- Duration of untreated illness in a cross-diagnostic sample of obsessive-compulsive disorder, panic disorder, and social anxiety disorder. [Journal Article]
- CSCNS Spectr 2018 Nov 13; :1-7
- CONCLUSIONS: There was substantial delay in treatment seeking among the anxiety and obsessive-compulsive disorder patients, particularly those with OCD or SAD. Perception of stress as a cause of OCD prompted treatment seeking, while severity of panic symptoms delayed treatment seeking.
- Posttraumatic Stress Symptoms and Emerging Adult Sexual Minority Men: Implications for Assessment and Treatment of Childhood Sexual Abuse. [Journal Article]
- JTJ Trauma Stress 2018; 31(5):665-675
- Emerging adulthood (EA) is a developmental period marked by unique challenges that affect health including burgeoning occupational, relational, and financial stability; and increased risk taking in t...
Emerging adulthood (EA) is a developmental period marked by unique challenges that affect health including burgeoning occupational, relational, and financial stability; and increased risk taking in terms of sexual behavior(s) and substance use. Data were collected from 296 HIV-uninfected sexual minority men with childhood sexual abuse (CSA) histories. We analyzed baseline assessment data from a multisite randomized controlled trial that tested the efficaciousness of an experimental psychosocial treatment and examined vulnerabilities known to be linked with CSA. Our analyses compared EA sexual minority men, aged 18-29, with older sexual minority men (OSMM) on posttraumatic stress disorder (PTSD) and other mental health and substance use outcomes. We found higher odds of PTSD, odds ratio (OR) = 0.57, 95% CI [0.33, 0.96]; panic disorder or panic disorder with agoraphobia, OR = 0.36, 95% CI [0.16, 0.85]; and cocaine use, OR = 0.50, 95% CI [0.25, 0.97], among OSMM and higher odds of alcohol intoxication, OR = 5.60, 95% CI [3.20, 9.82]; cannabis use, OR = 3.09, 95% CI [1.83, 5.21]; and non-HIV sexually transmitted infections, OR = 3.03, 95% CI [1.29, 7.13], among the EA men. These results present a complex picture of health risks among sexual minority men in general and EA sexual minority men in particular. HIV seroconversion linked health risk behaviors, among sexual minority men, may be better addressed via increased attention to treating trauma and comorbid mental health and substance use problems using evidence-based psychosocial assessments and integrated treatment platforms that are tailored to this population.
- Examining the relationships between error-related brain activity (the ERN) and anxiety disorders versus externalizing disorders in young children: Focusing on cognitive control, fear, and shyness. [Journal Article]
- CPCompr Psychiatry 2018 Oct 07; 87:112-119
- CONCLUSIONS: Overall, these results are novel insofar as they suggest that the temperamental factors of shyness and cognitive control may underlie the associations between the ERN and internalizing versus externalizing disorders.
- DNA methylation of FKBP5 and response to exposure-based psychological therapy. [Journal Article]
- AJAm J Med Genet B Neuropsychiatr Genet 2018 Oct 18
- Differential DNA methylation of the hypothalamic-pituitary-adrenal axis related gene FKBP5 has recently been shown to be associated with varying response to environmental influences and may play a ro...
Differential DNA methylation of the hypothalamic-pituitary-adrenal axis related gene FKBP5 has recently been shown to be associated with varying response to environmental influences and may play a role in how well people respond to psychological treatments. Participants (n = 111) received exposure-based cognitive behavioural therapy (CBT) for agoraphobia with or without panic disorder, or specific phobias. Percentage DNA methylation levels were measured for the promoter region and intron 7 of FKBP5. The association between percentage reduction in clinical severity and change in DNA methylation was tested using linear mixed models. The effect of genotype (rs1360780) was tested by the inclusion of an interaction term. The association between change in DNA methylation and FKBP5 expression was examined. Change in percentage DNA methylation at one CpG site of intron 7 was associated with percentage reduction in severity (β = -4.26, p = 3.90 × 10-4 ), where a decrease in DNA methylation was associated with greater response to therapy. An interaction was detected between rs1360780 and changes in DNA methylation in the promoter region of FKBP5 on treatment outcome (p = .045) but did not survive correction for multiple testing. Changes in DNA methylation were not associated with FKBP5 expression. Decreasing DNA methylation at one CpG site of intron 7 of FKBP5 was strongly associated with decreasing anxiety severity following exposure-based CBT. In addition, there was suggestive evidence that allele-specific methylation at the promoter region may also be associated with treatment response. The results of this study add to the growing literature demonstrating the role of biological processes such as DNA methylation in response to environmental influences.
- The mediating role of parenting behaviors in the relationship between early and late adolescent levels of anxiety: Specificity and informant effects. [Journal Article]
- JAJ Adolesc 2018 Oct 04; 69:118-129
- CONCLUSIONS: The findings of this study concern the un-conditional mediating role of parenting. Parenting behaviors may be more influential among some adolescents, depending on individual differences in other factors related to the development and course of adolescent anxiety. Thus, further research on moderating factors of the influence of parenting on adolescent anxiety is warranted.
- Virtual reality exposure therapy for anxiety and related disorders: A meta-analysis of randomized controlled trials. [Journal Article]
- JAJ Anxiety Disord 2018 Aug 10
- Trials of virtual reality exposure therapy (VRET) for anxiety-related disorders have proliferated in number and diversity since our previous meta-analysis that examined 13 total trials, most of which...
Trials of virtual reality exposure therapy (VRET) for anxiety-related disorders have proliferated in number and diversity since our previous meta-analysis that examined 13 total trials, most of which were for specific phobias (Powers & Emmelkamp, 2008). Since then, new trials have compared VRET to more diverse anxiety and related disorders including social anxiety disorder (SAD), posttraumatic stress disorder (PTSD), and panic disorder (PD) with and without agoraphobia. With the availability of this data, it is imperative to re-examine the efficacy of VRET for anxiety. A literature search for randomized controlled trials of VRET versus control or in vivo exposure yielded 30 studies with 1057 participants. Fourteen studies tested VRET for specific phobias, 8 for SAD or performance anxiety, 5 for PTSD, and 3 for PD. A random effects analysis estimated a large effect size for VRET versus waitlist (g = 0.90) and a medium to large effect size for VRET versus psychological placebo conditions (g = 0.78). A comparison of VRET and in vivo conditions did not show significantly different effect sizes (g = -0.07). These findings were relatively consistent across disorders. A meta-regression analysis revealed that larger sample sizes were associated with lower effect sizes in VRET versus control comparisons (β = -0.007, p < 0.05). These results indicate that VRET is an effective and equal medium for exposure therapy.
- A pragmatic randomized controlled trial of group transdiagnostic cognitive-behaviour therapy for anxiety disorders in primary care: study protocol. [Journal Article]
- BPBMC Psychiatry 2018 Oct 03; 18(1):320
- CONCLUSIONS: This rigorous evaluation of tCBT in the real world will provide invaluable information to decision makers, health care managers, clinicians and patients regarding the effectiveness of the intervention. Widespread implementation of tCBT protocols in primary care could lead to better effectiveness, efficiency, access and equity for the large number of patients suffering from anxiety disorders that are currently not obtaining evidence-based psychotherapy.
- The Diagnosis and Treatment of Anxiety Disorders. [Journal Article]
- DADtsch Arztebl Int 2018 Sep 14; 155(37):611-620
- CONCLUSIONS: In general, anxiety disorders can now be effectively treated. Patients should be informed of the therapeutic options and should be involved in treatment planning. Current research efforts are centered on individualized and therefore, it is hoped, even more effective treatment approaches than are available at present.
- Effects of Cognitive Behavioral Therapy on Neural Processing of Agoraphobia-Specific Stimuli in Panic Disorder and Agoraphobia. [Journal Article]
- PPPsychother Psychosom 2018 Sep 28; :1-16
- CONCLUSIONS: For the first time, neural effects of cognitive behavioral therapy were shown in patients suffering from panic disorder and agoraphobia using disorder-specific stimuli. The decrease in activation in the ventral striatum indicates that cognitive behavioral therapy modifies anticipatory anxiety and may ameliorate abnormally heightened salience attribution to expected threatening stimuli. The decreased amygdala activation in response to agoraphobia-specific stimuli indicates that cognitive behavioral therapy can alter the basal processing of agoraphobia-specific stimuli in a core region of the fear network.
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- Anxiety disorders: Psychiatric comorbidities and psychosocial stressors among adult outpatients. [Journal Article]
- SAS Afr J Psychiatr 2018; 24:1138
- CONCLUSIONS: Clinical practice should take the high rates of comorbidity into account and the importance of integrated substance-related interventions in mental healthcare settings is clear. Diagnostic practices regarding agoraphobia without panic, and the comorbidity of anxiety and personality disorders should receive further attention. Clinicians should be aware of the potential impact of the frequently reported psychosocial stressors.