J Anxiety Disord [JOURNAL]
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200 papers
Daily stress and emotions in relation to fear of negative and positive evaluation.
Reichenberger J, Arend AK, Blechert J
J Anxiety Disord · 2024 Oct · PMID 39332066 · Publisher ↗
Fear of negative (FNE) and positive (FPE) evaluation constitute distinct components of social anxiety and relate to altered affectivity. It is unclear whether individuals with strong FNE/FPE overreact to social stressors...
Fear of negative (FNE) and positive (FPE) evaluation constitute distinct components of social anxiety and relate to altered affectivity. It is unclear whether individuals with strong FNE/FPE overreact to social stressors only or to more unspecific ones as well. The present set of three studies (n = 109 and n = 97 healthy individuals in study 1/2, n = 49 patients with social anxiety disorder in study 3) assessed whether reactivity to various daily stressors and non-specific momentary stress/emotions assessed through ecological momentary assessment depend on individuals' level of FPE/FNE. Almost all relationships with FPE/FNE were explained by depressive symptoms, except for a unique association of FNE with reactivity to stressors from the distant social network. Relationships of FNE with momentary global stress and emotions were mixed, but again explained by depressive symptoms. More depressive symptoms were associated with higher stress, negative affect, and most stressor types as well as lower positive affect in all studies. These results show that for social stressors from the distant social network, FNE has explanatory power. They further document the role of depressive affect for reactivity to a wide range of everyday stressors and question the need for specific instruments assessing FPE/FNE unless stressors are explicitly social-evaluative in nature.
Cross-cultural validation of the BFOE model: Best practices and future directions for psychometric evaluation of the Fear of positive evaluation scale - Insights from a Dutch translation.
Lange WG, Howell AN, Weeks JW
J Anxiety Disord · 2024 Oct · PMID 39326352 · Publisher ↗
The Bivalent Fear of Evaluation (BFOE) model suggests that Social Anxiety Disorder is not only characterized by fear of negative evaluation (FNE), but also fear of positive evaluation (FPE). While FNE has been firmly est...
The Bivalent Fear of Evaluation (BFOE) model suggests that Social Anxiety Disorder is not only characterized by fear of negative evaluation (FNE), but also fear of positive evaluation (FPE). While FNE has been firmly established, research of the latter is accumulating. To evaluate the role of the BFOE Model, and particularly FPE, validated measures such as the Fear of Positive Evaluation Scale (FPES) are pivotal. Yet, validation of psychometric properties is often at stake or neglected when translating a scale to other languages. This hampers cross-cultural evaluation of questionnaires and related concepts considerably, including the BFOE Model. To illustrate, a freely available, but not validated Dutch version of the FPES was completed, along with other measures by 354 community participants from the Netherlands and Belgium in an online study. The Dutch FPES showed excellent convergent and discriminant validity. In addition, it explained additional variance in social anxiety above and beyond FNE. These results as well as those from the factor analyses were highly comparable with those deriving from evaluations of the original English version. In conclusion, the Dutch FPES showed excellent psychometric properties and is fit for further exploring consistency or differences in the BFOE model across cultures. Based on this case, practice guidelines for international use and validation of measures are discussed, and recommendations are provided.
Group metacognitive therapy for children and adolescents with anxiety and depression: A preliminary trial and test of proposed mechanisms.
Thingbak A, Wells A, O'Toole MS
J Anxiety Disord · 2024 Oct · PMID 39321673 · Publisher ↗
Preliminary research supports the feasibility of metacognitive therapy (MCT) in children with generalized anxiety, but the effectiveness of MCT in treating children with other anxiety and depressive disorders largely rem...
Preliminary research supports the feasibility of metacognitive therapy (MCT) in children with generalized anxiety, but the effectiveness of MCT in treating children with other anxiety and depressive disorders largely remains unknown. The purpose of this study was to investigate the effects associated with MCT in targeting symptoms of anxiety and depression in children and adolescents and to investigate mechanisms proposed by the metacognitive model. Ninety-seven participants aged 10-17 years (M = 12.9 ± 1.9, 82.5 % females) with anxiety and depressive disorders received eight sessions of group MCT. Participants were diagnostically assessed at pre- and post-treatment and completed symptom and process measures before, during, and after treatment, and again at three- and six-month follow-up. Multilevel models were conducted to investigate treatment-related and mediation effects. Results showed large reductions in total symptoms following treatment (d = 1.28). These reductions were associated with, and temporally preceded by changes in cognitive attentional syndrome (CAS), metacognitive beliefs, and self-reported attention control, but not objective attention control. Treatment gains were maintained at six-month follow-up (d = 1.18). Our results indicate that MCT may be a promising treatment for children and adolescents with anxiety and depression and provide preliminary evidence of changes in CAS, metacognition, and perceived attention control as potential drivers of treatment effects.
A within-person test of the metacognitive model: Daily dynamics between metacognitive beliefs, metacognitive strategies, and negative affect.
Cano-López JB, Anyan F, García-Sancho E … +2 more , Nordahl H, Salguero JM
J Anxiety Disord · 2024 Oct · PMID 39305537 · Publisher ↗
The metacognitive model of psychological disorders highlights that emotional distress is maintained by metacognitive strategies, which are related to underlying metacognitive beliefs. Considerable empirical evidence has...
The metacognitive model of psychological disorders highlights that emotional distress is maintained by metacognitive strategies, which are related to underlying metacognitive beliefs. Considerable empirical evidence has supported the role of metacognitions in psychopathology, but few studies have examined the suggested links between metacognitive beliefs, metacognitive strategies, and symptoms within individuals. Within-person effects provide better empirical tests of theory-based hypotheses derived from clinical models as they relate to change at the individual level. Thus, the current study sought to test central predictions from the metacognitive model at the within-person level using Dynamic Structural Equation Modelling (DSEM). A sample of 222 participants gathered at convenience participated in a 26-day long assessment period where they reported daily measures of metacognitive beliefs, metacognitive strategies, and negative affect. Temporal precedence and bidirectional relations between the variables, and the possible day-to-day and within days mediation role of metacognitive strategies between metacognitive beliefs and negative affect, were tested. When controlling for previous days effects, metacognitions and negative affect (but not metacognitive strategies) predicted each other the next day, showing a reciprocal relationship. However, metacognitive strategies were significant mediators between metacognitions and negative affect within days and day-to-day. Implications and future directions based on these findings are discussed.
Cognitive behavioral group therapy for social anxiety disorder - A critical review of methodological designs.
Wojtaszek JA, Koch EI, Arble E … +1 more , Loverich TM
J Anxiety Disord · 2024 Oct · PMID 39303446 · Publisher ↗
Social anxiety disorder (SAD) is highly prevalent with significant lifetime impacts, especially when left untreated. Cognitive behavioral therapy is the current gold standard treatment with successful patient outcomes. C...
Social anxiety disorder (SAD) is highly prevalent with significant lifetime impacts, especially when left untreated. Cognitive behavioral therapy is the current gold standard treatment with successful patient outcomes. Cognitive behavioral group therapy (CBGT) is one form that provides unique benefits to participants including normalization of symptoms and social support, as well as providing increased access to treatment at a lower per-session cost. Research on this mode of treatment has been ongoing for over 20 years, but we still have much to learn about its overall efficacy. The goals of this critical review were to summarize and evaluate the most current research, including an analysis of the overall methodological design quality, and provide recommendations for the enhancement of future studies based on best practices. Recent studies included some best practice design elements used in measuring efficacy such as the use of comparison groups, masking procedures, fidelity assessments, and consideration of clinical significance in outcomes. However, many gaps exist such as a lack of consensus around measures and therapy manuals, as well as baseline competencies of facilitators. Future studies should consider incorporating additional best practice elements aligning with study goals to strengthen designs and provide the field with even more confidence in this mode of treatment.
Dating in social anxiety disorder: A daily diary study.
Shechter Strulov T, Aderka IM
J Anxiety Disord · 2024 Oct · PMID 39270372 · Publisher ↗
Romantic relationships are vital for health, well-being and quality of life, and an increasing percentage of romantic relations begin via use of dating apps and subsequently progress to dates. In the present study we exa...
Romantic relationships are vital for health, well-being and quality of life, and an increasing percentage of romantic relations begin via use of dating apps and subsequently progress to dates. In the present study we examined dating application use and dates among individuals with SAD (n = 54) and without SAD (n = 54). Our sample included young adults (age range 18 to 33) who were not in a romantic relationship at the time of the study. For both individuals with SAD and without SAD, half of the participants were men, and half were women. We used a daily diary measurement in which participants reported on their dating application use and dates, as well as on concomitant emotions and perceptions for 21 consecutive days. We found that individuals with and without SAD did not differ in the frequency/duration of application use nor in the number of dates attended. However, individuals with SAD experienced dates as more negative compared to individuals without SAD (Cohen's d = 0.65). Interestingly, individuals with SAD did not significantly differ in their experience of dates as positive compared to individuals without SAD. Moreover, use of dating applications/going on dates were associated with increases in shame (Cohen's d = 0.59) and embarrassment (Cohen's d = 0.45) and this was found to a greater extent among individuals with SAD compared to individuals without SAD (Cohen's d = 0.50, 0.39 for shame and embarrassment respectively). Findings are discussed in the context of cognitive behavioral models of SAD and implications for treatment are considered.
A systematic review and meta-analysis of PTSD symptoms at mid-treatment during trauma-focused treatment for PTSD.
Purnell L, Graham A, Chiu K … +2 more , Trickey D, Meiser-Stedman R
J Anxiety Disord · 2024 Oct · PMID 39270371 · Publisher ↗
There is concern that trauma memory processing in psychological therapies leads to PTSD symptom exacerbation. We compared PTSD symptoms at mid-treatment in trauma-focused psychological therapy to control groups. We syste...
There is concern that trauma memory processing in psychological therapies leads to PTSD symptom exacerbation. We compared PTSD symptoms at mid-treatment in trauma-focused psychological therapy to control groups. We systematically searched multiple databases and searched grey literature. We included randomised controlled trials involving adults comparing trauma-focused psychological interventions with active non-trauma-focused interventions or waitlist conditions. Twenty-three studies met our inclusion criteria. We found no evidence of PTSD symptom exacerbation at mid-treatment in trauma-focused interventions compared to control groups (g=-.16, [95 % confidence interval, CI, -.34,.03]). Sensitivity analyses with high quality studies (risk of bias assessment ≥ 7; g=-.25; [95 % CI -.48, -.03], k = 12) and studies with passive controls (g=-.32; [95 % CI -.59, -.05], k = 8) yielded small effect sizes favouring trauma-focused interventions. At post-treatment, trauma-focused interventions yielded a medium effect on PTSD symptoms compared to all controls (g=-.57; [CI -.79, -.35], k = 23). Regarding depression, trauma-focused interventions yielded a small effect size compared to controls at mid-treatment (g=-.23; [95 % CI -.39, -.08], k = 12) and post-treatment (g=-.45; [CI -.66, -.25], k = 12). This meta-analysis found no evidence that trauma-focused psychotherapies elicit symptom exacerbation at mid-treatment in terms of PTSD or depression symptoms. Instead, this meta-analysis suggests that the benefits of trauma-focused interventions can be experienced through improved depression and possibly PTSD before the conclusion of therapy. However, it is possible that symptom exacerbation occurred before mid-treatment and/or that people who experience symptom exacerbation drop out of studies and so are not included in the analysis.
From negative feelings to impairments: A longitudinal study on the development of climate change anxiety.
Chan HW, Lin L, Tam KP … +1 more , Hong YY
J Anxiety Disord · 2024 Oct · PMID 39217778 · Publisher ↗
People may experience anxiety and related distress when they come in contact with climate change (i.e., climate change anxiety). Climate change anxiety can be conceptualized as either emotional-based response (the experi...
People may experience anxiety and related distress when they come in contact with climate change (i.e., climate change anxiety). Climate change anxiety can be conceptualized as either emotional-based response (the experience of anxiety-related emotions) or impairment-based response (the experience of impairment in daily functioning). To date, it remains uncertain how these distinct manifestations of climate change anxiety are related. Conceptually, the experience of climate change anxiety may transform from an adaptive and healthy emotional response to an impairment in daily functioning. We conducted two two-wave longitudinal studies to examine the possible bidirectional relationships between three manifestations of climate change anxiety. We recruited 942 adults (mean age = 43.1) and 683 parents (mean age = 46.2) in Studies 1 and 2, respectively. We found that Time 1 emotion-based response was positively linked to Time 2 cognitive-emotional impairment, while Time 1 cognitive-emotional impairment was positively related to Time 2 functional impairment. In Study 2, we also found a bidirectional positive relationship between generalized anxiety and emotion-based climate change anxiety over time. Overall, our findings provide initial support to the temporal relationships between different manifestations of climate change anxiety, corroborating that climate change anxiety may develop from emotional responses to impairment in functioning.
Reciprocal changes in functioning and PTSD symptoms over the course of psychotherapy.
Benfer N, Darnell BC, Rusowicz-Orazem L … +1 more , Litz BT
J Anxiety Disord · 2024 Oct · PMID 39213829 · Publisher ↗
Psychotherapies for posttraumatic stress disorder (PTSD) assume that PTSD symptom improvement will lead to improvements in functioning. Yet, few studies have examined the dynamic interplay between these constructs. Using...
Psychotherapies for posttraumatic stress disorder (PTSD) assume that PTSD symptom improvement will lead to improvements in functioning. Yet, few studies have examined the dynamic interplay between these constructs. Using a random intercepts cross-lagged panel model, we examined the association between functioning and PTSD, both modeled as a total score and as the DSM-5 subclusters, across twelve sessions of treatments that chiefly target functioning. Participants were 161 Veterans with PTSD enrolled in a randomized controlled trial comparing present centered therapy and an enhanced version of adaptive disclosure. Overall, PTSD symptoms, measured as the total PTSD score, led to changes in functioning more frequently than functioning predicting PTSD symptoms, although these effects did not appear until session 7. In terms of subclusters, functioning predicted changes in the PTSD subclusters B (intrusions), C (avoidance), and E (alterations in arousal and reactivity) at more timepoints compared to timepoints at which these subclusters predicted functioning. The dynamic relationships between PTSD and functioning in the context of functioning-focused treatments are complex, with functioning playing an important role in reduction of some of the core symptoms of PTSD.
Safety behaviors and positive emotions in social anxiety disorder.
Oren-Yagoda R, Oren B, Aderka IM
J Anxiety Disord · 2024 Oct · PMID 39197225 · Publisher ↗
The present study examined contextual factors that affect safety behavior use as well as positive emotions when using safety behaviors among individuals with SAD. Eighty-eight participants took part in the study, half (n...
The present study examined contextual factors that affect safety behavior use as well as positive emotions when using safety behaviors among individuals with SAD. Eighty-eight participants took part in the study, half (n = 44) met diagnostic criteria for SAD and half (n = 44) did not meet criteria for SAD. Participants completed a 21-day experience sampling methodology (ESM) measurement in which they reported on daily social interactions, safety behavior use, and emotions. Using multilevel linear modeling we found that both individuals with and without SAD used more safety behaviors when interacting with distant others compared to close others, but this effect was greater for individuals with SAD compared to individuals without SAD. We also found that social anxiety significantly moderated the relationship between safety behaviors in social interactions and positive emotions. Specifically, our findings indicated that individuals with higher levels of social anxiety reported lower levels of positive emotions when using safety behaviors. Implications of our findings for models of psychopathology and for treatment of SAD are discussed.
Scaling up psychological interventions into the daily lives of patients with anxiety and related disorders.
Ebrahimi OV, Asmundson GJG
J Anxiety Disord · 2024 Aug · PMID 39178811 · Publisher ↗
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Network analyses of ecological momentary emotion and avoidance assessments before and after cognitive behavioral therapy for anxiety disorders.
Meine LE, Müller-Bardorff M, Recher D … +7 more , Paersch C, Schulz A, Spiller T, Galatzer-Levy I, Kowatsch T, Fisher AJ, Kleim B
J Anxiety Disord · 2024 Aug · PMID 39153405 · Publisher ↗
Negative emotions and associated avoidance behaviors are core symptoms of anxiety. Current treatments aim to resolve dysfunctional coupling between them. However, precise interactions between emotions and avoidance in pa...
Negative emotions and associated avoidance behaviors are core symptoms of anxiety. Current treatments aim to resolve dysfunctional coupling between them. However, precise interactions between emotions and avoidance in patients' everyday lives and changes from pre- to post-treatment remain unclear. We analyzed data from a randomized controlled trial where patients with anxiety disorders underwent 16 sessions of cognitive behavioral therapy (CBT). Fifty-six patients (68 % female, age: M = 33.31, SD = 12.45) completed ecological momentary assessments five times a day on 14 consecutive days before and after treatment, rating negative emotions and avoidance behaviors experienced within the past 30 min. We computed multilevel vector autoregressive models to investigate contemporaneous and time-lagged associations between anxiety, depression, anger, and avoidance behaviors within patients, separately at pre- and post-treatment. We examined pre-post changes in network density and avoidance centrality, and related these metrics to changes in symptom severity. Network density significantly decreased from pre- to post-treatment, indicating that after therapy, mutual interactions between negative emotions and avoidance were attenuated. Specifically, contemporaneous associations between anxiety and avoidance observed before CBT were no longer significant at post-treatment. Effects of negative emotions on avoidance assessed at a later time point (avoidance instrength) decreased, but not significantly. Reduction in avoidance instrength positively correlated with reduction in depressive symptom severity, meaning that as patients improved, they were less likely to avoid situations after experiencing negative emotions. Our results elucidate mechanisms of successful CBT observed in patients' daily lives and may help improve and personalize CBT to increase its effectiveness.
Intolerance of uncertainty as a predictor of anxiety severity and trajectory during the COVID-19 pandemic.
Breaux R, Naragon-Gainey K, Katz BA … +24 more , Starr LR, Stewart JG, Teachman BA, Burkhouse KL, Caulfield MK, Cha CB, Cooper SE, Dalmaijer E, Kriegshauser K, Kusmierski S, Ladouceur CD, Asmundson GJG, Davis Goodwine DM, Fried EI, Gratch I, Kendall PC, Lissek S, Manbeck A, McFayden TC, Price RB, Roecklein K, Wright AGC, Yovel I, Hallion LS
J Anxiety Disord · 2024 Aug · PMID 39128179 · Full text
BACKGROUND: Efforts to identify risk and resilience factors for anxiety severity and course during the COVID-19 pandemic have focused primarily on demographic rather than psychological variables. Intolerance of uncertain...
BACKGROUND: Efforts to identify risk and resilience factors for anxiety severity and course during the COVID-19 pandemic have focused primarily on demographic rather than psychological variables. Intolerance of uncertainty (IU), a transdiagnostic risk factor for anxiety, may be a particularly relevant vulnerability factor. METHOD: N = 641 adults with pre-pandemic anxiety data reported their anxiety, IU, and other pandemic and mental health-related variables at least once and up to four times during the COVID-19 pandemic, with assessments beginning in May 2020 through March 2021. RESULTS: In preregistered analyses using latent growth models, higher IU at the first pandemic timepoint predicted more severe anxiety, but also a sharper decline in anxiety, across timepoints. This finding was robust to the addition of pre-pandemic anxiety and demographic predictors as covariates (in the full sample) as well as pre-pandemic depression severity (in participants for whom pre-pandemic depression data were available). Younger age, lower self/parent education, and self-reported history of COVID-19 illness at the first pandemic timepoint predicted more severe anxiety across timepoints with strong model fit, but did not predict anxiety trajectory. CONCLUSIONS: IU prospectively predicted more severe anxiety but a sharper decrease in anxiety over time during the pandemic, including after adjustment for covariates. IU therefore appears to have unique and specific predictive utility with respect to anxiety in the context of the COVID-19 pandemic.
Reward processes in extinction learning and applications to exposure therapy.
Rosenberg BM, Barnes-Horowitz NM, Zbozinek TD … +1 more , Craske MG
J Anxiety Disord · 2024 Aug · PMID 39128178 · Full text
Anxiety disorders are common and highly distressing mental health conditions. Exposure therapy is a gold-standard treatment for anxiety disorders. Mechanisms of Pavlovian fear learning, and particularly fear extinction,...
Anxiety disorders are common and highly distressing mental health conditions. Exposure therapy is a gold-standard treatment for anxiety disorders. Mechanisms of Pavlovian fear learning, and particularly fear extinction, are central to exposure therapy. A growing body of evidence suggests an important role of reward processes during Pavlovian fear extinction. Nonetheless, predominant models of exposure therapy do not currently incorporate reward processes. Herein, we present a theoretical model of reward processes in relation to Pavlovian mechanisms of exposure therapy, including a focus on dopaminergic prediction error signaling, coinciding positive emotional experiences (i.e., relief), and unexpected positive outcomes. We then highlight avenues for further research and discuss potential strategies to leverage reward processes to maximize exposure therapy response, such as pre-exposure interventions to increase reward sensitivity or post-exposure rehearsal (e.g., savoring, imaginal recounting strategies) to enhance retrieval and retention of learned associations.
Predicting treatment outcomes in patients with panic disorder: Cross-sectional and two-year longitudinal structural connectome analysis using machine learning methods.
Pae C, Kim HJ, Bang M … +2 more , Il Park C, Lee SH
J Anxiety Disord · 2024 Aug · PMID 39121510 · Publisher ↗
PURPOSE: This study examined the relationship between structural brain networks and long-term treatment outcomes in patients with panic disorder (PD) using machine learning methods. METHOD: The study involved 80 particip...
PURPOSE: This study examined the relationship between structural brain networks and long-term treatment outcomes in patients with panic disorder (PD) using machine learning methods. METHOD: The study involved 80 participants (53 PD patients and 27 healthy controls) and included clinical assessments and MRI scans at baseline and after two years (160 MRIs). Patients were categorized based on their response to two-year pharmacotherapy. Brain networks were analyzed using white matter tractography and network-based statistics. RESULTS: Results showed structural network changes in PD patients, particularly in the extended fear network, including frontal regions, thalamus, and cingulate gyrus. Longitudinal analysis revealed that increased connections to the amygdala, hippocampus, and insula were associated with better treatment response. Conversely, overconnectivity in the amygdala and insula at baseline was associated with poor response, and similar patterns were found in the insula and parieto-occipital cortex related to non-remission. This study found that SVM and CPM could effectively predict treatment outcomes based on network pattern changes in PD. CONCLUSIONS: These findings suggest that monitoring structural connectome changes in limbic and paralimbic regions is critical for understanding PD and tailoring treatment. The study highlights the potential of using personalized biomarkers to develop individualized treatment strategies for PD.
Clinicians' perspectives on retraumatisation during trauma-focused interventions for post-traumatic stress disorder: A survey of UK mental health professionals.
Purnell L, Chiu K, Bhutani GE … +3 more , Grey N, El-Leithy S, Meiser-Stedman R
J Anxiety Disord · 2024 Aug · PMID 39111232 · Publisher ↗
Concerns regarding retraumatisation have been identified as a barrier to delivering trauma-focused therapy for post-traumatic stress disorder (PTSD). We explored clinicians' understanding of what constitutes potential si...
Concerns regarding retraumatisation have been identified as a barrier to delivering trauma-focused therapy for post-traumatic stress disorder (PTSD). We explored clinicians' understanding of what constitutes potential signs of retraumatisation (PSoR), reported incidences of witnessing retraumatisation, use of (and confidence in) therapies for PTSD, fear of retraumatisation during therapy for PTSD, and whether having witnessed retraumatisation was associated with these variables. We surveyed 348 clinicians. There was variation in what clinicians viewed as PSoR. Retraumatisation was reported by clinicians in 3.4 % of patients undergoing trauma-focused therapy for PTSD. A variety of trauma-focused and non-trauma-focused therapies were routinely used, yet 14.4 % reported not using trauma-focused therapy. There was a significant negative correlation between participants' highest reported confidence in trauma-focused therapy and endorsement of PSoR (r = -.25) and fear of retraumatisation (r = -.28). Mean fear of retraumatisation was 30.3 (SD=23.4; a score we derived from asking participants out of 100 how much they worry about trauma-focused therapy being harmful in its own right/leading to a worsening of PTSD symptoms). Participants who had witnessed retraumatisation reported significantly greater endorsement of PSoR (d=.69 [95 % CI .37, 1.02]) and fear of retraumatisation (d=.94 [95 % CI .61, 1.26]). Confidence in using therapies for PTSD was varied and related to how clinicians understood retraumatisation. Retraumatisation is uncommon, but there is variability in clinicians' interpretation of what retraumatisation is, and its utility warrants research.
Holocaust centrality, anxiety, and other risk factors associated with terror threat salience among descendants of Holocaust survivors.
Greenblatt-Kimron L, Shrira A, Ben-Ezra M … +1 more , Palgi Y
J Anxiety Disord · 2024 Aug · PMID 39096561 · Publisher ↗
The study examined risk factors for sensitivity to terror threats among descendants of Holocaust survivors (Holocaust G1) during a significant rise in terrorist attacks in Israel. We examined the association of the numbe...
The study examined risk factors for sensitivity to terror threats among descendants of Holocaust survivors (Holocaust G1) during a significant rise in terrorist attacks in Israel. We examined the association of the number of familial Holocaust G1, trauma exposure, probable posttraumatic stress disorder (PTSD), anxiety symptoms, and Holocaust centrality with terror threat salience (TTS) in children and grandchildren of Holocaust G1 (Holocaust G2; G3). A web-based national sample included 297 Holocaust G2 (M=62.95, SD=10.25), 224 comparison G2 (M=61.79, SD=10.13), 379 Holocaust G3 (M=34.02, SD=8.65) and 171 comparison G3 (M=33.55, SD=8.26). Participants completed questionnaires on background characteristics, Holocaust background, trauma exposure, probable PTSD, anxiety symptoms, Holocaust centrality, and TTS. Findings showed that Holocaust G2 and G3 reported higher Holocaust centrality and TTS relative to comparisons, and Holocaust G3 reported higher levels of anxiety than comparison G3. The number of Holocaust G1, background characteristics, Holocaust centrality, and anxiety symptoms were associated with TTS in G2 and G3. Probable PTSD and trauma exposure were also associated with TTS in G2 and G3, respectively. Results highlight Holocaust centrality and anxiety among the factors associated with an increased preoccupation with terror threats in Holocaust descendants. Practitioners should implement interventions focusing on these factors, particularly at times of increased terrorism.
Neuromodulation treatments for post-traumatic stress disorder: A systematic review and network meta-analysis covering efficacy, acceptability, and follow-up effects.
Liu H, Wang X, Gong T … +6 more , Xu S, Zhang J, Yan L, Zeng Y, Yi M, Qian Y
J Anxiety Disord · 2024 Aug · PMID 39094317 · Publisher ↗
Neuromodulation treatments are novel interventions for post-traumatic stress disorder (PTSD), but their comparative effects at treatment endpoint and follow-up and the influence of moderators remain unclear. We included...
Neuromodulation treatments are novel interventions for post-traumatic stress disorder (PTSD), but their comparative effects at treatment endpoint and follow-up and the influence of moderators remain unclear. We included randomized controlled trials (RCTs) that explored neuromodulation, both as monotherapy and in combination, for treating patients with PTSD. 21 RCTs with 981 PTSD patients were included. The neuromodulation treatment was classified into nine protocols, including subtypes of transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), cervical vagal nerve stimulation (VNS), and trigeminal nerve stimulation (TNS). This Bayesian network meta-analysis demonstrated that (1) dual-tDCS (SMD = -1.30), high-frequency repetitive TMS (HF-rTMS) (SMD = -0.97), intermittent theta burst stimulation (iTBS) (SMD = -0.93), and low-frequency repetitive TMS (LF-rTMS) (SMD = -0.76) were associated with significant reductions in PTSD symptoms at the treatment endpoint, but these effects were not significant at follow-up; (2) no difference was found between any active treatment with sham controls; (3) regarding co-morbid additions, synchronized TMS (sTMS) was significantly associated with reductions of depression symptoms at treatment endpoint (SMD = -1.80) and dual-tDCS was associated with reductions in anxiety symptoms at follow-up (SMD = -1.70). Findings suggested dual-tDCS, HF-rTMS, iTBS, and LF-rTMS were effective for reducing PTSD symptoms, while their sustained efficacy was limited.
Daily-life reactivity and emotion regulation in children with social anxiety disorder.
Hauffe V, Vierrath V, Tuschen-Caffier B … +1 more , Schmitz J
J Anxiety Disord · 2024 Aug · PMID 39059189 · Publisher ↗
Prominent models of adult social anxiety disorder emphasize the role of hyperreactivity and emotion regulation (ER) difficulties. However, it is unclear whether these factors are relevant in childhood, a critical period...
Prominent models of adult social anxiety disorder emphasize the role of hyperreactivity and emotion regulation (ER) difficulties. However, it is unclear whether these factors are relevant in childhood, a critical period for the development of this disorder. We used ecological momentary assessment with mobile phones to assess daily-life emotional reactivity and use and effectiveness of ER strategies in children aged 10-13 years. We compared three groups: Social anxiety disorder (n = 29), clinical controls with mixed anxiety disorders (n = 27) and healthy controls (n = 31). We also investigated long-term effects of ER on trait social anxiety 12 months later. Hierarchical linear modelling revealed higher emotional reactivity and more use of suppression in children with social anxiety disorder compared to clinical and healthy controls. Contrary to our expectations, children with social anxiety disorder reported more use of avoidance and reappraisal compared to clinical, but not healthy, controls. The groups did not differ in subjective effectiveness of ER strategies. Use of suppression, avoidance, and rumination each predicted an increase in social anxiety 12 months later. Taken together, our results extend previous findings from lab and questionnaire studies and illustrate the role of maladaptive ER for child social anxiety disorder.
Correlates of treatment-seeking in DSM-5 generalized anxiety disorder: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions-III.
Zech JM, Patel TA, Cougle JR
J Anxiety Disord · 2024 Aug · PMID 39047416 · Publisher ↗
Generalized Anxiety Disorder (GAD) presents a significant personal and societal burden and is associated with chronic medical comorbidities and markedly lower quality of life. Effective treatments exist, less than half o...
Generalized Anxiety Disorder (GAD) presents a significant personal and societal burden and is associated with chronic medical comorbidities and markedly lower quality of life. Effective treatments exist, less than half of individuals with lifetime GAD will ever seek psychotherapeutic or pharmacological treatment. A thorough understanding of the factors that influence treatment seeking for GAD is warranted. The present study investigates the correlates of GAD treatment seeking, using data from the National Epidemiological Survey on Alcohol and Related Disorders-III (NESARC-III), which assessed for psychiatric disorders using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-5 Version (AUDADIS-5). A series of logistic regressions were run to identify demographic, diagnostic, and symptom-level correlates of treatment seeking in those meeting DSM-5 diagnostic criteria for GAD. Comorbid depression, panic disorder, and PTSD were all uniquely associated with higher rates of GAD-related treatment seeking. Additionally, several accompanying anxiety symptoms were also uniquely predicted treatment seeking, including fatigue, panic attacks, reassurance-seeking, and interpersonal avoidance. Findings underscore the multi-factorial nature of treatment seeking behavior in GAD and highlight the need for further research to fully understand these relationships and devise effective strategies to improve treatment seeking in this population.
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