an acceptable level of internal consistency (Cronbach's alpha of 0.76). Preference for individual or group therapy appears to impact treatment retention for patients with PDA. Matching patients' preferences to the type of treatment modality used appears to be pertinent, especially for the treatment of anxiety disorders. In terms of practical implications, the rationale and benefits of group therapy should be explained to participants reluctant to engage in group therapy. Individual intervention or a combination of group and individual treatment could be considered for clients who are likely to drop out of group therapy.

  4. Challenges in management of complex panic disorder in a palliative care setting

    PubMed Central

    Udo, Itoro; Gash, Amanda

    2012-01-01

    This is a complex case of post-traumatic stress disorder (PTSD) with comorbid panic disorder occurring in a woman in her mid-60s, with a family history of neurotic illness. PTSD arose in the context of treatment for terminal lung cancer. This patient who had been close to her father watched him die of cancer, when he was about her age. Her diagnosis and treatment prompted traumatic recollections of her father's illness and death that resulted in her voluntary withdrawal from cancer treatment. The goals of treatment were to promptly reduce anxiety, minimise use of sedating pharmacotherapy, promote lucidity and prolong anxiety-free state thereby allowing time for important family interactions. Prompt, sustained relief of severe anxiety was necessary to achieve comfort at the end of life. Skilled additions of psychological therapies (eye movement desensitisation reprocessing, clinical hypnosis and breathing exercises) with combined pharmacotherapy (mirtazepine and quetiapine) led to control of anxiety and reduction of post-traumatic stress. PMID:23047995

  5. Panic disorder among African Americans, Caribbean blacks and non-Hispanic whites

    PubMed Central

    Himle, Joseph A.; Taylor, Robert Joseph; Abelson, Jamie M.; Matusko, Niki; Muroff, Jordana; Jackson, James

    2014-01-01

    Introduction This study investigated co-morbidities, level of disability, service utilization and demographic correlates of panic disorder (PD) among African Americans, Caribbean blacks and non-Hispanic white Americans. Methods Data are from the National Survey of American Life (NSAL) and the National Comorbidity Survey-Replication (NCS-R). Results Non-Hispanic whites are the most likely to develop PD across the lifespan compared to the black subgroups. Caribbean blacks were found to experience higher levels of functional impairment. There were no gender differences found in prevalence of PD in Caribbean blacks, indicating that existing knowledge about who is at risk for developing PD (generally more prevalent in women) may not be true among this subpopulation. Furthermore, Caribbean blacks with PD were least likely to use mental health services compared to African Americans and non-Hispanic whites. Conclusion This study demonstrates that PD may affect black ethnic subgroups differently, which has important implications for understanding the nature and etiology of the disorder. PMID:22983664

  6. Neural Response to Reward Anticipation in Those with Depression with and without Panic Disorder

    PubMed Central

    Gorka, Stephanie M.; Huggins, Ashley A.; Fitzgerald, Daniel A.; Nelson, Brady D.; Phan, K. Luan; Shankman, Stewart A.

    2014-01-01

    Background One of the hallmark features of major depressive disorder (MDD) is reduced reward anticipation. There have been mixed findings in the literature as to whether reward anticipation deficits in MDD are related to diminished mesolimbic activation and/or enhanced dorsal anterior cingulate activation (dACC). One of the reasons for these mixed findings is that these studies have typically not addressed the role of comorbid anxiety, a class of disorders which frequently co-occur with depression and have a common neurobiology. Methods The aim of the current study was to examine group differences in neural responses to reward anticipation in 40 adults with either: 1) current MDD with no lifetime diagnosis of an anxiety disorder (MDD-only), 2) current MDD with comorbid panic disorder (MDD-PD), or 3) no lifetime diagnosis of psychopathology. All participants completed a passive slot machine task during a functional magnetic resonance imaging (fMRI) scan. Results Analyses indicated that there were no group differences in activation of mesolimbic reward regions; however, the MDD-only group exhibited greater dACC activation during the anticipation of rewards compared with the healthy controls and the comorbid MDD-PD group (who did not differ from each other). Limitations The sample size was small which limits generalizability. Conclusions These findings provide preliminary support for the role of hyperactive dACC functioning in reduced reward anticipation in MDD. They also indicate that comorbid anxiety may alter the association between MDD and neural responding to reward anticipation. PMID:24856553

  7. 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. PMID:26438640

  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. Hoarding in Children and Adolescents with Obsessive-Compulsive Disorder

    PubMed Central

    Samuels, Jack; Grados, Marco A.; Riddle, Mark A.; Bienvenu, O. Joseph; Goes, Fernando S.; Cullen, Bernadette; Wang, Ying; Greenberg, Benjamin D.; Fyer, Abby J.; McCracken, James T.; Geller, Dan; Murphy, Dennis L.; Knowles, James A.; Rasmussen, Steven A.; McLaughlin, Nicole C.; Piacentini, John; Pauls, David L.; Stewart, S. Evelyn; Shugart, Yin-Yao; Maher, Brion; Pulver, Ann E.; Nestadt, Gerald

    2014-01-01

    Compared to studies in adults, there have been few studies of hoarding in children and adolescents with obsessive-compulsive disorder (OCD). In the current study, we evaluated OCD clinical features, Axis I disorders, and social reciprocity scores in 641 children and adolescents with OCD, of whom 163 (25%) had hoarding compulsions and 478 did not. We found that, as a group, youth with hoarding had an earlier age at onset and more severe lifetime OCD symptoms, poorer insight, more difficulty making decisions and completing tasks, and more overall impairment. The hoarding group also had a greater lifetime prevalence of panic disorder, specific phobia, Tourette disorder, and tics. As measured with the Social Reciprocity Scale, the hoarding group had more severe deficits in parent-rated domains of social communication, social motivation, and restricted interests and repetitive behavior. In a multivariable model, the overall social reciprocity score, age at onset of OCD symptoms, symmetry obsessions, and indecision were independently related to hoarding in these children and adolescents with OCD. These features should be considered as candidate risk factors for the development of hoarding behavior in pediatric OCD. PMID:25309849

  10. Allelic variation in CRHR1 predisposes to panic disorder: evidence for biased fear processing.

    PubMed

    Weber, H; Richter, J; Straube, B; Lueken, U; Domschke, K; Schartner, C; Klauke, B; Baumann, C; Pané-Farré, C; Jacob, C P; Scholz, C-J; Zwanzger, P; Lang, T; Fehm, L; Jansen, A; Konrad, C; Fydrich, T; Wittmann, A; Pfleiderer, B; Ströhle, A; Gerlach, A L; Alpers, G W; Arolt, V; Pauli, P; Wittchen, H-U; Kent, L; Hamm, A; Kircher, T; Deckert, J; Reif, A

    2016-06-01

    Corticotropin-releasing hormone (CRH) is a major regulator of the hypothalamic-pituitary-adrenal axis. Binding to its receptor CRHR1 triggers the downstream release of the stress response-regulating hormone cortisol. Biochemical, behavioral and genetic studies revealed CRHR1 as a possible candidate gene for mood and anxiety disorders. Here we aimed to evaluate CRHR1 as a risk factor for panic disorder (PD). Allelic variation of CRHR1 was captured by 9 single-nucleotide polymorphisms (SNPs), which were genotyped in 531 matched case/control pairs. Four SNPs were found to be associated with PD, in at least one sub-sample. The minor allele of rs17689918 was found to significantly increase risk for PD in females after Bonferroni correction and furthermore decreased CRHR1 mRNA expression in human forebrains and amygdalae. When investigating neural correlates underlying this association in patients with PD using functional magnetic resonance imaging, risk allele carriers of rs17689918 showed aberrant differential conditioning predominantly in the bilateral prefrontal cortex and safety signal processing in the amygdalae, arguing for predominant generalization of fear and hence anxious apprehension. Additionally, the risk allele of rs17689918 led to less flight behavior during fear-provoking situations but rather increased anxious apprehension and went along with increased anxiety sensitivity. Thus reduced gene expression driven by CRHR1 risk allele leads to a phenotype characterized by fear sensitization and hence sustained fear. These results strengthen the role of CRHR1 in PD and clarify the mechanisms by which genetic variation in CRHR1 is linked to this disorder.

  11. The Explorative Analysis to Revise Fear Network Model for Panic Disorder

    PubMed Central

    Lai, Chien-Han; Wu, Yu-Te

    2016-01-01

    Abstract Functional connectome analysis in panic disorder (PDO) is a relatively new field for research. We tried to investigate the functional connectome alterations in PDO to re-examine the precision and role of fear network model for the pathophysiology of PDO. We enrolled 53 PDO patients and 54 controls with imaging data in this study. After preprocessing, we calculated the connectivity matrix of functional connectivity in whole brain for each subject. Then network-based statistics (The University of Melbourne and Melbourne Health, Australia) of connectome was used to perform group comparisons between patients and controls. The correlation between network measures of significant subnetwork and illness duration or severity of PDO was also performed. Within the 6 network models, only 1 network survived after multiple corrections. We found decreased functional connectivity in the edges between the following nodes: the left parahippocampal gyrus, bilateral precentral gyri, bilateral middle cingulate gyri, bilateral supramarginal gyri, bilateral calcarine fissures, and right lingual gyrus. The central hubs were the left parahippocampal gyrus and left precentral gyrus. The importance of limbic areas and connection with sensory and motor regions might shed light on the revision of fear network model for the pathophysiology of PDO. PMID:27149492

  12. Independent evaluator knowledge of treatment in a multicenter comparative treatment study of panic disorder.

    PubMed

    Roll, David; Ray, Susan E; Marcus, Sue M; Passarelli, Vincent; Money, Roy; Barlow, David H; Woods, Scott W; Shear, M Katherine; Gorman, Jack M

    2004-03-01

    The purpose of this study was to examine independent evaluators' (IEs) blindness to treatment condition during a Multicenter Comparative Treatment Study of Panic Disorder. IEs were 15 doctoral- and masters-level clinicians in psychology, social work, and medicine. They conducted three post-treatment assessments with each patient. Immediately after each assessment interview, IEs completed a form indicating which of the five possible treatments they believed the patient had received and any specific information that provided IEs with information about a patient's treatment condition. These forms were completed for 170 patients. Analyses were conducted to determine the accuracy of guesses about treatment condition by IEs during post-treatment assessments, the relationship between accuracy of IE guessing and actual treatment assignment, the relationship between accurate guessing and outcome ratings, and contributors to the breaking of the blind. A significant relationship was found between IE guesses and actual treatment at all three assessment points, across individual IEs, treatment sites, and IE professional affiliations. IEs were no more accurate in their guessing about patients taking medication than those receiving behavior therapy. Patients and project staff inadvertently provided information to IEs that enhanced the rates of accurate guessing. Implications of these findings on interpretation of the treatment study are discussed, and recommendations are made for improving blindness procedures.

  13. Startle Response to Unpredictable Threat in Comorbid Panic Disorder and Alcohol Dependence

    PubMed Central

    Gorka, Stephanie M.; Nelson, Brady D.; Shankman, Stewart A.

    2013-01-01

    Background Although the adverse consequences of comorbid panic disorder (PD) and alcohol dependence (AD) are well-established, relatively little is known about the mechanisms underlying their co-occurrence. Several researchers have postulated that alcohol's ability to dampen response to unpredictable threat may be an important motivational factor in comorbid PD and AD. To date, no research has examined these processes using a clinical sample and it is unclear whether individuals with PD and AD evidence different reactivity to unpredictable threat relative to individuals with PD-only. Methods The aim of the current study was to examine differences in aversive responding during predictable and unpredictable threat-of-shock in three groups of individuals with: 1) current PD and remitted AD (PD and AD), 2) current PD but no lifetime diagnosis of AD (PD-only), and 3) no lifetime diagnoses of PD or AD (controls). Aversive responding was assessed using a well-established electromyography (EMG) startle paradigm. Results Results indicated that PD and AD individuals evidenced greater startle potentiation during unpredictable (but not predictable) threat relative to controls and PD-only individuals (who did not differ). Conclusions These findings suggest that heightened reactivity to unpredictable threat may be an important process in PD and AD comorbidity and a possible key motivational factor underlying engagement in alcohol use. PMID:23465734

  14. Empirically supported treatments for panic disorder with agoraphobia in a Spanish psychology clinic.

    PubMed

    Ballesteros, Francisco; Labrador, Francisco J

    2014-01-01

    The aim of this work is to study the sociodemographic and clinical characteristics of patients diagnosed with Panic Disorder with Agoraphobia (PD/Ag), as well as the characteristics of the treatment and its results and cost in a University Psychology Clinic. Fifty patients demanded psychological assistance for PD/Ag; 80% were women, with an average age of 29.22 years (SD = 9.03). Mean number of evaluation sessions was 3.26 (SD = 1.03), and of treatment sessions, 13.39 (SD = 9.237). Of the patients, 83.33% were discharged (that is, questionnaire scores were below the cut-off point indicated by the authors, and no PD/Ag was observed at readministration of the semistructured interview), 5.5% refused treatment, and 11% were dropouts. The average number of treatment sessions of patients who achieved therapeutic success was 15.13 (SD = 8.98). Effect sizes (d) greater than 1 were obtained in all the scales. Changes in all scales were significant (p < .05). The estimated cost of treatment for patients who achieved therapeutic success was 945.12€. The treatment results are at least similar to those of studies of efficacy and effectiveness for PD/Ag. The utility of generalizing treatments developed in research settings to a welfare clinic is discussed. PMID:26054491

  15. Empirically supported treatments for panic disorder with agoraphobia in a Spanish psychology clinic.

    PubMed

    Ballesteros, Francisco; Labrador, Francisco J

    2014-01-01

    The aim of this work is to study the sociodemographic and clinical characteristics of patients diagnosed with Panic Disorder with Agoraphobia (PD/Ag), as well as the characteristics of the treatment and its results and cost in a University Psychology Clinic. Fifty patients demanded psychological assistance for PD/Ag; 80% were women, with an average age of 29.22 years (SD = 9.03). Mean number of evaluation sessions was 3.26 (SD = 1.03), and of treatment sessions, 13.39 (SD = 9.237). Of the patients, 83.33% were discharged (that is, questionnaire scores were below the cut-off point indicated by the authors, and no PD/Ag was observed at readministration of the semistructured interview), 5.5% refused treatment, and 11% were dropouts. The average number of treatment sessions of patients who achieved therapeutic success was 15.13 (SD = 8.98). Effect sizes (d) greater than 1 were obtained in all the scales. Changes in all scales were significant (p < .05). The estimated cost of treatment for patients who achieved therapeutic success was 945.12€. The treatment results are at least similar to those of studies of efficacy and effectiveness for PD/Ag. The utility of generalizing treatments developed in research settings to a welfare clinic is discussed.

  16. Enhanced cardiac perception predicts impaired performance in the Iowa Gambling Task in patients with panic disorder

    PubMed Central

    Wölk, Julian; Sütterlin, Stefan; Koch, Stefan; Vögele, Claus; Schulz, Stefan M

    2014-01-01

    Objective Somatic marker theory predicts that somatic cues serve intuitive decision making; however, cardiovascular symptoms are threat cues for patients with panic disorder (PD). Therefore, enhanced cardiac perception may aid intuitive decision making only in healthy individuals, but impair intuitive decision making in PD patients. Methods PD patients and age-and sex-matched volunteers without a psychiatric diagnosis (n = 17, respectively) completed the Iowa Gambling Task (IGT) as a measure of intuitive decision making. Interindividual differences in cardiac perception were assessed with a common mental-tracking task. Results In line with our hypothesis, we found a pattern of opposing associations (Fisher's Z = 1.78, P = 0.04) of high cardiac perception with improved IGT-performance in matched control-participants (r = 0.36, n = 14) but impaired IGT-performance in PD patients (r = −0.38, n = 13). Conclusion Interoceptive skills, typically assumed to aid intuitive decision making, can have the opposite effect in PD patients who experience interoceptive cues as threatening, and tend to avoid them. This may explain why PD patients frequently have problems with decision making in everyday life. Screening of cardiac perception may help identifying patients who benefit from specifically tailored interventions. PMID:24683516

  17. Panic disorder and perceived parental rearing behavior investigated by the Japanese version of the EMBU scale.

    PubMed

    Someya, T; Kitamura, H; Uehara, T; Sakado, K; Kaiya, H; Tang, S W; Takahashi, S

    2000-01-01

    Although recent studies have found dysfunctional parental rearing behaviour is associated with certain aspects of psychopathology of panic disorder (PD), the results are not in complete agreement. By using a translated Japanese version of the EMBU (Egna Minnen Beträffande Uppfostran), we investigated the parental rearing behavior perceived by 103 normal subjects, 71 PD patients with agoraphobia, and 32 PD patients without agoraphobia. The PD patients scored both parents as more rejecting and overprotective than did the controls. However, subgroup analysis showed that the patients with agoraphobia reported significantly more rejection from both parents and less emotional warmth from mothers, while the patients without agoraphobia, by contrast, reported more overprotection from both parents and more favouring subject from fathers than did the controls. Interestingly, these results were consistent with those documented in the Western literature, which reported "affectionless control" as a parenting style in PD, and, furthermore, indicated a cross-cultural similarity of parental rearing factor. In addition, it was suggested that a lack of care might be associated with the development of agoraphobia in Japan. PMID:10945135

  18. Histone Modifications in a Mouse Model of Early Adversities and Panic Disorder: Role for Asic1 and Neurodevelopmental Genes.

    PubMed

    Cittaro, Davide; Lampis, Valentina; Luchetti, Alessandra; Coccurello, Roberto; Guffanti, Alessandro; Felsani, Armando; Moles, Anna; Stupka, Elia; D' Amato, Francesca R; Battaglia, Marco

    2016-01-01

    Hyperventilation following transient, CO2-induced acidosis is ubiquitous in mammals and heritable. In humans, respiratory and emotional hypersensitivity to CO2 marks separation anxiety and panic disorders, and is enhanced by early-life adversities. Mice exposed to the repeated cross-fostering paradigm (RCF) of interference with maternal environment show heightened separation anxiety and hyperventilation to 6% CO2-enriched air. Gene-environment interactions affect CO2 hypersensitivity in both humans and mice. We therefore hypothesised that epigenetic modifications and increased expression of genes involved in pH-detection could explain these relationships. Medullae oblongata of RCF- and normally-reared female outbred mice were assessed by ChIP-seq for H3Ac, H3K4me3, H3K27me3 histone modifications, and by SAGE for differential gene expression. Integration of multiple experiments by network analysis revealed an active component of 148 genes pointing to the mTOR signalling pathway and nociception. Among these genes, Asic1 showed heightened mRNA expression, coherent with RCF-mice's respiratory hypersensitivity to CO2 and altered nociception. Functional enrichment and mRNA transcript analyses yielded a consistent picture of enhancement for several genes affecting chemoception, neurodevelopment, and emotionality. Particularly, results with Asic1 support recent human findings with panic and CO2 responses, and provide new perspectives on how early adversities and genes interplay to affect key components of panic and related disorders. PMID:27121911

  19. Histone Modifications in a Mouse Model of Early Adversities and Panic Disorder: Role for Asic1 and Neurodevelopmental Genes

    PubMed Central

    Cittaro, Davide; Lampis, Valentina; Luchetti, Alessandra; Coccurello, Roberto; Guffanti, Alessandro; Felsani, Armando; Moles, Anna; Stupka, Elia; D’ Amato, Francesca R.; Battaglia, Marco

    2016-01-01

    Hyperventilation following transient, CO2-induced acidosis is ubiquitous in mammals and heritable. In humans, respiratory and emotional hypersensitivity to CO2 marks separation anxiety and panic disorders, and is enhanced by early-life adversities. Mice exposed to the repeated cross-fostering paradigm (RCF) of interference with maternal environment show heightened separation anxiety and hyperventilation to 6% CO2-enriched air. Gene-environment interactions affect CO2 hypersensitivity in both humans and mice. We therefore hypothesised that epigenetic modifications and increased expression of genes involved in pH-detection could explain these relationships. Medullae oblongata of RCF- and normally-reared female outbred mice were assessed by ChIP-seq for H3Ac, H3K4me3, H3K27me3 histone modifications, and by SAGE for differential gene expression. Integration of multiple experiments by network analysis revealed an active component of 148 genes pointing to the mTOR signalling pathway and nociception. Among these genes, Asic1 showed heightened mRNA expression, coherent with RCF-mice’s respiratory hypersensitivity to CO2 and altered nociception. Functional enrichment and mRNA transcript analyses yielded a consistent picture of enhancement for several genes affecting chemoception, neurodevelopment, and emotionality. Particularly, results with Asic1 support recent human findings with panic and CO2 responses, and provide new perspectives on how early adversities and genes interplay to affect key components of panic and related disorders. PMID:27121911

  20. Therapist effects and the outcome—alliance correlation in cognitive behavioral therapy for panic disorder with agoraphobia

    PubMed Central

    Barlow, David H.; Gorman, Jack M.; Shear, M. Katherine; Woods, Scott W.

    2014-01-01

    Although the alliance–outcome correlation is well established, no published studies to date have separated between therapists’ and patients’ contributions while controlling for early symptom change. In this study, we examined therapist effects in two trials of CBT for panic disorder with agoraphobia (PDA) and the impact of therapists’ and patients’ contribution to the alliance on outcome and attrition in one trial. Alliance ratings were obtained from patients and therapists early and late in treatment (n = 133). Data were analyzed using multi-level modeling controlling for early symptom change. No therapist effects were found. The patients’ contribution to the alliance predicted outcome (in both panic severity and anxiety sensitivity) and attrition. The therapists’ contribution to the alliance predicted attrition but not outcome. Results suggest that the patient's contribution to the alliance plays an important role in CBT for PDA and that including common factors into research on CBT may help elucidate treatment processes. PMID:24275067

  1. Killing Two Birds with One Stone: Exposure Simultaneously Addressing Panic Disorder and Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Reinecke, Andrea; Hoyer, Juergen

    2010-01-01

    Massed exposure has gained acceptance as an effective method to treat anxiety disorders. When using this intervention in patients presenting with more than one anxiety disorder, specific treatment options need to be discussed. Should exposure be applied in sequential order for each of the comorbid disorders? Or can exposure sessions also be…

  2. Mean platelet volume and red cell distribution width levels in initial evaluation of panic disorder

    PubMed Central

    Asoglu, Mehmet; Aslan, Mehmet; Imre, Okan; Kivrak, Yuksel; Akil, Oznur; Savik, Emin; Buyukaslan, Hasan; Fedai, Ulker; Altındag, Abdurrahman

    2016-01-01

    Background As the relationship between psychological stress and platelet activation has been widely studied in recent years, activated platelets lead to certain biochemical changes, which occur in the brain in patients with mental disorders. However, data relating to the mean platelet volume (MPV) in patients with panic disorder (PD) are both limited and controversial. Herein, we aimed to evaluate, for the first time, the red cell distribution width (RDW) levels combined with MPV levels in patients with PD. Patients and methods Between January 2012 and June 2015, data of 30 treatment-naïve patients (16 females, 14 males; mean age: 37±10 years; range: 18–59 years) who were diagnosed with PD and 25 age- and sex-matched healthy volunteers (10 females, 15 males; mean age: 36±13 years; range: 18–59 years) (control group) were retrospectively analyzed. The white blood cell count (WBC), MPV, and RDW levels were measured in both groups. Results The mean WBC, MPV, and RDW levels were 9,173.03±2,400.31/mm3, 8.19±1.13 fl, and 12.47±1.14%, respectively, in the PD group. These values were found to be 7,090.24±1,032.61, 6.85±0.67, and 11.63±0.85, respectively, in the healthy controls. The WBC, MPV, and RDW levels were significantly higher in the patients with PD compared to the healthy controls (P=0.001, P=0.001, and P=0.003, respectively). However, there was no significant difference in the platelet number between the patients with PD and healthy controls (P>0.05). Conclusion Our study results are the first to demonstrate that the RDW levels combined with MPV levels significantly increase among patients with PD. We believe that increased RDW and MPV levels can be used as a novel marker for PD. PMID:27703361

  3. 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…

  4. The White Matter Microintegrity Alterations of Neocortical and Limbic Association Fibers in Major Depressive Disorder and Panic Disorder: The Comparison.

    PubMed

    Lai, Chien-Han; Wu, Yu-Te

    2016-03-01

    The studies regarding to the comparisons between major depressive disorder (MDD) and panic disorder (PD) in the microintegrity of white matter (WM) are uncommon. Therefore, we tried to a way to classify the MDD and PD. Fifty-three patients with 1st-episode medication-naive PD, 54 healthy controls, and 53 patients with 1st-episode medication-naive MDD were enrolled in this study. The controls and patients were matched for age, gender, education, and handedness. The diffusion tensor imaging scanning was also performed. The WM microintegrity was analyzed and compared between 3 groups of participants (ANOVA analysis) with age and gender as covariates. The MDD group had lower WM microintegrity than the PD group in the left anterior thalamic radiation, left uncinate fasciculus, left inferior fronto-occipital fasciculus, and bilateral corpus callosum. The MDD group had reductions in the microintegrity when compared to controls in the bilateral superior longitudinal fasciculi, inferior longitudinal fasciculi, inferior fronto-occipital fasciculi, and corpus callosum. The PD group had lower microintegrity in bilateral superior longitudinal fasciculi and left inferior fronto-occipital fasciculus when compared to controls. The widespread pattern of microintegrity alterations in fronto-limbic WM circuit for MDD was different from restrictive pattern of alterations for PD. PMID:26945417

  5. Agoraphobia With and Without Panic Disorder: A 20-Year Follow-up of Integrated Exposure and Psychodynamic Therapy.

    PubMed

    Hoffart, Asle; Hedley, Liv M; Svanøe, Karol; Langkaas, Tomas Formo; Sexton, Harold

    2016-02-01

    The aim of the current study was to compare the 20-year outcome in panic disorder with agoraphobia (PD with AG) and agoraphobia without panic disorder (AG without PD) patients after inpatient psychological treatment. Of 53 eligible patients having completed a medication-free integrated exposure and psychodynamic treatment, 38 (71.7%)-25 PD with AG and 13 AG without PD patients-attended 20-year follow-up. AG without PD patients improved less than PD with AG patients did on primary outcome measures. In the PD with AG group, there were large uncontrolled effect sizes (<-2.30). More of the AG without PD patients had avoidant personality disorder at pretreatment, but the presence of this disorder did not predict outcome. The follow-up results support that PD with AG and AG without PD are two different disorders. The results also suggest that the very long-term outcome in PD with AG patients is excellent for this integrated treatment. PMID:26588081

  6. Agoraphobia With and Without Panic Disorder: A 20-Year Follow-up of Integrated Exposure and Psychodynamic Therapy.

    PubMed

    Hoffart, Asle; Hedley, Liv M; Svanøe, Karol; Langkaas, Tomas Formo; Sexton, Harold

    2016-02-01

    The aim of the current study was to compare the 20-year outcome in panic disorder with agoraphobia (PD with AG) and agoraphobia without panic disorder (AG without PD) patients after inpatient psychological treatment. Of 53 eligible patients having completed a medication-free integrated exposure and psychodynamic treatment, 38 (71.7%)-25 PD with AG and 13 AG without PD patients-attended 20-year follow-up. AG without PD patients improved less than PD with AG patients did on primary outcome measures. In the PD with AG group, there were large uncontrolled effect sizes (<-2.30). More of the AG without PD patients had avoidant personality disorder at pretreatment, but the presence of this disorder did not predict outcome. The follow-up results support that PD with AG and AG without PD are two different disorders. The results also suggest that the very long-term outcome in PD with AG patients is excellent for this integrated treatment.

  7. Panic control treatment and its applications.

    PubMed

    Hofmann, S G; Spiegel, D A

    1999-01-01

    Panic Control Treatment (PCT) is a widely used, empirically validated cognitive-behavioral treatment for panic disorder. Initially developed for the treatment of panic disorder with limited agoraphobic avoidance, PCT more recently has been finding broader applications. It has been used as an aid to pharmacotherapy discontinuation in panic disorder; in the treatment of panic attacks associated with other disorders such as schizophrenia; and, in combination with a situational exposure component, in the treatment of patients with moderate to severe agoraphobia. The authors critically review the evidence for the clinical efficacy of PCT and recent work directed at further enhancing the long-term efficacy and cost-effectiveness of treatment. PMID:9888103

  8. Cognitive-behavioral treatment for panic disorder with agoraphobia: a randomized, controlled trial and cost-effectiveness analysis.

    PubMed

    Roberge, Pasquale; Marchand, André; Reinharz, Daniel; Savard, Pierre

    2008-05-01

    A randomized, controlled trial was conducted to examine the cost-effectiveness of cognitive-behavioral treatment (CBT) for panic disorder with agoraphobia. A total of 100 participants were randomly assigned to standard (n = 33), group (n = 35), and brief (n = 32) treatment conditions. Results show significant clinical and statistical improvement on standard symptom measures and quality of life from baseline to posttreatment and 3-month follow-up, with no significant differences between treatment conditions. Compared with standard CBT, brief and group CBT incurred lower treatment costs and had a superior cost-effectiveness ratio, suggesting the potential of these alternative treatment conditions in increasing access to effective treatment. PMID:18391051

  9. Expanding the limits of bibliotherapy for panic disorder: randomized trial of self-help without support but with a clear deadline.

    PubMed

    Nordin, Sara; Carlbring, Per; Cuijpers, Pim; Andersson, Gerhard

    2010-09-01

    Cognitive behavioral bibliotherapy for panic disorder has been found to be less effective without therapist support. In this study, participants were randomized to either unassisted bibliotherapy (n=20) with a scheduled follow-up telephone interview or to a waiting list control group (n=19). Following a structured psychiatric interview, participants in the treatment group were sent a self-help book consisting of 10 chapters based on cognitive behavioral strategies for the treatment of panic disorder. No therapist contact of any kind was provided during the treatment phase, which lasted for 10 weeks. Results showed that the treatment group had, in comparison to the control group, improved on all outcome measures at posttreatment and at 3-month follow-up. The tentative conclusion drawn from these results is that pure bibliotherapy with a clear deadline can be effective for people suffering from panic disorder with or without agoraphobia.

  10. Panic disorder with agoraphobia from a behavioral neuroscience perspective: Applying the research principles formulated by the Research Domain Criteria (RDoC) initiative.

    PubMed

    Hamm, Alfons O; Richter, Jan; Pané-Farré, Christiane; Westphal, Dorte; Wittchen, Hans-Ulrich; Vossbeck-Elsebusch, Anna N; Gerlach, Alexander L; Gloster, Andrew T; Ströhle, Andreas; Lang, Thomas; Kircher, Tilo; Gerdes, Antje B M; Alpers, Georg W; Reif, Andreas; Deckert, Jürgen

    2016-03-01

    In the current review, we reconceptualize a categorical diagnosis-panic disorder and agoraphobia-in terms of two constructs within the domain "negative valence systems" suggested by the Research Domain Criteria initiative. Panic attacks are considered as abrupt and intense fear responses to acute threat arising from inside the body, while anxious apprehension refers to anxiety responses to potential harm and more distant or uncertain threat. Taking a dimensional view, panic disorder with agoraphobia is defined with the threat-imminence model stating that defensive responses are dynamically organized along the dimension of the proximity of the threat. We tested this model within a large group of patients with panic disorder and agoraphobia (N = 369 and N = 124 in a replication sample) and found evidence that panic attacks are indeed instances of circa strike defense. This component of the defensive reactivity was related to genetic modulators within the serotonergic system. In contrast, anxious apprehension-characterized by attentive freezing during postencounter defense-was related to general distress and depressive mood, as well as to genetic modulations within the hypothalamic-pituitary-adrenal (HPA) axis. Patients with a strong behavioral tendency for active and passive avoidance responded better to exposure treatment if the therapist guides the patient through the exposure exercises. PMID:26877119

  11. Panic disorder with agoraphobia from a behavioral neuroscience perspective: Applying the research principles formulated by the Research Domain Criteria (RDoC) initiative.

    PubMed

    Hamm, Alfons O; Richter, Jan; Pané-Farré, Christiane; Westphal, Dorte; Wittchen, Hans-Ulrich; Vossbeck-Elsebusch, Anna N; Gerlach, Alexander L; Gloster, Andrew T; Ströhle, Andreas; Lang, Thomas; Kircher, Tilo; Gerdes, Antje B M; Alpers, Georg W; Reif, Andreas; Deckert, Jürgen

    2016-03-01

    In the current review, we reconceptualize a categorical diagnosis-panic disorder and agoraphobia-in terms of two constructs within the domain "negative valence systems" suggested by the Research Domain Criteria initiative. Panic attacks are considered as abrupt and intense fear responses to acute threat arising from inside the body, while anxious apprehension refers to anxiety responses to potential harm and more distant or uncertain threat. Taking a dimensional view, panic disorder with agoraphobia is defined with the threat-imminence model stating that defensive responses are dynamically organized along the dimension of the proximity of the threat. We tested this model within a large group of patients with panic disorder and agoraphobia (N = 369 and N = 124 in a replication sample) and found evidence that panic attacks are indeed instances of circa strike defense. This component of the defensive reactivity was related to genetic modulators within the serotonergic system. In contrast, anxious apprehension-characterized by attentive freezing during postencounter defense-was related to general distress and depressive mood, as well as to genetic modulations within the hypothalamic-pituitary-adrenal (HPA) axis. Patients with a strong behavioral tendency for active and passive avoidance responded better to exposure treatment if the therapist guides the patient through the exposure exercises.

  12. Disorder-specific versus transdiagnostic and clinician-guided versus self-guided internet-delivered treatment for panic disorder and comorbid disorders: A randomized controlled trial.

    PubMed

    Fogliati, V J; Dear, B F; Staples, L G; Terides, M D; Sheehan, J; Johnston, L; Kayrouz, R; Dear, R; McEvoy, P M; Titov, N

    2016-04-01

    Transdiagnostic cognitive behaviour therapy (TD-CBT) aims to target the symptoms of multiple disorders whereas disorder-specific CBT (DS-CBT) targets the symptoms of principal disorders. This study compared the relative benefits of internet-delivered TD-CBT and DS-CBT when provided in clinician-guided (CG-CBT) and self-guided (SG-CBT) formats for people with a principal diagnosis of Panic Disorder (PD). Participants (n=145) were randomly allocated to receive TD-CBT or DS-CBT and CG-CBT or SG-CBT. Large reductions in symptoms of PD (Cohen's d ≥ 0.71; avg. reduction ≥ 36%) and moderate-to-large reductions in symptoms of comorbid depression (Cohen's d ≥ 0.71; avg. reduction ≥ 33%), generalised anxiety disorder (Cohen's d ≥ 0.91; avg. reduction ≥ 34%) and social anxiety disorder (Cohen's d ≥ 0.50; avg. reduction ≥ 15%) were found over the 24-month follow-up period. Highlighting their efficacy and acceptability, no marked and consistent differences were observed between TD-CBT and DS-CBT or CG-CBT and DS-CBT.

  13. Candidate genes in panic disorder: meta-analyses of 23 common variants in major anxiogenic pathways.

    PubMed

    Howe, A S; Buttenschøn, H N; Bani-Fatemi, A; Maron, E; Otowa, T; Erhardt, A; Binder, E B; Gregersen, N O; Mors, O; Woldbye, D P; Domschke, K; Reif, A; Shlik, J; Kõks, S; Kawamura, Y; Miyashita, A; Kuwano, R; Tokunaga, K; Tanii, H; Smoller, J W; Sasaki, T; Koszycki, D; De Luca, V

    2016-05-01

    The utilization of molecular genetics approaches in examination of panic disorder (PD) has implicated several variants as potential susceptibility factors for panicogenesis. However, the identification of robust PD susceptibility genes has been complicated by phenotypic diversity, underpowered association studies and ancestry-specific effects. In the present study, we performed a succinct review of case-control association studies published prior to April 2015. Meta-analyses were performed for candidate gene variants examined in at least three studies using the Cochrane Mantel-Haenszel fixed-effect model. Secondary analyses were also performed to assess the influences of sex, agoraphobia co-morbidity and ancestry-specific effects on panicogenesis. Meta-analyses were performed on 23 variants in 20 PD candidate genes. Significant associations after correction for multiple testing were observed for three variants, TMEM132D rs7370927 (T allele: odds ratio (OR)=1.27, 95% confidence interval (CI): 1.15-1.40, P=2.49 × 10(-6)), rs11060369 (CC genotype: OR=0.65, 95% CI: 0.53-0.79, P=1.81 × 10(-5)) and COMT rs4680 (Val (G) allele: OR=1.27, 95% CI: 1.14-1.42, P=2.49 × 10(-5)) in studies with samples of European ancestry. Nominal associations that did not survive correction for multiple testing were observed for NPSR1 rs324891 (T allele: OR=1.22, 95% CI: 1.07-1.38, P=0.002), TPH1 rs1800532 (AA genotype: OR=1.46, 95% CI: 1.14-1.89, P=0.003) and HTR2A rs6313 (T allele: OR=1.19, 95% CI: 1.07-1.33, P=0.002) in studies with samples of European ancestry and for MAOA-uVNTR in female PD (low-active alleles: OR=1.21, 95% CI: 1.07-1.38, P=0.004). No significant associations were observed in the secondary analyses considering sex, agoraphobia co-morbidity and studies with samples of Asian ancestry. Although these findings highlight a few associations, PD likely involves genetic variation in a multitude of biological pathways that is diverse among populations. Future studies must

  14. Serotonin Transporter and COMT Polymorphisms as Independent Predictors of Health-related Quality of Life in Patients with Panic Disorder

    PubMed Central

    2016-01-01

    There is growing evidence of poor health-related quality of life (HRQOL) in patients with panic disorder (PD). However, little is known about the factors affecting HRQOL in patients with PD. The authors examined whether 5-HTTLPR tri-allelic approach and Cathechol-O-methyltransferase (COMT) Val158Met polymorphism can predict HRQOL in patients with PD controlling for sociodemographic factors and disorder-related symptom levels. The sample consisted of 179 patients with PD consecutively recruited from an outpatient clinic and age- and gender ratio-matched 110 healthy controls. The SF-36 was used to assess multiple domains of HRQOL. Hierarchical multiple regression analysis was performed to determine the independent effect of the 5-HTTLPR and COMT Val158Met on the SF-36 in panic patients. Patients with PD showed lowered HRQOL in all sub-domains of the SF-36 compared to healthy controls. The 5-HTTLPR independently and additively accounted for 2.2% of variation (6.7% of inherited variance) of perceived general health and the COMT Val158Met independently and additively accounted for 1.5% of variation (5.0% of inherited variance) of role limitation due to emotional problems in patient group. The present study suggests that specific genetic polymorphisms are associated with certain domains of HRQOL and provides a new insight on exploring the factors that predict HRQOL in patients with PD. PMID:27134498

  15. Serotonin Transporter and COMT Polymorphisms as Independent Predictors of Health-related Quality of Life in Patients with Panic Disorder.

    PubMed

    Kang, Eunho; Choe, Ah Young; Kim, Borah; Lee, Jun-Yeob; Choi, Tai Kiu; Na, Hae-Ran; Lee, Sang-Hyuk

    2016-05-01

    There is growing evidence of poor health-related quality of life (HRQOL) in patients with panic disorder (PD). However, little is known about the factors affecting HRQOL in patients with PD. The authors examined whether 5-HTTLPR tri-allelic approach and Cathechol-O-methyltransferase (COMT) Val(158)Met polymorphism can predict HRQOL in patients with PD controlling for sociodemographic factors and disorder-related symptom levels. The sample consisted of 179 patients with PD consecutively recruited from an outpatient clinic and age- and gender ratio-matched 110 healthy controls. The SF-36 was used to assess multiple domains of HRQOL. Hierarchical multiple regression analysis was performed to determine the independent effect of the 5-HTTLPR and COMT Val(158)Met on the SF-36 in panic patients. Patients with PD showed lowered HRQOL in all sub-domains of the SF-36 compared to healthy controls. The 5-HTTLPR independently and additively accounted for 2.2% of variation (6.7% of inherited variance) of perceived general health and the COMT Val(158)Met independently and additively accounted for 1.5% of variation (5.0% of inherited variance) of role limitation due to emotional problems in patient group. The present study suggests that specific genetic polymorphisms are associated with certain domains of HRQOL and provides a new insight on exploring the factors that predict HRQOL in patients with PD. PMID:27134498

  16. Effects of breathing training on voluntary hypo- and hyperventilation in patients with panic disorder and episodic anxiety.

    PubMed

    Wollburg, Eileen; Roth, Walton T; Kim, Sunyoung

    2011-06-01

    Anxiety disorders are associated with respiratory abnormalities. Breathing training (BT) aimed at reversing these abnormalities may also alter the anxiogenic effects of biological challenges. Forty-five Panic Disorder (PD) patients, 39 Episodic Anxiety patients, and 20 non-anxious controls underwent voluntary hypoventilation and hyperventilation tests twice while psychophysiological measures were recorded. Patients were randomized to one of two BT therapies (Lowering vs. Raising pCO(2)) or to a waitlist. Before treatment panic patients had higher respiration rates and more tidal volume instability and sighing at rest than did non-anxious controls. After the Lowering therapy, patients had lower pCO(2) during testing. However, neither reactivity nor recovery to either test differed between patients and controls, or were affected by treatment. Although the two treatments had their intended opposite effects on baseline pCO(2), other physiological measures were not affected. We conclude that baseline respiratory abnormalities are somewhat specific to PD, but that previously reported greater reactivity and slower recovery to respiratory challenges may be absent. PMID:21373936

  17. Nuclear magnetic resonance technology in acupoint catgut embedding therapy for the treatment of menopausal panic disorder: its applications

    NASA Astrophysics Data System (ADS)

    Chen, Gui-zhen; Zhang, Sha-sha; Xu, Yun-xiang; Wang, Xiao-yun

    2011-11-01

    Nuclear Magnetic Resonance (NMR) is a diagnostic method which is non-invasive and non-ionizing irradiative to the human body. It not only suits structural, but also functional imaging. The NMR technique develops rapidly in its application in life science, which has become the hotspot in recent years. Menopausal panic disorder (MPD) is a typical psychosomatic disease during climacteric period, which may affect physical and mental health. Looking for a convenient, effective, and safe method, which is free of toxic-side effects to control the disease, is a modern medical issue. Based on reviewing the etiology and pathogenesis of MPD according to dual traditional Chinese medicine (TCM) and western medicine, further analyzed the advantages and principles for selecting acupoint prescription by tonifying kidney and benefiting marrow therapy for acupoint catgut-embedding to this disease. The application of Nuclear Magnetic Resonance Spectroscopy (NMRS) and Magnetic Resonance Imaging (MRI) technologies in mechanism research on acupoint catgut embedding for the treatment of MPD was discussed. It's pointed out that this intervention method is safe and effective to treat MPD. Breakthrough will be achieved from the research of the selection of acupoint prescription and therapeutic mechanism of acupoint catgut embedding for the treatment of menopausal panic disorder by utilizing the Functional Nuclear Magnetic Resonance Imaging (fMRI) and Metabonomics technologies.

  18. Nuclear magnetic resonance technology in acupoint catgut embedding therapy for the treatment of menopausal panic disorder: its applications

    NASA Astrophysics Data System (ADS)

    Chen, Gui-zhen; Zhang, Sha-sha; Xu, Yun-xiang; Wang, Xiao-yun

    2012-03-01

    Nuclear Magnetic Resonance (NMR) is a diagnostic method which is non-invasive and non-ionizing irradiative to the human body. It not only suits structural, but also functional imaging. The NMR technique develops rapidly in its application in life science, which has become the hotspot in recent years. Menopausal panic disorder (MPD) is a typical psychosomatic disease during climacteric period, which may affect physical and mental health. Looking for a convenient, effective, and safe method, which is free of toxic-side effects to control the disease, is a modern medical issue. Based on reviewing the etiology and pathogenesis of MPD according to dual traditional Chinese medicine (TCM) and western medicine, further analyzed the advantages and principles for selecting acupoint prescription by tonifying kidney and benefiting marrow therapy for acupoint catgut-embedding to this disease. The application of Nuclear Magnetic Resonance Spectroscopy (NMRS) and Magnetic Resonance Imaging (MRI) technologies in mechanism research on acupoint catgut embedding for the treatment of MPD was discussed. It's pointed out that this intervention method is safe and effective to treat MPD. Breakthrough will be achieved from the research of the selection of acupoint prescription and therapeutic mechanism of acupoint catgut embedding for the treatment of menopausal panic disorder by utilizing the Functional Nuclear Magnetic Resonance Imaging (fMRI) and Metabonomics technologies.

  19. Panic, hyperventilation and perpetuation of anxiety.

    PubMed

    Dratcu, L

    2000-10-01

    1. Studies on the pathogenesis of panic disorder (PD) have concentrated on panic attacks. However, PD runs a chronic or episodic course and panic patients remain clinically unwell between attacks. Panic patients chronically hyperventilate, but the implications of this are unclear. 2. Provocation of panic experimentally has indicated that several biological mechanisms may be involved in the onset of panic symptoms. Evidence from provocation studies using lactate, but particularly carbon dioxide (CO2) mixtures, suggests that panic patients may have hypersensitive CO2 chemoreceptors. Klein proposed that PD may be due to a dysfunctional brain's suffocation alarm and that panic patients hyperventilate to keep pCO2 low. 3. Studies of panic patients in the non-panic state have shown EEG abnormalities in this patient group, as well as abnormalities in cerebral blood flow and cerebral glucose metabolism. These abnormalities can be interpreted as signs of cerebral hypoxia that may have resulted from hyperventilation. 4. Cerebral hypoxia is probably involved in the causation of symptoms of anxiety in sufferers of chronic obstructive pulmonary diseases. By chronically hyperventilating, panic patients may likewise be at risk of exposure to prolonged periods of cerebral hypoxia which, in turn, may contribute to the chronicity of their panic and anxiety symptoms. 5. Chronic hyperventilation may engender a self-perpetuating mechanism within the pathophysiology of PD, a hypothesis which warrants further studies of panic patients in the non-panic state. PMID:11131173

  20. Sleep panic attacks: a micro-movement analysis.

    PubMed

    Brown, Terry M; Uhde, Thomas W

    2003-01-01

    Earlier work by our group and others has pointed to a role for movement during sleep in sleep-panic attacks. Specifically, our group has reported that panic disorder patients, as a group, appear to move more during sleep than age-matched controls, whereas the subgroup of panic disorder who "panic" during sleep move less on the nights they experience sleep-panic attacks than they do on nights without sleep-panic attacks. We studied the movement of sleep-panic patients in a more detailed fashion with more than one sleep movement index. Fourteen patients with sleep-panic attacks were compared with 14 waking panic patients, 13 social phobic patients, and 14 normal controls. Subjects from the other groups were age matched to the sleep-panic group. Their comparison study night corresponded to the night number of the sleep-panic attack. Sleep-panic patients did move less on panic nights than did the normal controls on the corresponding sleep-panic night according to two separate sleep movement indices. Although not statistically significant, sleep-panic patients also moved less on their panic night than did either of the other anxious groups on corresponding nights. Rechtshaffen and Kales' Movement Time (MT) measure appears to overestimate actual min of movement during sleep in all subjects. The movement noted in sleep-panic patients may have some role in the pathophysiology of sleep-panic attacks. A possible mechanism is explained.

  1. [Prevalence of psychiatric disorders among homeless adolescents].

    PubMed

    Aichhorn, Wolfgang; Santeler, Stefan; Stelzig-Schöler, Renate; Kemmler, Georg; Steinmayr-Gensluckner, Maria; Hinterhuber, Hartmann

    2008-01-01

    Various studies show a high prevalence of mental disorders among homeless people. So far most of these studies deal solely with single men, mainly affected by homelessness. Few data exist for women, children, adolescents and whole families that are more and more affected by poverty and homelessness. This study, conducted in Innsbruck/Austria, determined the prevalence of psychiatric disorders among homeless adolescents. The adolescents were recruited in a counselling centre and homeless shelter specifically founded for homeless youth. Mental disorders were diagnosed with the Structured Clinical Interview for DSM-IV (SKID-I). 40 adolescents and young adults ranging from 14-23 years (mean 17.9 years) were included in the study. The results show that 58% of the homeless adolescents were exposed to continuous violence in their families and that violence was a major reason for them to leave home. The overall prevalence of diagnosed psychiatric disorders was 80% in the whole sample; the leading disorder was substance abuse/dependence (65%), followed by mood disorders (42.5%), anxiety disorders (17.5%) and eating disorders (17.5%). 57.5% of the adolescents had a history of self-harm and 25% reported at least one suicide attempt. Duration of homelessness had the greatest influence on the prevalence of mental disorders. Longer duration of homelessness was associated with a higher risk of psychiatric disorder or self-harm. These results demonstrate the urgent need for early psychosocial and psychiatric help for homeless adolescents. PMID:18826872

  2. Construct Validity of Adolescent Antisocial Personality Disorder

    ERIC Educational Resources Information Center

    Taylor, Jeanette; Elkins, Irene J.; Legrand, Lisa; Peuschold, Dawn; Iacono, William G.

    2007-01-01

    This study examined the construct validity of antisocial personality disorder (ASPD) diagnosed in adolescence. Boys and girls were grouped by history of DSM-III-R conduct disorder (CD) and ASPD: Controls (n = 340) had neither diagnosis; CD Only (n = 77) had CD by age 17 but no ASPD through age 20; Adolescent ASPD (n = 64) had ASPD by age 17. The…

  3. 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…

  4. Does Maintenance CBT Contribute to Long-Term Treatment Response of Panic Disorder with or without Agoraphobia? A Randomized Controlled Clinical Trial

    ERIC Educational Resources Information Center

    White, Kamila S.; Payne, Laura A.; Gorman, Jack M.; Shear, M. Katherine; Woods, Scott W.; Saksa, John R.; Barlow, David H.

    2013-01-01

    Objective: We examined the possibility that maintenance cognitive behavior therapy (M-CBT) may improve the likelihood of sustained improvement and reduced relapse in a multi-site randomized controlled clinical trial of patients who met criteria for panic disorder with or without agoraphobia. Method: Participants were all patients (N = 379) who…

  5. Psychological Treatment for Panic Disorder with Agoraphobia: A Randomized Controlled Trial to Examine the Role of Therapist-Guided Exposure in situ in CBT

    ERIC Educational Resources Information Center

    Gloster, Andrew T.; Wittchen, Hans-Ulrich; Einsle, Franziska; Lang, Thomas; Helbig-Lang, Sylvia; Fydrich, Thomas; Fehm, Lydia; Hamm, Alfons O.; Richter, Jan; Alpers, George W.; Gerlach, Alexander L.; Strohle, Andreas; Kircher, Tilo; Deckert, Jurgen; Zwanzger, Peter; Hofler, Michael; Arolt, Volker

    2011-01-01

    Objective: Cognitive-behavioral therapy (CBT) is a first-line treatment for panic disorder with agoraphobia (PD/AG). Nevertheless, an understanding of its mechanisms and particularly the role of therapist-guided exposure is lacking. This study was aimed to evaluate whether therapist-guided exposure in situ is associated with more pervasive and…

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

    PubMed

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

    2016-01-01

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

  7. 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

  8. Mental Disorders

    MedlinePlus

    ... disorders, including panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, and phobias Bipolar disorder Depression Mood disorders Personality disorders Psychotic disorders, including schizophrenia ...

  9. Lack of specific association between panicogenic properties of caffeine and HPA-axis activation. A placebo-controlled study of caffeine challenge in patients with panic disorder.

    PubMed

    Masdrakis, Vasilios G; Markianos, Manolis; Oulis, Panagiotis

    2015-09-30

    A subgroup of patients with Panic Disorder (PD) exhibits increased sensitivity to caffeine administration. However, the association between caffeine-induced panic attacks and post-caffeine hypothalamic-pituitary-adrenal (HPA)-axis activation in PD patients remains unclear. In a randomized, double-blind, cross-over experiment, 19 PD patients underwent a 400-mg caffeine-challenge and a placebo-challenge, both administered in the form of instant coffee. Plasma levels of adrenocorticotropic hormone (ACTH), cortisol and dehydroepiandrosterone sulfate (DHEAS) were assessed at both baseline and post-challenge. No patient panicked after placebo-challenge, while nine patients (47.3%) panicked after caffeine-challenge. Placebo administration did not result in any significant change in hormones' plasma levels. Overall, sample's patients demonstrated significant increases in ACTH, cortisol, and DHEAS plasma levels after caffeine administration. However, post-caffeine panickers and non-panickers did not differ with respect to the magnitude of the increases. Our results indicate that in PD patients, caffeine-induced panic attacks are not specifically associated with HPA-axis activation, as this is reflected in post-caffeine increases in ACTH, cortisol and DHEAS plasma levels, suggesting that caffeine-induced panic attacks in PD patients are not specifically mediated by the biological processes underlying fear or stress. More generally, our results add to the evidence that HPA-axis activation is not a specific characteristic of panic.

  10. [Psychotherapy of personality disorders in adolescence].

    PubMed

    Baader, Aline; Schmeck, Klaus; Resch, Franz; Kaess, Michael

    2014-01-01

    By the current state of knowledge adolescent personality disorders should be taken seriously due to their high prevalence and severe symptomatology. Personality disorders are characterized by a stable pattern of deviation concerning cognition, affectivity, impulse control, and interpersonal relationships and have negative repercussions in psychosocial functioning and subsequent development. There is emerging evidence that personality disorder diagnosis is reliable and valid during adolescence. It is essential to detect youth with personality pathology in order to refer them to specific psychotherapeutic interventions and consequently avoid further chronification and life-long functional impairment. This selective review will give an overview over personality disorders in adolescents as well as according psychotherapeutic interventions.

  11. Patterns of early change and their relationship to outcome and early treatment termination in patients with panic disorder

    PubMed Central

    Lutz, Wolfgang; Hofmann, Stefan G.; Rubel, Julian; Boswell, James F.; Shear, M. Katherine; Gorman, Jack M.; Woods, Scott W.; Barlow, David H.

    2014-01-01

    Objective Recently, innovative statistical tools have been used to model patterns of change in psychological treatments. These tools can detect patterns of change in patient progress early in treatment and allow for the prediction of treatment outcomes and treatment length. Method We used Growth Mixture Modeling to identify different latent classes of early change in patients with panic disorder (N = 326) who underwent a manualized cognitive-behavioral treatment. Results Four latent subgroups were identified, showing clusters of change trajectories over the first five sessions. One of the subgroups consisted of patients whose symptoms rapidly decreased and also showed the best outcomes. This information improved treatment prediction by 16.1% over patient intake characteristics. Early change patterns also significantly predicted patients’ early treatment termination. Patient intake characteristics that significantly predicted class membership included functional impairment and separation anxiety. Conclusions These findings suggest that early treatment changes are uniquely predictive of treatment outcome. PMID:24447004

  12. “Nomophobia”: Impact of Cell Phone Use Interfering with Symptoms and Emotions of Individuals with Panic Disorder Compared with a Control Group

    PubMed Central

    King, Anna Lucia Spear; Valença, Alexandre Martins; Silva, Adriana Cardoso; Sancassiani, Federica; Machado, Sergio; Nardi, Antonio Egidio

    2014-01-01

    Panic disorder refers to the frequent and recurring acute attacks of anxiety. Objective: This study describes the routine use of mobiles phones (MPs) and investigates the appearance of possible emotional alterations or symptoms related to their use in patients with panic disorder (PD). Background: We compared patients with PD and agoraphobia being treated at the Panic and Respiration Laboratory of The Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil, to a control group of healthy volunteers. Methods: An MP-use questionnaire was administered to a consecutive sample of 50 patients and 70 controls. Results: People with PD showed significant increases in anxiety, tachycardia, respiratory alterations, trembling, perspiration, panic, fear and depression related to the lack of an MP compared to the control group. Conclusions: Both groups exhibited dependence on and were comforted by having an MP; however, people with PD and agoraphobia showed significantly more emotional alterations as well as intense physical and psychological symptoms when they were apart from or unable to use an MP compared to healthy volunteers. PMID:24669231

  13. Effect of combined cognitive-behavioural therapy and endurance training on cortisol and salivary alpha-amylase in panic disorder.

    PubMed

    Plag, Jens; Gaudlitz, Katharina; Schumacher, Sarah; Dimeo, Fernando; Bobbert, Thomas; Kirschbaum, Clemens; Ströhle, Andreas

    2014-11-01

    Current data point to an alteration of both the hypothalamo-pituitary-adrenal (HPA)-system and the peripheral transmission of catecholamines in anxiety disorders. There is also some evidence for the effect of several components of cognitive-behavioural interventions such as coping and control and for an effect of exercise training on the neuroendocrine stress response in healthy subjects as well as patients suffering from distinct (mental) disorders. This double-blind, controlled study investigated the effect of cognitive-behavioural therapy (CBT) in combination with either high-level endurance training or low-level exercise on salivary cortisol (sC) and on levels of salivary alpha-amylase (sAA) in patients suffering from panic disorder (PD) with and without agoraphobia. In comparison to the low-level exercise condition, there were significantly lower sC-levels in the experimental group performing high-level endurance training at a 7-month follow-up. In contrast, there were no group differences in sAA levels during the study period. In this trial, we found evidence for a decelerated effect of endurance-training on HPA-system's functioning in PD. Further studies addressing the alteration of sAA levels in this population might investigate physical exercise different in intensity and duration.

  14. Predicting Response Trajectories during Cognitive-Behavioural Therapy for Panic Disorder: No Association with the BDNF Gene or Childhood Maltreatment

    PubMed Central

    Santacana, Martí; Arias, Bárbara; Mitjans, Marina; Bonillo, Albert; Montoro, María; Rosado, Sílvia; Guillamat, Roser; Vallès, Vicenç; Pérez, Víctor; Forero, Carlos G.; Fullana, Miquel A.

    2016-01-01

    Background Anxiety disorders are highly prevalent and result in low quality of life and a high social and economic cost. The efficacy of cognitive-behavioural therapy (CBT) for anxiety disorders is well established, but a substantial proportion of patients do not respond to this treatment. Understanding which genetic and environmental factors are responsible for this differential response to treatment is a key step towards “personalized medicine”. Based on previous research, our objective was to test whether the BDNF Val66Met polymorphism and/or childhood maltreatment are associated with response trajectories during exposure-based CBT for panic disorder (PD). Method We used Growth Mixture Modeling to identify latent classes of change (response trajectories) in patients with PD (N = 97) who underwent group manualized exposure-based CBT. We conducted logistic regression to investigate the effect on these trajectories of the BDNF Val66Met polymorphism and two different types of childhood maltreatment, abuse and neglect. Results We identified two response trajectories (“high response” and “low response”), and found that they were not significantly associated with either the genetic (BDNF Val66Met polymorphism) or childhood trauma-related variables of interest, nor with an interaction between these variables. Conclusions We found no evidence to support an effect of the BDNF gene or childhood trauma-related variables on CBT outcome in PD. Future studies in this field may benefit from looking at other genotypes or using different (e.g. whole-genome) approaches. PMID:27355213

  15. 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

  16. 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.

  17. [Obsessive-compulsive disorders in adolescents].

    PubMed

    Klein, R G; Rapoport, J L

    1990-01-01

    The research recently conducted and ongoing in adolescent obsessive-compulsive disorder indicates that the clinical signs and symptoms are indistinguishable from those seen in adults. Comorbidity appears to follow the same trends in adolescents and adults, with anxiety and affective symptomatology predominating. Contrary to expectation, Gilles de la Tourette disorder does not appear either as a concurrent syndrome, or as an eventual outcome in obsessive-compulsive adolescents. Males are greatly over-represented among adolescents with an early childhood onset. The neurological and neuropsychological findings are the only ones that appear to distinguish the adolescent and adult obsessive-compulsive patients. The findings point to frequent neurological abnormalities in adolescents with obsessive-compulsive disorder. The natural history over the short-term seems to be negatively affected by severity. The clinical efficacy of clomipramine and the failure of another tricyclic antidepressant parallels the therapeutic experience reported in adult patients. The presence of depression is unrelated to the efficacy of clomipramine. The neuropsychological and neurological abnormalities, together with the data from the longitudinal and treatment studies, strongly suggest that obsessive-compulsive disorder in adolescents is not a variant of the overall group of anxiety disorders.

  18. Cognitive-behavioral therapy helps prevent relapse and recurrence of panic disorder following alprazolam discontinuation: a long-term follow-up of the Peoria and Dartmouth studies.

    PubMed

    Bruce, T J; Spiegel, D A; Hegel, M T

    1999-02-01

    The present research evaluated patients from 2 previous studies (1 conducted in Peoria, the other at Dartmouth) during a 2- to 5-year posttreatment period. Results showed that 75% of the Peoria sample and 76% of the Dartmouth sample were able to discontinue alprazolam therapy, remain abstinent of any type of treatment for panic disorder, and maintain their acute-treatment clinical gains over this follow-up period. The degree to which patients' anxiety sensitivity declined during treatment predicted relapse versus survival during the 1st 6 months of follow-up, when most relapses occurred. Implications of these findings for benzodiazepine discontinuation, combined pharmacotherapy and psychotherapy, and relapse prevention in panic disorder are discussed.

  19. Predicting rapid response to cognitive-behavioural treatment for panic disorder: the role of hippocampus, insula, and dorsolateral prefrontal cortex.

    PubMed

    Reinecke, Andrea; Thilo, Kai; Filippini, Nicola; Croft, Alison; Harmer, Catherine J

    2014-11-01

    Although cognitive-behavioural therapy (CBT) is an effective first-line intervention for anxiety disorders, treatments remain long and cost-intensive, difficult to access, and a subgroup of patients fails to show any benefits at all. This study aimed to identify functional and structural brain markers that predict a rapid response to CBT. Such knowledge will be important to establish the mechanisms underlying successful treatment and to develop more effective, shorter interventions. Fourteen unmedicated patients with panic disorder underwent 3 T functional and structural magnetic resonance imaging (MRI) before receiving four sessions of exposure-based CBT. Symptom severity was measured before and after treatment. During functional MRI, patients performed an emotion regulation task, either viewing negative images naturally, or intentionally down-regulating negative affect by using previously taught strategies of cognitive reappraisal. Structural MRI images were analysed including left and right segmentation and volume estimation. Improved response to brief CBT was predicted by increased pre-treatment activation in bilateral insula and left dorsolateral prefrontal cortex (dlPFC) during threat processing, as well as increased right hippocampal gray matter volume. Previous work links these regions to improved threat processing and fear memory activation, suggesting that the activation of such mechanisms is crucial for exposure-based CBT to be effective.

  20. [Somatoform disorders in children and adolescents].

    PubMed

    Konichezky, Andres; Gothelf, Doron

    2011-02-01

    Somatoform disorders among children and adolescents may cause impairment in educational and social functioning and generate a great deal of psychosocial distress. The diagnosis of such disorders is complex due to the fact that they may appear as medical conditions. Hence, most of somatoform patients do not seek psychiatric assistance. The common feature of somatoform disorders as described in DSM-IV-TR is the presence of physical symptoms suggesting an underlying medical condition that is either not found or does not account for the level of functional impairment. The diagnostic criteria for the somatoform disorders were established for adults and are applied to children for lack of child-specific research base and a developmentally appropriate alternative system. The most common somatoform disorders in children and adolescents are recurrent abdominal pain and tension headache. Other disorders in the category include: somatization disorder, undifferentiated somatoform disorder, conversion disorder, hypochondriasis and body dysmorphic disorder Treatment is applied through a combination of pharmacotherapy and psychotherapy. SSRI'S are effective in somatoform disorders that have co-morbidity with anxiety and depression as well as in body dysmorphic disorder and hypochondriasis. Conversion disorder is usually treated with benzodiazepines and pain disorder with light analgesics, tricyclics and tegretol. In terms of psychotherapy, treatments most effective for somatoform disorders have been found to be cognitive-behavioral therapy, hypnosis and biofeedback. PMID:22164950

  1. Psychiatric Symptom Clusters as Risk Factors for Alcohol Use Disorders in Adolescence: A National Study

    PubMed Central

    Harford, Thomas C.; Yi, Hsiao-ye; Chen, Chiung M.; Grant, Bridget F.

    2015-01-01

    Background Few epidemiologic studies have examined a full range of adolescent psychiatric disorders in the general population. The association between psychiatric symptom clusters (PSCs) and DSM-IV alcohol use disorders (AUDs) among adolescents is not well understood. Methods This study draws upon the public-use data from the 2000 National Household Survey on Drug Abuse, including a study sample of 19,430 respondents ages 12 to 17. Logistic regression and exploratory structural equation modeling assess the associations between PSCs and DSM-IV AUDs by gender. The PSCs are based on brief screening scales devised from the Diagnostic Interview Schedule for Children Predictive Scales. Results Several PSCs were found to be significantly associated with DSM-IV AUDs, including separation anxiety, generalized anxiety, depression, oppositional defiant disorder, and conduct disorder among both genders, and panic disorder and obsessive compulsive disorder among females. Consistent with the literature, the analysis of PSCs yields three factors identical for both genders—two internalizing factors (fear and anxiety–misery) and one externalizing factor. Adolescents who scored higher on the externalizing factor tended to have higher levels of the AUD factor. Female adolescents who scored higher on the internalizing misery factor and lower on the internalizing fear factor also tended to have higher levels of the AUD factor. Conclusion The associations that we found between PSCs and AUDs among adolescents in this study are consistent with those found among adults in other studies, although gender may moderate associations between internalizing PSCs and AUDs. Our findings lend support to previous findings on the developmentally stable associations between disruptive behaviors and AUDs among adolescents as well as adults in the general population. PMID:26110378

  2. American Indian Adolescents and Disordered Eating

    ERIC Educational Resources Information Center

    Buser, Juleen K.

    2010-01-01

    School counselors play an important role in identifying and intervening with students struggling with disordered eating (e.g., Bardick et al., 2004). Research has shown that American Indian adolescents report higher rates of certain disordered eating behaviors than other racial groups. The literature on the prevalence and etiology of disordered…

  3. Risk of Substance Use Disorders in Adolescents with Bipolar Disorder

    ERIC Educational Resources Information Center

    Wilens, Timothy E.; Biederman, Joseph; Kwon, Anne; Ditterline, Jeffrey; Forkner, Peter; Moore, Hadley; Swezey, Allison; Snyder, Lindsey; Henin, Aude; Wozniak, Janet; Faraone, Stephen V.

    2004-01-01

    Objective: Previous work in adults and youths has suggested that juvenile onset bipolar disorder (BPD) is associated with an elevated risk of substance use disorders (SUD). Considering the public health importance of this issue, the authors now report on a controlled study of adolescents with and without BPD to evaluate the risk of SUD. Method:…

  4. The role of treatment delivery factors in exposure-based cognitive behavioral therapy for panic disorder with agoraphobia.

    PubMed

    Weck, Florian; Grikscheit, Florian; Höfling, Volkmar; Kordt, Anne; Hamm, Alfons O; Gerlach, Alexander L; Alpers, Georg W; Arolt, Volker; Kircher, Tilo; Pauli, Paul; Rief, Winfried; Lang, Thomas

    2016-08-01

    Treatment delivery factors (i.e., therapist adherence, therapist competence, and therapeutic alliance) are considered to be important for cognitive behavioral therapy (CBT) for panic disorder and agoraphobia (PD/AG). In the current study, four independent raters conducted process evaluations based on 168 two-hour videotapes of 84 patients with PD/AG treated with exposure-based CBT. Two raters evaluated patients' interpersonal behavior in Session 1. Two raters evaluated treatment delivery factors in Session 6, in which therapists provided the rationale for conducting exposure exercises. At the 6-month follow-up, therapists' adherence (r=0.54) and therapeutic alliance (r=0.31) were significant predictors of changes in agoraphobic avoidance behavior; therapist competence was not associated with treatment outcomes. Patients' interpersonal behavior in Session 1 was a significant predictor of the therapeutic alliance in Session 6 (r=0.17). The findings demonstrate that treatment delivery factors, particularly therapist adherence, are relevant to the long-term success of CBT for PD/AG. PMID:27235836

  5. Lifestyle Behaviours Add to the Armoury of Treatment Options for Panic Disorder: An Evidence-Based Reasoning

    PubMed Central

    Lambert, Rod

    2015-01-01

    This article presents an evidence-based reasoning, focusing on evidence of an Occupational Therapy input to lifestyle behaviour influences on panic disorder that also provides potentially broader application across other mental health problems (MHP). The article begins from the premise that we are all different. It then follows through a sequence of questions, examining incrementally how MHPs are experienced and classified. It analyses the impact of individual sensitivity at different levels of analysis, from genetic and epigenetic individuality, through neurotransmitter and body system sensitivity. Examples are given demonstrating the evidence base behind the logical sequence of investigation. The paper considers the evidence of how everyday routine lifestyle behaviour impacts on occupational function at all levels, and how these behaviours link to individual sensitivity to influence the level of exposure required to elicit symptomatic responses. Occupational Therapists can help patients by adequately assessing individual sensitivity, and through promoting understanding and a sense of control over their own symptoms. It concludes that present clinical guidelines should be expanded to incorporate knowledge of individual sensitivities to environmental exposures and lifestyle behaviours at an early stage. PMID:26095868

  6. Prevalence of Anxiety Disorders among Children and Adolescents in Iran: A Systematic Review

    PubMed Central

    Zarafshan, Hadi; Mohammadi, Mohammad-Reza

    2015-01-01

    Objective: We aimed to conduct a review to investigate the prevalence of anxiety disorders among Iranian children and adolescents. Method: We systematically reviewed the literature up to June 2014. We searched three Persian databases (Magiran, IranMedex and SID) and three English databases: PubMed, Scopus and PsycINFO. All original studies that investigated the current prevalence of anxiety in a sample of Iranian children and adolescents were entered into the study. All studies conducted on special samples or in special settings were excluded. By searching English databases, we obtained 124 original studies. After removing duplicate papers, 120 articles remained. In the next step, we screened the articles based on their title. In sum, 95 Persian and English articles had relevant titles. After screening based on the abstract and full text, 26 studies remained. After screening based on the full text, all selected studies were qualitatively assessed by two evaluators separately. Result: Twenty five studies were eligible and reported different types of anxiety disorders (i.e., generalized anxiety, separation anxiety, obsessive-compulsive disorder, phobias and panic disorder). The samples varied from 81 to 2996 among studies and their age range was 5 to 18 years. These studies were conducted in different cities of Iran. SCL-90 is a frequently used questionnaire. All anxiety disorders were mostly investigated with the prevalence rates ranging from 6.8% in Saravan to 85% in Bandar Abbas. OCD was the second common study with prevalence rates ranging from 1% in Tabriz to 11.9% in Gorgan. Conclusion: Our findings revealed considerable amount of anxiety disorder among Iranian children and adolescents. Given the fact that anxiety disorder has negative effects on the well-being and function of individuals and can lead to severe problems, this disorder should be considered in mental health programs designed for children and adolescents. PMID:26005473

  7. Narcissism--An Adolescent Disorder?

    ERIC Educational Resources Information Center

    Waddell, Margot

    2006-01-01

    This paper argues that the adolescent process needs to be accorded its own particularity of reference, especially where narcissism is concerned. The paper draws on literary and clinical examples to describe what is termed the "adolescent organisation". In many ways, this organisation reflects post-Kleinian theory of what constitutes narcissistic…

  8. Pharmacotherapy for substance abuse disorders in adolescence.

    PubMed

    Kaplan, Gabriel; Ivanov, Iliyan

    2011-02-01

    The public health effects of adolescent substance abuse disorders (SUD) reaches further than the immediate intoxicating effects. Medications play a limited role in the treatment of youth beyond addressing short-term symptoms but may improve longer-term outcomes for some patients. Given the potential devastating consequences of SUD, clinicians should become familiar with all available treatment options. This article reviews the pharmacotherapy for adolescent SUD to inform clinicians considering the use of this modality for selected groups of patients.

  9. Duloxetine-related panic attacks.

    PubMed

    Sabljić, Vladimir; Rakun, Radmir; Ružić, Klementina; Grahovac, Tanja

    2011-03-01

    Side-effects arising on the grounds of antidepressant administration pose as a substantial obstacle hindering successful depressive disorder treatment. Side-effects, especially those severe or those manifested through dramatic clinical presentations such as panic attacks, make the treatment far more difficult and shake patients' trust in both the treatment and the treating physician. This case report deals with a patient experiencing a moderately severe depressive episode, who responded to duloxetine treatment administered in the initial dose of 30 mg per day with as many as three panic attacks in two days. Upon duloxetine withdrawal, these panic attacks ceased as well. The patient continued tianeptine and alprazolam treatment during which no significant side-effects had been seen, so that she gradually recovered. Some of the available literature sources have suggested the possibility of duloxetine administration to the end of generalised anxiety disorder and panic attack treatment. However, they are outnumbered by the contributions reporting about duloxetine-related anxiety, aggressiveness and panic attacks. In line with the foregoing, further monitoring of each and every duloxetine-administered patient group needs to be pursued so as to be able to evaluate treatment benefits and weigh them against risks of anxiety or panic attack onset.

  10. Borderline personality disorder: study in adolescence.

    PubMed

    James, A; Berelowitz, M; Vereker, M

    1996-04-01

    The study of the presentation, symptomatology and family characteristics of an exclusively adolescent sample of patients with borderline personality disorder (BPD) was undertaken. Twenty-four cases of borderline personality disorder, 20 females, 4 males, identified using chart review and meeting the criteria of the Diagnostic Interview for Borderlines (DIB) and DSM III-R, were matched with psychiatric controls. Adolescents with borderline personality disorder were found to have high rates of affective symptomatology with Axis I diagnosis of major depressive disorder MDD (DSM-III-R), and high rates of interpersonal psychopathology, i.e., manipulation, devaluation, and a pervasive sense of boredom. The latter seem to be characteristic as for adults with borderline personality disorder. The families were particularly angry and volatile. PMID:9117533

  11. RGS2 ggenetic variation: association analysis with panic disorder and dimensional as well as intermediate phenotypes of anxiety.

    PubMed

    Hohoff, Christa; Weber, Heike; Richter, Jan; Domschke, Katharina; Zwanzger, Peter M; Ohrmann, Patricia; Bauer, Jochen; Suslow, Thomas; Kugel, Harald; Baumann, Christian; Klauke, Benedikt; Jacob, Christian P; Fritze, Jürgen; Bandelow, Borwin; Gloster, Andrew T; Gerlach, Alexander L; Kircher, Tilo; Lang, Thomas; Alpers, Georg W; Ströhle, Andreas; Fehm, Lydia; Wittchen, Hans-Ulrich; Arolt, Volker; Pauli, Paul; Hamm, Alfons; Reif, Andreas; Deckert, Jürgen

    2015-04-01

    Accumulating evidence from mouse models points to the G protein-coupled receptor RGS2 (regulator of G-protein signaling 2) as a promising candidate gene for anxiety in humans. Recently, RGS2 polymorphisms were found to be associated with various anxiety disorders, e.g., rs4606 with panic disorder (PD), but other findings have been negative or inconsistent concerning the respective risk allele. To further examine the role of RGS2 polymorphisms in the pathogenesis of PD, we genotyped rs4606 and five additional RGS2 tag single nucleotide polymorphisms (SNPs; rs16834831, rs10801153, rs16829458, rs1342809, rs1890397) in two independent PD samples, comprising 531 matched case/control pairs. The functional SNP rs4606 was nominally associated with PD when both samples were combined. The upstream SNP rs10801153 displayed a Bonferroni-resistant significant association with PD in the second and the combined sample (P = 0.006 and P = 0.017). We furthermore investigated the effect of rs10801153 on dimensional anxiety traits, a behavioral avoidance test (BAT), and an index for emotional processing in the respective subsets of the total sample. In line with categorical results, homozygous risk (G) allele carriers displayed higher scores on the Agoraphobic Cognitions Questionnaire (ACQ; P = 0.015) and showed significantly more defensive behavior during fear provoking situations (P = 0.001). Furthermore, significant effects on brain activation in response to angry (P = 0.013), happy (P = 0.042) and neutral faces (P = 0.032) were detected. Taken together, these findings provide further evidence for the potential role of RGS2 as a candidate gene for PD.

  12. [Bipolar disorder in childhood and adolescence].

    PubMed

    Fu-I, Lee

    2004-10-01

    Many advances in the knowledge of childhood- and adolescent-onset bipolar disorder have been seen over the last 15 years. Current efforts focus on investigating clinical features, developing more instruments for early diagnosis and improving treatment research. The present study aims to present the main clinical characteristic of the disorder in children and adolescents, as well as the nomenclature, description of clinical phenotypes and the most common cycling pattern in youths. A discussion of comorbidity, differential diagnosis and advances in psychopharmacological treatment will also be presented.

  13. Borderline Personality Disorder in Suicidal Adolescents

    PubMed Central

    Yen, Shirley; Gagnon, Kerry; Spirito, Anthony

    2015-01-01

    The diagnosis of Borderline Personality Disorder (BPD) in adolescents has been controversial. Thus, few studies have examined BPD in suicidal adolescents, even though it is strongly associated with suicidal behaviors in adults. This study examines differences between suicidal adolescents with (n=47) and without (n=72) BPD on history and characteristics of suicidal behavior, Axis I comorbidity, affect regulation, and aggression. Assessments were completed with both adolescents and parents, and consensus ratings based on best available data were analyzed. BPD participants were more likely to have a past history of suicide attempts and to have been admitted due to a suicide attempt (vs. suicidal ideation). There were no significant differences in self-injurious behaviors or degree of suicidal ideation. BPD participants also had more psychiatric comorbidity and higher aggression scores, but no significant differences in affective dysregulation compared to suicidal adolescents without BPD. Diagnostic stability over 6 months was modest. Our results demonstrate that compared to other acutely suicidal adolescents, the clinical profile of BPD participants is unique and suggests an increased risk for suicidal behaviors. This extends upon other studies which support the construct validity of BPD during adolescence and suggests that BPD should be considered in suicide risk assessment for adolescents. PMID:24343935

  14. Early-life risk factors for panic and separation anxiety disorder: insights and outstanding questions arising from human and animal studies of CO2 sensitivity.

    PubMed

    Battaglia, Marco; Ogliari, Anna; D'Amato, Francesca; Kinkead, Richard

    2014-10-01

    Genetically informative studies showed that genetic and environmental risk factors act and interact to influence liability to (a) panic disorder, (b) its childhood precursor separation anxiety disorder, and (c) heightened sensitivity to CO2, an endophenotype common to both disorders. Childhood adversities including parental loss influence both panic disorder and CO2 hypersensitivity. However, childhood parental loss and separation anxiety disorder are weakly correlated in humans, suggesting the presence of alternative pathways of risk. The transferability of tests that assess CO2 sensitivity - an interspecific quantitative trait common to all mammals - to the animal laboratory setting allowed for environmentally controlled studies of early parental separation. Animal findings paralleled those of human studies, in that different forms of early maternal separation in mice and rats evoked heightened CO2 sensitivity; in mice, this could be explained by gene-by-environment interactional mechanisms. While several questions and issues (including obvious divergences between humans and rodents) remain open, parallel investigations by contemporary molecular genetic tools of (1) human longitudinal cohorts and (2) animals in controlled laboratory settings, can help elucidate the mechanisms beyond these phenomena. PMID:24793177

  15. Is There Room for Second-Generation Antipsychotics in the Pharmacotherapy of Panic Disorder? A Systematic Review Based on PRISMA Guidelines

    PubMed Central

    Perna, Giampaolo; Alessandra, Alciati; Raffaele, Balletta; Elisa, Mingotto; Giuseppina, Diaferia; Paolo, Cavedini; Maria, Nobile; Daniela, Caldirola

    2016-01-01

    A role for second-generation antipsychotics (SGAs) in the treatment of panic disorders (PD) has been proposed, but the actual usefulness of SGAs in this disorder is unclear. According to the PRISMA guidelines, we undertook an updated systematic review of all of the studies that have examined, in randomized controlled trials, the efficacy and tolerability of SGAs (as either monotherapy or augmentation) in the treatment of PD, with or without other comorbid psychiatric disorders. Studies until 31 December 2015 were identified through PubMed, PsycINFO, Embase, Cochrane Library and Clinical trials.gov. Among 210 studies, five were included (two involving patients with a principal diagnosis of PD and three involving patients with bipolar disorder with comorbid PD or generalized anxiety disorder). All were eight-week trials and involved treatments with quetiapine extended release, risperidone and ziprasidone. Overall, a general lack of efficacy of SGAs on panic symptoms was observed. Some preliminary indications of the antipanic effectiveness of risperidone are insufficient to support its use in PD, primarily due to major limitations of the study. However, several methodological limitations may have negatively affected all of these studies, decreasing the validity of the results and making it difficult to draw reliable conclusions. Except for ziprasidone, SGAs were well tolerated in these short-term trials. PMID:27089322

  16. Early-life risk factors for panic and separation anxiety disorder: insights and outstanding questions arising from human and animal studies of CO2 sensitivity.

    PubMed

    Battaglia, Marco; Ogliari, Anna; D'Amato, Francesca; Kinkead, Richard

    2014-10-01

    Genetically informative studies showed that genetic and environmental risk factors act and interact to influence liability to (a) panic disorder, (b) its childhood precursor separation anxiety disorder, and (c) heightened sensitivity to CO2, an endophenotype common to both disorders. Childhood adversities including parental loss influence both panic disorder and CO2 hypersensitivity. However, childhood parental loss and separation anxiety disorder are weakly correlated in humans, suggesting the presence of alternative pathways of risk. The transferability of tests that assess CO2 sensitivity - an interspecific quantitative trait common to all mammals - to the animal laboratory setting allowed for environmentally controlled studies of early parental separation. Animal findings paralleled those of human studies, in that different forms of early maternal separation in mice and rats evoked heightened CO2 sensitivity; in mice, this could be explained by gene-by-environment interactional mechanisms. While several questions and issues (including obvious divergences between humans and rodents) remain open, parallel investigations by contemporary molecular genetic tools of (1) human longitudinal cohorts and (2) animals in controlled laboratory settings, can help elucidate the mechanisms beyond these phenomena.

  17. Panic Disorder is Associated with the Serotonin Transporter Gene (SLC6A4) But Not the Promoter Region (5-HTTLPR)

    PubMed Central

    Strug, Lisa J.; Suresh, Rathi; Fyer, Abby; Talati, Ardesheer; Adams, Philip B.; Li, Weili; Hodge, Susan E.; Gilliam, T. Conrad; Weissman, Myrna M.

    2008-01-01

    Panic disorder (PD) and social anxiety disorder (SAD) are moderately heritable anxiety disorders. We analyzed five genes, derived from pharmacological or translational mouse models, in a new case-control study of PD and SAD in European Americans: (1) the serotonin transporter (SLC6A4), (2) the serotonin receptor 1A (HTR1A), (3) catechol-o-methyltransferase (COMT), (4) a regulator of g-protein signalling, RGS2, and (5) the gastrin releasing peptide receptor (GRPR). Cases were interviewed using the Schedule for Affective disorders and Schizophrenia (SADS-LA-IV) and were required to have a probable or definite lifetime diagnosis of PD (N = 179), SAD (161) or both (140), with first onset by age 31 and a family history of anxiety. Final diagnoses were determined using the best estimate procedure, blind to genotyping data. Controls were obtained from the NIMH Human Genetics Initiative; only subjects above 25 years of age who screened negative for all psychiatric symptoms were included (N = 470). A total of 45 SNPs were successfully genotyped over the 5 selected genes using Applied Biosystems SNPlex protocol. SLC6A4 provided strong and consistent evidence of association with the PD and PD+SAD groups, with the most significant association in both groups being at rs140701 (χ2=10.72, p=0.001 with PD and χ2=8.59, p=0.003 in the PD+SAD group). This association remained significant after multiple test correction. Those carrying at least one copy of the haplotype A-A-G constructed from rs3794808, rs140701 and rs4583306 have 1.7 times the odds of PD than those without the haplotype (90%CI 1.2-2.3). The SAD only group did not provide evidence of association, suggesting a PD driven association. The findings remained after adjustment for age and sex, and there was no evidence that the association was due to population stratification. The promoter region of the gene, 5-HTTLPR, did not provide any evidence of association, regardless of whether analyzed as a triallelic or biallelic

  18. An Application of Functional Analytic Psychotherapy in a Case of Anxiety Panic Disorder without Agoraphobia

    ERIC Educational Resources Information Center

    Bermudez, Miguel Angel Lopez; Garcia, Rafael Ferro; Calvillo, Manuel

    2010-01-01

    Traditional methods of diagnosis are of little therapeutic use when diagnostic criteria are based upon topographical rather than functional aspects of behavior. Also, this sentence in the original seemed rather awkward and a bit unclear. In contrast to this, several authors have put forward experience avoidance disorders as an alternative which…

  19. Empathic Accuracy in Adolescents with Autism Spectrum Disorders and Adolescents with Attention-Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Demurie, Ellen; De Corel, Maaike; Roeyers, Herbert

    2011-01-01

    In research on theory of mind (ToM) in individuals with an autism spectrum disorder (ASD) mainly static mind-reading tasks were used. In this study both a static (Eyes Test) and a more naturalistic (empathic accuracy task) ToM measure were used to investigate the perspective taking abilities of adolescents with ASD (n = 13), adolescents with…

  20. Reduced Anterior Temporal and Hippocampal Functional Connectivity During Face Processing Discriminates Individuals with Social Anxiety Disorder from Healthy Controls and Panic Disorder, and Increases Following Treatment

    PubMed Central

    Pantazatos, Spiro P; Talati, Ardesheer; Schneier, Franklin R; Hirsch, Joy

    2014-01-01

    Group functional magnetic resonance imaging (fMRI) studies suggest that anxiety disorders are associated with anomalous brain activation and functional connectivity (FC). However, brain-based features sensitive enough to discriminate individual subjects with a specific anxiety disorder and that track symptom severity longitudinally, desirable qualities for putative disorder-specific biomarkers, remain to be identified. Blood oxygen level-dependent (BOLD) fMRI during emotional face perceptual tasks and a new, large-scale and condition-dependent FC and machine learning approach were used to identify features (pair-wise correlations) that discriminated patients with social anxiety disorder (SAD, N=16) from controls (N=19). We assessed whether these features discriminated SAD from panic disorder (PD, N=16), and SAD from controls in an independent replication sample that performed a similar task at baseline (N: SAD=15, controls=17) and following 8-weeks paroxetine treatment (N: SAD=12, untreated controls=7). High SAD vs HCs discrimination (area under the ROC curve, AUC, arithmetic mean of sensitivity and specificity) was achieved with two FC features during unattended neutral face perception (AUC=0.88, P<0.05 corrected). These features also discriminated SAD vs PD (AUC=0.82, P=0.0001) and SAD vs HCs in the independent replication sample (FC during unattended angry face perception, AUC=0.71, P=0.01). The most informative FC was left hippocampus-left temporal pole, which was reduced in both SAD samples (replication sample P=0.027), and this FC increased following the treatment (post>pre, t(11)=2.9, P=0.007). In conclusion, SAD is associated with reduced FC between left temporal pole and left hippocampus during face perception, and results suggest promise for emerging FC-based biomarkers for SAD diagnosis and treatment effects. PMID:24084831

  1. Eating Disorders in Paraguayan Adolescents

    ERIC Educational Resources Information Center

    Ramirez, Maria E.; McIntosh, David E.; Kruczek, Theresa

    2013-01-01

    Eating disorders, once thought to be exclusively a disorder of the more affluent Western countries, are now spreading around the world. Despite the wealth of information on the prevalence of eating disorders in developed countries, epidemiological data for South America is scarce. The 26-item Eating Attitude Test (EAT-26) was used to explore the…

  2. Evaluation of the effects of venlafaxine and pregabalin on the carbon dioxide inhalation models of Generalised Anxiety Disorder and panic.

    PubMed

    Diaper, Alison; Osman-Hicks, Victoria; Rich, Ann S; Craig, Kevin; Dourish, Colin T; Dawson, Gerard R; Nutt, David J; Bailey, Jayne E

    2013-02-01

    Previous studies have shown that subjective and objective symptoms of anxiety induced by 7.5% CO(2) inhalation can be attenuated by anxiolytics such as lorazepam and, to a lesser extent, paroxetine. Venlafaxine and pregabalin, two other licensed treatments for Generalised Anxiety Disorder, were used to further investigate the 7.5% and 35% CO(2) models of anxiety in healthy volunteers. Fifty-four participants were randomised to receive either placebo, venlafaxine or pregabalin. Study treatments were dosed incrementally over a three week period, to reach daily doses of 150 mg venlafaxine and 200mg pregabalin by the CO(2) challenge test day. Participants inhaled air 7.5% CO(2) for 20 minutes (single-blind presentation), and a non-blinded single vital capacity of 35% CO(2). Subjective ratings were recorded before and after each inhalation. Both 7.5% and 35% CO(2) inhalations produced the expected effects of increased ratings of symptoms of panic and anxiety, with increased blood pressure and heart rate. No significant treatment effects were found, although there were trends towards a reduction in feeling tense and nervous by both drugs compared with placebo during the 7.5% CO(2) challenge, and a reduction in alertness generally in the venlafaxine group compared with the pregabalin group. In contrast with the clear anxiolytic effects of benzodiazepines reported in several previous CO(2) studies, these findings suggest that the anxiogenic effects of CO(2) challenges are not significantly influenced by these serotonergic and GABAergic anxiolytics. This may be due to a lack of sensitivity of the CO(2) challenges in healthy volunteers to these drug types.

  3. Adolescent Post-Traumatic Stress Disorder

    ERIC Educational Resources Information Center

    Yule, William

    2003-01-01

    Based on over a decade of work in the area of PTSD, including a longitudinal study of PTSD among adolescents, Dr. Yule provides an introduction to post-traumatic stress disorder as it occurs in youth. This includes a look at the manifestations of stress reactions, the incidence and prevalence of PTSD, and the relationship between levels of…

  4. Recurrence of Panic Attacks after Influenza Vaccination: Two Case Reports

    PubMed Central

    Kim, Han-Joon; Jeon, Sang-Won; Yoon, Ho-Kyoung

    2016-01-01

    Human influenza is a contagious respiratory illness caused by the influenza virus. The influenza vaccination is recommended annually, but several adverse effects related to allergic reactions have been reported. Panic attacks are also known to occur, but no case of a panic attack adverse effect has been reported in South Korea. We present two cases of panic disorder patients whose symptoms were aggravated by the influenza vaccination. We assumed that dysregulation of T-lymphocytes in panic disorder patients could have a role in activating various kinds of cytokines and chemokines, which then can lead to panic attack aggravation. PMID:27776395

  5. D-cycloserine does not improve but might slightly speed up the outcome of in-vivo exposure therapy in patients with severe agoraphobia and panic disorder in a randomized double blind clinical trial.

    PubMed

    Siegmund, Anja; Golfels, Fabian; Finck, Claudia; Halisch, Anna; Räth, Daniela; Plag, Jens; Ströhle, Andreas

    2011-08-01

    D-cycloserine (DCS)-augmented exposure therapy has proven efficacy in the treatment of acrophobia, social phobia, panic disorder and OCD. Here we studied whether DCS can also improve the effect of cognitive behavioral therapy (CBT) in patients with agoraphobia and panic disorder. To this end, 39 patients with the diagnoses of agoraphobia and panic disorder were treated with 11 sessions of CBT including three individual in-vivo exposure sessions (flooding), augmented with either 50mg of DCS (N=20) or placebo (N=19) in a randomized double blind design. Primary outcome was the total score of the panic and agoraphobia scale. Both groups profited considerably from therapy and DCS did not significantly improve this outcome (p=0.475; η(2)p = 0.01). However, there was a statistical trend (p=0.075; η(2)p = 0.17) in the more severely ill patients that DCS accelerated symptom reduction in the primary outcome at post-therapy. No serious adverse effects occurred during the trial. We conclude that in patients with agoraphobia and panic disorder, DCS seems to lack an additional benefit to efficient cbt, probably due to a floor effect. Nonetheless, the acceleration of symptom reduction in severely ill patients might represent a valuable treatment option deserving further investigation.

  6. Obstetric management of adolescents with bleeding disorders.

    PubMed

    James, Andra H

    2010-12-01

    Adolescents with bleeding disorders who become pregnant must contend with the dual challenges of their bleeding disorder and their pregnancy. Adolescents are more likely to terminate a pregnancy than adult women, and when they do carry a pregnancy, they are more likely to deliver prematurely. Otherwise, they are at risk for the same complications that adult women with bleeding disorders experience, particularly bleeding complications postpartum. Since one half to two thirds of adolescent pregnancies are unplanned, issues related to reproduction should be addressed during routine visits with the pediatrician, hematologist or gynecologist. Girls who are at risk of being carriers for hemophilia A and B, severe von Willebrand disease, and other severe bleeding disorders should have their bleeding disorder status determined before they become pregnant. During pregnancy, a plan should be established to ensure that both mother and fetus deliver safely. Young women at risk for severe bleeding or at risk of having a severely affected infant should be referred for prenatal care and delivery to a center where, in addition to specialists in high-risk obstetrics, there is a hemophilia treatment center or a hematologist with expertise in hemostasis. Prior to delivery or any invasive procedures, young women at risk for severe bleeding should receive prophylaxis. Since administration of desmopressin may result in hyponatremia, whenever available, virally inactivated or recombinant clotting factor concentrates should be used for replacement as opposed to fresh frozen plasma or cryoprecipitate.

  7. Brain Structure Abnormalities in Adolescent Girls with Conduct Disorder

    ERIC Educational Resources Information Center

    Fairchild, Graeme; Hagan, Cindy C.; Walsh, Nicholas D.; Passamonti, Luca; Calder, Andrew J.; Goodyer, Ian M.

    2013-01-01

    Background: Conduct disorder (CD) in female adolescents is associated with a range of negative outcomes, including teenage pregnancy and antisocial personality disorder. Although recent studies have documented changes in brain structure and function in male adolescents with CD, there have been no neuroimaging studies of female adolescents with CD.…

  8. Interpersonal influences on late adolescent girls' and boys' disordered eating.

    PubMed

    Shomaker, Lauren B; Furman, Wyndol

    2009-04-01

    Perceived socio-cultural pressure to be thin has an important impact on disordered eating during early and middle adolescence, but less is known about late adolescence. Most prospective studies included only girls, and less is known about the influence on boys. This study investigated interpersonal influences on changes in late adolescent boys' and girls' symptoms of disordered eating over one year. Participants were a community sample of late adolescents 16-19 years of age (N=199; 49.75% girls), their mothers, and friends. Structural equation modeling revealed that interpersonal pressure to be thin and criticism about appearance predicted increases in disordered eating over time. Late adolescents', mothers' and friends' reports of pressure were associated with disordered eating at Time 1 and Time 2. Further, adolescents' perceptions and friends' reports of pressure to be thin predicted changes in disordered eating over time. Findings underscore the significance of interpersonal relationships for disordered eating during late adolescence in both girls and boys.

  9. THE PANIC ATTACK–PTSD MODEL: APPLICABILITY TO ORTHOSTATIC PANIC AMONG CAMBODIAN REFUGEES

    PubMed Central

    Hinton, Devon E.; Hofmann, Stefan G.; Pitman, Roger K.; Pollack, Mark H.; Barlow, David H.

    2009-01-01

    This article examines the ability of the “Panic Attack–PTSD Model” to predict how panic attacks are generated and how panic attacks worsen posttraumatic stress disorder (PTSD). The article does so by determining the validity of the Panic Attack–PTSD Model in respect to one type of panic attacks among traumatized Cambodian refugees: orthostatic panic (OP) attacks, that is, panic attacks generated by moving from lying or sitting to standing. Among Cambodian refugees attending a psychiatric clinic, we conducted two studies to explore the validity of the Panic Attack–PTSD Model as applied to OP patients, meaning patients with at least one episode of OP in the previous month. In Study 1, the “Panic Attack–PTSD Model” accurately indicated how OP is seemingly generated: among OP patients (N = 58), orthostasis-associated flashbacks and catastrophic cognitions predicted OP severity beyond a measure of anxious–depressive distress (SCL subscales), and OP severity significantly mediated the effect of anxious–depressive distress on CAPS severity. In Study 2, as predicted by the Panic Attack–PTSD Model, OP had a mediational role in respect to the effect of treatment on PTSD severity: among Cambodian refugees with PTSD and comorbid OP who participated in a CBT study (N = 56), improvement in PTSD severity was partially mediated by improvement in OP severity. PMID:18470741

  10. Taking an RDoC lens to the study of panic disorder: A commentary on Hamm et al. and other thoughts on RDoC.

    PubMed

    Shankman, Stewart A; Katz, Andrea C; Langenecker, Scott A

    2016-03-01

    The Research Domain Criteria (RDoC) initiative put forth by the National Institute of Mental Health represents an exciting new framework in which to study psychopathology. The article by Hamm et al. (2016) is an interesting application of an "RDoC lens" toward a program of research on panic disorder. This commentary highlights the many strengths of the Hamm et al. (2016) study-most notably the article's application of a well-studied animal model of anxiety (Fanselow's, , threat imminence model) to humans, utilization of an interesting behavioral paradigm (as an analog for avoidance behaviors in panic disorder), and using RDoC to examine predictors of treatment response. This commentary also discusses several questions about RDoC that arise out of Hamm et al. For example, (a) How should participants be selected for RDoC studies? (b) Are RDoC constructs risk factors (and risk factors for what)? (c) Besides Hamm et al.'s, approach, how else can RDoC be used in treatment studies? In sum, Hamm et al. is a very good example of an RDoC study, and in this early phase of the initiative, more examples for how the approach plays out are needed.

  11. Taking an RDoC lens to the study of panic disorder: A commentary on Hamm et al. and other thoughts on RDoC.

    PubMed

    Shankman, Stewart A; Katz, Andrea C; Langenecker, Scott A

    2016-03-01

    The Research Domain Criteria (RDoC) initiative put forth by the National Institute of Mental Health represents an exciting new framework in which to study psychopathology. The article by Hamm et al. (2016) is an interesting application of an "RDoC lens" toward a program of research on panic disorder. This commentary highlights the many strengths of the Hamm et al. (2016) study-most notably the article's application of a well-studied animal model of anxiety (Fanselow's, , threat imminence model) to humans, utilization of an interesting behavioral paradigm (as an analog for avoidance behaviors in panic disorder), and using RDoC to examine predictors of treatment response. This commentary also discusses several questions about RDoC that arise out of Hamm et al. For example, (a) How should participants be selected for RDoC studies? (b) Are RDoC constructs risk factors (and risk factors for what)? (c) Besides Hamm et al.'s, approach, how else can RDoC be used in treatment studies? In sum, Hamm et al. is a very good example of an RDoC study, and in this early phase of the initiative, more examples for how the approach plays out are needed. PMID:26877121

  12. [Menstrual cycle disorders in adolescence].

    PubMed

    Escobar, María E; Pipman, Viviana; Arcari, Andrea; Boulgourdjian, Elisabeth; Keselman, Ana; Pasqualini, Titania; Alonso, Guillermo; Blanco, Miguel

    2010-08-01

    The high prevalence of menstrual disorders during the first years after menarche is well recognized. This is usually a cause of concern for parents and patients, and a common reason for visiting the pediatrician. The immaturity of the hypothalamic-pituitary-ovarian axis is the major cause of these disorders, but there are also some general organic or emotional conditions that may alter the menstrual cycle, which is a sensitive indicator of health. Physiology of the menstrual cycle, its alterations, etiology, assessment, diagnosis and treatment are reviewed in this article.

  13. 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…

  14. Expected versus unexpected panic attacks: a naturalistic prospective study.

    PubMed

    Kenardy, J; Taylor, C B

    1999-01-01

    The purpose of this study was to identify factors that are associated with expectation of panic attacks as well as to validate the hypothesized tendency to identify false (panic) alarms in panic disorder. Ten women with panic disorder were assessed naturalistically using computer-assisted self-monitoring. This allowed for prospective assessment of expected versus unexpected panic attacks. Expectation of panic attacks was associated with panic occurrence, as well as elevated sense of threat or danger, anxiety, helplessness, avoidance, distress about physical symptoms, physical sensations, and catastrophic thoughts prior to the attack. In general, the state measured prior to unexpected attacks did not differ from ongoing nonpanic state. Furthermore, none of the variables measured during the attacks were able to distinguish unexpected attacks from expected attacks.

  15. Mental Health Disorders. Adolescent Health Highlight. Publication #2013-1

    ERIC Educational Resources Information Center

    Murphey, David; Barry, Megan; Vaughn, Brigitte

    2013-01-01

    Mental disorders are diagnosable conditions characterized by changes in thinking, mood, or behavior (or some combination of these) that can cause a person to feel stressed out and impair his or her ability to function. These disorders are common in adolescence. This "Adolescent Health Highlight" presents the warning signs of mental disorders;…

  16. Gestational risks and psychiatric disorders among indigenous adolescents.

    PubMed

    Whitbeck, Les B; Crawford, Devan M

    2009-02-01

    This study reports on the effects maternal prenatal binge drinking, cigarette smoking, drug use, and pregnancy and birth complications on meeting criteria for psychiatric disorders at ages 10-12 and 13-15 years among 546 Indigenous adolescents from a single culture in the northern Midwest and Canada. Adolescent DSM-IV psychiatric disorders were assessed with the Diagnostic Interview Schedule for Children-Revised (DISC-R). Results indicate that maternal behaviors when pregnant have significant effects on adolescent psychiatric disorders even when controlling for age and gender of adolescent, family per capita income, living in a single mother household, and adolescent reports of mother's positive parenting.

  17. Assessment of Defense Styles and Mechanisms in Iranian Patients Suffering from Obsessive Compulsive or Panic Disorders versus Normal Controls using Persian Version of Defense Style Questionnaire-40

    PubMed Central

    Shabanpour, Ruhollah; Zahiroddin, Ali Reza; Janbozorgi, Masoud

    2012-01-01

    Objective The aim of this study was to compare defense styles and mechanisms in adult patients suffering from obsessive-compulsive disorder (OCD), and panic disorder (PD) with normal subjects in Iran. Methods Defensive patterns of 22 patients with OCD, 28 patients with PD and those of 116 normal individuals (as a control group) were assessed using the Farsi version of Defense Style Questionnaire-40 (DSQ-40). The content validity of this questionnaire was done prior to the initiation of the present study. Results Both groups of patients with OCD or PD used more immature and less mature styles compared to the control group. No significant difference was observed in the use of neurotic style between the two groups. Conclusion It is suggested that immature defenses may have an important role in the pathogenesis of OCD and PD. PMID:23056115

  18. Smoking Behavior and Alcohol Consumption in Individuals With Panic Attacks

    PubMed Central

    Mathew, Amanda R.; Norton, Peter J.; Zvolensky, Michael J.; Buckner, Julia D.; Smits, Jasper A. J.

    2011-01-01

    Individuals with anxiety often report greater smoking and drinking behaviors relative to those without a history of anxiety. In particular, smoking and alcohol use have been directly implicated among individuals experiencing panic attacks, diagnosed with panic disorder, or high on panic-relevant risk factors such as anxiety sensitivity. Less is known, however, about specific features of panic that may differentiate among those who do or do not use cigarettes or alcohol. The purpose of the current study was to replicate previous research findings of an association between panic symptomatology, cigarette smoking, and alcohol consumption, as well as extend findings by examining whether specific symptoms of panic attacks differentiated among those who do or do not use cigarettes or alcohol. Participants (n = 489) completed the Panic Attack Questionnaire-IV, a highly detailed assessment of panic attacks and symptoms, as well as self-report measures of smoking history and alcohol use. Consistent with previous research, participants who reported a history of panic attacks (n = 107) were significantly more likely to report current daily or lifetime daily cigarette smoking, and significantly greater hazardous or harmful alcohol use than participants with no panic history (n = 382). Although smoking and hazardous alcohol use were highly associated regardless of panic status, participants with panic attacks showed elevated hazardous alcohol use after controlling for daily or lifetime smoking. Surprisingly, although participants who reported having had at least one panic attack were more likely to smoke, panic attack symptoms, intensity, or frequency did not differentiate panickers who did or did not smoke. Furthermore, panic-related variables were not shown to differentially relate to problematic drinking among panickers. Implications for understanding the complex relationship between panic attacks and smoking and drinking behaviors are discussed. PMID:21915160

  19. Treatment of Adolescent Substance Use Disorders

    PubMed Central

    Belendiuk, Katherine A.; Riggs, Paula

    2014-01-01

    Opinion statement Significant progress has been made in development and dissemination of evidence-based behavioral interventions for adolescents with substance use disorders (SUD). Medications have also shown promise in reducing substance use when used in conjunction with psychosocial treatment for adolescents with SUD, even in the context of co-occurring psychopathology. Although the efficacy or “probable efficacy” of the behavioral interventions discussed in this review have been established based on at least two randomized controlled trials, they produce relatively low abstinence rates and modest reductions in substance use that attenuate over time. Research has shown that abstinence rates may increase with the addition of abstinence-based incentives, however, post-treatment relapse rates remain high with few treated adolescents sustaining abstinence one year post-treatment. This may be due to the paucity of continuing care or post-treatment recovery support services and the lack of integrated or concurrent treatment for co-occurring psychiatric conditions that contribute to poorer treatment outcomes. Thus, despite significant progress, there is clearly room for improvement of existing treatment for adolescents with SUD. There is also critical need to increase the availability and access to substance and behavioral health treatment services for adolescents. Although 10–15% of U.S. high school students would currently meet diagnostic criteria for at least one SUD, only 10% of those who could benefit from substance treatment receive it. Five-year trends showing significant increases in the use of marijuana and nonmedical prescription drugs among U. S. high school students are evidence of the shortcomings of existing school-based interventions and poor access to community-based substance treatment for non-juvenile-justice involved youth. There is clearly a need to adapt or develop more effective prevention, early interventions, and treatment for youth who are

  20. Psychological Disorder in Adolescents and Adults with Asperger Syndrome.

    ERIC Educational Resources Information Center

    Tantam, Digby

    2000-01-01

    Discussion of psychological disorder in adolescents and adults with Asperger syndrome suggests that these individuals commonly develop a psychological disorder secondary to Asperger syndrome including affective disorders, anxiety-related disorders, and conduct disorders. Treatment usually involves a combination of psychoeducation, social change,…

  1. Interoceptive fear conditioning as a learning model of panic disorder: an experimental evaluation using 20% CO(2)-enriched air in a non-clinical sample.

    PubMed

    Acheson, Dean T; Forsyth, John P; Prenoveau, Jason M; Bouton, Mark E

    2007-10-01

    Despite the role afforded interoceptive fear conditioning in etiologic accounts of panic disorder, there are no good experimental demonstrations of such learning in humans. The aim of the present study was to evaluate the interoceptive conditioning account using 20% carbon dioxide (CO(2))-enriched air as an interoceptive conditioned stimulus (CS) (i.e., physiologically inert 5-s exposures) and unconditioned stimulus (US) (i.e., physiologically prepotent 15-s exposures). Healthy participants (N=42) were randomly assigned to one of three conditions: a CS-only, contingent CS-US pairings, or unpaired/non-contingent CS and US presentations. Electrodermal and self-report (e.g., distress, fear) served as indices of conditioned emotional responding. Results showed greater magnitude electrodermal and evaluative fear conditioning in the paired relative to the CS-only condition. The explicitly unpaired condition showed even greater electrodermal and evaluative responding during acquisition, and marked resistance to extinction. The latter results are consistent with the possibility that the unpaired procedure constituted a partial reinforcement procedure in which CO(2) onset was paired with more extended CO(2) exposure on 50% of the trials. Overall, the findings are consistent with contemporary learning theory accounts of panic.

  2. 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…

  3. Preventing Obesity and Eating Disorders in Adolescents.

    PubMed

    Golden, Neville H; Schneider, Marcie; Wood, Christine

    2016-09-01

    Obesity and eating disorders (EDs) are both prevalent in adolescents. There are concerns that obesity prevention efforts may lead to the development of an ED. Most adolescents who develop an ED did not have obesity previously, but some teenagers, in an attempt to lose weight, may develop an ED. This clinical report addresses the interaction between obesity prevention and EDs in teenagers, provides the pediatrician with evidence-informed tools to identify behaviors that predispose to both obesity and EDs, and provides guidance about obesity and ED prevention messages. The focus should be on a healthy lifestyle rather than on weight. Evidence suggests that obesity prevention and treatment, if conducted correctly, do not predispose to EDs. PMID:27550979

  4. Attributional Style in Clinically Depressed and Conduct Disordered Adolescents.

    ERIC Educational Resources Information Center

    Curry, John F.; Craighead, W. Edward

    1990-01-01

    Tested reformulated learned helplessness theory of depression with adolescent inpatients (N=63) diagnosed as depressed, conduct disordered, or both. Adolescents with major depressive diagnosis differed from nondepressed adolescents with significantly lower attributional style scores for positive events. Subjects who reported more severe depression…

  5. Neurocognitive Functioning in Adolescents with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Reinvall, Outi; Voutilainen, Arja; Kujala, Teija; Korkman, Marit

    2013-01-01

    There is a paucity of research studying comprehensive neurocognitive profiles of adolescents with higher functioning autism spectrum disorders (ASD). This study compared the neurocognitive profiles of higher functioning adolescents with ASD (n = 30, mean age 13.5) with that of typically developing adolescents (n = 30; mean age 13.7). Adolescents…

  6. Adolescent substance use disorders in the school setting.

    PubMed

    Yule, Amy M; Prince, Jefferson B

    2012-01-01

    Adolescent substance use is a major public health problem that concerns parents, schools, clinicians, and policy makers. The authors review school-based prevention programs, school drug policies, clinical signs and symptoms of substance impairment, recommendations for referral and engaging adolescents who are using substances, and treatment interventions for adolescent substance use disorders.

  7. Histories of Child Maltreatment and Psychiatric Disorder in Pregnant Adolescents

    ERIC Educational Resources Information Center

    Romano, Elisa; Zoccolillo, Mark; Paquette, Daniel

    2006-01-01

    Objective: The study investigated histories of child maltreatment and psychiatric disorder in a high-risk sample of pregnant adolescents. Method: Cross-sectional data were obtained for 252 pregnant adolescents from high school, hospital, and group home settings in Montreal (Canada). Adolescents completed a child maltreatment questionnaire and a…

  8. School Experiences of Adolescents with Attention-Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Wiener, Judith; Daniels, Lesley

    2016-01-01

    This article reports on a qualitative study of the school experiences of adolescents with attention-deficit/hyperactivity disorder (ADHD) in the context of quantitative research on teacher attitudes and practices, adolescent self-appraisals, and social and family relationships. Twelve adolescents with ADHD participated in in-depth, semistructured…

  9. Media Use among Adolescents with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Kuo, Melissa H.; Orsmond, Gael I.; Coster, Wendy J.; Cohn, Ellen S.

    2014-01-01

    This study explores how adolescents with autism spectrum disorder (ASD) use media, and the factors associated with their media use. A total of 91 adolescents with ASD and their parents completed mail-based surveys. In all, 78% of the adolescents with ASD watched television (approximately 2 h/day), and 98% used computers (approximately 5 h/day) on…

  10. 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,…

  11. School Climate and Continuity of Adolescent Personality Disorder Symptoms

    ERIC Educational Resources Information Center

    Kasen, Stephanie; Cohen, Patricia; Chen, Henian; Johnson, Jeffrey G.; Crawford, Thomas N.

    2009-01-01

    Background: Schools are key social contexts for shaping development and behavior in youths; yet, little is known of their influence on adolescent personality disturbance. Method: A community-based sample of 592 adolescents was assessed for family and school experiences, Axis I psychiatric disorders, and Axis II personality disorder (PD) symptoms,…

  12. Eating Disorders in a Nonclinical Adolescent Population: Implications for Treatment.

    ERIC Educational Resources Information Center

    Lachenmeyer, Juliana Rasic; Muni-Brander, Paulette

    1988-01-01

    Investigated prevalence of adolescent eating disorders across gender, cultural groupings, and socioeconomic status. Administered Eating Attitudes Test, Binge-Eating Questionnaire, and demographic questionnaire to 1,261 high school students. Results indicated high rate of eating disorders in nonclinical adolescent population. Eating disorders…

  13. A randomized, controlled clinical trial of standard, group and brief cognitive-behavioral therapy for panic disorder with agoraphobia: a two-year follow-up.

    PubMed

    Marchand, André; Roberge, Pasquale; Primiano, Sandra; Germain, Vanessa

    2009-12-01

    A randomized controlled clinical trial with a wait-list control group was conducted to examine the effectiveness of three modalities (brief, group, and standard) of cognitive-behavioral treatment (CBT) for panic disorder with agoraphobia. A total of 100 participants meeting DSM-IV criteria were randomly assigned to each treatment condition: a 14-session standard CBT (n=33), a 14-session group CBT (n=35) and a 7-session brief CBT (n=32). Participants received a self-study manual and were assigned weekly readings and exercises. The results indicate that regardless of the treatment condition, CBT for moderate to severe PDA is beneficial in medium and long term. To this effect, all three-treatment conditions significantly reduced the intensity of symptoms, increased participants' quality of life, offered high effect sizes, superior maintenance of gains over time, and lower rates of relapse, compared to the wait-list control. PMID:19709851

  14. [Analysis of the cost and the effectiveness of a psychotherapy for panic disorder with agoraphobia (PDA) versus a treatment combining pharmacotherapy and psychotherapy].

    PubMed

    Marchand, André; Germain, Vanessa; Reinharz, Daniel; Mainguy, Nicole; Landry, Pierre

    2004-01-01

    Pharmacotherapy and cognitive-behavioral therapy (CBT) are efficient treatments for Panic disorder with agoraphobia (PDA) yet they remain expensive. This study aims to compare the cost/effectiveness ratio of a CBT for PDA versus a combined treatment of CBT and pharmacotherapy. Eighty-four people followed a CBT either alone or combined with medication. They have been evaluated before treatment, immediately after, as well as one and two years later. The therapy efficacy is calculated at each assessment according to a "Global Functioning Index". Direct and indirect costs are calculated with the "Health Cost Interview". Results suggest that both treatments are equally effective. However, CBT alone is less expensive than CBT with pharmacotherapy. Thus, it offers a better cost-effectiveness ratio that even increases in the long term. PMID:15928793

  15. Considering Comorbidity in Adolescents with Social Anxiety Disorder

    PubMed Central

    Bonilla, Natalia; Muela-Martinez, Jose-Antonio

    2016-01-01

    Social anxiety disorder is a highly prevalent psychiatric disorder, with elevated comorbidity rates with other mental health disorders and may cause severe negative consequences. In adolescence, there is a lack of research on how comorbid disorders to social anxiety tends to form particular associations. With a large sample of adolescents with a clinical diagnosis of social anxiety disorder, data have revealed that certain disorders are more frequent and tend to dwell on concrete aggregates. Thus, it may be particularly useful and efficient for mental health providers, pediatricians and school counselors to screen for generalized anxiety disorder and specific phobia when assessing SAD in youth. Overall, findings stress the presence of comorbidity being the rule rather than the exception in adolescents with social anxiety disorder, and the need for further examination of its impact on assessment and differential diagnosis on this psychiatric disorder.

  16. Psychiatric Disorders in Iranian Children and Adolescents

    PubMed Central

    Mohammadi, Mohammad Reza; Salmanian, Maryam; Asadian-koohestani, Fatemeh; Ghanizadeh, Ahmad; Alavi, Ali; Malek, Ayyoub; Dastgiri, Saeed; Moharreri, Fatemeh; Hebrani, Paria; Arman, Soroor; Khoshhal Dastjerdi, Javad; Motavallian, Ali

    2016-01-01

    Objective: The aim of the present study was to investigate the epidemiology of psychiatric disorders in children and adolescents in five provinces of Iran: Tehran, Shiraz, Isfahan, Tabriz and Mashhad. Method: In the present study, we selected 9,636 children and adolescents aged 6–18 years through multistage cluster random sampling method from Tehran, Shiraz, Isfahan, Tabriz and Mashhad. We instructed the clinical psychologists to complete the Strengths and Difficulties Questionnaire (SDQ) for the participants, andthose who received a high score on SDQ, completed the Persian version of Kiddie-SADS-Present and Lifetime Version (K-SADS-PL). We used descriptive analysis and 95% confidence interval to investigate the relationship between scores of the K-SADS questionnaire and demographic factors. We used one-way ANOVA to test the significant differences among the disorders according to sex, age and province of residence. Results: Based on the results, oppositional defiant disorder (ODD) (4.45%) had the highest prevalence of psychiatric disorders in the five provinces and substance abuse and alcohol abuse (0%) had the lowest prevalence. In addition, attention deficit hyperactivity disorder (ADHD) had the most prevalence in boys (5.03%) and ODD had the most prevalence in girls (4.05%). Among the three age groups, 6 to 9 year olds had the highest rates of ADHD (5.69%); 10 to 14 and 15 to 18 year olds had the highest rates of ODD (4.32% and 4.37% respectively). Among the five provinces, Tehran and Mashhad allocated the highest rates of ODD; Isfahan and Shiraz had the highest rates of ADHD; and Tabriz had the highest rates of social phobia. Conclusion: The current study revealed that the overall frequency of psychiatric disorders based on Kiddie-SADS-Present and Lifetime Version (K-SADS-PL) was higher than a similar study. Moreover, in this study, among the five provinces, Tehran and Mashhad allocated the highest rates of ODD; Isfahan and Shiraz had the highest rates of

  17. Effective emotion regulation strategies improve fMRI and ECG markers of psychopathology in panic disorder: implications for psychological treatment action

    PubMed Central

    Reinecke, A; Filippini, N; Berna, C; Western, D G; Hanson, B; Cooper, M J; Taggart, P; Harmer, C J

    2015-01-01

    Impairments in emotion regulation are thought to have a key role in the pathogenesis of anxiety disorders, but the neurobiological underpinnings contributing to vulnerability remain poorly understood. It has been a long-held view that exaggerated fear is linked to hyperresponsivity of limbic brain areas and impaired recruitment of prefrontal control. However, increasing evidence suggests that prefrontal–cortical networks are hyperactive during threat processing in anxiety disorders. This study directly explored limbic–prefrontal neural response, connectivity and heart-rate variability (HRV) in patients with a severe anxiety disorder during incidental versus intentional emotion regulation. During 3 Tesla functional magnetic resonance imaging, 18 participants with panic disorder and 18 healthy controls performed an emotion regulation task. They either viewed negative images naturally (Maintain), or they were instructed to intentionally downregulate negative affect using previously taught strategies of cognitive reappraisal (Reappraisal). Electrocardiograms were recorded throughout to provide a functional measure of regulation and emotional processing. Compared with controls, patients showed increased neural activation in limbic–prefrontal areas and reduced HRV during incidental emotion regulation (Maintain). During intentional regulation (Reappraisal), group differences were significantly attenuated. These findings emphasize patients' ability to regulate negative affect if provided with adaptive strategies. They also bring prefrontal hyperactivation forward as a potential mechanism of psychopathology in anxiety disorders. Although these results challenge models proposing impaired allocation of prefrontal resources as a key characteristic of anxiety disorders, they are in line with more recent neurobiological frameworks suggesting that prefrontal hyperactivation might reflect increased utilisation of maladaptive regulation strategies quintessential for anxiety

  18. [GEITDAH consensus on conduct disorders in children and adolescents].

    PubMed

    Sasot-Llevadot, Jordi; Ibáñez-Bordas, Rosa M; Soto-López, Antonio; Montañés-Rada, Francisco; Gastaminza-Pérez, Xavier; Alda-Díez, José A; Cantó-Díez, Tomás; Catalá, Miguel A; Ferrin-Erdozáin, Maite; García-Giral, Marta; Graell-Bernal, Montserrat; Granada-Jiménez, Olvido; Herreros-Rodríguez, Óscar; Mardomingo-Sanz, María J; Mojarro-Práxedes, Dolores; Morey-Canyelles, Jaume; Ortiz-Guerra, Juan; Pàmies-Massana, Montserrat; Rey-Sánchez, Francisco; Romera-Torrens, María; Rubio-Morell, Belén; Ruiz-Lázaro, Pedro M; Ruiz-Sanz, Francisco

    2015-08-16

    In this paper, the Special Interest Group on Attention Deficit Hyperactivity Disorder (GEITDAH, from its name in Spanish) presents a consensus reached by experts from all over Spain on conduct disorders in children and adolescents. Following the initial work by the team at the Pedopsychiatry Unit at the Quiron-Teknon Hospital in Barcelona, agreements have been reached on a number of basic aspects that could be the starting point for future consensuses. A top priority aim of the work was also to update the criteria in the Diagnostic and statistical manual of mental disorders, fifth edition, for conduct disorders in children and adolescents, together with their comorbidity with attention deficit hyperactivity disorder.

  19. Defense mechanisms in adolescent conduct disorder and adjustment reaction.

    PubMed

    Cramer, Phebe; Kelly, Francis D

    2004-02-01

    The use of defense mechanisms by male and female adolescents with a diagnosis of conduct disorder was compared with the defense use of adolescents with a diagnosis of adjustment reaction. Because conduct disorder has been shown to be associated with a developmental lag in several areas of psychological functioning, we expected that these adolescents would show immaturity in the use of defenses. This expectation was confirmed. As compared with adjustment reaction, conduct disordered youths were more likely to use the immature defense of denial and less likely to use the mature defense of identification.

  20. Disordered Eating among Female Adolescents: Prevalence, Risk Factors, and Consequences

    ERIC Educational Resources Information Center

    Bryla, Karen Y.

    2003-01-01

    Disordered eating among American adolescent females represents a significant health issue in our current cultural climate. Disordered eating receives insufficient attention, however, due to the public's unfamiliarity with symptoms and consequences, absence of treatment options, and unreliable instrumentation to detect disordered eating. Disordered…

  1. Family Functioning and the Course of Adolescent Bipolar Disorder

    ERIC Educational Resources Information Center

    Sullivan, Aimee E.; Judd, Charles M.; Axelson, David A.; Miklowitz, David J.

    2012-01-01

    The symptoms of bipolar disorder affect and are affected by the functioning of family environments. Little is known, however, about the stability of family functioning among youth with bipolar disorder as they cycle in and out of mood episodes. This study examined family functioning and its relationship to symptoms of adolescent bipolar disorder,…

  2. EFFECTS OF MATERNAL DEPRESSION AND PANIC DISORDER ON MOTHER–INFANT INTERACTIVE BEHAVIOR IN THE FACE-TO-FACE STILL-FACE PARADIGM

    PubMed Central

    Weinberg, M. Katherine; Beeghly, Marjorie; Olson, Karen L.; Tronick, Edward

    2011-01-01

    The present study evaluated the interactive behavior of three groups of mothers and their 3-month-old infants in the Face-to-Face Still-Face paradigm. The mothers had either a clinical diagnosis of major depressive disorder (MDD, n = 33) with no comorbidity, a clinical diagnosis of panic disorder (PD, n = 13) with no comorbidity, or no clinical diagnosis (n = 48). The sample was selected to be at otherwise low social and medical risk, and all mothers with PD or MDD were in treatment. The findings indicated that (a) infants of mothers with PD or MDD displayed the traditional still-face and reunion effects described in previous research with nonclinical samples; (b) the 3-month-old infants in this study showed similar, but not identical, gender effects to those described for older infants; and (c) there were no patterns of maternal or infant interactive behavior that were unique to the PD, MDD, or control groups. These results are discussed in light of mothers’ risk status, receipt of treatment, severity of illness, and comorbidity of PD and MDD. PMID:21731149

  3. Does Maintenance CBT Contribute to Long-Term Treatment Response of Panic Disorder With or Without Agoraphobia? A Randomized Controlled Clinical Trial

    PubMed Central

    White, Kamila S.; Payne, Laura A.; Gorman, Jack M.; Shear, M. Katherine; Woods, Scott W.; Saksa, John R.; Barlow, David H.

    2012-01-01

    Objective To examine the possibility that maintenance cognitive behavior therapy (M–CBT) may improve the likelihood of sustained improvement and reduced relapse in a multi-site randomized controlled clinical trial of patients who met criteria for panic disorder with or without agoraphobia. Method Participants were all patients (N = 379) who first began an open trial of acute-phase CBT. Patients completing and responding to acute-phase treatment were randomized to receive either nine monthly sessions of M-CBT (n = 79) or assessment only (n = 78) and were then followed for an additional 12 months without treatment. Results M–CBT produced significantly lower relapse rates (5.2%) and reduced work and social impairment compared to the assessment only condition (18.4%) at a 21-month follow-up (MFU). Multivariate Cox proportional hazards models showed that residual symptoms of agoraphobia at the end of acute-phase treatment were independently predictive of time to relapse during 21-MFU (HR = 1.15, p < .01). Conclusions M–CBT aimed at reinforcing acute treatment gains to prevent relapse and offset disorder recurrence may improve long-term outcome in PD/A. PMID:23127290

  4. Teachers' Perceptions of Adolescent Females with Voice Disorders

    ERIC Educational Resources Information Center

    Zacharias, Stephanie R. C.; Kelchner, Lisa N.; Creaghead, Nancy

    2013-01-01

    Purpose: The purpose of this study was to explore teachers' attitudes toward, and perceptions of personality traits of, female adolescents who presented with voice disorders. Method: For this comparative study consisting of a 25-item web-based semantic differential survey, teachers rated voice recordings of 4 female adolescents (considered…

  5. Cortisol Levels and Conduct Disorder in Adolescent Mothers

    ERIC Educational Resources Information Center

    Pajer, Kathleen; Gardner, William

    2004-01-01

    This study investigates the function of the hypothalamic-pituitary-adrenal (HPA) axis in adolescent antisocial girls. This question is important because disturbance of HPA functioning has been found in populations of violent adult males and antisocial adolescent males, suggesting that it may be a marker of a physiological disorder associated with…

  6. Does Smoking Intervention Influence Adolescent Substance Use Disorder Treatment Outcomes?

    ERIC Educational Resources Information Center

    Myers, Mark G.; Prochaska, Judith J.

    2008-01-01

    Although tobacco use is reported by the majority of substance use disordered (SUD) youth, little work has examined tobacco focused interventions with this population. The present study is an initial investigation of the effect of a tobacco use intervention on adolescent SUD treatment outcomes. Participants were adolescents in SUD treatment taking…

  7. Peer Relationship Difficulties in Adolescents with Bipolar Disorder

    ERIC Educational Resources Information Center

    Siegel, Rebecca S.; Freeman, Andrew J.; La Greca, Annette M.; Youngstrom, Eric A.

    2015-01-01

    Background: Pediatric bipolar disorder (PBD) is associated with psychosocial impairment, but few studies have examined peer relationship functioning and PBD. Adolescence is a crucial developmental period when peers become increasingly salient. Objective: This study compared perceived friendship quality and peer victimization in adolescents with…

  8. Physical Aggression in Children and Adolescents with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Mazurek, Micah O.; Kanne, Stephen M.; Wodka, Ericka L.

    2013-01-01

    Aggression is a clinically significant problem for many children and adolescents with autism spectrum disorders (ASD). However, there have been few large-scale studies addressing this issue. The current study examined the prevalence and correlates of physical aggression in a sample of 1584 children and adolescents with ASD enrolled in the Autism…

  9. Screening and Assessing Adolescent Substance Use Disorders in Clinical Populations

    ERIC Educational Resources Information Center

    Winters, Ken C.; Kaminer, Yifrah

    2008-01-01

    The different established screening methodologies and comprehensive assessment techniques used in evaluating adolescents suspected of or known to have substance abuse disorders are discussed. Recommendations and suggestions for establishing standards of training and professional efficiency are also highlighted to treat adolescents with substance…

  10. Recent Stressful Life Events among Bahraini Adolescents with Adjustment Disorder.

    ERIC Educational Resources Information Center

    Al-Ansari, Ahmed; Matar, Ali M.

    1993-01-01

    Retrospectively examined adolescents from two time periods, diagnosed with adjustment disorder (n=72), for type of life stressors that initiated referrals to child psychiatry unit and compared them to control group of 42 referred adolescents with no psychopathology. Disappointment in relationships with family member or friend of opposite sex was…

  11. Victimization and Posttraumatic Stress Disorder among Homeless Adolescents.

    ERIC Educational Resources Information Center

    Stewart, Angela J.; Steiman, Mandy; Cauce, Ana Mari; Cochran, Bryan N.; WhiteBeck, Les B.; Hoyt, Dan R.

    2004-01-01

    Objective: To examine street victimization and posttraumatic stress symptoms among urban homeless adolescents and to test whether emotional numbing and avoidance represent distinct posttraumatic stress disorder (PTSD) symptom clusters. Method: Structured, private interviews were conducted with homeless adolescents (N = 374) in the Seattle…

  12. Cortisol Levels and Conduct Disorder in Adolescent Mothers

    ERIC Educational Resources Information Center

    Azar, Rima; Zoccolillo, Mark; Paquette, Daniel; Quiros, Elsa; Baltzer, Franziska; Tremblay, Richard E.

    2004-01-01

    Objective: To examine the association between cortisol levels and conduct disorder (CD) in adolescent mothers. Past research has shown that low levels of cortisol were associated with CD, particularly with its aggressive symptoms. The authors tested the hypothesis that adolescent mothers with CD would show lower levels of salivary cortisol…

  13. Identity disturbance in adolescence: associations with borderline personality disorder.

    PubMed

    Westen, Drew; Betan, Ephi; Defife, Jared A

    2011-02-01

    Although establishing a coherent identity is often viewed as a normative developmental task of adolescence, an important question is whether forms of identity disturbance seen in adult personality disorders can also be distinguished in adolescents. If so, such disturbances would constitute an essential target for research and clinical interventions. The goal of this study is to investigate the nature of identity disturbance in an adolescent clinical sample and to explore its links with personality pathology, particularly borderline personality disorder. A national random sample of 139 psychiatrists and clinical psychologists completed a battery of instruments on a randomly selected adolescent patient in their care, including measures of Axis II symptoms and the Identity Disturbance Questionnaire-Adolescent Version, an instrument designed for clinically experienced observers that assesses a wide range of manifestations of potential identity disturbance among adolescents. Factor analysis of the Identity Disturbance Questionnaire--Adolescent Version yielded four clinically and conceptually coherent factors that resembled dimensions previously identified in adults: lack of normative commitment, role absorption, painful incoherence, and lack of consistency. As in adults, identity disturbance in adolescents is a clinically meaningful, multidimensional construct exhibiting significant relationships with different forms of severe personality pathology, most notably borderline personality disorder. As such, identity disturbance can be a manifestation of psychopathology above and beyond the typical Sturm und Drang (storm and stress) of adolescence.

  14. Adolescents coping with mood disorder: a grounded theory study.

    PubMed

    Meadus, R J

    2007-04-01

    A grounded theory methodology was used to explore the phenomenon of coping as experienced by adolescents with a mood disorder. Mood disorders among children and adolescents are more persistent than previously thought and have numerous negative associated features, including further episodes of depression, impaired social, academic and vocational relationships, use of alcohol and other drugs, and an increased risk of suicide. Current literature offered little awareness of how adolescents cope with a mood disorder, as well as their perspective of how such an illness impacts their lives. A substantive theory regarding the process of coping for adolescents with a mood disorder was generated from the data collected from one male and eight female adolescents. Using grounded theory coding procedures, a four-phase coping theory identified by the categories feeling different, cutting off connections, facing the challenge/reconnecting, and learning from the experience was developed. The core category identified in this research was An Unplanned Journey: Coping Through Connections. Implications identified for nursing practice, research and education included greater attention on the prevention of adolescent mood disorder, and the education of adolescents about the development and enhancement of healthy coping skills. PMID:17352785

  15. Clinical phenomenology of child and adolescent dissociative disorders.

    PubMed

    Hornstein, N L; Putnam, F W

    1992-11-01

    A comparison of two separately diagnosed samples of children and adolescents with dissociative disorders demonstrates good construct validity for these diagnoses in childhood. Descriptive analyses of the total sample reveal a clinical profile characterized by a plethora of affective, anxiety, conduct, posttraumatic, and dissociative symptoms. Children with multiple personality disorder (MPD) differ from those with dissociative disorder not otherwise specified (DDNOS) in having more amnesias, identity disturbances, and hallucinations. Adolescents were more symptomatic than children age 11 or younger and more likely to receive a diagnosis of multiple personality disorder.

  16. Adolescent's perceptions of parenting behaviours and its relationship to adolescent Generalized Anxiety Disorder symptoms.

    PubMed

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

    2006-06-01

    This study examined the relationship between how adolescents perceived parenting behaviours and adolescent Generalized Anxiety Disorder (GAD) symptom scores. The 1106 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 symptoms of GAD. The findings of this study demonstrate that adolescent perceptions of parental alienation and rejection are strongly associated with adolescent GAD symptom scores. Additionally, mid-adolescence females perceive more parental alienation in relation to their GAD symptom scores than both early and mid-adolescent males. And early adolescent males perceive more parental rejection in relation to their GAD symptom scores than mid-adolescent males.

  17. Associations between psychosocial problems and personality disorders among Egyptian adolescents.

    PubMed

    Elbheiry, Abd-Elraqeep; Emam, Mahmoud

    2013-01-01

    The study investigated the relationship between psychosocial problems and personality disorders among a sample of 817 Egyptian adolescents (408 males and 409 females). Using 15 subscales from the Adolescent Psychopathology Scale (APS-long form) we assessed prevalence rates of a number of internalizing and externalizing psychosocial disorders. Additionally, we investigated whether there are gender differences in psychopathology among Egyptian adolescents and to what extent can psychosocial problems predict specific personality disorders. Stepwise multiple regression analyses showed that the participants experienced higher levels of PD, AV, and BD. Gender differences were found in certain personality disorders as well as in externalizing and internalizing psychosocial problems. A number of externalizing and internalizing psychosocial problems were highly predictive of specific personality disorders.

  18. Diabulimia: how eating disorders can affect adolescents with diabetes.

    PubMed

    Davidson, Jennifer

    2014-09-16

    Adherence to self-management and medication regimens is required to achieve optimal blood glucose control in adolescents with type 1 diabetes mellitus. Non-adherence places adolescents at serious risk of short and long-term health complications. Adherence difficulties may be exacerbated by concurrent eating disorders. Diabulimia is a term used to describe the deliberate administration of insufficient insulin to maintain glycaemic control for the purpose of causing weight loss. This article explores the concept of diabulimia and the compounding complications of an eating disorder on maintaining self-management regimens in adolescents with diabetes. PMID:25204951

  19. Family-based Treatment of Child and Adolescent Eating Disorders.

    PubMed

    Forsberg, Sarah; Lock, James

    2015-07-01

    Best-practice guidelines for the treatment of child and adolescent eating disorders recommend the inclusion of parents. Family-based treatment (FBT) posits that families are not only important in supporting their children but are critical change agents in the recovery process. As originally developed for anorexia nervosa, parents take a central role in managing and disrupting eating disorder symptoms. The most evidence-based treatment model for adolescent anorexia nervosa, FBT has also recently been found to be useful in the treatment of adolescent bulimia nervosa. This article provides a summary of the theoretic model, evidence base, and application of FBT.

  20. The Neurobiological Basis of Adolescent-onset Borderline Personality Disorder

    PubMed Central

    Goodman, Marianne; Mascitelli, Kathryn; Triebwasser, Joseph

    2013-01-01

    Objective: Over the past two decades, neurobiological studies in adult onset borderline personality disorder have made important strides, but inquiry into adolescent-onset BPD is still in its infancy and our understanding of the neurobiology of adolescent BPD remains highly tentative. Methods: This paper highlights recent findings in genetics, neuroendocrinology and neuroimaging for adult and adolescent-onset BPD. Results: Neurobiological studies of adolescent-onset BPD to date have focused mainly on volumetric studies of various brain regions and measurements of HPA axis components, with comparatively few publications on brain functioning. Conclusion: Such information is essential to developing more effective screening, treatment and preventive strategies. PMID:23970910

  1. Developmentally informed pharmacotherapy for child and adolescent depressive disorders.

    PubMed

    Sakolsky, Dara; Birmaher, Boris

    2012-04-01

    This article reviews evidence-based pharmacotherapy for children and adolescents with depression. Several randomized controlled trials (RCTs) support the use of fluoxetine for the treatment of childhood and adolescent depression as well as escitalopram in the treatment of adolescent depression. To date, one RCT has demonstrated the effectiveness of sertraline or citalopram for the treatment of major depressive disorder in youth. Only a small number of RCTs for depression have included children, and none of these trials were adequately powered to detect differences in the efficacy of medication between children and adolescents. PMID:22537729

  2. Myocardial perfusion imaging study of CO(2)-induced panic attack.

    PubMed

    Soares-Filho, Gastão L F; Machado, Sergio; Arias-Carrión, Oscar; Santulli, Gaetano; Mesquita, Claudio T; Cosci, Fiammetta; Silva, Adriana C; Nardi, Antonio E

    2014-01-15

    Chest pain is often seen alongside with panic attacks. Moreover, panic disorder has been suggested as a risk factor for cardiovascular disease and even a trigger for acute coronary syndrome. Patients with coronary artery disease may have myocardial ischemia in response to mental stress, in which panic attack is a strong component, by an increase in coronary vasomotor tone or sympathetic hyperactivity setting off an increase in myocardial oxygen consumption. Indeed, coronary artery spasm was presumed to be present in cases of cardiac ischemia linked to panic disorder. These findings correlating panic disorder with coronary artery disease lead us to raise questions about the favorable prognosis of chest pain in panic attack. To investigate whether myocardial ischemia is the genesis of chest pain in panic attacks, we developed a myocardial perfusion study through research by myocardial scintigraphy in patients with panic attacks induced in the laboratory by inhalation of 35% carbon dioxide. In conclusion, from the data obtained, some hypotheses are discussed from the viewpoint of endothelial dysfunction and microvascular disease present in mental stress response. PMID:24188891

  3. Behavioral Disorder amongst Adolescents Attending Secondary School in Southeast Nigeria

    PubMed Central

    Chinawa, J. M.; Manyike, P. C.; Obu, H. A.; Odetunde, O. I.; Aniwada, E. C.; Ndu, I. K.; Chinawa, A. T.

    2014-01-01

    Background. Adolescents are prone to various forms of behavioral problems. These behavioral issues in adolescents can have serious consequences for the adolescents. Objectives. The objectives of the study are to determine the causative factors of adolescent problems and specific manifestations. Methods. Behavioral problems were investigated using a random sampling of adolescents from secondary schools in southeast Nigeria from February to April, 2014. A self-administered questionnaire was developed from Health Kids Colorado Questionnaire. Results. A total of 763 subjects completed the questionnaire. Adolescents who reported to have used tobacco 3 to 5 and 6 to 9 times during the last 30 days are just 3.14% and 3.4%, respectively. Nineteen (2.49%) adolescents claimed that they have had sex before but not in the last 3 months. Adolescents who attempted suicide are from 15 years and peaked at 18. Eighty-three (11%) adolescents who are 15 years old attempted suicide in a year; this peaks at 17 years where 235 (30.8%) committed suicide. Majority of adolescents with behavioral disorder are from the upper class family. Conclusion. This study revealed that adolescents exhibit several forms of behavioral problems. PMID:25276048

  4. Meta-analysis argues for a female-specific role of MAOA-uVNTR in panic disorder in four European populations.

    PubMed

    Reif, Andreas; Weber, Heike; Domschke, Katharina; Klauke, Benedikt; Baumann, Christian; Jacob, Christian P; Ströhle, Andreas; Gerlach, Alexander L; Alpers, Georg W; Pauli, Paul; Hamm, Alfons; Kircher, Tilo; Arolt, Volker; Wittchen, Hans-Ulrich; Binder, Elisabeth B; Erhardt, Angelika; Deckert, Jürgen

    2012-10-01

    Panic disorder (PD) is a common mental disorder, ranking highest among the anxiety disorders in terms of disease burden. The pathogenesis of PD is multifactorial with significant heritability, however only a few convincing risk genes have been reported thus far. One of the most promising candidates is the gene encoding monoamine oxidase A (MAOA), due to its key role in monoaminergic neurotransmission, established validity of animal models, and the efficacy of MAO inhibitors in the treatment of PD. A promoter repeat polymorphism in MAOA (MAOA-uVNTR) impacts on gene expression; high-expression alleles have been reported to increase the risk for PD. To further scrutinize the role of this polymorphism, we performed a formal meta-analysis on MAOA-uVNTR and PD using original data from four published European (Estonian, German, Italian, and Polish) samples and genotypes from three hitherto unpublished German PD samples, resulting in the largest (n = 1,115 patients and n = 1,260 controls) genetic study on PD reported to date. In the unpublished samples, evidence for association of MAOA-uVNTR with PD was obtained in one of the three samples. Results of the meta-analysis revealed a significant and female-specific association when calculating an allelic model (OR = 1.23, P = 0.006). This sex-specific effect might be explained by a gene-dose effect causing higher MAOA expression in females. Taken together, our meta-analysis therefore argues that high-expression MAOA-uVNTR alleles significantly increase the risk towards PD in women. However, epigenetic mechanisms might obfuscate the genetic association, calling for ascertainment in larger samples as well as assessment of the MAOA promoter methylation status therein. PMID:22911667

  5. Meta-analysis argues for a female-specific role of MAOA-uVNTR in panic disorder in four European populations.

    PubMed

    Reif, Andreas; Weber, Heike; Domschke, Katharina; Klauke, Benedikt; Baumann, Christian; Jacob, Christian P; Ströhle, Andreas; Gerlach, Alexander L; Alpers, Georg W; Pauli, Paul; Hamm, Alfons; Kircher, Tilo; Arolt, Volker; Wittchen, Hans-Ulrich; Binder, Elisabeth B; Erhardt, Angelika; Deckert, Jürgen

    2012-10-01

    Panic disorder (PD) is a common mental disorder, ranking highest among the anxiety disorders in terms of disease burden. The pathogenesis of PD is multifactorial with significant heritability, however only a few convincing risk genes have been reported thus far. One of the most promising candidates is the gene encoding monoamine oxidase A (MAOA), due to its key role in monoaminergic neurotransmission, established validity of animal models, and the efficacy of MAO inhibitors in the treatment of PD. A promoter repeat polymorphism in MAOA (MAOA-uVNTR) impacts on gene expression; high-expression alleles have been reported to increase the risk for PD. To further scrutinize the role of this polymorphism, we performed a formal meta-analysis on MAOA-uVNTR and PD using original data from four published European (Estonian, German, Italian, and Polish) samples and genotypes from three hitherto unpublished German PD samples, resulting in the largest (n = 1,115 patients and n = 1,260 controls) genetic study on PD reported to date. In the unpublished samples, evidence for association of MAOA-uVNTR with PD was obtained in one of the three samples. Results of the meta-analysis revealed a significant and female-specific association when calculating an allelic model (OR = 1.23, P = 0.006). This sex-specific effect might be explained by a gene-dose effect causing higher MAOA expression in females. Taken together, our meta-analysis therefore argues that high-expression MAOA-uVNTR alleles significantly increase the risk towards PD in women. However, epigenetic mechanisms might obfuscate the genetic association, calling for ascertainment in larger samples as well as assessment of the MAOA promoter methylation status therein.

  6. Panic of 1907.

    ERIC Educational Resources Information Center

    Federal Reserve Bank of Boston, MA.

    This pamphlet recaps the chain of events known as The Bank Panic of 1907. Historians view this as a watershed event that had a lasting impact on the financial system of the United States. The panic resulted from the collapse of the United Copper Company and was averted with the intervention of John D. Rockefeller and the J. P. Morgan Company. The…

  7. Mood Stabilizers in Children and Adolescents With Autism Spectrum Disorders.

    PubMed

    Canitano, Roberto

    2015-01-01

    Autism spectrum disorders (ASDs) are a group of neurodevelopmental disorders including autistic disorder, Asperger syndrome, and pervasive developmental disorder not otherwise specified as to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. All these categories are grouped together in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, classification under the category of Autism Spectrum Disorders.Behavioral disorders including irritability, attention-deficit/hyperactivity disorder (ADHD) symptoms, and aggression are additional symptoms found in up to 20% of children and adolescents with ASD and require careful evaluation for appropriate treatment. Attention-deficit/hyperactivity disorder is defined by impaired attention, hyperactivity, and impulsivity, whereas ASD is defined by social dysfunction, communicative impairment, and restricted/repetitive behaviors. They should be distinctly evaluated in children and adolescents with ASD and intellectual disability in contrast to individuals without intellectual disability, because significant differences between these conditions exist. Mood disorders are also common in ASD and should be systematically investigated in this population of children and adolescents. Approximately 50% of children and adolescents with ASD receive medication for comorbid behavioral/ADHD and mood symptoms, mostly stimulants, antiepileptics and antipsychotics. Guidelines for the evaluation and treatment including medications for ADHD-like symptoms have recently been provided and should be carefully considered. Antiepileptic drugs are commonly used in ASDs with epilepsy, because seizures are associated with ASD in 10% to 30% of young patients, and as mood stabilizers. Lithium is another option for children and adolescents with ASD who present with symptoms of a mood disorder, such as elevated moods/euphoria, mania, and paranoia, whether accompanied or not by irritability. Experimental treatments are under

  8. Subclinical bulimia predicts conduct disorder in middle adolescent girls.

    PubMed

    Viinamäki, Anni; Marttunen, Mauri; Fröjd, Sari; Ruuska, Jaana; Kaltiala-Heino, Riittakerttu

    2013-01-01

    This study investigates the comorbidity and longitudinal associations between self-reported conduct disorder and subclinical bulimia in a community-based sample of Finnish adolescents in a 2-year prospective follow-up study. There are 2070 adolescents who participated in the survey as ninth graders (mean age 15.5) and followed-up 2 years later. The Youth Self-Report Externalizing scale was used to measure conduct disorder and DSM-IV-based questionnaire to measure bulimia. Co-occurrence of female conduct disorder and subclinical bulimia was found at ages 15 and 17. Subclinical bulimia among girls at age 15 was a risk factor for conduct disorder at age 17, but conduct disorder at age 15 was not predictive of subclinical bulimia at age 17. The pathway from bulimia to conduct disorder may be suggestive of an association with future borderline personality disorder among girls.

  9. Perceived Expressed Emotion in Adolescents with Binge-Eating Disorder.

    PubMed

    Schmidt, Ricarda; Tetzlaff, Anne; Hilbert, Anja

    2015-10-01

    A sizeable body of research has documented Expressed Emotion (EE) to predict clinical outcomes in various psychiatric disorders, including eating disorders. Patients' perceptions of relative's EE, however, were found to play an important role in the processing of EE. This study aimed to examine the level of perceived EE in adolescent binge-eating disorder (BED) and its impact on eating disorder psychopathology. Adolescents (12-20 years) seeking treatment for BED (n = 40) were compared to adolescents without current or lifetime eating disorder (CG; n = 40). Both groups were stratified according to age, sex, body mass index (BMI, kg/m(2)), and socio-economic status. The Five Minute Speech Sample (FMSS) and the Brief Dyadic Scale of EE were administered to assess patients' perceived maternal EE. Additionally, adolescents and mothers completed questionnaires on eating disorder and general psychopathology. On the FMSS, 37.5 % of patients with BED perceived their mothers as high EE (vs. 12.5 % in the CG). On the Brief Dyadic Scale of EE, patients with BED reported significantly higher levels of perceived maternal criticism, emotional overinvolvement, and lower levels of perceived warmth than controls. After controlling for the diagnosis of BED, perceived criticism and warmth, as assessed by questionnaire, significantly explained adolescents' global eating disorder psychopathology. Negative perceptions of maternal behavior and emotional atmosphere towards the child are characteristic of adolescent BED. As documented for other eating disorders, family factors are likely to have substantial implications for the maintenance and treatment of adolescent BED.

  10. Preventing suicide in adolescents with alcohol use disorders.

    PubMed

    Makhija, Nita J; Sher, Leo

    2007-01-01

    Adolescent suicide is an escalating crisis that needs to be addressed by clinicians and researchers. Alcohol use has consistently been implicated in adolescent suicide and it is generally assumed that alcohol use leads to an increased risk in suicidality, suicide attempts and completed suicides. It can lead to adolescent suicidality through alcohol myopia, disinhibition, and impaired judgment. Multiple genetically related intermediate phenotypes might contribute to the risk of alcohol misuse and suicidal behavior in adolescents. Genetic variations that enhance the risk for mood and anxiety symptoms or susceptibility to stress might increase risk through different mechanisms. Comorbid disorders such as depression are frequently exhibited in adolescents who misuse alcohol, therefore any adolescent who appears to be at risk for alcoholism or depression should always be screened for all other psychiatric disorders and for suicidality; some signs suicidal adolescents may exhibit include withdrawal, personality change, and a loss of interest in pleasurable activities. While assessment is important, prevention is crucial in any attempt to decrease the incidence of adolescent suicide. The US Center for Disease Control and Prevention (CDC) has established a set of seven guidelines that can be implemented from kindergarten through high school in order to establish alcohol prevention efforts in schools. Through beginning prevention efforts at a young age, it is hopeful that both alcohol misuse and adolescent suicide can be reduced. PMID:17458324

  11. The role of safety behaviors in exposure-based treatment for panic disorder and agoraphobia: associations to symptom severity, treatment course, and outcome.

    PubMed

    Helbig-Lang, Sylvia; Richter, Jan; Lang, Thomas; Gerlach, Alexander L; Fehm, Lydia; Alpers, Georg W; Ströhle, Andreas; Kircher, Tilo; Deckert, Jürgen; Gloster, Andrew T; Wittchen, Hans-Ulrich

    2014-12-01

    The potentially detrimental effects of safety behaviors during exposure therapy are still subject to debate. Empirical findings are inconsistent, and few studies have investigated effects of idiosyncratic safety behavior manifestations during exposure or in everyday life. These limitations might be due to a lack of appropriate measures that address individual safety behaviors. We examined psychometric properties and predictive value of the Texas Safety Maneuver Scale (TSMS), a questionnaire specifically targeting safety behaviors in panic disorder and agoraphobia. Effects of safety behavior use, both during everyday life and during therapy, were examined using data from a multicenter RCT of N=268 patients that aimed at evaluating efficacy and mechanisms of action of two variants of an exposure-based therapy. The TSMS total score demonstrated good internal consistency (α=0.89), and it showed significant correlations with selected measures of baseline anxiety and impairment. The proposed factor structure could not be replicated. Frequent safety behavior use at baseline was associated with actual safety behavior during exposure exercises. Pronounced in-situ safety behavior, but not baseline safety behavior was associated to detrimental treatment outcome. The results underline the relevance of a rigorous safety behavior assessment in therapy. The actual relationship between safety behavior use and treatment outcome is yet to determine. PMID:25445073

  12. BRAIN STRUCTURAL AND FUNCTIONAL CHANGES IN ADOLESCENTS WITH PSYCHIATRIC DISORDERS

    PubMed Central

    Miguel-Hidalgo, José Javier

    2013-01-01

    During adolescence hormonal and neurodevelopmental changes geared to ensure reproduction and achieve independence are very likely mediated by growth of neural processes, remodeling of synaptic connections, increased myelination in prefrontal areas, and maturation of connecting subcortical regions. These processes, greatly accelerated in adolescence, follow an asynchronous pattern in different brain areas. Neuroimaging research using functional and structural magnetic resonance imaging has produced most of the insights regarding brain structural and functional neuropathology in adolescent psychiatric disorders. In schizophrenia, first episodes during adolescence are linked to greater-than-normal losses in gray matter density and white matter integrity, and show a divergence of maturational trajectories from normative neural development, in a progression similar to that of adult-onset schizophrenia. Anxiety and mood disorders in adolescence have been linked to abnormally increased activity in the amygdala and ventral prefrontal cortical areas, although some data suggest that neural abnormalities in the amygdala and anxiety maybe particularly more frequent in adolescents than in adults. Alcohol misuse in adolescence results in reduced integrity in the white matter and reduced gray matter density that, given the high intensity of adolescent synaptic and myelin remodeling, may result in persistent and profound changes in circuits supporting memory, emotional and appetitive control. Interaction of persistent changes due to prenatal exposure with contemporaneous expression of genetic factors and disturbing environmental exposure may be an important factor in the appearance of psychiatric disorders in adolescence. Further progress in understanding adolescent psychopathology will require postmortem research of molecular and cellular determinants in the adolescent brain. PMID:23828425

  13. Defense Mechanisms in Adolescence as Predictors of Adult Personality Disorders.

    PubMed

    Strandholm, Thea; Kiviruusu, Olli; Karlsson, Linnea; Miettunen, Jouko; Marttunen, Mauri

    2016-05-01

    Our study examines whether defense styles and separate defenses in depressed adolescent outpatients predict adult personality disorders (PDs). We obtained data from consecutive adolescent outpatients who participated in the Adolescent Depression Study at baseline and at the 8-year follow-up (N = 140). Defense styles were divided into mature, neurotic, image-distorting, and immature and a secondary set of analyses were made with separate defenses as predictors of a PD diagnosis. Neurotic, image-distorting, and immature defense styles in adolescence were associated with adulthood PDs. Neurotic defense style associated with cluster B diagnosis and image-distorting defense style associated with cluster A diagnosis. Separate defenses of displacement, isolation, and reaction formation were independent predictors of adult PD diagnosis even after adjusting for PD diagnosis in adolescence. Defense styles and separate defenses predict later PDs and could be used in the focusing of treatment interventions for adolescents.

  14. Media use among adolescents with autism spectrum disorder.

    PubMed

    Kuo, Melissa H; Orsmond, Gael I; Coster, Wendy J; Cohn, Ellen S

    2014-11-01

    This study explores how adolescents with autism spectrum disorder (ASD) use media, and the factors associated with their media use. A total of 91 adolescents with ASD and their parents completed mail-based surveys. In all, 78% of the adolescents with ASD watched television (approximately 2 h/day), and 98% used computers (approximately 5 h/day) on any given day. They most frequently watched cartoons, played computer or video games that involved shooting, and visited websites that contained information on video games. Adolescents with ASD who watched television with parents reported more positive parent-child relationships. Adolescents with ASD who visited social networking websites or received emails from friends reported more positive friendships. The findings help us understand media-use habits of adolescents with ASD and suggest areas for future research.

  15. Media use among adolescents with autism spectrum disorder.

    PubMed

    Kuo, Melissa H; Orsmond, Gael I; Coster, Wendy J; Cohn, Ellen S

    2014-11-01

    This study explores how adolescents with autism spectrum disorder (ASD) use media, and the factors associated with their media use. A total of 91 adolescents with ASD and their parents completed mail-based surveys. In all, 78% of the adolescents with ASD watched television (approximately 2 h/day), and 98% used computers (approximately 5 h/day) on any given day. They most frequently watched cartoons, played computer or video games that involved shooting, and visited websites that contained information on video games. Adolescents with ASD who watched television with parents reported more positive parent-child relationships. Adolescents with ASD who visited social networking websites or received emails from friends reported more positive friendships. The findings help us understand media-use habits of adolescents with ASD and suggest areas for future research. PMID:24142797

  16. Autism Spectrum Disorders in Gender Dysphoric Children and Adolescents

    ERIC Educational Resources Information Center

    de Vries, Annelou L. C.; Noens, Ilse L. J.; Cohen-Kettenis, Peggy T.; van Berckelaer-Onnes, Ina A.; Doreleijers, Theo A.

    2010-01-01

    Only case reports have described the co-occurrence of gender identity disorder (GID) and autism spectrum disorders (ASD). This study examined this co-occurrence using a systematic approach. Children and adolescents (115 boys and 89 girls, mean age 10.8, SD = 3.58) referred to a gender identity clinic received a standardized assessment during which…

  17. Programming for Adolescents with Behavioral Disorders. Volume 3.

    ERIC Educational Resources Information Center

    Braaten, Sheldon, Ed.; And Others

    The book contains 10 papers concerning programming for adolescents with behavioral disorders. Papers have the following titles and authors: "What You See Is Not Always What You Get" (Richard Neel); "Implications of the Relationship between Observational and Rating Scale Data for the Assessment of Behavioral Disorders" (Russell Skiba and Patrick…

  18. Neuropsychological Effects of Posttraumatic Stress Disorder in Children and Adolescents

    ERIC Educational Resources Information Center

    Turley, Matthew R.; Obrzut, John E.

    2012-01-01

    Posttraumatic Stress Disorder (PTSD) can affect people of all ages but the literature is lacking on children and adolescents who experience PTSD. The consequences of this disorder extend beyond the basic symptoms by which it is defined. Neuroanatomically, the brains of children with PTSD have been found to be abnormally symmetrical in several…

  19. The Enigma of Bipolar Disorder in Children and Adolescents

    ERIC Educational Resources Information Center

    Hatchett, Gregory T.

    2009-01-01

    In the past decade, there has been a proliferation in the number of children and adolescents diagnosed with bipolar disorder. Except in rare cases, the young people who receive this diagnosis do not meet the strict diagnostic criteria for bipolar disorder I or II in the DSM-IV-TR. Many pediatric psychiatrists insist there are important development…

  20. Treatment Guidelines for Children and Adolescents with Bipolar Disorder

    ERIC Educational Resources Information Center

    Kowatch, Robert A.; Fristad, Mary; Birmaher, Boris; Wagner, Karen Dineen; Findling, Robert L.; Hellander, Martha

    2005-01-01

    Clinicians who treat children and adolescents with bipolar disorder desperately need current treatment guidelines. These guidelines were developed by expert consensus and a review of the extant literature about the diagnosis and treatment of pediatric bipolar disorders. The four sections of these guidelines include diagnosis, comorbidity, acute…

  1. Olfactocentric Paralimbic Cortex Morphology in Adolescents with Bipolar Disorder

    ERIC Educational Resources Information Center

    Wang, Fei; Kalmar, Jessica H.; Womer, Fay Y.; Edmiston, Erin E.; Chepenik, Lara G.; Chen, Rachel; Spencer, Linda; Blumberg, Hilary P.

    2011-01-01

    The olfactocentric paralimbic cortex plays a critical role in the regulation of emotional and neurovegetative functions that are disrupted in core features of bipolar disorder. Adolescence is thought to be a critical period in both the maturation of the olfactocentric paralimbic cortex and in the emergence of bipolar disorder pathology. Together,…

  2. Commentary: Treatment Guidelines for Child and Adolescent Bipolar Disorder

    ERIC Educational Resources Information Center

    McClellan, Jon

    2005-01-01

    Once considered rare in children, pediatric bipolar disorder is now widely diagnosed in the United States. The illness has become a cultural phenomenon, adorning the cover of Time magazine and headlining national news broadcasts. Kowatch and colleagues, in compiling consensus recommendations for bipolar disorder in children and adolescents, have…

  3. Adolescent Eating Disorders: Anorexia and Bulimia. Publication 352-004.

    ERIC Educational Resources Information Center

    Bayer, Alan E.; Baker, Daniel H.

    This document presents an overview of anorexia nervosa and bulimia in adolescents. A brief review of the historical background of these eating disorders is included. Causes of anorexia and bulimia are discussed and physical, behavioral, emotional, and perceptual characteristics of the disorders are listed in a section on symptoms. The need for a…

  4. [Personality disorders in adolescence: conceptual issues and treatment approaches].

    PubMed

    Schmeck, Klaus

    2008-01-01

    Objective of this paper is to search for answers for the question if it is justified to use the diagnosis of personality disorder already in adolescence. Recent research data confirm that the stability of basic personality traits is only gradually lower in adolescence compared to adulthood. Using the diagnostic criteria of adults there is not much of a difference concerning prevalence rate and stability in adolescence and adulthood. Meta-analyses reveal that patients with personality disorders can successfully be treated with specalized treatment programs so that personality disorders should not be viewed as life-course persistent. It is argued that an early assessment with standardized procedures can help to identify adolescents with personality disorders so that specialized treatment approaches can be started. In adulthood there is empirical evidence for the use of Dialectical-Behavior Therapy DBT, Transference Focused Psychotherapy TFP, Mentalization-based Therapy MBT and Schema-focused Psychotherapy SFT for the use in patients with personality disorders. These treatment approaches have to be adapted to the special situation of adolescents so that their use can help to prevent these early developing disorders to become chronic.

  5. 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…

  6. Clinical Precursors of Adolescent Conduct Disorder in Children with Attention-Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Whittinger, Naureen S.; Langley, Kate; Fowler, Tom A.; Thomas, Hollie V.; Thapar, Anita

    2007-01-01

    Objective: To examine precursors of adolescent conduct disorder (CD) in children with attention-deficit/hyperactivity disorder (ADHD), investigating the significance of childhood oppositional defiant disorder (ODD) and ADHD. Method: A total of 151 children with ADHD recruited from child psychiatric and pediatric clinics were assessed through…

  7. A Personality Disorders: Schizotypal, Schizoid and Paranoid Personality Disorders in Childhood and Adolescence

    PubMed Central

    Esterberg, Michelle L.; Goulding, Sandra M.

    2010-01-01

    Cluster A personality disorders (PD), including schizotypal personality disorder (SPD), paranoid personality disorder (PPD), and schizoid PD, are marked by odd and eccentric behaviors, and are grouped together because of common patterns in symptomatology as well as shared genetic and environmental risk factors. The DSM-IV-TR describes personality disorders as representing stable and enduring patterns of maladaptive traits, and much of what is understood about Cluster A personality disorders in particular stems from research with adult populations. Less in known about these disorders in children and adolescents, and controversy remains regarding diagnosis of personality disorders in general in youth. The current paper reviews the available research on Cluster A personality disorders in childhood and adolescence; specifically, we discuss differentiating between the three disorders and distinguishing them from other syndromes, measuring Cluster A disorders in youth, and the nature and course of these disorders throughout childhood and adolescence. We also present recent longitudinal data from a sample of adolescents diagnosed with Cluster A personality disorders from our research laboratory, and suggest directions for future research in this important but understudied area. PMID:21116455

  8. A Personality Disorders: Schizotypal, Schizoid and Paranoid Personality Disorders in Childhood and Adolescence.

    PubMed

    Esterberg, Michelle L; Goulding, Sandra M; Walker, Elaine F

    2010-12-01

    Cluster A personality disorders (PD), including schizotypal personality disorder (SPD), paranoid personality disorder (PPD), and schizoid PD, are marked by odd and eccentric behaviors, and are grouped together because of common patterns in symptomatology as well as shared genetic and environmental risk factors. The DSM-IV-TR describes personality disorders as representing stable and enduring patterns of maladaptive traits, and much of what is understood about Cluster A personality disorders in particular stems from research with adult populations. Less in known about these disorders in children and adolescents, and controversy remains regarding diagnosis of personality disorders in general in youth. The current paper reviews the available research on Cluster A personality disorders in childhood and adolescence; specifically, we discuss differentiating between the three disorders and distinguishing them from other syndromes, measuring Cluster A disorders in youth, and the nature and course of these disorders throughout childhood and adolescence. We also present recent longitudinal data from a sample of adolescents diagnosed with Cluster A personality disorders from our research laboratory, and suggest directions for future research in this important but understudied area.

  9. Diagnosis and subtypes of adolescent antisocial personality disorder.

    PubMed

    Jones, Meredith; Westen, Drew

    2010-04-01

    The present study examined the application of the Antisocial Personality Disorder (APD) diagnosis to adolescents and investigated the possibility of subtypes of APD adolescents. As part of a broader study of adolescent personality in clinically-referred patients, experienced clinicians provided personality data on a randomly selected patient in their care using the SWAP-II-A personality pathology instrument. Three hundred thirteen adolescents met adult DSM-IV diagnostic criteria for APD. To characterize adolescents with the disorder, we aggregated the data to identify the items most descriptive and distinctive of APD adolescents relative to other teenagers in the sample (N = 950). Q-factor analysis identified five personality subtypes: psychopathic-like, socially withdrawn, impulsive-histrionic, emotionally dysregulated, and attentionally dysregulated. The five subtypes differed in predictable ways on a set of external criteria related to global adaptive functioning, childhood family environment, and family history of psychiatric illness. Both the APD diagnosis and the empirically derived APD subtypes provided incremental validity over and above the DSM-IV disruptive behavior disorders in predicting global adaptive functioning, number of arrests, early-onset severe externalizing pathology, and quality of peer relationships. Although preliminary, these results provide support for the use of both APD and personality-based subtyping systems in adolescents.

  10. Mental health trajectories from adolescence to adulthood: Language disorder and other childhood and adolescent risk factors.

    PubMed

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

    2016-05-01

    Longitudinal research on mental health development beyond adolescence among nonclinical populations is lacking. This study reports on psychiatric disorder trajectories from late adolescence to young adulthood in relation to childhood and adolescent risk factors. Participants were recruited for a prospective longitudinal study tracing a community sample of 5-year-old children with communication disorders and a matched control cohort to age 31. Psychiatric disorders were measured at ages 19, 25, and 31. Known predictors of psychopathology and two school-related factors specifically associated with language disorder (LD) were measured by self-reports and semistructured interviews. The LD cohort was uniquely characterized by a significantly decreasing disorder trajectory in early adulthood. Special education was associated with differential disorder trajectories between LD and control cohorts, whereas maltreatment history, specific learning disorder, family structure, and maternal psychological distress were associated with consistent trajectories between cohorts. From late adolescence to young adulthood, childhood LD was characterized by a developmentally limited course of psychiatric disorder; maltreatment was consistently characterized by an elevated risk of psychiatric disorder regardless of LD history, whereas special education was associated with significantly decreasing risk of psychiatric disorder only in the presence of LD.

  11. Pharmacotherapy of attention-deficit hyperactivity disorder in adolescents.

    PubMed

    Childress, Ann C; Berry, Sally A

    2012-02-12

    Attention-deficit hyperactivity disorder (ADHD) is a common neurobehavioural disorder in children and adolescents, consisting of developmentally inappropriate levels of inattention and/or hyperactivity and impulsivity. The majority of children with ADHD will continue to experience significant ADHD symptoms as teens. ADHD in adolescents can result in significant functional impairment and poorer quality of life. Children and adolescents with ADHD are at higher risk of developing other psychiatric illnesses such as mood, conduct and substance abuse disorders. Stimulants (amphetamines and methylphenidates) and nonstimulants (atomoxetine, guanfacine extended-release (XR) and clonidine XR) have been found to be effective and are approved by the US FDA for the treatment of ADHD in adolescents in the US. Of the agents approved in the US, only guanfacine XR and clonidine XR are not approved in any other countries. There is growing evidence that treatment of ADHD with stimulants reduces the risk of development of other psychiatric co-morbidities, including substance abuse disorders. To date, all FDA-approved stimulants and nonstimulants that have been adequately studied have been demonstrated to be safe and effective in treating ADHD in both children and adolescents. Therefore, clinical decisions used in selecting pharmacotherapy to treat ADHD in children aged 6-12 years can be applied in the adolescent population. PMID:22316347

  12. [Symptoms of DSM IV borderline personality disorder in a nonclinical population of adolescents: study of a series of 35 patients].

    PubMed

    Chabrol, H; Chouicha, K; Montovany, A; Callahan, S

    2001-01-01

    personality disorder in adolescents. Two criteria of schizotypal personality disorder were also frequent in this group: 68.6% of the borderline group reported odd beliefs or magical thinking, in particular beliefs in clairvoyance or telepathy and 88.6% reported unusual perceptual experiences, in particular sensing the presence of a force or person and bodily illusions. Moreover, 31.4% of the borderline group reported transient "quasi" psychotic experiences, mainly "quasi" visual hallucinations. Auditory hallucinations or delusional ideas were not observed. This symptomatology suggests a "quasi" psychotic dimension of adolescent borderline personality disorder. Affective instability was the next most frequent symptom which was usually marked by a cyclothymic appearance. Comorbidity with major depressive disorder was high: 85.7% of the borderline subjects had a concurrent diagnosis of major depression versus 45.8% of the non-borderline subjects. Thus, major depression is more frequent than most of the borderline personality disorder criteria, with the exception of the already noted paranoid ideation and affective instability. Hypomanic symptoms were frequent in the borderline group (65.7%) as well as in the non-borderline group (38.8%). This symptomatology suggests that adolescent borderline personality disorder is linked to an attenuated bipolar spectrum characterised by major depressive episodes and soft signs of bipolarity. However, hypomanic symptoms, which were quite frequent in non-borderline subjects, might also be due to a mechanism of defence, i.e. the denial of depression. Comorbidity with anxiety disorders appeared also to be high: anxiety symptoms were found in 91.4% of the borderline subjects who reported symptoms of generalised anxiety disorder, panic disorder, and somatoform disorders. The overall clinical appearance of these borderline adolescents not referred for treatment seemed to be quite similar to that of borderline adolescents in clinical samples. This

  13. Update on the medical management of eating disorders in adolescents.

    PubMed

    Golden, Neville H; Katzman, Debra K; Sawyer, Susan M; Ornstein, Rollyn M; Rome, Ellen S; Garber, Andrea K; Kohn, Michael; Kreipe, Richard E

    2015-04-01

    The medical practitioner has an important role to play in the management of adolescents with eating disorders, usually as part of a multidisciplinary team. This article reviews the role of the medical practitioner in the diagnosis and treatment of eating disorders, updating the reader on the changing epidemiology of eating disorders, revised diagnostic criteria, newer methods of assessing degree of malnutrition, more aggressive approaches to refeeding, and current approaches to managing low bone mass.

  14. [Behavioral disorders and substance abuse in adolescents with mental retardation].

    PubMed

    Papachristou, Ec; Anagnostopoulos, Dk

    2014-01-01

    The percentage of people with mental retardation in the general population is estimated at about 2.3%, with adolescence (15-20 years) constituting the development period during which a peak in rates of mental retardation is observed. The increased prevalence of adolescence may be explained from the fact that the specified requirements of the school initially, and society later, inevitably lead to comparative evaluation of the teen with mental retardation in relation to peers, thus making mental retardation more apparent. Adolescents with mental retardation face a number of physical and psychological needs which are not often distinguishable and as a consequence undergo the deterioration of their already burdened quality of life. In particular, mental health problems occur 3 to 4 times more often in adolescents with mental retardation compared with adolescents of the general population. This review presents the most recent epidemiological findings regarding the correlation between behavioral disorders, substance use and the possible comorbidity in adolescents with intellectual disability, both at community level and residential care level. Epidemiological data indicate that behavioral disorders are among the most common types of psychopathology in mentally retarded adolescents with the severity and symptoms varying depending on the personal characteristics of each adolescent. Regarding substance use, the available data show that the rates of substance use (alcohol, smoking, illicit drugs) are lower in this specific population group but the differences over the last years tend to be eliminated. Finally, according to the few surveys that were examined referring to the comorbidity of behavioral disorders and substance use in adolescents with intellectual disability, the results were contradictory. Specifically, while behavioral disorders continued to be one of the most common types of psychopathology, the related substances disorders indicated lower rates compared to

  15. [Behavioral disorders and substance abuse in adolescents with mental retardation].

    PubMed

    Papachristou, Ec; Anagnostopoulos, Dk

    2014-01-01

    The percentage of people with mental retardation in the general population is estimated at about 2.3%, with adolescence (15-20 years) constituting the development period during which a peak in rates of mental retardation is observed. The increased prevalence of adolescence may be explained from the fact that the specified requirements of the school initially, and society later, inevitably lead to comparative evaluation of the teen with mental retardation in relation to peers, thus making mental retardation more apparent. Adolescents with mental retardation face a number of physical and psychological needs which are not often distinguishable and as a consequence undergo the deterioration of their already burdened quality of life. In particular, mental health problems occur 3 to 4 times more often in adolescents with mental retardation compared with adolescents of the general population. This review presents the most recent epidemiological findings regarding the correlation between behavioral disorders, substance use and the possible comorbidity in adolescents with intellectual disability, both at community level and residential care level. Epidemiological data indicate that behavioral disorders are among the most common types of psychopathology in mentally retarded adolescents with the severity and symptoms varying depending on the personal characteristics of each adolescent. Regarding substance use, the available data show that the rates of substance use (alcohol, smoking, illicit drugs) are lower in this specific population group but the differences over the last years tend to be eliminated. Finally, according to the few surveys that were examined referring to the comorbidity of behavioral disorders and substance use in adolescents with intellectual disability, the results were contradictory. Specifically, while behavioral disorders continued to be one of the most common types of psychopathology, the related substances disorders indicated lower rates compared to

  16. Substance use disorders in an adolescent inpatient psychiatric population.

    PubMed

    Deas-Nesmith, D; Campbell, S; Brady, K T

    1998-04-01

    This study examined the comorbidity of substance use disorders and other psychiatric disorders in adolescent populations. The study population was comprised of 100 consecutive admissions, ages 13 to 17, to an acute care adolescent psychiatric inpatient unit for substance use disorders. Patients were assessed using the Personal Experience Screening Questionnaire (PESQ) and the substance-use disorder portion of the Structured Clinical Interview for DSM III-R (SCID-R). Thirty-three (33%) patients were identified as having a substance abuse or dependence diagnosis. There was no significant difference in the age between substance users and nonsubstance users. There were significantly more whites in the substance-using group. Sixty percent of all adolescents interviewed had histories of sexual or physical trauma, with trauma being significantly more common in the substance-using group. There were no significant differences in the number or type of other Axis I or Axis II diagnoses between the two groups. While substance users and nonsubstance users had no significant difference in the number of past psychiatric hospitalizations, nonsubstance users had significantly more past medical hospitalizations. These results indicate that high rates of comorbid substance abuse and psychiatric disorders exist in adolescents, and more in-depth study of comorbidity among adolescents is warranted. PMID:9581443

  17. Substance use disorders in an adolescent inpatient psychiatric population.

    PubMed Central

    Deas-Nesmith, D.; Campbell, S.; Brady, K. T.

    1998-01-01

    This study examined the comorbidity of substance use disorders and other psychiatric disorders in adolescent populations. The study population was comprised of 100 consecutive admissions, ages 13 to 17, to an acute care adolescent psychiatric inpatient unit for substance use disorders. Patients were assessed using the Personal Experience Screening Questionnaire (PESQ) and the substance-use disorder portion of the Structured Clinical Interview for DSM III-R (SCID-R). Thirty-three (33%) patients were identified as having a substance abuse or dependence diagnosis. There was no significant difference in the age between substance users and nonsubstance users. There were significantly more whites in the substance-using group. Sixty percent of all adolescents interviewed had histories of sexual or physical trauma, with trauma being significantly more common in the substance-using group. There were no significant differences in the number or type of other Axis I or Axis II diagnoses between the two groups. While substance users and nonsubstance users had no significant difference in the number of past psychiatric hospitalizations, nonsubstance users had significantly more past medical hospitalizations. These results indicate that high rates of comorbid substance abuse and psychiatric disorders exist in adolescents, and more in-depth study of comorbidity among adolescents is warranted. PMID:9581443

  18. Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide

    MedlinePlus

    ... Treatment: A Research-Based Guide » Acknowledgements Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide ... Contents Acknowledgements From the Director Introduction Principles of Adolescent Substance Use Disorder Treatment Frequently Asked Questions Treatment ...

  19. [Systematics of somatoform disorders in children and adolescents].

    PubMed

    Winter, Sibylle; Köberle, Carolin; Lenz, Klaus; Pfeiffer, Ernst; Lehmkuhl, Ulrike

    2013-01-01

    Somatoform disorders in children and adolescents are common and can cause significantly reduced wellbeing and quality of life. Considerable subjective impairment leads to a high number of doctors' visits, which along with a reoccurrence of negative findings, often results in a sense of helplessness in the patient and a lack of trust towards the physician. The criteria for somatoform disorders are illustrated based on the classification scheme ICD-10 and in consideration of the DSM-V. Referring to Noeker (2008) the special role of the parents for the development of somatoform disorders is explained. The typical clinical profile of somatoform disorders in children and adolescents is described. As a diagnostic instrument the newly developed Screening for Somatoform Disorders in Children and Adolescents (SOMS-CA) (Winter, Pfeiffer, Köberle, Lenz, Lehmkuhl, 2008) is introduced. Furthermore it is demonstrated that patients with somatoform disorders are seen predominantly within consulting and liaison services of the paediatric clinic. The importance of interdisciplinary cooperation between paediatrics and child and adolescent psychiatry and -psychotherapy in early diagnosis and introduction of appropriate treatment is highlighted. PMID:24428081

  20. [GEITDAH consensus on conduct disorders in children and adolescents].

    PubMed

    Sasot-Llevadot, Jordi; Ibáñez-Bordas, Rosa M; Soto-López, Antonio; Montañés-Rada, Francisco; Gastaminza-Pérez, Xavier; Alda-Díez, José A; Cantó-Díez, Tomás; Catalá, Miguel A; Ferrin-Erdozáin, Maite; García-Giral, Marta; Graell-Bernal, Montserrat; Granada-Jiménez, Olvido; Herreros-Rodríguez, Óscar; Mardomingo-Sanz, María J; Mojarro-Práxedes, Dolores; Morey-Canyelles, Jaume; Ortiz-Guerra, Juan; Pàmies-Massana, Montserrat; Rey-Sánchez, Francisco; Romera-Torrens, María; Rubio-Morell, Belén; Ruiz-Lázaro, Pedro M; Ruiz-Sanz, Francisco

    2015-08-16

    In this paper, the Special Interest Group on Attention Deficit Hyperactivity Disorder (GEITDAH, from its name in Spanish) presents a consensus reached by experts from all over Spain on conduct disorders in children and adolescents. Following the initial work by the team at the Pedopsychiatry Unit at the Quiron-Teknon Hospital in Barcelona, agreements have been reached on a number of basic aspects that could be the starting point for future consensuses. A top priority aim of the work was also to update the criteria in the Diagnostic and statistical manual of mental disorders, fifth edition, for conduct disorders in children and adolescents, together with their comorbidity with attention deficit hyperactivity disorder. PMID:26204088

  1. Quality of perceived parenting in oppositional and conduct disordered adolescents.

    PubMed

    Rey, J M; Plapp, J M

    1990-05-01

    In order to ascertain whether there was a relationship between parenting style and the development of conduct (CD) and oppositional (OD) disorder, the authors compared ratings on a self-report measure of perceived parenting (Parental Bonding Instrument) by normal adolescents (N = 62) and by adolescents with CD (N = 62) or OD (N = 49). No differences were found between the CD and OD groups. However, there were significant differences between the clinical groups and the normal control group: adolescents with CD or OD perceived their parents as more overprotective and less caring. PMID:2347834

  2. Menstruation disorders in adolescents with eating disorders – target body mass index percentiles for their resolution

    PubMed Central

    Vale, Beatriz; Brito, Sara; Paulos, Lígia; Moleiro, Pascoal

    2014-01-01

    ABSTRACT Objective: To analyse the progression of body mass index in eating disorders and to determine the percentile for establishment and resolution of the disease. Methods: A retrospective descriptive cross-sectional study. Review of clinical files of adolescents with eating disorders. Results: Of the 62 female adolescents studied with eating disorders, 51 presented with eating disorder not otherwise specified, 10 anorexia nervosa, and 1 bulimia nervosa. Twenty-one of these adolescents had menstrual disorders; in that, 14 secondary amenorrhea and 7 menstrual irregularities (6 eating disorder not otherwise specified, and 1 bulimia nervosa). In average, in anorectic adolescents, the initial body mass index was in 75th percentile; secondary amenorrhea was established 1 month after onset of the disease; minimum weight was 76.6% of ideal body mass index (at 4th percentile) at 10.2 months of disease; and resolution of amenorrhea occurred at 24 months, with average weight recovery of 93.4% of the ideal. In eating disorder not otherwise specified with menstrual disorder (n=10), the mean initial body mass index was at 85th percentile; minimal weight was in average 97.7% of the ideal value (minimum body mass index was in 52nd percentile) at 14.9 months of disease; body mass index stabilization occured at 1.6 year of disease; and mean body mass index was in 73rd percentile. Considering eating disorder not otherwise specified with secondary amenorrhea (n=4); secondary amenorrhea occurred at 4 months, with resolution at 12 months of disease (mean 65th percentile body mass index). Conclusion: One-third of the eating disorder group had menstrual disorder – two-thirds presented with amenorrhea. This study indicated that for the resolution of their menstrual disturbance the body mass index percentiles to be achieved by female adolescents with eating disorders was 25–50 in anorexia nervosa, and 50–75, in eating disorder not otherwise specified. PMID:25003922

  3. The Human Ortholog of Acid-Sensing Ion Channel Gene ASIC1a Is Associated With Panic Disorder And Amygdala Structure And Function

    PubMed Central

    Smoller, Jordan W.; Gallagher, Patience J.; Duncan, Laramie E.; McGrath, Lauren M.; Haddad, Stephen A.; Holmes, Avram.; Wolf, Aaron B.; Hilker, Sidney; Block, Stefanie R.; Weill, Sydney; Young, Sarah; Choi, Eun Young; Rosenbaum, Jerrold F.; Biederman, Joseph; Faraone, Stephen V.; Roffman, Joshua; Manfro, Gisele G.; Blaya, Carolina; Hirshfeld-Becker, Dina R.; Stein, Murray B.; Van Ameringen, Michael; Tolin, David F.; Otto, Michael W.; Pollack, Mark H.; Simon, Naomi M.; Buckner, Randy L.; Ongur, Dost; Cohen, Bruce M.

    2014-01-01

    Background Individuals with panic disorder (PD) exhibit a hypersensitivity to inhaled carbon dioxide (CO2), possibly reflecting a lowered threshold for sensing signals of suffocation. Animal studies have shown that CO2-mediated fear behavior depends on chemosensing of acidosis in the amygdala via the acid sensing ion channel ASIC1a. We examined whether the human ortholog of the ASIC1a gene, ACCN2, is associated with the presence of PD and with amygdala structure and function. Methods We conducted a case-control analysis (N=414 PD cases, 846 healthy controls) of ACCN2single nucleotide polymorphisms (SNPs) and PD. We then tested whether variants showing significant association with PD are also associated with amygdala volume (n=1,048) and/or task-evoked reactivity to emotional stimuli (n=103) in healthy individuals. Results Two SNPs at the ACCN2 locus showed evidence of association with PD: rs685012 (OR=1.32, gene-wise corrected p=0.011) and rs10875995 (OR=1.26, gene-wise corrected p=0.046). The association appeared to be stronger when early-onset (age ≤ 20) PD cases and when cases with prominent respiratory symptoms were compared to controls. The PD risk allele at rs10875995 was associated with increased amygdala volume (p=0.035), as well as task-evoked amygdala reactivity to fearful and angry faces (p=0.0048). Conclusions Genetic variation at ACCN2 appears to be associated with PD and with amygdala phenotypes that have been linked to anxiety proneness. These results support the possibility that modulation of acid-sensing ion channels may have therapeutic potential for PD. PMID:24529281

  4. 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…

  5. PATIENT-REPORTED OUTCOMES OF QUALITY OF LIFE, FUNCTIONING, AND DEPRESSIVE SYMPTOM SEVERITY IN MAJOR DEPRESSIVE DISORDER COMORBID WITH PANIC DISORDER BEFORE AND AFTER SSRI TREATMENT IN THE STAR*D TRIAL

    PubMed Central

    IsHak, Waguih William; Mirocha, James; Christensen, Scott; Wu, Fan; Kwock, Richard; Behjat, Joseph; Pi, Sarah; Akopyan, A.; Peselow, Eric D.; Cohen, Robert M.; Elashoff, David

    2014-01-01

    Background Panic disorder (PD) is highly comorbid with major depressive disorder (MDD) with potential impact on patient-reported outcomes of quality of life (QOL), functioning, and depressive symptom severity Methods Using data from the sequenced treatment alternatives to relieve depression (STAR*D) trial, we compared entry and post-SSRI-treatment QOL, functioning, and depressive symptom severity scores in MDD patients with comorbid PD (MDD+PD) to MDD patients without PD (MDDnoPD). We also compared pre- and posttreatment proportions of patients with severe impairments in quality of life and functioning. Results MDD+PD patients experienced significantly lower QOL and functioning and more severe depressive symptoms than MDDnoPD patients at entry. Following treatment with citalopram, both groups showed significant improvements, however, nearly 30–60% of patients still suffered from severe quality of life and functioning impairments. MDD+PD patients exited with lower QOL and functioning than MDDnoPD patients, a difference that became statistically insignificant after adjusting for baseline measures of depressive symptom severity, functioning, and QOL, comorbid anxiety disorders (PTSD, GAD, social, and specific phobias), age, and college education. Conclusions Functional outcomes using QOL and functioning measures should be utilized in treating and researching MDD so that shortfalls in traditional treatment can be identified and additional interventions can be designed to address severe baseline QOL and functioning deficits in MDD comorbid with PD. PMID:23861180

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

    PubMed Central

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

    2015-01-01

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

  7. 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.

  8. The pharmacological treatment of anxiety disorders in children and adolescents.

    PubMed

    Nash, Lawrence T; Hack, Sabine

    2002-05-01

    As the recognition of paediatric and adolescent anxiety disorders improves, so does the number of recommended treatments. Newer medications (chiefly serotonergic antidepressants) have emerged as the pharmacological treatment of choice and have largely replaced benzodiazepines and tricyclic antidepressants (TCAs) for these disorders. This review will focus on placebo-controlled and open-label studies concerning the treatment of anxiety in children and adolescents, comparing data from newer antidepressant medications (plus buspirone) with data on TCAs and benzodiazepines in this population. There are few randomised, placebo-controlled trials of medications for anxiety in children and adolescents, with most data coming from open-label trials and case series. Moreover, there are no studies comparing pharmacological versus behavioural treatments. Most recent data concerning the efficacy of selective serotonin reuptake inhibitors suggests that these agents will be effective and safe in the treatment of paediatric anxiety disorders. The potential side effect profiles of these newer agents also makes them an attractive first choice for anxiety when compared to the benzodiazepines or TCAs, each of which poses its own potentially serious adverse effects. More research is needed in the area of psychopharmacological treatments for paediatric and adolescent anxiety, not only to substantiate the current beliefs that serotonergic agents are effective and safe but to pinpoint the factors that might predict responses to particular agents or classes of medications. Future investigations should focus on treatments which have already proven effective for adult anxiety disorders (both medications and psychotherapies), given the apparent links between paediatric and adult anxiety disorders.

  9. Executive Attention Impairment in Adolescents with Major Depressive Disorder

    PubMed Central

    Sommerfeldt, Sasha L.; Cullen, Kathryn R.; Han, Georges; Fryza, Brandon J.; Houri, Alaa K.; Klimes-Dougan, Bonnie

    2015-01-01

    Objective Neural network models that guide neuropsychological assessment practices are increasingly used to explicate depression, though a paucity of work has focused on regulatory systems that are under development in adolescence. The purpose of this study was to evaluate subsystems of attention related to executive functioning including alerting, orienting, and executive attention networks, as well as sustained attention with varying working memory load, in a sample of depressed and well adolescents. Method Neuropsychological functioning in 99 adolescents diagnosed with major depressive disorder (MDD) and 63 adolescent healthy controls (M = 16.6 years old) was assessed on the Attention Network Task (ANT) and the Continuous Performance Test, Identical Pairs (CPT). Results Adolescents with MDD, particularly those who were not medicated, were slower to process conflict (slower reaction time on the executive attention scale of the ANT) compared to controls, particularly for those who were not undergoing psychopharmacological treatment. Tentative evidence also suggests that within the MDD group, orienting performance was more impaired in those with a history of comorbid substance use disorder, and alerting was more impaired in those with a history of a suicide attempt. Conclusions Adolescents with depression showed impaired executive attention, although cognitive performance varied across subgroups of patients. These findings highlight the importance of examining neurocognitive correlates associated with features of depression and suggest an avenue for future research to help guide the development of interventions. PMID:26566871

  10. Executive Attention Impairment in Adolescents With Major Depressive Disorder.

    PubMed

    Sommerfeldt, Sasha L; Cullen, Kathryn R; Han, Georges; Fryza, Brandon J; Houri, Alaa K; Klimes-Dougan, Bonnie

    2016-01-01

    Neural network models that guide neuropsychological assessment practices are increasingly used to explicate depression, though a paucity of work has focused on regulatory systems that are under development in adolescence. The purpose of this study was to evaluate subsystems of attention related to executive functioning including alerting, orienting, and executive attention networks, as well as sustained attention with varying working memory load, in a sample of depressed and well adolescents. Neuropsychological functioning in 99 adolescents diagnosed with major depressive disorder (MDD) and 63 adolescent healthy controls (M = 16.6 years old) was assessed on the Attention Network Test (ANT) and the Continuous Performance Test, Identical Pairs. Adolescents with MDD, particularly those who were not medicated, were slower to process conflict (slower reaction time on the Executive Attention scale of the ANT) compared to controls, particularly for those who were not undergoing psychopharmacological treatment. Tentative evidence also suggests that within the MDD group, orienting performance was more impaired in those with a history of comorbid substance use disorder, and alerting was more impaired in those with a history of a suicide attempt. Adolescents with depression showed impaired executive attention, although cognitive performance varied across subgroups of patients. These findings highlight the importance of examining neurocognitive correlates associated with features of depression and suggest an avenue for future research to help guide the development of interventions.

  11. Medication-Assisted Treatment of Adolescents With Opioid Use Disorders.

    PubMed

    2016-09-01

    Opioid use disorder is a leading cause of morbidity and mortality among US youth. Effective treatments, both medications and substance use disorder counseling, are available but underused, and access to developmentally appropriate treatment is severely restricted for adolescents and young adults. Resources to disseminate available therapies and to develop new treatments specifically for this age group are needed to save and improve lives of youth with opioid addiction. PMID:27550978

  12. Somatic Disorders of Childhood and Adolescence.

    ERIC Educational Resources Information Center

    Siegel, Lawrence J.

    1990-01-01

    Briefly reviews number of theories which address role of psychological factors in etiology of somatic disorders. Focuses on psychological treatment approaches that have been used to alleviate or reduce symptomatic behaviors associated with eating disorders, elimination disorders, and headaches in children. Discusses role of school psychologists in…

  13. Etiological model of disordered eating behaviors in Brazilian adolescent girls.

    PubMed

    Fortes, Leonardo de Sousa; Filgueiras, Juliana Fernandes; Oliveira, Fernanda da Costa; Almeida, Sebastião Sousa; Ferreira, Maria Elisa Caputo

    2016-01-01

    The objective was to construct an etiological model of disordered eating behaviors in Brazilian adolescent girls. A total of 1,358 adolescent girls from four cities participated. The study used psychometric scales to assess disordered eating behaviors, body dissatisfaction, media pressure, self-esteem, mood, depressive symptoms, and perfectionism. Weight, height, and skinfolds were measured to calculate body mass index (BMI) and percent body fat (%F). Structural equation modeling explained 76% of variance in disordered eating behaviors (F(9, 1,351) = 74.50; p = 0.001). The findings indicate that body dissatisfaction mediated the relationship between media pressures, self-esteem, mood, BMI, %F, and disordered eating behaviors (F(9, 1,351) = 59.89; p = 0.001). Although depressive symptoms were not related to body dissatisfaction, the model indicated a direct relationship with disordered eating behaviors (F(2, 1,356) = 23.98; p = 0.001). In conclusion, only perfectionism failed to fit the etiological model of disordered eating behaviors in Brazilian adolescent girls. PMID:27167040

  14. Sexuality Education for Adolescents and Adults with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Tullis, Christopher A.; Zangrillo, Amanda N.

    2013-01-01

    As people with autism spectrum disorders (ASD) mature from adolescents into adults, social deficits may become more pronounced and apparent in new areas (e.g., social functioning and sexuality). Like neurotypicals, sexuality may be directly related to quality of life for people with ASD. Current practice for addressing sexuality in the ASD…

  15. Spatial Contrast Sensitivity in Adolescents with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Koh, Hwan Cui; Milne, Elizabeth; Dobkins, Karen

    2010-01-01

    Adolescents with autism spectrum disorders (ASD) and typically developing (TD) controls underwent a rigorous psychophysical assessment that measured contrast sensitivity to seven spatial frequencies (0.5-20 cycles/degree). A contrast sensitivity function (CSF) was then fitted for each participant, from which four measures were obtained: visual…

  16. Habit Reversal Training for Tic Disorders in Children and Adolescents

    ERIC Educational Resources Information Center

    Piacentini, John; Chang, Susanna

    2005-01-01

    Chronic tic disorders, including Tourette's syndrome (TS), affect approximately .5% of children and adolescents. Although strong evidence exists supporting a neurobiological etiology, operant factors may play a role in the maintenance of tic behaviors. Pharmacological approaches remain the most commonly used intervention for chronic tic disorder…

  17. Obsessive-Compulsive Disorder in Childhood and Adolescence.

    ERIC Educational Resources Information Center

    McGough, James J.; And Others

    1993-01-01

    Reviews literature on Obsessive-Compulsive Disorder (OCD) in children and adolescents, emphasizing clinical presentation, evaluation, and treatment options. Notes that patients with OCD show remarkable similarities in clinical presentations, and have distinct profiles on cognitive, behavioral, and psychological measures. Concludes that advances in…

  18. Somatic Symptoms in Children and Adolescents with Anxiety Disorders

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  19. Does Temperament Moderate Treatment Response in Adolescent Substance Use Disorders?

    ERIC Educational Resources Information Center

    Burleson, Joseph A.; Kaminer, Yifrah

    2008-01-01

    To assess whether temperament moderates response to treatment for substance use disorders (SUD), n = 88 consecutively referred adolescents with SUD were randomized to cognitive-behavioral (CBT) or psychoeducational (PET) therapies. Principal components analyses reduced the 10-attribute Dimensions of Temperament Revised (DOTS-R) to three factors…

  20. 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…

  1. Reward Processing in Adolescents with Bipolar I Disorder

    ERIC Educational Resources Information Center

    Singh, Manpreet K.; Chang, Kiki D.; Kelley, Ryan G.; Cui, Xu; Sherdell, Lindsey; Howe, Meghan E.; Gotlib, Ian H.; Reiss, Allan L.

    2013-01-01

    Objective: Bipolar disorder (BD) is a debilitating psychiatric condition that commonly begins in adolescence, a developmental period that has been associated with increased reward seeking. Because youth with BD are especially vulnerable to negative risk-taking behaviors, understanding the neural mechanisms by which dysregulated affect interacts…

  2. Information Processing in Adolescents with Bipolar I Disorder

    ERIC Educational Resources Information Center

    Whitney, Jane; Joormann, Jutta; Gotlib, Ian H.; Kelley, Ryan G.; Acquaye, Tenah; Howe, Meghan; Chang, Kiki D.; Singh, Manpreet K.

    2012-01-01

    Background: Cognitive models of bipolar I disorder (BD) may aid in identification of children who are especially vulnerable to chronic mood dysregulation. Information-processing biases related to memory and attention likely play a role in the development and persistence of BD among adolescents; however, these biases have not been extensively…

  3. The Impact of Obesity on Developmental Coordination Disorder in Adolescence

    ERIC Educational Resources Information Center

    Wagner, Matthias Oliver; Kastner, Julia; Petermann, Franz; Jekauc, Darko; Worth, Annette; Bos, Klaus

    2011-01-01

    Developmental coordination disorder (DCD) as well as overweight and obesity are of increasing importance in the study of human development. Data on the relation between DCD and obesity in adolescence are of particular interest because both phenomena are unlikely to disappear with age. The objective of this study was to determine the impact of…

  4. Factors Related to Eating Disorders in Young Adolescent Girls.

    ERIC Educational Resources Information Center

    Eisele, Jill; And Others

    1986-01-01

    Identified factors related to eating disorders in young adolescent girls. Findings revealed significant differences among the girls based on intact versus broken family; subjects' actual and preferred weight; whether the family ate meals together; average grades; age and grade in school; fathers' occupation; future career plans; place of…

  5. Sertraline in Children and Adolescents with Major Depressive Disorder

    ERIC Educational Resources Information Center

    Donnelly, Craig L.; Wagner, Karen Dineen; Rynn, Moira; Ambrosini, Paul; Landau, Phyllis; Yang, Ruoyong; Wohlberg, Christopher J.

    2006-01-01

    Objective: To explore time to first response and time to first persistent response of sertraline versus placebo and compare these parameters between children (6-11 years old, n = 177) and adolescents (12-17 years old, n = 199) with major depressive disorder. Method: A 10-week placebo-controlled treatment was followed by a 24-week open-label…

  6. Cognitive-Behavioral Therapy for Adolescent Body Dysmorphic Disorder

    ERIC Educational Resources Information Center

    Greenberg, Jennifer L.; Markowitz, Sarah; Petronko, Michael R.; Taylor, Caitlin E.; Wilhelm, Sabine; Wilson, G. Terence

    2010-01-01

    The onset of appearance-related concerns associated with body dysmorphic disorder (BDD) typically occurs in adolescence, and these concerns are often severe enough to interfere with normal development and psychosocial functioning. Cognitive behavioral therapy (CBT) is an effective treatment for adults with BDD. However, no treatment studies…

  7. Adolescent Eating Disorders: Who's at Risk and Why?

    ERIC Educational Resources Information Center

    Glovinsky, Diane M.

    1993-01-01

    In a culture glorifying thinness and beauty, most females (especially adolescents) carry some risk of developing eating disorders. A recent survey of 280 South Carolina middle school students disclosed significant female/male differences. About 70% of the girls felt fat; many used various weight-loss techniques, including dieting, fasting,…

  8. Adolescent Females with Communication Disorders Involved in Violence: Educators' Opinions

    ERIC Educational Resources Information Center

    Montgomery, Judy K.; Sanger, Dixie; Moore-Brown, Barbara J.; Smith, Leslie; Scheffler, Marilyn

    2003-01-01

    This study focused on increasing the awareness of educational leaders about the relationship between students with communication disorders and violence. A review of selected research on adolescent females with language problems residing in a correctional facility served to support a survey study and extend discussions about the need for…

  9. Eating Disorders and Sexual Abuse among Adolescents.

    ERIC Educational Resources Information Center

    Hernandez, Jeanne

    This study was conducted to examine the list of identifying factors and predictors of childhood physical abuse, extrafamilial sexual abuse, and incest among male and female adolescents in the general population. In 1989, a survey was administered to 6,224 9th and 12th grade students in public schools in Minnesota. The findings revealed that more…

  10. [Social factors and pathomorphosis of phobic disorders in adolescence].

    PubMed

    Golovina, A G

    2011-01-01

    Author studied 330 patients (265 boys and 65 girls), aged 15-17 years, with phobic disorders. The common trends of the sociogenic pathomorphosis of these disorders were revealed. The socially determined pathomorphosis of phobias in adolescence manifests itself in the appearance of new phobic objects, changes in subjects of phobias and frequencies of their types. Social phobic states, most vulnerable to environmental factors, that reached the level of psychopatologically completed syndromes were the most frequent (20.7% of all phobias). In their structure, there were fears of social interaction, about a half of them (10.3%) directly relating with school situations (erytophobia, school phobia, fears of incompetence, phobia of public speaking etc). A model of assistance to adolescents with phobic disorders is suggested. PMID:22027662

  11. Characteristics of individuals meeting criteria for new onset panic attacks following exposure to a typhoon.

    PubMed

    Roberson-Nay, Roxann; Berenz, Erin C; Acierno, Ron; Tran, Trinh Luong; Trung, Lam Tu; Tam, Nguyen Thanh; Tuan, Tran; Buoi, La Thi; Ha, Tran Thu; Thach, Tran Duc; Amstadter, Ananda B

    2013-10-30

    The association between trauma exposure and panic attacks has received increased attention over the past decade, with mounting evidence suggesting an overlapping etiologic pathway. This study examined the incidence of new onset panic attacks in 775 Vietnamese individuals in the 2-3 months following Typhoon Xangsane. Pre-typhoon (Wave 1) and post-typhoon (Wave 2) assessments were conducted, allowing for consideration of factors occurring prior to the typhoon in addition to typhoon-relevant responding. Of the 775 participants, 11.6% (n=90) met criteria for lifetime panic attack pre-typhoon and 2.8% (n=22) met post-typhoon panic attack criteria. Individuals with pre-typhoon panic were significantly older and reported less education compared to the no-panic group. Individuals in both panic groups were more likely to screen positive on a Wave1 psychiatric screening measure, endorse greater typhoon exposure and prior traumatic event exposure and were significantly more likely to meet DSM-IV criteria for posttraumatic stress disorder (PTSD) and major depression (MDD) post-typhoon compared with persons reporting no history of panic attacks. Pre and post-typhoon panic exhibited similar patterns across variables and both panic conditions were associated with the development of PTSD and MDD, suggesting that persons experiencing panic attacks may represent a vulnerable population in need of early intervention services. PMID:23778303

  12. Characteristics of individuals meeting criteria for new onset panic attacks following exposure to a typhoon.

    PubMed

    Roberson-Nay, Roxann; Berenz, Erin C; Acierno, Ron; Tran, Trinh Luong; Trung, Lam Tu; Tam, Nguyen Thanh; Tuan, Tran; Buoi, La Thi; Ha, Tran Thu; Thach, Tran Duc; Amstadter, Ananda B

    2013-10-30

    The association between trauma exposure and panic attacks has received increased attention over the past decade, with mounting evidence suggesting an overlapping etiologic pathway. This study examined the incidence of new onset panic attacks in 775 Vietnamese individuals in the 2-3 months following Typhoon Xangsane. Pre-typhoon (Wave 1) and post-typhoon (Wave 2) assessments were conducted, allowing for consideration of factors occurring prior to the typhoon in addition to typhoon-relevant responding. Of the 775 participants, 11.6% (n=90) met criteria for lifetime panic attack pre-typhoon and 2.8% (n=22) met post-typhoon panic attack criteria. Individuals with pre-typhoon panic were significantly older and reported less education compared to the no-panic group. Individuals in both panic groups were more likely to screen positive on a Wave1 psychiatric screening measure, endorse greater typhoon exposure and prior traumatic event exposure and were significantly more likely to meet DSM-IV criteria for posttraumatic stress disorder (PTSD) and major depression (MDD) post-typhoon compared with persons reporting no history of panic attacks. Pre and post-typhoon panic exhibited similar patterns across variables and both panic conditions were associated with the development of PTSD and MDD, suggesting that persons experiencing panic attacks may represent a vulnerable population in need of early intervention services.

  13. Low body weight in male children and adolescents with schizoid personality disorder or Asperger's disorder.

    PubMed

    Hebebrand, J; Henninghausen, K; Nau, S; Himmelmann, G W; Schulz, E; Schäfer, H; Remschmidt, H

    1997-07-01

    This study explored the hypothesis that body weight is reduced in male children and adolescents with schizoid personality disorder or Asperger's disorder. The body weights of 33 consecutively admitted male subjects with one of these disorders were retrospectively assessed with percentiles for the body mass index (BMI). The mean percentile (+/- SD) for the BMI was 31.6 +/- 27.6 and differed significantly from the expected value of 50 (P<0.001). Ten subjects had a BMI of < or = 10th age percentile. Post hoc comparisons revealed that BMI percentiles were (a) reduced to a similar extent in patients with schizoid personality disorder and Asperger's disorder and (b) reduced to a greater extent in patients with abnormal eating behaviour. During childhood and adolescence both diagnoses are associated with an increased risk of being underweight. Population-based BMI percentiles are useful for detecting associations between specific psychopathological syndromes and body weight.

  14. Quality of life of adolescents with autism spectrum disorders: comparison to adolescents with diabetes.

    PubMed

    Cottenceau, Hélène; Roux, Sylvie; Blanc, Romuald; Lenoir, Pascal; Bonnet-Brilhault, Frédérique; Barthélémy, Catherine

    2012-05-01

    Relationships are of great importance during adolescence. Because of their social, communication and behavioral impairments, adolescents with Asperger's syndrome (AS) or high functioning autism (HFA) probably suffer from considerable impairment of their quality of life when facing their peers in school. Nevertheless, only one recent study has been published on this subject, indicating a lower health-related quality of life in children and adolescents with autism spectrum disorders (ASD) than in healthy controls. The goals of our study were to clarify the consequences of autistic disorder without mental retardation on such adolescents' daily lives, and to consider them in comparison with the impact of a chronic somatic disease (diabetes) and with the period of adolescence itself, using the VSP-A questionnaire. Adolescents with diabetes were chosen as a comparison group because of the encumbrance of having a constant need for insulin supplementation, to be assimilated to the constant need for communicative adjustments in teenagers with ASD, and the consequences in daily life. The effects of social skill training and social support on quality of life and the appropriateness of using the VSP-A in this population were also studied. Twenty-six adolescents with AS and HFA, 44 diabetic adolescents, and 250 controls completed a self-administered and validated questionnaire on quality of life, the VSP-A. Scores for adolescents with ASD were significantly lower than those of the control and the diabetic adolescents, especially for friendships, leisure time, and affective and sexual relationships. On the other hand, better scores were obtained for the relationships with parents and teachers and for self-image. Social parameters affected the quality of life of subjects with ASD, such as having friends, regularly participating in a sport, and having the support of a school carer. For subjects with autistic spectrum disorders and without mental retardation, impairment of quality

  15. 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…

  16. Sleep and circadian contributions to adolescent alcohol use disorder.

    PubMed

    Hasler, Brant P; Soehner, Adriane M; Clark, Duncan B

    2015-06-01

    Adolescence is a time of marked changes across sleep, circadian rhythms, brain function, and alcohol use. Starting at puberty, adolescents' endogenous circadian rhythms and preferred sleep times shift later, often leading to a mismatch with the schedules imposed by secondary education. This mismatch induces circadian misalignment and sleep loss, which have been associated with affect dysregulation, increased drug and alcohol use, and other risk-taking behaviors in adolescents and adults. In parallel to developmental changes in sleep, adolescent brains are undergoing structural and functional changes in the circuits subserving the pursuit and processing of rewards. These developmental changes in reward processing likely contribute to the initiation of alcohol use during adolescence. Abundant evidence indicates that sleep and circadian rhythms modulate reward function, suggesting that adolescent sleep and circadian disturbance may contribute to altered reward function, and in turn, alcohol involvement. In this review, we summarize the relevant evidence and propose that these parallel developmental changes in sleep, circadian rhythms, and neural processing of reward interact to increase risk for alcohol use disorder (AUD).

  17. Working around a contested diagnosis: borderline personality disorder in adolescence.

    PubMed

    Koehne, Kristy; Hamilton, Bridget; Sands, Natisha; Humphreys, Cathy

    2013-01-01

    This discourse analytic study sits at the intersection of everyday communications with young people in mental health settings and the enduring sociological critique of diagnoses in psychiatry. The diagnosis of borderline personality disorder (BPD) is both contested and stigmatized, in mental health and general health settings. Its legitimacy is further contested within the specialist adolescent mental health setting. In this setting, clinicians face a quandary regarding the application of adult diagnostic criteria to an adolescent population, aged less than 18 years. This article presents an analysis of interviews undertaken with Child and Adolescent Mental Health Services (CAMHS) clinicians in two publicly funded Australian services, about their use of the BPD diagnosis. In contrast with notions of primacy of diagnosis or of transparency in communications, doctors, nurses and allied health clinicians resisted and subverted a diagnosis of BPD in their work with adolescents. We delineate specific social and discursive strategies that clinicians displayed and reflected on, including: team rules which discouraged diagnostic disclosure; the lexical strategy of hedging when using the diagnosis; the prohibition and utility of informal 'borderline talk' among clinicians; and reframing the diagnosis with young people. For clinicians, these strategies legitimated their scepticism and enabled them to work with diagnostic uncertainty, in a population identified as vulnerable. For adolescent identities, these strategies served to forestall a BPD trajectory, allowing room for troubled adolescents to move and grow. These findings illuminate how the contest surrounding this diagnosis in principle is expressed in everyday clinical practice. PMID:22674745

  18. Parental Mediation of Television Viewing and Videogaming of Adolescents with Autism Spectrum Disorder and Their Siblings

    ERIC Educational Resources Information Center

    Kuo, Melissa H.; Magill-Evans, Joyce; Zwaigenbaum, Lonnie

    2015-01-01

    Adolescents with autism spectrum disorder spend considerable time in media activities. Parents play an important role in shaping adolescents' responses to media. This study explored the mediation strategies that parents of adolescents with autism spectrum disorder used to manage television and video game use, factors associated with their use of…

  19. Comparison of Obesity, Physical Activity, and Sedentary Behaviors between Adolescents with Autism Spectrum Disorders and Without

    ERIC Educational Resources Information Center

    McCoy, Stephanie M.; Jakicic, John M.; Barone Gibbs, Bethany

    2016-01-01

    Body mass index classification, physical activity (PA), and sedentary behaviors were compared in adolescents with autism spectrum disorder (ASD) to typically developing adolescents. Participants included 42,747 adolescents (ASD, n = 915) from the 2011-2012 National Survey of Children's Health. After controlling for covariates, adolescents were…

  20. 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…

  1. ERICA: prevalence of common mental disorders in Brazilian adolescents

    PubMed Central

    Lopes, Claudia S; Abreu, Gabriela de Azevedo; dos Santos, Debora França; Menezes, Paulo Rossi; de Carvalho, Kenia Mara Baiocchi; Cunha, Cristiane de Freitas; de Vasconcellos, Mauricio Teixeira Leite; Bloch, Katia Vergetti; Szklo, Moyses

    2016-01-01

    ABSTRACT OBJECTIVE To describe the prevalence of common mental disorders in Brazilian adolescent students, according to geographical macro-regions, school type, sex, and age. METHODS We evaluated 74,589 adolescents who participated in the Cardiovascular Risk Study in Adolescents (ERICA), a cross-sectional, national, school-based study conducted in 2013-2014 in cities with more than 100,000 inhabitants. A self-administered questionnaire and an electronic data collector were employed. The presence of common mental disorders was assessed using the General Health Questionnaire (GHQ-12). We estimated prevalence and 95% confidence intervals of common mental disorders by sex, age, and school type, in Brazil and in the macro-regions, considering the sample design. RESULTS The prevalence of common mental disorders was of 30.0% (95%CI 29.2-30.8), being higher among girls (38.4%; 95%CI 37.1-39.7) when compared to boys (21.6%; 95%CI 20.5-22.8), and among adolescents who were from 15 to 17 years old (33.6%; 95%CI 32.2-35.0) compared to those aged between 12 and 14 years (26.7%; 95%CI 25.8-27.6). The prevalence of common mental disorders increased with age for both sexes, always higher in girls (ranging from 28.1% at 12 years to 44.1% at 17 years) than in boys (ranging from 18.5% at 12 years to 27.7% at 17 years). We did not observe any significant difference by macro-region or school type. Stratified analyses showed higher prevalence of common mental disorders among girls aged from 15 to 17 years of private schools in the North region (53.1; 95%CI 46.8-59.4). CONCLUSIONS The high prevalence of common mental disorders among adolescents and the fact that the symptoms are often vague mean these disorders are not so easily identified by school administrators or even by health services. The results of this study can help the proposition of more specific prevention and control measures, focused on highest risk subgroups. PMID:26910549

  2. ERICA: prevalence of common mental disorders in Brazilian adolescents.

    PubMed

    Lopes, Claudia S; Abreu, Gabriela de Azevedo; dos Santos, Debora França; Menezes, Paulo Rossi; de Carvalho, Kenia Mara Baiocchi; Cunha, Cristiane de Freitas; de Vasconcellos, Mauricio Teixeira Leite; Bloch, Katia Vergetti; Szklo, Moyses

    2016-02-01

    OBJECTIVE To describe the prevalence of common mental disorders in Brazilian adolescent students, according to geographical macro-regions, school type, sex, and age. METHODS We evaluated 74,589 adolescents who participated in the Cardiovascular Risk Study in Adolescents (ERICA), a cross-sectional, national, school-based study conducted in 2013-2014 in cities with more than 100,000 inhabitants. A self-administered questionnaire and an electronic data collector were employed. The presence of common mental disorders was assessed using the General Health Questionnaire (GHQ-12). We estimated prevalence and 95% confidence intervals of common mental disorders by sex, age, and school type, in Brazil and in the macro-regions, considering the sample design. RESULTS The prevalence of common mental disorders was of 30.0% (95%CI 29.2-30.8), being higher among girls (38.4%; 95%CI 37.1-39.7) when compared to boys (21.6%; 95%CI 20.5-22.8), and among adolescents who were from 15 to 17 years old (33.6%; 95%CI 32.2-35.0) compared to those aged between 12 and 14 years (26.7%; 95%CI 25.8-27.6). The prevalence of common mental disorders increased with age for both sexes, always higher in girls (ranging from 28.1% at 12 years to 44.1% at 17 years) than in boys (ranging from 18.5% at 12 years to 27.7% at 17 years). We did not observe any significant difference by macro-region or school type. Stratified analyses showed higher prevalence of common mental disorders among girls aged from 15 to 17 years of private schools in the North region (53.1; 95%CI 46.8-59.4). CONCLUSIONS The high prevalence of common mental disorders among adolescents and the fact that the symptoms are often vague mean these disorders are not so easily identified by school administrators or even by health services. The results of this study can help the proposition of more specific prevention and control measures, focused on highest risk subgroups.

  3. Factors Associated with Substance Use in Adolescents with Eating Disorders

    PubMed Central

    Mann, Andrea P; Accurso, Erin C.; Stiles-Shields, Colleen; Capra, Lauren; Labuschagne, Zandre; Karnik, Niranjan S.; Grange, Daniel Le

    2014-01-01

    Purpose To examine the prevalence and potential risk factors associated with substance use in adolescents with eating disorders (EDs). Methods This cross-sectional study included 290 adolescents, ages 12 –18 years, who presented for an initial ED evaluation at The Eating Disorders Program at The University of Chicago Medicine (UCM) between 2001 and 2012. Several factors, including DSM-5 diagnosis, diagnostic scores, and demographic characteristics were examined. Multinomial logistic regression was used to test associations between several factors and patterns of drug use for alcohol, cannabis, tobacco, and any substance. Results Lifetime prevalence of any substance use was found to be 24.6% in those with anorexia nervosa (AN), 48.7% in bulimia nervosa (BN), and 28.6% in eating disorder not otherwise specified (EDNOS). Regular substance use (monthly, daily, and bingeing behaviors) or a substance use disorder (SUD) was found in 27.9% of all patients. Older age was the only factor associated with regular use of any substance in the final multinomial model. Older age and non-White race was associated with greater alcohol and cannabis use. Although binge-purge frequency and BN diagnosis were associated with regular substance use in bivariate analyses, gender, race and age were more robustly associated with substance use in the final multinomial models. Conclusions Co-morbid substance use in adolescents with EDs is an important issue. Interventions targeting high-risk groups reporting regular substance use or SUDs are needed. PMID:24656448

  4. [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

  5. [Eating Disorders and drug use in adolescents].

    PubMed

    Bisetto Pons, David; Botella Guijarro, Álvaro; Sancho Muñoz, Alberto

    2012-01-01

    The aim of the study was to show whether there was a connection between drug use and Eating Disorders, as well as to identify the type of drugs most widely used and to ascertain whether they are used to suppress appetite. An "ad hoc" scale was developed using the items of the Eating Disorder Diagnostic Scale, whose aim is to detect cases at risk of certain types of eating disorder, and items for assessing drug use. This scale was applied to samples of teenagers (n=446) aged 13-18 from various secondary schools in the Valencia Region (Comunidad Valenciana) in Spain. An association was found between teenagers that use drugs, and particularly between the variable "use of some kind of drug as an appetite suppressant", and being at risk of having an eating disorder. Tobacco was the drug most commonly used (accounting for 66% of those within the risk threshold of the Eating Disorder Diagnostic Scale). We conclude that those teenagers from the sample who fall within any of the risk thresholds consume more drugs than those who do not fall within the risk threshold of the Eating Disorder Diagnostic Scale. Stimulant-type drugs are those most widely used by these teenagers with the aim of suppressing appetite.

  6. Recent stressful life events among Bahraini adolescents with adjustment disorder.

    PubMed

    al-Ansari, A; Matar, A M

    1993-01-01

    Adolescents from two time periods, diagnosed with adjustment disorder (n = 72), were examined retrospectively for the type of life stressors that initiated their referrals to a child psychiatry unit. They were compared with a control group of adolescents (n = 42) who were referred to the unit during the same time periods and who received a diagnosis of "no psychopathology." Disappointment in relationships with a family member or with a friend of the opposite sex was found to be the main stressor. Frequency of distribution of the stressors was almost the same in the two time periods. Patients were more often females from nonintact families and referred mainly by medical personnel. The different presenting symptoms and the contribution of the stressors to the adolescents' difficulties are discussed.

  7. Eating disorder examination questionnaire: norms for young adolescent girls.

    PubMed

    Carter, J C; Stewart, D A; Fairburn, C G

    2001-05-01

    This paper reports young adolescent female norms for the Eating Disorder Examination Questionnaire (EDE-Q). The standardization sample was comprised of 808 girls aged between 12 and 14 years from three single-sex schools (one private and two state schools). Means, standard deviations and percentile ranks for raw EDE-Q subscale scores are presented. Prevalence figures for key eating disorder behaviors over the previous two weeks were as follows: 4% self-induced vomiting; 1% laxative misuse; 0.4% diuretic misuse; and 8% regular binge eating. PMID:11341255

  8. Attempted suicide of an adolescent with autism spectrum disorder.

    PubMed

    Mikami, Katsunaka; Onishi, Yuichi; Matsumoto, Hideo

    2014-01-01

    Although the suicide risk of autism spectrum disorder (ASD) has been suggested to be higher than previously recognized, there are few case reports focusing on the process for preventing suicide reattempts. We reported that a 17-year-old male who had attempted suicide by jumping was admitted to our emergency department and hospitalized for lumbar spine fracture. In addition to the diagnosis of adjustment disorder, he was diagnosed as ASD according to his life history. This article presents the characteristics of the suicidal behaviors and the process for preventing a suicide reattempt associated with an adolescent with ASD who attempted suicide. PMID:25084822

  9. Aspects of sleep disorders in children and adolescents

    PubMed Central

    Stores, Gregory

    2009-01-01

    Sleep disorders in children and adolescents is a topic that has been, and remains, neglected in both public health education and professional training. Although much knowledge has been accumulated in recent times, it has been poorly disseminated and, therefore, relatively little is put into practice. Only some general issues can be discussed in this article. The aspects chosen relate mainly to clinical practice, but they also have relevance for research. They concern various differences between sleep disorders in children and those in adults, the occurrence of such disorders in young people, their effects on psychological and physical development, the essential (but often ignored) distinction between sleep problems and their underlying causes (ie, sleep disorders), types of sleep disturbance encountered at different ages during development, and the differential diagnosis of certain parasomnias that are at particular risk of being confused with each other. PMID:19432390

  10. Sleep and Circadian Contributions to Adolescent Alcohol Use Disorder

    PubMed Central

    Hasler, Brant P.; Soehner, Adriane M.; Clark, Duncan B.

    2014-01-01

    Adolescence is a time of marked changes across sleep, circadian rhythms, brain function, and alcohol use. Starting at puberty, adolescents’ endogenous circadian rhythms and preferred sleep times shift later, often leading to a mismatch with the schedules imposed by secondary education. This mismatch induces circadian misalignment and sleep loss, which have been associated with affect dysregulation, increased drug and alcohol use, and other risk-taking behaviors in adolescents and adults. In parallel to developmental changes in sleep, adolescent brains are undergoing structural and functional changes in the circuits subserving the pursuit and processing of rewards. These developmental changes in reward processing likely contribute to the initiation of alcohol use during adolescence. Abundant evidence indicates that sleep and circadian rhythms modulate reward function, suggesting that adolescent sleep and circadian disturbance may contribute to altered reward function, and in turn, alcohol involvement. In this review, we summarize the relevant evidence and propose that these parallel developmental changes in sleep, circadian rhythms, and neural processing of reward interact to increase risk for alcohol use disorder (AUD). PMID:25442171

  11. Eating disorders in adolescents with a history of obesity.

    PubMed

    Sim, Leslie A; Lebow, Jocelyn; Billings, Marcie

    2013-10-01

    Adolescent patients with obesity are at significant risk of developing an eating disorder (ED), yet due to their higher weight status their symptoms often go unrecognized and untreated. Although not widely known, individuals with a weight history in the overweight (BMI-for-age ≥85th percentile but <95th percentile, as defined by Centers for Disease Control and Prevention growth charts) or obese (BMI-for-age ≥95th percentile, as defined by the Centers for Disease Control and Prevention growth charts) range, represent a substantial portion of adolescents presenting for ED treatment. Given research that suggests that early intervention promotes the best chance of recovery, it is imperative that these children's and adolescents' ED symptoms are identified and that intervention is offered before the disease progresses. This report presents 2 examples of EDs that developed in the context of obese adolescents' efforts to reduce their weight. Each case shows specific challenges in the identification of ED behaviors in adolescents with this weight history and the corresponding delay such teenagers experience accessing appropriate treatment.

  12. 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

  13. Onset of Alcohol or Substance Use Disorders Following Treatment for Adolescent Depression

    ERIC Educational Resources Information Center

    Curry, John; Silva, Susan; Rohde, Paul; Ginsburg, Golda; Kennard, Betsy; Kratochvil, Christopher; Simons, Anne; Kirchner, Jerry; May, Diane; Mayes, Taryn; Feeny, Norah; Albano, Anne Marie; Lavanier, Sarah; Reinecke, Mark; Jacobs, Rachel; Becker-Weidman, Emily; Weller, Elizabeth; Emslie, Graham; Walkup, John; Kastelic, Elizabeth; Burns, Barbara; Wells, Karen; March, John

    2012-01-01

    Objective: This study tested whether positive response to short-term treatment for adolescent major depressive disorder (MDD) would have the secondary benefit of preventing subsequent alcohol use disorders (AUD) or substance use disorders (SUD). Method: For 5 years, we followed 192 adolescents (56.2% female; 20.8% minority) who had participated in…

  14. Functional Outcomes of Child and Adolescent Oppositional Defiant Disorder Symptoms in Young Adult Men

    ERIC Educational Resources Information Center

    Burke, Jeffrey D.; Rowe, Richard; Boylan, Khrista

    2014-01-01

    Background: Oppositional defiant disorder (ODD) is considered to be a disorder of childhood, yet evidence suggests that prevalence rates of the disorder are stable into late adolescence and trajectories of symptoms persist into young adulthood. Functional outcomes associated with ODD through childhood and adolescence include conflict within…

  15. Adolescent substance use disorders and comorbidity.

    PubMed

    Simkin, Deborah R

    2002-04-01

    remove barriers. This technique allows youth to be less defensive and more proactive. Monti et al. [59] have demonstrated that this technique has been useful in getting youth into treatment. Primary care physicians can use instruments that will assess the possibility of both externalizing (e.g., ADHD) and internalizing (e.g., depression and anxiety) disorders. Examples of this type of instrument are the Auchenbach child behavior checklist, teacher report form, and youth self-report form, which survey symptoms for these disorders [1]. Social anxiety disorder can be detected by asking whether the prelatency child went into new situations willingly and tended to hang back or whether the child had difficulty separating from his or her parents. Other questions to ask are whether the child tended to isolate or was fearful of speaking in front of the class. Of course, any bruising or behavior that suggests exposure to adult-related sexual acts may cause concern for physical or sexual abuse and possible PTSD. However, interest in sex earlier than expected for the age of the child may also indicate the possibility of bipolar disorder. These children have many symptoms of ADHD with a high degree of irritability and may seem boastful or grandiose. They may be "daredevils" with no fear of dangerous consequences. Referral to a specialist is necessary to evaluate these children further. Because substance use at age 14 or 15 years can be predicted by academic and social behavior at ages 7 to 9 years, early detection of poor social skills and learning difficulties is essential [43]. Learning disorders can be uncovered by asking the school to do an evaluation. However, schools having economic problems may not be able to accommodate all requests. A parent may have to pay a private provider to complete this workup because insurance companies seldom pay for educational testing. Learning disorders may go undetected because many school systems opt to use a higher deviation from the full

  16. Adolescent substance use disorders and comorbidity.

    PubMed

    Simkin, Deborah R

    2002-04-01

    remove barriers. This technique allows youth to be less defensive and more proactive. Monti et al. [59] have demonstrated that this technique has been useful in getting youth into treatment. Primary care physicians can use instruments that will assess the possibility of both externalizing (e.g., ADHD) and internalizing (e.g., depression and anxiety) disorders. Examples of this type of instrument are the Auchenbach child behavior checklist, teacher report form, and youth self-report form, which survey symptoms for these disorders [1]. Social anxiety disorder can be detected by asking whether the prelatency child went into new situations willingly and tended to hang back or whether the child had difficulty separating from his or her parents. Other questions to ask are whether the child tended to isolate or was fearful of speaking in front of the class. Of course, any bruising or behavior that suggests exposure to adult-related sexual acts may cause concern for physical or sexual abuse and possible PTSD. However, interest in sex earlier than expected for the age of the child may also indicate the possibility of bipolar disorder. These children have many symptoms of ADHD with a high degree of irritability and may seem boastful or grandiose. They may be "daredevils" with no fear of dangerous consequences. Referral to a specialist is necessary to evaluate these children further. Because substance use at age 14 or 15 years can be predicted by academic and social behavior at ages 7 to 9 years, early detection of poor social skills and learning difficulties is essential [43]. Learning disorders can be uncovered by asking the school to do an evaluation. However, schools having economic problems may not be able to accommodate all requests. A parent may have to pay a private provider to complete this workup because insurance companies seldom pay for educational testing. Learning disorders may go undetected because many school systems opt to use a higher deviation from the full

  17. How adolescents with substance use disorder spend research payments.

    PubMed

    Thurstone, Christian; Salomensen-Sautel, Stacy; Riggs, Paula D

    2010-10-01

    There is concern that research reimbursements to adolescents may increase substance use. However, these concerns have not been examined empirically. Participants were 70 adolescents (13-19 years) with at least one non-nicotine substance use disorder (SUD) enrolled in a 12-week clinical trial of atomoxetine/placebo for attention/deficit-hyperactivity disorder (ADHD). Adolescent participants received cash reimbursement after each study visit (maximum possible = $425 over 12 weeks). Participants reported each week how they spent the previous reimbursement. Results were tallied, and correlates of spending a payment on substances were examined. Results showed that 26 of 70 subjects reported spending at least one research payment on alcohol or drugs, and 25 of 70 subjects reported spending at least one payment on tobacco. Comparing those who did and did not spend a research payment on alcohol/drugs, those who did had more frequent baseline alcohol/drug use but did not differ in demographics (age, gender) or other clinical characteristics (ADHD severity, diagnosis of conduct disorder, number of SUD diagnoses, number of treatment sessions attended, or pre/post-change in number of days used substances in the past 28 days). Comparing those who did and did not spend a payment on tobacco, those who did were slightly older and had more frequent baseline tobacco use. In conclusion, a significant proportion of subjects used at least a portion of one research payment to buy alcohol, drugs or tobacco. However, there was little indication that research payments increased substance use. PMID:20627618

  18. Latent Classes of Adolescent Posttraumatic Stress Disorder Predict Functioning and Disorder after 1 Year

    ERIC Educational Resources Information Center

    Ayer, Lynsay; Danielson, Carla Kmett; Amstadter, Ananda B.; Ruggiero, Ken; Saunders, Ben; Kilpatrick, Dean

    2011-01-01

    Objective: To identify latent classes of posttraumatic stress disorder (PTSD) symptoms in a national sample of adolescents, and to test their associations with PTSD and functional impairment 1 year later. Method: A total of 1,119 trauma-exposed youth aged 12 through 17 years (mean = 14.99 years, 51% female and 49% male) participating in the…

  19. [Psychosocial Characteristics of Adolescent Girls with Posttraumatic Stress Disorders and Substance Use Disorders].

    PubMed

    Thomsen, Monika; Baldus, Christiane; Herschelmann, Susanne; Schäfer, Ingo; Thomasius, Rainer

    2016-09-01

    Psychosocial Characteristics of Adolescent Girls with Posttraumatic Stress Disorders and Substance Use Disorders Already in adolescence posttraumatic stress disorder (PTSD) and substance use disorders (SUD) often occur comorbid. SUD is usually in the focus of treatment and underlying PTSD is not always recognized. To date there is no explicit offer for the simultaneous treatment of both clinical pictures in adolescence. In the present study we tested whether the group intervention Seeking Safety, that is implemented successfully in adulthood, would also be interesting for the youth clientele. In addition we analyzed the characteristics of a target group of girls and young women between 14 and 21 years, that could be reached for such a program in a German city. In the present study we conducted 39 complete interviews that enable an estimation of the various strains and symptoms of those affected. The results clarify that female adolescents with a dual diagnosis PTSD and SUD are currently not sufficiently addressed by the supply system and could benefit from a specific treatment like Seeking Safety. PMID:27595808

  20. An Investigation of Comorbid Psychological Disorders, Sleep Problems, Gastrointestinal Symptoms and Epilepsy in Children and Adolescents with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Mannion, Arlene; Leader, Geraldine; Healy, Olive

    2013-01-01

    The current study investigated comorbidity in eighty-nine children and adolescents with Autism Spectrum Disorder in Ireland. Comorbidity is the presence of one or more disorders in addition to a primary disorder. The prevalence of comorbid psychological disorders, behaviours associated with comorbid psychopathology, epilepsy, gastrointestinal…

  1. Eating disorder behaviors and attitudes in Japanese adolescent girls and boys in high schools.

    PubMed

    Nakai, Yoshikatsu; Noma, Shun'ichi; Nin, Kazuko; Teramukai, Satoshi; Wonderlich, Stephen A

    2015-12-15

    To investigate eating disorder behaviors and attitudes in adolescents, we administered the eating disorder examination questionnaire (EDE-Q) to Japanese adolescent girls and boys. The EDE-Q global scores in Japanese girls and boys, respectively, were significantly lower than those in girls and boys in previous studies. Objective binge eating episodes and extreme dietary restriction were the common behaviors, whereas self-induced vomiting and the misuse of laxatives were uncommon. Differences in the EDE-Q data between Japanese adolescents and adolescents in previous studies from Western countries suggest that there may be certain cultural differences in eating disorder psychopathology in adolescents.

  2. [Functional Neuroimaging Pilot Study of Borderline Personality Disorder in Adolescents].

    PubMed

    LeBoeuf, Amélie; Guilé, Jean-Marc; Labelle, Réal; Luck, David

    2016-01-01

    Borderline personality disorder (BPD) is being increasingly recognized by clinicians working with adolescents, and the reliability and validity of the diagnosis have been established in the adolescent population. Adolescence is known to be a period of high risk for BPD development as most patients identify the onset of their symptoms to be in the adolescent period. As with other mental health disorders, personality disorder, are thought to result from the interaction between biological and environmental factors. Functional neuroimaging studies are reporting an increasing amount of data on abnormal neuronal functions in BPD adult patients. However, no functional neuroimaging studies have been conducted in adolescents with BPD.Objectives This pilot project aims to evaluate the feasibility of a functional magnetic resonance imaging (fMRI) study coupled with clinical and psychological measures in adolescent girls with a diagnosis of BPD. It also aims to identify neuronal regions of interest (ROI) for the study of BPD in adolescent girls.Method Six female adolescents meeting DSM-IV criteria for BPD and 6 female adolescents without psychiatric disorder were recruited. Both groups were evaluated for BPD symptoms, depressive symptoms, impulsivity, affective lability, and other potential psychiatric comorbidities. We used fMRI to compare patterns of regional brain activation between these two groups as they viewed 20 positive, 20 negative and 20 neutral emotion-inducing pictures, which were presented in random order.Results Participants were recruited over a period of 22 months. The protocol was well tolerated by participants. Mean age of the BPD group and control group was 15.8 ± 0.9 years-old and 15.5 ± 1.2 years-old respectively. Psychiatric comorbidity and use of medication was common among participants in the BPD group. This group showed higher impulsivity and affective lability scores. For the fMRI task, BPD patients demonstrated greater differences in activation

  3. Untangling genetic networks of panic, phobia, fear and anxiety

    PubMed Central

    Villafuerte, Sandra; Burmeister, Margit

    2003-01-01

    As is the case for normal individual variation in anxiety levels, the conditions panic disorder, agoraphobia and other phobias have a significant genetic basis. Recent reports have started to untangle the genetic relationships between predispositions to anxiety and anxiety disorders. PMID:12914652

  4. [Eating disorders in childhood and adolescence. Anorexia nervosa, bulimia nervosa, binge eating disorder].

    PubMed

    Gerlinghoff, M; Backmund, H

    2004-03-01

    The most important eating disorders are anorexia and bulimia, which most frequently occur for the first time during adolescence and continue into adulthood. Medical complications and accompanying psychological disturbances cause a significant mortality rate of up to 6% in anorexia and up to 3% in bulimia. The pathogenesis of eating disorders is still unclear. Current etiological concepts are multidimensional including biological, individual, familial, and sociocultural factors. In spite of a great variety of therapeutic possibilities, the prognosis for eating disorders is quite poor. In the long term, only about 50% of the persons affected overcome their illness. Preventive measures are therefore indispensable.

  5. Cerebral blood flow changes during sodium-lactate-induced panic attacks

    SciTech Connect

    Stewart, R.S.; Devous, M.D. Sr.; Rush, A.J.; Lane, L.; Bonte, F.J.

    1988-04-01

    Dynamic single-photon emission computed axial tomography (CAT) with inhaled xenon-133 was used to measure regional cerebral blood flow in 10 drug-free patients with DSM-III-diagnosed panic disorder and in five normal control subjects. All subjects underwent regional cerebral blood flow studies while at rest or during normal saline infusion and during sodium lactate infusion. Six of the 10 patients and none of the control subjects experienced lactate-induced panic attacks. Lactate infusion markedly raised hemispheric blood flow levels in both control subjects and patients who did not panic. Patients who did panic experienced either a minimal increase or a decrease in hemispheric blood flow.

  6. Relation between Amygdala Structure and Function in Adolescents with Bipolar Disorder

    ERIC Educational Resources Information Center

    Kalmar, Jessica H.; Wang, Fei; Chepenik, Lara G.; Womer, Fay Y.; Jones, Monique M.; Pittman, Brian; Shah, Maulik P.; Martin, Andres; Constable, R. Todd; Blumberg, Hilary P.

    2009-01-01

    Adolescents with bipolar disorder showed decreased amygdala volume and increased amygdala response to emotional faces. Amygdala volume is inversely related to activation during emotional face processing.

  7. Friendship characteristics and activity patterns of adolescents with an autism spectrum disorder.

    PubMed

    Kuo, Melissa H; Orsmond, Gael I; Cohn, Ellen S; Coster, Wendy J

    2013-07-01

    This study compared perceptions of adolescents' friendships between adolescents with an autism spectrum disorder (ASD) and their parents, examined factors associated with friendship qualities, and investigated the adolescents' reports on the activities they did with friends and how activity patterns differed by gender. Ninety-one adolescents with an ASD and their parents completed mail-based surveys during the summer months. Adolescents with an ASD identified more friends than did their parents, but they agreed on the friends' characteristics. About half of the adolescents spent an average of 4 hours per day with friends during the summer months. Male adolescents with an ASD most frequently played video games with friends, whereas females most frequently had conversations with friends. The findings suggest that adolescents with an ASD and their parents identify different peers as the adolescent's friends. The findings also reveal similarities and differences in friendships between adolescents with an ASD and typically developing adolescents.

  8. Adolescent with Tourette Syndrome and Bipolar Disorder: A Case Report

    PubMed Central

    Kwon, Young-Joon

    2014-01-01

    Tourette syndrome consists of multiple motor tics and one or more vocal tics. Psychopathology occurs in approximately 90% of Tourette syndrome patients, with attention-deficit/hyperactivity, mood, and obsessive-compulsive disorders being common. Additionally, Tourette syndrome and bipolar disorder may be related in some individuals. However, it is unclear why bipolar disorder may be overrepresented in Tourette syndrome patients, and more research is needed. Herein, we report the case of a 15-year-old boy diagnosed with both Tourette syndrome and bipolar disorder, whose symptoms improved with aripiprazole, atomoxetine, and valproate. The patient was diagnosed with Tourette syndrome at 8 years of age when he developed tics and experienced his first depressive episode. The patient had a poor response to a variety of antidepressants and anti-tic medications. A combination of valproate and aripiprazole stabilized both the patient's tics and mood symptoms. It is important to assess individuals with Tourette syndrome for other disorders, including bipolar disorder. The treatment of children and adolescents with both Tourette syndrome and bipolar disorder is an important clinical issue. PMID:25598829

  9. Immune system dysregulation in adolescent major depressive disorder

    PubMed Central

    Gabbay, Vilma; Klein, Rachel G.; Alonso, Carmen M.; Babb, James S.; Nishawala, Melissa; De Jesus, Georgette; Hirsch, Glenn S.; Hottinger-Blanc, Pauline M.Z.; Gonzalez, Charles J.

    2009-01-01

    Background A large body of evidence suggests that immune system dysregulation is associated with Major Depressive Disorder (MDD) in adults. This study extends this work to adolescent MDD to examine the hypotheses of immune system dysregulation in adolescents with MDD, as manifested by significantly: (i) elevated plasma levels of cytokines (interferon [IFN]-γ, tumor necrosis factor-α, interleukin [IL]-6, IL-1β, and IL-4); and (ii) Th1/Th2 cytokine imbalance shifted toward Th1 as indexed by increased IFN-γ/IL-4. Method Thirty adolescents with MDD (19 females; 13 medication-free/naïve; ages 12–19) of at least 6 weeks duration and a minimum severity score of 40 on the Children’s Depression Rating Scale—Revised, and 15 healthy comparisons (8 females), group-matched for age, were enrolled. Plasma cytokines were examined using enzyme-linked immunosorbent assay. Mann–Whitney test was used to compare subjects with MDD and controls. Results Adolescents with MDD had significantly elevated plasma IFN-γ levels (3.38 ± 11.8 pg/ml versus 0.37 ± 0.64 pg/ml; p<0.003), and IFN-γ/IL-4 ratio (16.6 ± 56.5 versus 1.76 ± 2.28; p = 0.007). A trend for IL-6 to be elevated in the MDD group was also observed (1.52 ± 2.88 pg/ml versus 0.49 ± 0.90 pg/ml; p=0.09). Importantly, findings remained evident when medicated subjects were excluded. Conclusions Findings suggest that immune system dysregulation may be associated with adolescent MDD, with an imbalance of Th1/Th2 shifted toward Th1, as documented in adult MDD. Larger studies with medication-free adolescents should follow. PMID:18790541

  10. TEMPORAL DISCOUNTING AND CONDUCT DISORDER IN ADOLESCENTS

    PubMed Central

    White, Stuart F.; Clanton, Roberta; Brislin, Sarah J.; Meffert, Harma; Hwang, Soonjo; Sinclair, Stephen; Blair, R. James R.

    2015-01-01

    The current study examined temporal discounting (the decrease in subjective reward value as a function of increasing delay) in youths with conduct disorder (CD) and the extent to which this was modulated by level of psychopathic traits. In the temporal discounting task, participants were asked to choose between immediate rewards of varying values and a larger reward, held at a constant value ($10), whose receipt was delayed by different time intervals across trials (e.g., 7 days, 360 days). The level of immediate reward necessary for selection over the larger, delayed reward is the measure of temporal discounting. Forty-six youths (21 with CD and 25 healthy youths) participated in this study. Compared with healthy youths, youths with CD chose significantly smaller amounts of immediate reward rather than the larger future rewards. This was the case even in youths with CD without comorbid attention-deficit/hyperactivity disorder. However, level of psychopathic traits did not modulate temporal discounting in this sample. These results are discussed in terms of neurobiological models of CD and psychopathic traits. PMID:24344883

  11. [Disorders of psychosexual maturation in adolescents with residual organic deficiency].

    PubMed

    Gur'eva, V A; Burelov, E A; Kuznetsov, I V; Smirnova, L K

    1991-01-01

    The paper is concerned with disorders of psychosexual maturity in adolescents (n-70). For that purpose in view a comparative nosological study of the early residual organic psychopathlike conditions (46 cases) and of organic psychopathies (24 cases) formed during the pubertal crisis was done at a forensic psychiatry hospital. According to the data obtained in the majority of the test subjects, there occurred asynchronisms of puberty (80%). Unlike group II (organic psychopathy) where disharmonic puberty was predominant, retarded puberty was recorded most frequently in group I. The main variants of psychosexual maturity were distinguished within the framework of the forms indicated: 2 variants in retardation and 6 variants in disharmonic puberty. Disharmonic puberty, then retarded puberty and pubertas precox were found to be dangerous for the onset of sexual disorders (perversions, deviations). Expert criteria for assessing the depth of sexual disorders were specified in addition. The new data obtained are of importance of both general and forensic psychiatry. PMID:1646545

  12. The impact of obesity on developmental coordination disorder in adolescence.

    PubMed

    Wagner, Matthias Oliver; Kastner, Julia; Petermann, Franz; Jekauc, Darko; Worth, Annette; Bös, Klaus

    2011-01-01

    Developmental coordination disorder (DCD) as well as overweight and obesity are of increasing importance in the study of human development. Data on the relation between DCD and obesity in adolescence are of particular interest because both phenomena are unlikely to disappear with age. The objective of this study was to determine the impact of obesity on severe DCD in adolescence. A total of 99 obese adolescents aged between 11 and 16 years and 99 normal-weight controls matched for age and gender were included in this cross-sectional study. The Movement Assessment Battery for Children 2 (age band 3) was used to determine subjects' stage of motor development. Results made clear that (i) obese show a higher severe DCD-risk in comparison to normal-weight adolescents (p<.01) which is (ii) most pronounced in balance (p<.01), and (iii) thereby rather appears in boys (p≤.10). Thus, our results at least do not exclude the possibility that obesity might have a detrimental effect on the etiopathology of DCD beyond childhood. Therefore, primary obesity prevention measures may additionally contribute to the prevention of a possible consolidation of severe DCD.

  13. An Update on Evidence-Based Psychosocial Treatments for Eating Disorders in Children and Adolescents.

    PubMed

    Lock, James

    2015-01-01

    Eating disorders are relatively common and serious disorders in adolescents. However, there are few controlled psychosocial intervention studies with this younger population. This review updates a previous Journal of Clinical Child and Adolescent Psychology review published in 2008. The recommendations in this review were developed after searching the literature including PubMed/Medline and employing the relevant medical subject headings. In addition, the bibliographies of book chapters and treatment guideline articles were reviewed; last, colleagues were asked for suggested additional source materials. Psychosocial treatments examined include family therapy, individual therapy, cognitive behavioral therapy, interpersonal psychotherapy, cognitive training, and dialectical behavior therapy. Using the most recent Journal of Clinical Child and Adolescent Psychology methodological review criteria, family treatment-behavior (FT-B) is the only well-established treatment for adolescents with anorexia nervosa. Family treatment-systemic and insight oriented individual psychotherapy are probably efficacious treatments for adolescents with anorexia nervosa. There are no well-established treatments for adolescents with bulimia nervosa, binge eating disorder, or avoidant restrictive food intake disorder. Possibly efficacious psychosocial treatments for adolescent bulimia nervosa include FT-B and supportive individual therapy. Internet-delivered cognitive behavioral therapy is a possibly efficacious treatment for binge eating disorder. Experimental treatments for adolescent eating disorders include enhanced cognitive behavioral therapy, dialectical behavioral therapy, cognitive training, and interpersonal psychotherapy. FT-B is the only well-established treatment for adolescent eating disorders. Additional research examining treatment for eating disorders in youth is warranted.

  14. Indentifying co-occurring disorders in adolescent population.

    PubMed

    Hoffmann, Norman G; Bride, Brian E; MacMaster, Samuel A; Abrantes, Ana M; Estroff, Todd W

    2004-01-01

    A structured diagnostic interview (Practical Adolescent Diagnostic Interview) designed to gather basic information about substance use disorders, other mental health conditions, and related experiences was used in a variety of clinical settings. Anonymous data from 279 adolescents interviewed as part of routine clinical assessments in a variety of clinical programs were analyzed to assess the ability of the questions to identify potential problem areas and to provide a preliminary exploration of interrelationships between those problems. Results demonstrated that the vast majority of individuals manifested indications of multiple problems. For a given diagnostic condition, the trend is for those meeting at least the minimal DSM-IV criteria to exhibit substantially more than the minimum number of symptoms. Internal consistencies for item groups defining the various conditions range from more than .700 to over .900 indicating adequate to excellent internal consistency and reliability. Utility of the instrument for routine clinical use is also discussed.

  15. [Treatment of eating disorders in adolescents--the view of a child and adolescence psychiatric hospital].

    PubMed

    Pfeiffer, Ernst; Hansen, Berit; Korte, Alexander; Lehmkuhl, Ulrike

    2005-04-01

    The paper presents--in the sense of clinical guidelines--reality of clinical care in a child and adolescence university hospital specialised on eating disorders. Need of a multimodal therapeutic approach is emphasized, including normalisation of weight and eating behaviour, nursing and pedagogical measures, individual, group and family therapy, completed by body therapy, art and music therapy and in case psychopharmacotherapy. Recommendations for overcoming weak spots are made.

  16. Eating Disorders Among a Community-based Sample of Chilean Female Adolescents.

    PubMed

    Granillo, M Teresa; Grogan-Kaylor, Andrew; Delva, Jorge; Castillo, Marcela

    2011-12-01

    The purpose of this study was to explore the prevalence and correlates of eating disorders among a community-based sample of female Chilean adolescents. Data were collected through structured interviews with 420 female adolescents residing in Santiago, Chile. Approximately 4% of the sample reported ever being diagnosed with an eating disorder. Multivariate logistic regression analyses revealed that those with higher symptoms of anxiety and who had tried cigarettes were significantly more likely to have been diagnosed with an eating disorder. Findings indicate that Chilean female adolescents are at risk of eating disorders and that eating disorders, albeit maladaptive, may be a means to cope with negative affect, specifically anxiety.

  17. In a rat model of panic, corticotropin responses to dorsal periaqueductal gray stimulation depend on physical exertion.

    PubMed

    de Souza Armini, Rubia; Bernabé, Cristian Setúbal; Rosa, Caroline Azevedo; Siller, Carlos Antônio; Schimitel, Fagna Giacomin; Tufik, Sérgio; Klein, Donald Franklin; Schenberg, Luiz Carlos

    2015-03-01

    Panic disorder patients are exquisitely and specifically sensitive to hypercapnia. The demonstration that carbon dioxide provokes panic in fear-unresponsive amygdala-calcified Urbach-Wiethe patients emphasizes that panic is not fear nor does it require the activation of the amygdala. This is consonant with increasing evidence suggesting that panic is mediated caudally at midbrain's dorsal periaqueductal gray matter (DPAG). Another startling feature of the apparently spontaneous clinical panic is the counterintuitive lack of increments in corticotropin, cortisol and prolactin, generally considered 'stress hormones'. Here we show that the stress hormones are not changed during DPAG-evoked panic when escape is prevented by stimulating the rat in a small compartment. Neither did the corticotropin increase when physical exertion was statistically adjusted to the same degree as non-stimulated controls, as measured by lactate plasma levels. Conversely, neuroendocrine responses to foot-shocks were independent from muscular effort. Data are consonant with DPAG mediation of panic attacks. PMID:25618592

  18. In a rat model of panic, corticotropin responses to dorsal periaqueductal gray stimulation depend on physical exertion.

    PubMed

    de Souza Armini, Rubia; Bernabé, Cristian Setúbal; Rosa, Caroline Azevedo; Siller, Carlos Antônio; Schimitel, Fagna Giacomin; Tufik, Sérgio; Klein, Donald Franklin; Schenberg, Luiz Carlos

    2015-03-01

    Panic disorder patients are exquisitely and specifically sensitive to hypercapnia. The demonstration that carbon dioxide provokes panic in fear-unresponsive amygdala-calcified Urbach-Wiethe patients emphasizes that panic is not fear nor does it require the activation of the amygdala. This is consonant with increasing evidence suggesting that panic is mediated caudally at midbrain's dorsal periaqueductal gray matter (DPAG). Another startling feature of the apparently spontaneous clinical panic is the counterintuitive lack of increments in corticotropin, cortisol and prolactin, generally considered 'stress hormones'. Here we show that the stress hormones are not changed during DPAG-evoked panic when escape is prevented by stimulating the rat in a small compartment. Neither did the corticotropin increase when physical exertion was statistically adjusted to the same degree as non-stimulated controls, as measured by lactate plasma levels. Conversely, neuroendocrine responses to foot-shocks were independent from muscular effort. Data are consonant with DPAG mediation of panic attacks.

  19. Friendship Characteristics and Activity Patterns of Adolescents with an Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Kuo, Melissa H.; Orsmond, Gael I.; Cohn, Ellen S.; Coster, Wendy J.

    2013-01-01

    This study compared perceptions of adolescents' friendships between adolescents with an autism spectrum disorder (ASD) and their parents, examined factors associated with friendship qualities, and investigated the adolescents' reports on the activities they did with friends and how activity patterns differed by gender. Ninety-one…

  20. Mapping the Clinical Complexities of Adolescents with Substance Use Disorders: A Typological Study

    ERIC Educational Resources Information Center

    Meyers, Kathleen; McDermott, Paul A.; Webb, Alicia; Hagan, Teresa Ann

    2006-01-01

    Because of the vast improvements in adolescent substance use assessment, it is widely recognized that adolescent substance use disorders (SUD) encompasses diverse drugs, patterns and etiologies and are characterized by extensive heterogeneity in other life domains. The next step in advancing adolescent SUD assessment is to classify adolescents…

  1. Social Correlates of Bullying in Adolescents with Attention-Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Timmermanis, Victoria; Wiener, Judith

    2011-01-01

    The present study examines the levels and social correlates of bullying in adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD). Sixty-four male and female participants (40 ADHD) and their parents and teachers complete standardized questionnaires. Compared to adolescents without ADHD, adolescents with ADHD are more likely to report…

  2. 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…

  3. Pervasive Developmental Disorder Behavior in Adolescents with Intellectual Disability and Co-Occurring Somatic Chronic Diseases

    ERIC Educational Resources Information Center

    Oeseburg, B.; Groothoff, J. W.; Dijkstra, G. J.; Reijneveld, S. A.; Jansen, D. E. M. C.

    2010-01-01

    Evidence on the association between somatic chronic diseases in ID-adolescents and the full range of pervasive developmental disorder behavior (PDD behavior) is scarce. The aim of the present study is to assess the association between somatic chronic diseases in ID-adolescents and mild PDD behavior. We obtained data on 1044 ID-adolescents, aged…

  4. Psychiatric Disorders in a Sample of Saudi Arabian Adolescents with Sickle Cell Disease

    ERIC Educational Resources Information Center

    Amr, Mostafa Abdel-Monhem; Amin, Tarek Tawfik; Hablas, Hatem Refaat

    2010-01-01

    The objectives of this study were to determine the magnitude of psychiatric disorders and to define socio-demographic and disease-related risk factors in a sample of adolescents with SCD in Al-Hassa, Saudi Arabia. The sample consisted of 110 adolescents with SCD and a convenient sample of 202 adolescents without SCD as controls. Psychiatric…

  5. The Daily Lives of Adolescents with an Autism Spectrum Disorder: Discretionary Time Use and Activity Partners

    ERIC Educational Resources Information Center

    Orsmond, Gael I.; Kuo, Hsin-Yu

    2011-01-01

    This study explores the daily lives, particularly discretionary time, of adolescents with an autism spectrum disorder (ASD). We describe the activities and activity partners of adolescents, the factors associated with their discretionary time use, and the impact of time use on their autism symptoms. Mothers of 103 adolescents with an ASD completed…

  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. Are There Differences in Neurocognition and Social Cognition Among Adolescents with Schizophrenia, a Pervasive Developmental Disorder, and Both Disorders?

    PubMed

    Waris, Petra; Tani, Pekka; Lindberg, Nina; Lipsanen, Jari; Kettunen, Kirsi; Kaltiala-Heino, Riittakerttu; Saarimaa, Leena-Kaisa; Reinvall, Outi; Voutilainen, Arja; Hokkanen, Laura

    2016-01-01

    Schizophrenia (SCH) and pervasive developmental disorders (PDDs) belong to different diagnostic categories. There is, however, overlap between these 2 diagnostic groups. The aim of this preliminary study was to evaluate some aspects of neurocognitions and social cognitions in adolescents with SCH (n = 10, 2 boys and 8 girls; age range = 13.3-17.7 years), a PDD (n = 15, 7 boys and 8 girls; age range = 13.3-18.0 years), or both disorders (n = 8, 5 boys and 3 girls; age range = 13.5-18 years). Eight subtests (Information, Similarities, Arithmetic, Comprehension, Picture Completion, Coding B, Block Design, and Object Assembly) of the Wechsler Intelligence Scale for Children-Third Version and 2 subtests (Theory of Mind [ToM] and Affect Recognition) of the NEPSY-II were administered. Adolescents with both disorders and those with a PDD only performed better on visual processing tasks than did adolescents with SCH only. On the other hand, adolescents with both disorders as well as those with SCH only experienced more problems with processing speed than did adolescents with a PDD only. Adolescents with SCH only performed significantly more poorly with verbal ToM tasks compared with those with a PDD only. Adolescents with both disorders performed as well as those with SCH only. All in all, our preliminary findings support the current idea that SCH and PDDs are separate disorders. PMID:27015370

  8. Are There Differences in Neurocognition and Social Cognition Among Adolescents with Schizophrenia, a Pervasive Developmental Disorder, and Both Disorders?

    PubMed

    Waris, Petra; Tani, Pekka; Lindberg, Nina; Lipsanen, Jari; Kettunen, Kirsi; Kaltiala-Heino, Riittakerttu; Saarimaa, Leena-Kaisa; Reinvall, Outi; Voutilainen, Arja; Hokkanen, Laura

    2016-01-01

    Schizophrenia (SCH) and pervasive developmental disorders (PDDs) belong to different diagnostic categories. There is, however, overlap between these 2 diagnostic groups. The aim of this preliminary study was to evaluate some aspects of neurocognitions and social cognitions in adolescents with SCH (n = 10, 2 boys and 8 girls; age range = 13.3-17.7 years), a PDD (n = 15, 7 boys and 8 girls; age range = 13.3-18.0 years), or both disorders (n = 8, 5 boys and 3 girls; age range = 13.5-18 years). Eight subtests (Information, Similarities, Arithmetic, Comprehension, Picture Completion, Coding B, Block Design, and Object Assembly) of the Wechsler Intelligence Scale for Children-Third Version and 2 subtests (Theory of Mind [ToM] and Affect Recognition) of the NEPSY-II were administered. Adolescents with both disorders and those with a PDD only performed better on visual processing tasks than did adolescents with SCH only. On the other hand, adolescents with both disorders as well as those with SCH only experienced more problems with processing speed than did adolescents with a PDD only. Adolescents with SCH only performed significantly more poorly with verbal ToM tasks compared with those with a PDD only. Adolescents with both disorders performed as well as those with SCH only. All in all, our preliminary findings support the current idea that SCH and PDDs are separate disorders.

  9. Headaches as Somatoform Disorders in Children and Adolescents

    PubMed Central

    Emich-Widera, Ewa; Szwed-Białożyt, Barbara; Kopyta, Ilona; Kostorz, Anna

    2012-01-01

    Somatoform disorders are often the main cause for seeking professional advice and performing a number of specialist checks. The aim of the study was to determine the frequency of somatoform disorders in the form of headaches in children and adolescents neurologically diagnosed and the risk factors thereof. Analysis of the biological and situational risk factors were established. Somatoform disorders were diagnosed in 27 out of 276 children with headaches. We concluded that in the differential diagnosis of headaches, somatoform headaches should not be omitted as every 10th patient in the developmental age diagnosed on the neurological ward because of headache shows signs of somatoform headaches. In diagnostically difficult cases it is recommended that analysis of biological and situational risk factors be performed with special attention paid to chronic disease of the patient and/or in his immediate family, the patient’s psychological disorders and dysfunctional or low social status families. The creation of separate criteria for somatoform disorders of the developmental age should be considered. PMID:25478111

  10. Practitioner Review: Adolescent Alcohol Use Disorders--Assessment and Treatment Issues

    ERIC Educational Resources Information Center

    Perepletchikova, Francheska; Krystal, John H.; Kaufman, Joan

    2008-01-01

    Background: Alcohol use disorders in adolescents are associated with significant morbidity and mortality. Over the past decade, there has been a burgeoning of research on adolescent alcohol use disorders. Methods: A summary of the alcohol assessment tools is provided, and randomized studies reviewed and synthesized to provide an overview of state…

  11. Practice Parameter for the Assessment and Treatment of Children and Adolescents with Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Journal of the American Academy of Child & Adolescent Psychiatry, 2012

    2012-01-01

    Research in etiology, neurobiology, genetics, clinical correlates, and evidence-based treatments in children and adolescents with obsessive-compulsive disorder indicate a need for the revision of the Practice Parameters for the Assessment and Treatment of Children and Adolescents with Obsessive-Compulsive Disorder first published a decade ago. The…

  12. Maltreatment and Depression in Adolescent Sexual Offenders with an Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Walters, Jessica Bleil; Hughes, Tammy L.; Sutton, Lawrence R.; Marshall, Stephanie N.; Crothers, Laura M.; Lehman, Cathryn; Paserba, Dave; Talkington, Vanessa; Taormina, Rochelle; Huang, Ann

    2013-01-01

    This study examined the self-reported presence and severity of abuse, neglect, and depressive symptoms for 43 adolescents adjudicated delinquent due to a sexual offense. Twenty-seven of the adolescent sexual offenders were also diagnosed with an autism spectrum disorder, and 16 did not carry an autism spectrum disorder diagnosis. Both groups…

  13. Borderline personality disorder in adolescents: the He-who-must-not-be-named of psychiatry

    PubMed Central

    Larrivée, Marie-Pier

    2013-01-01

    This article reviews the possibility and pertinence of diagnosing borderline personality disorder in adolescents. The etiology and clinical manifestations of this disorder in adolescents are discussed, and its management is addressed in terms of psychotherapy, pharmacology, hospitalization issues, and family involvement considerations. PMID:24174891

  14. Pain and Sleep-Wake Disturbances in Adolescents with Depressive Disorders

    ERIC Educational Resources Information Center

    Murray, Caitlin B.; Murphy, Lexa K.; Palermo, Tonya M.; Clarke, Gregory M.

    2012-01-01

    The aims of this study were to (a) assess and compare sleep disturbances (including daytime and nighttime sleep patterns) in adolescents with depressive disorders and healthy peers, (b) examine the prevalence of pain in adolescents with depressive disorders and healthy peers, and (c) examine pubertal development, pain intensity, and depressive…

  15. Borderline personality disorder in adolescents: the He-who-must-not-be-named of psychiatry.

    PubMed

    Larrivée, Marie-Pier

    2013-06-01

    This article reviews the possibility and pertinence of diagnosing borderline personality disorder in adolescents. The etiology and clinical manifestations of this disorder in adolescents are discussed, and its management is addressed in terms of psychotherapy, pharmacology, hospitalization issues, and family involvement considerations.

  16. Eating Disorders among a Community-Based Sample of Chilean Female Adolescents

    ERIC Educational Resources Information Center

    Granillo, M. Teresa; Grogan-Kaylor, Andrew; Delva, Jorge; Castillo, Marcela

    2011-01-01

    The purpose of this study was to explore the prevalence and correlates of eating disorders among a community-based sample of female Chilean adolescents. Data were collected through structured interviews with 420 female adolescents residing in Santiago, Chile. Approximately 4% of the sample reported ever being diagnosed with an eating disorder.…

  17. One-Year Incidence of Psychiatric Disorders and Associated Risk Factors among Adolescents in the Community

    ERIC Educational Resources Information Center

    Roberts, Robert E.; Roberts, Catherine R.; Chan, Wenyaw

    2009-01-01

    Background: We have few data on incidence of psychiatric disorders among adolescents. This study examined first incidence of disorders among adolescents and baseline factors which increased or decreased risk of new onset cases a year later. Methods: Data were analyzed from Teen Health 2000 (TH2K), a probability sample of 4,175 youths 11-17 and…

  18. 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…

  19. The Prevalence and Characteristics of Psychiatric Disorders among Adolescent Bedouin with Mild to Moderate Intellectual Disability

    ERIC Educational Resources Information Center

    Manor-Binyamini, Iris

    2010-01-01

    The aim of this study was to examine the prevalence and types of psychiatric disorders among Bedouin adolescents with mild to moderate intellectual disability. This is the first study ever conducted on this topic within the Bedouin community in the Negev in Israel. The issue of psychiatric disorders among adolescents with intellectual disability…

  20. 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…

  1. Motor Proficiency and Physical Fitness in Adolescent Males with and without Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Pan, Chien-Yu

    2014-01-01

    This study compared components of motor proficiency and physical fitness in adolescents with and without autism spectrum disorders, and assessed the associations between the two measures within each group. A total of 62 adolescent males with ("n" = 31) and without ("n" = 31) autism spectrum disorders aged 10-17 years completed…

  2. Children with a Prepubertal and Early Adolescent Bipolar Disorder Phenotype from Pediatric Versus Psychiatric Facilities

    ERIC Educational Resources Information Center

    Tillman, Rebecca; Geller, Barbara; Frazier, Jeanne; Beringer, Linda; Zimerman, Betsy; Klages, Tricia; Bolhofner, Kristine

    2005-01-01

    Objective: To examine characteristics between subjects with a prepubertal and early adolescent bipolar disorder phenotype from pediatric versus psychiatric venues. Method: Subjects (N = 93) with a prepubertal and early adolescent bipolar disorder phenotype were obtained through consecutive new case ascertainment from designated pediatric and…

  3. A Prospective Study of Risk Factors for the Development of Depression and Disordered Eating in Adolescents

    ERIC Educational Resources Information Center

    Ferreiro, Fatima; Seoane, Gloria; Senra, Carmen

    2011-01-01

    There is evidence that females display higher levels of depressive symptoms and disordered eating than males from adolescence onward. This study examined whether different risk factors and their interaction with sex (moderator effect) prospectively predicted depressive symptoms and disordered eating in adolescents. A total of 415 female…

  4. Suicide and suicide attempts in adolescent-onset psychotic disorders.

    PubMed

    Jarbin, Håkan; Von Knorring, Anne-Liis

    2004-01-01

    Eighty-eight subjects with adolescent-onset psychotic disorders (mean age+/-standard deviation 15.7+/-1.5 years), mainly schizophrenia and affective disorders, were followed up 10.6+/-3.6 years later, rediagnosed (DSM-IV) and assessed with the Positive and Negative Symptom Scale, abuse of drugs including nicotine, the Lancashire Quality of Life Profile and occurrence of suicide or suicide attempts. Four males (4.5% of subjects) had died from suicide while another 25% of the subjects had attempted suicide. Suicide attempts were associated to more depressive symptoms but fewer negative symptoms at first episode, and to number of admissions and to dependence on nicotine at follow-up in a logistic regression. Satisfaction with religion, health, family relations and safety at follow-up were inversely associated to attempting suicide but only satisfaction with religious belief remained after controlling for concurrent symptoms of anxiety and depression.

  5. Parental mediation of television viewing and videogaming of adolescents with autism spectrum disorder and their siblings.

    PubMed

    Kuo, Melissa H; Magill-Evans, Joyce; Zwaigenbaum, Lonnie

    2015-08-01

    Adolescents with autism spectrum disorder spend considerable time in media activities. Parents play an important role in shaping adolescents' responses to media. This study explored the mediation strategies that parents of adolescents with autism spectrum disorder used to manage television and video game use, factors associated with their use of different strategies, and whether mediation strategies changed over time. A secondary purpose was to examine whether parents applied different mediation strategies to adolescents with autism spectrum disorder versus siblings, and the factors that created stress related to managing media use. Parents of 29 adolescents with autism spectrum disorder and 16 siblings completed questionnaires at two time points. Parents most frequently supervised their television viewing by watching it with the adolescents, and used restrictive strategies to regulate their videogaming. Parents used similar strategies for siblings, but more frequently applied restrictive and instructive strategies for videogaming with adolescents with autism spectrum disorder than their siblings. Restrictive mediation of television viewing for the adolescents decreased significantly over the year. Adolescents' time spent in media activities, age, and behavior problems, and parents' concerns about media use were significant factors associated with the strategies that parents employed. Parents' stress related to the adolescents' behavioral and emotional responses to parental restrictions.

  6. An Efficacy/effectiveness Study of Cognitive-Behavioral Treatment for Adolescents with Comorbid Major Depression and Conduct Disorder.

    ERIC Educational Resources Information Center

    Rohde, Paul; Clarke, Gregory N.; Mace, David E.; Jorgensen, Jenel S.; Seeley, John R.

    2004-01-01

    Objective: To evaluate effectiveness of the Adolescent Coping With Depression (CWD-A) course, a cognitive-behavioral group intervention for depressed adolescents with comorbid conduct disorder. Method: Between 1998 and 2001, 93 nonincarcerated adolescents (ages 13-17 years) meeting criteria for major depressive disorder and conduct disorder were…

  7. 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

  8. Maternal Borderline Personality Disorder Symptoms and Parenting of Adolescent Daughters

    PubMed Central

    Zalewski, Maureen; Stepp, Stephanie D.; Scott, Lori N.; Whalen, Diana J.; Beeney, Joseph F.; Hipwell, Alison E.

    2014-01-01

    Maternal borderline personality disorder (BPD) symptoms are associated with poorer parenting. However, most studies conducted are with young children. In the current study, the authors examined associations between maternal BPD symptoms and parenting in an urban community sample of 15- to 17-year-old girls (n = 1,598) and their biological mothers. Additionally, the authors tested the impact of adolescent temperament on these associations. Mothers reported on their own psychopathology and their daughters' temperament. Adolescent girls reported on mothers' parenting methods in terms of psychological and behavioral control. Results demonstrated that maternal BPD symptoms were associated with aspects of psychological and behavioral control, even after controlling for maternal depression and alcohol use severity. After examining specific BPD components that may account for these associations, the authors found that affective/behavioral dysregulation, but not interpersonal dysregulation or identity disturbance, uniquely accounted for parenting. Adolescent temperament did not moderate these associations. BPD symptoms, particularly affective/behavioral dysregulation, are important targets when conducting parenting interventions. PMID:24689767

  9. Callous–unemotional traits in adolescents with autism spectrum disorder

    PubMed Central

    Leno, Virginia Carter; Charman, Tony; Pickles, Andrew; Jones, Catherine R. G.; Baird, Gillian; Happé, Francesca; Simonoff, Emily

    2015-01-01

    Background People with callous–unemotional traits and also those with autism spectrum disorder (ASD) display sociocognitive difficulties. However, the frequency and neurocognitive correlates of callous–unemotional traits within individuals with ASD are unknown. Aims To determine the prevalence of callous–unemotional traits in individuals with ASD and test their association with behavioural and cognitive measures. Method Parents of 92 adolescents with ASD completed the Antisocial Processes Screening Device (APSD) for callous–unemotional traits. Adolescents participated in tasks of emotion recognition, theory of mind and cognitive flexibility. Results In total 51% (n = 47) scored above a cut-off expected to identify the top 6% on the APSD. Of these 17% (n = 8) had concurrent conduct problems. Regression analyses found callous–unemotional traits were associated with specific impairment in fear recognition but not with theory of mind or cognitive flexibility. Conclusions Adolescents with ASD show high rates of callous–unemotional traits but, unlike in the general population, these are not strongly associated with conduct problems. The relationship of callous–unemotional traits to impairments in fear recognition suggests similar affective difficulties as in individuals with callous–unemotional traits without ASD. PMID:26382954

  10. Characteristics, correlates, and outcomes of childhood and adolescent depressive disorders

    PubMed Central

    Rao, Uma; Chen, Li-Ann

    2009-01-01

    Depressive illness beginning early in life can have serious developmental and functional consequences. Therefore, understanding the disorder during this developmental stage is critical for determining its etiology and course, as well as for deveiopinq effective intervention straieqies. This paper summarizes current knoviedqe reqardinq the etiology, phenomenoiogy, correlates, natural course, and consequences of unipolar depression in children and adolescents. Using adult depression as a framevork, the unique aspects of childhood and adolescence are considered in order to better understand depression within a developmental context. The data suggest that the clinical presentation, correlates, and natural course of depression are remarkably similar across the lifespan. There are, however, important developmental differences. Specifically, the familial and psychological context in which depression develops in youngsters is associated with variability in the frequency and nature of depressive symptoms and comorbid conditions among children and adolescents. Maturational differences have also been identified in the neurobiological correlates of depression. These developmental differences may be associated with the observed variability in clinical response to treatment and longitudinal course. Characterization of the developmental differences will be helpful in developing more specific and effective interventions for youngsters, thereby allowing them to reach their full potential as adults. PMID:19432387

  11. Identity status and attachment in adolescents with attention deficit hyperactivity disorder.

    PubMed

    Cuhadaroğlu Çetin, Füsun; Akdemir, Devrim; Tüzün, Zeynep; Cak, Tuna; Senses Dinç, Gülser; Taşğın Çöp, Esra; Evinç, Gülin

    2013-01-01

    Identity and attachment are two concepts of different theories that might be related and that are developmentally very important in adolescence. The aim of this study was to explore the sense of identity, attachment styles and their relation in a group of adolescents with attention deficit hyperactivity disorder (ADHD). Thirty-four adolescents who were diagnosed with ADHD in childhood were reevaluated at the age of 13-16 years. The comparison group consisted of age- and gender-matched adolescents without a psychiatric disorder. The Sense of Identity Assessment Form (SIAF) and the Relationship Scales Questionnaire (RSQ) were used to examine the sense of identity and attachment styles of adolescents, respectively. Compared to adolescents without a psychiatric disorder, adolescents with ADHD, independent of the presence of a comorbid psychiatric disorder, had a similar identity formation process; however, adolescents with ADHD and a comorbid psychiatric disorder experienced more preoccupied attachment styles. Comorbid psychiatric disorders seem to be related to the insecure attachment patterns in adolescents with ADHD.

  12. Eating disorders in adolescence: attachment issues from a developmental perspective

    PubMed Central

    Gander, Manuela; Sevecke, Kathrin; Buchheim, Anna

    2015-01-01

    In the present article we review findings from an emerging body of research on attachment issues in adolescents with eating disorders from a developmental perspective. Articles for inclusion in this review were identified from PsychINFO (1966–2013), Sciencedirect (1970–2013), Psychindex (1980–2013), and Pubmed (1980–2013). First, we will outline the crucial developmental changes in the attachment system and discuss how they might be related to the early onset of the disease. Then we will report on the major results from attachment studies using self-report and narrative instruments in that age group. Studies with a developmental approach on attachment will be analyzed in more detail. The high incidence of the unresolved attachment pattern in eating disorder samples is striking, especially for patients with anorexia nervosa. Interestingly, this predominance of the unresolved category was also found in their mothers. To date, these transgenerational aspects are still poorly understood and therefore represent an exciting research frontier. Future studies that include larger adolescent samples and provide a more detailed description including symptom severity and comorbidity would contribute to a better understanding of this complex and painful condition. PMID:26321974

  13. Treatment of Autism Spectrum Disorder in Children and Adolescents

    PubMed Central

    DeFilippis, Melissa; Wagner, Karen Dineen

    2016-01-01

    Autism spectrum disorder is a diagnosis that includes significant social communication deficits/delays along with restricted patterns of interests and behaviors. The prevalence of this diagnosis has increased over the past few decades, and it is unclear whether this is solely attributable to the increased awareness of milder forms of the disorder among medical providers. The current treatment options for the core symptoms of autism are limited to psychosocial therapies, such as applied behavior analysis. Medications have been most effective in treating the associated behavioral symptoms of autism, though studies have examined potential benefits in some of the core symptoms of autism with certain medications, especially the repetitive behaviors often seen with this diagnosis. Risperidone and aripiprazole are currently the only medications FDA approved for symptoms associated with autism spectrum disorders, targeting the irritability often seen with this diagnosis. Children and adolescents with autism spectrum disorder appear to be more susceptible to adverse effects with medications; therefore, initiation with low doses and titrating very slowly is recommended. Some complementary alternative treatments have been researched as possible treatments in autism, though evidence supporting many of these is very limited. PMID:27738378

  14. 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.

  15. A Review of Medication Use for Children and Adolescents with Eating Disorders

    PubMed Central

    Couturier, Jennifer; Lock, James

    2007-01-01

    Objective This paper aims to review the research literature on the use of medication for eating disorders in children and adolescents. Method The literature was reviewed on the pharmacotherapy of anorexia nervosa (AN), bulimia nervosa (BN) and eating disorder not otherwise specified (EDNOS). The PubMed database was searched for all articles on medication use in the child and adolescent population using the terms medication, antipsychotic, antidepressant, child, adolescent, eating disorders, anorexia nervosa and bulimia nervosa. Results Very little literature exists on the use of medication for the treatment of eating disorders in children and adolescents. There is one retrospective study on the use of SSRIs and some case reports on atypical antipsychotics for children and adolescents with AN, and one small open trial on SSRIs for adolescent BN. Conclusions Evidence-based pharmacological treatment for children and adolescents with eating disorders is not yet possible due to the limited number of studies available. It appears that olanzapine and other atypical antipsychotics may prove to be promising for AN at low body weights. It remains uncertain whether SSRIs are helpful in preventing relapse in AN. For children and adolescents with BN, the first line pharmacological option is fluoxetine given the large evidence base of this drug with the adult population and a small open trial of adolescents with BN. PMID:18392170

  16. Long Acting Risperidone in an Adolescent with Conduct Disorder: A Case Report

    PubMed Central

    Tutkunkardaş, Mustafa Deniz; Abali, Osman

    2011-01-01

    Adolescent conduct disorder (CD) is generally hard to manage clinically, as this population often refuses to take oral medications. Families and acquaintances of these adolescents usually suffer from extreme psychological, financial and social difficulties. Oral antipsychotics are the primary drugs of choice clinically, after behavioral treatments. Here we report a case with attention deficit hyperactivity disorder and conduct disorder who refuses to take any medications, was not eligible for behavioral treatments and was treated successfully with long acting risperidone.

  17. 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. PMID:25365346

  18. Trajectories of Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder Symptoms as Precursors of Borderline Personality Disorder Symptoms in Adolescent Girls

    ERIC Educational Resources Information Center

    Stepp, Stephanie D.; Burke, Jeffrey D.; Hipwell, Alison E.; Loeber, Rolf

    2012-01-01

    Little empirical evidence exists regarding the developmental links between childhood psychopathology and borderline personality disorder (BPD) in adolescence. The current study addresses this gap by examining symptoms of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) as potential precursors. ADHD and BPD…

  19. Parenting Stress of Parents of Adolescents with Attention-Deficit Hyperactivity Disorder.

    PubMed

    Wiener, Judith; Biondic, Daniella; Grimbos, Teresa; Herbert, Monique

    2016-04-01

    This study examined parenting stress among parents of adolescents with Attention-Deficit Hyperactivity Disorder (ADHD). The sample comprised 138 adolescents (84 ADHD, 52 boys, 32 girls; 54 non-ADHD, 24 boys, 30 girls) age 13 to 18 and their parents. Mothers (n = 135) and fathers (n = 98) of participating teens completed the Stress Index for Parents of Adolescents. Mothers and fathers of adolescents with ADHD reported more stress than parents of adolescents without ADHD with regard to their children's challenging behaviors (Adolescent domain stress). Mothers of adolescents with ADHD also reported that they experienced elevated levels of stress in terms of role restrictions, feelings of social alienation, conflict with their partner, feelings of guilt and incompetence (Parent domain stress), and relationship with their children (Adolescent-Parent Relationship domain stress; APR). The extent to which clinical levels of adolescent Oppositional Defiant Disorder (ODD) symptoms or externalizing behavior in general were associated with parenting stress depended on the rater of these behaviors. Parenting stress was associated with higher levels of ODD and other externalizing behaviors when these behaviors were rated by parents but not when they were rated by teachers. In addition, over and above adolescent ADHD classification, mothers' self-reported ADHD symptoms were associated with higher parenting stress in the Adolescent and Parent domains, and fathers' self-reported ADHD symptoms were associated with lower APR stress. The results suggest directions that should be considered for addressing parenting stress when designing interventions for families of adolescents with ADHD.

  20. Paranoid Thoughts in Adolescents with Social Anxiety Disorder.

    PubMed

    Pisano, S; Catone, G; Pascotto, A; Iuliano, R; Tiano, C; Milone, A; Masi, G; Gritti, A

    2016-10-01

    Recently, social anxiety disorder (SAD) and paranoia have been demonstrated to be closely related. However, data were primarily drawn from adult community samples or patients with schizophrenia. The present study used a cross-sectional design to evaluate a sample of adolescents with SAD (n = 30, mean age 15.3 ± 0.9 years) compared with an age- and sex-matched group of healthy controls (n = 26, mean age 15.9 ± 1.6 years). The SAD group displayed more frequent and intense paranoid thoughts than the control group (t = 4.16, p < 0.001). The level of paranoid thoughts was significantly predicted by the degree of social phobia, even after adjusting for sex and other anxiety disorders, although adjusting for depression slightly reduced the extent and significance of the prediction. A lack of awareness about the association between SAD and paranoia may lead to incorrect diagnoses (e.g. misdiagnosis of psychotic disorders), or it may negatively influence the (psycho)therapeutic process and patient outcomes.