Journal of Anxiety Disorders最新文献

{"title":"Clinicians’ perspectives on retraumatisation during trauma-focused interventions for post-traumatic stress disorder: A survey of UK mental health professionals","authors":"Lucy Purnell ,&nbsp;Kenny Chiu ,&nbsp;Gita E. Bhutani ,&nbsp;Nick Grey ,&nbsp;Sharif El-Leithy ,&nbsp;Richard Meiser-Stedman","doi":"10.1016/j.janxdis.2024.102913","DOIUrl":"10.1016/j.janxdis.2024.102913","url":null,"abstract":"<div><p>Concerns regarding retraumatisation have been identified as a barrier to delivering trauma-focused therapy for post-traumatic stress disorder (PTSD). We explored clinicians’ understanding of what constitutes potential signs of retraumatisation (PSoR), reported incidences of witnessing retraumatisation, use of (and confidence in) therapies for PTSD, fear of retraumatisation during therapy for PTSD, and whether having witnessed retraumatisation was associated with these variables. We surveyed 348 clinicians. There was variation in what clinicians viewed as PSoR. Retraumatisation was reported by clinicians in 3.4 % of patients undergoing trauma-focused therapy for PTSD. A variety of trauma-focused and non-trauma-focused therapies were routinely used, yet 14.4 % reported not using trauma-focused therapy. There was a significant negative correlation between participants’ highest reported confidence in trauma-focused therapy and endorsement of PSoR (<em>r</em> = −.25) and fear of retraumatisation (<em>r</em> = −.28). Mean fear of retraumatisation was 30.3 (<em>SD</em>=23.4; a score we derived from asking participants out of 100 how much they worry about trauma-focused therapy being harmful in its own right/leading to a worsening of PTSD symptoms). Participants who had witnessed retraumatisation reported significantly greater endorsement of PSoR (<em>d</em>=.69 [95 % CI .37, 1.02]) and fear of retraumatisation (<em>d</em>=.94 [95 % CI .61, 1.26]). Confidence in using therapies for PTSD was varied and related to how clinicians understood retraumatisation. Retraumatisation is uncommon, but there is variability in clinicians’ interpretation of what retraumatisation is, and its utility warrants research.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"106 ","pages":"Article 102913"},"PeriodicalIF":4.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0887618524000896/pdfft?md5=a3686b30d33aa1660792f91227aa9b61&pid=1-s2.0-S0887618524000896-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reward processes in extinction learning and applications to exposure therapy","authors":"Benjamin M. Rosenberg ,&nbsp;Nora M. Barnes-Horowitz ,&nbsp;Tomislav D. Zbozinek ,&nbsp;Michelle G. Craske","doi":"10.1016/j.janxdis.2024.102911","DOIUrl":"10.1016/j.janxdis.2024.102911","url":null,"abstract":"<div><p>Anxiety disorders are common and highly distressing mental health conditions. Exposure therapy is a gold-standard treatment for anxiety disorders. Mechanisms of Pavlovian fear learning, and particularly fear extinction, are central to exposure therapy. A growing body of evidence suggests an important role of reward processes during Pavlovian fear extinction. Nonetheless, predominant models of exposure therapy do not currently incorporate reward processes. Herein, we present a theoretical model of reward processes in relation to Pavlovian mechanisms of exposure therapy, including a focus on dopaminergic prediction error signaling, coinciding positive emotional experiences (i.e., relief), and unexpected positive outcomes. We then highlight avenues for further research and discuss potential strategies to leverage reward processes to maximize exposure therapy response, such as pre-exposure interventions to increase reward sensitivity or post-exposure rehearsal (e.g., savoring, imaginal recounting strategies) to enhance retrieval and retention of learned associations.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"106 ","pages":"Article 102911"},"PeriodicalIF":4.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917858","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":"Scaling up psychological interventions into the daily lives of patients with anxiety and related disorders","authors":"Omid V. Ebrahimi,&nbsp;Gordon J.G. Asmundson","doi":"10.1016/j.janxdis.2024.102916","DOIUrl":"10.1016/j.janxdis.2024.102916","url":null,"abstract":"","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"106 ","pages":"Article 102916"},"PeriodicalIF":4.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142040413","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":"Intolerance of uncertainty as a predictor of anxiety severity and trajectory during the COVID-19 pandemic","authors":"Rosanna Breaux ,&nbsp;Kristin Naragon-Gainey ,&nbsp;Benjamin A. Katz ,&nbsp;Lisa R. Starr ,&nbsp;Jeremy G. Stewart ,&nbsp;Bethany A. Teachman ,&nbsp;Katie L. Burkhouse ,&nbsp;M. Kathleen Caulfield ,&nbsp;Christine B. Cha ,&nbsp;Samuel E. Cooper ,&nbsp;Edwin Dalmaijer ,&nbsp;Katie Kriegshauser ,&nbsp;Susan Kusmierski ,&nbsp;Cecile D. Ladouceur ,&nbsp;Gordon J.G. Asmundson ,&nbsp;Darlene M. Davis Goodwine ,&nbsp;Eiko I. Fried ,&nbsp;Ilana Gratch ,&nbsp;Philip C. Kendall ,&nbsp;Shmuel Lissek ,&nbsp;Lauren S. Hallion","doi":"10.1016/j.janxdis.2024.102910","DOIUrl":"10.1016/j.janxdis.2024.102910","url":null,"abstract":"<div><h3>Background</h3><p>Efforts to identify risk and resilience factors for anxiety severity and course during the COVID-19 pandemic have focused primarily on demographic rather than psychological variables. Intolerance of uncertainty (IU), a transdiagnostic risk factor for anxiety, may be a particularly relevant vulnerability factor.</p></div><div><h3>Method</h3><p><em>N</em> = 641 adults with pre-pandemic anxiety data reported their anxiety, IU, and other pandemic and mental health-related variables at least once and up to four times during the COVID-19 pandemic, with assessments beginning in May 2020 through March 2021.</p></div><div><h3>Results</h3><p>In preregistered analyses using latent growth models, higher IU at the first pandemic timepoint predicted more severe anxiety, but also a sharper decline in anxiety, across timepoints. This finding was robust to the addition of pre-pandemic anxiety and demographic predictors as covariates (in the full sample) as well as pre-pandemic depression severity (in participants for whom pre-pandemic depression data were available). Younger age, lower self/parent education, and self-reported history of COVID-19 illness at the first pandemic timepoint predicted more severe anxiety across timepoints with strong model fit, but did not predict anxiety trajectory.</p></div><div><h3>Conclusions</h3><p>IU prospectively predicted more severe anxiety but a sharper decrease in anxiety over time during the pandemic, including after adjustment for covariates. IU therefore appears to have unique and specific predictive utility with respect to anxiety in the context of the COVID-19 pandemic.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"106 ","pages":"Article 102910"},"PeriodicalIF":4.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917857","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":"Correlates of treatment-seeking 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.2024.102909","DOIUrl":"10.1016/j.janxdis.2024.102909","url":null,"abstract":"<div><p>Generalized Anxiety Disorder (GAD) presents a significant personal and societal burden and is associated with chronic medical comorbidities and markedly lower quality of life. Effective treatments exist, less than half of individuals with lifetime GAD will ever seek psychotherapeutic or pharmacological treatment. A thorough understanding of the factors that influence treatment seeking for GAD is warranted. The present study investigates the correlates of GAD treatment seeking, using data from the National Epidemiological Survey on Alcohol and Related Disorders-III (NESARC-III), which assessed for psychiatric disorders using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-5 Version (AUDADIS-5). A series of logistic regressions were run to identify demographic, diagnostic, and symptom-level correlates of treatment seeking in those meeting DSM-5 diagnostic criteria for GAD. Comorbid depression, panic disorder, and PTSD were all uniquely associated with higher rates of GAD-related treatment seeking. Additionally, several accompanying anxiety symptoms were also uniquely predicted treatment seeking, including fatigue, panic attacks, reassurance-seeking, and interpersonal avoidance. Findings underscore the multi-factorial nature of treatment seeking behavior in GAD and highlight the need for further research to fully understand these relationships and devise effective strategies to improve treatment seeking in this population.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"106 ","pages":"Article 102909"},"PeriodicalIF":4.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761777","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":"Holocaust centrality, anxiety, and other risk factors associated with terror threat salience among descendants of Holocaust survivors","authors":"Lee Greenblatt-Kimron ,&nbsp;Amit Shrira ,&nbsp;Menachem Ben-Ezra ,&nbsp;Yuval Palgi","doi":"10.1016/j.janxdis.2024.102908","DOIUrl":"10.1016/j.janxdis.2024.102908","url":null,"abstract":"<div><p>The study examined risk factors for sensitivity to terror threats among descendants of Holocaust survivors (Holocaust G1) during a significant rise in terrorist attacks in Israel. We examined the association of the number of familial Holocaust G1, trauma exposure, probable posttraumatic stress disorder (PTSD), anxiety symptoms, and Holocaust centrality with terror threat salience (TTS) in children and grandchildren of Holocaust G1 (Holocaust G2; G3). A web-based national sample included 297 Holocaust G2 (<em>M</em>_age=62.95, <em>SD</em>=10.25), 224 comparison G2 (<em>M</em>_age=61.79, <em>SD</em>=10.13), 379 Holocaust G3 (<em>M</em>_age=34.02, <em>SD</em>=8.65) and 171 comparison G3 (<em>M</em>_age=33.55, <em>SD</em>=8.26). Participants completed questionnaires on background characteristics, Holocaust background, trauma exposure, probable PTSD, anxiety symptoms, Holocaust centrality, and TTS. Findings showed that Holocaust G2 and G3 reported higher Holocaust centrality and TTS relative to comparisons, and Holocaust G3 reported higher levels of anxiety than comparison G3. The number of Holocaust G1, background characteristics, Holocaust centrality, and anxiety symptoms were associated with TTS in G2 and G3. Probable PTSD and trauma exposure were also associated with TTS in G2 and G3, respectively. Results highlight Holocaust centrality and anxiety among the factors associated with an increased preoccupation with terror threats in Holocaust descendants. Practitioners should implement interventions focusing on these factors, particularly at times of increased terrorism.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"106 ","pages":"Article 102908"},"PeriodicalIF":4.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141838865","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":"Investigating the under-recognition of childbirth-related post-traumatic stress disorder among the public and mental health professionals","authors":"Rotem Kahalon ,&nbsp;Jonathan E. Handelzalts","doi":"10.1016/j.janxdis.2024.102897","DOIUrl":"10.1016/j.janxdis.2024.102897","url":null,"abstract":"<div><h3>Background</h3><p>Childbirth posttraumatic stress disorder (PTSD) poses significant challenges, impacting both mothers and infants. This work investigates whether childbirth PTSD is less recognized than PTSD caused by other index events.</p></div><div><h3>Methods</h3><p>In two preregistered experimens we investigated the public and professional perception of PTSD resulting from childbirth compared to other traumatic events (i.e., sexual assault, car accident, terror attack, and an earthquake).</p></div><div><h3>Findings</h3><p>Study 1, conducted among the general population in the U.S. revealed that a woman depicted as experiencing PTSD symptoms due to childbirth, was less likely to be recognized as suffering from PTSD than a woman with the same symptoms resulting from other traumatic events. Study 2 demonstrated that mental health professionals worldwide are also less inclined to diagnose PTSD when childbirth is the index event in comparison to other index events.</p></div><div><h3>Discussion</h3><p>Due to the importance of social recognition in the treatment of PTSD, the findings underscore the urgent need for heightened awareness and education regarding childbirth PTSD to bridge the recognition gap among the general population and mental health professionals.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"106 ","pages":"Article 102897"},"PeriodicalIF":4.8,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604358","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":"Unveiling temporal dynamics of PTSD and its functional impairments: A longitudinal study in UK healthcare workers","authors":"René Freichel ,&nbsp;Philipp Herzog ,&nbsp;Jo Billings ,&nbsp;Michael A.P. Bloomfield ,&nbsp;Richard J. McNally ,&nbsp;Talya Greene","doi":"10.1016/j.janxdis.2024.102896","DOIUrl":"10.1016/j.janxdis.2024.102896","url":null,"abstract":"<div><p>PTSD has been associated with negative long-term consequences, including social and occupational impairments. Yet, a nuanced understanding of the interplay between PTSD symptoms and distinct domains of impairments on a short-term basis (weeks/ months) at the within-person level remains underexplored. In a large sample (<em>n</em> _{wave 1} = 1096, <em>n</em> _{wave 7} = 304) of UK healthcare workers assessed across seven assessment waves during the COVID-19 pandemic (spaced 6 weeks apart), we employed exploratory graphical vector autoregression models (GVAR) models to discern within-person temporal (across time) and contemporaneous (within same time window) dynamics between PTSD symptoms and functional impairment domains. The contemporaneous network highlighted strong co-occurrences between different symptoms and impairments. The temporal network revealed a mutually reinforcing cycle between intrusion and avoidance symptoms. Intrusion symptoms showed the highest out-strength (i.e., most predictive symptom), predicting avoidance symptoms, elevated sense of current threat, and various functional impairments. Avoidance symptoms, elevated after increased levels of intrusions, predicted work impairments that in turn were associated with difficulties in fulfilling other obligations. Our findings underscore the dynamics between perceived threat and intrusions, and the role intrusions may play in predicting a cascade of adverse effects. Targeted interventions aimed at mitigating intrusions may disrupt this negative cycle.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"106 ","pages":"Article 102896"},"PeriodicalIF":4.8,"publicationDate":"2024-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0887618524000720/pdfft?md5=7e73db0fa8f89b9741c2e964bbdf04a6&pid=1-s2.0-S0887618524000720-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141624067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tonic immobility triggered by COVID-19-related trauma is associated with long-term PTSD symptoms","authors":"Sérgio de Souza Junior ,&nbsp;Camila Monteiro Fabricio Gama ,&nbsp;Raquel Menezes Gonçalves ,&nbsp;Thayssa Lorrany Campos Guerra ,&nbsp;Eliane Volchan ,&nbsp;Fátima Smith Erthal ,&nbsp;Izabela Mocaiber ,&nbsp;Isabel de Paula Antunes David ,&nbsp;Liana Catarina Lima Portugal ,&nbsp;Mauro Vitor Mendlowicz ,&nbsp;William Berger ,&nbsp;Leticia de Oliveira ,&nbsp;Mirtes Garcia Pereira","doi":"10.1016/j.janxdis.2024.102894","DOIUrl":"10.1016/j.janxdis.2024.102894","url":null,"abstract":"<div><p>During the COVID-19 pandemic healthcare workers were repeatedly exposed to traumatic experiences. Facing life-threatening events and repeated exposure to traumatic duty-related situations may cause posttraumatic stress disorder (PTSD). While tonic immobility has been considered a key vulnerability factor for PTSD, little is known about this relationship in the long term. In this study, we aimed to determine whether peritraumatic tonic immobility triggered by COVID-19-related trauma predicts PTSD symptom severity six to twelve months later. We conducted an online longitudinal survey using the PTSD Checklist for the DSM-5 (PCL-5) and the Tonic Immobility Scale to assess PTSD symptoms and the tonic immobility response, respectively. Multivariate regression models revealed a significant association between tonic immobility and PTSD symptoms. Each one-unit increase in the tonic immobility score was associated with a 1.5 % increase in the average PTSD symptom score six to twelve months after the traumatic event that triggered the tonic immobility. Furthermore, participants who showed significant or extreme levels of tonic immobility were 3.5 times or 7.3 times more likely to have a probable PTSD diagnosis, respectively. Hence, peritraumatic tonic immobility seems to have a lasting deleterious effect on mental health. Psychological treatment for health care professionals is urgent, and psychoeducation about the involuntary, biological nature of tonic immobility is essential to reduce suffering.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"105 ","pages":"Article 102894"},"PeriodicalIF":4.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499292","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":"Re-assessing the assessment of fears of positive and negative evaluation: Scale development and psychometric evaluation of the Bivalent Fear of Evaluation Scale (BFOES)","authors":"Justin W. Weeks ,&nbsp;Miranda Beltzer ,&nbsp;Karen M. Schmidt ,&nbsp;Thomas M. Olino ,&nbsp;Philippe R. Goldin ,&nbsp;James J. Gross ,&nbsp;Richard G. Heimberg ,&nbsp;Peggy M. Zoccola","doi":"10.1016/j.janxdis.2024.102879","DOIUrl":"10.1016/j.janxdis.2024.102879","url":null,"abstract":"<div><p>The <em>bivalent fear of evaluation</em> (BFOE) model of social anxiety divides fear of evaluation into two distinct valences: fear of positive evaluation (FPE) and fear of negative evaluation (FNE). However, there is evidence that the two most widely utilized and psychometrically supported measures of FNE and FPE contain items which are ambiguous with regard to valence of evaluative fear. To formally address this, the BFOE Scale (BFOES) was developed, by merging items from measures of FNE and FPE into a single scale with an integrated response format. The present studies examined the psychometric profile of the BFOES across a large pooled archival dataset (<em>N</em> = 2216), which included approximately 10 % (<em>n</em> = 224) patients with social anxiety disorder (SAD). The factorial validity, internal consistency, and construct validity of the BFOES were examined. Additionally, item response theory analyses were employed for the purpose of merging items from self-report scales which utilized different Likert-type response formats. Results from both studies provided support for the psychometric profile of the BFOES. The implications of the BFOES for the assessment of social anxiety, and theoretical models of fear of evaluation and SAD, are discussed.</p></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"105 ","pages":"Article 102879"},"PeriodicalIF":4.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141416155","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}