Journal of Anxiety Disorders最新文献

{"title":"Who defines improvement? Patients' global reports of improvement compared to standardized measures of improvement in cognitive processing therapy for posttraumatic stress disorder","authors":"Elizabeth Alpert ,&nbsp;Annie B. Fox ,&nbsp;Tara E. Galovski","doi":"10.1016/j.janxdis.2025.103027","DOIUrl":"10.1016/j.janxdis.2025.103027","url":null,"abstract":"<div><div>Standardized measures have typically been used to assess symptom change during treatment in psychological research and practice. However, standardized measures may not fully capture patients' experiences of therapeutic change. Patients' global reports of their improvement during treatment across domains of symptoms and functioning are also important and may provide distinct information from standardized measures. The current study compared both types of patient reports of improvement during cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD). We also examined process-level predictors of improvement assessed using both methods. Participants were 254 adult survivors of interpersonal violence receiving CPT. Patients' global reports of improvement in each domain (PTSD symptoms, relationships, health concerns, sexual functioning, school/work performance, and life satisfaction), each rated on a Likert scale via the Treatment Outcome Questionnaire, were significantly correlated with the corresponding standardized measure of improvement in the same domain, with most effect sizes in the small-to-medium range. Patients' perceptions of the therapy (helpfulness, likability) significantly predicted both global ratings and standardized measures of improvement, while patients' perceptions of the therapeutic relationship, patients' perceptions of barriers to therapy attendance, and objective indices of attendance did not predict improvement. Results highlight the importance of patients' experiences with treatment and suggest that assessing patients' global ratings of their improvement during treatment provides distinct information from standardized measures of improvement, and both are important to include when measuring therapeutic change.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"113 ","pages":"Article 103027"},"PeriodicalIF":4.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal course of posttraumatic stress disorder and chronic pain conditions: A population-based study of Canadian military personnel over 16 years","authors":"Aleiia J.N. Asmundson ,&nbsp;Michelle M. Paluszek ,&nbsp;Jordana L. Sommer ,&nbsp;Shay-Lee Bolton ,&nbsp;Jitender Sareen ,&nbsp;Tracie O. Afifi ,&nbsp;Renée El-Gabalawy ,&nbsp;Gordon J.G. Asmundson","doi":"10.1016/j.janxdis.2025.103025","DOIUrl":"10.1016/j.janxdis.2025.103025","url":null,"abstract":"<div><h3>Background</h3><div>Posttraumatic stress disorder (PTSD) and chronic pain are highly prevalent, comorbid, and debilitating conditions in the military. The present study was designed to examine the prevalence of chronic pain conditions (i.e., migraines, back problems, arthritis) across PTSD courses (i.e., no PTSD, remitted, new onset, persistent/recurrent) and examine the association between PTSD course and the presence and onset of chronic pain conditions in a population-representative sample of Canadian military members. Methods: Cross-tabulations and logistic regressions were conducted on data (n = 2941) from the 2002 Canadian Community Health Survey Mental Health and Well-being Canadian Forces Supplement and the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-Up Survey. Results: The prevalence of chronic pain conditions across PTSD courses ranged from 8 % to 61 %, with no PTSD consistently having the lowest prevalence. After adjusting for covariates, respondents with new onset PTSD had elevated odds of back problems (AOR=1.43, 95 % CI [1.10–1.90], <em>p</em> &lt; .05), arthritis (AOR=1.46, 95 % CI [1.06–2.00], <em>p</em> &lt; .05), and a new onset chronic pain condition more broadly (AOR=1.66, 95 % CI [1.15–2.39], <em>p</em> &lt; .01), compared to those with no PTSD. Those with remitted PTSD had greater odds of migraines (AOR=2.43, 95 % CI [1.29–4.58], <em>p</em> &lt; .01), while those with persistent PTSD had lower odds of back problems (AOR=0.45, 95 % CI [0.23–0.88], <em>p</em> &lt; .05), compared to those with no PTSD. Conclusion: Findings indicate that the prevalence and type of chronic pain that co-occurs with PSTD in Canadian military members varies as a function of the course of PTSD. This underscores the importance of evaluating pain in those with PTSD and suggests that the course of PTSD is a relevant consideration in case conceptualization and treatment planning.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"113 ","pages":"Article 103025"},"PeriodicalIF":4.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144088960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The unique autonomic signatures of savoring meditation for anxiety reduction: A pilot randomized controlled trial","authors":"Tomoko Kishimoto ,&nbsp;Ximing Hao ,&nbsp;Qiyu Bai","doi":"10.1016/j.janxdis.2025.103024","DOIUrl":"10.1016/j.janxdis.2025.103024","url":null,"abstract":"<div><div>Anxiety disorders are often characterized by excessive sympathetic activation and dysfunction. While breathing relaxation reliably reduces anxiety by dampening sympathetic activity and enhancing parasympathetic tone, the autonomic signatures underlying positive emotion interventions, such as savoring meditation, remain less understood. In this pilot randomized controlled trial, we recruited 44 participants with probable generalized anxiety disorders (GAD) by questionnaires (GAD-7 score ≥ 10, which represents moderate or higher anxiety severity), who were assigned to a savoring meditation (<em>n</em> = 22) or a breathing relaxation (<em>n</em> = 22) intervention. We measured heart rate variability (HRV) indicators (respiratory sinus arrhythmia, RSA; low-frequency HRV, LF; the low-frequency/high-frequency ratio, LF/HF) and self-reported emotional states (happiness, anxiety, sadness, calmness) before and after the intervention. Linear mixed models with multiple imputation examined outcome change between and within conditions. The savoring group exhibited increased sympathetic and decreased parasympathetic activity (significantly lower RSA, higher LF and LF/HF), contrasting with the relaxation group’s pattern. Both interventions resulted in significant and similar reductions in anxiety after worrying. These preliminary results suggest that savoring meditation for anxiety reduction may have unique autonomic signatures, offering novel insights for positive emotion interventions in anxiety research.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"113 ","pages":"Article 103024"},"PeriodicalIF":4.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the co-occurrence of posttraumatic stress disorder symptoms and dysregulated positive emotion processes: A network analysis","authors":"Siyuan Wang ,&nbsp;Madeline M. Rodenbaugh ,&nbsp;Casey Straud ,&nbsp;Nicole H. Weiss ,&nbsp;Ateka A. Contractor","doi":"10.1016/j.janxdis.2025.103022","DOIUrl":"10.1016/j.janxdis.2025.103022","url":null,"abstract":"<div><div>Emerging research indicates an important role of positive emotion processes in posttraumatic stress disorder (PTSD) symptomatology. To extend this research, we utilized a network approach to examine associations between PTSD symptom clusters (intrusions, avoidance, negative alterations in cognition and mood [NACM], alterations in arousal and reactivity [AAR]) and dysregulated positive emotion processes (levels of positive affect, self-focused positive rumination, emotion-focused positive rumination, dampening, impulse control difficulties, difficulties engaging in goal-directed behaviors, nonacceptance of positive emotions). Specifically, we examined differential relations between PTSD symptom clusters and positive emotion processes, and symptoms that most strongly connected these constructs (i.e., communities). The sample included 191 trauma-exposed adults recruited from Amazon’s MTurk ( <em>M</em>_age = 38.54 ± 10.99 years, 53.4 % women, 63.4 % with probable PTSD). A regularized Guassian Graphic Model consisting of four nodes representing the PTSD symptom clusters’ community and seven nodes representing the positive emotion processes' community was generated. The strongest positive associations across communities were the NACM-dampening and the AAR-dampening edges. Bridge symptoms with the highest inter-community connectivity were dampening, AAR, intrusions, NACM, and impulse control difficulties. Overall, this study indicates the importance of incorporating positive emotion processes in the conceptualization of PTSD. Our results also highlight that dampening of positive emotions and difficulties with impulse control while experiencing positive emotions may be meaningful targets in PTSD treatment.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"113 ","pages":"Article 103022"},"PeriodicalIF":4.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moving towards a subjective conceptualization of betrayal: Examining associations between perceived betrayal, emotion dysregulation, and PTSD symptoms in sexual trauma survivors","authors":"Mariel Emrich ,&nbsp;Camille L. Garnsey,&nbsp;Erika K. Osherow,&nbsp;Crystal L. Park","doi":"10.1016/j.janxdis.2025.103023","DOIUrl":"10.1016/j.janxdis.2025.103023","url":null,"abstract":"<div><h3>Background</h3><div>Sexual trauma survivors commonly experience feelings of betrayal. Betrayal has largely been studied as a static trauma characteristic that is determined by a survivor’s closeness to the perpetrator. This approach overlooks survivors’ <em>subjective feelings and experiences</em>. This study examines whether: 1) degree of perceived betrayal differs by type of survivor-perpetrator relationship, 2) perceived betrayal in the early aftermath of trauma predicts subsequent PTSD symptoms, and 3) emotion dysregulation mediates the relationship between perceived betrayal and PTSD symptoms.</div></div><div><h3>Methods</h3><div>Women (<em>N</em> = 203; ages 19–86) who experienced sexual trauma within a month of recruitment completed questionnaires on Prolific at T1 (within 30 days of trauma), T2 (4 weeks post-T1), and T3 (8 weeks post-T1). Descriptive statistics and an independent samples t-test examined differences in perceived betrayal across survivor-perpetrator relationship characteristics. Structural equation models assessed perceived betrayal at T1 predicting PTSD symptoms at T3 and the potential mediating effect of T2 emotion dysregulation.</div></div><div><h3>Results</h3><div>Although betrayal was highest among survivors who knew the perpetrator prior to the trauma (<em>M</em> = 76.8, range 0–100), average perceived betrayal was high across the sample (<em>M</em> = 70.5), and the quarter of survivors who identified the perpetrator as a stranger also reported elevated betrayal (<em>M</em> = 51.6). T1 perceived betrayal significantly predicted T3 PTSD symptoms with increases in emotion dysregulation partially mediating this effect (<em>p</em> = .01).</div></div><div><h3>Conclusions</h3><div>Findings support moving towards a subjective conceptualization of betrayal that incorporates survivors’ perceptions. Moreover, emotion dysregulation may be an important intervention target in the early aftermath of sexual trauma and warrants further empirical research.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"112 ","pages":"Article 103023"},"PeriodicalIF":4.8,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parental cognitions and child anxiety: A systematic review","authors":"Jeremy K. Fox ,&nbsp;Lauren E. Fleming","doi":"10.1016/j.janxdis.2025.103021","DOIUrl":"10.1016/j.janxdis.2025.103021","url":null,"abstract":"<div><div>Given the well-established link between maladaptive parenting behaviors (e.g., control, accommodation) and the development and maintenance of child anxiety, it is important to understand parental cognitions that may underlie these parenting behaviors. The goal of this systematic review was to examine the extent to which parental cognitions are associated with child anxiety. A systematic electronic database search of PubMed, PsycINFO, ProQuest Psychology, and EBSCO Child Development and Adolescent Studies was conducted in February 2024. In total, 31 studies met inclusion criteria from 9867 abstracts initially identified. The review revealed that a large number of studies have consistently found associations between child anxiety and two types of parental cognitions, negative beliefs about child anxiety and negative expectations of the child’s anxiety. In contrast, studies investigating parental worries about threats to their child and cognitions about parenting are more limited and have produced mixed findings and smaller effects. Future research should examine the directionality and mechanisms of relations between parental cognitions and child anxiety using longitudinal designs, as well as explore the role of cultural factors. Findings suggest that parental cognitions may be an important factor in understanding child anxiety and a potential target for prevention and early intervention.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"112 ","pages":"Article 103021"},"PeriodicalIF":4.8,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concise multi-class anxiety disorder risk assessment: A novel advanced machine learning approach","authors":"Haochong Yang ,&nbsp;Yuan Hong Sun ,&nbsp;Kang Lee","doi":"10.1016/j.janxdis.2025.103018","DOIUrl":"10.1016/j.janxdis.2025.103018","url":null,"abstract":"<div><div>Rapidly assessing anxiety disorder risk is crucial for effective mental health screen and intervention. However, traditional survey tools such as DASS-42 are time-consuming in responding and scoring. We used a novel advanced machine learning approach to create a concise anxiety disorder scale based on DASS-42. By applying advanced ML techniques and feature selection, we created a concise version of the anxiety risk scale while maintaining high validity. The resulting model requires fewer questions to predict anxiety risk levels effectively. This optimized scale was implemented in an online tool for quick self-screening and clinical use. This innovation holds significant societal implications, offering scalable, efficient, and accurate methods that facilitate faster and earlier anxiety disorder detection and intervention, especially among underserved and high-risk populations. The study highlights how machine learning can create practical, accessible mental health assessment tools, contributing to improved well-being outcomes.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"112 ","pages":"Article 103018"},"PeriodicalIF":4.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Question-based computational language approach outperform ratings scale in discriminating between anxiety and depression","authors":"Mona Tabesh ,&nbsp;Mariam Mirström ,&nbsp;Rebecca Astrid Böhme ,&nbsp;Marta Lasota ,&nbsp;Yousef Javaherian ,&nbsp;Thibaud Agbotsoka-Guiter ,&nbsp;Sverker Sikström","doi":"10.1016/j.janxdis.2025.103020","DOIUrl":"10.1016/j.janxdis.2025.103020","url":null,"abstract":"<div><div>Major Depression (MD) and General Anxiety Disorder (GAD) are the most common mental health disorders, which typically are assessed quantitatively by rating scales such as PHQ-9 and GAD-7. However, recent advances in natural language processing (NLP) and machine learning (ML) have opened up the possibility of question-based computational language assessment (QCLA). Here we investigate how accurate open-ended questions, using descriptive keywords or autobiographical narratives, can discriminate between participants that self-reported diagnosis of depression and anxiety, or health control. The results show that both language and rating scale measures can discriminate well, however, autobiographical narratives discriminate best between healthy and anxiety (ϕ = 1.58), as well as healthy and depression (ϕ = 1.38). Descriptive keywords, and to a certain extent autobiographical narratives, also discriminate better than summed scores of GAD-7 and PHQ-9 (ϕ=0.80 in discrimination between anxiety and depression), but not when individual items of these scales were analyzed by ML (ϕ=0.86 and ϕ=0.91 in item-level analysis of PHQ-9 and GAD-7, respectively). Combining the scales consistently elevated the discrimination even more (ϕ=1.39 in comparison between depression and anxiety), both in item-level and sum-scores analyses. These results indicate that QCLA measures often, but not in all cases, are better than standardized rating scales for assessment of depression and anxiety. Implication of these findings for mental health assessments are discussed.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"112 ","pages":"Article 103020"},"PeriodicalIF":4.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From research to real-world global applications: Advancing team science in the study of anxiety disorders","authors":"Ateka A. Contractor","doi":"10.1016/j.janxdis.2025.103019","DOIUrl":"10.1016/j.janxdis.2025.103019","url":null,"abstract":"","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"112 ","pages":"Article 103019"},"PeriodicalIF":4.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological interventions for adult posttraumatic stress disorder: A systematic review of published meta-analyses","authors":"Ahlke Kip ,&nbsp;Linnea Ritter ,&nbsp;Thole H. Hoppen ,&nbsp;Davide Papola ,&nbsp;Giovanni Ostuzzi ,&nbsp;Corrado Barbui ,&nbsp;Nexhmedin Morina","doi":"10.1016/j.janxdis.2025.103017","DOIUrl":"10.1016/j.janxdis.2025.103017","url":null,"abstract":"<div><h3>Objective</h3><div>A large and growing number of published meta-analyses have examined the efficacy of psychological interventions for post-traumatic stress disorder (PTSD). Conclusions drawn from these meta-analyses on treatment efficacy greatly influence clinical practice. This study aimed to provide a comprehensive review of meta-analyses of randomized controlled trials (RCTs) on psychological interventions for adult PTSD, focusing on their content, methodology, and reporting quality.</div></div><div><h3>Method</h3><div>Systematic database searches were conducted in March 2024 using MEDLINE, PsycInfo, PTSDpubs, Web of Science, and the Cochrane Database of Systematic Reviews. The quality of meta-analyses was assessed using AMSTAR 2. The systematic review was registered on PROSPERO (CRD42020151234).</div></div><div><h3>Results</h3><div>Overall, 55 meta-analyses with 93 meta-analytic comparisons at treatment endpoint and 28 comparisons at follow-up were included. Meta-analyses most consistently showed superiority of psychological interventions over control conditions. However, beneficial long-term effects exceeding one-month post-treatment were limited to trauma-focused cognitive behavior interventions (TF-CBT) and eye movement desensitization and reprocessing (EMDR). There was a substantial overlap of primary RCTs, indicating redundancy between meta-analyses. Furthermore, the quality of meta-analyses varied substantially.</div></div><div><h3>Conclusions</h3><div>There is a need to enhance the methodological and reporting quality of meta-analyses, avoid the production of redundant meta-analyses, and conduct more high-quality, large RCTs with long-term assessments.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"112 ","pages":"Article 103017"},"PeriodicalIF":4.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}