Thomas M. Olino , Samantha L. Birk , Julia A.C. Case , Justin Weeks
{"title":"An Initial examination of fear of negative and positive evaluation in youth","authors":"Thomas M. Olino , Samantha L. Birk , Julia A.C. Case , Justin Weeks","doi":"10.1016/j.janxdis.2023.102784","DOIUrl":"10.1016/j.janxdis.2023.102784","url":null,"abstract":"<div><p>Fear of negative evaluation (FNE) and fear of positive evaluation (FPE) are both core features of social anxiety. The majority of research with these constructs has been done with older adolescents and adults, with only one previous study examining FNE and FPE in childhood. However, this previous work relied exclusively on parent-report of youth FNE and FPE. Here, we examined the factor structure of FNE and FPE using youth self-reports. Moreover, we examined the associations with dimensions of internalizing and externalizing problems. We found that two-factor structure of FNE and FPE was a marginal fit to the data. Exploratory models identified three items that showed significant cross-loadings on non-target factors. Overall, we found that FNE was associated with dimensions of internalizing problems reported by youth and their mothers. FPE was associated with internalizing problems reported by youth, but not parents. Associations between FNE and clinical outcomes were stronger than those for FPE. This study demonstrates promise of FNE and FPE in youth and highlights important directions for future research.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":null,"pages":null},"PeriodicalIF":10.3,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239975","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}
Peter Sele , Asle Hoffart , Marylène Cloitre , Elizabeth Hembree , Tuva Øktedalen
{"title":"Comparing phase-based treatment, prolonged exposure, and skills-training for Complex Posttraumatic Stress Disorder: A randomized controlled trial","authors":"Peter Sele , Asle Hoffart , Marylène Cloitre , Elizabeth Hembree , Tuva Øktedalen","doi":"10.1016/j.janxdis.2023.102786","DOIUrl":"10.1016/j.janxdis.2023.102786","url":null,"abstract":"<div><h3>Objective</h3><p>This study examines treatment effects in STAIR Narrative Therapy (SNT), a phase-based treatment where Skills Training in Affective and Interpersonal Regulation (STAIR) precedes Narrative Therapy (NT), compared to Prolonged Exposure (PE) and to STAIR.</p></div><div><h3>Method</h3><p>Ninety-two adult patients diagnosed with DSM-5 PTSD and ICD-11 CPTSD following childhood abuse were randomly assigned to enhanced versions of SNT (12 group STAIR sessions + 8 individual NT sessions), PE (8–16 individual sessions), or STAIR (12 group STAIR sessions) provided in residential care. Outcome was assessed by mixed models.</p></div><div><h3>Results</h3><p>PE produced greater improvements in DSM-5 PTSD symptoms compared to SNT from pre-treatment to post-treatment, but not compared to STAIR. Reductions in ICD-11 CPTSD symptoms were not significantly different among conditions. From pre-treatment to 1 year follow-up, PE produced greater PTSD symptom improvements than SNT and STAIR, and PE and STAIR produced greater CPTSD symptom improvements than SNT.</p></div><div><h3>Conclusions</h3><p>The predicted stronger effect of SNT compared to PE and STAIR on DSM-5 PTSD and ICD-11 CPTSD symptoms was not supported by the findings. The benefits of immediate trauma-focused treatments (TFT) as compared to phase-based treatments, and the potential non-inferiority of skills-training as compared to TFT in CPTSD needs to be further investigated.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":null,"pages":null},"PeriodicalIF":10.3,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693200","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}
Rachel de Jong, M. Lommen, W. V. van Hout, R. Kuijpers, Lisanne L. Stone, Peter J. de Jong, M. Nauta
{"title":"Better together? A randomized controlled microtrial comparing different levels of therapist and parental involvement in exposure-based treatment of childhood specific phobia.","authors":"Rachel de Jong, M. Lommen, W. V. van Hout, R. Kuijpers, Lisanne L. Stone, Peter J. de Jong, M. Nauta","doi":"10.2139/ssrn.4356630","DOIUrl":"https://doi.org/10.2139/ssrn.4356630","url":null,"abstract":"INTRODUCTION\u0000Exposure is often limited to homework assignments in routine clinical care. The current study compares minimally-guided (MGE) and parent-guided (PGE) out-session homework formats to the 'golden standard' of therapist-guided in-session exposure with minimally-guided exposure at home (TGE).\u0000\u0000\u0000METHODS\u0000Children with specific phobia (N = 55, age 8-12, 56% girls) participated in a single-blind, randomized controlled microtrial with a four-week baseline-treatment period design. Clinical interviews, behavioral avoidance tests, and self-report measures were assessed at pre-treatment, post-treatment, and at one-month follow-up.\u0000\u0000\u0000RESULTS\u0000TGE resulted in a larger decline of specific phobia severity from baseline to post-treatment compared to MGE but not compared to PGE. Parental anxiety was found to be a moderator of less treatment efficacy of PGE from baseline to post-treatment. Overall, there was no meaningful difference in efficacy of TGE versus MGE or PGE from baseline to follow-up.\u0000\u0000\u0000CONCLUSIONS\u0000These findings suggest that for improving short-term treatment gains, exposure exercises can best be conducted with the help of a therapist within the therapy session before they are conducted as homework assignments outside the therapy session. However, for long-term treatment gains exposure exercises can be handled by the child itself or with help of its parents.","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":null,"pages":null},"PeriodicalIF":10.3,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45885074","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}
Rachel de Jong , Miriam J.J. Lommen , Wiljo J.P.J. van Hout , Rowella C.W.M. Kuijpers , Lisanne Stone , Peter de Jong , Maaike H. Nauta
{"title":"Better together? A randomized controlled microtrial comparing different levels of therapist and parental involvement in exposure-based treatment of childhood specific phobia","authors":"Rachel de Jong , Miriam J.J. Lommen , Wiljo J.P.J. van Hout , Rowella C.W.M. Kuijpers , Lisanne Stone , Peter de Jong , Maaike H. Nauta","doi":"10.1016/j.janxdis.2023.102785","DOIUrl":"10.1016/j.janxdis.2023.102785","url":null,"abstract":"<div><h3>Introduction</h3><p>Exposure is often limited to homework assignments in routine clinical care. The current study compares minimally-guided (MGE) and parent-guided (PGE) out-session homework formats to the ‘golden standard’ of therapist-guided in-session exposure with minimally-guided exposure at home (TGE).</p></div><div><h3>Methods</h3><p>Children with specific phobia (N = 55, age 8–12, 56% girls) participated in a single-blind, randomized controlled microtrial with a four-week baseline-treatment period design. Clinical interviews, behavioral avoidance tests, and self-report measures were assessed at pre-treatment, post-treatment, and at one-month follow-up.</p></div><div><h3>Results</h3><p>TGE resulted in a larger decline of specific phobia severity from baseline to post-treatment compared to MGE but not compared to PGE. Parental anxiety was found to be a moderator of less treatment efficacy of PGE from baseline to post-treatment. Overall, there was no meaningful difference in efficacy of TGE versus MGE or PGE from baseline to follow-up.</p></div><div><h3>Conclusions</h3><p>These findings suggest that for improving short-term treatment gains, exposure exercises can best be conducted with the help of a therapist within the therapy session before they are conducted as homework assignments outside the therapy session. However, for long-term treatment gains exposure exercises can be handled by the child itself or with help of its parents.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":null,"pages":null},"PeriodicalIF":10.3,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41216369","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}
Nicole M. Christ , Ryan A. Schubert , Rhea Mundle , Sarah Pridgen , Philip Held
{"title":"Using machine learning to predict sudden gains in intensive treatment for PTSD","authors":"Nicole M. Christ , Ryan A. Schubert , Rhea Mundle , Sarah Pridgen , Philip Held","doi":"10.1016/j.janxdis.2023.102783","DOIUrl":"10.1016/j.janxdis.2023.102783","url":null,"abstract":"<div><p>Sudden gains have been found in PTSD treatment across samples and treatment modality. Sudden gains have consistently predicted better treatment response, illustrating clear clinical implications, though attempts to identify predictors of sudden gains have produced inconsistent findings. To date, sudden gains have not been examined in intensive PTSD treatment programs (ITPs). This study explored the occurrence of sudden gains in a 3-week and 2-week ITP (<em>n</em> = 465 and <em>n</em> = 235), evaluated the effect of sudden gains on post-treatment and follow-up PTSD severity while controlling for overall change, and used three machine learning algorithms to assess our ability to predict sudden gains. We found 31% and 19% of our respective samples experienced a sudden gain during the ITP. In both ITPs, sudden gain status predicted greater PTSD symptom improvement at post-treatment (t<sub>2 W</sub>=−8.57, t<sub>3 W</sub>=−14.86, p < .001) and at 3-month follow-up (t<sub>2 W</sub>=−3.82, t<sub>3 W</sub>=−5.32, p < .001). However, the effect for follow-up was no longer significant after controlling for total symptom reduction across the ITP (t<sub>2 W</sub>=−1.59, t<sub>3 W</sub>=−0.32, p > .05). Our ability to predict sudden gains was poor (AUC <.7) across all three machine learning algorithms. These findings demonstrate that sudden gains can be detected in intensive treatment for PTSD, though their implications for treatment outcomes may be limited. Moreover, despite the use of three machine-learning methods across two fairly large clinical samples, we were still unable to identify variables that accurately predict whether an individual will experience a sudden gain during treatment. Implications for clinical application of these findings and for future studies are discussed.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":null,"pages":null},"PeriodicalIF":10.3,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693201","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}
Lauren B. Yadlosky, Wenzhu B. Mowrey, Sandra S. Pimentel
{"title":"Risky business: Considerations of emotion regulation and high-risk behaviors in anxious adolescents","authors":"Lauren B. Yadlosky, Wenzhu B. Mowrey, Sandra S. Pimentel","doi":"10.1016/j.janxdis.2023.102760","DOIUrl":"10.1016/j.janxdis.2023.102760","url":null,"abstract":"<div><p><span><span>A growing body of empirical literature connects anxiety symptoms and high-risk suicidal and self-harming behaviors in youth. Emotion regulation<span><span> (ER) processes and deficits have been identified as important factors in the etiology, maintenance, and treatment of both youth anxiety and high-risk behaviors. The present study assessed the association between these variables using an acute, socio-demographically diverse clinical sample of youth presenting to an outpatient </span>mental health clinic. Ninety-nine youth aged 12–20 years old completed measures of anxiety symptoms, ER difficulties, and lifetime history of high-risk behaviors including non-suicidal self-injury (NSSI) and suicide attempts. Unadjusted analyses show that more severe anxiety symptoms were associated with more ER difficulties and history of risk behavior. Multivariate </span></span>linear regression models considering age, sex, race/ethnicity, and risk history show that more severe anxiety symptoms remained significantly associated with more ER difficulties (</span><em>p</em> < 0.0001) and positive suicide attempt history (<em>p</em> < 0.01). Findings highlight the importance of integrating considerations of ER into the case conceptualization and treatment planning of high-risk, anxious youth to inform evidenced-based care with this population. The need for targeted, ongoing risk assessment with anxious youth to identify and mitigate risk is also demonstrated.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":null,"pages":null},"PeriodicalIF":10.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10172413","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}
Amanda Krygsman , Ann H. Farrell , Heather Brittain , Tracy Vaillancourt
{"title":"Anxiety symptoms before and during the COVID-19 pandemic: A longitudinal examination of Canadian young adults","authors":"Amanda Krygsman , Ann H. Farrell , Heather Brittain , Tracy Vaillancourt","doi":"10.1016/j.janxdis.2023.102769","DOIUrl":"10.1016/j.janxdis.2023.102769","url":null,"abstract":"<div><p>The COVID-19 pandemic has resulted in many changes that may impact anxiety symptoms (i.e., general anxiety and somatization), particularly for young adults who were at higher risk for anxiety than older adults. We examined anxiety symptoms before (age 19, 20, 21, and 22) and during the pandemic (age 23 and 24) in a cohort of Canadian young adults (<em>n</em><span> = 396). Latent growth curve models were performed for general anxiety and somatization and the pandemic time points were estimated as structured residuals to quantify the change from participants’ expected trajectories. We also examined whether fear of COVID-19 predicted the changes in anxiety symptoms during the pandemic. Results indicated that a history of general anxiety and somatization positively predicted fear of COVID-19 during the pandemic and negatively predicted pandemic change from predicted values for both general anxiety and somatization. Increased COVID-19 fear was related within time to increases in general anxiety at ages 23 and 24 and increases in somatization at age 24. We also found that the proportion of individuals in the subclinical/clinical range of somatization was higher from age 23–24, but not from age 22–23 and there were no differences for general anxiety. Results highlight the need to consider within-person change and development in evaluating anxiety symptom changes and predictors of changes in anxiety symptoms.</span></p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":null,"pages":null},"PeriodicalIF":10.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10579281","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}
M. Tracie Shea , Janice L. Krupnick , Frederic J. Sautter , Mihriye Mete , Bonnie L. Green , Sonya B. Norman , Shauna L. Finley , Erica Eaton
{"title":"A randomized clinical trial comparing Interpersonal Psychotherapy with Prolonged Exposure for the treatment of PTSD in veterans","authors":"M. Tracie Shea , Janice L. Krupnick , Frederic J. Sautter , Mihriye Mete , Bonnie L. Green , Sonya B. Norman , Shauna L. Finley , Erica Eaton","doi":"10.1016/j.janxdis.2023.102770","DOIUrl":"10.1016/j.janxdis.2023.102770","url":null,"abstract":"<div><p><span><span>Trauma-focused therapies are recommended as first-line treatments for </span>posttraumatic stress disorder (PTSD), but many veterans do not complete or sufficiently respond to these treatments. Interpersonal Therapy (IPT) is a non-trauma focused approach that directly addresses the interpersonal and social impairments associated with PTSD. This two-site randomized controlled equivalence trial compared IPT with Prolonged Exposure (PE) in improving PTSD symptoms and interpersonal functioning in 109 veterans with PTSD. Secondary outcomes included functioning and </span>quality of life. We hypothesized that IPT would be statistically equivalent to PE in reducing PTSD symptoms, and superior to PE in improving interpersonal functioning and secondary outcomes of work and social adjustment and quality of life. PTSD symptom severity decreased significantly in both treatments from pre- to post-treatment. Although IPT improved as much as PE and treatments did not differ significantly, the 95 % confidence interval for the difference between the groups did not fall completely within the margin of equivalence. IPT was not superior to PE in improvement in interpersonal functioning or on secondary outcomes. Findings from multi-level linear mixed models using longitudinal data (posttreatment, three and six month follow up) for the primary outcomes of PTSD and interpersonal functioning were consistent with the post-treatment analyses. Although statistically inconclusive in terms of equivalence, the comparable reduction in PTSD symptoms slightly favoring IPT suggests that IPT is an acceptable alternative to gold-standard trauma-focused treatments for veterans with PTSD.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":null,"pages":null},"PeriodicalIF":10.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41137969","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":"Pride in social anxiety disorder","authors":"Roni Oren-Yagoda, Nadav Paz, Idan M. Aderka","doi":"10.1016/j.janxdis.2023.102759","DOIUrl":"10.1016/j.janxdis.2023.102759","url":null,"abstract":"<div><p><span>The present study examined differences in the experience of pride between individuals with and without social anxiety disorder (SAD), and is the first to examine both the effects of context on pride and the temporal relationship between pride and anxiety in participants’ daily lives. Eighty-eight participants took part in the study, half (</span><em>n</em> = 44) met diagnostic criteria for SAD and half (<em>n</em><span> = 44) did not. Both groups completed an experience sampling measurement (ESM) to assess the levels of pride and anxiety and the nature of interpersonal contexts in which these emotions were experienced every day for 21 consecutive days. Using multilevel linear modeling, our findings suggest that pride is diminished among individuals with SAD, that situations percieved as highly neagative and positive, or as highly meaningful and positive are associated with the highest levels of pride, and that the experience of pride is associated with subsequent reductions in anxiety among individuals with SAD. These findings point to the role of pride in the disorder and can be used to inform and enhance therapeutic interventions for SAD.</span></p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":null,"pages":null},"PeriodicalIF":10.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10113222","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}
Lisa Espinosa , Laura Singh , Tabea Eimer , Andreas Olsson , Emily A. Holmes
{"title":"Reading others’ social appraisals after viewing an aversive film online impacts mood but not intrusive memories","authors":"Lisa Espinosa , Laura Singh , Tabea Eimer , Andreas Olsson , Emily A. Holmes","doi":"10.1016/j.janxdis.2023.102763","DOIUrl":"10.1016/j.janxdis.2023.102763","url":null,"abstract":"<div><p>Exposure to aversive footage online can affect our well-being, but to what extent does reading others’ appraisals of this content modulate our affective responses? In a pre-registered online study (N = 170), we used a digital trauma film paradigm as an analogue for the naturalistic exposure to aversive visual content online. We investigated whether online social reappraisal about the film influenced acute affective responses and subsequent intrusive memories. First, we examined whether the digital trauma film paradigm induced similar affective responses as in-lab experiments (within-subjects; change in negative mood and intrusive memories of the film during seven days). Participants reported a negative mood change and experienced intrusive memories of the film, extending findings from in-lab experiments. Next, we tested a social reappraisal manipulation that provides written comments from (fictitious) previous participants (between-subjects; reading positive, negative, or no comments) modulated participants’ affective responses. As predicted, relative to controls and negative comments, reading positive comments decreased negative mood. However, reading negative comments did not increase negative mood. Contrary to predictions, the social reappraisal manipulation did not modulate the number of intrusive memories. Findings suggest the benefit of positive social reappraisal for mitigating negative mood, but not intrusive memories following aversive film content online.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":null,"pages":null},"PeriodicalIF":10.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10137266","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}