Anticipatory fear, worry and generalised anxiety.
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1126 to 1150 of 4,916Comparison of self-report measures for identifying late-life generalized anxiety in primary care.
This study evaluated the Penn State Worry Questionnaire, Penn State Worry Questionnaire-Abbreviated, and the Generalized Anxiety Disorder Questionnaire-IV for identifying generalized anxiety disorder in older medical patients. Participants were 191 of 281 patients screened for a clinical trial evaluating cognitive-behavior treatment, n = 110 with generalized anxiety disorder, 81 without. Participants completed the Penn State Worry Questionnaire and Generalized Anxiety Disorder Questionnaire-IV at pretreatment. Kappa coefficients estimated agreement with the Structured Clinical Interview for Diagnosis. Receiver operating characteristic curves compared sensitivity and specificity of self-report measures. The Penn State Worry Questionnaire (cutoff = 50) provided the strongest prediction of generalized anxiety disorder (sensitivity, 76%; specificity, 73%; 75% correctly classified; kappa = .4…
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Psychometric properties of the Depression Anxiety and Stress Scale-21 in older primary care patients.
The Depression Anxiety Stress Scale (DASS) was designed to efficiently measure the core symptoms of anxiety and depression and has demonstrated positive psychometric properties in adult samples of anxiety and depression patients and student samples. Despite these findings, the psychometric properties of the DASS remain untested in older adults, for whom the identification of efficient measures of these constructs is especially important. To determine the psychometric properties of the DASS 21-item version in older adults, we analyzed data from 222 medical patients seeking treatment to manage worry. Consistent with younger samples, a three-factor structure best fit the data. Results also indicated good internal consistency, excellent convergent validity, and good discriminative validity, especially for the Depression scale. Receiver operating curve analyses indicated that the DASS-21 pred…
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Quetiapine as an adjunctive pharmacotherapy for the treatment of non-remitting generalized anxiety disorder: a flexible-dose, open-label pilot trial.
Background: Generalized anxiety disorder (GAD) is a chronic disorder associated with significant morbidity and disability. Traditional therapies are associated with poor levels of remission, and often result in troublesome side effects.
Methods: This was a 12-week, open-label, flexible-dose study to assess the efficacy and tolerability of quetiapine as an adjunctive treatment to traditional medication. 40 outpatients with GAD who had not achieved remission following at least 8 weeks of an adequate dose of traditional therapy were enrolled. The primary endpoint was the mean change from pre-treatment to week 12 in the Hamilton Anxiety Rating Scale (HAM-A) total scores. Secondary endpoints included: the proportion of patients achieving remission (HAM-A total score of < or =10 at week 12), Clinical Global Impressions-Severity of Illness (CGI-S), Clinical Global Impressions-Global Improvement…
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The construct of generalized anxiety disorder in Alzheimer disease.
Objectives: The objectives of this study were to examine the criterion validity in Alzheimer disease (AD) of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and the International Classification of Diseases, 10th Revision (ICD-10) criteria for generalized anxiety disorder (GAD), to clarify the symptoms associated with excessive anxiety and worry in AD, to examine the co-occurrence of GAD and depression in these patients, and to determine the neuropsychologic and functional impact of GAD in AD.
Results: One hundred forty-four of a consecutive series of 552 patients with probable AD (26%) reported excessive anxiety and worry difficult to control for most of the 6 months before the psychiatric evaluation. Excessive anxiety and worry were significantly associated with restlessness, irritability, muscle tension, fears, and respiratory symptoms of anxiety. Using t…
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A comparison of intolerance of uncertainty in analogue obsessive-compulsive disorder and generalized anxiety disorder.
Intolerance of uncertainty has been defined as the unwillingness to tolerate the possibility that negative events may occur in the future, no matter how low the probability [Personality Individual Differences 17 (1994), 791-802]. Previous research suggests that intolerance of uncertainty may be more specific to worry and generalized anxiety disorder (GAD) than to other anxiety disorders [e.g., Dugas, M. J., Buhr, K., & Ladouceur, R. (2004). The role of intolerance of uncertainty in the etiology and maintenance of generalized anxiety disorder. In R. G. Heimberg, C. L. Turk, & D. S. Mennin (Eds.), Generalized anxiety disorder: Advances in research and practice (pp. 143-163). New York: Guilford Press]. However, Tolin et al. [J. Anxiety Disorders 17 (2003), 233-242] argued that intolerance of uncertainty may also play a central role in obsessive-compulsive disorder (OCD). Therefore, the curr…
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Further validation of a cognitive-behavioral model of generalized anxiety disorder: diagnostic and symptom specificity.
The goal of this study was to investigate the diagnostic and symptom specificity of a model of GAD that has four main features: intolerance of uncertainty, positive beliefs about worry, poor problem orientation, and cognitive avoidance. The authors compared 17 patients with non-comorbid generalized anxiety disorder (GAD) to 28 patients with non-comorbid panic disorder with agoraphobia (PDA) and found that only intolerance of uncertainty showed evidence of diagnostic specificity, i.e., intolerance of uncertainty scores were higher in the GAD group relative to the PDA group. In terms of symptom specificity, when both groups were combined, all model variables were significantly related to worry but unrelated to fear of bodily sensations, agoraphobic cognitions, and behavioral avoidance. Taken together, these findings provide further support for the link between intolerance of uncertainty an…
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Comparisons between rumination and worry in a non-clinical population.
Major depression is characterised by ruminative thinking whilst worry is considered central in generalised anxiety disorder (GAD). However, not only do these two forms of repetitive negative thinking regularly co-occur in the same individual but similarities between worry and rumination are apparent. Adapting a methodology developed by Langlois et al. (Behav. Res. Therapy 38 (2000) 157-173), this study directly compared worry and rumination in a non-clinical population across a series of variables drawn from current models (appraisal, general descriptors and emotional reactions). Each of 149 female volunteers, with a wide range of age and backgrounds, identified a ruminative thought and a different worry and subsequently evaluated them using the Cognitive Intrusion Questionnaire. Significant within-subject differences were revealed on seven variables: chronicity, unpleasantness, reality …
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Psychological treatment of social anxiety disorder: a meta-analysis.
Background: Older meta-analyses of the effects of psychological treatments of social anxiety disorder have found that these treatments have moderate to large effects. However, these earlier meta-analyses also included non-randomized studies, and there are many featured studies in this area which were published after the recent meta-analysis.
Method: We conducted a systematic literature search and identified 29 randomized studies examining the effects of psychological treatments, with a total of 1628 subjects. The quality of studies varied. For the analyses, we used the computer program comprehensive meta-analysis (version 2.2.021; Biostat, Englewood, NJ, USA).
Results: The mean effect size on social anxiety measures (47 contrast groups) was 0.70, 0.80 on cognitive measures (26 contrast groups) and 0.70 both on depression (19 contrast groups) and general anxiety measures (16 contrast grou…
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Predictors of clinician use of exposure therapy in community mental health settings.
Exposure therapy is recognized as the key component of cognitive-behavioral treatment for anxiety. However, exposure is the least used evidence-based treatment in community mental health settings and is the most challenging technique for clinicians to adopt within the context of effectiveness and implementation trials. Little work has examined clinician and organizational characteristics that predict use of exposure, which is important for identifying implementation strategies that may increase its use. In a large sample of community health clinicians (N=335) across 31 clinical practice sites, this study characterized clinician and organizational predictors of exposure use and relaxation for anxiety. Mixed effects regression analyses indicated that both clinician attitudes and an organization's implementation climate may be important levers for interventions seeking to increase clinician…
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Emotion regulation patterns in adolescents with high-functioning autism spectrum disorder: comparison to typically developing adolescents and association with psychiatric symptoms.
Autism spectrum disorder (ASD) is often associated with poor emotional control and psychopathology, such as anxiety and depression; however, little is known about the underlying mechanisms. Emotion regulation (ER) is a potential contributing factor, but there has been limited research on ER and its role in comorbid psychopathology in ASD. In this study, we compared self-reported ER with self- and parent reports of psychopathology in 25 high-functioning adolescents with ASD and 23 age- and Intelligence Quotient (IQ)-matched typically developing controls. Contrary to expectations, both groups reported similar levels of adaptive, voluntary forms of ER (problem solving, acceptance, etc.). However, the ASD group reported significantly greater use of involuntary forms of ER that are typically maladaptive, including remaining focused on the stressor (e.g. rumination and emotional arousal) and s…
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Prevalence patterns and associated factors of psychological distress among Syrian refugees in middle eastern host countries: a scoping review.
Since 2011, the Syrian conflict has generated one of the largest displacement crises globally, with most Syrian refugees hosted in neighboring Middle Eastern countries. These host settings differ substantially in legal, social, settlement, and service conditions, which shapes both refugee experiences and the interpretation of mental health evidence. Protracted displacement, cumulative trauma, and post- migration adversity have contributed to a substantial burden of psychological distress, yet distress may be expressed not only through post-traumatic stress, depression, and anxiety symptoms, but also through culturally embedded experiences such as somatic complaints, grief, family disruption, role loss, stigma, uncertainty, and reduced dignity. This scoping review mapped prevalence patterns of psychological distress and associated risk and protective factors among Syrian refugees residing…
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Bedtime procrastination and psychological distress in university students: a systematic review and meta-analysis of their association.
Bedtime procrastination (BP), the voluntary delay of sleep despite the opportunity and intention to sleep, is prevalent among university students, a population particularly vulnerable to both sleep problems and psychological distress. While theoretically linked to mental health, the magnitude and consistency of its associations with depression, anxiety, and stress remain unclear. This systematic review and meta-analysis aimed to quantify these associations and explore potential moderators. We systematically searched PubMed, Web of Science, EBSCOhost, ScienceDirect, WanFang Data, and ProQuest from inception to 2025. Observational studies reporting correlations between BP and depression, anxiety, or perceived stress in university students were included. Study quality was assessed using the Joanna Briggs Institute checklists. Random-effects meta-analyses were conducted to synthesize Pearson…
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An idiographic analysis of change processes in the unified transdiagnostic treatment of depression.
Unlabelled: Idiographic research methods can provide rich information regarding the process of change in specific treatments.
Objective: Adopting an idiographic, exploratory approach, this study examined (a) temporal patterns of 3 transdiagnostic change constructs (mindfulness, cognitive reappraisal, and emotion avoidance), (b) the relationships between these constructs and depression and anxiety symptom severity over time, and (c) changes in these constructs in relation to the introduction of specific transdiagnostic intervention strategies in a single case.
Method: The case was a 64-year-old, White, female patient with principal major depressive disorder and secondary generalized anxiety disorder being treated with the Unified Protocol (UP). Univariate and multivariate time series analyses were applied to symptom and change construct data.
Results: (a) Clinically significant decreases …
matched on Anxiety (mesh), Anxiety Disorders (mesh), anxiety symptoms (text), generalized anxiety (text)
Resolving Ambiguity in Emotional Disorders: The Nature and Role of Interpretation Biases.
People with emotional disorders, such as social anxiety disorder (SAD), generalized anxiety disorder (GAD), and depression, demonstrate a consistent tendency, or bias, to generate negative interpretations of ambiguous material. This is different from people without emotional disorders who tend, in general, to make positive interpretations of ambiguity. If central components of an emotional disorder have high levels of inherent ambiguity (e.g., concern about the negative perceptions of others in SAD, or worry in GAD), then interpretive bias may have a causal maintaining role, and this has been demonstrated in studies using cognitive bias modification techniques. This research has also shown that interpretation biases combine with other cognitive processes, such as imagery and memory, which could exacerbate distress. Psychological interventions will benefit from effectively targeting negat…
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Tauber NM, O'Toole MS, Dinkel A, Galica J, Humphris G, Lebel S, Maheu C, Ozakinci G, Prins J, Sharpe L, Smith AB, Thewes B, Simard S, Zachariae R (2019)meta-analysisMEDLINE-indexed journal, not yet read by usJournal of clinical oncology : official journal of the American Society of Clinical Oncology292 citations Effect of Psychological Intervention on Fear of Cancer Recurrence: A Systematic Review and Meta-Analysis.
Purpose: Fear of cancer recurrence (FCR) is a significantly distressing problem that affects a substantial number of patients with and survivors of cancer; however, the overall efficacy of available psychological interventions on FCR remains unknown. We therefore evaluated this in the present systematic review and meta-analysis.
Methods: We searched key electronic databases to identify trials that evaluated the effect of psychological interventions on FCR among patients with and survivors of cancer. Controlled trials were subjected to meta-analysis, and the moderating influence of study characteristics on the effect were examined. Overall quality of evidence was evaluated using the GRADE system. Open trials were narratively reviewed to explore ongoing developments in the field (PROSPERO registration no.: CRD42017076514).
Results: A total of 23 controlled trials (21 randomized controlled …
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Social Media and Youth Mental Health.
Purpose of review: We review recent evidence regarding the relationship between the social media (SM) habits, experiences, and the mental health of youth. We examine effects of social media use (SMU) on specific diagnoses including depression and anxiety. The relationship between psychiatric illness, specific SM experiences, and the issue of SM mental health contagion is also explored.
Recent findings: Youth engagement in SMU has increased dramatically in recent years, concurrent with increases in prevalence of depression and anxiety. The relationship between SMU and mental illness is complex and depends on characteristics of the user (e.g., social comparison and fear of missing out (FOMO) and their SM habits and experiences (e.g., cyberbullying, and sexting,). SM engagement has distinct impacts on anxiety, depression, and suicidality. Growing evidence documents how SM may be a medium fo…
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Calder AE, Hasler G (2023)reviewMEDLINE-indexed journal, not yet read by usNeuropsychopharmacology : official publication of the American College of Neuropsychopharmacology205 citations Towards an understanding of psychedelic-induced neuroplasticity.
Classic psychedelics, such as LSD, psilocybin, and the DMT-containing beverage ayahuasca, show some potential to treat depression, anxiety, and addiction. Importantly, clinical improvements can last for months or years after treatment. It has been theorized that these long-term improvements arise because psychedelics rapidly and lastingly stimulate neuroplasticity. The focus of this review is on answering specific questions about the effects of psychedelics on neuroplasticity. Firstly, we review the evidence that psychedelics promote neuroplasticity and examine the cellular and molecular mechanisms behind the effects of different psychedelics on different aspects of neuroplasticity, including dendritogenesis, synaptogenesis, neurogenesis, and expression of plasticity-related genes (e.g., brain-derived neurotrophic factor and immediate early genes). We then examine where in the brain psyc…
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Caring for the Caregiver (C4C): An Integrated Stepped Care Model for Caregivers of Children With Medical Complexity.
Children with medical complexity (CMC) are a medically fragile subset of children who rely on parental caregivers for substantial care needs. Caregivers of CMC often experience adverse health outcomes such as depression and anxiety, sleep deprivation, financial hardships, and social isolation. Caregivers of CMC are at risk of premature mortality, which is thought to be mediated by chronic and elevated stress, as well as psychiatric morbidity risk. Access to mental health care, where the needs of both the caregiver and child are considered, can enable caregivers to meet high caregiving demands and improve both child and caregiver outcomes. We describe the Caring for the Caregiver (C4C) model, a novel integrated stepped care model consisting of collaboration between a psychiatrist and a pediatric complex care program. This model provides support in 3 steps: 1) early identification of distr…
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Interventions using the Qur'an to promote mental health: a systematic scoping review.
Background: Accommodating and addressing the beliefs and attitudes of Muslim patients, means designing culturally competent mental health services. Practicing Muslims around the world often use the Qur'an when seeking guidance for health.
Aims: The aim of this study was to identify interventions using the Qur'an as a promoting factor for mental health.
Methods: The paucity of academic literature in the area meant a systematic scoping review of the evidence was appropriate. Conducting the search for peer-reviewed evidence used six databases, searching for grey literature used Google Scholar, for evidence published up to 29th December 2022. Analysis used the Patterns, Advances, Gaps, Evidence for practice and Research recommendations (PAGER) framework for scoping reviews to report the findings clearly and accessibly.
Results: Out of 1590 articles from databases and 35 from other sources (n…
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An Integrative Review of Community-Based Mental Health Interventions Among Resettled Refugees from Muslim-Majority Countries.
Resettled refugees from Muslim-majority countries are underrepresented in research and meeting their mental health needs remains a challenge for countries of resettlement. In this integrative review, we synthesize community-based mental health interventions using an ecological framework. Eleven relevant studies were identified using PubMed and PsychInfo database. Most interventions focus on micro-system level factors like promoting integration and social connections suggest improvement of outcomes including depression, anxiety, and psychological distress. Studies suggest how mental health programs addressing psychosocial wellbeing improves outcomes across ecological levels through: (1) early screening upon resettlement; (2) education and raising awareness of mental health; and (3) engagement of refugees in local community social support systems. Largely qualitative studies suggest benefi…
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Stress, Burnout, Anxiety and Depression among Teachers: A Scoping Review.
Background: Worldwide, stress and burnout continue to be a problem among teachers, leading to anxiety and depression. Burnout may adversely affect teachers' health and is a risk factor for poor physical and mental well-being. Determining the prevalence and correlates of stress, burnout, anxiety, and depression among teachers is essential for addressing this public health concern.
Objective: To determine the extent of the current literature on the prevalence and correlates of stress, burnout, anxiety, and depression among teachers.
Method: This scoping review was performed using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). Relevant search terms were used to determine the prevalence and correlates of teachers' stress, burnout, anxiety, and depression. Articles were identified using MEDLINE (Medical Literature Analysis an…
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Johnson Rolfes J, Paulsen M (2022)reviewMEDLINE-indexed journal, not yet read by usJournal of perinatology : official journal of the California Perinatal Association16 citations Protecting the infant-parent relationship: special emphasis on perinatal mood and anxiety disorder screening and treatment in neonatal intensive care unit parents.
Perinatal mood and anxiety disorders (PMADs) are common, particularly among parents of infants requiring admission to the neonatal intensive care unit (NICU), yet remain underdiagnosed and undertreated. Undertreated parental mental health disorders can interfere with healthy infant development, compounding abnormal neurodevelopment and psychosocial development that preterm or ill newborns may already face. Interdisciplinary efforts to increase PMAD awareness, screening, and referral uptake may improve family-infant health and developmental outcomes in high-risk infants requiring NICU admission. Therefore, special emphasis on PMAD screening and treatment in NICU parents aligns with the American Academy of Pediatrics mission and should be a focus in neonatal care and included in education, quality improvement, and outcome-based research initiatives.
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Depression in young people.
Depression rates in young people have risen sharply in the past decade, especially in females, which is of concern because adolescence is a period of rapid social, emotional, and cognitive development and key life transitions. Adverse outcomes associated with depression in young people include depression recurrence; the onset of other psychiatric disorders; and wider, protracted impairments in interpersonal, social, educational, and occupational functioning. Thus, prevention and early intervention for depression in young people are priorities. Preventive and early intervention strategies typically target predisposing factors, antecedents, and symptoms of depression. Young people who have a family history of depression, exposure to social stressors (eg, bullying, discordant relationships, or stressful life events), and belong to certain subgroups (eg, having a chronic physical health prob…
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Virtual Reality Biofeedback in Health: A Scoping Review.
Over the past decades, virtual reality (VR) has found its way into biofeedback (BF) therapy programs. Using VR promises to overcome challenges encountered in traditional BF such as low treatment motivation, low attentional focus and the difficulty of transferring learnt abilities to everyday life. Yet, a comprehensive research synthesis is still missing. Hence, this scoping review aims to provide an overview over empirical studies on VR based BF regarding key outcomes, included samples, used soft- and hardware, BF parameters, mode of application and potential limitations. We systematically searched Medline, PsycINFO, Scopus, CINAHL, Google Scholar and Open Grey for empirical research. Eighteen articles met the inclusion criteria. Samples mostly consisted of healthy (44.4%) and/or adult (77.7%) participants. Outcomes were mainly anxiety (44.4%), stress (44.4%) or pain reduction (11.1%), w…
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Interoception, Trait Anxiety, and the Gut Microbiome: A Cognitive and Physiological Model.
Trait anxiety is characterized as a constant and often subliminal state that persists during daily life. Interoception is the perception of internal states and sensations, including from the autonomic nervous system. This review aims to develop a predictive model to explain the emergence, manifestations, and maintenance of trait anxiety. The model begins with the assumption that anxiety states arise from active interoceptive inference. The subsequent activation of autonomic responses results from aversive sensory encounters. A cognitive model is proposed for trait anxiety that includes the aversive sensory components from interoception, exteroception, and proprioception. A further component of the hypothesis is that repeated exposure to subliminal anxiety-evoking sensory elements can lead to an overgeneralization of this response to other inputs that are generally non-aversive. Increased…
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