The COVID-19 pandemic is a chronically stressful event, particularly for youth. Here, we examine (i) changes in mood and anxiety symtpoms, (ii) pandemic-related stress as a mediator of change in ...symptoms, and (ii) threat processing biases as a predictor of increased anxiety during the pandemic. A clinically well-characterized sample of 81 youth ages 8–18 years (
M
= 13.8 years,
SD
= 2.65; 40.7% female) including youth with affective and/or behavioral psychiatric diagnoses and youth without psychopathology completed pre- and during pandemic assessments of anxiety and depression and COVID-related stress. Forty-six youth also completed a threat processing fMRI task pre-pandemic. Anxiety and depression significantly increased during the pandemic (all
p
s < 0.05). Significant symptom change was partially mediated by pandemic stress and worries. Increased prefrontal activity in response to neutral faces pre-pandemic was associated with more intense parent-reported anxiety during the pandemic (all
Fs
(1.95,81.86) > 14.44,
ps
< 0.001). The present work extends existing knowledge on the mediating role of psychological stress on symptoms of anxiety and depression in youth.
Death anxiety is considered to be a basic fear underlying the development and maintenance of numerous psychological conditions. Treatment of transdiagnostic constructs, such as death anxiety, may ...increase treatment efficacy across a range of disorders. Therefore, the purpose of the present review is to: (1) examine the role of Terror Management Theory (TMT) and Experimental Existential Psychology in understanding death anxiety as a transdiagnostic construct, (2) outline inventories used to evaluate the presence and severity of death anxiety, (3) review research evidence pertaining to the assessment and treatment of death anxiety in both non-clinical and clinical populations, and (4) discuss clinical implications and future research directions. Numerous inventories have been developed to evaluate the presence and severity of death anxiety, and research has provided compelling evidence that death anxiety is a significant issue, both theoretically and clinically. In particular, death anxiety appears to be a basic fear at the core of a range of mental disorders, including hypochondriasis, panic disorder, and anxiety and depressive disorders. Large-scale, controlled studies to determine the efficacy of well-established psychological therapies in the treatment of death anxiety as a transdiagnostic construct are warranted.
•Death anxiety is a normal human experience, yet it can engender paralyzing fear.•Terror Management Theory has generated extensive research into death anxiety.•Death anxiety is a transdiagnostic construct involved in numerous disorders.•Existential and Cognitive–Behavior therapies can successfully treat death anxiety.•More research into the clinical aspects of death anxiety across disorders is needed.
Generalized anxiety disorder (GAD) typically begins during adolescence and can persist into adulthood. The pathophysiological mechanisms underlying this disorder remain unclear. Recent evidence from ...resting state functional magnetic resonance imaging (R-fMRI) studies in adults suggests disruptions in amygdala-based circuitry; the present study examines this issue in adolescents with GAD.
Resting state fMRI scans were obtained from 15 adolescents with GAD and 20 adolescents without anxiety who were group matched on age, sex, scanner, and intelligence. Functional connectivity of the centromedial, basolateral, and superficial amygdala subdivisions was compared between groups. We also assessed the relationship between amygdala network dysfunction and anxiety severity.
Adolescents with GAD exhibited disruptions in amygdala-based intrinsic functional connectivity networks that included regions in medial prefrontal cortex, insula, and cerebellum. Positive correlations between anxiety severity scores and amygdala functional connectivity with insula and superior temporal gyrus were also observed within the GAD group. There was some evidence of greater overlap (less differentiation of connectivity patterns) of the right basolateral and centromedial amygdala networks in the adolescents with, relative to those without, GAD.
These findings suggest that adolescents with GAD manifest alterations in amygdala circuits involved in emotion processing, similar to findings in adults. In addition, disruptions were observed in amygdala-based networks involved in fear processing and the coding of interoceptive states.
Interleukin (IL)-17a has been highly conserved during evolution of the vertebrate immune system and widely studied in contexts of infection and autoimmunity. Studies suggest that IL-17a promotes ...behavioral changes in experimental models of autism and aggregation behavior in worms. Here, through a cellular and molecular characterization of meningeal γδ17 T cells, we defined the nearest central nervous system-associated source of IL-17a under homeostasis. Meningeal γδ T cells express high levels of the chemokine receptor CXCR6 and seed meninges shortly after birth. Physiological release of IL-17a by these cells was correlated with anxiety-like behavior in mice and was partially dependent on T cell receptor engagement and commensal-derived signals. IL-17a receptor was expressed in cortical glutamatergic neurons under steady state and its genetic deletion decreased anxiety-like behavior in mice. Our findings suggest that IL-17a production by meningeal γδ17 T cells represents an evolutionary bridge between this conserved anti-pathogen molecule and survival behavioral traits in vertebrates.
Studies on the relationship between separation anxiety disorder (SAD) in childhood and panic disorder (PD) in adolescence and adulthood have yielded results which suggest a common underlying ...vulnerability for both disorders. In this study, we examined whether one such possible vulnerability—anxiety sensitivity—differed for youth diagnosed with SAD versus other anxiety disorders. Anxiety sensitivity was assessed using the Childhood Anxiety Sensitivity Index (CASI) in 315 clinic-referred youth (ages 6–17, 113 girls). 145 children (46%) were diagnosed with one or more primary anxiety disorder, including SAD (
n
= 22), generalized anxiety (GAD) (
n
= 79), social anxiety (SocA) (
n
= 55), and specific phobia (SP) (
n
= 45). Children with SAD reported higher levels of anxiety sensitivity and fears of physical symptoms than children with SP and SocA, but not children with GAD. We speculate that children who have SAD and GAD and high anxiety sensitivity may be more vulnerable to develop PD.
Research shows high rates of anxious symptoms in people autistic spectrum disorder (ASD). Finding factors related to the development of anxiety in ASD is necessary. Emotion regulation (ER) is ...associated with anxiety in ASD. Moreover, some studies find higher rates of anxiety in women with ASD. A total of 121 adults (M = 35.46 years, SD = 9.46) with ASD and intellectual disabilities were evaluated to verify moderating role of gender and mediating role of ER. A moderated mediation analysis supported the moderated role of gender in the relationship mediated by emotional dysregulation between ASD and anxiety. These findings suggest that interventions designed to prevent or reduce anxiety symptoms in women with ASD should include among their goals emotional regulation.
Lay Summary
If we want to reduce or prevent anxiety symptoms in women with ASD we must work on emotional regulation.
Despite an increase in mental health problems, with psychosomatic symptoms having been observed in new generations of Swedish youth, the extent to which these problems correspond to an increase in ...adult mental problems is unknown. The present study investigates whether Swedish adolescents with high levels of psychosomatic symptoms are at risk of developing depression and anxiety problems in adulthood and whether sex moderates any association. Moreover, we aim to understand whether different clusters of youth psychosomatic symptoms - somatic, psychological and musculoskeletal - have different impacts on adult mental health.
One thousand five hundred forty-five Swedish adolescents - aged 13 (49%) and 15 (51%) - completed surveys at baseline (T1) and 3 years later (T2); of them, 1174 (61% females) also participated after 6 years (T3). Multivariate logistic models were run.
Youth with high levels of psychosomatic symptoms had higher odds of high levels of depressive symptoms at T2 and T3. Moreover, psychosomatic symptoms at T1 predicted a high level of anxiety symptoms and diagnoses of anxiety disorders at T3. When analyzed separately, musculoskeletal symptoms predicted higher odds of having high levels of depressive symptoms at T2 and T3 while somatic symptoms predicted high levels of anxiety symptoms at T2. Moreover, somatic symptoms at T1 predicted diagnoses of depression and anxiety disorders at T3. Sex did not moderate any of the relationships.
The study supports the idea that an increase in mental health problems, such as psychosomatic symptoms, can seriously impact the psychological health of new generations of young adults.
Behavioral inhibition (BI) is an early-appearing temperament characterized by strong reactions to novelty. BI shows a good deal of stability over childhood and significantly increases the risk for ...later diagnosis of social anxiety disorder (SAD). Despite these general patterns, many children with high BI do not go on to develop clinical, or even subclinical, anxiety problems. Therefore, understanding the cognitive and neural bases of individual differences in developmental risk and resilience is of great importance. The present review is focused on the relation of BI to two types of information processing: automatic (novelty detection, attention biases to threat, and incentive processing) and controlled (attention shifting and inhibitory control). We propose three hypothetical models (Top-Down Model of Control; Risk Potentiation Model of Control; and Overgeneralized Control Model) linking these processes to variability in developmental outcomes for BI children. We argue that early BI is associated with an early bias to quickly and preferentially process information associated with motivationally salient cues. When this bias is strong and stable across development, the risk for SAD is increased. Later in development, children with a history of BI tend to display normative levels of performance on controlled attention tasks, but they demonstrate exaggerated neural responses in order to do so, which may further potentiate risk for anxiety-related problems. We conclude by discussing the reviewed studies with reference to the hypothetical models and make suggestions regarding future research and implications for treatment.
Objective
Although one‐third of cancer patients are perceived to have a need for psychological support based on the percentage of mental disorders, little is known about the actual utilization of ...psychological care in cancer. We aimed to assess cancer patients' reported use of psychological care and its correlates in a large, representative sample.
Methods
In a multicenter, cross‐sectional study in Germany, 4020 cancer patients (mean age 58 years, 51% women) were evaluated. We obtained self‐reports of use of psychotherapy and psychological counseling. We measured distress with the Distress Thermometer, symptoms of depression with the Patient Health Questionnaire, anxiety with the Generalized Anxiety Disorder Scale, and social support with the Illness‐specific Social Support Scale. In a subsample of 2141, we evaluated the presence of a mental disorder using the Composite International Diagnostic Interview.
Results
In total, 28.9% (95% confidence interval 27.4%‐30.4%) reported having used psychotherapy or psychological counseling or both because of distress due to cancer. Independent correlates of utilization included age (odds ratio OR = 0.97 per year, sex (male, OR = 0.55), social support (OR = 0.96), symptoms of depression (OR = 1.04) and anxiety (OR = 1.08), the diagnosis of a mental disorder (OR = 1.68), and a positive attitude toward psychosocial support (OR = 1.27). Less than half of those currently diagnosed with a mental disorder reported having taken up psychological support offers.
Conclusion
Special efforts should be made to reach populations that report low utilization of psychological care in spite of having a need for support.
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