Anxiety and worry القلق

وَضَرَبَ ٱللَّهُ مَثَلࣰ ا قَرۡيَةࣰ كَانَتۡ ءَامِنَةࣰ مُّطۡمَئِنَّةࣰ يَأۡتِيهَا رِزۡقُهَا رَغَدࣰ ا مِّن كُلِّ مَكَانࣲ فَكَفَرَتۡ بِأَنۡعُمِ ٱللَّهِ فَأَذَٰقَهَا ٱللَّهُ لِبَاسَ ٱلۡجُوعِ وَٱلۡخَوۡفِ بِمَا كَانُواْ يَصۡنَعُونَ

God presents the example of a town that was secure and at ease, with provisions coming to it abundantly from all places. Then it became ungrateful for God’s blessings, so God afflicted it with the garment of famine and fear, for what its people had done

وَلَنَبۡلُوَنَّكُم بِشَيۡءࣲ مِّنَ ٱلۡخَوۡفِ وَٱلۡجُوعِ وَنَقۡصࣲ مِّنَ ٱلۡأَمۡوَٰلِ وَٱلۡأَنفُسِ وَٱلثَّمَرَٰتِۗ وَبَشِّرِ ٱلصَّٰبِرِينَ

We shall certainly test you with fear and hunger, and loss of property, lives, and crops. But [Prophet], give good news to those who are steadfast

لَا يَحۡزُنُهُمُ ٱلۡفَزَعُ ٱلۡأَكۡبَرُ وَتَتَلَقَّىٰهُمُ ٱلۡمَلَٰٓئِكَةُ هَٰذَا يَوۡمُكُمُ ٱلَّذِي كُنتُمۡ تُوعَدُونَ

They will have no fear of the great Terror: the angels will receive them with the words, ‘This is the Day you were promised!’

أَشِحَّةً عَلَيۡكُمۡۖ فَإِذَا جَآءَ ٱلۡخَوۡفُ رَأَيۡتَهُمۡ يَنظُرُونَ إِلَيۡكَ تَدُورُ أَعۡيُنُهُمۡ كَٱلَّذِي يُغۡشَىٰ عَلَيۡهِ مِنَ ٱلۡمَوۡتِۖ فَإِذَا ذَهَبَ ٱلۡخَوۡفُ سَلَقُوكُم بِأَلۡسِنَةٍ حِدَادٍ أَشِحَّةً عَلَى ٱلۡخَيۡرِۚ أُوْلَٰٓئِكَ لَمۡ يُؤۡمِنُواْ فَأَحۡبَطَ ٱللَّهُ أَعۡمَٰلَهُمۡۚ وَكَانَ ذَٰلِكَ عَلَى ٱللَّهِ يَسِيرࣰ ا

who begrudge you [believers] any help. When fear comes, you [Prophet] see them looking at you with eyes rolling like someone in their death throes; when fear has passed, they attack you with sharp tongues and begrudge you any good. Such men do not believe, and God brings their deeds to nothing- that is all too easy for God

وَإِذَا جَآءَهُمۡ أَمۡرࣱ مِّنَ ٱلۡأَمۡنِ أَوِ ٱلۡخَوۡفِ أَذَاعُواْ بِهِۦۖ وَلَوۡ رَدُّوهُ إِلَى ٱلرَّسُولِ وَإِلَىٰٓ أُوْلِي ٱلۡأَمۡرِ مِنۡهُمۡ لَعَلِمَهُ ٱلَّذِينَ يَسۡتَنۢبِطُونَهُۥ مِنۡهُمۡۗ وَلَوۡلَا فَضۡلُ ٱللَّهِ عَلَيۡكُمۡ وَرَحۡمَتُهُۥ لَٱتَّبَعۡتُمُ ٱلشَّيۡطَٰنَ إِلَّا قَلِيلࣰ ا

Whenever news of any matter comes to them, whether concerning peace or war, they spread it about; if they referred it to the Messenger and those in authority among them, those seeking its meaning would have found it out from them. If it were not for God’s bounty and mercy towards you, you would almost all have followed Satan

إِنَّ ٱلَّذِينَ قَالُواْ رَبُّنَا ٱللَّهُ ثُمَّ ٱسۡتَقَٰمُواْ تَتَنَزَّلُ عَلَيۡهِمُ ٱلۡمَلَٰٓئِكَةُ أَلَّا تَخَافُواْ وَلَا تَحۡزَنُواْ وَأَبۡشِرُواْ بِٱلۡجَنَّةِ ٱلَّتِي كُنتُمۡ تُوعَدُونَ

As for those who say, ‘Our Lord is God,’ and take the straight path towards Him, the angels come down to them and say, ‘Have no fear or grief, but rejoice in the good news of Paradise, which you have been promised

And We will indeed try you with something of fear and hunger, and decrease of wealth, souls, and fruits; and give good news to the patient. The custom of the Lord is that whenever He threatens the servant and shows harshness in a verse, then, right after that or before it, He caresses the servant and gives him hope. Thus in this verse He breaks the servant by mentioning those harsh things and varieties of trial. Then He gives good news, He caresses, and He says, “and give good news to the patient.” And, at the beginning of these verses He says, “Surely God is with the patient” [2:153]. Glory be to Him! How gentle and how merciful He is to His servants! And We will indeed try you. He says, “We will test you, sometimes with fear, sometimes with dread, sometimes with poverty, sometimes with hunger, sometimes with outward affliction, sometimes with inward sorrow.” The outward trial and evide

The greatest terror shall not make them sorrow, and the angels will receive them: “This is the day that you were promised.” On the Day of Resurrection in the greatest gathering place and most tremendous courtyard, they will not hear from the angels the call “no good news” [25:22], nor the address, “Stand apart today, O offenders!” [36:59], nor the harsh call, “Slink into it, and do not talk to Me!” [23:108]. They will not hear the call of separation's pain, nor will they despair of mercy. Rather the angels will keep on coming, company after company, and they will give the good news: “This is the day that you were promised,” that is, “This is the day in which you have the promised reward.” Among them are those who will be received by the angels, and among them are those who will be addressed and made known by the King. God will say, “My servants, have you been yearning for Me?” He will sa

And God strikes a similitude mathalan is substituted by the following qaryatan a town Mecca — meaning its inhabitants — secure from any raids never becoming agitated and peaceful without anyone ever needing to emigrate from it on account of anxiety or fear its provision coming to it plenteously abundantly from every place. But it rejected God’s graces by denying the Prophet s so God made it taste the garb of hunger and so they suffered seven years of drought and fear as a result of the raiding parties of the Prophet s all because of what they used to do.

Surely We will try you with something of fear of an enemy and hunger by way of drought and diminution of goods as a result of destruction and lives as a result of slaughter death and disease and fruits by way of crop damage that is to say We will try you to see if you practise patience or not; yet give good tidings of Paradise to the patient during calamities;

The Supreme Terror — which is that a servant be ordered off to the Fire shall not grieve them and the angels shall receive them upon their exiting from their graves saying to them ‘This is your day the one which you were promised’ during the life of the world.

And Allah gives the example of a township (Makkah), it was secure and peaceful: its provision coming to it in abundance from every place, but it (its people) denied the favors of Allah. So Allah made it taste extreme hunger (famine) and fear, because of what they did (112)There has come to them a Messenger from among themselves, but they denied him, so the torment seized them while they were wrongdoers (113) The Example of Makkah This example refers to the people of Makkah, which had been secure, peaceful and stable, a secure sanctuary while men were being snatched away from everywhere outside of it. Whoever entered Makkah, he was safe, and he had no need to fear, as Allah said: وَقَالُوا إِن نَّتَّبِعِ الْهُدَىٰ مَعَكَ نُتَخَطَّفْ مِنْ أَرْضِنَا ۚ أَوَلَمْ نُمَكِّن لَّهُمْ حَرَمًا آمِنًا يُجْبَىٰ إِلَيْهِ ثَمَرَاتُ كُلِّ شَيْءٍ رِّزْقًا مِّن لَّدُنَّا (And they say: "If we follow th

أَخْبَرَنَا أَبُو عَبْدِ الرَّحْمَنِ، أَحْمَدُ بْنُ شُعَيْبٍ قَالَ أَنْبَأَنَا عَمْرُو بْنُ عَلِيٍّ، قَالَ حَدَّثَنَا أَبُو عَاصِمٍ، قَالَ حَدَّثَنَا ابْنُ أَبِي ذِئْبٍ، قَالَ حَدَّثَنِي أَسِيدُ بْنُ أَبِي أَسِيدٍ، عَنْ مُعَاذِ بْنِ عَبْدِ اللَّهِ، عَنْ أَبِيهِ، قَالَ أَصَابَنَا طَشٌّ وَظُلْمَةٌ فَانْتَظَرْنَا رَسُولَ اللَّهِ صلى الله عليه وسلم لِيُصَلِّيَ بِنَا ثُمَّ ذَكَرَ كَلاَمًا مَعْنَاهُ فَخَرَجَ رَسُولُ اللَّهِ صلى الله عليه وسلم لِيُصَلِّيَ بِنَا فَقَالَ ‏"‏ قُلْ ‏"‏ ‏.‏ فَقُلْتُ مَا أَقُولُ قَالَ ‏"‏ ‏{‏ قُلْ هُوَ اللَّهُ أَحَدٌ ‏}‏ وَالْمُعَوِّذَتَيْنِ حِينَ تُمْسِي وَحِينَ تُصْبِحُ ثَلاَثًا يَكْفِيكَ كُلَّ شَىْءٍ ‏"‏ ‏.‏

It was narrated from Mu'adh bin 'Abdullah that his father said:"It was raining and dark, and we were waiting for the Messenger of Allah [SAW] to lead us in prayer. Then the Messenger of Allah [SAW] came out to lead us in prayer and he said: 'Say.' I said: 'What should I say?' He said: 'Say: He is Allah, (the) One and Al-Mu'awwadhatain in the evening and in the morning, three times, and that will suffice you against everything

أَخْبَرَنَا مُحَمَّدُ بْنُ عَلِيٍّ، قَالَ حَدَّثَنِي الْقَعْنَبِيُّ، عَنْ عَبْدِ الْعَزِيزِ، عَنْ عَبْدِ اللَّهِ بْنِ سُلَيْمَانَ، عَنْ مُعَاذِ بْنِ عَبْدِ اللَّهِ بْنِ خُبَيْبٍ، عَنْ أَبِيهِ، عَنْ عُقْبَةَ بْنِ عَامِرٍ الْجُهَنِيِّ، قَالَ بَيْنَا أَنَا أَقُودُ، بِرَسُولِ اللَّهِ صلى الله عليه وسلم رَاحِلَتَهُ فِي غَزْوَةٍ إِذْ قَالَ ‏"‏ يَا عُقْبَةُ قُلْ ‏"‏ ‏.‏ فَاسْتَمَعْتُ ثُمَّ قَالَ ‏"‏ يَا عُقْبَةُ قُلْ ‏"‏ ‏.‏ فَاسْتَمَعْتُ فَقَالَهَا الثَّالِثَةَ فَقُلْتُ مَا أَقُولُ فَقَالَ ‏"‏ ‏{‏ قُلْ هُوَ اللَّهُ أَحَدٌ ‏}‏ ‏"‏ ‏.‏ فَقَرَأَ السُّورَةَ حَتَّى خَتَمَهَا ثُمَّ قَرَأَ ‏{‏ قُلْ أَعُوذُ بِرَبِّ الْفَلَقِ ‏}‏ وَقَرَأْتُ مَعَهُ حَتَّى خَتَمَهَا ثُمَّ قَرَأَ ‏{‏ قُلْ أَعُوذُ بِرَبِّ النَّاسِ ‏}‏ فَقَرَأْتُ مَعَهُ حَتَّى خَتَمَهَا ثُمَّ قَالَ ‏"‏ مَا تَعَوَّذَ بِمِثْلِهِنَّ أَحَدٌ ‏"‏ ‏.‏

It was narrated that 'Uqbah bin 'Amir Al-Juhani said:"While I was leading the Messenger of Allah [SAW] on his mount on a military campaign, he said: 'O 'Uqbah, say!' I listened, then he said: 'O 'Uqbah, say!' I listened, then he said it a third time. I said: 'What should I say?' He said: 'Say: He is Allah, (the) One...' and he recited the Surah to the end. Then he recited: 'Say: I seek refuge with (Allah) the Lord of the daybreak...' and I recited it with him until the end. Then he recited: 'Say: I seek refuge with (Allah) the Lord of mankind...' and I recited it with him until the end. Then he said: 'No one ever sought refuge (with Allah) by means of anything like them

حَدَّثَنَا عَبَّاسُ بْنُ عَبْدِ الْعَظِيمِ الْعَنْبَرِيُّ، وَغَيْرُ، وَاحِدٍ، قَالُوا حَدَّثَنَا أَبُو دَاوُدَ الطَّيَالِسِيُّ، حَدَّثَنَا عِمْرَانُ الْقَطَّانُ، عَنْ قَتَادَةَ، عَنْ سَعِيدِ بْنِ أَبِي الْحَسَنِ، عَنْ أَبِي هُرَيْرَةَ، رضى الله عنه عَنِ النَّبِيِّ صلى الله عليه وسلم قَالَ ‏ "‏ لَيْسَ شَيْءٌ أَكْرَمَ عَلَى اللَّهِ تَعَالَى مِنَ الدُّعَاءِ ‏"‏ ‏.‏ قَالَ أَبُو عِيسَى هَذَا حَدِيثٌ حَسَنٌ غَرِيبٌ لاَ نَعْرِفُهُ مَرْفُوعًا إِلاَّ مِنْ حَدِيثِ عِمْرَانَ الْقَطَّانِ وَعِمْرَانُ الْقَطَّانُ هُوَ ابْنُ دَاوَرَ وَيُكْنَى أَبَا الْعَوَّامِ ‏.‏ حَدَّثَنَا مُحَمَّدُ بْنُ بَشَّارٍ، حَدَّثَنَا عَبْدُ الرَّحْمَنِ بْنُ مَهْدِيٍّ، عَنْ عِمْرَانَ الْقَطَّانِ، بِهَذَا الإِسْنَادِ نَحْوَهُ ‏.‏

Abu Hurairah narrated that:The Prophet said: “There is nothing more honorable with Allah [Most High] than supplication.”

حَدَّثَنَا أَحْمَدُ بْنُ مَنِيعٍ، حَدَّثَنَا مَرْوَانُ بْنُ مُعَاوِيَةَ، عَنِ الأَعْمَشِ، عَنْ ذَرٍّ، عَنْ يُسَيْعٍ، عَنِ النُّعْمَانِ بْنِ بَشِيرٍ، عَنِ النَّبِيِّ صلى الله عليه وسلم قَالَ ‏"‏ الدُّعَاءُ هُوَ الْعِبَادَةُ ‏"‏ ‏.‏ ثُمَّ قَرَأََ ‏:‏ ‏(‏وقالَ رَبُّكُمُ ادْعُونِي أَسْتَجِبْ لَكُمْ إِنَّ الَّذِينَ يَسْتَكْبِرُونَ عَنْ عِبَادَتِي سَيَدْخُلُونَ جَهَنَّمَ دَاخِرِينَ ‏)‏ ‏.‏ قَالَ هَذَا حَدِيثٌ حَسَنٌ صَحِيحٌ ‏.‏ وَقَدْ رَوَاهُ مَنْصُورٌ وَالأَعْمَشُ عَنْ ذَرٍّ وَلاَ نَعْرِفُهُ إِلاَّ مِنْ حَدِيثِ ذَرٍّ ‏.‏ هُوَ ذَرُّ بْنُ عَبْدِ اللَّهِ الْهَمْدَانِيُّ ثِقَةٌ وَالِدُ عُمَرَ بْنِ ذَرٍّ ‏.‏

An-Nu`man bin Bashir narrated that:The Prophet said: “The supplication, is worship.” Then he recited: And Your Lord said: “Call upon me, I will respond to you. Verily, those who scorn My worship, they will surely enter Hell humiliated

حبس النفس عن الجزع والهلع والتشكي فيحبس النفس عن التسخط واللسان عن الشكوى والجوراح عما لا ينبغي فعله وهو ثبات القلب على الأحكام القدرية والشرعية

وأما الشح فهو خلق ذميم يتولد من سوء الظن وضعف النفس ويمده وعد الشيطان حتى يصير هلعا والهلع شدة الحرص على الشيء والشره به فتولد عنه المنع لبذله والجزع لفقده كما قال تعالى @QB@ إن الإنسان خلق هلوعا إذا مسه الشر جزوعا وإذا مسه الخير منوعا @QE@

ويضاد الصبر الهلع وهو الجزع عند ورود المصيبة والمنع عند ورود النعمة قال تعالى @QB@ إن الإنسان خلق هلوعا إذا مسه الشر جزوعا وإذا مسه الخير منوعا @QE@ وهذا تفسير الهلوع قال الجوهرى الهلع أفحش الجزع وقد هلع بالكسر فهو هلع وهلوع وفى الحديث شر ما فى العبد شح هالع وجبن خالع

526 وعن عمرو بن تغلب بفتح التاء المثناة فوق وإسكان الغين المعجمة وكسر اللام رضي الله عنه أن رسول الله صلى الله عليه وسلم أتي بمال أو سبي فقسمه فأعطى رجالا وترك رجالا فبلغه أن الذين ترك عتبوا فحمد الله ثم أثنى عليه ثم قال أما بعد فوالله إني لأعطي الرجل وأدع الرجل والذي أدع أحب إلي من الذي أعطي ولكني إنما أعطي أقواما لما أرى في قلوبهم من الجزع والهلع وأكل أقواما إلى ما جعل الله في قلوبهم من الغني والخير منهم عمرو بن تغلب قال عمرو بن تغلب فوالله ما أحب أن لي بكلمة رسول الله صلى الله عليه وسلم حمر النعم رواه البخاري الهلع هو أشد الجزع وقيل الضجر

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وفعل هذا الباب صبرت أصبر بالفتح في الماضي والكسر في المستقبل وأما صبرت أصبر بالضم في المستقبل فهو بمعنى الكفالة والصبير الكفيل كأنه حبس نفسه للغرم ومنه قولهم أصبرنى أي جعلني كفيلا وقيل أصل الكلمة من الشدة والقوة ومنه الصبر للدواء المعروف لشدة مرارته وكراهته قال الأصمعى إذا لقي الرجل الشدة بكمالها قيل لقيها بأصبارها ومنه الصبر بضم الصاد للأرض ذات الحصب لشدتها وصلابتها ومنه سميت الحرة أم صبار ومنه قولهم وقع القوم في أمر صبور بتشديد الباء أي أمر شديد ومنه صبارة الشتاء بتخفيف الباء وتشديد الراء لشدة برده وقيل مأخوذ من الجمع والضم فالصابر يجمع نفسه ويضمها عن الهلع والجزع ومنه صبرة الطعام وصبارة الحجارة

The cognitive anxiety sensitivity treatment (CAST) in anxiety prevention - Focus on separation anxiety and interoception.: Given the high prevalence and considerable clinical and societal burden of anxiety disorders, preventive measures are urgently warranted to reduce their incidence and overall healthcare impact. Anxiety sensitivity (AS) - a key element in learning theories of anxiety disorders in the context of interoceptive conditioning - constitutes a malleable risk factor of particularly panic disorder and separation anxiety, which share developmental, nosological, epidemiological and pathomechanistic characte

Resistance exercise training among young adults with analogue generalized anxiety disorder.: Introduction: The objective of this randomized controlled trial (RCT) was to quantify the effects of eight weeks of World Health Organization and American College of Sports Medicine guidelines-based resistance exercise training (RET) among participants meeting criteria for subclinical, or analogue-GAD (AGAD) METHODS: Forty-four participants (mean age (y): 25.4.6±4.9.2) were randomized to either an eight-week, fully-supervised, one-on-one RET intervention or wait-list control. AGAD status was det

A network model of depressive and anxiety symptoms: a statistical evaluation.: Background: Although network analysis studies of psychiatric syndromes have increased in recent years, most have emphasized centrality symptoms and robust edges. Broadening the focus to include bridge symptoms within a systematic review could help to elucidate symptoms having the strongest links in network models of psychiatric syndromes. We conducted this systematic review and statistical evaluation of network analyses on depressive and anxiety symptoms to identify the most central symptoms and

Experience sampling and ecological momentary assessment for studying the daily lives of patients with anxiety disorders: a systematic review.: Anxiety disorders are highly prevalent. Symptoms may occur unpredictably (e.g., panic attacks) or predictably in specific situations (e.g., social phobia). Consequently, it may be difficult to assess anxiety and related constructs realistically in the laboratory or by traditional retrospective questionnaires. Experience sampling methods (ESM) and ecological momentary assessment (EMA) can deepen the understanding of the course of anxiety disorders by frequently assessing symptoms and other variab

Pharmacotherapy for anxiety and comorbid alcohol use disorders.: Background: Anxiety disorders are a potentially disabling group of disorders that frequently co-occur with alcohol use disorders. Comorbid anxiety and alcohol use disorders are associated with poorer outcomes, and are difficult to treat with standard psychosocial interventions. In addition, improved understanding of the biological basis of the conditions has contributed to a growing interest in the use of medications for the treatment of people with both diagnoses. Objectives: To assess the effe

The impact of psychological treatment on intolerance of uncertainty in generalized anxiety disorder: A systematic review and meta-analysis.: Research has demonstrated a strong link between intolerance of uncertainty and generalized anxiety disorder (GAD). The current systematic review and meta-analysis aimed to evaluate how effective evidence-based psychological treatments are at reducing intolerance of uncertainty for adults with GAD. An extensive literature search identified 26 eligible studies, with a total of 1199 participants with GAD. Psychological treatments (k = 32 treatment groups) yielded large significant within-group effe

Management of treatment-resistant generalized anxiety disorder.

Generalized anxiety disorder (GAD) is characterized by persistent and excessive worry. Around half of the patients treated for GAD will fail to respond to initial treatment. Treatment-resistant (or refractory) GAD is defined as failure to respond to at least 1 trial of antidepressant therapy at adequate dose and duration. Review of the literature indicates several potential medication classes and individual agents that can be used as augmentation strategies to treat residual symptoms when recommended therapy per clinical practice guidelines fails. A thorough literature search revealed 2 medication classes with the largest amount of data to support their use in treatment-resistant GAD treatment: gamma-aminobutyric acid-related agents and atypical antipsychotics. This article focuses on evidence-based recommendations for the use of these agents as adjunctive therapies for patients with tre…

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Psychometric Properties of the Generalized Anxiety Disorder-7 and Generalized Anxiety Disorder-Mini in United States University Students

Background: Generalized Anxiety Disorder (GAD) is common in young adults, yet few studies have established the psychometric properties of the GAD-7 screener in college students. Methods: A secondary analysis of 3 studies was conducted to determine GAD-7 factor structure stability, create a GAD-Mini version using standard procedures, evaluate the psychometric properties, validity, sensitivity, specificity, and predictive values of both versions in young adults. Results: Exploratory and confirmatory principal components analysis indicated the GAD-7 has a single factor structure with strong loadings, reliability, and stability across data collected at 3 studies. Data from all studies met criteria indicative of good to excellent model fit. Iterative confirmatory principal components analyses revealed the most parsimonious set of items that maintained scale unidimensionality, strong loadings,…

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Changes in Functional Connectivity Following Treatment With Emotion Regulation Therapy.

Emotion regulation therapy (ERT) is an efficacious treatment for distress disorders (i.e., depression and anxiety), predicated on a conceptual model wherein difficult to treat distress arises from intense emotionality (e.g., neuroticism, dispositional negativity) and is prolonged by negative self-referentiality (e.g., worry, rumination). Individuals with distress disorders exhibit disruptions in two corresponding brain networks including the salience network (SN) reflecting emotion/motivation and the default mode network (DMN) reflecting self-referentiality. Using resting-state functional connectivity (rsFC) analyses, seeded with primary regions in each of these networks, we investigated whether ERT was associated with theoretically consistent changes across nodes of these networks and whether these changes related to improvements in clinical outcomes. This study examined 21 generalized …

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The Effects of Worry in Daily Life: An Ecological Momentary Assessment Study Supporting the Tenets of the Contrast Avoidance Model.

The contrast avoidance model (CAM) suggests that worry increases and sustains negative emotion to prevent a negative emotional contrast (sharp upward shift in negative emotion) and increase the probability of a positive contrast (shift toward positive emotion). In Study 1, we experimentally validated momentary assessment items (N = 25). In Study 2, participants with generalized anxiety disorder (N = 31) and controls (N = 37) were prompted once per hour regarding their worry, thought valence, and arousal 10 times a day for 8 days. Higher worry duration, negative thought valence, and uncontrollable train of thoughts predicted feeling more keyed up concurrently and sustained anxious activation 1 hr later. More worry, feeling keyed up, and uncontrollable train of thoughts predicted lower likelihood of a negative emotional contrast in thought valence and higher likelihood of a positive emotio…

matched on generalized anxiety (text), worry (text)

Correlates of worry and functional somatic symptoms in generalized anxiety disorder.

Background: Worry and functional somatic symptoms (FSS) are important clinical features of generalized anxiety disorder (GAD). Although there is literature on the prevalence of worry and FSS in GAD, there is limited data on psychological correlates of worry and somatic symptoms in patients with GAD. Objective: The purpose of this research was to evaluate the relationship of worry and FSS with somatosensory amplification, health anxiety (hypochondriasis), and alexithymia in patients with GAD. Methods: Forty patients with the diagnosis of GAD were assessed with Penn State Worry Questionnaire, Bradford Somatic Inventory (BSI), GAD-7 Scale, somatosensory amplification Scale (SSAS), Whiteley Index (WI), and Toronto Alexithymia Scale-20 Hindi version (TAS-H-20). Results: Worry had significant positive correlation with total scores of BSI, GAD-7 scale, TAS-H-20 subscale 1, SSAS, and WI. Younger…

matched on generalized anxiety (text), worry (text)

No Time Like the Present: Thinking About the Past and the Future Is Related to State Dissociation Among Individuals With High Levels of Psychopathological Symptoms.

Several short-term pathways have been implicated in relation to dissociative experiences, among them are daily stress, sleepiness, and rumination. In addition, it has been claimed that mechanisms contributing to dissociative experiences may differ, according to specific psychopathological symptoms. Accordingly, this study had two aims. The first was to sample moment-to-moment increases or decreases in current stress, sleepiness, and rumination, in order to assess their temporal relations with state dissociation. Rumination was broken down to its basic two subcomponents: the negative value of the thoughts and thinking about the past (in comparison to present or future), in order to differentiate it from other repetitive thought patterns (e.g., worry). The second goal was to explore whether depression, anxiety, and obsessive-compulsive symptoms may moderate the links between the three mech…

matched on anxiety symptoms (text), worry (text)

Usefulness of self-report questionnaires for psychological assessment of patients with tinnitus and hyperacusis and patients' views of the questionnaires.

Objective: The objective was to determine the relevance and applicability of psychological questionnaires to patients seeking help for tinnitus and/or hyperacusis. Design: This was a questionnaire-based survey. The following questionnaires were administered: Generalised Anxiety Disorder (GAD-7), Short Health Anxiety Inventory (SHAI), Mini-Social Phobia Inventory (Mini-SPIN), Obsessive Compulsive Inventory-Revised (OCI-R), Panic Disorder Severity Scale-Self Report (PDSS-SR), Patient Health Questionnaire (PHQ-9) and Penn State Worry Questionnaire-Abbreviated version (PSWQ-A). In addition, a patient feedback questionnaire was completed asking about the extent to which each questionnaire was relevant to them and how strongly they would recommend its use in the assessment of patients with tinnitus and hyperacusis. Study sample: A total of 150/402 consecutive patients seen in a one-year period…

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Emotion Regulation Therapy: A Mechanism-Targeted Treatment for Disorders of Distress

"Distress disorders," which include generalized anxiety disorder and major depression are often highly comorbid with each other and appear to be characterized by common temperamental features that reflect heightened sensitivity to underlying motivational systems related to threat/safety and reward/loss. Further, individuals with distress disorders tend to utilize self-referential processes (e.g., worry, rumination, self-criticism) in a maladaptive attempt to respond to motivationally relevant distress, often resulting in suboptimal contextual learning. Despite the success of cognitive behavioral therapies for emotional disorders, a sizable subgroup of patients with distress disorders fail to evidence adequate treatment response. Emotion Regulation Therapy (ERT) is a theoretically derived, evidence based, treatment that integrates principles (e.g., skills training, exposure) from traditio…

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What’s in a name? Intolerance of uncertainty, other uncertainty-relevant constructs, and their differential relations to worry and generalized anxiety disorder

A number of studies have examined the association of intolerance of uncertainty (IU) to trait worry and generalized anxiety disorder (GAD). However, few studies have examined the extent of overlap between IU and other psychological constructs that bear conceptual resemblance to IU, despite the fact that IU-type constructs have been discussed and examined extensively within psychology and other disciplines. The present study investigated (1) the associations of IU, trait worry, and GAD status to a negative risk orientation, trait curiosity, indecisiveness, perceived constraints, self-oriented and socially prescribed perfectionism, intolerance of ambiguity, the need for predictability, and the need for order and structure and (2) whether IU is a unique correlate of trait worry and of the presence versus absence of Probable GAD, when overlap with other uncertainty-relevant constructs is acc…

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Revising the Intolerance of Uncertainty Model of Generalized Anxiety Disorder: Evidence from UK and Italian Undergraduate Samples.

The Intolerance of Uncertainty Model (IUM) of Generalized Anxiety Disorder (GAD) attributes a key role to Intolerance of Uncertainty (IU), and additional roles to Positive Beliefs about Worry (PBW), Negative Problem Orientation (NPO), and Cognitive Avoidance (CA), in the development and maintenance of worry, the core feature of GAD. Despite the role of the IUM components in worry and GAD has been considerably demonstrated, to date no studies have explicitly assessed whether and how PBW, NPO, and CA might turn IU into worry and somatic anxiety. The current studies sought to re-examine the IUM by assessing the relationships between the model's components on two different non-clinical samples made up of UK and Italian undergraduate students. One-hundred and seventy UK undergraduates and 488 Italian undergraduates completed measures assessing IU, worry, somatic anxiety, depression, and refin…

matched on generalized anxiety (text), worry (text)

Rumination and implicit avoidance following bereavement: an approach avoidance task investigation.

Background and objectives: Rumination, a risk factor in adjustment to bereavement, has often been considered a confrontation process. However, building on research on worry in generalized anxiety disorder (GAD) and rumination in post-traumatic stress disorder (PTSD), researchers recently developed the Rumination as Avoidance Hypothesis (RAH), which states that rumination after bereavement serves to avoid the reality of the loss. In the present study, RAH was tested by investigating if rumination is associated with implicit loss avoidance. Methods: An Approach Avoidance Task (AAT) was used to assess automatic behavior tendencies. Using a joystick, 71 persons who recently lost a first-degree relative (90.1% women), pulled stimuli toward themselves or pushed them away from themselves. Stimuli represented the loss (picture deceased + loss word), were loss-related but ambiguous (picture decea…

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Rumination and Worry in Daily Life: Examining the Naturalistic Validity of Theoretical Constructs.

Rumination and worry, two forms of perseverative thinking, hold promise as core processes that transect depressive and anxiety disorders. Whereas previous studies have been limited to the laboratory or to single diagnoses, we used experience sampling methods to assess and validate rumination and worry as transdiagnostic phenomena in the daily lives of individuals diagnosed with Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD), and co-occurring MDD-GAD. Clinical and healthy control participants carried a hand-held electronic device for one week. Eight times per day they reported on their current levels of rumination and worry and their theoretically postulated features: thought unpleasantness, repetitiveness, abstractness, uncontrollability, temporal orientation, and content, and overall senses of certainty and control. Both rumination and worry emerged as transdiagnost…

matched on generalized anxiety (text), worry (text)

Change in Decentering Mediates Improvement in Anxiety in Mindfulness-Based Stress Reduction for Generalized Anxiety Disorder.

Objective: We sought to examine psychological mechanisms of treatment outcomes of a mindfulness meditation intervention for Generalized Anxiety Disorder (GAD). Methods: We examined mindfulness and decentering as two potential therapeutic mechanisms of action of generalized anxiety disorder (GAD) symptom reduction in patients randomized to receive either mindfulness-based stress reduction (MBSR) or an attention control class (N=38). Multiple mediation analyses were conducted using a non-parametric cross product of the coefficients approach that employs bootstrapping. Results: Analyses revealed that change in decentering and change in mindfulness significantly mediated the effect of MBSR on anxiety. When both mediators were included in the model, the multiple mediation analysis revealed a significant indirect effect through increases in decentering, but not mindfulness. Furthermore, the di…

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Perinatal Generalized Anxiety Disorder: Assessment and Treatment

Perinatal generalized anxiety disorder (GAD) has a high prevalence of 8.5%-10.5% during pregnancy and 4.4%-10.8% postpartum. Despite its attendant dysfunction in the patient, this potentially debilitating mental health condition is often underdiagnosed. This overview will provide guidance for clinicians in making timely diagnosis and managing symptoms appropriately. A significant barrier to the diagnosis of GAD in the perinatal population is difficulty in distinguishing normal versus pathological worry. Because a perinatal-specific screening tool for GAD is nonexistent, early identification, diagnosis and treatment is often compromised. The resultant maternal dysfunction can potentially impact mother-infant bonding and influence neurodevelopmental outcomes in the children. Comorbid occurrence of GAD and major depressive disorder changes the illness course and its treatment outcome. Psych…

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Generalized anxiety disorder in primary care: mental health services use and treatment adequacy

PURPOSE: Generalized Anxiety Disorder (GAD) is a common mental disorder in the primary care setting, marked by persistent anxiety and worries. The aims of this study were to: 1) examine mental health services utilisation in a large sample of primary care patients; 2) explore detection of GAD and minimal standards for pharmacological and psychological treatment adequacy based on recommendation from clinical practice guidelines; 3) examine correlates of treatment adequacy, i.e. predisposing, enabling and needs factors according to the Behavioural Model of Health Care Use. METHODS: A sample of 373 adults meeting DSM-IV criteria for Generalized Anxiety Disorder in the past 12 months took part in this study. Data were drawn from the "Dialogue" project, a large primary care study conducted in 67 primary care clinics in Quebec, Canada. Following a mental health screening in medical clinics (n =…

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Test of mindfulness and hope components in a psychological intervention for women with cancer recurrence.

OBJECTIVE: Psychological interventions can attenuate distress and enhance coping for those with an initial diagnosis of cancer, but there are few intervention options for individuals with cancer recurrence. To address this gap, we developed and tested a novel treatment combining Mindfulness, Hope Therapy, and biobehavioral components. METHOD: An uncontrolled, repeated measures design was used. Women (N = 32) with recurrent breast or gynecologic cancers were provided 20 treatment sessions in individual (n = 12) or group (n = 20) formats. On average, participants were middle aged (M = 58) and Caucasian (81%). Independent variables (i.e., hope and mindfulness) and psychological outcomes (i.e., depression, negative mood, worry, and symptoms of generalized anxiety disorder) were assessed pre-treatment and 2, 4, and 7 months later. Session-by-session therapy process (positive and negative affe…

matched on generalized anxiety (text), worry (text)

Relationships Between Amount of Post-Intervention of Mindfulness Practice and Follow-up Outcome Variables in an Acceptance-Based Behavior Therapy for Generalized Anxiety Disorder: The Importance of Informal Practice.

Because most behavioral treatments are time-limited, skills and practices that foster long-term maintenance of gains made during treatment are of critical importance. While some studies have found mindfulness practice to be associated with improvements in outcome variables over the course of treatment (Vettese et al., 2009), very little is known about the effects of continued mindfulness practice following treatment termination. The current study examined the relationships between separate single item measurements of three types of mindfulness practices (formal, informal, and mindfulness of breath in daily life) and longer-term outcomes in worry, clinician-rated anxiety severity, and quality of life following treatment with an acceptance-based behavior therapy (ABBT) for Generalized Anxiety Disorder (GAD) in two separate treatment studies. Results from Study 1 showed that at 9-month foll…

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Differentiating Worry and Rumination: Evidence from Heart Rate Variability During Spontaneous Regulation.

Worry is the defining feature of generalized anxiety disorder (GAD), and rumination is a central process in depression. GAD and depression are highly comorbid, and worry and rumination reflect similar perseverative cognitive processes. Prior studies have largely assessed these emotion regulation strategies at the trait level, which has resulted in a limited understanding of their phasic characteristics, including associated physiological processes. We addressed this limitation by examining the relationship between spontaneous state-level worry and rumination and heart rate variability (HRV)-a physiological measure of emotion regulation-in response to emotion-eliciting film clips. We found differential associations between worry and rumination in relation to HRV, such that, worry was more consistently associated with HRV across emotional contexts than rumination was. Findings highlight fu…

matched on generalized anxiety (text), worry (text)

Characteristics of worry in Generalized Anxiety Disorder

BACKGROUND & OBJECTIVES: Groups of clients and community volunteers with Generalized Anxiety Disorder (GAD) and clients with Panic Disorder were compared to a group with elevated worry but without GAD on a range of measures, to identify individual differences beyond a high propensity to worry. METHOD: Participants completed standardised questionnaires and a behavioural worry task that assesses frequency and severity of negative thought intrusions. RESULTS: Relative to high worriers, clients with GAD had higher scores on trait anxiety, depression, more negative beliefs about worry, a greater range of worry topics, and more frequent and severe negative thought intrusions. Relative to community volunteers with GAD, clients in treatment reported poorer attentional control. Compared to clients with Panic Disorder, clients with GAD had higher trait anxiety, propensity to worry, negative belief…

matched on generalized anxiety (text), worry (text)

AVOIDANCE, SAFETY BEHAVIOR, AND REASSURANCE SEEKING IN GENERALIZED ANXIETY DISORDER

BACKGROUND: The behavioral symptoms of Generalized Anxiety Disorder (GAD) are not well characterized. This study examines behavioral symptoms in patients with GAD compared to healthy participants, their change during behavioral therapy, and their role for predicting short- and long-term outcome. METHODS: Secondary data analysis of 56 patients with DSM-IV GAD from a randomized controlled trial testing worry exposure (n = 29) and applied relaxation (n = 27), compared to 33 demographically matched healthy participants. Participants reported on attempts to control or prevent worry, specifically cognitive and behavioral avoidance, safety behavior, and reassurance, along with other GAD symptoms. The Hamilton Anxiety Scale served as immediate (post therapy) and the Penn State Worry Questionnaire as immediate and long-term (6-/12-month follow-up) treatment outcome measure. RESULTS: GAD patients …

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A multicomponent yoga-based, breath intervention program as an adjunctive treatment in patients suffering from generalized anxiety disorder with or without comorbidities

OBJECTIVES: The aim of this study is to evaluate the efficacy and tolerability of Sudarshan Kriya Yoga (SKY) course in generalized anxiety disorder (GAD) outpatients, who after eight weeks of an appropriate dose of traditional therapy had not yet achieved remission. SUBJECTS: The adult participants (18-65 years) were outpatients with a primary diagnosis of GAD with or without comorbidities on the Mini-International Neuropsychiatric Interview (MINI). Participants had a minimum of eight weeks standard treatment with an appropriate dose of a standard prescription anxiolytic, a clinician global impression-severity (CGI-S) score of 5-7, a Hamilton anxiety scale (HAM-A) total score ≥20 including a score of >2 on the anxious mood and tension items. MATERIALS AND METHODS: Forty-one patients were enrolled in an open-label trial of the SKY course as an adjunct to standard treatment of GAD at the S…

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Altered cerebral blood flow patterns associated with pathologic worry in the elderly

BACKGROUND: Generalized anxiety disorder (GAD) is the most prevalent anxiety disorder among the elderly and has high functional and cognitive morbidity. However, late-life GAD is relatively understudied and its functional neuroanatomy is uncharted. Several imaging studies have suggested abnormalities in the cognitive control systems of emotion regulation in anxiety disorders in young adults. The aim of this study was to examine the neural correlates of emotion regulation in late-life GAD. METHOD: We compared 7 elderly GAD subjects and 10 elderly nonanxious comparison subjects using functional MRI. Regional cerebral blood flow (rCBF) was measured using pulsed arterial spin labeling perfusion MRI at rest and during an emotion regulation paradigm. RESULTS: Relative to the rest condition, elderly nonanxious comparison subjects had increased rCBF during worry induction (WI) in the right insul…

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Intolerance of uncertainty and decisions about delayed, probabilistic rewards.

Worry is the inflated concern about potential future threats and is a hallmark feature of generalized anxiety disorder. Previous theoretical work has suggested that worry may be a consequence of intolerance of uncertainty (IU). The current study seeks to explore the behavioral consequences of IU. Specifically, we examine how IU might be associated with aspects of reward-based decision making. We utilized a simple laboratory gambling task in which participants chose between small, low-probability rewards available immediately at the beginning of each trial and large, high-probability rewards only available after some variable delay. Results demonstrate that higher levels of intolerance of uncertainty were associated with a tendency to select the immediately available, but less valuable and less probable rewards. IU also predicted decision-makers' sensitivity to outcomes. We discuss the co…

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Distress and Avoidance in Generalized Anxiety Disorder: Exploring the Relationships with Intolerance of Uncertainty and Worry

Theory and research suggest that treatments targeting experiential avoidance may enhance outcomes for patients with generalized anxiety disorder (GAD). The present study examined the role of experiential avoidance and distress about emotions in a treatment-seeking sample with a principal diagnosis of GAD compared with demographically matched nonanxious controls and sought to explore their shared relationship with two putative psychopathological processes in GAD: intolerance of uncertainty and worry. Patients with GAD reported significantly higher levels of experiential avoidance and distress about emotions compared with nonclinical controls while controlling for depressive symptoms, and measures of these constructs significantly predicted GAD status. Additionally, experiential avoidance and distress about anxious, positive, and angry emotions shared unique variance with intolerance of un…

matched on generalized anxiety (text), worry (text)

Anticipatory Activation in the Amygdala and Anterior Cingulate in Generalized Anxiety Disorder and Prediction of Treatment Response

OBJECTIVE: The anticipation of adverse outcomes, or worry, is a cardinal symptom of generalized anxiety disorder. Prior work with healthy subjects has shown that anticipating aversive events recruits a network of brain regions, including the amygdala and anterior cingulate cortex. This study tested whether patients with generalized anxiety disorder have alterations in anticipatory amygdala function and whether anticipatory activity in the anterior cingulate cortex predicts treatment response. METHOD: Functional magnetic resonance imaging (fMRI) was employed with 14 generalized anxiety disorder patients and 12 healthy comparison subjects matched for age, sex, and education. The event-related fMRI paradigm was composed of one warning cue that preceded aversive pictures and a second cue that preceded neutral pictures. Following the fMRI session, patients received 8 weeks of treatment with e…

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