J Anxiety Disord [JOURNAL]
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200 papers
Effectiveness of a transdiagnostic protocol for anxiety and depression in primary care: The PsicAP-CV Stepped Wedge Cluster Randomized Trial.
Esteller-Collado G, Pérez-Jover V, Román CVH … +9 more , Malonda-Vidal E, Llorca-Mestre A, Prieto-Vila M, Carpallo-González M, González-Blanch C, Ruíz-Rodríguez P, Moriana JA, Cano-Vindel A, Muñoz-Navarro R
J Anxiety Disord · 2025 Aug · PMID 40526977 · Publisher ↗
INTRODUCTION: Anxiety and depressive disorders represent a public health challenge, with high prevalence rates and considerable impact on quality of life (QoL) and functioning. Despite evidence supporting the efficacy of...
INTRODUCTION: Anxiety and depressive disorders represent a public health challenge, with high prevalence rates and considerable impact on quality of life (QoL) and functioning. Despite evidence supporting the efficacy of transdiagnostic cognitive behavioural therapy (TD-CBT), its implementation in settings such as primary care (PC) remains limited. The aim of this paper is to analyse the results of the PsicAP-CV, a clinical trial evaluating the effectiveness and implementation of TD-CBT in the PC setting. METHODS: The study included 320 patients from the PsicAP-CV trial, a Stepped Wedge Cluster-Randomised Trial (SW-CRT). Symptoms of anxiety and depression were assessed, as well as QoL and functioning. Linear models were used to study treatment effects on outcomes and rates of recovery, reliable recovery and deterioration were calculated. RESULTS: findings indicate that TD-CBT is more effective than treatment-as-usual (TAU) in reducing symptoms of anxiety and depression, as well as improving QoL and functioning. In addition, although the overall reduction in symptomatology was similar between patients who received immediate treatment (EG) and those who received delayed treatment (EG), there was a trend in favour of the EG group in the recovery indicators. DISCUSSION: these findings confirm the efficacy of TD-CBT for treating common mental disorders in PC and point to SW-CRT designs as a feasible and ethically sound avenue for implementing and scaling these evidence-based interventions within public health systems. They also support the broader integration of psychologists into PC, thus offering a scalable model that can significantly improve access to and outcomes of mental health care. TRIAL REGISTRATION: EURADICT 2013-001955-11/ISRCTN58437086.
PTSD and cognition in older adults: A systematic literature review.
van Rossum JE, den Camp SO, Uiterwijk R … +4 more , Deckers K, Orgeta V, Gulpers BJA, Sobczak S
J Anxiety Disord · 2025 Aug · PMID 40517583 · Publisher ↗
Post-traumatic stress disorder (PTSD) is a disabling mental health disorder affecting psychosocial functioning and quality of life. This systematic review is the first to summarize existing global literature on the relat...
Post-traumatic stress disorder (PTSD) is a disabling mental health disorder affecting psychosocial functioning and quality of life. This systematic review is the first to summarize existing global literature on the relationship between PTSD and specific domains of cognitive function in the general population of older adults. We searched PsycINFO, Medline and CINAHL up until November 1st 2024. Studies were included if they were longitudinal cohort or cross-sectional studies of adults aged 60 years and over with a clinical diagnosis of PTSD or subthreshold PTSD symptoms, reporting on any domain of cognitive functioning using a standardised measure. Eighteen good or satisfactory quality articles met criteria for this review, of which three were longitudinal cohort studies and fifteen were cross-sectional studies. PTSD was associated with significant accelerated general cognitive decline and possible accelerated decline in attention and memory over time. Older adults with PTSD additionally performed significantly worse on measures of global cognitive function and memory compared to those without PTSD. For executive function results were mixed; two studies showed significant negative associations, whereas four other studies showed no significant differences between individuals with and without PTSD. Proactive screening of individuals with PTSD for cognitive decline and an additional focus of PTSD treatment on cognitive functioning are needed.
FOMO's apprehension of missing out and constant connection desire dimensions differentially correlate with problematic smartphone and social media use, but not with depression or generalized anxiety.
Elhai JD, Casale S, Bond RA
J Anxiety Disord · 2025 Aug · PMID 40460757 · Publisher ↗
The fear of missing out (FOMO) involves an apprehension of missing out on rewarding experiences, and a desire to continually stay connected with people. However, this two-dimension conceptualization of FOMO has not been...
The fear of missing out (FOMO) involves an apprehension of missing out on rewarding experiences, and a desire to continually stay connected with people. However, this two-dimension conceptualization of FOMO has not been properly empirically examined. We examined this two-factor model using confirmatory factor analysis in 326 American college students, and 433 Italian participants recruited through social media. We discovered that in both samples, the two-factor model fit well; e.g., the US sample's comparative fit index (CFI) = .990, Tucker-Lewis Index (TLI) = .985; Italian sample's CFI = .941, TLI = .917. The two-factor model fit significantly better than a one-factor model in both samples (ps<.001) (though magnitude of differences was small, with CFI differences ranging from .001-.007). In both samples, problematic social media use severity was more correlated (ps<.001) with FOMO's constant connection desire factor (US sample r = .749; Italian sample r = .845) than apprehension of missing out factor (US sample r = .622; Italian sample r = .500). In the American sample, problematic smartphone use severity also correlated more (p < .001) with constant connection desire (r = .668) than apprehension of missing out (r = .587). However, in the American sample depression severity correlated equally (ps>.05) with FOMO's constant connection desire (r = .466) and apprehension of missing out (r = .503) factors; generalized anxiety disorder symptoms also equally correlated (ps>.05) with FOMO's constant connection desire (r = .470) and apprehension of missing out (r = .508). We discuss implications of our findings for measurement of FOMO, and FOMO's relationship with problematic Internet use and negative affectivity.
CBT-based self-help guided by a lay provider for generalized anxiety in older adults: A randomized controlled trial.
Landreville P, Gosselin P, Grenier S … +1 more , Carmichael PH
J Anxiety Disord · 2025 Jul · PMID 40460664 · Publisher ↗
Treatments for generalized anxiety disorder (GAD) that circumvent the barriers to accessing mental health care in older adults are needed. The main goal of this multisite randomized controlled trial was to evaluate the e...
Treatments for generalized anxiety disorder (GAD) that circumvent the barriers to accessing mental health care in older adults are needed. The main goal of this multisite randomized controlled trial was to evaluate the efficacy of CBT-based self-help guided by a lay provider (LP) for generalized anxiety (i.e., threshold or subthreshold GAD) in older adults. Participants (≥ 60 years) were block randomized based on diagnosis to an experimental (n = 75) or wait-list control group (n = 75). Experimental group participants used a manual presenting CBT-based readings and exercises and received brief weekly support calls by LPs. Groups were similar in terms of sociodemographic characteristics and initially did not differ significantly on outcomes. At post-treatment, the experimental group showed greater improvement across both primary outcomes (i.e., worry tendency, p < .0001, Standardized mean difference [SMD] = -1.5971, and GAD severity, p < .0001, SMD = -1.1639) and most additional outcomes (e.g., targeted psychological vulnerabilities, depressive symptoms, sleep difficulties, and GAD diagnosis) with small to large effect sizes (SMD = -0.4358 to -1.5402). The experimental group also showed maintenance of treatment effects or other improvements at 6- and 12-month follow-up. Participants in the control group who completed the treatment after their waiting period also improved on worry tendency (SMD = -1.2477) and GAD severity (SMD = -0.8443) and most of the other variables (SMD = -0.3728 to -1.0154). Results demonstrate that self-help guided by a LP is effective for treating GAD in older adults and that the improvements are sustained after treatment.
Burden of anxiety disorders among older adults aged ≥ 55 years in 204 countries and territories, 1990-2021: A population-based study.
Wang B, Zhang Q, Liu K … +9 more , Fu L, Ao C, Zhang P, Lan C, Wu Q, Yang F, Lu Y, Fu X, Li Y
J Anxiety Disord · 2025 Jul · PMID 40460663 · Publisher ↗
BACKGROUND: Despite anxiety disorders being a significant public health concern, studies assessing their global burden among older adults are limited. We aimed to analyse trends in the global burden of anxiety disorders...
BACKGROUND: Despite anxiety disorders being a significant public health concern, studies assessing their global burden among older adults are limited. We aimed to analyse trends in the global burden of anxiety disorders in older adults aged ≥ 55 years. METHODS: Data on the incidence and disability-adjusted life-years (DALYs) for anxiety disorders were retrieved from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. Temporal trends were quantified using estimated annual percentage changes. RESULTS: In 2021, global DALYs for anxiety disorders were estimated at 8.21 million (95 % UI 5.62-11.48 million), nearly 2.5 times higher than in 1990, with an age-standardised rate of 552.7 DALYs (95 % UI 378.1-772.5) per 100,000 population. Between 1990 and 2021, the age-standardised DALY rate (ASDR) remained stable (-0.05 % [95 % CI -0.16-0.05]), with minimal differences between men (0.04 % [-0.05-0.12]) and women (-0.08 % [-0.21-0.05]). The 55-59 age group showed the highest ASDR (538.5 [361.3-767.7] per 100,000 population). The highest increases in ASDR were observed in the low-middle (0.15 % [0.03-0.28]) and low sociodemographic index regions (0.09 % [0.02-0.15]). The regions with the highest ASDRs were Latin America, Western Europe, and High-income North America. CONCLUSION: While global trends in anxiety disorders among older adults remained stable, the total burden increased significantly, with marked regional disparities. Tailored mental health interventions, early detection, and treatment in primary care are essential to reduce the future burden of anxiety disorders in older adults, especially in low and middle-income countries.
Longitudinal course of posttraumatic stress disorder and chronic pain conditions: A population-based study of Canadian military personnel over 16 years.
Asmundson AJN, Paluszek MM, Sommer JL … +5 more , Bolton SL, Sareen J, Afifi TO, El-Gabalawy R, Asmundson GJG
J Anxiety Disord · 2025 Jul · PMID 40393203 · Publisher ↗
BACKGROUND: Posttraumatic stress disorder (PTSD) and chronic pain are highly prevalent, comorbid, and debilitating conditions in the military. The present study was designed to examine the prevalence of chronic pain cond...
BACKGROUND: Posttraumatic stress disorder (PTSD) and chronic pain are highly prevalent, comorbid, and debilitating conditions in the military. The present study was designed to examine the prevalence of chronic pain conditions (i.e., migraines, back problems, arthritis) across PTSD courses (i.e., no PTSD, remitted, new onset, persistent/recurrent) and examine the association between PTSD course and the presence and onset of chronic pain conditions in a population-representative sample of Canadian military members. METHODS: Cross-tabulations and logistic regressions were conducted on data (n = 2941) from the 2002 Canadian Community Health Survey Mental Health and Well-being Canadian Forces Supplement and the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-Up Survey. RESULTS: The prevalence of chronic pain conditions across PTSD courses ranged from 8 % to 61 %, with no PTSD consistently having the lowest prevalence. After adjusting for covariates, respondents with new onset PTSD had elevated odds of back problems (AOR=1.43, 95 % CI [1.10-1.90], p < .05), arthritis (AOR=1.46, 95 % CI [1.06-2.00], p < .05), and a new onset chronic pain condition more broadly (AOR=1.66, 95 % CI [1.15-2.39], p < .01), compared to those with no PTSD. Those with remitted PTSD had greater odds of migraines (AOR=2.43, 95 % CI [1.29-4.58], p < .01), while those with persistent PTSD had lower odds of back problems (AOR=0.45, 95 % CI [0.23-0.88], p < .05), compared to those with no PTSD. CONCLUSION: Findings indicate that the prevalence and type of chronic pain that co-occurs with PSTD in Canadian military members varies as a function of the course of PTSD. This underscores the importance of evaluating pain in those with PTSD and suggests that the course of PTSD is a relevant consideration in case conceptualization and treatment planning.
Who defines improvement? Patients' global reports of improvement compared to standardized measures of improvement in cognitive processing therapy for posttraumatic stress disorder.
Alpert E, Fox AB, Galovski TE
J Anxiety Disord · 2025 Jul · PMID 40381493 · Full text
Standardized measures have typically been used to assess symptom change during treatment in psychological research and practice. However, standardized measures may not fully capture patients' experiences of therapeutic c...
Standardized measures have typically been used to assess symptom change during treatment in psychological research and practice. However, standardized measures may not fully capture patients' experiences of therapeutic change. Patients' global reports of their improvement during treatment across domains of symptoms and functioning are also important and may provide distinct information from standardized measures. The current study compared both types of patient reports of improvement during cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD). We also examined process-level predictors of improvement assessed using both methods. Participants were 254 adult survivors of interpersonal violence receiving CPT. Patients' global reports of improvement in each domain (PTSD symptoms, relationships, health concerns, sexual functioning, school/work performance, and life satisfaction), each rated on a Likert scale via the Treatment Outcome Questionnaire, were significantly correlated with the corresponding standardized measure of improvement in the same domain, with most effect sizes in the small-to-medium range. Patients' perceptions of the therapy (helpfulness, likability) significantly predicted both global ratings and standardized measures of improvement, while patients' perceptions of the therapeutic relationship, patients' perceptions of barriers to therapy attendance, and objective indices of attendance did not predict improvement. Results highlight the importance of patients' experiences with treatment and suggest that assessing patients' global ratings of their improvement during treatment provides distinct information from standardized measures of improvement, and both are important to include when measuring therapeutic change.
The unique autonomic signatures of savoring meditation for anxiety reduction: A pilot randomized controlled trial.
Kishimoto T, Hao X, Bai Q
J Anxiety Disord · 2025 Jul · PMID 40367767 · Publisher ↗
Anxiety disorders are often characterized by excessive sympathetic activation and dysfunction. While breathing relaxation reliably reduces anxiety by dampening sympathetic activity and enhancing parasympathetic tone, the...
Anxiety disorders are often characterized by excessive sympathetic activation and dysfunction. While breathing relaxation reliably reduces anxiety by dampening sympathetic activity and enhancing parasympathetic tone, the autonomic signatures underlying positive emotion interventions, such as savoring meditation, remain less understood. In this pilot randomized controlled trial, we recruited 44 participants with probable generalized anxiety disorders (GAD) by questionnaires (GAD-7 score ≥ 10, which represents moderate or higher anxiety severity), who were assigned to a savoring meditation (n = 22) or a breathing relaxation (n = 22) intervention. We measured heart rate variability (HRV) indicators (respiratory sinus arrhythmia, RSA; low-frequency HRV, LF; the low-frequency/high-frequency ratio, LF/HF) and self-reported emotional states (happiness, anxiety, sadness, calmness) before and after the intervention. Linear mixed models with multiple imputation examined outcome change between and within conditions. The savoring group exhibited increased sympathetic and decreased parasympathetic activity (significantly lower RSA, higher LF and LF/HF), contrasting with the relaxation group's pattern. Both interventions resulted in significant and similar reductions in anxiety after worrying. These preliminary results suggest that savoring meditation for anxiety reduction may have unique autonomic signatures, offering novel insights for positive emotion interventions in anxiety research.
Exploring the co-occurrence of posttraumatic stress disorder symptoms and dysregulated positive emotion processes: A network analysis.
Wang S, Rodenbaugh MM, Straud C … +2 more , Weiss NH, Contractor AA
J Anxiety Disord · 2025 Jul · PMID 40315704 · Publisher ↗
Emerging research indicates an important role of positive emotion processes in posttraumatic stress disorder (PTSD) symptomatology. To extend this research, we utilized a network approach to examine associations between...
Emerging research indicates an important role of positive emotion processes in posttraumatic stress disorder (PTSD) symptomatology. To extend this research, we utilized a network approach to examine associations between PTSD symptom clusters (intrusions, avoidance, negative alterations in cognition and mood [NACM], alterations in arousal and reactivity [AAR]) and dysregulated positive emotion processes (levels of positive affect, self-focused positive rumination, emotion-focused positive rumination, dampening, impulse control difficulties, difficulties engaging in goal-directed behaviors, nonacceptance of positive emotions). Specifically, we examined differential relations between PTSD symptom clusters and positive emotion processes, and symptoms that most strongly connected these constructs (i.e., communities). The sample included 191 trauma-exposed adults recruited from Amazon's MTurk ( M = 38.54 ± 10.99 years, 53.4 % women, 63.4 % with probable PTSD). A regularized Guassian Graphic Model consisting of four nodes representing the PTSD symptom clusters' community and seven nodes representing the positive emotion processes' community was generated. The strongest positive associations across communities were the NACM-dampening and the AAR-dampening edges. Bridge symptoms with the highest inter-community connectivity were dampening, AAR, intrusions, NACM, and impulse control difficulties. Overall, this study indicates the importance of incorporating positive emotion processes in the conceptualization of PTSD. Our results also highlight that dampening of positive emotions and difficulties with impulse control while experiencing positive emotions may be meaningful targets in PTSD treatment.
Moving towards a subjective conceptualization of betrayal: Examining associations between perceived betrayal, emotion dysregulation, and PTSD symptoms in sexual trauma survivors.
Emrich M, Garnsey CL, Osherow EK … +1 more , Park CL
J Anxiety Disord · 2025 Jun · PMID 40305905 · Publisher ↗
BACKGROUND: Sexual trauma survivors commonly experience feelings of betrayal. Betrayal has largely been studied as a static trauma characteristic that is determined by a survivor's closeness to the perpetrator. This appr...
BACKGROUND: Sexual trauma survivors commonly experience feelings of betrayal. Betrayal has largely been studied as a static trauma characteristic that is determined by a survivor's closeness to the perpetrator. This approach overlooks survivors' subjective feelings and experiences. This study examines whether: 1) degree of perceived betrayal differs by type of survivor-perpetrator relationship, 2) perceived betrayal in the early aftermath of trauma predicts subsequent PTSD symptoms, and 3) emotion dysregulation mediates the relationship between perceived betrayal and PTSD symptoms. METHODS: Women (N = 203; ages 19-86) who experienced sexual trauma within a month of recruitment completed questionnaires on Prolific at T1 (within 30 days of trauma), T2 (4 weeks post-T1), and T3 (8 weeks post-T1). Descriptive statistics and an independent samples t-test examined differences in perceived betrayal across survivor-perpetrator relationship characteristics. Structural equation models assessed perceived betrayal at T1 predicting PTSD symptoms at T3 and the potential mediating effect of T2 emotion dysregulation. RESULTS: Although betrayal was highest among survivors who knew the perpetrator prior to the trauma (M = 76.8, range 0-100), average perceived betrayal was high across the sample (M = 70.5), and the quarter of survivors who identified the perpetrator as a stranger also reported elevated betrayal (M = 51.6). T1 perceived betrayal significantly predicted T3 PTSD symptoms with increases in emotion dysregulation partially mediating this effect (p = .01). CONCLUSIONS: Findings support moving towards a subjective conceptualization of betrayal that incorporates survivors' perceptions. Moreover, emotion dysregulation may be an important intervention target in the early aftermath of sexual trauma and warrants further empirical research.
Concise multi-class anxiety disorder risk assessment: A novel advanced machine learning approach.
Yang H, Sun YH, Lee K
J Anxiety Disord · 2025 Jun · PMID 40288106 · Publisher ↗
Rapidly assessing anxiety disorder risk is crucial for effective mental health screen and intervention. However, traditional survey tools such as DASS-42 are time-consuming in responding and scoring. We used a novel adva...
Rapidly assessing anxiety disorder risk is crucial for effective mental health screen and intervention. However, traditional survey tools such as DASS-42 are time-consuming in responding and scoring. We used a novel advanced machine learning approach to create a concise anxiety disorder scale based on DASS-42. By applying advanced ML techniques and feature selection, we created a concise version of the anxiety risk scale while maintaining high validity. The resulting model requires fewer questions to predict anxiety risk levels effectively. This optimized scale was implemented in an online tool for quick self-screening and clinical use. This innovation holds significant societal implications, offering scalable, efficient, and accurate methods that facilitate faster and earlier anxiety disorder detection and intervention, especially among underserved and high-risk populations. The study highlights how machine learning can create practical, accessible mental health assessment tools, contributing to improved well-being outcomes.
Parental cognitions and child anxiety: A systematic review.
Fox JK, Fleming LE
J Anxiety Disord · 2025 Jun · PMID 40279836 · Publisher ↗
Given the well-established link between maladaptive parenting behaviors (e.g., control, accommodation) and the development and maintenance of child anxiety, it is important to understand parental cognitions that may unde...
Given the well-established link between maladaptive parenting behaviors (e.g., control, accommodation) and the development and maintenance of child anxiety, it is important to understand parental cognitions that may underlie these parenting behaviors. The goal of this systematic review was to examine the extent to which parental cognitions are associated with child anxiety. A systematic electronic database search of PubMed, PsycINFO, ProQuest Psychology, and EBSCO Child Development and Adolescent Studies was conducted in February 2024. In total, 31 studies met inclusion criteria from 9867 abstracts initially identified. The review revealed that a large number of studies have consistently found associations between child anxiety and two types of parental cognitions, negative beliefs about child anxiety and negative expectations of the child's anxiety. In contrast, studies investigating parental worries about threats to their child and cognitions about parenting are more limited and have produced mixed findings and smaller effects. Future research should examine the directionality and mechanisms of relations between parental cognitions and child anxiety using longitudinal designs, as well as explore the role of cultural factors. Findings suggest that parental cognitions may be an important factor in understanding child anxiety and a potential target for prevention and early intervention.
Question-based computational language approach outperform ratings scale in discriminating between anxiety and depression.
Tabesh M, Mirström M, Böhme RA … +4 more , Lasota M, Javaherian Y, Agbotsoka-Guiter T, Sikström S
J Anxiety Disord · 2025 Jun · PMID 40279835 · Publisher ↗
Major Depression (MD) and General Anxiety Disorder (GAD) are the most common mental health disorders, which typically are assessed quantitatively by rating scales such as PHQ-9 and GAD-7. However, recent advances in natu...
Major Depression (MD) and General Anxiety Disorder (GAD) are the most common mental health disorders, which typically are assessed quantitatively by rating scales such as PHQ-9 and GAD-7. However, recent advances in natural language processing (NLP) and machine learning (ML) have opened up the possibility of question-based computational language assessment (QCLA). Here we investigate how accurate open-ended questions, using descriptive keywords or autobiographical narratives, can discriminate between participants that self-reported diagnosis of depression and anxiety, or health control. The results show that both language and rating scale measures can discriminate well, however, autobiographical narratives discriminate best between healthy and anxiety (ϕ = 1.58), as well as healthy and depression (ϕ = 1.38). Descriptive keywords, and to a certain extent autobiographical narratives, also discriminate better than summed scores of GAD-7 and PHQ-9 (ϕ=0.80 in discrimination between anxiety and depression), but not when individual items of these scales were analyzed by ML (ϕ=0.86 and ϕ=0.91 in item-level analysis of PHQ-9 and GAD-7, respectively). Combining the scales consistently elevated the discrimination even more (ϕ=1.39 in comparison between depression and anxiety), both in item-level and sum-scores analyses. These results indicate that QCLA measures often, but not in all cases, are better than standardized rating scales for assessment of depression and anxiety. Implication of these findings for mental health assessments are discussed.
Psychological interventions for adult posttraumatic stress disorder: A systematic review of published meta-analyses.
Kip A, Ritter L, Hoppen TH … +4 more , Papola D, Ostuzzi G, Barbui C, Morina N
J Anxiety Disord · 2025 Jun · PMID 40250015 · Publisher ↗
OBJECTIVE: A large and growing number of published meta-analyses have examined the efficacy of psychological interventions for post-traumatic stress disorder (PTSD). Conclusions drawn from these meta-analyses on treatmen...
OBJECTIVE: A large and growing number of published meta-analyses have examined the efficacy of psychological interventions for post-traumatic stress disorder (PTSD). Conclusions drawn from these meta-analyses on treatment efficacy greatly influence clinical practice. This study aimed to provide a comprehensive review of meta-analyses of randomized controlled trials (RCTs) on psychological interventions for adult PTSD, focusing on their content, methodology, and reporting quality. METHOD: Systematic database searches were conducted in March 2024 using MEDLINE, PsycInfo, PTSDpubs, Web of Science, and the Cochrane Database of Systematic Reviews. The quality of meta-analyses was assessed using AMSTAR 2. The systematic review was registered on PROSPERO (CRD42020151234). RESULTS: Overall, 55 meta-analyses with 93 meta-analytic comparisons at treatment endpoint and 28 comparisons at follow-up were included. Meta-analyses most consistently showed superiority of psychological interventions over control conditions. However, beneficial long-term effects exceeding one-month post-treatment were limited to trauma-focused cognitive behavior interventions (TF-CBT) and eye movement desensitization and reprocessing (EMDR). There was a substantial overlap of primary RCTs, indicating redundancy between meta-analyses. Furthermore, the quality of meta-analyses varied substantially. CONCLUSIONS: There is a need to enhance the methodological and reporting quality of meta-analyses, avoid the production of redundant meta-analyses, and conduct more high-quality, large RCTs with long-term assessments.
From research to real-world global applications: Advancing team science in the study of anxiety disorders.
Contractor AA
J Anxiety Disord · 2025 Jun · PMID 40240227 · Publisher ↗
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Early hypervigilance and sustained attention for the eye region in adolescents with social anxiety disorder.
Hauffe V, Rauschenbach AL, Fassot EM … +2 more , Schmitz J, Tuschen-Caffier B
J Anxiety Disord · 2025 Jun · PMID 40220702 · Publisher ↗
Social anxiety disorder (SAD) is a highly prevalent and debilitating affliction that typically manifests during childhood and adolescence. While theoretical models of adult SAD emphasize the role of attentional biases, l...
Social anxiety disorder (SAD) is a highly prevalent and debilitating affliction that typically manifests during childhood and adolescence. While theoretical models of adult SAD emphasize the role of attentional biases, little is known about maintaining factors during childhood and adolescence. The objective of our eye-tracking study was to determine whether youth with SAD exhibit a hypervigilance-avoidance pattern of visual attention for faces. To this end, we used a free-viewing paradigm to present angry, happy, and neutral faces, and non-social object stimuli to three groups of adolescents aged 10-15 years: SAD (n = 57), specific phobia (SP; n = 41), and healthy controls (HC; n = 65). A screen-based eye tracker recorded gaze behavior and pupil dilation. Among participants, only older adolescents with SAD exhibited shorter latencies of first fixation to the eye region compared to HC. Contrary to our expectations, there were no differences in duration of first fixation to the eye region among the groups. Instead, compared to HC, older adolescents with SAD showed longer dwell times on the eye region during the first 1000 - 3000 ms of stimulus presentation. No significant differences among the groups were found regarding scanpath length or pupillary reactivity. Taken together, our findings suggest early hypervigilance followed by sustained attention to the eye region in older adolescents with SAD, which may indicate difficulties in disengaging attention. We discuss the theoretical and practical implications in detail.
"To die, to sleep": A systematic review and meta-analysis of the relationship between death anxiety and sleep.
Menzies RE, Brown J, Marchant J
J Anxiety Disord · 2025 Jun · PMID 40187048 · Publisher ↗
Poor sleep has long been established as both a symptom and cause of psychopathology. Similarly, death anxiety has attracted growing attention for its transdiagnostic role in mental illnesses, particularly anxiety-related...
Poor sleep has long been established as both a symptom and cause of psychopathology. Similarly, death anxiety has attracted growing attention for its transdiagnostic role in mental illnesses, particularly anxiety-related disorders. However, the relationship between death anxiety and sleep has not been systematically explored. This systematic review and meta-analysis examined the relationship between sleep and death anxiety. In total, 15 studies were included in this review, representing a total sample size of 2786 participants. A review of these studies revealed that death anxiety was significantly associated with a number of sleep outcomes, particularly insomnia and poor sleep quality. Mixed results were found regarding the relationship between death anxiety and nightmare frequency. A meta-analysis of seven studies revealed a significant but small relationship between death anxiety and sleep problems (r = .225). Neither gender nor age emerged as a significant moderator of this relationship. These studies were generally of moderate quality, and there was limited evidence of publication bias. The current findings support the relationship between death anxiety and sleep. Further research is needed to clarify the direction of this effect, and whether targeting one in treatment may produce direct improvements in the other.
Find your rhythm and regulate: Breath-synced vibration feedback during breath-focused mindfulness reduces respiration variability in trauma-exposed adults.
McDermott TJ, Siegle GJ, Guelfo A … +11 more , Huynh K, Karkare MC, Krawczak R, Johnston A, Elbasheir A, Fulton TM, Semerod J, Jagadeesh D, Lathan EC, Krafty RT, Fani N
J Anxiety Disord · 2025 Jun · PMID 40163930 · Full text
Stress and anxiety are associated with increased autonomic arousal, including altered respiration. Breath-focused mindfulness meditation can reduce stress and anxiety, but trauma-exposed adults with dissociation have dif...
Stress and anxiety are associated with increased autonomic arousal, including altered respiration. Breath-focused mindfulness meditation can reduce stress and anxiety, but trauma-exposed adults with dissociation have difficulty engaging in this practice. Our ongoing clinical trial examines if vibration-augmented breath-focused mindfulness (VABF) can improve outcomes and increase engagement. Here, we tested if VABF reduces respiration rate (RR) or respiration variability (RV), and examined associations between RR, RV, and emotion ratings. 128 trauma-exposed adults (mean age = 30.21 years) with elevated dissociation volunteered and completed at least 50 % of intervention visits. Participants were randomized to one of four mindfulness meditation interventions: VABF (n = 34); breath-focus only (n = 33); vibration only (n = 34); open awareness (no vibration or breath-focus, n = 27). Results from linear mixed-effects models showed that VABF decreased RV across visits while all the other interventions showed increased RV across visits (p = .008; η = .014), and RV was positively associated with both anxiety and anger ratings (ps < .001; rs > .125). Findings suggest RV is a meaningful metric for examining regulatory processes in clinical populations with elevated autonomic arousal and negative emotionality. They also show that RV is modifiable through VABF, which holds significant promise as an intervention to improve regulatory processes in trauma-exposed populations.
Emotion regulation difficulties in children and adolescents with obsessive-compulsive disorder: A multi-informant and multi-method study.
Thoustrup CL, Blair RJ, Christensen SH … +15 more , Uhre V, Pretzmann L, Korsbjerg NLJ, Uhre C, Mora-Jensen AC, Ritter M, Lønfeldt NN, Thorsen ED, Quintana DS, Sajadieh A, Thomsen JH, Plessen KJ, Vangkilde S, Pagsberg AK, Hagstrøm J
J Anxiety Disord · 2025 Apr · PMID 40147257 · Publisher ↗
Pediatric obsessive-compulsive disorder (OCD) is associated with emotion regulation (ER) difficulties. Most studies are based on self-reports, while few have examined how these difficulties are expressed across modalitie...
Pediatric obsessive-compulsive disorder (OCD) is associated with emotion regulation (ER) difficulties. Most studies are based on self-reports, while few have examined how these difficulties are expressed across modalities, which may hold important diagnostic and therapeutic information. We applied a multi-informant and multi-method approach to examine ER difficulties in 211 children aged 8-17 years: 121 with OCD and 90 non-clinical controls. Child ER difficulties were assessed with The Difficulties in Emotion Regulation Scale (self-report and parent-report) and a Tangram frustration task with investigator-rated behavior, self-rated frustration, and heart rate variability (HRV). Children with OCD differed significantly from non-clinical controls in showing: (i) elevated child ER difficulties on self-report (partial eta squared =.068-.165) and parent-report (partial eta squared =.207-.369); (ii) more investigator-rated ER difficulties during the task (Cohen's d = -.33); (iii) increased levels of self-rated frustration before and after the task (partial eta squared =.089); notably, the magnitude of this increase did not differ between children with and without OCD. Finally, (iv) all children, regardless of group, demonstrated significant HRV changes during the frustration task, with no discernible group differences in the magnitude of these changes. Results suggest the OCD-related experience of ER difficulties may not impact autonomic functioning.
Is intolerance of uncertainty a necessary condition for anxiety symptoms in adolescents? A necessary condition analysis study.
Marchetti I, Pedretti LM, Iannattone S … +5 more , Colpizzi I, Farina A, Di Blas L, Ghisi M, Bottesi G
J Anxiety Disord · 2025 Jun · PMID 40139111 · Publisher ↗
BACKGROUND: Intolerance of uncertainty (IU) is a well-established risk factor for anxiety disorders, as higher levels of IU increase the likelihood of future maladaptive outcomes. However, the presence of low levels of I...
BACKGROUND: Intolerance of uncertainty (IU) is a well-established risk factor for anxiety disorders, as higher levels of IU increase the likelihood of future maladaptive outcomes. However, the presence of low levels of IU does not imply that maladaptive outcomes will not occur, as other risk factors can still lead to the onset of anxiety symptoms. Currently, it is unknown whether IU also serves as a necessary cause for anxiety symptoms, meaning that its absence would ensure the absence of these symptoms. METHODS: A sample of 186 adolescents (58.6 % boys) between 14 and 18 years of age (M = 16.58 ± 1.01) was followed for six months, with evaluations every three months. Several self-reports were administered to measure IU and general anxiety problems, derived from the Youth Self Report 11-18, and anxiety-specific symptoms, derived from the Self-Administered Psychiatric Scales for Children and Adolescents. The Necessary Condition Analysis approach was applied to determine the extent to which IU is a necessary condition for anxiety. FINDINGS: The analyses revealed that IU is a necessary condition for anxiety problems (d =.23 -.24), generalized anxiety disorder symptoms (d =.18 -.19), social anxiety disorder symptoms (d =.19 -.29), and school-related anxiety symptoms (d =.19 -.23) after three and six months. However, IU was not a statistically significant necessary condition for separation anxiety disorder symptoms. At baseline, between 29 % and 70 % of the sample exhibited the necessary levels of IU to potentially experience subclinical anxiety symptoms at subsequent follow-ups. DISCUSSION: IU is a necessary condition for the potential development of anxiety symptoms during adolescence. Recognizing necessary conditions for anxiety symptoms and mental disorders, in general, could lead to substantial progress, given its impact on enhancing our theoretical understanding and improving prevention strategies and clinical treatments.
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