Anxiety Disorders

Tipos de ansiedad frente a la donación hipotética de embriones para investigación. Una aproximación desde la perspectiva de género

by Jorge Alberto Álvarez-Díaz

Contextual factors and anxiety in minority and European American youth presenting for treatment across two urban university clinics

by Rinad Beidas

Further research needed: A comment on Coyne and van Sonderen's call to abandon the Hospital Anxiety and Depression Scale

by Sam Norton

S Norton, A Sacker, J Done. Journal of Psychosomatic Research, in press

The Angry Spotlight: Trait Anger and Selective Visual Attention to Rewards

by Stephanie Gagnon

Ford, B.Q., Tamir, M.A., Gagnon, S.A., Taylor, H.A., & Brunye, T.T. (in press). European Journal of Personality.

This investigation examined links between trait anger and selective attention to threats and rewards. Existing... more This investigation examined links between trait anger and selective attention to threats and rewards. Existing research has focused mainly on trait anxiety and is equally consistent with several competing theoretical accounts of trait emotion and visual attention. Both valence-based and motivation-based accounts predict that trait anxiety would be associated with biased attention toward threats. In contrast, a valence-based account predicts that trait anger would be associated with biased attention toward threats, whereas a motivation-based account predicts that it would be associated with biased attention toward rewards. To test these predictions, we measured trait anxiety, trait anger and selective attention to threats and rewards. Consistent with a motivation-based account, we found that trait anger was associated with selective attention toward rewarding but not threatening information, whereas trait anxiety was associated with selective attention toward threatening but not rewarding information. Copyright © 2012 John Wiley & Sons, Ltd.

Training School Mental Health Providers to Deliver Cognitive-Behavioral Therapy

by Rinad Beidas

Trait Anxiety and Fear Responses to Safety Cues: Stimulus Generalization or Sensitization?

by Anneke Haddad

Haddad, A. D. M., Pritchett, D., Lissek, S., & Lau, J. Y. F. (2012). Trait Anxiety and Fear Responses to Safety Cues: Stimulus Generalization or Sensitization?. Journal of Psychopathology and Behavioral Assessment, 1-9.

Abnormal fear responding to threat cues may contribute to the aetiology and maintenance of persistent fears and... more Abnormal fear responding to threat cues may contribute to the aetiology and maintenance of persistent fears and pathological anxiety. Chronic anxiety may also involve abnormal fear responding to ‘safety’ cues, which do not signal danger. Yet investigations of fear responding to acquired safety cues are scarce and the basis of such responding remains unclear. Moreover, previous studies do not distinguish between stimulus generalization (an associative mechanism based on perceptual similarity between threat and safety cues) and sensitization (a non-associative mechanism whereby fear responses to any novel, intense, or fear-related stimulus are temporarily elevated). This study investigated responses to acquired safety cues in volunteers with varying trait anxiety, using a novel fear conditioning paradigm designed to distinguish between effects of trait anxiety on generalization and sensitization. The paradigm used three conditioned stimuli: a threat cue (CS+) and two safety cues (CS−), one perceptually similar to the CS+ and one perceptually dissimilar. Conditioned fear to these cues was indexed by fear potentiation of the startle blink reflex, skin conductance responses, and self-report. To examine how trait anxiety moderated responses to safety cues, participants were divided into high and low trait anxiety subgroups. Startle, skin conductance, and self-reported fear measures indicated that generalization of fear occurred for the safety cue which resembled the threat cue, but not for the perceptually dissimilar safety cue, consistent with the stimulus generalization hypothesis. There was some evidence that stimulus generalization was exaggerated in anxious individuals. The current study sheds light on the mechanism by which fear responses to safety cues arise in healthy individuals, and offers some insight into the influence of this mechanism in chronic anxiety.

How does attention training work in social phobia: Disengagement from threat or re-engagement to non-threat?

by Alexandre Heeren

Heeren, A., Lievens, L., & Philippot, P. (2011). How does attention training work in social phobia: Disengagement from threat or reengagement to non-threat? Journal of Anxiety Disorders, 25, 1108-1115.

Attention Training Toward and Away from Threat in Social Phobia: Effects on Subjective, Behavioral, and Physiological Measures of Anxiety

by Alexandre Heeren

Heeren, A., Reese, H., McNally, R. J., & Philippot, P. (2012). Atttention training toward and away from threat in social phohia: Effects on behavioral, subjective, and physiological measures of anxiety. Behaviour Research and Therapy, 50, 30-39

Richtlijn Angststoornissen en verslaving [Guideline Anxiety Disorders and Addiction]

by Anke Snoek

Snoek, Anke, Elske Wits, and Wim Meulders. "Richtlijn Middelenmisbruik of -Afhankelijkheid En Angststoornissen. Addendum Bij De Mdr Angststoornissen." Amersfoort/Rotterdam: Resultaten Scoren/IVO, 2012.

Aim: Many people with substance abuse or dependency suffer from anxiety disorders, and vice versa. Appropriate... more Aim: Many people with substance abuse or dependency suffer from anxiety disorders, and vice versa. Appropriate guidelines for the treatment of co-morbid anxiety disorders and substance abuse disorders are lacking. In 2003 (revised 2009) a guideline for the treatment of anxiety disorders was developed. The project aimed to develop an addendum to this guideline for people with a co-morbid substance abuse disorder.

Method: The guideline was constructed according to the Masterprotocol that has been developed by IVO within the  Scoring Results‟ program. The draft-guideline has been tested in two addiction care facilities.

Results: A treatment guideline. Focus will be on
an integrated approach, in which the complexity of the issue is handled by different stakeholders working together.

The Effect of Symptom Visibility on Informant Reporting

by Elizabeth McDade-Montez

Examining the Potential Influence of Diabetes on Depression and Anxiety Symptoms via Multiple Sample Confirmatory Factor Analysis

by Elizabeth McDade-Montez

Panic disorder and cardiovascular/cerebrovascular problems

by Jeffrey Kahn, M.D.

Am J Psychiatry. 1990 Nov;147(11):1504-8.

Panic disorder and cardiovascular/cerebrovascular problems:... more Am J Psychiatry. 1990 Nov;147(11):1504-8.

Panic disorder and cardiovascular/cerebrovascular problems: results from a community survey.

Weissman MM, Markowitz JS, Ouellette R, Greenwald S, Kahn JP.


Source

Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY.


Abstract

Follow-up studies of psychiatric patients with panic disorder have shown an abnormally high mortality rate in men due to cardiovascular and cerebrovascular events. The authors report that in the New Haven portion of the Epidemiologic Catchment Area program the risk for stroke in persons with lifetime diagnoses of panic disorder was over twice that in persons with other psychiatric disorders or no psychiatric disorder. After adjustments for demographic differences between groups, the risk was even higher. While the results should be interpreted cautiously because of the small sample and absence of medical examinations, these findings are consistent with clinical studies showing an association between panic disorder and cardiovascular/cerebrovascular events.

Idiopathic cardiomyopathy and panic disorder: Clinical association in cardiac transplant candidates.

by Jeffrey Kahn, M.D.

Am J Psychiatry. 1987 Oct;144(10):1327-30. Idiopathic cardiomyopathy and panic disorder: clinical association in cardiac transplant candidates. Kahn JP, Drusin RE, Klein DF. Source: Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY.

Patients under evaluation for cardiac transplant surgery were seen for routine psychiatric diagnosis and treatment. Of... more Patients under evaluation for cardiac transplant surgery were seen for routine psychiatric diagnosis and treatment. Of 35 patients with idiopathic cardiomyopathy, 83% (N = 29) had definite or probable panic disorder. Of 25 patients with postinfarction cardiac failure, rheumatic heart disease, or congenital heart disease, only 16% (N = 4) had definite or probable panic disorder. The authors suggest that autonomic mechanisms may underlie the association of cardiomyopathy and panic disorder and that increased cardiac sympathetic tone or circulating catecholamines may cause myocarditis and cardiomyopathy.

Adjunctive alprazolam for schizophrenia with panic anxiety: Clinical observation and pathogenetic implications.

by Jeffrey Kahn, M.D.

Am J Psychiatry. 1988 Jun;145(6):742-4. Adjunctive alprazolam for schizophrenia with panic anxiety: clinical observation and pathogenetic implications. Kahn JP, Puertollano MA, Schane MD, Klein DF. Source: Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032.

Abstract

Seven patients with schizophrenia and panic attacks all showed marked improvement of positive... more Abstract

Seven patients with schizophrenia and panic attacks all showed marked improvement of positive and negative schizophrenic symptoms when alprazolam was openly added to antipsychotic medication. Panic attacks may identify alprazolam-responsive schizophrenic patients and may define a distinct pathophysiologic subgroup.

Cardiac left ventricular hypertrophy and chamber dilatation in panic disorder patients: implications for idiopathic dilated cardiomyopathy

by Jeffrey Kahn, M.D.

Psychiatry Res. 1990 Apr;32(1):55-61. Cardiac left ventricular hypertrophy and chamber dilatation in panic disorder patients: implications for idiopathic dilated cardiomyopathy. Kahn JP, Gorman JM, King DL, Fyer AJ, Liebowitz MR, Klein DF. Source: College of Physicians and Surgeons, Columbia University, New York, NY.

Abstract: Echocardiographic comparison of 35 panic disorder patients to 35 normal control subjects found subclinical... more Abstract: Echocardiographic comparison of 35 panic disorder patients to 35 normal control subjects found subclinical increases of cardiac left ventricular chamber size in eight panic patients (and one control subject), and of left ventricular mass (corrected for body surface area) in seven panic patients. There was a significantly greater variance of left heart chamber size and corrected mass in panic patients compared with control subjects, without significant group mean differences. Consistent with a previously reported association of panic anxiety and idiopathic dilated cardiomyopathy, this study suggests that some healthy panic patients may have subclinical myocardial changes.

El estrés y su psicoherbología: investigación contemporánea

by Carlos Manuel Quirce Balma

The present paper has attempted a unification of the history of stress with the psychoherbology
that has been... more The present paper has attempted a unification of the history of stress with the psychoherbology
that has been used in Costa Rican folklore for decades for the purpose of healing the various
manifestations of distress. These manifestations have been differentiated in the categories of
anxiety, depression, idiopathic type pain and psychotic like symptomatology, with the purpose
of indicating the diverse herbal profiles that are commonly used to treat them. The various
techniques involved in measuring stress dysfunctions and the effect of curative herbs upon
them, have been discussed in the context of animal model experimentation.

What Ecology Really Means

by Tim Morton

Published in Bare Essentials magazine (Australia), May 2012.

Ecology doesn't mean feeling part of something bigger. Ecology doesn't mean feeling part of something bigger.

Carbon dioxide induction of panic anxiety in schizophrenia with auditory hallucinations

by Jeffrey Kahn, M.D.

Psychiatry Res. 2011 Aug 30;189(1):38-42. Epub 2011 Jun 29.

Carbon dioxide induction of panic anxiety in... more Psychiatry Res. 2011 Aug 30;189(1):38-42. Epub 2011 Jun 29.

Carbon dioxide induction of panic anxiety in schizophrenia with auditory hallucinations.

Savitz AJ, Kahn TA, McGovern KE, Kahn JP.


Source

Department of Psychiarty, Weill Cornell Medical College, White Plains, NY 10605, USA.


Abstract

Panic is commonly co-morbid with schizophrenia. Panic may emerge prodromally, contribute to specific psychotic symptoms, and predict medication response. Panic is often missed due to agitation, impaired cognition, psychotic symptom overlap and limited clinician awareness. Carbon dioxide exposure has been used reliably to induce panic in non-psychotic panic subjects, but has not been systematically studied in schizophrenia. Eight inpatients with schizophrenia, recent auditory hallucinations, none preselected for panic, all on antipsychotic medication, received a structured Panic and Schizophrenia Interview (PaSI), assessing DSM-IV panic symptoms concurrent with paroxysmal auditory hallucinations. On that interview, all eight subjects reported panic concurrent with auditory hallucinations. At one sitting, subjects were exposed, in random order, to 35% carbon dioxide and to placebo room air, blinded to condition. All subjects experienced panic to carbon dioxide, one with limited symptoms. Only one subject panicked to placebo. One subject (one of only two without antipanic medication) had paroxysmal voices concurrent with induced panic. With added adjunctive clonazepam, that patient had marked clinical improvement and no response to carbon dioxide re-challenge. This first systematic examination offers preliminary evidence that carbon dioxide safely induces panic symptoms in schizophrenia. Panic may be prevalent and pathophysiologically significant in schizophrenia with auditory hallucinations.

Treatment of Comorbid Panic Disorder and Schizophrenia: Evidence for a Panic Psychosis

by Jeffrey Kahn, M.D.

Treatment of Comorbid Panic Disorder and Schizophrenia:
Evidence for a Panic Psychosis
Jeffrey P. Kahn, MD; and John R. Meyers, MD

Why is it important to consider comorbid
panic disorder in schizophrenia?
After all, schizophrenia wreaks... more Why is it important to consider comorbid
panic disorder in schizophrenia?
After all, schizophrenia wreaks such
devastation on patients' lives that panic disorder
would seem trivial in comparison. However, clinical
experience and a growing literature suggest
that comorbid panic disorder may be a major
determinant of distress and dysfunction across
many psychiatric disorders, including schizophrenia.

The recognition of panic disorder in
patients with schizophrenia is crucial for designing
effective treatment. In addition, panic disorder
may play a significant pathogenetic role in
some schizophrenic illness.

During the past 30 years, the diagnosis of psychotic
disorders has become increasingly precise.
Symptoms that were once lumped together under
one diagnosis are now accurately distinguished
from one another, with disorders such as psychotic
mania, delusional depression, and paranoid
delusional disorder being properly differentiated.
These more specific diagnoses came into common
use as psychiatry better understood their symptom
clusters, natural history, and treatment
response. For example, the discovery of lithium
made the distinction between psychotic mania and
schizophrenia far more clinically pressing.

As a result of recent interest in psychiatric
comorbidity, illnesses once thought to be distinct
from one another, such as obsessive-compulsive
disorder and schizophrenia, are now known to
have important areas of overlap. Some clinicians
use the term "schizo-obsessive disorder" to
describe this condition. Similarly, social phobia
has been suggested as an etiologic factor for
schizophrenia. This article considers the treatment
of comorbid panic disorder and schizophrenia
and, in light of these new perspectives, the
possibility of a distinct "panic psychosis."

The gender effect on emotional processing is modulated by psychopathological factors: an event-related potentials study

by Delphine Grynberg

Campanella, S., Falbo, L., Rossignol, M., Grynberg, D., Balconi, M., Verbanck, P., & Maurage, P. (2012). Psychiatry Research, accepted for publication.

Several studies have suggested that women are more sensitive than men to emotions in general. Eventrelated potential... more Several studies have suggested that women are more sensitive than men to emotions in general. Eventrelated potential (ERP) studies have demonstrated N2 and P3b modulations, suggesting that women allocate more attentional resources to emotions than men do. However, the exact origin of this emotional modulation by sex is still a matter of debate. We wondered whether these sex differences might be due to some specific personality traits of women and men. Thirty participants (15 males and 15 females) were selected so that there were no sex differences on alexithymia, or depression and anxiety scales. The participants were asked to complete a “modified emotional” oddball task, in which they had to detect deviant stimuli among frequent neutral ones as quickly as possible. Behavioral performance, N2 and P3b ERP data were analyzed. When personality factors were controlled for, the sex differences on N2 and P3b components of the ERPs disappeared. Moreover, linear regression analyses showed that alexithymia was much better than sex at predicting the N2 latencies, while depression was the best factor for predicting the P3b latency. These results suggest that personality factors should be taken into account when sex differences on emotional processing are investigated.