Journal of Anxiety Disorders最新文献

{"title":"Brain-heart coupling in response to imminent threat in panic disorder, social anxiety disorder, and healthy controls","authors":"Sarah-Louise Unterschemmann ,&nbsp;Christian Panitz ,&nbsp;Pauline Petereit ,&nbsp;Hannah Comtesse ,&nbsp;Matthias F.J. Sperl ,&nbsp;Erik M. Mueller","doi":"10.1016/j.janxdis.2025.103069","DOIUrl":"10.1016/j.janxdis.2025.103069","url":null,"abstract":"<div><h3>Background</h3><div>Imminent threat does not only capture attention but also triggers defensive psychophysiological responses associated with fight-flight-freeze behavior. However, within-subject associations between central markers of attentional stimulus processing and peripheral components of early defensive activation (e.g., cardiac acceleration) are not well understood. These associations may be especially important in understanding dynamics of anxiety disorders that are characterized by cardiovascular symptoms such as panic disorder.</div></div><div><h3>Methods</h3><div>We analyzed data from <em>N</em> = 90 participants with panic disorder (PD), social anxiety disorder (SAD), as well as healthy controls (CG) who completed a threat conditioning paradigm with face stimuli as conditioned stimuli (CS) and an aversive white noise burst as unconditioned stimulus (US). In addition to univariate analyses of ERPs and heartbeat, single-trial EEG evoked by the noise burst at centromedial sites and heart period were used to calculate intraindividual coupling of unconditioned cortico-cardiac responses.</div></div><div><h3>Results</h3><div>The noise burst evoked strong cardiac acceleration and an event-related potential with a pronounced N100 component. Importantly, the magnitude of single-trial cardiac acceleration was predicted within individuals by the preceding single-trial N100 magnitude. This cortico-cardiac coupling, but not the N100 component or cardiac acceleration per se, was enhanced in individuals with panic disorder compared to social anxiety disorder, with intermediate levels of coupling observed in healthy controls.</div></div><div><h3>Conclusion</h3><div>The present results suggest a central role of early attentional stimulus processing in subsequent cardiac defensive responses. Furthermore, they indicate that cortico-cardiac defensive responses may be altered in individuals with panic disorder specifically, rather than in anxiety disorders in general.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"115 ","pages":"Article 103069"},"PeriodicalIF":4.5,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105067","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":"Safety behavior fading for social anxiety: A randomized controlled trial of a self-monitoring intervention","authors":"James M. Zech ,&nbsp;Tapan A. Patel ,&nbsp;Jesse R. Cougle","doi":"10.1016/j.janxdis.2025.103068","DOIUrl":"10.1016/j.janxdis.2025.103068","url":null,"abstract":"<div><div>Safety behaviors (SBs) are hypothesized to play a key role in social anxiety and present as a viable target of psychosocial treatments. While SB reduction is a component of some cognitive-behavioral therapies for social anxiety, prior research suggests safety behavior fading also represents a viable, standalone digital treatment for social anxiety. The aim of the present study was to test a one-month self-monitoring SB treatment in individuals reporting elevated social anxiety symptoms against a credible control condition. Participants (<em>N</em> = 201) were randomized to either a SB fading condition (<em>n</em> = 99) or an unhealthy behavior fading control (<em>n</em> = 102). Compared to control, SB fading led to lower SB use at post but not one-month follow-up. Contrary to predictions, both conditions saw significant and comparable reductions in social anxiety and related outcomes (depression, loneliness) at posttreatment and follow-up. Treatment credibility and expectancy moderated the effect of condition, such that among participants with more positive beliefs about treatment (after being provided with the rationale), those in the SB condition reported significantly lower follow-up social anxiety than those in control. Further, in the SB condition, both higher social interaction frequency and lower loneliness at baseline were predictive of lower social anxiety at follow-up. Overall, our findings show limitations to SB fading as a standalone intervention and suggest this strategy is more effective among those who interact with others more frequently and who are more confident in this treatment approach. We discuss clinical implications and future research directions, including potential refinements to SB treatment protocols.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"115 ","pages":"Article 103068"},"PeriodicalIF":4.5,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988614","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":"Predicting anxiety symptoms through gaze-directed attention: A mobile eye-tracking study of adolescents during a real-world speech task","authors":"Emily Hutchinson ,&nbsp;Erica Huynh ,&nbsp;Mary Woody ,&nbsp;Dev Chopra ,&nbsp;Amelia Lint ,&nbsp;Enoch Du ,&nbsp;Kristy Benoit Allen ,&nbsp;Cecile Ladouceur ,&nbsp;Jennifer Silk","doi":"10.1016/j.janxdis.2025.103058","DOIUrl":"10.1016/j.janxdis.2025.103058","url":null,"abstract":"<div><div>Adolescence is a key period in which anxiety symptoms dramatically increase, particularly among adolescent girls. Identifying potentially-modifiable risk factors that contribute to anxiety symptoms may be critical to mitigate anxiety symptoms and disorders among youth. Attention biases are one set of cognitive risk factors implicated in the development and maintenance of anxiety disorders. Yet previous research remains mixed as to what pattern of attention bias characterizes adolescents at-risk for developing anxiety. Further, prior literature has largely relied on indirect measures of attention (e.g., reaction time) and tasks with low ecological validity. The present study investigated how attention to social evaluative feedback contributed to concurrent and prospective anxiety symptoms in adolescent girls (n = 90, baseline <em>M</em>_age = 12.31, <em>SD</em> =.83). The present study used a novel speech task and mobile eye-tracking technology to assess gaze-directed attention in an ecologically valid context that adolescents encounter daily. We hypothesized that adolescents who engage in vigilance, avoidance, and the combination of vigilance-avoidance of potentially critical social evaluative feedback would report greater concurrent and prospective anxiety symptoms. We also explored the association between gaze-directed attention to positive social feedback. Contrary to our hypotheses, adolescents who exhibited both initial and sustained avoidance of potentially critical social feedback reported the greatest anxiety three-years later, controlling for baseline anxiety symptoms. Findings highlight the importance of avoidance in real-world socially threatening scenarios in contributing to and maintaining anxiety. Findings also highlight the value of studying attention biases that contribute to anxiety symptoms among adolescents using reliable methods and in real-world contexts.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"115 ","pages":"Article 103058"},"PeriodicalIF":4.5,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903216","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":"Prevalence and correlates of alcohol, cannabis, and tobacco use disorder in DSM-5 generalized anxiety disorder: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions-III","authors":"James M. Zech,&nbsp;Tapan A. Patel,&nbsp;Jesse R. Cougle","doi":"10.1016/j.janxdis.2025.103060","DOIUrl":"10.1016/j.janxdis.2025.103060","url":null,"abstract":"<div><div>Substance use disorders have been linked to Generalized Anxiety Disorder (GAD), though much of this research predates DSM-5 diagnostic criteria. Further, little prior work has examined the demographic correlates of specific substance use disorders among individuals with GAD. These demographic correlates, as well as the presence of comorbid substance use disorder, may also impact treatment seeking in individuals with GAD. In the present study, we explored the relationship between GAD and common substance use disorders (Alcohol Use Disorder, Cannabis Use Disorder, and Tobacco Use Disorder), as well as the demographic factors associated with these disorders among individuals with GAD in a large, nationally representative sample. We also tested whether each of these substance use disorders were associated with GAD-related treatment seeking. Controlling for demographics and comorbidities, lifetime GAD was positively associated with lifetime Alcohol and Cannabis Use Disorder, but not Tobacco Use Disorder, whereas past-year GAD was positively associated with past year Cannabis and Tobacco Use Disorder but not past year Alcohol Use Disorder. Lastly, lifetime Alcohol Used Disorder but not Cannabis or Tobacco Use Disorder was associated with higher rates of GAD-related treatment seeking. Collectively, these findings reflect an updated examination of GAD and disordered substance use using DSM-5 diagnostic criteria and indicate the importance substance use comorbidities in the context of GAD.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"115 ","pages":"Article 103060"},"PeriodicalIF":4.5,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144894845","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 role of tonic immobility during re-experiencing trauma in PTSD treatment","authors":"Nadine C. van der Burg ,&nbsp;Muriel A. Hagenaars ,&nbsp;Ad de Jongh ,&nbsp;Agnes van Minnen","doi":"10.1016/j.janxdis.2025.103059","DOIUrl":"10.1016/j.janxdis.2025.103059","url":null,"abstract":"<div><div>Tonic immobility (TI) is a profound paralysis that may occur during extreme stress. Previous studies have found that TI during trauma was associated with poorer recovery from posttraumatic stress disorder (PTSD). Importantly, TI can re-occur during re-experiencing the trauma (TI_re-exp). It is unclear whether TI_re-exp also hinders recovery from PTSD or declines along with other PTSD symptoms after treatment. We examined whether pre-treatment self-reported TI_re-exp would predict PTSD symptoms after trauma-focused treatment, including related constructs as depression and dissociation. and investigated pre- to post-treatment changes in TI_re-exp. We also explored individual differences in TI_re-exp course. A total of 257 patients with PTSD, referred to a clinic for intensive trauma-focused therapy, completed measures for PTSD symptoms and TI_re-exp at pre- and posttreatment, and potential confounding variables (dissociative tendencies, somatoform dissociation, dissociative subtype, and depression) at pre-treatment. Higher pre-treatment TI_re-exp predicted elevated post-treatment PTSD symptoms, but not after controlling for potentially confounding constructs. Overall, TI_re-exp decreased from pre- to post-treatment, and a greater decrease in TI_re-exp was associated with a greater decrease in PTSD symptoms. However, four distinct clusters could be identified, which differed in TI_re-exp course: High-stable, High-decrease, Moderate and Low TI_re-exp. End-state was worse for patients in the High-stable and Moderate clusters. Thus, in the general sample, pre-treatment TI_re-exp was not associated with reduced recovery, and TI_re-exp generally decreased after treatment, suggesting that TI_re-exp may be related to the PTSD symptomatology, responding well to trauma-focused CBT treatment. However, TI_re-exp may not decline in specific patient groups. Future research may address how TI_re-exp can be targeted for these patients.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"115 ","pages":"Article 103059"},"PeriodicalIF":4.5,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908483","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":"Covert or connected: Motivations for online and interpersonal reassurance-seeking in OCD","authors":"Carly A. Parsons,&nbsp;Hannah Jooyoung Kim,&nbsp;Surat Singh,&nbsp;Tuguldur Lkhagva,&nbsp;Jiayin Wang,&nbsp;Lynn E. Alden","doi":"10.1016/j.janxdis.2025.103057","DOIUrl":"10.1016/j.janxdis.2025.103057","url":null,"abstract":"<div><div>Interpersonal reassurance-seeking is a common anxiety-management strategy used by individuals with a range of disorders, but can be particularly repetitive and exacting among individuals with obsessive-compulsive disorder (OCD). Although this strategy yields short-term relief, it also comes at a cost, creating frustration and straining relationships. Non-interpersonal sources of reassurance—such as the internet—have been less thoroughly studied, but may offer unique advantages. In this mixed-methods study, we explored the differentiating benefits and drawbacks of interpersonal and online reassurance-seeking for individuals with and without OCD. Participants (<em>n</em> = 62 OCD, <em>n</em> = 58 control) completed an imaginal exposure task, after which they indicated their reassurance source preference (interpersonal vs. online) and their primary reasons for this preference. Participants also answered two general questions about their usual motivations for seeking reassurance from each source at the exclusion of the other. We used content analysis to identify patterns in participants’ responses, and quantitative methods to examine the most common motivations as well as any between-group differences. Common reasons for seeking reassurance interpersonally included desires for emotional support and personalization, and these findings did not differ between groups. Common reasons for online reassurance typically involved interpersonal concerns, and participants with OCD were more likely to specifically express concern about the personal consequences of revealing one’s worries to others. Motivations related to trust and seeking shared experiences were common for both reassurance types. These findings are discussed in the context of the broader literature on reassurance-seeking and obsessive-compulsive symptomatology.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"115 ","pages":"Article 103057"},"PeriodicalIF":4.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144810651","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":"Perinatal PTSD and the mother-infant bond: A systematic review and meta-analysis.","authors":"Franciska Rehberg, Lydia Rihm, Ariane Göbel, Freya Thiel, Verena C S Büechl, Manon Even, Susan Garthus-Niegel","doi":"10.1016/j.janxdis.2025.103050","DOIUrl":"10.1016/j.janxdis.2025.103050","url":null,"abstract":"<p><strong>Background: </strong>Despite a growing body of literature, understanding of the relationship between maternal symptoms of perinatal posttraumatic stress disorder (PTSD) and the emerging mother-infant bond (MIB) remains limited. This systematic review and meta-analysis elucidates this association considering both general PTSD (gPTSD) symptoms (i.e., not originating from childbirth) as well as childbirth-related PTSD (CB-PTSD) symptoms.</p><p><strong>Methods: </strong>A comprehensive literature search screening for articles published until 10/03/2024 was conducted. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Pooled effect sizes were estimated with random effects models.</p><p><strong>Results: </strong>The systematic review includes 22 studies (9472 participants) and indicates a positive association between perinatal PTSD symptoms and impaired MIB. However, the relationship might be explained by confounding factors (e.g., depressive symptoms, general psychological distress). Meta-analyses suggest a small to moderate positive association (r = .32) between postnatal gPTSD symptoms and impaired MIB (n = 8) and a moderate positive association (r = .38) between CB-PTSD symptoms and impaired MIB (n = 15). Additional exploratory meta-analyses indicate that within the CB-PTSD construct, general rather than childbirth-related PTSD symptoms are more strongly related to MIB (n = 5).</p><p><strong>Limitations: </strong>Heterogeneity across studies, methodological complexities in distinguishing perinatal PTSD subtypes, and a small number of studies should be noted.</p><p><strong>Conclusions: </strong>The results indicate differential associations between gPTSD versus CB-PTSD and MIB. However, further research is required to fully elucidate the relationship between maternal perinatal PTSD and MIB and the role of individual symptom domains to inform the targeted development of interventions.</p>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"114 ","pages":"103050"},"PeriodicalIF":4.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817972","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":"Memory and identity processes in ICD-11 complex posttraumatic stress disorder: Tests of a new theory","authors":"Philip Hyland ,&nbsp;Marcus Broughill ,&nbsp;Mark Shevlin ,&nbsp;Chris R. Brewin","doi":"10.1016/j.janxdis.2025.103055","DOIUrl":"10.1016/j.janxdis.2025.103055","url":null,"abstract":"<div><h3>Background</h3><div>This study empirically tested several predictions arising from the Memory and Identity (M&amp;I) Theory of <em>ICD-11</em> Complex PTSD (CPTSD). Specifically, it examined the psychometric properties of two measures—the Experiences of Traumatic Memories Questionnaire (ETMQ) and the Trauma Identity Questionnaire (TIQ)—and tested relationships between different types of trauma exposure, disturbances in memory and identity, and CPTSD symptoms.</div></div><div><h3>Methods</h3><div>Data were collected from a non-probability based representative sample of the general adult population of the United Kingdom (<em>N</em> = 975), and latent variable modelling was used to test all hypotheses.</div></div><div><h3>Results</h3><div>Confirmatory factor analytic results provided support for the psychometric properties of the ETMQ and TIQ as measures of traumatic memories and negative identities. Multiple traumatization and interpersonal forms of trauma were associated with more disturbances in trauma memories and negative identities. Seven of the nine model-predicted associations between trauma memories, negative identities, and CPTSD symptoms were observed, including a link between a fragmented sense of self and emotional numbing.</div></div><div><h3>Conclusions</h3><div>Results support core elements of the M&amp;I Theory, highlighting trauma memory and identity disturbances as key mechanisms in CPTSD.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"114 ","pages":"Article 103055"},"PeriodicalIF":4.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721784","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":"Assessing executive functioning in individuals with social anxiety disorder (SAD) across the lifespan: A systematic literature review and meta-analysis","authors":"Alexandra A. Harrison,&nbsp;Lan Nguyen,&nbsp;Karen Murphy,&nbsp;David Neumann","doi":"10.1016/j.janxdis.2025.103056","DOIUrl":"10.1016/j.janxdis.2025.103056","url":null,"abstract":"<div><div>Social anxiety disorder is a pervasive clinical disorder characterised by intense fear and/or avoidance of one or more social situations, and has been linked to deficits in executive functioning performance. However, methodological differences and mixed results have made it difficult to draw definitive conclusions from individual studies. The current systematic review and meta-analysis collated the results from 49 studies to examine the link between social anxiety disorder and executive functioning across the lifespan. Findings revealed that individuals with social anxiety performed significantly worse than healthy controls or low social anxiety groups on measures of executive functioning (<em>r</em> = -.15), specifically cognitive flexibility (<em>r</em> = -.20), inhibitory control (<em>r</em> = -.18), and global executive functioning (<em>r</em> = -.17). No significant association was evident between working memory and social anxiety (<em>r</em> = -.06). In addition, the type of measure (self-report vs cognitive task) moderated the relationship between social anxiety and executive functioning. Although age did not moderate the overall relationship, the association between the individual domains of executive functioning and social anxiety differed between youth and adults, which may reflect the different developmental timelines between the domains across the lifespan. The findings offer valuable insight into our understanding of the development of executive functions for individuals with social anxiety and could assist with forming new strategies or interventions to improve daily functioning in this clinical population.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"115 ","pages":"Article 103056"},"PeriodicalIF":4.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750438","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":"Savoring meditation for emotional disorders: Targeting positive emotion regulation deficits","authors":"Tomoko Kishimoto ,&nbsp;Ximing Hao ,&nbsp;Jianwei Qian","doi":"10.1016/j.janxdis.2025.103054","DOIUrl":"10.1016/j.janxdis.2025.103054","url":null,"abstract":"<div><div>Deficits in positive emotion regulation (PER) contribute to emotional disorders but are less studied than negative emotion regulation (NER). One maladaptive PER strategy, positive emotion contrast-seeking (PEC-seeking), involves sustaining negative affect to enhance later positive emotions, reinforcing anxiety and depression. This study developed and tested a savoring-based, transdiagnostic intervention to reduce PEC-seeking and alleviate emotional disorder symptoms. A single-blind RCT with 59 Chinese college students with elevated depression and anxiety (majority meeting depression criteria) compared a two-week group savoring meditation intervention to waitlist control. Changes in depression, anxiety, savoring beliefs, and PEC-seeking were assessed at Baseline (T0), MidTest (T1), PostTest (T2), and one-month Follow-up (T3). The experimental group also reported positive and negative affect before and after each group session and individual practice. Savoring meditation significantly reduced depression (T1, <em>d</em> = −1.11, <em>p</em> = .005; T2, <em>d</em> = −1.60, <em>p</em> &lt; .001) with effects maintained at follow-up (T3, <em>p</em> &lt; .001). Negative affect also declined significantly (Session 5, <em>p</em> &lt; .001), though changes in positive affect were not statistically significant. The intervention increased savoring beliefs (T1, <em>d</em> = 1.42, T2, <em>d</em> = 1.41, <em>ps</em> =.003) and reduced PEC-seeking (T1, <em>d</em> = −0.92, <em>p</em> = .027), which in turn mediated reductions in depression. Although anxiety symptoms declined within the experimental group over time, between-group differences did not reach statistical significance. Nonetheless, the effect size was larger for the experimental group (T2, <em>d</em> = 0.34) than for the waitlist group (<em>d</em> = 0.01), suggesting a potential anxiolytic effect of the intervention. These findings suggest that targeting maladaptive PER strategies, especially PEC-seeking, via savoring meditation may effectively reduce emotional disorder symptoms. This study highlights PER’s role in transdiagnostic interventions and provides novel insights into PER-focused therapies.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"114 ","pages":"Article 103054"},"PeriodicalIF":4.8,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702323","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}