What do childhood anxiety disorders predict? Bittner, Antje; Egger, Helen L.; Erkanli, Alaattin ...
Journal of child psychology and psychiatry,
December 2007, Volume:
48, Issue:
12
Journal Article
Peer reviewed
Background: Few longitudinal studies of child and adolescent psychopathology have examined the links between specific childhood anxiety disorders and adolescent psychiatric disorder. In this paper ...we test the predictive specificity of separation anxiety disorder (SAD), overanxious disorder (OAD), generalized anxiety disorder (GAD), and social phobia.
Methods: Data come from the Great Smoky Mountains Study (GSMS). A representative population sample of children – ages 9, 11, and 13 years at intake – was followed to age 19. Diagnoses of both childhood (before age 13 years) and adolescent psychiatric disorders (age 13 to 19 years) were available from 906 participants.
Results: Childhood SAD predicted adolescent SAD, whereas OAD was associated with later OAD, panic attacks, depression and conduct disorder (CD). GAD was related only to CD. Social phobia in childhood was associated with adolescent OAD, social phobia, and attention‐deficit/hyperactivity disorder (ADHD).
Conclusions: Anxiety disorders in childhood are predictors of a range of psychiatric disorders in adolescence. It appears that children meriting a well‐defined diagnosis are missed by the current rules for the diagnosis of GAD. Future studies should examine whether OAD deserves reconsideration as a nosological entity.
•First study to examine the contribution of the Big 5 personality traits, health anxiety, and COVID-19 psychological distress to generalised anxiety and depressive symptoms.•COVID-19 psychological ...distress predicts generalised anxiety and depressive symptoms beyond all other variables.•Specific personality traits appear to be protective of COVID-19 psychological distress.
In the current study we sought to extend our understanding of vulnerability and protective factors (the Big Five personality traits, health anxiety, and COVID-19 psychological distress) in predicting generalised anxiety and depressive symptoms during the COVID-19 pandemic. Participants (n = 502), who were United States residents, completed a variety of sociodemographic questions and the following questionnaires: Big Five Inventory‐10 (BFI-10), Whitley Index 7 (WI-7), Coronavirus Anxiety Scale (CAS), COVID-19 Anxiety Syndrome Scale (C19-ASS), and Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS). Results showed that extraversion, agreeableness, conscientiousness, and openness were negatively correlated with generalised anxiety and depressive symptoms and that neuroticism, health anxiety and both measures of COVID-19 psychological distress were positively correlated with generalised anxiety and depressive symptoms. We used path analysis to determine the pattern of relationships specified by the theoretical model we proposed. Results showed that health anxiety, COVID-19 anxiety, and the COVID-19 anxiety syndrome partially mediated the relationship between the Big Five personality traits and generalised anxiety and depressive symptoms. Specifically, extraversion, agreeableness, and conscientiousness were negatively associated with the three mediators, which, in turn, were positively associated with generalised anxiety and depressive symptoms, with COVID-19 anxiety showing the strongest effect. Conversely, neuroticism and openness were positively associated with COVID-19 anxiety and the COVID-19 anxiety syndrome, respectively. These relationships were independent of age, gender, employment status and risk status. The model accounted for a substantial variance of generalised anxiety and depression symptoms (R2 = .75). The implications of these findings are discussed.
Background
Depression and anxiety may unfavorably impact on cardiac autonomic dysregulation. However, it is unclear whether this relationship results from a causal effect or may be attributable to ...confounding factors. We tested the relationship between depression and anxiety with heart rate (HR) and heart rate variability (HRV) across a 9‐year follow‐up (FU) period and investigated possible confounding by antidepressant use and genetic pleiotropy.
Methods
Data (no. of observations = 6,994, 65% female) were obtained from the longitudinal Netherlands Study of Depression and Anxiety, with repeated waves of data collection of HR, HRV, depression, anxiety, and antidepressant use. Summary statistics from meta‐analyses of genome‐wide association studies were used to derive polygenic risk scores of depression, HR, and HRV.
Results
Across the 9‐year FU, generalized estimating equations analyses showed that the relationship between cardiac autonomic dysregulation and depression/anxiety rendered nonsignificant after adjusting for antidepressant use. A robust association was found between antidepressant use (especially tricyclic antidepressants, selective serotonin, and noradrenalin reuptake inhibitors) and unfavorable cardiac autonomic activity across all waves. However, no evidence was found for a genetic correlation of depression with HR and HRV, indicating that confounding by genetic pleiotropy is minimal.
Conclusions
Our results indicate that the association between depression/anxiety and cardiac autonomic dysregulation does not result from a causal pathway or genetic pleiotropy, and these traits might therefore not be inevitably linked. Previously reported associations were likely confounded by the use of certain classes of antidepressants.
•Psychological therapies resulted in decreased activation in limbic regions: insula and ACC.•Decreased prefrontal activation was also found pre-to-post psychological therapy.•Results offer partial ...support for the dual-process model of psychotherapy.
Understanding the neural mechanisms underlying psychological therapy could aid understanding of recovery processes and help target treatments. The dual-process model hypothesises that psychological therapy is associated with increased emotional-regulation in prefrontal brain regions and decreased implicit emotional-reactivity in limbic regions; however, research has yielded inconsistent findings. Meta-analyses of brain activity changes accompanying psychological therapy (22 studies, n = 352) and neural predictors of symptomatic improvement (11 studies, n = 293) in depression and anxiety were conducted using seed-based d mapping. Both resting-state and task-based studies were included, and analysed together and separately. The most robust findings were significant decreases in anterior cingulate/paracingulate gyrus, inferior frontal gyrus and insula activation after therapy. Cuneus activation was predictive of subsequent symptom change. The results are in agreement with neural models of improved emotional-reactivity following therapy as evidenced by decreased activity within the anterior cingulate and insula. We propose compensatory as well as corrective neural mechanisms of action underlie therapeutic efficacy, and suggest the dual-process model may be too simplistic to account fully for treatment mechanisms. More research on predictors of psychotherapeutic response is required to provide reliable predictors of response.
Abstract Recent findings support the relevance of anxiety sensitivity (AS) and interoceptive exposure (IE) across emotional disorders. This study (a) evaluated levels of AS across different anxiety ...disorders, (b) examined change in AS over the course of transdiagnostic psychological intervention, and its relationship with outcome, and (c) described the implementation of IE to address AS with patients with different anxiety disorders. Participants ( N = 54) were patients who received treatment with the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) in two consecutive treatment trials. Participants completed a measure of AS at pre- and posttreatment, and multiple occasions during treatment. Symptom severity was assessed at pre- and posttreatment, and clinical information related to physical symptoms and IE were collected as part of routine clinical practice. Elevated AS was observed at pretreatment across diagnoses and decreases in AS were observed from pre- to posttreatment. Similar changes occurred across the diagnostic categories, notably coinciding with the introduction of IE. Change in AS was correlated with reduced symptom levels at posttreatment and 6-month follow-up. Patients with different anxiety disorders endorsed similar physical symptoms and practiced similar IE exercises with similar effects. Results provide preliminary support for the usefulness of IE as a treatment strategy across the spectrum of anxiety disorders, and additional support for the transdiagnostic relevance of AS.
Although anxiety and depression have been considered as two distinct entities according to the diagnostic criteria, anxious depression (comorbid anxiety and depression) is relatively a common ...syndrome. According to the DSM-5 criteria, it uses "with anxious distress specifier" to define anxious depression in its MDD section. Anxious depression is known to have different neurobiological profiles compared to non-anxious depression. Several studies have revealed significant differences between anxious depression and non-anxious depression regarding the hypothalamic-pituitary-adrenal (HPA) axis function, structural and functional brain imaging findings, inflammation markers, etc. Patients with anxious depression were significantly more likely to be found in primary care setting and more likely to be associated with female gender, non-single, unemployed, less educated, and more severe depression. Previous reports also showed that patients with anxious depression had more frequent episodes of major depression and a higher risk of suicidal ideation and previous suicide attempts than those with non-anxious depression. Although anxious depression is known to be associated with poor treatment outcomes in several studies, recent researches have sought to find better treatment strategy to improve patients with anxious depression.
Anxiety disorders are debilitating psychiatric illnesses with detrimental effects on human health. These heightened states of arousal are often in the absence of obvious threatening cues and are ...difficult to treat owing to a lack of understanding of the neural circuitry and cellular machinery mediating these conditions. Activation of noradrenergic circuitry in the basolateral amygdala is thought to have a role in stress, fear, and anxiety, and the specific cell and receptor types responsible is an active area of investigation. Here we take advantage of two novel cellular approaches to dissect the contributions of G-protein signaling in acute and social anxiety-like states. We used a chemogenetic approach utilizing the Gαs DREADD (rM3Ds) receptor and show that selective activation of generic Gαs signaling is sufficient to induce acute and social anxiety-like behavioral states in mice. Second, we use a recently characterized chimeric receptor composed of rhodopsin and the β2 -adrenergic receptor (Opto-β2 AR) with in vivo optogenetic techniques to selectively activate Gαs β-adrenergic signaling exclusively within excitatory neurons of the basolateral amygdala. We found that optogenetic induction of β-adrenergic signaling in the basolateral amygdala is sufficient to induce acute and social anxiety-like behavior. These findings support the conclusion that activation of Gαs signaling in the basolateral amygdala has a role in anxiety. These data also suggest that acute and social anxiety-like states may be mediated through signaling pathways identical to β-adrenergic receptors, thus providing support that inhibition of this system may be an effective anxiolytic therapy.
Network Analysis of Anxiety in the Autism Realm Montazeri, Farhad; de Bildt, Annelies; Dekker, Vera ...
Journal of autism and developmental disorders,
06/2019, Volume:
49, Issue:
6
Journal Article
Peer reviewed
Open access
The anxiety and autism realms are each complicated and heterogeneous, and relationships between the two areas are especially complex. Network analysis offers a promising approach to the phenotypic ...complexities of typical and atypical human behavior. The Revised Children’s Anxiety and Depression Scale (RCADS) was used to assess anxiety in 126 high-functioning 9–13 year-olds with ASDs. Network graphs of Autism Diagnostic Observation Schedule items and RCADS anxiety total score, social, generalized, panic and separation anxiety subscores consistently found the anxiety node (score) to be highly peripheral. Also, the networks of RCADS anxiety items themselves were similar for the ASDs group and a general population comparison group (n = 2017). The results suggest anxiety is not a central part of autism and that anxiety is dynamically similar (aspects of anxiety relate to one another in a similar manner) in high-functioning autism and the general population.
Perfectionism is a risk and maintaining factor for eating disorders, anxiety disorders and depression. The objective of this paper is to review the four bodies of evidence supporting the notion that ...perfectionism is a transdiagnostic process. First, a review of the literature was conducted that demonstrates the elevation of perfectionism across numerous anxiety disorders, depression, and eating disorders compared to healthy controls. Data is presented that shows perfectionism increases vulnerability for eating disorders, and that it maintains obsessive–compulsive disorder, social anxiety and depression as it predicts treatment outcome in these disorders. Second, evidence is examined showing that elevated perfectionism is associated with co-occurrence of psychopathology. Third, the different conceptualisations of perfectionism are reviewed, including a cognitive-behavioural conceptualisation of clinical perfectionism that can be utilised to understand this transdiagnostic process. Fourth, evidence that treatment of perfectionism results in reductions in anxiety, depression and eating pathology is reviewed. Finally, the importance of clinicians considering the routine assessment and treatment of perfectionism is outlined.
Anxiety and Epigenetics Bartlett, Andrew A; Singh, Rumani; Hunter, Richard G
Advances in experimental medicine and biology,
2017, Volume:
978
Journal Article
Peer reviewed
Anxiety disorders are highly prevalent psychiatric disorders often comorbid with depression and substance abuse. Twin studies have shown that anxiety disorders are moderately heritable. Yet, ...genome-wide association studies (GWASs) have failed to identify gene(s) significantly associated with diagnosis suggesting a strong role for environmental factors and the epigenome. A number of anxiety disorder subtypes are considered "stress related." A large focus of research has been on the epigenetic and anxiety-like behavioral consequences of stress. Animal models of anxiety-related disorders have provided strong evidence for the role of stress on the epigenetic control of the hypothalamic-pituitary-adrenal (HPA) axis and of stress-responsive brain regions. Neuroepigenetics may continue to explain individual variation in susceptibility to environmental perturbations and consequently anxious behavior. Behavioral and pharmacological interventions aimed at targeting epigenetic marks associated with anxiety may prove fruitful in developing treatments.
PDF
