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

Intolerance of uncertainty, worry, and rumination in major depressive disorder and generalized anxiety disorder.

Intolerance of uncertainty (IU) can be defined as a cognitive bias that affects how a person perceives, interprets, and responds to uncertain situations. Although IU has been reported mainly in literature relating to worry and anxiety symptoms, it may be also important to investigate the relationship between IU, rumination, and depression in a clinical sample. Furthermore, individuals who are intolerant of uncertainty easily experience stress and could cope with stressful situations using repetitive thought such as worry and rumination. Thus, we investigated whether different forms of repetitive thought differentially mediate the relationship between IU and psychological symptoms. Participants included 27 patients with MDD, 28 patients with GAD, and 16 patients with comorbid GAD/MDD. Even though worry, rumination, IU, anxiety, and depressive symptoms correlated substantially with each ot…

matched on Anxiety (mesh), Anxiety Disorders (mesh), anxiety symptoms (text), generalized anxiety (text), worry (text)

ACOG Committee Opinion No. 757: Screening for Perinatal Depression.

Perinatal depression, which includes major and minor depressive episodes that occur during pregnancy or in the first 12 months after delivery, is one of the most common medical complications during pregnancy and the postpartum period, affecting one in seven women. It is important to identify pregnant and postpartum women with depression because untreated perinatal depression and other mood disorders can have devastating effects. Several screening instruments have been validated for use during pregnancy and the postpartum period. The American College of Obstetricians and Gynecologists recommends that obstetrician-gynecologists and other obstetric care providers screen patients at least once during the perinatal period for depression and anxiety symptoms using a standardized, validated tool. It is recommended that all obstetrician-gynecologists and other obstetric care providers complete a…

matched on Anxiety (mesh), anxiety symptoms (text)

The clinical effectiveness of sertraline in primary care and the role of depression severity and duration (PANDA): a pragmatic, double-blind, placebo-controlled randomised trial.

Background: Depression is usually managed in primary care, but most antidepressant trials are of patients from secondary care mental health services, with eligibility criteria based on diagnosis and severity of depressive symptoms. Antidepressants are now used in a much wider group of people than in previous regulatory trials. We investigated the clinical effectiveness of sertraline in patients in primary care with depressive symptoms ranging from mild to severe and tested the role of severity and duration in treatment response. Methods: The PANDA study was a pragmatic, multicentre, double-blind, placebo-controlled randomised trial of patients from 179 primary care surgeries in four UK cities (Bristol, Liverpool, London, and York). We included patients aged 18 to 74 years who had depressive symptoms of any severity or duration in the past 2 years, where there was clinical uncertainty abo…

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

Integrated primary care for patients with mental and physical multimorbidity: cluster randomised controlled trial of collaborative care for patients with depression comorbid with diabetes or cardiovascular disease

OBJECTIVE: To test the effectiveness of an integrated collaborative care model for people with depression and long term physical conditions. DESIGN: Cluster randomised controlled trial. SETTING: 36 general practices in the north west of England. PARTICIPANTS: 387 patients with a record of diabetes or heart disease, or both, who had depressive symptoms (≥ 10 on patient health questionaire-9 (PHQ-9)) for at least two weeks. Mean age was 58.5 (SD 11.7). Participants reported a mean of 6.2 (SD 3.0) long term conditions other than diabetes or heart disease; 240 (62%) were men; 360 (90%) completed the trial. INTERVENTIONS: Collaborative care included patient preference for behavioural activation, cognitive restructuring, graded exposure, and/or lifestyle advice, management of drug treatment, and prevention of relapse. Up to eight sessions of psychological treatment were delivered by specially …

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

Delivery of Evidence-Based Treatment for Multiple Anxiety Disorders in Primary Care

CONTEXT: Improving the quality of mental health care requires moving clinical interventions from controlled research settings into real-world practice settings. Although such advances have been made for depression, little work has been performed for anxiety disorders. OBJECTIVE: To determine whether a flexible treatment-delivery model for multiple primary care anxiety disorders (panic, generalized anxiety, social anxiety, and posttraumatic stress disorders) would be better than usual care (UC). DESIGN, SETTING, AND PATIENTS: A randomized controlled effectiveness trial of Coordinated Anxiety Learning and Management (CALM) compared with UC in 17 primary care clinics in 4 US cities. Between June 2006 and April 2008, 1004 patients with anxiety disorders (with or without major depression), aged 18 to 75 years, English- or Spanish-speaking, were enrolled and subsequently received treatment for…

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

Virtual Reality Therapy in Mental Health.

Initially designed for the treatment of phobias, the use of virtual reality in phobic disorders has expanded to other mental health disorders such as posttraumatic stress disorder, substance-related disorders, eating disorders, psychosis, and autism spectrum disorder. The goal of this review is to provide an accessible understanding of why this approach is important for future practice, given its potential to provide clinically relevant information associated with the assessment and treatment of people suffering from mental illness. Most of the evidence is available for the use of virtual reality exposure therapy in anxiety disorders and posttraumatic stress disorder. There is hardly any evidence that virtual reality therapy is effective in generalized anxiety disorder and obsessive-compulsive disorder. There is increasing evidence that cue exposure therapy is effective in addiction and …

matched on Anxiety Disorders (mesh), Phobic Disorders (mesh), generalized anxiety (text)

Cognitive Behavioral Therapy, Mindfulness-Based Cognitive Therapy and Acceptance Commitment Therapy for Anxiety Disorders: Integrating Traditional with Digital Treatment Approaches.

Anxiety disorders are an enormous societal burden given their high lifetime prevalence among adult populations worldwide. A variety of anxiety disorders can be successfully treated with psychological treatments such as cognitive behavioral therapy (CBT), mindfulness-based cognitive therapy (MBCT), and acceptance and commitment therapy (ACT), either as stand-alone individual or group treatment or as adjunctive treatment to pharmacotherapy. Furthermore, a growing body of evidence suggests that therapist-guided Internet-delivered CBT (iCBT) and, to some degree, digitalized mindfulness- and acceptance-based interventions may be an efficacious complement to traditional face-to-face therapy. In view of the current advances regarding the integration of traditional and innovative treatment approaches, this chapter provides an overview on the theory and evidence base for different delivery modes …

matched on Anxiety Disorders (mesh), Phobic Disorders (mesh), generalized anxiety (text)

Oxytocin in General Anxiety and Social Fear: A Translational Approach.

The neuropeptide oxytocin (OXT) has been revealed as a profound anxiolytic and antistress factor of the brain, besides its many prosocial and reproductive effects. Therefore, there is substantial scientific and medical interest in its potential therapeutic use for the treatment of psychopathologies associated with anxiety, fear, and social dysfunctions, such as generalized anxiety disorder, posttraumatic stress disorder, and social anxiety disorder, as well as autism and schizophrenia, among others. Focusing on preclinical studies, we review the existing evidence for the regulatory capacity of OXT to fine-tune general and social anxiety-related behaviors, as well as cued and social fear conditioning from a translational perspective. The available evidence from animal and human studies substantiates the hypothesis of an imbalance of the endogenous brain OXT system in the etiology of anxie…

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The pharmacologic treatment of anxiety disorders: a review of progress.

Anxiety disorders, as a group, are among the most common mental health conditions and frequently cause significant functional impairment. Both psychotherapeutic and pharmacologic techniques are recognized to be effective management strategies. This review provides a discussion of the major classes of psychotropic medications investigated in clinical trials of the following anxiety disorders: panic disorder, social anxiety disorder, generalized anxiety disorder, posttraumatic stress disorder, and obsessive-compulsive disorder. Findings suggest that both selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors are useful first-line agents for most of the anxiety disorders, particularly given the frequent comorbidity with mood disorders. Highly serotonergic agents are preferred for obsessive-compulsive disorder. Other antidepressants, such as tricyclic antide…

matched on Anxiety Disorders (mesh), Phobic Disorders (mesh), generalized anxiety (text)

Internet addiction or excessive internet use.

Background: Problematic Internet addiction or excessive Internet use is characterized by excessive or poorly controlled preoccupations, urges, or behaviors regarding computer use and Internet access that lead to impairment or distress. Currently, there is no recognition of internet addiction within the spectrum of addictive disorders and, therefore, no corresponding diagnosis. It has, however, been proposed for inclusion in the next version of the Diagnostic and Statistical Manual of Mental Disorder (DSM). Objective: To review the literature on Internet addiction over the topics of diagnosis, phenomenology, epidemiology, and treatment. Methods: Review of published literature between 2000-2009 in Medline and PubMed using the term "internet addiction. Results: Surveys in the United States and Europe have indicated prevalence rate between 1.5% and 8.2%, although the diagnostic criteria and …

matched on Anxiety Disorders (mesh), Phobic Disorders (mesh), generalized anxiety (text)

A randomized controlled trial of emotion regulation therapy for generalized anxiety disorder with and without co-occurring depression.

OBJECTIVE: Generalized anxiety disorder (GAD) and major depression (MDD), especially when they co-occur, are associated with suboptimal treatment response. One common feature of these disorders is negative self-referential processing (NSRP; i.e., worry, rumination), which worsens treatment outcome. Emotion Regulation Therapy (ERT) integrates principles from affect science with traditional and contemporary cognitive-behavioral treatments to identify and modify the functional nature of NSRP by targeting motivational and regulatory mechanisms, as well as behavioral consequences. METHOD: Building on encouraging open trial findings, 53 patients with a primary diagnosis of GAD (43% with comorbid MDD) were randomly assigned to immediate treatment with ERT (n = 28) or a modified attention control condition (MAC, n = 25). RESULTS: ERT patients, as compared with MAC patients, evidenced statistical…

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

Integrating motivational interviewing with cognitive-behavioral therapy for severe generalized anxiety disorder: An allegiance-controlled randomized clinical trial.

OBJECTIVE: Although integrating motivational interviewing (MI) and cognitive-behavioral therapy (CBT) has been recommended for treating anxiety, few well-controlled tests of such integration exist. METHOD: In the present randomized trial for severe generalized anxiety disorder (GAD), we compared the efficacy of 15 sessions of CBT alone (N = 43) versus 4 MI sessions followed by 11 CBT sessions integrated with MI to address client resistance/ambivalence (N = 42). Clients were adults, predominantly female and Caucasian, with a high rate of diagnostic comorbidity. To control for allegiance, therapists were nested within treatment group and supervised separately by experts in the respective treatments. RESULTS: Piecewise multilevel models revealed no between-groups differences in outcomes from pre- to posttreatment; however, there were treatment effects over the follow-up period with MI-CBT c…

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

Guided, internet-based, rumination-focused cognitive behavioural therapy (i-RFCBT) versus a no-intervention control to prevent depression in high-ruminating young adults, along with an adjunct assessment of the feasibility of unguided i-RFCBT, in the REducing Stress and Preventing Depression trial (RESPOND): study protocol for a phase III randomised controlled trial

BACKGROUND: Depression is a global health challenge. Prevention is highlighted as a priority to reduce its prevalence. Although effective preventive interventions exist, the efficacy and coverage can be improved. One proposed means to increase efficacy is by using interventions to target specific risk factors, such as rumination. Rumination-focused CBT (RFCBT) was developed to specifically target depressive rumination and reduces acute depressive symptoms and relapse for patients with residual depression in a randomised controlled trial. Preliminary findings from a Dutch randomised prevention trial in 251 high-risk 15- to 22-year-old subjects selected with elevated worry and rumination found that both supported internet-RFBCT and group-delivered RFCBT equally reduced depressive symptoms and the onset of depressive cases over a period of 1 year, relative to the no-intervention control. ME…

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

Decentering as a potential common mechanism across two therapies for generalized anxiety disorder.

OBJECTIVE: The purpose of this study was to examine decentering as a potential mechanism of action across 2 treatments for generalized anxiety disorder: an acceptance-based behavioral therapy (ABBT) and applied relaxation (AR). METHOD: Sixty-four individuals who completed at least half of the 16 total sessions of either ABBT or AR (65.6% female; 79.7% identified as White; average age = 34.41 years) completed measures of decentering (Experiences Questionnaire) and of symptoms of anxiety (Depression Anxiety Stress Scale-Stress subscale) at 5 time points over the course of therapy, and a measure of worry (Penn State Worry Questionnaire) at pre- and posttreatment. RESULTS: Initial growth curve models showed that decentering increased significantly over therapy (z = 7.09), and this increase was associated with a decrease in worry symptoms (Penn State Worry Questionnaire) at posttreatment (z =…

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

Intolerance of Uncertainty: A Common Factor in the Treatment of Emotional Disorders

UNLABELLED: Intolerance of uncertainty (IU) is a characteristic predominantly associated with generalized anxiety disorder (GAD); however, emerging evidence indicates that IU may be a shared element of emotional disorders. AIMS: This study aimed to examine IU across diagnostic categories, change in IU during transdiagnostic treatment, and the relationship between change in IU and treatment outcome. METHOD: Patients diagnosed with heterogeneous anxiety and depressive disorders received up to 18 weeks of a transdiagnostic cognitive-behavioral therapy intervention. Patient self-reported IU and self-report and clinician-rated symptom/functioning measures were administered at pretreatment and posttreatment. RESULTS: When controlling for negative affectivity, IU correlated with measures of depressive symptoms and worry severity at pretreatment. Patients with GAD and panic disorder exhibited th…

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

A randomized clinical trial comparing an acceptance-based behavior therapy to applied relaxation for generalized anxiety disorder.

OBJECTIVE: To examine whether an empirically and theoretically derived treatment combining mindfulness- and acceptance-based strategies with behavioral approaches would improve outcomes in generalized anxiety disorder (GAD) over an empirically supported treatment. METHOD: This trial randomized 81 individuals (65.4% female, 80.2% identified as White, average age 32.92) diagnosed with GAD to receive 16 sessions of either an acceptance-based behavior therapy (ABBT) or applied relaxation (AR). Assessments at pretreatment, posttreatment, and 6-month follow-up included the following primary outcome measures: GAD clinician severity rating, Structured Interview Guide for the Hamilton Anxiety Rating Scale, Penn State Worry Questionnaire, Depression Anxiety Stress Scale, and the State-Trait Anxiety Inventory. Secondary outcomes included the Beck Depression Inventory-II, Quality of Life Inventory, …

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

Antidepressant Medication Augmented With Cognitive-Behavioral Therapy for Generalized Anxiety Disorder in Older Adults

OBJECTIVE Generalized anxiety disorder is common among older adults and leads to diminished health and cognitive functioning. Although antidepressant medications are efficacious, many elderly individuals require augmentation treatment. Furthermore, little is known about maintenance strategies for older people. The authors examined whether sequenced treatment combining pharmacotherapy and cognitive-behavioral therapy (CBT) boosts response and prevents relapse in older adults with generalized anxiety disorder. METHOD Participants were individuals at least 60 years of age with generalized anxiety disorder (N=73) who were recruited from outpatient clinics at three sites. Participants received 12 weeks of open-label escitalopram and were then randomly assigned to one of four conditions: 16 weeks of escitalopram (10-20 mg/day) plus modular CBT, followed by 28 weeks of maintenance escitalopram;…

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

A Multifaith Spiritually Based Intervention Versus Supportive Therapy for Generalized Anxiety Disorder: A Pilot Randomized Controlled Trial

OBJECTIVES: We have previously reported that a multifaith spiritually based intervention (SBI) may have efficacy in the treatment of generalized anxiety disorder (GAD). This randomized pilot trial tested whether the SBI had greater efficacy than a nonspecific control condition in GAD. METHOD: Twenty-three participants with GAD of at least moderate severity were randomized to 12 individual sessions of the SBI (n = 11) or supportive psychotherapy (SP)--our control condition (n = 12). RESULTS: Intent-to-treat analysis revealed the SBI fared better than SP in decreasing blind clinician ratings of anxiety and illness severity and self-report worry and intolerance of uncertainty, with large between-group effect sizes. The SBI also produced greater changes in spiritual well-being. Results remained the same when supplementary analyses were performed on the completer sample. Treatment gains were …

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

Therapist Behaviours in Internet-Delivered Cognitive Behaviour Therapy: Analyses of E-Mail Correspondence in the Treatment of Generalized Anxiety Disorder

BACKGROUND: Internet-delivered cognitive behaviour therapy (iCBT) has been found to be an effective way to disseminate psychological treatment, and support given by a therapist seems to be important in order to achieve good outcomes. Little is known about what the therapists actually do when they provide support in iCBT and whether their behaviour influences treatment outcome. AIMS: This study addressed the content of therapist e-mails in guided iCBT for generalized anxiety disorder. METHOD: We examined 490 e-mails from three therapists providing support to 44 patients who participated in a controlled trial on iCBT for generalized anxiety disorder. RESULTS: Through content analysis of the written correspondence, eight distinguishable therapist behaviours were derived: deadline flexibility, task reinforcement, alliance bolstering, task prompting, psychoeducation, self-disclosure, self-eff…

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

Internet-Based Psychodynamic versus Cognitive Behavioral Guided Self-Help for Generalized Anxiety Disorder: A Randomized Controlled Trial

BACKGROUND: Guided Internet-based cognitive behavior therapy (ICBT) has been tested in many trials and found to be effective in the treatment of anxiety and mood disorders. Generalized anxiety disorder (GAD) has also been treated with ICBT, but there are no controlled trials on guided Internet-based psychodynamic treatment (IPDT). Since there is preliminary support for psychodynamic treatment for GAD, we decided to test if a psychodynamically informed self-help treatment could be delivered via the Internet. The aim of the study was to investigate the efficacy of IPDT for GAD and to compare against ICBT and a waiting list control group. METHOD: A randomized controlled superiority trial with individuals diagnosed with GAD comparing guided ICBT (n = 27) and IPDT (n = 27) against a no treatment waiting list control group (n = 27). The primary outcome measure was the Penn State Worry Question…

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

Feasibility of Exercise Training for the Short-Term Treatment of Generalized Anxiety Disorder: A Randomized Controlled Trial

BACKGROUND: Exercise training may be especially helpful for patients with generalized anxiety disorder (GAD). We conducted a randomized controlled trial to quantify the effects of 6 weeks of resistance (RET) or aerobic exercise training (AET) on remission and worry symptoms among sedentary patients with GAD. METHODS: Thirty sedentary women aged 18-37 years, diagnosed by clinicians blinded to treatment allocation with a primary DSM-IV diagnosis of GAD and not engaged in any treatment other than pharmacotherapy, were randomly allocated to RET, AET, or a wait list (WL). RET involved 2 weekly sessions of lower-body weightlifting. AET involved 2 weekly sessions of leg cycling matched with RET for body region, positive work, time actively engaged in exercise, and load progression. Remission was measured by the number needed to treat (NNT). Worry symptoms were measured by the Penn State Worry Q…

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

Guided Internet-Delivered Cognitive Behavior Therapy for Generalized Anxiety Disorder: A Randomized Controlled Trial

Generalized anxiety disorder (GAD) has been effectively treated with cognitive behavioural therapy (CBT) in face-to face settings. Internet-delivered CBT could be a way to increase the accessibility and affordability of CBT for people suffering from GAD. The aim of this study was to evaluate the efficacy of guided Internet-delivered CBT for GAD in a controlled trial with a wait-list control group. A total of 89 participants were included following online screening and a structured psychiatric telephone interview. Participants were randomized to either an 8-week treatment group (n = 44) or a wait-list control group (n = 45). Treatment consisted of a self-help program based on CBT principles and applied relaxation along with therapist guidance. The main outcome measure was the Penn State Worry Questionnaire. Ratings of clinical improvement and symptoms were included as well as secondary ou…

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

The impact of motivational interviewing on resistance in cognitive behavioural therapy for generalized anxiety disorder

The present study simultaneously examined observed resistance and homework compliance in Cognitive Behavioural Therapy (CBT) between those with severe generalized anxiety disorder who did (n =18) and did not (n =17) receive Motivational Interviewing (MI) prior to CBT. Large effects for reduced resistance early in CBT were observed in the MI pretreatment group relative to the no-pretreatment group. Moreover, receiving four sessions of MI was associated with significantly lower levels of resistance, compared to receiving four sessions of CBTalone. Using path analysis, resistance, but not homework compliance, was found to strongly and directly mediate the relationship between treatment group and worry reduction. Findings suggest that MI improves treatment outcomes when added to CBT for generalized anxiety by reducing client resistance to, and increasing client engagement with treatment.

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

Internet Treatment for Generalized Anxiety Disorder: A Randomized Controlled Trial Comparing Clinician vs. Technician Assistance

BACKGROUND: Internet-based cognitive behavioural therapy (iCBT) for generalized anxiety disorder (GAD) has been shown to be effective when guided by a clinician. The present study sought to replicate this finding, and determine whether support from a technician is as effective as guidance from a clinician. METHOD: Randomized controlled non-inferiority trial comparing three groups: Clinician-assisted vs. technician-assisted vs. delayed treatment. Community-based volunteers applied to the VirtualClinic (www.virtualclinic.org.au) research program and 150 participants with GAD were randomized. Participants in the clinician- and technician-assisted groups received access to an iCBT program for GAD comprising six online lessons, weekly homework assignments, and weekly supportive contact over a treatment period of 10 weeks. Participants in the clinician-assisted group also received access to a …

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

A multifaith spiritually based intervention for generalized anxiety disorder: a pilot randomized trial

This pilot trial evaluated the efficacy of a multifaith spiritually based intervention (SBI) for generalized anxiety disorder (GAD). Patients meeting DSM-IV criteria for GAD of at least moderate severity were randomized to either 12 sessions of the SBI (n=11) delivered by a spiritual care counselor or 12 sessions of psychologist-administered cognitive-behavioral therapy (CBT; n=11). Outcome measures were completed at baseline, post-treatment, and 3-month and 6-month follow-ups. Primary efficacy measures included the Hamilton Anxiety Rating Scale, Beck Anxiety Inventory, and Penn State Worry Questionnaire. Data analysis was performed on the intent-to-treat sample using the Last Observation Carried Forward method. Eighteen patients (82%) completed the study. The SBI produced robust and clinically significant reductions from baseline in psychic and somatic symptoms of GAD and was comparable…

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