An increased neural response to making errors has emerged as a biomarker of anxiety. Error negativity (Ne) or errorrelated negativity (ERN) is an event-related potential generated when people commit ...errors; the Ne/ERN is greater among people with anxiety and predicts increases in anxiety. However, no previous study has examined whether the Ne/ERN can be used as a prognostic indicator among people with current anxiety. The present study addressed this gap by examining whether the Ne/ERN prospectively predicts increases in anxiety symptoms in clinically anxious children and adolescents.
The sample included 34 female participants between the ages of 8 and 14 years who met the criteria for a clinical anxiety disorder based on clinical interview. The Ne/ERN was measured using a flanker task.
Increased Ne/ERN at baseline predicted increases in total anxiety symptoms 2 years later, even when accounting for baseline symptoms. The Ne/ERN predicted increases in the symptom domains of generalized anxiety, social anxiety and harm avoidance/perfectionism, but not panic, separation anxiety, school avoidance or physical symptoms.
The sample size was small, which may have inflated the false discovery rate. To mitigate this possibility, we used multiple self-report measures, and the results for the 2 measures (as well as their symptom domains) converged.
These data suggest that the Ne/ERN can delineate specific risk trajectories, even among those who already meet the criteria for a clinical anxiety disorder. Considering the need for prognostic markers among people with clinical anxiety, the current findings are an important and novel extension of previous work.
IntroductionAlthough dysfunctional breathing is a common symptom in general population and affects qualities of life, it is still underdiagnosed. There are some studies of prevalence of it in asthma, ...but few studies in mental illness.ObjectivesThe purposes of this study were to explore the prevalence of it in anxiety related disorders, and to investigate whether anxiety influence it.Methods150 patients diagnosed with anxiety or depressive disorders, and 135 controls were recruited. Nijmegen questionnaire was used to assess dysfunctional breathing, and Hospital anxiety depression scale was used.ResultsThe prevalence of dysfunctional breathing in anxiety related disorders was higher than that in control.In the linear regression model, anxiety accounted for 61.2 % of dysfunctional breathing, but depressed mood. With covariate adjusted for anxiety, scores of dysfunctional breathing in anxiety or depressive disorders were higher than in controls.ConclusionsDysfunctional breathing in anxiety related disorders is higher than that in control. Adjusting anxiety, its difference is still. Anxiety affects dysfunctional breathing, but depressed mood does not.Disclosure of InterestNone Declared
Abstract Reports the characteristics of a large, representative sample of treatment-seeking anxious youth ( N = 488). Participants, aged 7–17 years (mean 10.7 years), had a principal DSM-IV diagnosis ...of separation anxiety disorder (SAD), generalized anxiety disorder (GAD), or social phobia (SP). Although youth with a co-primary diagnosis for which a different disorder-specific treatment would be indicated (e.g., major depressive disorder, substance abuse) were not included, there were few other exclusion criteria. Participants and their parent/guardian underwent an extensive baseline assessment using a broad array of measures capturing diagnostic status, anxiety symptoms and severity, and areas of functional impairment. Means and standard deviations of the measures of psychopathology and data on diagnostic status are provided. The sample had moderate to severe anxiety disorder and was highly comorbid, with 55.3% of participants meeting criteria for at least one non-targeted DSM-IV disorder. Anxiety disorders in youth often do not present as a single/focused disorder: such disorders in youth overlap in symptoms and are highly comorbid among themselves.
This book empowers health care professionals to accurately identify and diagnose anxiety and depression in older adult patients and help them find relief, stay independent, and lower their risk of ...suicide.Specialized material covers the unique factors facing older adults, including cognitive impairment, functional independence, and living near the end of life.
Purpose of Review
The purpose of this paper was to provide a comprehensive narrative review of the relationship between physical activity (PA) and anxiety and the rationale for including it as a ...treatment option for anxiety disorders. Several gaps in the literature are highlighted alongside recommendations for future research.
Recent Findings
PA in the general population has established efficacy in preventing and managing cardiovascular disease and improving wellbeing. Recent epidemiological data further suggests that people who are more active may be less likely to have anxiety disorders. In addition, evidence from systematic reviews of randomised control trials suggests that exercise training, a subset of PA, can reduce symptoms in anxiety and stress-related disorders, such as post-traumatic stress disorder, agoraphobia and panic disorder.
Summary
Anxiety disorders are common, burdensome and costly to individuals and wider society. In addition to the profound negative impact on individuals’ wellbeing and functioning, they are associated with worsened physical health, including a higher risk for cardiovascular diseases and premature mortality. Although pharmacotherapy and psychological interventions are helpful for many, these treatment approaches are not effective for everyone and are insufficient to address common physical health complications, such as the elevated risk of cardiovascular disease. Given the combined anxiolytic and physical health benefits of increased activity, PA presents a promising additional treatment option for people with anxiety disorders. However, there remain key gaps in the literature regarding the mechanisms underlying the effects of PA, optimal PA protocols, methods of improving adherence and the importance of physical fitness. These must be addressed for PA to be successfully implemented in mental health services.
Objective: Test changes in (a) coping efficacy and (b) anxious self-talk as potential mediators of treatment gains at 3-month follow-up in the Child/Adolescent Anxiety Multimodal Treatment Study ...(CAMS). Method: Participants were 488 youth (ages 7-17; 50.4% male) randomized to cognitive-behavioral therapy (CBT; Coping cat program), pharmacotherapy (sertraline), their combination, or pill placebo. Participants met Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition (DSM-IV) criteria for generalized anxiety disorder, social phobia, and/or separation anxiety disorder. Coping efficacy (reported ability to manage anxiety provoking situations) was measured by youth and parent reports on the Coping Questionnaire, and anxious self-talk was measured by youth report on the Negative Affectivity Self-Statement Questionnaire. Outcome was measured using the Pediatric Anxiety Rating Scale (completed by Independent Evaluators blind to condition). For temporal precedence, residualized treatment gains were assessed at 3-month follow-up. Results: Residualized gains in coping efficacy mediated gains in the CBT, sertraline, and combination conditions. In the combination condition, some unique effect of treatment remained. Treatment assignment was not associated with a reduction in anxious self-talk, nor did anxious self-talk predict changes in anxiety symptoms. Conclusions: The findings suggest that improvements in coping efficacy are a mediator of treatment gains. Anxious self-talk did not emerge as a mediator.
What is the public health significance of this article?
These findings suggest that, within empirically supported treatments for anxiety in youth, the youth's self-perceived ability to manage anxiety provoking situations plays a role in beneficial change.
Full text
Available for:
CEKLJ, FFLJ, NUK, ODKLJ, PEFLJ
Anxiety is not new. Yet now more than ever, anxiety seems to define
our times. Anxiety disorders are the most common psychiatric
disorders in the United States, exceeding mood, impulse-control,
and ...substance-use disorders, and they are especially common among
younger cohorts. More and more Americans are taking antianxiety
medications. According to polling data, anxiety is experienced more
frequently than other negative emotions. Why have we become so
anxious? In Unnerved , Jason Schnittker investigates the
social, cultural, medical, and scientific underpinnings of the
modern state of mind. He explores how anxiety has been understood
from the late nineteenth century to the present day and why it has
assumed a more central position in how we think about mental
health. Contrary to the claims that anxiety reflects large-scale
traumas, abrupt social transitions, or technological revolutions,
Schnittker argues that the ascent of anxiety has been driven by
slow transformations in people, institutions, and social
environments. Changes in family formation, religion, inequality,
and social relationships have all primed people to be more anxious.
At the same time, the scientific and medical understanding of
anxiety has evolved, pushing it further to the fore. The rise in
anxiety cannot be explained separately from changes in how
patients, physicians, and scientists understand the disorder.
Ultimately, Schnittker demonstrates that anxiety has carried the
imprint of social change more acutely than have other emotions or
disorders, including depression. When societies change, anxiety
follows.
Behavioral inhibition (BI) is a temperament identified in early childhood that is a risk factor for later social anxiety. However, mechanisms underlying the development of social anxiety remain ...unclear. To better understand the emergence of social anxiety, longitudinal studies investigating changes at behavioral neural levels are needed.
BI was assessed in the laboratory at 2 and 3 years of age (N = 268). Children returned at 12 years, and an electroencephalogram was recorded while children performed a flanker task under 2 conditions: once while believing they were being observed by peers and once while not being observed. This methodology isolated changes in error monitoring (error-related negativity) and behavior (post-error reaction time slowing) as a function of social context. At 12 years, current social anxiety symptoms and lifetime diagnoses of social anxiety were obtained.
Childhood BI prospectively predicted social-specific error-related negativity increases and social anxiety symptoms in adolescence; these symptoms directly related to clinical diagnoses. Serial mediation analysis showed that social error-related negativity changes explained relations between BI and social anxiety symptoms (n = 107) and diagnosis (n = 92), but only insofar as social context also led to increased post-error reaction time slowing (a measure of error preoccupation); this model was not significantly related to generalized anxiety.
Results extend prior work on socially induced changes in error monitoring and error preoccupation. These measures could index a neurobehavioral mechanism linking BI to adolescent social anxiety symptoms and diagnosis. This mechanism could relate more strongly to social than to generalized anxiety in the peri-adolescent period.
PDF
