J Anxiety Disord [JOURNAL]
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200 papers
Mindfulness- and acceptance-based programmes for obsessive-compulsive disorder: A systematic review and meta-analysis.
Bürkle JJ, Schmidt S, Fendel JC
J Anxiety Disord · 2025 Mar · PMID 39862744 · Publisher ↗
Mindfulness- and acceptance-based programmes (MABPs) in the treatment of obsessive-compulsive disorder (OCD) are increasingly gaining research interest, yet a comprehensive systematic review and meta-analysis is missing....
Mindfulness- and acceptance-based programmes (MABPs) in the treatment of obsessive-compulsive disorder (OCD) are increasingly gaining research interest, yet a comprehensive systematic review and meta-analysis is missing. To fill this gap, we analysed 46 trials involving 2221 patients. Two independent reviewers screened records, extracted data, assessed risk of bias, and rated overall quality of evidence. MABPs were associated with large reductions in OCD-severity in between-group analysis in randomised controlled trials (k = 33; g = -.87; CI = -1.13,-.60) and within-group pre-post analysis in all MABPs (k = 49; g = -1.72; CI = -2.00,-1.44). Depressive symptoms decreased between- and within-group with a small to moderate effect, with maintained reductions at follow-up for both OCD and depression. Moderate to large pre-post improvements were also observed in anxiety, obsessive beliefs, and quality of life. MABPs did not differ from cognitive behavioural therapy and exposure and response prevention (k = 9; g=.02; CI = -.23,.26) but were superior to medication (k = 5; g = -.77; CI = -1.44,-.11) and waitlist (k = 16; g = -1.66; CI = -2.1,-1.24). Symptom reductions were observed across world regions, but to varying degrees. When combined, increases in mindfulness and psychological flexibility predicted reductions in OCD symptoms. Outcomes were not moderated by treatment duration, samples', and therapists' characteristics. MABPs can reduce OCD-severity, but further high-quality trials with long-term follow-ups are needed to confirm results.
Intolerance of uncertainty, aging, and anxiety and mental health concerns: A scoping review and meta-analysis.
Yu MHM, Cao Y, Fung SSY … +3 more , Kwan GSY, Tse ZCK, Shum DHK
J Anxiety Disord · 2025 Mar · PMID 39842138 · Publisher ↗
Although intolerance of uncertainty (IU) is associated with negative outcomes, studies focusing on older adults are still emerging. Specifically, the relationship between IU and psychological health in this population re...
Although intolerance of uncertainty (IU) is associated with negative outcomes, studies focusing on older adults are still emerging. Specifically, the relationship between IU and psychological health in this population remains unclear. Moreover, no review has focused on understanding the unique contributions of IU and aging to anxiety and mental health in older adults. This scoping review and meta-analysis addressed this gap and provided a comprehensive understanding of the relationship between IU, aging, and mental health. Among 45 studies reviewed, 37 were included in the meta-analysis using mixed effect analysis to examine the relationship between IU and age across adulthood. The remaining eight studies, along with seven selected from the meta-analysis, were included in the scoping review to evaluate the relationship between IU, anxiety, and mental health. Among these, 12 studies focused on late adulthood, two on overall adulthood, and one included both late and overall adulthood. Results of the meta-analysis revealed an overall significant age difference in IU throughout adulthood. Moreover, results of the scoping review indicated a direct correlation between IU and anxiety, and other psychological issues in elderly. These findings provide insights for future research and interventions aimed at reducing IU and improving mental health among older adults.
Epidemiology of DSM-5 PTSD and ICD-11 PTSD and complex PTSD in the Netherlands.
Hoeboer CM, Nava F, Haagen JFG … +3 more , Broekman BFP, van der Gaag RJ, Olff M
J Anxiety Disord · 2025 Mar · PMID 39808949 · Publisher ↗
INTRODUCTION: Information regarding the prevalence of potentially traumatic events (PTEs), DSM-5 posttraumatic stress disorder (PTSD) and ICD-11 complex PTSD (CPTSD) in the Netherlands is currently lacking, as is data on...
INTRODUCTION: Information regarding the prevalence of potentially traumatic events (PTEs), DSM-5 posttraumatic stress disorder (PTSD) and ICD-11 complex PTSD (CPTSD) in the Netherlands is currently lacking, as is data on treatment uptake and treatment barriers. We aimed to provide prevalence estimates for potentially traumatic events, PTSD and CPTSD in the Netherlands, describe treatment seeking behavior and explore associated risk factors. METHOD: We included a sample of 1690 participants aged 16 years and older across the Netherlands via the Longitudinal Internet studies for the Social Sciences panel, a true probability sample of households drawn from the population register by Statistics Netherlands. We recruited participants between September 1st, 2023, and November 1st 2023. All participants completed online self-report questionnaires, and a subset consented to an interview (n = 204). Instruments included the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), the PTSD Checklist for DSM-5 (PCL-5) and the International Trauma Questionnaire (ITQ). RESULTS: The lifetime prevalence of any PTE was 81.5 %. The estimated lifetime prevalence of DSM-5 PTSD was 11.1 % and current prevalence 1.3 %. The estimated current prevalence of ICD-11 PTSD was 1.0 % and ICD-11 complex PTSD was 1.6 %. Especially females, younger adults, those with a lower education and those with a non-Dutch cultural background were at risk for PTSD. About half of the people with probable lifetime PTSD sought professional help and one-third received first-line PTSD treatment. Common reasons for refraining from seeking professional support included a lack of knowledge, shame and avoidance. CONCLUSIONS: PTEs, PTSD and CPTSD are common in the Netherlands and disproportionately distributed in society. Although evidence-based treatments for PTSD are available, only about one-third of those with lifetime PTSD receive first-line treatment. Findings underscore the need for targeted screening and preventative interventions, alongside public health campaigns aimed at enhancing knowledge and mitigating stigma about PTSD.
Changes and persistence in heart rate variability before and during social stress: A comparison of individuals with and without social anxiety disorder.
Cheah C, Lavery C, Johnson AR … +3 more , Clarke PJF, Hyett MP, McEvoy PM
J Anxiety Disord · 2025 Mar · PMID 39805253 · Publisher ↗
Individuals with social anxiety disorder (SAD) experience significant and persistent fear of social situations as they anticipate rejection, scrutiny, and embarrassment. Given that physiological reactions to social situa...
Individuals with social anxiety disorder (SAD) experience significant and persistent fear of social situations as they anticipate rejection, scrutiny, and embarrassment. Given that physiological reactions to social situations may shape emotional experience in SAD, understanding psychophysiological changes operating in SAD may be important to address this potentially key perpetuating factor. This study compared the patterns of change (via contrasts of estimated marginal means) and persistence (via autoregressive models) of two indices of heart rate variability (HRV; Root Mean Square of Successive Differences between normal heartbeats, and High-Frequency absolute units) as physiological measures of emotion regulation, between individuals with SAD (n = 94) and without (n = 59) using the Trier Social Stress Test phases (TSST). Results revealed that the SAD group increased their need to regulate their emotions (peak HRV) during the preparation (i.e., anticipation) phase, particularly among women, whereas HRV peaked for the non-SAD group during the social-evaluative context. The SAD group's increase in HRV in the preparation phase, relative to non-SAD group, was the opposite of the hypothesised effect. The non-SAD group demonstrated no significant persistence of HRV between some TSST phases, whereas the SAD group showed significant persistence across all phases, however no between-group differences were found. These findings provide novel evidence of similarities and differences in HRV between individuals with and without SAD while anticipating and encountering social-evaluative contexts.
Personalized stress optimization intervention to reduce adolescents' anxiety: A randomized controlled trial leveraging machine learning.
Liu J, Hu J, Qi Y … +2 more , Wu X, Gan Y
J Anxiety Disord · 2025 Mar · PMID 39798259 · Publisher ↗
Anxiety symptoms are among the most prevalent mental health disorders in adolescents, highlighting the need for scalable and accessible interventions. As anxiety often co-occurs with perceived stress during adolescence,...
Anxiety symptoms are among the most prevalent mental health disorders in adolescents, highlighting the need for scalable and accessible interventions. As anxiety often co-occurs with perceived stress during adolescence, stress interventions may offer a promising approach to reducing anxiety. Previous stress interventions have largely focused on the view that stress is harmful, aiming to manage and mitigate its negative effects. Stress optimization presents a novel intervention perspective, suggesting that stress can also lead to positive outcomes. However, it remains unclear whether stress optimization can effectively reduce anxiety symptoms in adolescents. We developed a single-session stress optimization intervention and investigated the conditions under which it was most effective. A large-scale randomized controlled trial was conducted (N = 1779, aged 12-18 years), with participants reporting their perceived stress, stress mindset, and anxiety over a two-month follow-up period. Machine learning is a promising approach for assessing personalized intervention effects. Conservative Bayesian causal forest analysis was employed to detect both treatment and heterogeneous intervention effects. The findings revealed that the intervention effectively reduced anxiety symptoms in the school context over a two-month follow-up (0.87 posterior probability). Furthermore, adolescents with higher anxiety and perceived stress at baseline experienced the most significant reductions in anxiety outcomes (standard deviations of -0.18 and -0.11 respectively). The single-session stress optimization intervention demonstrated potential for cost-effective scaling.
The effects of intelligence on exposure to combat and posttraumatic stress disorder across multiple deployments.
Zalmenson T, Yair N, Azriel O … +10 more , Shamai-Leshem D, Alon Y, Tik N, Levinstein Y, Ben-Yehuda A, Tatsa-Laur L, Pine DS, Bliese PD, Tavor I, Bar-Haim Y
J Anxiety Disord · 2025 Jan · PMID 39732084 · Full text
INTRODUCTION: Past work relates intelligence quotient (IQ) to risk for Post-Traumatic Stress Disorder (PTSD) among soldiers. We gathered data over multiple deployments to assess how IQ relates to the rate of symptom deve...
INTRODUCTION: Past work relates intelligence quotient (IQ) to risk for Post-Traumatic Stress Disorder (PTSD) among soldiers. We gathered data over multiple deployments to assess how IQ relates to the rate of symptom development both directly and through increasing the risk for traumatic combat exposure. METHODS: Male infantry soldiers from a maneuver brigade (N = 582) were followed over the 3-year period of their mandatory military service. Data were collected at 3-time-points: 1) shortly after enlistment and before deployment; 2) about 15 months into the service following one deployment, and another year later following additional deployments. IQ was measured before recruitment into the military; PTSD symptoms and combat exposure were measured at each time-point. RESULTS: Lower general IQ, and in particular lower abstract reasoning capabilities, related to steeper increases in PTSD symptoms, TIME×IQ= -.05, SE= .02, t(442.79) = -3.255, p < .01, controlling for the effect of pre-military traumatic experience. This relation was partly mediated by combat exposure, Effect= -.04, BootSE= .01, 95 % CI [-.06, -.02]. CONCLUSION: The results identify important risk factors for PTSD that can inform approaches to PTSD mitigation in the military and other organizations. Given that this study enrolled a male sample the generalizability of the results awaits further research.
Exposure therapy consortium: Outcomes of the proof-of-principle study.
Smits JAJ, Abramowitz JS, Anderson RA … +34 more , Arch JJ, Badeja D, Barzilay S, Belanger AN, Borchert T, Bryant E, Burger AS, Dixon LJ, Dutcher CD, Fitzgerald HE, Graham BM, Haberkamp A, Hofmann SG, Hoyer J, Huppert JD, Johnson D, Kabha BQ, Kirk A, Margraf J, McEvoy PM, McSpadden B, Newby J, Otto MW, Papini S, Parsons EM, Pittig A, Pittig R, Rief W, Schaumburg S, Timpano KR, Waltemate L, Wannemüller A, Weise C, Exposure Therapy Consortium
J Anxiety Disord · 2025 Jan · PMID 39732083 · Full text
BACKGROUND: This paper reports on the outcomes of a proof-of-principle study for the Exposure Therapy Consortium, a global network of researchers and clinicians who work to improve the effectiveness and uptake of exposur...
BACKGROUND: This paper reports on the outcomes of a proof-of-principle study for the Exposure Therapy Consortium, a global network of researchers and clinicians who work to improve the effectiveness and uptake of exposure therapy. The study aimed to test the feasibility of the consortium's big-team science approach and test the hypothesis that adding post-exposure processing focused on enhancing threat reappraisal would enhance the efficacy of a one-session large-group interoceptive exposure therapy protocol for reducing anxiety sensitivity. METHODS: The study involved a multi-site cluster-randomized controlled trial comparing exposure with post-processing (ENHANCED), exposure without post-processing (STANDARD), and a stress management intervention (CONTROL) in students with elevated anxiety sensitivity. Feasibility was assessed using site performance metrics (e.g., timeline, sample size, missing data). Efficacy was assessed up to 1-month follow-up using the Anxiety Sensitivity Index-3. RESULTS: Despite challenges posed by unforeseen global crises, a standardized protocol for screening, assessment, and treatment at 12 research sites across four continents was successfully implemented, resulting in a total sample size of 400 with minimal missing data. Challenges in recruitment and adherence to the projected timelines were encountered. Significant reductions in anxiety sensitivity were observed in all conditions. Contrary to hypotheses, group differences were only observed at post-treatment, when ENHANCED and CONTROL outperformed STANDARD but were not significantly different from each other. CONCLUSIONS: This study demonstrates the feasibility of the Exposure Therapy Consortium. Findings raise questions regarding the efficacy of large group exposure interventions and underscore the importance of careful research site selection and an iterative approach to treatment development.
Limited consensus on what climate anxiety is: Insights from content overlap analysis on 12 questionnaires.
van Dijk S, van Schie K, Smeets T … +1 more , Mertens G
J Anxiety Disord · 2025 Jan · PMID 39724678 · Publisher ↗
Climate anxiety is a phenomenon that is gaining importance due to the general public's increased awareness of the worsening climate crisis. At present, climate anxiety is not operationalized consistently across the exist...
Climate anxiety is a phenomenon that is gaining importance due to the general public's increased awareness of the worsening climate crisis. At present, climate anxiety is not operationalized consistently across the existing literature. It is important to gain more consensus on the definition and operationalization of climate anxiety to facilitate reliable and generalizable research and to further develop interventions. Content analysis can contribute to this by providing insight into the overlap in the content of climate anxiety measures. With a systematic search, this study identified and analyzed 12 distinct scales measuring climate anxiety. The 119 items covered a total of 57 disparate symptoms. Jaccard indices showed that the mean overlap between symptoms of different climate anxiety scales was generally very low, as was the overlap between pairwise comparisons of climate anxiety scales. These results highlight the lack of uniformity in assessing climate anxiety and the need to properly define and operationalize this concept. The potential reasons for low overlap and how this might impact the reliability and validity of existing measures are discussed. It is critical that future work aims at finding consensus on the definition of climate anxiety (e.g., through a Delphi study) and psychometrically comparing the different questionnaires.
Corrigendum to "Reward processes in extinction learning and applications to exposure therapy" [Journal of Anxiety Disorders 106 (2024) 102911].
Rosenberg BM, Barnes-Horowitz NM, Zbozinek TD … +1 more , Craske MG
J Anxiety Disord · 2025 Jan · PMID 39721366 · Full text
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Name avoidance in social anxiety: Understanding alexinomia.
Ditye T, Sartorio M, Welleschik L
J Anxiety Disord · 2025 Jan · PMID 39721365 · Publisher ↗
Emerging evidence suggests that certain individuals are unable to address others by name, presumably owing to anxiety experienced in social situations. This fear of using personal names has been termed alexinomia and occ...
Emerging evidence suggests that certain individuals are unable to address others by name, presumably owing to anxiety experienced in social situations. This fear of using personal names has been termed alexinomia and occurs in all forms of relationships and communication. The symptoms of alexinomia show large overlap with the symptoms typically associated with social anxiety, raising the question of whether social anxiety could be the main driving factor of this type of name avoidance. Here, we investigated the relationship between alexinomia and social anxiety by testing name avoidance behavior in a sample of 190 participants with varying degrees of social anxiety. Results showed a strong positive relationship between these two variables. High levels of social anxiety, as measured by two independent standardized psychological instruments (i.e., the Social Interaction Anxiety Scale and the Liebowitz Social Anxiety Scale), were associated with higher degrees of fear-based name avoidance. This was shown by regression analysis as well as analyses of group differences. The findings indicate that alexinomia could be a common symptom in socially anxious individuals that so far has not been discussed in the psychological literature on social anxiety.
Tri-level anxiety and depression symptom trajectory in adolescents: The role of emotion regulation diversity.
Wen A, Metts AV, Zinbarg RE … +2 more , Mineka S, Craske MG
J Anxiety Disord · 2025 Jan · PMID 39700826 · Publisher ↗
Anxiety and depression are associated with impaired emotion regulation (ER). Recently, a novel construct named ER diversity has been proposed to assess the diversity in ER strategy use. Low ER diversity, particularly und...
Anxiety and depression are associated with impaired emotion regulation (ER). Recently, a novel construct named ER diversity has been proposed to assess the diversity in ER strategy use. Low ER diversity, particularly under stressful circumstances, may be a transdiagnostic vulnerability factor for anxiety and depression. This study utilized a longitudinal design to examine the association between ER diversity and transdiagnostic anxiety and depressive symptom trajectory in adolescents (N = 627 at baseline), while accounting for life stress. Measures of ER strategy use, chronic interpersonal life stress, neuroticism, and transdiagnostic dimensional symptoms of anxiety and depression were assessed. The ER diversity index and the traditional ER sum score were computed. Higher ER diversity index was associated with steeper decline in the Fears symptom factor over time, above and beyond the ER sum score and neuroticism. Moreover, chronic interpersonal life stress influenced these associations. When chronic interpersonal life stress was low, Fears declined over time regardless of the ER diversity level; when chronic interpersonal life stress was high, Fears only declined when ER diversity was high. Thus, low diversity in ER strategy use, particularly under stressful circumstances, may be a vulnerability factor for fear symptom development.
Screening social anxiety with the Social Artificial Intelligence Picture System.
Ju Q, Xu Z, Chen Z … +3 more , Fan J, Zhang H, Peng Y
J Anxiety Disord · 2025 Jan · PMID 39671733 · Publisher ↗
Social anxiety disorder (SAD) is a prevalent anxiety disorder marked by strong fear and avoidance of social scenarios. Early detection of SAD lays the foundation for the introduction of early interventions. However, due...
Social anxiety disorder (SAD) is a prevalent anxiety disorder marked by strong fear and avoidance of social scenarios. Early detection of SAD lays the foundation for the introduction of early interventions. However, due to the nature of social avoidance in social anxiety, the screening is challenging in the clinical setting. Classic questionnaires also bear the limitations of subjectivity, memory biases under repeated measures, and cultural influence. Thus, there exists an urgent need to develop a reliable and easily accessible tool to be widely used for social anxiety screening. Here, we developed the Social Artificial Intelligence Picture System (SAIPS) based on generative multi-modal foundation artificial intelligence (AI) models, containing a total of 279 social pictures and 118 control pictures. Social scenarios were constructed to represent core SAD triggers such as fear of negative evaluation, social interactions, and performance anxiety, mapping to specific dimensions of social anxiety to capture its multifaceted nature. Pictures devoid of social interactions were included as a control, aiming to reveal response patterns specific to social scenarios and to improve the system's precision in predicting social anxiety traits. Through laboratory and online experiments, we collected ratings on SAIPS from five dimensions. Machine learning results showed that ratings on SAIPS robustly reflected and predicted an individual's trait of social anxiety, especially social anxiety and arousal ratings. The prediction was reliable, even based on a short version with less than 30 pictures. Together, SAIPS may serve as a promising tool to support social anxiety screening and longitudinal predictions.
How strongly are trait positive and negative affectivity associated with anxiety symptoms? A multilevel meta-analysis of cross-sectional studies in anxiety disorders.
Flückiger C, Mahlke F, John G … +4 more , Daus P, Zinbarg RE, Allemand M, Schürmann-Vengels J
J Anxiety Disord · 2025 Jan · PMID 39667042 · Publisher ↗
There are well-established theoretical and empirical foundations for a negative association between trait positive affectivity and anxiety symptoms in anxiety disorders and a positive association between trait negative a...
There are well-established theoretical and empirical foundations for a negative association between trait positive affectivity and anxiety symptoms in anxiety disorders and a positive association between trait negative affectivity and anxiety symptoms, respectively. However, no previous meta-analysis systematically estimated to what extent trait positive and negative affectivity are associated with anxiety symptoms in anxiety disorders. The aim of this study was to conduct a systematic review and meta-analysis to obtain an evidence-based estimate of the associations between trait positive and negative affectivity with anxiety symptoms in anxiety disorders. We performed a systematic search including studies reporting estimates of the associations between trait positive and negative affectivity measures and anxiety measures in clinical populations that suffer from at least one anxiety disorder. We identified 13 and 14 eligible studies, documenting 19 and 21 mainly unpublished effect sizes from 1489 individuals that suffer from an anxiety disorder. We estimated an overall correlational effect size (r) using multilevel meta-analytic models accounting for within- and between-study variance components. The results of the omnibus models showed a small to moderate negative association between positive affectivity and anxiety symptoms (r = -0.19, 95 % CI [-0.30, -0.09]) and a strong positive association between negative affectivity and anxiety symptoms respectively (r = 0.53, 95 % CI [0.44, 0.61]). These associations are different from each other (r = .35, p < .001). The results are consistent with theoretical claims that anxiety disorders are highly associated with negative affectivity but to a lesser extent with positive affectivity. More research and systematic documentation are necessary to determine moderators of these overall associations.
Post-event processing in social anxiety: A scoping review.
Flynn AJ, Yoon KL
J Anxiety Disord · 2025 Jan · PMID 39622110 · Publisher ↗
Graded exposure successfully reduces fear in specific phobias and anxiety disorders, yet social exposure in daily life often fails to mitigate social anxiety. Post-event processing, perseverative, negative, self-referent...
Graded exposure successfully reduces fear in specific phobias and anxiety disorders, yet social exposure in daily life often fails to mitigate social anxiety. Post-event processing, perseverative, negative, self-referential thinking that occurs following a social-evaluative event, may partly explain inhibited desensitization to social fears. Post-event processing has been studied extensively since its first description by Clark and Wells (1995) and previously reviewed (e.g., Brozovich & Heimberg, 2008; Wong, 2016). However, these reviews are now dated or limited in scope. In the present scoping review, we pay particular attention to contemporary research that addresses unanswered questions raised in past reviews (e.g., Brozovich & Heimberg, 2008), synthesizing existing knowledge. Specifically, we discuss post-event processing's evolving role in cognitive models of social anxiety disorder, its core features, its eliciting situations (e.g., performance vs. social interactions), its relation to other cognitive and affective constructs (e.g., memory, performance appraisal, self-focused attention), and its assessment. Our findings indicate that post-event processing is more frequent after performance situations than social interactions, is related to negative memory biases, is bi-directionally related to worsening performance appraisals, and may be precipitated by self-focused attention. Future research directions include elucidating post-event processing's course, clarifying post-event processing's potential causal role in the development of social anxiety disorder, and identifying factors that underlie post-event processing's deleterious nature.
Corrigendum to "Metacognitive therapy versus exposure and response prevention for obsessive-compulsive disorder - a non-inferiority randomized controlled trial" Journal of Anxiety Disorders (2024), Volume 104, June 2024, 102873.
Exner C, Kleiman A, Haberkamp A … +3 more , Hansmeier J, Milde C, Glombiewski JA
J Anxiety Disord · 2024 Dec · PMID 39579598 · Publisher ↗
Abstract loading — click title to view on PubMed.
Negative emotion differentiation buffers against intergenerational risk for social anxiety in at-risk adolescent girls.
Seah THS, Silk JS, Forbes EE … +1 more , Ladouceur CD
J Anxiety Disord · 2024 Dec · PMID 39546986 · Publisher ↗
Social anxiety disorder (SAD) tends to emerge during adolescence and is more prevalent among those assigned female at birth. Parental social anxiety confers risk for adolescent SAD but less is known regarding protective...
Social anxiety disorder (SAD) tends to emerge during adolescence and is more prevalent among those assigned female at birth. Parental social anxiety confers risk for adolescent SAD but less is known regarding protective factors. Research suggests that emotion differentiation (the ability to discriminate between similarly valenced emotions, e.g., fear vs. sadness vs. anger) may be protective, as it is associated with adaptive psychosocial outcomes. However, little work has examined how emotion differentiation influences the development of SAD, particularly during periods of higher risk such as adolescence. In a longitudinal study of adolescent girls at high temperamental risk for SAD (aged 11-14-years; n=114), we tested whether emotion differentiation (derived using negative and positive emotion ratings from 16-day ecological momentary assessments at baseline) moderated the relationship between parental and adolescent social anxiety symptoms across two years. Results revealed significant moderation by negative (but not positive) emotion differentiation (p=.042): Baseline parental social anxiety was positively associated with adolescent social anxiety symptoms at two-year follow-up but only at lower (vs. higher) levels of emotion differentiation, even after controlling for baseline depressive symptoms. Exploratory analyses showed that these effects were unique to avoidance of social situations (p=.014). Findings highlight the protective effects of emotion differentiation and have important clinical implications for understanding and treating SAD.
Interplay of serum BDNF levels and childhood adversity in predicting earlier-onset post-traumatic stress disorder: A two-year longitudinal study.
Kim JM, Kang HJ, Kim JW … +5 more , Lee JY, Jang H, Kim JC, Kim SW, Shin IS
J Anxiety Disord · 2024 Dec · PMID 39546985 · Publisher ↗
This longitudinal study explored the intricate relationships between serum Brain-Derived Neurotrophic Factor (sBDNF) levels, exposure to childhood adversities, and the subsequent development of Post-Traumatic Stress Diso...
This longitudinal study explored the intricate relationships between serum Brain-Derived Neurotrophic Factor (sBDNF) levels, exposure to childhood adversities, and the subsequent development of Post-Traumatic Stress Disorder (PTSD), distinguishing between earlier- and delayed-onset forms over a two-year follow-up period in individuals sustaining physical injuries. We recruited patients presenting with moderate to severe physical injuries at a trauma center, conducting baseline assessments of sBDNF levels and childhood adversities through the Adverse Childhood Experiences (ACE) questionnaire. Additionally, detailed socio-demographic and clinical data were compiled. The Clinician-Administered PTSD Scale for DSM-5 was employed to diagnose PTSD at 3, 6, 12, and 24 months post-injury. Binary and multinomial logistic regression analyses were applied to elucidate the interactions between sBDNF levels, childhood adversities, and PTSD onset patterns. Among 895 participants, PTSD was diagnosed in 107 individuals (11.9 %), with 76 (8.4 %) exhibiting symptoms indicative of earlier-onset PTSD and 31 (3.5 %) demonstrating delayed-onset PTSD. Significantly, lower sBDNF levels were associated with a higher risk of earlier-onset PTSD specifically in the context of childhood adversities. This association was not observed in individuals without childhood adversities or in those with delayed-onset PTSD. The findings suggest a complex and critical interplay between neurobiological factors, specifically sBDNF levels, and early life adversities in influencing the timing of PTSD onset, potentially deepening the understanding of PTSD etiology.
Excessive avoidance bias towards uncertain faces in non-clinical social anxiety individuals.
Kou Y, Xing H, Zheng R … +4 more , Wu Y, Feng S, Zou F, Zhang M
J Anxiety Disord · 2024 Dec · PMID 39541825 · Publisher ↗
Previous survey studies have consistently shown a strong link between social anxiety and intolerance for uncertainty. However, this association lacks empirical validation from laboratory investigations. To bridge this ga...
Previous survey studies have consistently shown a strong link between social anxiety and intolerance for uncertainty. However, this association lacks empirical validation from laboratory investigations. To bridge this gap, we conducted a study utilizing the ultimatum game task to assign distinct social connotations (egoistic, altruistic, and uncertain) to three initially neutral faces. Subsequently, we utilized the Approach-Avoidance Task (AAT) paradigm to evaluate participants' approach-avoidance tendencies towards the faces with varying social meanings. Additionally, we collected data on participants' levels of social anxiety and trait anxiety. Our results indicate that both social anxiety and trait anxiety levels impact individuals' avoidance behaviors when faced with socially uncertain cues. This suggests that individuals with higher levels of social anxiety may demonstrate increased sensitivity to uncertainty in social contexts, leading to avoidance behaviors. Crucially, our findings directly underscore the heightened avoidance tendencies of non-clinical individuals with social anxiety towards socially uncertain stimuli, thereby providing new empirical support for research on anxiety disorders related to uncertainty.
Intensive treatments for children and adolescents with anxiety or obsessive-compulsive disorders: A systematic review and meta-analysis.
Ganzevoort COW, Wolters LH, Hornstra R … +8 more , Grieve CM, Højgaard DRMA, Skarphedinsson GA, Weidle B, Waite P, Bertie LA, Tomlinson M, Nauta MH
J Anxiety Disord · 2024 Dec · PMID 39522354 · Publisher ↗
Anxiety and obsessive-compulsive disorders have a significant negative impact on youth. Cognitive behavioural therapy (CBT) is recommended and established as effective first-step treatment, but persistent symptoms and no...
Anxiety and obsessive-compulsive disorders have a significant negative impact on youth. Cognitive behavioural therapy (CBT) is recommended and established as effective first-step treatment, but persistent symptoms and non-response are common. Intensive psychological treatments deliver more or longer sessions over a shorter time span, with fewer session gaps. However, an understanding of their effectiveness, characteristics, acceptability, and feasibility is lacking. Systematically searching five databases yielded four controlled and 36 uncontrolled studies (N=2707) involving youth with primary anxiety or obsessive-compulsive disorders, many of whom received prior treatments. Intensive treatments were acceptable and feasible, with low drop-out rates. Between-group analyses compared intensive treatment with standard treatment (k = 2) or waitlist (k = 2), revealing no significant post-treatment differences in symptom severity or remission. Uncontrolled within-group analyses of intensive treatments showed large improvements from pre- to post-treatment in symptoms (k = 47), remission (k = 17), impairment (k = 22), functioning (k = 5), and quality of life (k = 2), with larger effects at follow-ups. Intensive treatments show promise for youth with anxiety or obsessive-compulsive disorders by potentially offering high treatment completion rates and comparable outcomes to standard CBT, aiding earlier recovery and reducing overall suffering. This systematic review/meta-analysis provides a comprehensive overview of intensive treatments, their theoretical considerations, and empirical findings. Future RCTs should compare the effectiveness of standard and intensive treatments and identify optimal populations for their use.
Fear of positive evaluation and social affiliation in social anxiety disorder and major depression.
Rassaby M, Spaulding IG, Taylor CT
J Anxiety Disord · 2024 Oct · PMID 39340974 · Publisher ↗
Fear of positive evaluation (FPE) is posited as a core feature of social anxiety disorder (SAD); however, little is known about its role in interpersonal functioning. We examined relationships between FPE and responses t...
Fear of positive evaluation (FPE) is posited as a core feature of social anxiety disorder (SAD); however, little is known about its role in interpersonal functioning. We examined relationships between FPE and responses to a standardized social affiliation paradigm designed to facilitate positive social connection with an unacquainted conversation partner (trained confederate). The sample included adults with SAD (N = 52), major depressive disorder (MDD; N = 23), comorbid SAD and MDD (N = 36), and non-psychiatric controls (N = 33). Participants completed measures assessing FPE, affect, safety behaviors, and desire for future interaction. Confederates and observers rated participant behavior and their own desire for future interaction. FPE was most elevated in the SAD and comorbid groups, followed by the MDD group, and then non-psychiatric controls. In the full sample, FPE was associated with greater self-reported anxiety and safety behavior use, lower self-reported positive affect and desire for future interaction, lower observer-rated desire for future interaction and approach behaviors, and greater observer-rated anxious behaviors. Within-group correlations revealed that associations were weaker in the SAD only and comorbid groups (cf. control and MDD only groups); however, post-hoc moderation analyses indicated that the relationships between FPE and the outcomes of interest largely held across varying levels of social anxiety and depression severity. Findings underscore the potential role of FPE as a transdiagnostic factor relevant to understanding interpersonal functioning in social anxiety and depression.
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