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Journal of Anxiety Disorders

Mark B Powers, Barbara O Rothbaum
No abstract text is available yet for this article.
August 23, 2018: Journal of Anxiety Disorders
Emily E Bernstein, Richard J McNally
Pattern separation is a facet of memory encoding that facilitates the adaptive integration of old and new experiences. At the computational level, this process reduces overlap between how two entities are represented. Behaviorally, this allows for greater memory resolution while avoiding memory interference; similar entities are perceived as distinct. Poor pattern separation could contribute to psychopathology, especially anxiety, as individuals with high anxiety tend to overgeneralize their perception of threat, or have difficulty distinguishing between currently safe contexts and previously threatening ones...
August 23, 2018: Journal of Anxiety Disorders
Ateka A Contractor, Talya Greene, Megan Dolan, Jon D Elhai
Co-occurring posttraumatic stress disorder (PTSD) and depression following traumatic experiences are cumulatively associated with functional impairment. To examine mechanisms for the PTSD-depression comorbidity, we investigated their cluster-level associations. Using data obtained from Amazon's Mechanical Turk platform, 368 trauma-exposed participants were split into two subsamples: those with (n = 163) and without (n = 185) probable PTSD. In both subsamples, confirmatory factor analyses indicated an optimal seven-factor PTSD Hybrid Model...
August 16, 2018: Journal of Anxiety Disorders
Lily A Brown, Thea Gallagher, Julie Petersen, Kathy Benhamou, Edna B Foa, Anu Asnaani
BACKGROUND: Anxiety disorders commonly co-occur with suicidal ideation (SI). To our knowledge, no studies have reported on the baseline prevalence of SI and the reduction in SI in a naturalistic sample receiving cognitive behavior therapy (CBT) for anxiety-related disorders. METHODS: Participants (n = 355) recruited from an anxiety specialty clinic reported SI at pre-, mid-, and post-CBT. Multilevel mixed effects logistic regression models compared differences in SI endorsement over Time...
August 8, 2018: Journal of Anxiety Disorders
Jonathan D Huppert, Yogev Kivity, Lior Cohen, Asher Y Strauss, Yoni Elizur, Michal Weiss
No studies have compared face-to-face cognitive-behavioral therapy (CBT) and attention bias modification (ABM) for social anxiety disorder (SAD) and their purported mechanisms. We asked: 1) Is CBT more effective than ABM? and 2) Are changes in attentional biases and cognitions temporally related to symptom change? Forty-three patients were randomly assigned to 8 sessions of ABM or up to 20 sessions of individual CBT. Intent-to-treat results revealed that CBT was superior to ABM in response rates and on symptom measures at endpoint, but not on other measures...
August 7, 2018: Journal of Anxiety Disorders
Philip Lindner, Alexander Miloff, Simon Fagernäs, Joel Andersen, Martin Sigeman, Gerhard Andersson, Tomas Furmark, Per Carlbring
Public speaking anxiety (PSA) is a common condition which can be treated effectively with exposure therapy. However, inherent difficulties in stimuli presentation and control limits dissemination and the therapeutic potential. Virtual Reality (VR) technology has the potential to resolve these issues and provide a scalable platform for self-help interventions. No previous study has examined whether this can be achieved using the first generation of consumer VR hardware and software. In the current trial, n = 25 + 25 participants were randomized to either one-session therapist-led VR exposure therapy for PSA followed by a four-week internet-administered VR to in-vivo transition program, or a waiting-list...
July 24, 2018: Journal of Anxiety Disorders
Javier Fernández-Álvarez, Alexander Rozental, Per Carlbring, Desirée Colombo, Giuseppe Riva, Page L Anderson, Rosa María Baños, Amanda A Benbow, Stéphane Bouchard, Juana María Bretón-López, Georgina Cárdenas, JoAnn Difede, Paul Emmelkamp, Azucena García-Palacios, Verónica Guillén, Hunter Hoffman, Isabel Kampann, Ramona Moldovan, Andreas Mühlberger, Max North, Paul Pauli, Wenceslao Peñate Castro, Soledad Quero, Miquel Tortella-Feliu, Kataryzna Wyka, Cristina Botella
Ample evidence supports the use of Virtual Reality (VR) for anxiety disorders. Nonetheless, currently there is no evidence about moderators or potential negative effects of VR treatment strategies. An Individual Patient Data (IPD) approach was employed with 15 retrieved datasets. The current study sample was composed of 810 patients. Randomized control trials (RCTs) for each primary outcome measure were performed, in addition to moderator analyses of the socio-demographic variables. Deterioration rates were 14 patients (4...
July 17, 2018: Journal of Anxiety Disorders
Daniel Fatori, Carlos Alberto de Bragança Pereira, Fernando R Asbahr, Guaraci Requena, Pedro G Alvarenga, Maria Alice de Mathis, Luis A Rohde, James F Leckman, John S March, Guilherme V Polanczyk, Eurípedes C Miguel, Roseli G Shavitt
OBJECTIVE: This sequential multiple assignment randomized trial (SMART) tested the effect of beginning treatment of childhood OCD with fluoxetine (FLX) or group cognitive-behavioral therapy (GCBT) accounting for treatment failures over time. METHODS: A two-stage, 28-week SMART was conducted with 83 children and adolescents with OCD. Participants were randomly allocated to GCBT or FLX for 14 weeks. Responders to the initial treatment remained in the same regimen for additional 14 weeks...
July 16, 2018: Journal of Anxiety Disorders
Annegret Schneider, Jackie Andrade, Karin Tanja-Dijkstra, David R Moles
Dental anxiety is a prevalent problem with marked psychological, physical and public health implications. Based on cognitive theory and evidence, we hypothesized that vivid, sensory image-based cognitions play a role in dental anxiety. A quantitative online survey (N = 306) and qualitative semi-structured interviews (N = 18) found that vivid sensory images were common irrespective of dental anxiety levels, but that their content, associated distress and responses varied. Participants reporting higher anxiety experienced intense and intrusive fear-provoking dental imagery focusing on unpleasant sensations, which were associated with the intrusive recollection of negative past experiences and avoidance of dentistry...
June 30, 2018: Journal of Anxiety Disorders
Ateka A Contractor, Lily A Brown, Stephanie V Caldas, Anne N Banducci, Daniel J Taylor, Cherie Armour, M Tracie Shea
Encoding and retrieval difficulties, and avoidance of both traumatic and positive memories, are associated with posttraumatic stress disorder (PTSD) symptoms. However, most PTSD research and clinical work has solely examined the role of traumatic memories in the maintenance/resolution of PTSD symptoms. This review provides a comprehensive discussion of the literature on positive memories and PTSD. First, we review theories and evidence on the relations between trauma, PTSD, and memory processes (particularly positive memories)...
June 25, 2018: Journal of Anxiety Disorders
Diana-Mirela Cândea, Aurora Szentagotai-Tăta
There is a growing body of investigations showing that shame and guilt are important features of various psychological problems including anxiety disorders. This study quantitatively summarized the magnitude of the associations of shame and guilt with anxiety symptoms. We looked both at the associations with broader categories of anxiety symptoms (i.e., undifferentiated anxiety symptoms, trait and state anxiety), but also with symptoms specific to individual anxiety disorders. In most cases, shame was more strongly associated with anxiety symptoms (in general medium effect sizes) than guilt (in general small effect sizes)...
August 2018: Journal of Anxiety Disorders
Natasha Benfer, Joseph R Bardeen, Ian Cero, Lindsay B Kramer, Sarah E Whiteman, Travis A Rogers, Madison W Silverstein, Frank W Weathers
Evidence suggests that posttraumatic stress (PTS) disorder (PTSD) symptom presentations may vary as a function of index trauma type. Network analysis was employed in the present study to examine differences in PTS symptom centrality (i.e., the relative influence of a symptom on the network), and PTS symptom associations across three trauma types: motor vehicle accident (MVA), sexual assault (SA), and sudden accidental/violent death of a loved one (SAD). The final sample comprised 554 female undergraduates who had experienced a MVA (n = 226), SA (n = 222), or SAD (n = 106) per Diagnostic Statistical Manual-Fifth Edition (DSM-5) criteria...
August 2018: Journal of Anxiety Disorders
Verena Keil, Robert Hepach, Severin Vierrath, Detlef Caffier, Brunna Tuschen-Caffier, Christoph Klein, Julian Schmitz
Cognitive models and adult research associate social anxiety disorder (SAD) with hypervigilant-avoidant processing of social information, such as eye contact. However, processing biases in childhood SAD remain mostly unexplored. We examined 10- to 13-year-old children's eye contact processing and pupil dilation in response to happy, neutral, and angry faces in three groups: SAD (n = 31), mixed anxiety disorders (MAD; n = 30), and healthy controls (HC; n = 32). Compared to HC, SAD children showed faster first fixations on the eye region of neutral faces and shorter first fixation durations on the eye region of all faces...
August 2018: Journal of Anxiety Disorders
Renatha El Rafihi-Ferreira, Edwiges F M Silvares, Fernando R Asbahr, Thomas H Ollendick
Sixty-eight 4-6 year old children who co-slept with their parents and who avoided sleeping alone due to intense nighttime fears were randomized to a brief combined parent-based intervention (CBT-based bibliotherapy plus doll) or a wait list control group. After the waiting period, the wait list participants were offered treatment. Co-sleeping patterns, sleep records, anxiety, general fears, and behavior problems were assessed with parent-report measures. Nighttime fears were assessed with parent-report measures and a single item visual analogue scale for the young children...
August 2018: Journal of Anxiety Disorders
Klariz Tucker, Tyra Dark, Jeffrey S Harman
PURPOSE: Given that out-of-pocket (OOP) costs impact adherence to treatment and recent and proposed changes to the health insurance system that impact OOP costs, it is imperative to understand the OOP cost burden faced by individuals with anxiety disorders depending upon type of insurance coverage. The objective of this study was to determine the annual OOP cost burden faced by individuals with anxiety disorders and the variation of these costs by type of insurance coverage. METHODS: Using weighted nationally representative data from the 2011-2014 Medical Expenditure Panel Surveys, total OOP health care costs were assessed for all respondents who indicated that they had an anxiety disorder (N = 9985)...
August 2018: Journal of Anxiety Disorders
Adam M Reid, Andrew G Guzick, Alyka Glor Fernandez, Brett Deacon, Joseph P H McNamara, Gary R Geffken, Ryan McCarty, Catherine W Striley
Exposure therapy is a highly effective, evidence-based treatment technique for children and adolescents with anxiety disorders. Regardless, therapists in the community are reported to use exposure relatively rarely compared with other approaches. The goal of the present study was to identify how practicing clinicians treat youth with anxiety disorders across the United States and what factors contribute to their use of exposure therapy. Recruited from public directories, 257 private practice therapists who treat anxious youth were surveyed...
August 2018: Journal of Anxiety Disorders
Sean Minns, Andrew Levihn-Coon, Emily Carl, Jasper A J Smits, Wayne Miller, Don Howard, Santiago Papini, Simon Quiroz, Eunjung Lee-Furman, Michael Telch, Per Carlbring, Drew Xanthopoulos, Mark B Powers
Stereoscopic 3D gives the viewer the same shape, size, perspective and depth they would experience viewing the real world and could mimic the perceptual threat cues present in real life. This is the first study to investigate whether an immersive stereoscopic 3D video exposure-based treatment would be effective in reducing fear of spiders. Participants with a fear of spiders (N = 77) watched two psychoeducational videos with facts about spiders and phobias. They were then randomized to a treatment condition that watched a single session of a stereoscopic 3D immersive video exposure-based treatment (six 5-min exposures) delivered through a virtual reality headset or a psychoeducation only control condition that watched a 30-min neutral video (2D documentary) presented on a computer monitor...
August 2018: Journal of Anxiety Disorders
Laura Loucks, Carly Yasinski, Seth D Norrholm, Jessica Maples-Keller, Loren Post, Liza Zwiebach, Devika Fiorillo, Megan Goodlin, Tanja Jovanovic, Albert A Rizzo, Barbara O Rothbaum
This initial feasibility study examined the use of virtual reality exposure therapy (VRE) in the treatment of MST-related PTSD, with newly developed content tailored to MST. Participants included 15 veterans (26% male) with MST-related PTSD. Assessment of PTSD, depression, and psychophysiological indicators of distress occurred at pre-treatment, post-treatment, and 3-month follow-up. Treatment included 6-12 VRE sessions. There were significant reductions in pre- to post-treatment PTSD (CAPS severity: t(10) = 3...
June 18, 2018: Journal of Anxiety Disorders
Greg M Reger, Derek Smolenski, Aaron Norr, Andrea Katz, Benjamin Buck, Barbara O Rothbaum
Prolonged exposure (PE) is a treatment for posttraumatic stress disorder (PTSD) based on emotional processing theory. According to this theory, emotional engagement during imaginal exposure is critical to clinical outcome. One rationale for virtual reality exposure therapy (VRE) is the ability of trauma-relevant, multi-sensory stimuli to increase emotional engagement. This study compared the subjective distress of active duty soldiers (N = 108) during exposure via PE or VRE. Soldiers with higher mean or peak distress during the first imaginal exposure had higher baseline PTSD symptom severity...
June 8, 2018: Journal of Anxiety Disorders
Katharina Bey, Christian Kaufmann, Leonhard Lennertz, Anja Riesel, Julia Klawohn, Stephan Heinzel, Rosa Grützmann, Norbert Kathmann, Michael Wagner
Patients with obsessive-compulsive disorder (OCD) show deficient planning capacity in the Tower of London (TOL) problem solving task. Preliminary evidence for similar deficits in unaffected first-degree relatives suggests that impaired planning may constitute an endophenotype of OCD. However, results on this issue are inconsistent, possibly owing to small sample sizes and variability in problem structure across TOL tasks. Here, we adopted a computerized version of the TOL task featuring a 2 × 2 factorial design (high/low search depth × full/partial tower goal state) and examined a well-characterized sample of n = 72 OCD patients, n = 76 unaffected first-degree relatives and n = 102 healthy comparison subjects...
June 2018: Journal of Anxiety Disorders
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