Fear of judgement and avoidance of social exposure.
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Qurʾān
القرآن4 shownVerses named for this subject by hand come first. The rest are found by the subject’s own Arabic and English senses and are shown as lexical matches, not as anchors anyone has confirmed.
Qur'ān 33:37Arabic sense: تخشى الناس
وَإِذۡ تَقُولُ لِلَّذِيٓ أَنۡعَمَ ٱللَّهُ عَلَيۡهِ وَأَنۡعَمۡتَ عَلَيۡهِ أَمۡسِكۡ عَلَيۡكَ زَوۡجَكَ وَٱتَّقِ ٱللَّهَ وَتُخۡفِي فِي نَفۡسِكَ مَا ٱللَّهُ مُبۡدِيهِ وَتَخۡشَى ٱلنَّاسَ وَٱللَّهُ أَحَقُّ أَن تَخۡشَىٰهُۖ فَلَمَّا قَضَىٰ زَيۡدࣱ مِّنۡهَا وَطَرࣰ ا زَوَّجۡنَٰكَهَا لِكَيۡ لَا يَكُونَ عَلَى ٱلۡمُؤۡمِنِينَ حَرَجࣱ فِيٓ أَزۡوَٰجِ أَدۡعِيَآئِهِمۡ إِذَا قَضَوۡاْ مِنۡهُنَّ وَطَرࣰ اۚ وَكَانَ أَمۡرُ ٱللَّهِ مَفۡعُولࣰ ا
When you [Prophet] said to the man who had been favoured by God and by you, ‘Keep your wife and be mindful of God,’ you hid in your heart what God would later reveal: you were afraid of people, but it is more fitting that you fear God. When Zayd no longer wanted her, We gave her to you in marriage so that there might be no fault in believers marrying the wives of their adopted sons after they no longer wanted them. God’s command must be carried out
Qur'ān 4:77Arabic sense: يخشون الناس
أَلَمۡ تَرَ إِلَى ٱلَّذِينَ قِيلَ لَهُمۡ كُفُّوٓاْ أَيۡدِيَكُمۡ وَأَقِيمُواْ ٱلصَّلَوٰةَ وَءَاتُواْ ٱلزَّكَوٰةَ فَلَمَّا كُتِبَ عَلَيۡهِمُ ٱلۡقِتَالُ إِذَا فَرِيقࣱ مِّنۡهُمۡ يَخۡشَوۡنَ ٱلنَّاسَ كَخَشۡيَةِ ٱللَّهِ أَوۡ أَشَدَّ خَشۡيَةࣰۚ وَقَالُواْ رَبَّنَا لِمَ كَتَبۡتَ عَلَيۡنَا ٱلۡقِتَالَ لَوۡلَآ أَخَّرۡتَنَآ إِلَىٰٓ أَجَلࣲ قَرِيبࣲۗ قُلۡ مَتَٰعُ ٱلدُّنۡيَا قَلِيلࣱ وَٱلۡأٓخِرَةُ خَيۡرࣱ لِّمَنِ ٱتَّقَىٰ وَلَا تُظۡلَمُونَ فَتِيلًا
[Prophet], do you not see those who were told, ‘Restrain yourselves from fighting, perform the prayer, and pay the prescribed alms’? When fighting was ordained for them, some of them feared men as much as, or even more than, they feared God, saying, ‘Lord, why have You ordained fighting for us? If only You would give us just a little more time.’ Say to them, ‘Little is the enjoyment in this world, the Hereafter is far better for those who are mindful of God: you will not be wronged by as much as the fibre in a date stone
Qur'ān 2:150Arabic sense: لا تخشوهم
وَمِنۡ حَيۡثُ خَرَجۡتَ فَوَلِّ وَجۡهَكَ شَطۡرَ ٱلۡمَسۡجِدِ ٱلۡحَرَامِۚ وَحَيۡثُ مَا كُنتُمۡ فَوَلُّواْ وُجُوهَكُمۡ شَطۡرَهُۥ لِئَلَّا يَكُونَ لِلنَّاسِ عَلَيۡكُمۡ حُجَّةٌ إِلَّا ٱلَّذِينَ ظَلَمُواْ مِنۡهُمۡ فَلَا تَخۡشَوۡهُمۡ وَٱخۡشَوۡنِي وَلِأُتِمَّ نِعۡمَتِي عَلَيۡكُمۡ وَلَعَلَّكُمۡ تَهۡتَدُونَ
wherever you may have started out, turn your face in the direction of the Sacred Mosque; wherever any of you may be, turn your faces towards it, so that people may have no argument against you- except for the wrongdoers among them: do not fear them; fear Me- and so that I may perfect My favour on you and you may be guided
Qur'ān 5:3Arabic sense: لا تخشوهم
حُرِّمَتۡ عَلَيۡكُمُ ٱلۡمَيۡتَةُ وَٱلدَّمُ وَلَحۡمُ ٱلۡخِنزِيرِ وَمَآ أُهِلَّ لِغَيۡرِ ٱللَّهِ بِهِۦ وَٱلۡمُنۡخَنِقَةُ وَٱلۡمَوۡقُوذَةُ وَٱلۡمُتَرَدِّيَةُ وَٱلنَّطِيحَةُ وَمَآ أَكَلَ ٱلسَّبُعُ إِلَّا مَا ذَكَّيۡتُمۡ وَمَا ذُبِحَ عَلَى ٱلنُّصُبِ وَأَن تَسۡتَقۡسِمُواْ بِٱلۡأَزۡلَٰمِۚ ذَٰلِكُمۡ فِسۡقٌۗ ٱلۡيَوۡمَ يَئِسَ ٱلَّذِينَ كَفَرُواْ مِن دِينِكُمۡ فَلَا تَخۡشَوۡهُمۡ وَٱخۡشَوۡنِۚ ٱلۡيَوۡمَ أَكۡمَلۡتُ لَكُمۡ دِينَكُمۡ وَأَتۡمَمۡتُ عَلَيۡكُمۡ نِعۡمَتِي وَرَضِيتُ لَكُمُ ٱلۡإِسۡلَٰمَ دِينࣰ اۚ فَمَنِ ٱضۡطُرَّ فِي مَخۡمَصَةٍ غَيۡرَ مُتَجَانِفࣲ لِّإِثۡمࣲ فَإِنَّ ٱللَّهَ غَفُورࣱ رَّحِيمࣱ
You are forbidden to eat carrion; blood; pig’s meat; any animal over which any name other than God’s has been invoked; any animal strangled, or victim of a violent blow or a fall, or gored or savaged by a beast of prey, unless you still slaughter it [in the correct manner]; or anything sacrificed on idolatrous altars. You are also forbidden to allot shares [of meat] by drawing marked arrows -a heinous practice- today the disbelievers have lost all hope that you will give up your religion. Do not fear them: fear Me. Today I have perfected your religion for you, completed My blessing upon you, and chosen as your religion islam: [total devotion to God]; but if any of you is forced by hunger to eat forbidden food, with no intention of doing wrong, then God is most forgiving and merciful
Tafsīr
التفسير6 shownCommentary on the verses above, at most two editions per verse.
en-asbab-al-nuzul-by-al-wahidi on 4:77en-asbab-al-nuzul-by-al-wahidicommentary on an ayah this subject surfaced
(Hast thou not seen those unto whom it was said: Withhold your hands�) [4:77]. Said al-Kalbi: �This verse was revealed about some Companions of the Messenger of Allah, Allah bless him and give him peace, among whom were �Abd al-Rahman ibn �Awf, al-Miqdad ibn al-Aswad, Qudamah ibn Maz�un and Sa�d ibn Abi Waqqas. These Companions were subjected to a lot of harm from the idolaters. They used to say: �O Messenger of Allah, allow us to fight them�, but his answer was always: �Keep your hands off them, for I have not been commanded to fight them�. When the Messenger of Allah, Allah bless him and give him peace, migrated to Medina and Allah, exalted is He, commanded them to fight the idolaters, some of them disliked fighting and found it very hard. And so Allah, exalted is He, revealed this verse�. Sa�id ibn Muhammad ibn Ahmad al-�Adl informed us> Abu �Amr Hamdan> al-Hasan ibn Sufyan> Muhammad
en-asbab-al-nuzul-by-al-wahidi on 5:3en-asbab-al-nuzul-by-al-wahidicommentary on an ayah this subject surfaced
Forbidden to you are carrion and blood, the flesh of swine, that which has been offered up to other than God, the strangled, the beaten down, the fallen, the gored, what has been eaten by predators-except what you slaughter-what is sacrificed on stone alters, and that which you al- lot by divining arrows-that is ungodliness. Today those who disbelieve have despaired of your religion, so fear them not, and fear Me. Today I have perfected for you your religion and I have completed My blessings upon you, and I have approved for you the submission as a religion. Although carrion is vile and forbidden, a measure of it is still allowed at the time of constraint. Among the sorts of carrion is the flesh of a brother Muslim that is eaten by backbiting. In this there is never a concession in any state, whether by constraint or free choice. Hence this carrion is worse than that carrion, and its pro
en-al-jalalayn on 33:37en-al-jalalayncommentary on an ayah this subject surfaced
And when idh is dependent because of an implied preceding udhkur ‘mention when’ you said to him to whom God had shown favour by guiding him to Islam and to whom you too had shown favour by manumitting him — this was Zayd b. Hāritha who had been a prisoner of war before the coming of Islam in the period of al-jāhiliyya. The Messenger of God s purchased him before his call to prophethood and then manumitted him and adopted him as his son — ‘Retain your wife for yourself and fear God’ before divorcing her. But you had hidden in your heart what God was to disclose what He was to manifest of your love for her and of the fact that should Zayd part with her you would marry her and you feared people would say ‘He has married his son’s wife!’ though God is worthier that you should fear Him in all things so take her in marriage and do not be concerned with what people say. Zayd subsequently divorc
en-al-jalalayn on 4:77en-al-jalalayncommentary on an ayah this subject surfaced
Have you not seen those to whom it was said ‘Restrain your hands from fighting the disbelievers when they desired it at Mecca because of the harm the disbelievers had inflicted upon them — and these were a group from among the Companions — and establish the prayer and pay the alms’? Then as soon as fighting was prescribed was made obligatory for them lo a party of them fear people the disbelievers that is they fear punishment at their hands through death as they would fear the punishment of God or with more fear than their fear of Him ashadda ‘more’ is in the accusative because it is a circumstantial qualifier; the response to the lammā ‘as soon as’ is indicated by idhā ‘lo’ and what follows in other words they are taken aback by fear and they said frightened of death ‘Our Lord why have You prescribed fighting for us? Why not lawlā is to be understood as hallā defer us to a near term?’ S
en-tafisr-ibn-kathir on 33:37en-tafisr-ibn-kathircommentary on an ayah this subject surfaced
And (remember) when you said to him on whom Allah has bestowed grace and you have done a favor: "Keep your wife to yourself, and have Taqwa of Allah." But you did hide in yourself that which Allah will make manifest, you did fear the people whereas Allah had a better right that you should fear Him. So, when Zayd had completed his aim with her, We gave her to you in marriage, so that there may be no difficulty to the believers in respect of the wives of their adopted sons when the latter have no desire to keep them. And Allah's command must be fulfilled (37)
Allah's rebuke to His Messenger صلی اللہ علیہ وسلم and the Story of Zayd and Zaynab
Allah tells what His Prophet ﷺ said to his freed slave Zayd bin Harithah, may Allah be pleased with him, who was the one on whom Allah had bestowed grace, i.e., through Islam and following the Messenger ﷺ.
وَأَنْعَمْتَ عَلَيْهِ
(and you have done a
en-al-jalalayn on 2:150en-al-jalalayncommentary on an ayah this subject surfaced
From whatever place you issue turn your face towards the Sacred Mosque; and wherever you may be turn your faces towards it all of which is being repeated for emphasis so that there be not any argument from the people the Jews or the idolaters against you so that there be not any cause for contention regarding the change to a different direction of prayer. In this way their contentions against you will cease to exist both the contentions of the Jews when they say ‘He Muhammad (s) rejects our religion but follows our direction of prayer’ and of the idolaters when they say ‘He Muhammad (s) claims to follow the creed of Abraham but he contravenes his Abraham’s qibla’; excepting the evildoers among them acting in obstinacy who will say ‘He Muhammad (s) only changed to this direction because of his natural inclination towards the idolatrous religion of his forefathers’. The exceptive statement
Ḥadīth
الحديث6 shownSound narrations only, and never matched by text. A narration appears here because a compiler filed it under a chapter this subject maps to, or because someone read it and anchored it. Each row says which.
حَدَّثَنَا هَنَّادٌ، حَدَّثَنَا أَبُو مُعَاوِيَةَ، عَنِ الأَعْمَشِ، عَنْ أَبِي صَالِحٍ، عَنْ أَبِي هُرَيْرَةَ، قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم " وَالَّذِي نَفْسِي بِيَدِهِ لاَ تَدْخُلُوا الْجَنَّةَ حَتَّى تُؤْمِنُوا وَلاَ تُؤْمِنُوا حَتَّى تَحَابُّوا أَلاَ أَدُلُّكُمْ عَلَى أَمْرٍ إِذَا أَنْتُمْ فَعَلْتُمُوهُ تَحَابَبْتُمْ أَفْشُوا السَّلاَمَ بَيْنَكُمْ " . وَفِي الْبَابِ عَنْ عَبْدِ اللَّهِ بْنِ سَلاَمٍ وَشُرَيْحِ بْنِ هَانِئٍ عَنْ أَبِيهِ وَعَبْدِ اللَّهِ بْنِ عَمْرٍو وَالْبَرَاءِ وَأَنَسٍ وَابْنِ عُمَرَ . قَالَ أَبُو عِيسَى هَذَا حَدِيثٌ حَسَنٌ صَحِيحٌ .
Narrated Abu Hurairah:that the Messenger of Allah (ﷺ) said: "By the One in Whose Hand is my soul! You will not enter Paradise until you believe, and you will not believe until you love one another. Shall I inform you about a matter which if you do it, then you will love one another? Spread the Salam among each other
حَدَّثَنَا عَبْدُ اللَّهِ بْنُ عَبْدِ الرَّحْمَنِ، وَالْحُسَيْنُ بْنُ مُحَمَّدٍ الْحَرِيرِيُّ، بَلْخِيٌّ قَالاَ حَدَّثَنَا مُحَمَّدُ بْنُ كَثِيرٍ، عَنْ جَعْفَرِ بْنِ سُلَيْمَانَ الضُّبَعِيِّ، عَنْ عَوْفٍ، عَنْ أَبِي رَجَاءٍ، عَنْ عِمْرَانَ بْنِ حُصَيْنٍ، أَنَّ رَجُلاً، جَاءَ إِلَى النَّبِيِّ صلى الله عليه وسلم فَقَالَ السَّلاَمُ عَلَيْكُمْ . قَالَ قَالَ النَّبِيُّ صلى الله عليه وسلم " عَشْرٌ " . ثُمَّ جَاءَ آخَرُ فَقَالَ السَّلاَمُ عَلَيْكُمْ وَرَحْمَةُ اللَّهِ فَقَالَ النَّبِيُّ صلى الله عليه وسلم " عِشْرُونَ " . ثُمَّ جَاءَ آخَرُ فَقَالَ السَّلاَمُ عَلَيْكُمْ وَرَحْمَةُ اللَّهِ وَبَرَكَاتُهُ فَقَالَ النَّبِيُّ صلى الله عليه وسلم " ثَلاَثُونَ " . قَالَ أَبُو عِيسَى هَذَا حَدِيثٌ حَسَنٌ صَحِيحٌ غَرِيبٌ مِنْ هَذَا الْوَجْهِ . وَفِي الْبَابِ عَنْ عَلِيٍّ وَأَبِي سَعِيدٍ وَسَهْلِ بْنِ حُنَيْفٍ .
Narrated 'Imran bin Husain:"A man came to the Prophet (ﷺ) and said: 'As-Salamu 'Alaykum (Peace be upon you).'" [He said:] "So the Prophet (ﷺ) said: 'Ten.' Then another came and he said: 'As-Salamu 'Alaykum Wa Rahmatullah (Peace be upon you, and the mercy of Allah).' So the Prophet (ﷺ) said: 'Twenty.' Then another came and said: 'As-Salamu 'Alaykum Wa Rahmatullahi Wa Barakatuh (Peace be upon you, and the mercy of Allah, and His Blessings).' So the Prophet (ﷺ) said: 'Thirty
حَدَّثَنَا يَحْيَى بْنُ جَعْفَرٍ، حَدَّثَنَا عَبْدُ الرَّزَّاقِ، عَنْ مَعْمَرٍ، عَنْ هَمَّامٍ، عَنْ أَبِي هُرَيْرَةَ، عَنِ النَّبِيِّ صلى الله عليه وسلم قَالَ " خَلَقَ اللَّهُ آدَمَ عَلَى صُورَتِهِ، طُولُهُ سِتُّونَ ذِرَاعًا، فَلَمَّا خَلَقَهُ قَالَ اذْهَبْ فَسَلِّمْ عَلَى أُولَئِكَ النَّفَرِ مِنَ الْمَلاَئِكَةِ جُلُوسٌ، فَاسْتَمِعْ مَا يُحَيُّونَكَ، فَإِنَّهَا تَحِيَّتُكَ وَتَحِيَّةُ ذُرِّيَّتِكَ. فَقَالَ السَّلاَمُ عَلَيْكُمْ. فَقَالُوا السَّلاَمُ عَلَيْكَ وَرَحْمَةُ اللَّهِ. فَزَادُوهُ وَرَحْمَةُ اللَّهِ، فَكُلُّ مَنْ يَدْخُلُ الْجَنَّةَ عَلَى صُورَةِ آدَمَ، فَلَمْ يَزَلِ الْخَلْقُ يَنْقُصُ بَعْدُ حَتَّى الآنَ ".
Narrated Abu Huraira:The Prophet (ﷺ) said, "Allah created Adam in His picture, sixty cubits (about 30 meters) in height. When He created him, He said (to him), "Go and greet that group of angels sitting there, and listen what they will say in reply to you, for that will be your greeting and the greeting of your offspring." Adam (went and) said, 'As-Salamu alaikum (Peace be upon you).' They replied, 'AsSalamu-'Alaika wa Rahmatullah (Peace and Allah's Mercy be on you) So they increased 'Wa Rahmatullah' The Prophet (ﷺ) added 'So whoever will enter Paradise, will be of the shape and picture of Adam Since then the creation of Adam's (offspring) (i.e. stature of human beings is being diminished continuously) to the present time
حَدَّثَنَا أَبُو الْيَمَانِ، أَخْبَرَنَا شُعَيْبٌ، عَنِ الزُّهْرِيِّ، قَالَ أَخْبَرَنِي سُلَيْمَانُ بْنُ يَسَارٍ، أَخْبَرَنِي عَبْدُ اللَّهِ بْنُ عَبَّاسٍ ـ رضى الله عنهما ـ قَالَ أَرْدَفَ رَسُولُ اللَّهِ صلى الله عليه وسلم الْفَضْلَ بْنَ عَبَّاسٍ يَوْمَ النَّحْرِ خَلْفَهُ عَلَى عَجُزِ رَاحِلَتِهِ، وَكَانَ الْفَضْلُ رَجُلاً وَضِيئًا، فَوَقَفَ النَّبِيُّ صلى الله عليه وسلم لِلنَّاسِ يُفْتِيهِمْ، وَأَقْبَلَتِ امْرَأَةٌ مِنْ خَثْعَمَ وَضِيئَةٌ تَسْتَفْتِي رَسُولَ اللَّهِ صلى الله عليه وسلم فَطَفِقَ الْفَضْلُ يَنْظُرُ إِلَيْهَا، وَأَعْجَبَهُ حُسْنُهَا، فَالْتَفَتَ النَّبِيُّ صلى الله عليه وسلم يَنْظُرُ إِلَيْهَا، فَأَخْلَفَ بِيَدِهِ فَأَخَذَ بِذَقَنِ الْفَضْلِ، فَعَدَلَ وَجْهَهُ عَنِ النَّظَرِ إِلَيْهَا، فَقَالَتْ يَا رَسُولَ اللَّهِ إِنَّ فَرِيضَةَ اللَّهِ فِي الْحَجِّ عَلَى عِبَادِهِ أَدْرَكَتْ أَبِي شَيْخًا كَبِيرًا، لاَ يَسْتَطِيعُ أَنْ يَسْتَوِيَ عَلَى الرَّاحِلَةِ، فَهَلْ يَقْضِي عَنْهُ أَنْ أَحُجَّ عَنْهُ قَالَ " نَعَمْ ".
Narrated `Abdullah bin `Abbas:Al-Fadl bin `Abbas rode behind the Prophet (ﷺ) as his companion rider on the back portion of his she camel on the Day of Nahr (slaughtering of sacrifice, 10th Dhul-Hijja) and Al-Fadl was a handsome man. The Prophet (ﷺ) stopped to give the people verdicts. In the meantime, a beautiful woman From the tribe of Khath'am came, asking the verdict of Allah's Messenger (ﷺ). Al-Fadl started looking at her as her beauty attracted him. The Prophet (ﷺ) looked behind while Al-Fadl was looking at her; so the Prophet (ﷺ) held out his hand backwards and caught the chin of Al-Fadl and turned his face (to the owner sides in order that he should not gaze at her. She said, "O Allah's Messenger (ﷺ)! The obligation of Performing Hajj enjoined by Allah on His worshipers, has become due (compulsory) on my father who is an old man and who cannot sit firmly on the riding animal. Will it be sufficient that I perform Hajj on his behalf?" He said, "Yes
حَدَّثَنِي عُقْبَةُ بْنُ مُكْرَمٍ، حَدَّثَنَا أَبُو عَاصِمٍ، عَنِ ابْنِ جُرَيْجٍ، ح وَحَدَّثَنِي مُحَمَّدُ بْنُ، مَرْزُوقٍ حَدَّثَنَا رَوْحٌ، حَدَّثَنَا ابْنُ جُرَيْجٍ، أَخْبَرَنِي زِيَادٌ، أَنَّ ثَابِتًا، مَوْلَى عَبْدِ الرَّحْمَنِ بْنِ زَيْدٍ أَخْبَرَهُ أَنَّهُ، سَمِعَ أَبَا هُرَيْرَةَ، يَقُولُ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم " يُسَلِّمُ الرَّاكِبُ عَلَى الْمَاشِي وَالْمَاشِي عَلَى الْقَاعِدِ وَالْقَلِيلُ عَلَى الْكَثِيرِ " .
Abu Huraira reported Allah's Messenger (ﷺ) as saying:The rider should first greet the pedestrian, and the pedestrian the one who is seated and a small group should greet a larger group (with as-Salam-u-'Alaikum)
حَدَّثَنَا أَبُو بَكْرِ بْنُ أَبِي شَيْبَةَ، حَدَّثَنَا عَفَّانُ، حَدَّثَنَا عَبْدُ الْوَاحِدِ بْنُ زِيَادٍ، حَدَّثَنَا عُثْمَانُ بْنُ حَكِيمٍ، عَنْ إِسْحَاقَ بْنِ عَبْدِ اللَّهِ بْنِ أَبِي طَلْحَةَ، عَنْ أَبِيهِ، قَالَ قَالَ أَبُو طَلْحَةَ كُنَّا قُعُودًا بِالأَفْنِيَةِ نَتَحَدَّثُ فَجَاءَ رَسُولُ اللَّهِ صلى الله عليه وسلم فَقَامَ عَلَيْنَا فَقَالَ " مَا لَكُمْ وَلِمَجَالِسِ الصُّعُدَاتِ اجْتَنِبُوا مَجَالِسَ الصُّعُدَاتِ " . فَقُلْنَا إِنَّمَا قَعَدْنَا لِغَيْرِ مَا بَاسٍ قَعَدْنَا نَتَذَاكَرُ وَنَتَحَدَّثُ . قَالَ " إِمَّا لاَ فَأَدُّوا حَقَّهَا غَضُّ الْبَصَرِ وَرَدُّ السَّلاَمِ وَحُسْنُ الْكَلاَمِ " .
Abu Talha reported:While we were sitting in front of the houses and talking amongst ourselves, Allah's Messenger (ﷺ) happened to come there. He stood by us and said: What about you and your meetings on the paths? Avoid these meetings on the paths. We said: We were sitting here without (any intention of doing harm to the passers-by) ; we are sitting to discuss matters and to hold conversation amongst ourselves. Thereupon he said: If there is no help (for you but to sit on these paths), then give the paths their rights and these are lowering of the gaze, exchanging of greetings and good conversation
Research library, full list
151 to 175 of 487Effect of a Biofeedback Intervention on Heart Rate Variability in Individuals With Panic Disorder: A Randomized Controlled Trial.
Objective: Some individuals with panic disorder (PD) display reduced heart rate variability (HRV), which may result in an increased risk of cardiovascular mortality. Heart rate variability-biofeedback (HRV-BF) training has been shown to improve the modulation of the autonomic activity. Therefore, this randomized controlled trial was conducted to investigate the effect of a 4-week HRV-BF intervention in individuals with PD. HRV-BF training improved the modulation of the autonomic activity. Therefore, with this randomized controlled trial, we aimed to investigate the effect of a 4-week HRV-BF intervention in people with PD.
Methods: Thirty-six women and 16 men with PD (mean age = 35.85 [15.60] years) were randomly allocated either to HRV-BF with 0.1-Hz breathing as intervention group or to HRV-Sham-BF as active control group. HRV-BF was performed for 4 weeks, whereas HRV was measured both …
matched on Panic Disorder (mesh)
Neurocognitive processes in d-cycloserine augmented single-session exposure therapy for anxiety: A randomized placebo-controlled trial.
Drugs targeting N-methyl-d-aspartate (NMDA) receptors and the ability to learn new associations have been proposed as adjunct treatments to boost the success of exposure therapy for anxiety disorders. However, the effects of the NMDA partial agonist d-cycloserine on psychological treatment have been mixed. We investigated potential neurocognitive mechanisms underlying the clinical effects of d-cycloserine-augmented exposure, to inform the optimal combination of this and similar agents with psychological treatment. Panic disorder patients were randomised to single-dose d-cycloserine (250 mg; N = 17) or matching placebo (N = 16) 2hrs before one session of exposure therapy. Neurocognitive markers were assessed one day after treatment, including reaction-time based threat bias for fearful faces (primary outcome) and amygdala response to threat (secondary outcome). Clinical symptom severity w…
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Therapist-led and self-led one-session virtual reality exposure therapy for public speaking anxiety with consumer hardware and software: A randomized controlled trial.
Public speaking anxiety (PSA) is a common condition which can be treated effectively with exposure therapy. However, inherent difficulties in stimuli presentation and control limits dissemination and the therapeutic potential. Virtual Reality (VR) technology has the potential to resolve these issues and provide a scalable platform for self-help interventions. No previous study has examined whether this can be achieved using the first generation of consumer VR hardware and software. In the current trial, n = 25 + 25 participants were randomized to either one-session therapist-led VR exposure therapy for PSA followed by a four-week internet-administered VR to in-vivo transition program, or a waiting-list. Linear mixed effects modeling revealed significant, large (within Cohen's d = 1.67) decreases in self-reported PSA. The waiting-list was then given access to an internet-administered, sel…
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The influence of comorbid anxiety on the effectiveness of Cognitive Therapy and Interpersonal Psychotherapy for Major Depressive Disorder.
Background: Anxious depression is an important subtype of Major Depressive Disorder (MDD) defined by both syndromal (anxiety disorders) and dimensional (anxiety symptoms) criteria. A debated question is how anxiety affects MDD treatment. This study examined the impact of comorbid anxiety disorders and symptoms on the effectiveness of and dropout during Cognitive Therapy (CT) and Interpersonal Psychotherapy (IPT) for MDD.
Methods: Depressed individuals were randomized to CT (n = 76) or IPT (n = 75). Outcome was depression severity measured with the Beck Depression Inventory-II (BDI-II) at the start of each therapy session, post treatment, and monthly up to five months follow-up. Anxiety disorders were assessed with the Structured Clinical Interview for DSM-IV Axis I disorders, (phobic) anxiety symptoms were assessed with Brief Symptom Inventory subscales.
Results: Approximately one third …
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Medial prefrontal cortex stimulation accelerates therapy response of exposure therapy in acrophobia.
Background: Animal as well as human research indicated that the ventral medial prefrontal cortex (vmPFC) is highly relevant for fear extinction learning. Recently, we showed that targeting the vmPFC with high-frequency repetitive transcranial magnetic stimulation (rTMS) in a placebo-controlled study with 45 healthy controls induced higher prefrontal activity during extinction of conditioned stimuli (CS+) in the active compared to the sham stimulated group and better extinction learning as indicated by ratings, fear potentiated startles and skin conductance responses.
Objective: In this study, we aimed to proof our concept of accelerating extinction learning using rTMS of the mPFC in a group of anxiety disorder patients.
Methods: To specifically evaluate the impact of rTMS on exposure-based therapy, we applied a sham-controlled protocol over the vmPFC (FPz) succeeded by a virtual reality …
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The effect of neck-specific exercise with or without a behavioral approach on psychological factors in chronic whiplash-associated disorders: A randomized controlled trial with a 2-year follow-up.
Background: To investigate the effect of neck-specific exercise with (NSEB) or without (NSE) a behavioural approach and prescribed physical activity (PPA) on general pain disability and psychological factors in chronic whiplash-associated disorders (WAD), grade 2 and 3, with a 2-year follow-up.
Methods: A randomized controlled multi-centre study of 3 exercise interventions (NSE, NSEB or PPA) including a 2-year follow-up. A total of 216 volunteers with chronic WAD were recruited and 194 were analyzed, mean age 40.4 (Standard Deviation [SD] 11.4). Measures of general pain disability, pain catastrophizing, anxiety and depression, and kinesiophobia were evaluated at baseline, and 3, 6, 12 and 24 months with linear mixed models.
Results: General pain disability decreased by 28% in the NSEB group from baseline to 3 months (P < 0.001) and the improvements in disability were maintained over time…
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Feldman JM, Matte L, Interian A, Lehrer PM, Lu SE, Scheckner B, Steinberg DM, Oken T, Kotay A, Sinha S, Shim C (2016)randomised controlled trialMEDLINE-indexed journal, not yet read by usBehaviour research and therapy32 citations Psychological treatment of comorbid asthma and panic disorder in Latino adults: Results from a randomized controlled trial.
Confusion between panic and asthma symptoms can result in serious self-management errors. A cognitive behavior psychophysiological therapy (CBPT) intervention was culturally adapted for Latinos consisting of CBT for panic disorder (PD), asthma education, differentiation between panic and asthma symptoms, and heart rate variability biofeedback. An RCT compared CBPT to music and relaxation therapy (MRT), which included listening to relaxing music and paced breathing at resting respiration rates. Fifty-three Latino (primarily Puerto Rican) adults with asthma and PD were randomly assigned to CBPT or MRT for 8 weekly sessions. Both groups showed improvements in PD severity, asthma control, and several other anxiety and asthma outcome measures from baseline to post-treatment and 3-month follow-up. CBPT showed an advantage over MRT for improvement in adherence to inhaled corticosteroids. Improv…
matched on Panic Disorder (mesh)
Rothbaum BO, Price M, Jovanovic T, Norrholm SD, Gerardi M, Dunlop B, Davis M, Bradley B, Duncan EJ, Rizzo A, Ressler KJ (2014)randomised controlled trialMEDLINE-indexed journal, not yet read by usThe American journal of psychiatry245 citations A randomized, double-blind evaluation of D-cycloserine or alprazolam combined with virtual reality exposure therapy for posttraumatic stress disorder in Iraq and Afghanistan War veterans.
Objective: The authors examined the effectiveness of virtual reality exposure augmented with D-cycloserine or alprazolam, compared with placebo, in reducing posttraumatic stress disorder (PTSD) due to military trauma.
Method: After an introductory session, five sessions of virtual reality exposure were augmented with D-cycloserine (50 mg) or alprazolam (0.25 mg) in a double-blind, placebo-controlled randomized clinical trial for 156 Iraq and Afghanistan war veterans with PTSD.
Results: PTSD symptoms significantly improved from pre- to posttreatment across all conditions and were maintained at 3, 6, and 12 months. There were no overall differences in symptoms between D-cycloserine and placebo at any time. Alprazolam and placebo differed significantly on the Clinician-Administered PTSD Scale score at posttreatment and PTSD diagnosis at 3 months posttreatment; the alprazolam group showed a …
matched on Virtual Reality Exposure Therapy (mesh)
Embodied terror management: interpersonal touch alleviates existential concerns among individuals with low self-esteem.
Individuals with low (rather than high) self-esteem often struggle with existential concerns. In the present research, we examined whether these existential concerns may be alleviated by seemingly trivial experiences of both real and simulated interpersonal touch. A brief touch on the shoulder by a female experimenter led individuals with low self-esteem to experience less death anxiety (Study 1) and more social connectedness after a death reminder (Study 2). Reminding individuals with low self-esteem of death increased their desire for touch, as indicated by higher value estimates of a teddy bear, a toy animal that simulates interpersonal touch (Study 3). Finally, holding a teddy bear (vs. a cardboard box) led individuals with low self-esteem to respond to a death reminder with less defensive ethnocentrism (Study 4). Individuals with high self-esteem were unaffected by touch (Studies 1-…
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Soravia LM, Heinrichs M, Winzeler L, Fisler M, Schmitt W, Horn H, Dierks T, Strik W, Hofmann SG, de Quervain DJ (2014)randomised controlled trialMEDLINE-indexed journal, not yet read by usDepression and anxiety78 citations Glucocorticoids enhance in vivo exposure-based therapy of spider phobia.
Background: Preclinical and clinical studies indicate that the administration of glucocorticoids may promote fear extinction processes. In particular, it has been shown that glucocorticoids enhance virtual reality based exposure therapy of fear of heights. Here, we investigate whether glucocorticoids enhance the outcome of in vivo exposure-based group therapy of spider phobia.
Methods: In a double blind, block-randomized, placebo-controlled, between-subject study design, 22 patients with specific phobia of spiders were treated with two sessions of in vivo exposure-based group therapy. Cortisol (20 mg) or placebo was orally administered 1 hr before each therapy session. Patients returned for a follow-up assessment one month after therapy.
Results: Exposure-based group therapy led to a significant decrease in phobic symptoms as assessed with the Fear of Spiders Questionnaire (FSQ) from pre…
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Collaborative care for depression and anxiety disorders in patients with recent cardiac events: the Management of Sadness and Anxiety in Cardiology (MOSAIC) randomized clinical trial.
Importance: Depression and anxiety are associated with adverse cardiovascular outcomes in patients with recent acute cardiac events. There has been minimal study of collaborative care (CC) management models for mental health disorders in high-risk cardiac inpatients, and no prior CC intervention has simultaneously managed depression and anxiety disorders.
Objective: To determine the impact of a low-intensity CC intervention for depression, generalized anxiety disorder, and panic disorder among patients hospitalized for an acute cardiac illness.
Design, setting, and participants: Single-blind randomized clinical trial, with study assessors blind to group assignment, from September 2010 through July 2013 of 183 patients admitted to inpatient cardiac units in an urban academic general hospital for acute coronary syndrome, arrhythmia, or heart failure and found to have clinical depression, g…
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Gaggioli A, Pallavicini F, Morganti L, Serino S, Scaratti C, Briguglio M, Crifaci G, Vetrano N, Giulintano A, Bernava G, Tartarisco G, Pioggia G, Raspelli S, Cipresso P, Vigna C, Grassi A, Baruffi M, Wiederhold B, Riva G (2014)randomised controlled trialMEDLINE-indexed journal, not yet read by usJournal of medical Internet research68 citations Experiential virtual scenarios with real-time monitoring (interreality) for the management of psychological stress: a block randomized controlled trial.
Background: The recent convergence between technology and medicine is offering innovative methods and tools for behavioral health care. Among these, an emerging approach is the use of virtual reality (VR) within exposure-based protocols for anxiety disorders, and in particular posttraumatic stress disorder. However, no systematically tested VR protocols are available for the management of psychological stress.
Objective: Our goal was to evaluate the efficacy of a new technological paradigm, Interreality, for the management and prevention of psychological stress. The main feature of Interreality is a twofold link between the virtual and the real world achieved through experiential virtual scenarios (fully controlled by the therapist, used to learn coping skills and improve self-efficacy) with real-time monitoring and support (identifying critical situations and assessing clinical change) …
matched on Virtual Reality Exposure Therapy (mesh)
Butow PN, Bell ML, Smith AB, Fardell JE, Thewes B, Turner J, Gilchrist J, Beith J, Girgis A, Sharpe L, Shih S, Mihalopoulos C, members of the Conquer Fear Authorship Group (2013)randomised controlled trialMEDLINE-indexed journal, not yet read by usBMC cancer86 citations Conquer fear: protocol of a randomised controlled trial of a psychological intervention to reduce fear of cancer recurrence.
Background: Up to 70% of cancer survivors report clinically significant levels of fear of cancer recurrence (FCR). Despite the known negative impact of FCR on psychological wellbeing and quality of life, little research has investigated interventions for high FCR. Our team has developed and piloted a novel intervention (Conquer Fear) based on the Self-Regulatory Executive Function Model and Relational Frame Theory and is evaluating Conquer Fear in a randomised controlled trial (RCT). We aim to compare the efficacy and cost-efficacy of the Conquer Fear Intervention and relaxation training in reducing the impact of FCR.
Methods/design: This study is a multi-centre RCT with 260 participants randomised either to the Conquer Fear Intervention or relaxation training. Both interventions will be delivered in five sessions over 10 weeks by trained psychologists, psychiatrists and social workers w…
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Effectiveness of cognitive behavioral therapy supported by virtual reality in the treatment of body image in eating disorders: one year follow-up.
Body image disturbance is a significant maintenance and prognosis factor in eating disorders. Hence, existing eating disorder treatments can benefit from direct intervention in patients' body image. No controlled studies have yet compared eating disorder treatments with and without a treatment component centered on body image. This paper includes a controlled study comparing Cognitive Behavioral Treatment (CBT) for eating disorders with and without a component for body image treatment using Virtual Reality techniques. Thirty-four participants diagnosed with eating disorders were evaluated and treated. The clinical improvement was analyzed from statistical and clinical points of view. Results showed that the patients who received the component for body image treatment improved more than the group without this component. Furthermore, improvement was maintained in post-treatment and at one …
matched on Virtual Reality Exposure Therapy (mesh)
Motor learning, retention and transfer after virtual-reality-based training in Parkinson's disease--effect of motor and cognitive demands of games: a longitudinal, controlled clinical study.
Objectives: To evaluate the learning, retention and transfer of performance improvements after Nintendo Wii Fit™ training in patients with Parkinson's disease and healthy elderly people.
Design: Longitudinal, controlled clinical study.
Participants: Sixteen patients with early-stage Parkinson's disease and 11 healthy elderly people.
Interventions: Warm-up exercises and Wii Fit training that involved training motor (shifts centre of gravity and step alternation) and cognitive skills. A follow-up evaluative Wii Fit session was held 60 days after the end of training. Participants performed a functional reach test before and after training as a measure of learning transfer.
Main outcome measures: Learning and retention were determined based on the scores of 10 Wii Fit games over eight sessions. Transfer of learning was assessed after training using the functional reach test.
Results: Patient…
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Reduced risk-taking behavior as a trait feature of anxiety.
Affect can have a significant influence on decision-making processes and subsequent choice. One particularly relevant type of negative affect is anxiety, which serves to enhance responses to threatening stimuli or situations. In its exaggerated form, it can lead to psychiatric disorders, with detrimental consequences for quality of life, including the ability to make choices. This study investigated, for the first time, how pathological anxiety affects risk-taking behavior. In this study, 20 anxious participants meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for either generalized anxiety disorder (n = 10) and for panic attack disorder (n = 10), as well as 20 matched nonanxious controls, performed a gambling task. To investigate the tendency toward either a risk-seeking or a risk-averse behavior, we employed a task that did not allow for learning …
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Wong QJ, Moulds ML (2012)randomised controlled trialMEDLINE-indexed journal, not yet read by usJournal of behavior therapy and experimental psychiatry14 citations Processing mode during repetitive thinking in socially anxious individuals: evidence for a maladaptive experiential mode.
Background and objectives: Evidence from the depression literature suggests that an analytical processing mode adopted during repetitive thinking leads to maladaptive outcomes relative to an experiential processing mode. To date, in socially anxious individuals, the impact of processing mode during repetitive thinking related to an actual social-evaluative situation has not been investigated. We thus tested whether an analytical processing mode would be maladaptive relative to an experiential processing mode during anticipatory processing and post-event rumination.
Methods: High and low socially anxious participants were induced to engage in either an analytical or experiential processing mode during: (a) anticipatory processing before performing a speech (Experiment 1; N = 94), or (b) post-event rumination after performing a speech (Experiment 2; N = 74). Mood, cognition, and behavioura…
matched on Phobic Disorders (mesh)
The COMTval158met polymorphism is associated with symptom relief during exposure-based cognitive-behavioral treatment in panic disorder.
Background: Cognitive behavioral therapy (CBT) represents a learning process leading to symptom relief and resulting in long-term changes in behavior. CBT for panic disorder is based on exposure and exposure-based processes can be studied in the laboratory as extinction of experimentally acquired fear responses. We have recently demonstrated that the ability to extinguish learned fear responses is associated with a functional genetic polymorphism (COMTval158met) in the COMT gene and this study was aimed at transferring the experimental results on the COMTval158met polymorphism on extinction into a clinical setting.
Methods: We tested a possible effect of the COMTval158met polymorphism on the efficacy of CBT, in particular exposure-based treatment modules, in a sample of 69 panic disorder patients.
Results: We present evidence that panic patients with the COMTval158met met/met genotype ma…
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Hirshfeld-Becker DR, Masek B, Henin A, Blakely LR, Pollock-Wurman RA, McQuade J, DePetrillo L, Briesch J, Ollendick TH, Rosenbaum JF, Biederman J (2010)randomised controlled trialMEDLINE-indexed journal, not yet read by usJournal of consulting and clinical psychology114 citations Cognitive behavioral therapy for 4- to 7-year-old children with anxiety disorders: a randomized clinical trial.
Objective: To examine the efficacy of a developmentally appropriate parent-child cognitive behavioral therapy (CBT) protocol for anxiety disorders in children ages 4-7 years.
Method:
Design: Randomized wait-list controlled trial. Conduct: Sixty-four children (53% female, mean age 5.4 years, 80% European American) with anxiety disorders were randomized to a parent-child CBT intervention (n = 34) or a 6-month wait-list condition (n = 30). Children were assessed by interviewers blind to treatment assignment, using structured diagnostic interviews with parents, laboratory assessments of behavioral inhibition, and parent questionnaires.
Analysis: Chi-square analyses of outcome rates and linear and ordinal regression of repeated measures, examining time by intervention interactions.
Results: The response rate (much or very much improved on the Clinical Global Impression Scale for Anxiety) amon…
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Otto MW, Tolin DF, Simon NM, Pearlson GD, Basden S, Meunier SA, Hofmann SG, Eisenmenger K, Krystal JH, Pollack MH (2010)randomised controlled trialMEDLINE-indexed journal, not yet read by usBiological psychiatry164 citations Efficacy of d-cycloserine for enhancing response to cognitive-behavior therapy for panic disorder.
Background: Traditional combination strategies of cognitive-behavior therapy plus pharmacotherapy have met with disappointing results for anxiety disorders. Enhancement of cognitive-behavior therapy with d-cycloserine (DCS) pharmacotherapy represents a novel strategy for improving therapeutic learning from cognitive-behavior therapy that remains untested in panic disorder.
Method: This is a randomized, double-blind, placebo-controlled augmentation trial examining the addition of isolated doses of 50 mg d-cycloserine or pill placebo to brief exposure-based cognitive-behavior therapy. Randomized participants were 31 outpatients meeting DSM-IV criteria for panic disorder with or without agoraphobia, who were offered five sessions of manualized cognitive-behavior therapy emphasizing exposure to feared internal sensations (interoceptive exposure) but also including informational, cognitive, a…
matched on Panic Disorder (mesh)
Virtual reality cognitive behavior therapy for public speaking anxiety: a randomized clinical trial.
Public speaking anxiety (PSA) is a common phobia. Although cognitive behavior therapy (CBT) is preferred, difficulties arise with the exposure component (lack of therapist control, patient's inability to imagine, self-flooding, loss of confidentiality resulting from public exposure). Virtual reality CBT (VRCBT) enables a high degree of therapist control, thus overcoming these difficulties. This study examined whether VRCBT is an alternative to CBT. Participants with PSA were randomly assigned to VRCBT (28 participants), CBT (30 participants), and wait list control (WLC; 30 participants). VRCBT and CBT were significantly more effective than WLC in anxiety reduction on four of five anxiety measures, and on subject's self-rating of anxiety during a behavioral task. No significant differences were found on observer ratings of the behavioral task. However, twice as many participants dropped o…
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Feedback of end-tidal pCO2 as a therapeutic approach for panic disorder.
Background: Given growing evidence that respiratory dysregulation is a central feature of panic disorder (PD) interventions for panic that specifically target respiratory functions could prove clinically useful and scientifically informative. We tested the effectiveness of a new, brief, capnometry-assisted breathing therapy (BRT) on clinical and respiratory measures in PD.
Methods: Thirty-seven participants with PD with or without agoraphobia were randomly assigned to BRT or to a delayed-treatment control group. Clinical status, respiration rate, and end-tidal pCO(2) were assessed at baseline, post-treatment, 2-month and 12-month follow-up. Respiratory measures were also assessed during homework exercises using a portable capnometer as a feedback device.
Results: Significant improvements (in PD severity, agoraphobic avoidance, anxiety sensitivity, disability, and respiratory measures) we…
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Arntz A, Tiesema M, Kindt M (2007)randomised controlled trialMEDLINE-indexed journal, not yet read by usJournal of behavior therapy and experimental psychiatry121 citations Treatment of PTSD: a comparison of imaginal exposure with and without imagery rescripting.
We tested whether the effectiveness of imaginal exposure (IE) treatment for posttraumatic stress disorder (PTSD) was enhanced by combining IE with imagery rescripting (IE+IR). It was hypothesized that IE+IR would be more effective than IE by (1) providing more corrective information so that more trauma-related problems can be addressed, and (2) allowing patients to express emotions that they had been inhibiting, such as anger. In a controlled study 71 chronic PTSD patients were randomly assigned to IE or IE+IR. Data of 67 patients were available. Treatment consisted of 10 weekly individual therapy sessions and treatment evaluation was conducted post-treatment and at 1-month follow-up. Results show that when compared with wait-list, treatment reduced severity of PTSD symptoms. More patients dropped out of IE than out of IE+IR before the 8th sessions, 51% vs. 25%, p=.03. Completers and int…
matched on Phobic Disorders (mesh)
Symptom provocation and reduction in patients suffering from spider phobia: an fMRI study on exposure therapy.
Neurofunctional mechanisms underlying cognitive behavior therapy (CBT) are still not clearly understood. This functional magnetic resonance imaging (fMRI) study focused on changes in brain activation as a result of one-session CBT in patients suffering from spider phobia. Twenty-six female spider phobics and 25 non-phobic subjects were presented with spider pictures, generally disgust-inducing, generally fear-inducing and affectively neutral scenes in an initial fMRI session. Afterwards, the patients were randomly assigned to either a therapy group (TG) or a waiting list group (WG). The scans were repeated one week after the treatment or after a one-week waiting period. Relative to the non-phobic participants, the patients displayed increased activation in the amygdala and the fusiform gyrus as well as decreased activation in the medial orbitofrontal cortex (OFC) during the first exposur…
matched on Phobic Disorders (mesh)
Sleep-related problems among children and adolescents with anxiety disorders.
Objective: The present study examined sleep-related problems (SRPs) among a large sample (n = 128) of youth with anxiety disorders (i.e., generalized, separation, and social). The frequency of eight specific SRPs was examined in relation to age, gender, type of anxiety disorder, anxiety severity, and functional impairment. The impact of pharmacological treatment (fluvoxamine versus pill placebo) in reducing SRPs also was examined.
Method: As part of a large, double-blind, randomized, controlled trial (Research Units on Pediatric Psychopharmacology Anxiety Study Group), clinician and parent reports of SRPs were examined among children and adolescents, ages 6 to 17 years, before and after treatment.
Results: Eighty-eight percent of youth experienced at least one SRP, and a majority (55%) experienced three or more. Total SRPs were positively associated with anxiety severity and interference…
matched on Phobic Disorders (mesh)