All aspects of our life are ruled by the concept of „fast society” - from fast food to „fast (on-line) relationships” and, in turn, to „fast therapy”. Clients and counsellors alike are in a rush to ...find a quick way to solve the problem. This approach to „panic attack” problems could sometimes lead to a dead end. What is more, this dynamic of the therapeutic process could increase the client’s confusion and let the sensation of fear unexplained. The following paper puts forward three case studies, where the „not-knowing” position of the therapists unlocks the situation, helping the clients become aware of the elements from context that are connected to their fear. The meanings behind the attacks are revealed in the conversational field when the therapist stops their search for explanations and becomes patient enough to be curios and invite the client to explore detailed stories of their daily life.
Abstract
Introduction
Directed forgetting is the process of actively trying to forget specific information. Sleep selectively improves directed remembering, without enhancing consolidation for ...information was directed to be forgotten. Emotional information is also prioritized for consolidation across sleep. This study aimed to determine whether sleep-enhanced directed forgetting could be observed for emotional information.
Methods
Participants were shown 100 words on a screen. Following each word, a green “R,” indicated a word to be remembered, whereas a red “F” indicated a word to be forgotten. Half of the words were negatively valenced, and half were neutral. After encoding participants completed an immediate recognition task in which they were presented with 100 words (25 previously observed “Remember” words, 25 previously observed “Forget” words, and 50 foil words). Following a 12-hour delay, participants were asked to freely recall any of the words they saw on the original list. Of the total 26 participants, 10 were in the wake group, and 16 were in the sleep group.
Results
In immediate recognition, “remember” words were significantly better recognized than “forget” words (F(1,24)=15.578, p=.001). There was no main effect of emotion, nor a main effect of sleep group. There was, however, a significant interaction between memory and emotion (F(1,24)=14.051, p=.001). Negative remember words were significantly better recognized, and neutral words were better forgotten. Following the delay, remember words were significantly better recalled than forget words (F(1,24)=23.763, p<0.001). Negative words were also better recalled (F(1,24)=3.96, p=0.05). However, there was no effect of sleep on memory (F(1,24)=0.572, p=0.454). Individuals in the wake group made significantly more errors than the sleep group (F(1,24)=10.999, p=0.003), and errors tended to be more negative (F(1,24)=27.969, p<0.001).
Conclusion
This work further replicated the impact of directed forgetting. In addition, while this work did show a stronger memory for negative words, this study failed to demonstrate a role for sleep in this interaction. Sleep did, however, protect the participant from errors in recall. Overall, improved understanding of directed forgetting of emotional information could benefit individuals with emotional trauma.
Support (If Any)
N/A
This chapter introduces a constructivist model of informal and incidental learning developed in the 1990s, and various perspectives that authors subsequently use to reexamine and trouble how adult ...educators conceptualize and practice informal and incidental learning in today's environment.
Introduction
The curious effect of an increase of the placebo effect across year of publication has been shown for depression, schizophrenia, obsessive-compulsive disorder, as well as for some ...medical conditions like hypertension and pain.
Objectives
We aimed to observe how randomised clinical trials with a placebo control behave at this respect in panic disorder trials.
Methods
We searched the PubMed database using the strategy: (panic disorder OR panic attack disorder) AND placebo, which on 3 November 2020 produced 779 records. Inclusion criteria were the above stated, excluded were all studies focusing on the same patients as others and those not providing intelligible data. In our selection we used the PRISMA statement and reached agreement with Delphi rounds.
Results
We identified through other sources further 3 studies. The finally eligible studies were 82, excluded were 700 studies, mainly consisting of reviews (176), challenge studies (173), not dealing with panic disorder (67), studies with unsuitable designs to detect placebo effect (53), studies using same populations as others (36), those with misfocused outcomes (57), those lumping diagnoses and not allowing to separate data for panic disorder (22), and those not using placebo at all (21). Mean response to placebo in included panic disorder studies was 36.01±19.812, ranging from 0 to 76.19%; the correlation with year of publication was positive and significant (Pearson’s r= 0.246; p=0.026).
Conclusions
The effect of placebo in randomised control trials has increased across the years, but this field of research appears to be idle in recent years.
Disclosure
No significant relationships.
Context
The scarcity of cross‐national reports and the changes in Diagnostic and Statistical Manual version 5 (DSM‐5) regarding panic disorder (PD) and panic attacks (PAs) call for new ...epidemiological data on PD and PAs and its subtypes in the general population.
Objective
To present representative data about the cross‐national epidemiology of PD and PAs in accordance with DSM‐5 definitions.
Design and setting
Nationally representative cross‐sectional surveys using the World Health Organization Composite International Diagnostic Interview version 3.0.
Participants
Respondents (n = 142,949) from 25 high, middle, and lower‐middle income countries across the world aged 18 years or older.
Main outcome measures
PD and presence of single and recurrent PAs.
Results
Lifetime prevalence of PAs was 13.2% (SE 0.1%). Among persons that ever had a PA, the majority had recurrent PAs (66.5%; SE 0.5%), while only 12.8% fulfilled DSM‐5 criteria for PD. Recurrent PAs were associated with a subsequent onset of a variety of mental disorders (OR 2.0; 95% CI 1.8–2.2) and their course (OR 1.3; 95% CI 1.2–2.4) whereas single PAs were not (OR 1.1; 95% CI 0.9–1.3 and OR 0.7; 95% CI 0.6–0.8). Cross‐national lifetime prevalence estimates were 1.7% (SE 0.0%) for PD with a median age of onset of 32 (IQR 20–47). Some 80.4% of persons with lifetime PD had a lifetime comorbid mental disorder.
Conclusions
We extended previous epidemiological data to a cross‐national context. The presence of recurrent PAs in particular is associated with subsequent onset and course of mental disorders beyond agoraphobia and PD, and might serve as a generic risk marker for psychopathology.
Internet-delivered cognitive behaviour therapy (ICBT) has existed for 20 years and there are now several controlled trials for a range of problems. In this paper, we focused on recent meta-analytic ...reviews of the literature and found moderate to large effects reported for panic disorder, social anxiety disorder, generalized anxiety disorder, posttraumatic stress disorder, and major depression. In total, we reviewed 9 recent meta-analytic reviews out of a total of 618 meta-analytic reviews identified using our search terms. In these selected reviews, 166 studies were included, including overlap in reviews on similar conditions. We also covered a recent review on transdiagnostic treatments and 2 reviews on face-to-face v. internet treatment. The growing number of meta-analytic reviews of studies now suggests that ICBT works and can be as effective as face-to-face therapy.
IntroductionPanic attacks(PA) or episodic paroxysmal anxiety are attacks of severe anxiety (panic) or fear (most often - fear of death, less often - fear of losing consciousness, loss of control, ...helplessness or fear of “going crazy”), accompanied by a rapid heartbeat and a feeling of “suffocation” , “lack of air.” Sometimes there are additional symptoms such as increased blood pressure, a feeling of “internal trembling”, trembling in the limbs, a feeling of “hot flashes” of heat or cold, numbness of the extremities, increased sweating, a feeling of “unstability” or dizziness, nausea, derealization or depersonalization.ObjectivesIt was revealed that many patients with cervical and spinal pain suffer from PA. Psychotherapy and traditional psychopharmacology treatment often not effective. The goal of our study was analysis of radical anti-oxidative therapy for the PA patients in addition to traditional to traditional psychoparmacology and psychotherapy techniques.Methods12 patients with cervical and 31 with lumbar pain experienced panic attacks during outbreaks of panic attacks. 6 cervical pain patient and 17 patients with lumbar pain were treated by antipsychotic medications also by cognitive behavioral therapy, hypno-suggestive therapy and autogenic training. Other patients also receive hyperbaric oxidation therapy (HBO) in addition to psychopharmacology and psychotherapy.ResultsIt was revealed that patients with PA comorbid with vertebral pathology had much better effects in terms of evading of psychopathologic outcomes. PA became much more rarely and finally disappeared at all. The anti-oxidative treatment was also very beneficial for neurologic symptoms cause by vertebral pain.ConclusionsAnti-oxidative therapy showed very marked effect. In this regard, new anti-oxidative treatment seems to be promisable for management of such conditions.Disclosure of InterestNone Declared
The Age of Onset of Anxiety Disorders Lijster, Jasmijn M. de; Dierckx, Bram; Utens, Elisabeth M.W.J. ...
Canadian journal of psychiatry,
04/2017, Volume:
62, Issue:
4
Journal Article
Peer reviewed
Open access
Objective:
The objective was to estimate the age of onset (AOO) for all anxiety disorders and for specific subtypes. Gender differences in the AOO of anxiety disorders were examined, as were the ...influence of study characteristics on reported AOOs.
Methods:
Seven electronic databases were searched up to October 2014, with keywords representing anxiety disorder subtypes, AOO, and study design. The inclusion criteria were studies using a general population sample that provided data on the AOO for all anxiety disorders, or specific anxiety disorders, according to DSM-III-R, DSM-IV, or ICD-10 criteria.
Results:
There were 1028 titles examined, which yielded 24 studies meeting the inclusion criteria. Eight studies reported the AOO and gender. Meta-analysis found a mean AOO of all anxiety disorders of 21.3 years (95% CI 17.46 to 25.07). Separation anxiety disorder, specific phobia, and social phobia had their mean onset before the age of 15 years, whereas the AOO of agoraphobia, obsessive-compulsive disorder, posttraumatic stress disorder, panic disorder, and generalized anxiety disorder began, on average, between 21.1 and 34.9 years. Meta-analysis revealed no difference in the AOO between genders. A prospective study design and higher developmental level of the study country were associated with an earlier AOO.
Conclusions:
Results from this meta-analysis indicate that anxiety disorder subtypes differ in the mean AOO, with onsets ranging from early adolescence to young adulthood. These findings suggest that prevention strategies of anxiety disorders should be directed towards factors associated with the development of anxiety disorder subtypes in the age groups with the greatest vulnerability for developing those disorders.
Anxiety disorders Penninx, Brenda WJH; Pine, Daniel S; Holmes, Emily A ...
The Lancet,
03/2021, Volume:
397, Issue:
10277
Journal Article
Peer reviewed
Open access
Anxiety disorders form the most common group of mental disorders and generally start before or in early adulthood. Core features include excessive fear and anxiety or avoidance of perceived threats ...that are persistent and impairing. Anxiety disorders involve dysfunction in brain circuits that respond to danger. Risk for anxiety disorders is influenced by genetic factors, environmental factors, and their epigenetic relations. Anxiety disorders are often comorbid with one another and with other mental disorders, especially depression, as well as with somatic disorders. Such comorbidity generally signifies more severe symptoms, greater clinical burden, and greater treatment difficulty. Reducing the large burden of disease from anxiety disorders in individuals and worldwide can be best achieved by timely, accurate disease detection and adequate treatment administration, scaling up of treatments when needed. Evidence-based psychotherapy (particularly cognitive behavioural therapy) and psychoactive medications (particularly serotonergic compounds) are both effective, facilitating patients' choices in therapeutic decisions. Although promising, no enduring preventive measures are available, and, along with frequent therapy resistance, clinical needs remain unaddressed. Ongoing research efforts tackle these problems, and future efforts should seek individualised, more effective approaches for treatment with precision medicine.
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