Journal of Anxiety Disorders最新文献

{"title":"CBT-based self-help guided by a lay provider for generalized anxiety in older adults: A randomized controlled trial","authors":"Philippe Landreville ,&nbsp;Patrick Gosselin ,&nbsp;Sébastien Grenier ,&nbsp;Pierre-Hugues Carmichael","doi":"10.1016/j.janxdis.2025.103028","DOIUrl":"10.1016/j.janxdis.2025.103028","url":null,"abstract":"<div><div>Treatments for generalized anxiety disorder (GAD) that circumvent the barriers to accessing mental health care in older adults are needed. The main goal of this multisite randomized controlled trial was to evaluate the efficacy of CBT-based self-help guided by a lay provider (LP) for generalized anxiety (i.e., threshold or subthreshold GAD) in older adults. Participants (≥ 60 years) were block randomized based on diagnosis to an experimental (<em>n</em> = 75) or wait-list control group (<em>n</em> = 75). Experimental group participants used a manual presenting CBT-based readings and exercises and received brief weekly support calls by LPs. Groups were similar in terms of sociodemographic characteristics and initially did not differ significantly on outcomes. At post-treatment, the experimental group showed greater improvement across both primary outcomes (i.e., worry tendency, <em>p</em> &lt; .0001, Standardized mean difference [SMD] = −1.5971, and GAD severity, p &lt; .0001, SMD = −1.1639) and most additional outcomes (e.g., targeted psychological vulnerabilities, depressive symptoms, sleep difficulties, and GAD diagnosis) with small to large effect sizes (SMD = −0.4358 to −1.5402). The experimental group also showed maintenance of treatment effects or other improvements at 6- and 12-month follow-up. Participants in the control group who completed the treatment after their waiting period also improved on worry tendency (SMD = −1.2477) and GAD severity (SMD = −0.8443) and most of the other variables (SMD = −0.3728 to −1.0154). Results demonstrate that self-help guided by a LP is effective for treating GAD in older adults and that the improvements are sustained after treatment.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"113 ","pages":"Article 103028"},"PeriodicalIF":4.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal course of posttraumatic stress disorder and chronic pain conditions: A population-based study of Canadian military personnel over 16 years","authors":"Aleiia J.N. Asmundson ,&nbsp;Michelle M. Paluszek ,&nbsp;Jordana L. Sommer ,&nbsp;Shay-Lee Bolton ,&nbsp;Jitender Sareen ,&nbsp;Tracie O. Afifi ,&nbsp;Renée El-Gabalawy ,&nbsp;Gordon J.G. Asmundson","doi":"10.1016/j.janxdis.2025.103025","DOIUrl":"10.1016/j.janxdis.2025.103025","url":null,"abstract":"<div><h3>Background</h3><div>Posttraumatic stress disorder (PTSD) and chronic pain are highly prevalent, comorbid, and debilitating conditions in the military. The present study was designed to examine the prevalence of chronic pain conditions (i.e., migraines, back problems, arthritis) across PTSD courses (i.e., no PTSD, remitted, new onset, persistent/recurrent) and examine the association between PTSD course and the presence and onset of chronic pain conditions in a population-representative sample of Canadian military members. Methods: Cross-tabulations and logistic regressions were conducted on data (n = 2941) from the 2002 Canadian Community Health Survey Mental Health and Well-being Canadian Forces Supplement and the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-Up Survey. Results: The prevalence of chronic pain conditions across PTSD courses ranged from 8 % to 61 %, with no PTSD consistently having the lowest prevalence. After adjusting for covariates, respondents with new onset PTSD had elevated odds of back problems (AOR=1.43, 95 % CI [1.10–1.90], <em>p</em> &lt; .05), arthritis (AOR=1.46, 95 % CI [1.06–2.00], <em>p</em> &lt; .05), and a new onset chronic pain condition more broadly (AOR=1.66, 95 % CI [1.15–2.39], <em>p</em> &lt; .01), compared to those with no PTSD. Those with remitted PTSD had greater odds of migraines (AOR=2.43, 95 % CI [1.29–4.58], <em>p</em> &lt; .01), while those with persistent PTSD had lower odds of back problems (AOR=0.45, 95 % CI [0.23–0.88], <em>p</em> &lt; .05), compared to those with no PTSD. Conclusion: Findings indicate that the prevalence and type of chronic pain that co-occurs with PSTD in Canadian military members varies as a function of the course of PTSD. This underscores the importance of evaluating pain in those with PTSD and suggests that the course of PTSD is a relevant consideration in case conceptualization and treatment planning.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"113 ","pages":"Article 103025"},"PeriodicalIF":4.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144088960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The unique autonomic signatures of savoring meditation for anxiety reduction: A pilot randomized controlled trial","authors":"Tomoko Kishimoto ,&nbsp;Ximing Hao ,&nbsp;Qiyu Bai","doi":"10.1016/j.janxdis.2025.103024","DOIUrl":"10.1016/j.janxdis.2025.103024","url":null,"abstract":"<div><div>Anxiety disorders are often characterized by excessive sympathetic activation and dysfunction. While breathing relaxation reliably reduces anxiety by dampening sympathetic activity and enhancing parasympathetic tone, the autonomic signatures underlying positive emotion interventions, such as savoring meditation, remain less understood. In this pilot randomized controlled trial, we recruited 44 participants with probable generalized anxiety disorders (GAD) by questionnaires (GAD-7 score ≥ 10, which represents moderate or higher anxiety severity), who were assigned to a savoring meditation (<em>n</em> = 22) or a breathing relaxation (<em>n</em> = 22) intervention. We measured heart rate variability (HRV) indicators (respiratory sinus arrhythmia, RSA; low-frequency HRV, LF; the low-frequency/high-frequency ratio, LF/HF) and self-reported emotional states (happiness, anxiety, sadness, calmness) before and after the intervention. Linear mixed models with multiple imputation examined outcome change between and within conditions. The savoring group exhibited increased sympathetic and decreased parasympathetic activity (significantly lower RSA, higher LF and LF/HF), contrasting with the relaxation group’s pattern. Both interventions resulted in significant and similar reductions in anxiety after worrying. These preliminary results suggest that savoring meditation for anxiety reduction may have unique autonomic signatures, offering novel insights for positive emotion interventions in anxiety research.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"113 ","pages":"Article 103024"},"PeriodicalIF":4.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who defines improvement? Patients' global reports of improvement compared to standardized measures of improvement in cognitive processing therapy for posttraumatic stress disorder","authors":"Elizabeth Alpert ,&nbsp;Annie B. Fox ,&nbsp;Tara E. Galovski","doi":"10.1016/j.janxdis.2025.103027","DOIUrl":"10.1016/j.janxdis.2025.103027","url":null,"abstract":"<div><div>Standardized measures have typically been used to assess symptom change during treatment in psychological research and practice. However, standardized measures may not fully capture patients' experiences of therapeutic change. Patients' global reports of their improvement during treatment across domains of symptoms and functioning are also important and may provide distinct information from standardized measures. The current study compared both types of patient reports of improvement during cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD). We also examined process-level predictors of improvement assessed using both methods. Participants were 254 adult survivors of interpersonal violence receiving CPT. Patients' global reports of improvement in each domain (PTSD symptoms, relationships, health concerns, sexual functioning, school/work performance, and life satisfaction), each rated on a Likert scale via the Treatment Outcome Questionnaire, were significantly correlated with the corresponding standardized measure of improvement in the same domain, with most effect sizes in the small-to-medium range. Patients' perceptions of the therapy (helpfulness, likability) significantly predicted both global ratings and standardized measures of improvement, while patients' perceptions of the therapeutic relationship, patients' perceptions of barriers to therapy attendance, and objective indices of attendance did not predict improvement. Results highlight the importance of patients' experiences with treatment and suggest that assessing patients' global ratings of their improvement during treatment provides distinct information from standardized measures of improvement, and both are important to include when measuring therapeutic change.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"113 ","pages":"Article 103027"},"PeriodicalIF":4.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From research to real-world global applications: Advancing team science in the study of anxiety disorders","authors":"Ateka A. Contractor","doi":"10.1016/j.janxdis.2025.103019","DOIUrl":"10.1016/j.janxdis.2025.103019","url":null,"abstract":"","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"112 ","pages":"Article 103019"},"PeriodicalIF":4.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concise multi-class anxiety disorder risk assessment: A novel advanced machine learning approach","authors":"Haochong Yang ,&nbsp;Yuan Hong Sun ,&nbsp;Kang Lee","doi":"10.1016/j.janxdis.2025.103018","DOIUrl":"10.1016/j.janxdis.2025.103018","url":null,"abstract":"<div><div>Rapidly assessing anxiety disorder risk is crucial for effective mental health screen and intervention. However, traditional survey tools such as DASS-42 are time-consuming in responding and scoring. We used a novel advanced machine learning approach to create a concise anxiety disorder scale based on DASS-42. By applying advanced ML techniques and feature selection, we created a concise version of the anxiety risk scale while maintaining high validity. The resulting model requires fewer questions to predict anxiety risk levels effectively. This optimized scale was implemented in an online tool for quick self-screening and clinical use. This innovation holds significant societal implications, offering scalable, efficient, and accurate methods that facilitate faster and earlier anxiety disorder detection and intervention, especially among underserved and high-risk populations. The study highlights how machine learning can create practical, accessible mental health assessment tools, contributing to improved well-being outcomes.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"112 ","pages":"Article 103018"},"PeriodicalIF":4.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early hypervigilance and sustained attention for the eye region in adolescents with social anxiety disorder","authors":"Vera Hauffe ,&nbsp;Anna-Lina Rauschenbach ,&nbsp;Eva-Maria Fassot ,&nbsp;Julian Schmitz ,&nbsp;Brunna Tuschen-Caffier","doi":"10.1016/j.janxdis.2025.103016","DOIUrl":"10.1016/j.janxdis.2025.103016","url":null,"abstract":"<div><div>Social anxiety disorder (SAD) is a highly prevalent and debilitating affliction that typically manifests during childhood and adolescence. While theoretical models of adult SAD emphasize the role of attentional biases, little is known about maintaining factors during childhood and adolescence. The objective of our eye-tracking study was to determine whether youth with SAD exhibit a hypervigilance-avoidance pattern of visual attention for faces. To this end, we used a free-viewing paradigm to present angry, happy, and neutral faces, and non-social object stimuli to three groups of adolescents aged 10–15 years: SAD (<em>n</em> = 57), specific phobia (SP; <em>n</em> = 41), and healthy controls (HC; <em>n</em> = 65). A screen-based eye tracker recorded gaze behavior and pupil dilation. Among participants, only older adolescents with SAD exhibited shorter latencies of first fixation to the eye region compared to HC. Contrary to our expectations, there were no differences in duration of first fixation to the eye region among the groups. Instead, compared to HC, older adolescents with SAD showed longer dwell times on the eye region during the first 1000 – 3000 ms of stimulus presentation. No significant differences among the groups were found regarding scanpath length or pupillary reactivity. Taken together, our findings suggest early hypervigilance followed by sustained attention to the eye region in older adolescents with SAD, which may indicate difficulties in disengaging attention. We discuss the theoretical and practical implications in detail.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"112 ","pages":"Article 103016"},"PeriodicalIF":4.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Question-based computational language approach outperform ratings scale in discriminating between anxiety and depression","authors":"Mona Tabesh ,&nbsp;Mariam Mirström ,&nbsp;Rebecca Astrid Böhme ,&nbsp;Marta Lasota ,&nbsp;Yousef Javaherian ,&nbsp;Thibaud Agbotsoka-Guiter ,&nbsp;Sverker Sikström","doi":"10.1016/j.janxdis.2025.103020","DOIUrl":"10.1016/j.janxdis.2025.103020","url":null,"abstract":"<div><div>Major Depression (MD) and General Anxiety Disorder (GAD) are the most common mental health disorders, which typically are assessed quantitatively by rating scales such as PHQ-9 and GAD-7. However, recent advances in natural language processing (NLP) and machine learning (ML) have opened up the possibility of question-based computational language assessment (QCLA). Here we investigate how accurate open-ended questions, using descriptive keywords or autobiographical narratives, can discriminate between participants that self-reported diagnosis of depression and anxiety, or health control. The results show that both language and rating scale measures can discriminate well, however, autobiographical narratives discriminate best between healthy and anxiety (ϕ = 1.58), as well as healthy and depression (ϕ = 1.38). Descriptive keywords, and to a certain extent autobiographical narratives, also discriminate better than summed scores of GAD-7 and PHQ-9 (ϕ=0.80 in discrimination between anxiety and depression), but not when individual items of these scales were analyzed by ML (ϕ=0.86 and ϕ=0.91 in item-level analysis of PHQ-9 and GAD-7, respectively). Combining the scales consistently elevated the discrimination even more (ϕ=1.39 in comparison between depression and anxiety), both in item-level and sum-scores analyses. These results indicate that QCLA measures often, but not in all cases, are better than standardized rating scales for assessment of depression and anxiety. Implication of these findings for mental health assessments are discussed.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"112 ","pages":"Article 103020"},"PeriodicalIF":4.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does intolerance of uncertainty predict child generalised anxiety? A longitudinal study","authors":"Zoe J. Ryan ,&nbsp;Holly Rayson ,&nbsp;Jayne Morriss ,&nbsp;Helen F. Dodd","doi":"10.1016/j.janxdis.2025.103004","DOIUrl":"10.1016/j.janxdis.2025.103004","url":null,"abstract":"<div><div>Intolerance of uncertainty (IU) is the tendency to find uncertainty distressing. IU is related to anxiety in adults and youth but it is unclear whether IU plays a maintenance or causal role, particularly across childhood. Our research examined whether: (1) IU is associated with generalised anxiety in preschool-aged children; (2) IU in preschool-aged children is associated with the trajectory of generalised anxiety into middle childhood; and (3) IU is associated with the trajectory of internalising symptoms and externalising symptoms over time. Parents completed questionnaires (child anxiety, IU, internalising and externalising symptoms) about their children at three timepoints when their child was: 3–4 years old (<em>n</em> = 180); 5–7 years old (<em>n</em> = 162); and 8–10 years old (<em>n</em> = 148). Those with higher IU had higher concurrent generalised anxiety, internalising and externalising symptoms at each measurement point. Preschoolers with higher IU, relative to lower IU, had, on average, higher generalised anxiety across childhood. Unexpectedly though, children who were higher in IU as preschoolers were more likely to show a decrease in generalised anxiety over time. These findings indicate that IU is a consistent correlate of generalised anxiety, internalising and externalising symptoms, but that it may not play a causal role in the onset of generalised anxiety in children.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"112 ","pages":"Article 103004"},"PeriodicalIF":4.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681595","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":"Find your rhythm and regulate: Breath-synced vibration feedback during breath-focused mindfulness reduces respiration variability in trauma-exposed adults","authors":"Timothy J. McDermott ,&nbsp;Greg J. Siegle ,&nbsp;Alfonsina Guelfo ,&nbsp;Kayla Huynh ,&nbsp;Maya C. Karkare ,&nbsp;Rebecca Krawczak ,&nbsp;Amanda Johnston ,&nbsp;Aziz Elbasheir ,&nbsp;Travis M. Fulton ,&nbsp;Jacob Semerod ,&nbsp;Divya Jagadeesh ,&nbsp;Emma C. Lathan ,&nbsp;Robert T. Krafty ,&nbsp;Negar Fani","doi":"10.1016/j.janxdis.2025.103008","DOIUrl":"10.1016/j.janxdis.2025.103008","url":null,"abstract":"<div><div>Stress and anxiety are associated with increased autonomic arousal, including altered respiration. Breath-focused mindfulness meditation can reduce stress and anxiety, but trauma-exposed adults with dissociation have difficulty engaging in this practice. Our ongoing clinical trial examines if vibration-augmented breath-focused mindfulness (VABF) can improve outcomes and increase engagement. Here, we tested if VABF reduces respiration rate (RR) or respiration variability (RV), and examined associations between RR, RV, and emotion ratings. 128 trauma-exposed adults (mean age = 30.21 years) with elevated dissociation volunteered and completed at least 50 % of intervention visits. Participants were randomized to one of four mindfulness meditation interventions: VABF (<em>n</em> = 34); breath-focus only (<em>n</em> = 33); vibration only (<em>n</em> = 34); open awareness (no vibration or breath-focus, <em>n</em> = 27). Results from linear mixed-effects models showed that VABF decreased RV across visits while all the other interventions showed increased RV across visits (<em>p</em> = .008; <em>η</em>_<em>p</em>² = .014), and RV was positively associated with both anxiety and anger ratings (<em>p</em>s &lt; .001; <em>r</em>s &gt; .125). Findings suggest RV is a meaningful metric for examining regulatory processes in clinical populations with elevated autonomic arousal and negative emotionality. They also show that RV is modifiable through VABF, which holds significant promise as an intervention to improve regulatory processes in trauma-exposed populations.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"112 ","pages":"Article 103008"},"PeriodicalIF":4.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735172","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}