Journal of Anxiety Disorders最新文献

{"title":"Antisaccade performance in spider phobia and its association with multimodal correlates of fear","authors":"Fabian Breuer ,&nbsp;Anne Sophie Hildebrand ,&nbsp;Johannes B. Finke ,&nbsp;Leandra Bucher ,&nbsp;Udo Dannlowski ,&nbsp;Tim Klucken ,&nbsp;Kati Roesmann ,&nbsp;Elisabeth Johanna Leehr","doi":"10.1016/j.janxdis.2025.103078","DOIUrl":"10.1016/j.janxdis.2025.103078","url":null,"abstract":"<div><h3>Introduction</h3><div>This study explored inhibitory control in spider phobic (SP) and healthy control (HC) individuals using an emotional antisaccade task. Attentional control theory (ACT) suggests anxiety related deficits in inhibitory control, yet studies on antisaccade performance in anxiety disordered patients are sparse. This study addressed this research gap and additionally aimed to explore putative associations of antisaccade performance with multimodal measures of fear of spiders.</div></div><div><h3>Methods</h3><div>A sample of 76 participants (41 SP, 35 HC) completed an antisaccade task, employing schematic pictures of spiders and flowers. We measured antisaccade latencies and error rates, respectively. In a free-viewing task, we obtained psychophysiological and subjective fear responses to pictures of spiders. Self-rated fear of spiders was assessed via questionnaires and avoidance behavior was assessed in a behavioral avoidance test.</div></div><div><h3>Results</h3><div>Contrary to ACT predictions, SP exhibited shorter antisaccade latencies irrespective of stimulus category, indexing more efficient inhibitory control, while showing no differences in antisaccade error rates when compared to HC. Consistent with prior findings, SP participants showed elevated psychophysiological responding, fear ratings and avoidance behavior. No significant associations emerged between inhibitory control performance and these measures of fear.</div></div><div><h3>Discussion</h3><div>Our findings suggest enhanced inhibitory control efficiency in SP compared to HC, contrasting impairments predicted by ACT and observed in subclinical anxiety. These findings may indicate a compensatory adaptation in anxiety disorders, enabling rapid attentional avoidance of threat. Our results also imply that inhibitory control may be differentially affected across various anxiety disorders, depending on their predisposition towards fear or anxiety, while also being independent from diverse measures of fear and anxiety.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"116 ","pages":"Article 103078"},"PeriodicalIF":4.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245266","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":"Treating young adult generalized anxiety disorder with text-message delivered cognitive behavioral therapy: A randomized clinical trial testing efficacy and clinical mechanisms","authors":"Michael J. Mason ,&nbsp;J. Douglas Coatsworth ,&nbsp;Aaron Brown ,&nbsp;Nikola Zaharakis ,&nbsp;Michael Russell ,&nbsp;Jeremy Mennis","doi":"10.1016/j.janxdis.2025.103089","DOIUrl":"10.1016/j.janxdis.2025.103089","url":null,"abstract":"<div><div>Approximately one in five (19.5 %) young adults have experienced generalized anxiety disorder (GAD) in the past year. Compared with other age groups, they are least likely to receive mental health treatment despite reporting greater need for these services. To address these issues, we conducted a randomized clinical trial with 102 young adults using an 8-week, automated text-message delivered cognitive behavioral therapy (CBT-txt-A) to treat GAD. We examined treatment engagement, tested treatment efficacy, and tested 3 clinical mechanisms of change. Participants were from 33 states, recruited from Instagram and Facebook who presented with at least moderate GAD symptomatology. Assessments occurred at baseline prior to randomization and at 1, 2, and 3 months after enrollment. The primary outcome, severity of GAD symptoms, was assessed using the GAD-7 measure. Behavioral activation, perseverative thinking, and cognitive distortions were hypothesized clinical mechanisms. Participants were randomized to CBT-txt-A or a waitlist control condition. Results indicated that participants in the CBT-txt-A group significantly reduced their GAD symptoms over time compared to the control condition, producing a large effect size (Cohen <em>d</em> = 0.83). One quarter of the treatment group moved into the high-end state functioning level, representing no or minimal GAD symptoms, compared to 5.5 % of the controls. Mediation analyses indicated that CBT-txt-A increased behavioral activation, and reduced perseverative thinking and cognitive distortion, at 2 months, which in turn, was then associated with reductions in GAD symptoms at 3 months. Results provide evidence for the efficacy of CBT-txt-A in reducing GAD symptoms through three hypothesized clinical mechanisms.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"116 ","pages":"Article 103089"},"PeriodicalIF":4.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410506","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":"On the non-inferiority of metacognitive therapy for OCD: Clarifying the methodology and rationale","authors":"Cornelia Exner ,&nbsp;Alexandra Kleiman ,&nbsp;Anke Haberkamp ,&nbsp;Jana Hansmeier ,&nbsp;Christopher Milde ,&nbsp;Julia Anna Glombiewski","doi":"10.1016/j.janxdis.2025.103094","DOIUrl":"10.1016/j.janxdis.2025.103094","url":null,"abstract":"","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"116 ","pages":"Article 103094"},"PeriodicalIF":4.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528789","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 symptomatology and assessment of emetophobia: A comprehensive scoping review","authors":"Molly S. Harbor,&nbsp;Paul E. Jenkins,&nbsp;Kate Harvey","doi":"10.1016/j.janxdis.2025.103076","DOIUrl":"10.1016/j.janxdis.2025.103076","url":null,"abstract":"<div><div>Emetophobia, the specific fear of vomiting, is a poorly understood anxiety disorder. Despite a growing body of research, comprehensive reviews on its presentation and assessment are limited and dated. This scoping review maps, synthesises and explores existing literature on the assessment measures and symptomatology of emetophobia. Its purpose is to inform future clinical practices by identifying reliable assessment instruments and facilitating more accurate diagnosis, treatment planning, and research comparisons. Five online databases (PubMed, SCOPUS, PsycINFO, Google Scholar, PsyArXiy) were searched using terms related to emetophobia. In total, 483 unique articles were located of which 38 were eligible for inclusion (35 described symptomatology; 3 described assessment measures). Among studies exploring symptoms, 17 were single case studies, 11 were cross-sectional surveys and 7 were other designs (e.g., case series, retrospective studies). Findings indicate that emetophobia is a multifaceted condition consisting of physical, psychological and behavioural symptoms. Avoidance behaviours are the most frequently reported symptom, described in 91 % of included literature. There is little research exploring the differences in child and adult symptom presentation which may result in misdiagnosis if an adult-centric criteria is applied. Two self-report questionnaires have been created and their psychometric properties assessed but, given numerous studies relied on longer, unvalidated assessment measures, these two measures appear to need further development. This review establishes that emetophobia is a complex and debilitating condition impacting multiple domains of life. Its findings will inform future research into the development and evaluation of tailored interventions targeting the specific presentation of emetophobia.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"116 ","pages":"Article 103076"},"PeriodicalIF":4.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145223546","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":"Physical activity moderates the relationship between PTSD symptom severity and approach-avoidance conflict decision-making","authors":"Kevin M. Crombie ,&nbsp;Motoki Sato ,&nbsp;Samantha A. Chatham ,&nbsp;John Leri ,&nbsp;Mark T. Richardson ,&nbsp;Josh M. Cisler","doi":"10.1016/j.janxdis.2025.103075","DOIUrl":"10.1016/j.janxdis.2025.103075","url":null,"abstract":"<div><div>Avoidance of potentially dangerous contexts is beneficial for survival (i.e., adaptive avoidance), but the generalization of avoidance behavior to other generally safe contexts (i.e., maladaptive avoidance) can lead to detrimental mental health consequences, including diminished potential for reward. Decisions around pursuing reward in the presence of threat or avoiding threat at the cost of obtaining greater reward presents an approach-avoidance conflict (AAC). Although AAC is expected to be biased among trauma-exposed adults, especially those with posttraumatic stress disorder (PTSD), there have only been two prior behavioral investigations of AAC among adults with PTSD or experiencing PTSD symptoms. While greater levels of physical activity (PA) contribute to enhanced cognitive performance during reward-based decision-making tasks, it remains unknown whether greater PA also offers a protective effect or rather dampens the potential for greater AAC and sacrifice of reward in the presence of threat. The current study administered a trauma-related AAC behavioral task to trauma-exposed adults with varying PTSD symptom severity (N = 93), to examine potential interactive relationships between PTSD symptom severity, PA, and AAC decision-making under threat. The task involved a total of 150 trials and was divided into two phases: congruent (the option with the highest probability of a positive point outcome was also the option that was least likely to result in the presentation of a trauma-related image), and conflict (the option with the highest probability of a positive point outcome was also the option that was most likely to result in the presentation of a threat-related image). Results from linear mixed effects models revealed that PA moderated the relationship between PTSD symptom severity and AAC, as we observed a positive relationship between PTSD symptom severity and AAC for lower PA volume (i.e., greater conflict), and a more negative relationship between PTSD symptom severity and AAC as PA volume increased (i.e., less conflict). These results suggest that greater PA may promote a greater propensity to engage in goal-directed behavior and seek reward in the presence of threat in those with greater PTSD symptom severity.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"116 ","pages":"Article 103075"},"PeriodicalIF":4.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189641","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, correlates, and treatment gap of generalized anxiety disorder among adults in Bangladesh: Results from a nationally representative survey","authors":"Ahsan Aziz Sarkar ,&nbsp;Md Faruq Alam ,&nbsp;Helal Uddin Ahmed ,&nbsp;Mohammad Tariqul Alam ,&nbsp;Niaz Mohammad Khan","doi":"10.1016/j.janxdis.2025.103077","DOIUrl":"10.1016/j.janxdis.2025.103077","url":null,"abstract":"<div><div>This study presents nationally representative findings on the epidemiology of generalized anxiety disorder (GAD) among Bangladeshi adults, based on data from a nationwide household survey. Participants were initially screened using the Self-Reporting Questionnaire (SRQ), and those screening positive underwent face-to-face clinical interviews by trained psychiatrists. Diagnoses were established using DSM-5 criteria. A total of 7270 adults completed all measures used in this survey. The weighted lifetime prevalence of GAD was 3.5 % (95 % CI: 2.9–4.2), with higher rates observed among women (4.2 %) and rural residents (3.7 %) compared to men (2.7 %) and urban residents (2.8 %). Significant correlates included female sex (OR = 1.62, p = 0.012), lower educational attainment (OR = 2.42–3.49, p &lt; 0.05), and a family history of mental illness (OR = 2.56, p = 0.004). Despite the substantial burden, the treatment gap remained alarmingly high, with only 3.9 % of individuals with GAD seeking professional help. Individuals with a family history of mental illness were significantly more likely to seek treatment (OR = 8.32, p &lt; 0.001) for GAD, while no significant associations were found with other sociodemographic factors. These findings highlight the need for community-based awareness programs, the integration of mental health services into primary care, a focus on high-risk groups, and the strengthening of the mental health workforce to address the substantial burden of GAD and reduce the pervasive treatment gap in Bangladesh.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"116 ","pages":"Article 103077"},"PeriodicalIF":4.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253004","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":"Measurement invariance of the Straightforwardly-Worded Social Interaction Anxiety Scale and Associations with life satisfaction among emerging adults attending University in 10 countries","authors":"Stefania Sette ,&nbsp;Robert J. Coplan ,&nbsp;Laura L. Ooi ,&nbsp;Antonio Zuffianò ,&nbsp;Bowen Xiao ,&nbsp;Quincy J.J. Wong ,&nbsp;Ronald M. Rapee ,&nbsp;Wonjung Oh ,&nbsp;Junsheng Liu ,&nbsp;Yunhee Kim ,&nbsp;Hyoun K. Kim ,&nbsp;Shanmukh Kamble ,&nbsp;Carolina Greco ,&nbsp;Aysun Dogan ,&nbsp;Karen Noel Castillo ,&nbsp;Nora Braathu ,&nbsp;Evalill Bølstad ,&nbsp;Sevgi Bayram-Ozdemir ,&nbsp;Julie C. Bowker","doi":"10.1016/j.janxdis.2025.103092","DOIUrl":"10.1016/j.janxdis.2025.103092","url":null,"abstract":"<div><div>The aim of the present study was to assess the measurement invariance of the long version of the straightforwardly-worded <em>Social Interaction Anxiety Scale</em> (S-SIAS) across 10 countries and explore links with life satisfaction in a large sample of emerging adults attending university. Participants were <em>N</em> = 4284 university students (<em>M</em>_age = 19.89 years, <em>SD</em> = 1.83; 65 % females) from 10 countries (i.e., Argentina, Australia, Canada, China, India, Italy, South Korea, Norway, Turkey, and the United States), who completed self-report assessments of social anxiety and life satisfaction. Findings from a multiple-group factor analysis alignment method indicated approximate measurement invariance for the S-SIAS across the 10 country sites. University students from Norway reported the highest mean level of social anxiety of all groups, whereas participants from Argentina reported the lowest social anxiety. Results from multigroup regression analysis indicated that social anxiety was negatively associated with life satisfaction in all samples (except for Argentina and Australia, where the life satisfaction measure was not collected), but the strength of the association was stronger in Norway compared to samples from other countries. Results are discussed in terms of the meaning and implication of social anxiety across cultures.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"116 ","pages":"Article 103092"},"PeriodicalIF":4.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551727","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":"Tailored strategies to increase the use of an evidence-based psychotherapy for posttraumatic stress disorder: A stepped-wedge randomized trial in military clinics","authors":"Craig S. Rosen ,&nbsp;Alan L. Peterson ,&nbsp;David S. Riggs ,&nbsp;Christopher K. Haddock ,&nbsp;Chunki Fong ,&nbsp;Stacey Young-McCaughan ,&nbsp;Jeffrey Cook ,&nbsp;Katherine Anne Comtois ,&nbsp;Elisa V. Borah ,&nbsp;C. Adrian Davis ,&nbsp;Katherine A. Dondanville ,&nbsp;Erin P. Finley ,&nbsp;Sara A. Jahnke ,&nbsp;Melissa Mistretta ,&nbsp;Andrea Neitzer ,&nbsp;Shannon Wiltsey-Stirman ,&nbsp;Erin R. Frick ,&nbsp;Olivia Hayes ,&nbsp;Spencer Clayton ,&nbsp;Allison M. Conforte ,&nbsp;Carmen P. McLean","doi":"10.1016/j.janxdis.2025.103080","DOIUrl":"10.1016/j.janxdis.2025.103080","url":null,"abstract":"<div><div>Clinician training is often not sufficient to increase the adoption of evidence-based psychotherapies (EBPs). To address organizational barriers that may limit use of EBPs, a tailored implementation strategy—Targeted Assessment and Context-Tailored Implementation of Change Strategies (TACTICS)—was developed. TACTICS involved external facilitation (appointing a local implementation team and external coach, conducting need assessment interviews, creating site-specific implementation plans, and weekly coaching for the site champion) augmented with a planning rubric and resources for making operational changes. The effect of adding TACTICS after clinician training was evaluated in a cluster-randomized stepped-wedge trial across eight military treatment facilities. Psychotherapists (n = 212) received training in prolonged exposure (PE) therapy. TACTICS was subsequently introduced with timing randomized by site. PE utilization was measured via natural language processing of notes from 26,429 psychotherapy encounters across 3459 patients. After accounting for time effects, TACTICS increased PE use compared to training alone (OR = 1.05–2.21, p &lt; .03). Nonetheless, overall use of PE declined over time (OR = 0.067–0.316, p &lt; .001). In post-hoc analyses, declining use of PE over time was strongly associated with a decreasing supply of psychotherapy appointments per patient (r = .98). These findings suggest that local implementation support improves EBP adoption beyond training alone. However, lasting use may require broader system supports such as adequate staffing and policies that encourage use of EBPs.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"116 ","pages":"Article 103080"},"PeriodicalIF":4.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472159","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":"Psychometric evaluation of the Posttraumatic Stress Disorder Checklist for DSM-5 in daily surveys: An item response theory and longitudinal measurement invariance analysis","authors":"Brett A. Messman ,&nbsp;Siyuan Wang ,&nbsp;Prathiba Batley ,&nbsp;Nicole H. Weiss ,&nbsp;Jennifer A. Newberry ,&nbsp;Ateka A. Contractor","doi":"10.1016/j.janxdis.2025.103079","DOIUrl":"10.1016/j.janxdis.2025.103079","url":null,"abstract":"<div><div>The Posttraumatic Stress Disorder (PTSD) Checklist for the DSM-5 (PCL-5) has demonstrated excellent psychometric qualities across cross-sectional studies, yet the scale’s performance in intensive longitudinal studies is less known. Using data from the PCL-5 administered daily for 9 days, we (a) conducted item analysis of the PCL-5 using the graded response model to examine item characteristics (thresholds and discrimination parameters) and (b) examined differential item functioning (DIF) to evaluate whether the PCL-5 measured the PTSD latent trait identically across daily surveys (i.e., longitudinal measurement invariance). Methodologically, 256 trauma-exposed university students (<em>M</em>age = 21.01 ± 4.24; 85.8 % women; 41.0 % probable PTSD) completed the 20-item PCL-5 for 9 consecutive days. Across days, results indicated lower but acceptable discrimination for PCL-5 items 8 (traumatic amnesia), 16 (reckless or self-destructive behaviors), and 17 (hypervigilance). Further, 14 % of participants exhibited person misfit at least once across the 9 days. DIF analysis indicated that Item 2 (nightmares) exhibited DIF across days indicating potential bias; however, the effect sizes for DIF were negligible. In conclusion, the results broadly provide psychometric support for using the 20-item PCL-5 in intensive longitudinal studies. Future replication of study results across diverse and clinical populations could help to further strengthen these findings.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"116 ","pages":"Article 103079"},"PeriodicalIF":4.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271242","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":"Cross-cultural network structures of social anxiety, body dysmorphic, and major depressive disorder symptoms in individualistic vs. collectivistic societies: A comparison between American, German, and Japanese populations","authors":"Shota Noda ,&nbsp;Chantal Kasch ,&nbsp;Cameron E. Lindsay ,&nbsp;Stefan G. Hofmann","doi":"10.1016/j.janxdis.2025.103090","DOIUrl":"10.1016/j.janxdis.2025.103090","url":null,"abstract":"<div><div>Social anxiety disorder (SAD), body dysmorphic disorder (BDD), and major depressive disorder (MDD) are highly comorbid, which may be influenced by cultural variables associated with individualism vs. collectivism with particular emphasis on shame. This study investigated the network structures comprising symptoms of SAD, BDD, MDD, and shame across three countries typically associated with either a high tendency of collectivism (Japan), a high tendency of individualism (USA), or in between (Germany). Participants included 319 Japanese, 440 US Americans, and 308 Germans from the general populations of their respective countries, who completed questionnaires assessing the aforementioned symptoms as well as individualistic and collectivistic tendencies. Psychometric network analyses were conducted using Gaussian Graphical Models to separately examine the network structures of (a) individualistic and collectivistic tendencies and (b) symptoms of SAD, BDD, MDD, and shame. A Network Comparison Test (NCT) was used to assess the overall consistency of these networks across countries. The NCT revealed significant cross-cultural differences in the network structures of individualistic and collectivistic tendencies across countries, as well as in the networks of symptoms of SAD, BDD, MDD, and shame between Japan and Germany and between Japan and the USA. Although certain central symptoms were shared across all countries, others differed. These findings underscore the coexistence of cultural homogeneity and heterogeneity in the manifestation and organization of SAD, BDD, and MDD symptoms, emphasizing the importance of culturally sensitive, targeted interventions.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"116 ","pages":"Article 103090"},"PeriodicalIF":4.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460281","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}