Anxiety Disorders

Some but not all models of obsessive–compulsive disorder (OCD) emphasize the role of dysfunctional beliefs in the etiology and maintenance of this disorder. Clinical observations suggest that some OCD patients have prominent dysfunctional beliefs associated with their obsessions and compulsions, while other patients do not show this pattern. It is possible that dysfunctional beliefs play a role in only a

Despite the established evidence for threat-related attention bias in anxiety, the mechanisms underlying this bias remain unclear. One important unresolved question is whether disorder-congruent threats capture attention to a greater extent than do more general or disorder-incongruent threat stimuli. Evidence for attention bias specificity in anxiety would implicate involvement of previous learning and memory processes in threat-related attention bias, whereas lack of content specificity would point to perturbations in more generic attention processes. Enhanced clarity of mechanism could have clinical implications for the stimuli types used in Attention Bias Modification Treatments (ABMT). Content specificity of threat-related attention bias in anxiety and potential moderators of this effect were investigated. A systematic search identified 37 samples from 29 articles (N=866). Relevant data were extracted based on specific coding rules, and Cohen's d effect size was used to esti...

Anxiety disorders are common in adolescents (ages 12 to 18) and contribute to a range of impairments. There has been speculation that adolescents with anxiety are at risk for being treatment nonresponders. In this review, the authors examine the efficacy of cognitive-behavioral therapy (CBT) for adolescents with anxiety. Outcomes from mixed child and adolescent samples and from adolescent-only samples indicate that approximately two-thirds of youths respond favorably to CBT. CBT produces moderate to large effects and shows superiority over control/comparison conditions. The literature does not support differential outcomes by age: adolescents do not consistently manifest poorer outcomes relative to children. Although extinction paradigms find prolonged fear extinction in adolescent samples, basic research does not fully align with the processes and goals of real-life exposure. Furthermore, CBT is flexible and allows for tailored application in adolescents, and it may be delivered in...

Mental health outcomes for survivors of critical congenital heart disease (CHD) remain under-investigated. We sought to examine psychiatric disorders and psychosocial functioning in adolescents with single ventricle CHD and to explore whether patient-related risk factors predict dysfunction. This cohort study recruited 156 adolescents with single ventricle CHD who underwent the Fontan procedure and 111 healthy referents. Participants underwent comprehensive psychiatric evaluation including a clinician-rated psychiatric interview and parent- and self-report ratings of anxiety, disruptive behavior, including attention-deficit/hyperactivity disorder (ADHD), and depressive symptoms. Risk factors for dysfunction included IQ, medical characteristics, and concurrent brain abnormalities. Adolescents with single ventricle CHD had higher rates of lifetime psychiatric diagnosis compared with referents (CHD: 65%, referent: 22%; P < .001). Specifically, they had higher rates of lifetime anxie...

Plasma catecholamines and heart rate were determined in drug-free groups of anxious patients and normal controls before and 20 min after intramuscular injection of 0.01 mg/kg of 1/1000 diluted epinephrine. Levels of anxiety after the injection were determined via the State Anxiety Scale of State Trait Anxiety Inventory. Both groups showed substantial increases in plasma levels of epinephrine and norepinephrine and heart rate after the injection. However, there were no significant differences between anxious patients and controls on plasma catecholamines and heart rate before or after the injection and post injection levels of State Anxiety. The anxious subjects showed a significant correlation between post injection heart rate and State Anxiety.

This paper explores how symptoms of mental health problems influence acquired immune deficiency syndrome-related risk behaviors, and how changes in those symptoms relate to risk behaviors engaged in by young adults. Repeated interviews with 602 youths since 1984 provide a history of change in behaviors. Mental health symptoms during adolescence (alcohol/drug [r = .28]; conduct disorder [r = .27]; depression [r = .16]; suicide [r = .14]; anxiety [r = .16]; and posttraumatic stress [r = .09]) are associated with higher numbers of risk behaviors (specifically, prostitution, use of intravenous drugs, and choice of a high-risk sex partner) during young adulthood. Changes in mental health symptoms between adolescence and young adulthood are related to the number of risk behaviors engaged in by young adulthood (total number of symptoms [B = .10], alcohol/drug abuse or dependence [B = .34], depression [B = .20], suicidality [B = .35], anxiety [B = .13], and posttraumatic stress [B = .14]). Changes in symptoms of mental health problems are associated specifically with those risk behaviors that are initiated primarily in young adulthood: intravenous drug use, prostitution, and choice of risky partners. The findings show that prevention and treatment of mental health problems are important components of preventive interventions for human immunodeficiency virus infection in high-risk teens and young adults.

The 30 patients who underwent lung transplantation between 1990 and 1996 were included in this study, and data were analyzed to find predictors of 1-year survival posttransplantation. All patients were followed throughout the posttransplantation period. Fifteen patients had ...

To evaluate the impact of a Mindfulness Based Stress Reduction (MBSR) program in patients with chronic bothersome tinnitus on the (1) severity of symptoms of tinnitus and (2) functional connectivity in neural attention networks. Open-label interventional pilot study. Outpatient academic medical center. A total of 13 adult participants with a median age of 55 years, suffering from bothersome tinnitus. An 8-week MBSR program was conducted by a trained MBSR instructor. The primary outcome measure was the difference in patient-reported tinnitus symptoms using the Tinnitus Handicap Index (THI) and Tinnitus Functional Index (TFI) between pre-intervention, post-MBSR, and 4-week post-MBSR assessments. Secondary outcomes included change in measurements of depression, anxiety, mindfulness, and cognitive abilities. Functional connectivity magnetic resonance imaging (MRI) was performed at pre- and post-MBSR intervention time points to serve as a neuroimaging biomarker of critical cortical netwo...

This paper describes a study to examine how a social situation can be simulated in a virtual environment, and how to provoke the same behavioral response as in a real life social situation. The aim is to create new Virtual Reality worlds for treating social phobia. Two cases were examined in a virtual environment to assess whether it was able to recreate social behavior of people. First, we examined if participants who enter a crowded room in the virtual environment prefer to take a seat in a chair that is close to them. ...

After reading vignettes, a group of spider-phobic girls (n=18) and a group of nonphobic girls (n=18) rated the subjective probability of spiders entering their private living space, their tendency to approach and make physical contact, and the subjective probability of spiders doing physical harm. In addition, they indicated their eagerness to eat a favorite food item before as well as after it had been shortly contacted by spiders. In support of the idea that spider phobia results from the convergence of spiders’ disgusting properties and the subjective probability of involuntary contact, phobic girls reported relatively high ratings concerning: (a) the probability of spiders entering their room; (b) spiders’ tendency to approach and make physical contact; and (c) spiders’ disgust-evoking status. Finally, regression analysis indicated that spiders’ disgust-evoking status is the single best predictor of spider phobia, whereas the independent contribution of the perceived probability of spiders doing physical harm was found to be negligible. All in all, the present findings strongly support the idea that spider phobia essentially reflects a fear of physical contact with a disgusting stimulus.

Background  Trafficking in women is a widespread human rights violation commonly associated with poor mental health. Yet, to date, no studies have used psychiatric diagnostic assessment to identify common forms of mental distress among survivors returning to their home country. Methods  A longitudinal study was conducted of women aged 18 and over who returned to Moldova between December 2007 and December 2008

This book (in Dutch) is an attempt to provide a conceptual framework that helps the reader to integrate the existential dimension of anxiety with other clinical and explanatory approaches to anxiety.
The book is no longer in print. This is a pre-print (uncorrected) WORD-file of the entire manuscript, which was published by BOOM (Amsterdam) in 2001