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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
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...
June 18, 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)...
June 15, 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
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...
June 4, 2018: Journal of Anxiety Disorders
Lily A Brown, Carolyn D Davies, Alexander Gerlach, Ruth Cooper, Stephan Stevens, Michelle G Craske
While several empirically supported treatments for posttraumatic stress disorder (PTSD) have been developed, these treatments are neither widely available nor universally efficacious. This pilot, proof of concept study evaluated a computerized imaginal exposure Script-Driven Imagery Training (SDI-T) for individuals with elevated trauma reactivity. The training was supplemented with two forms of linguistic processing, affect labeling (SDI-T + AL) and distraction (SDI-T + D), to determine whether linguistic inhibitory regulation augmented the effects of SDI-T...
June 4, 2018: Journal of Anxiety Disorders
Talya Greene
While peritraumatic dissociation has been identified as a predictor of posttraumatic stress disorder, it may also have some protective aspect. The study uses experience sampling methods to assess acute dissociation reactions during conflict, and to investigate these reactions as predictors of subsequent posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG). During the 2014 Israel-Gaza conflict, Israeli civilians (n = 96) exposed to rocket fire gave twice-daily experience sampling method (ESM) reports of dissociation symptoms for 30 days via mobile phone...
May 30, 2018: Journal of Anxiety Disorders
Jana Ross, Dominic Murphy, Cherie Armour
Network analysis is a relatively new methodology for studying psychological disorders. It focuses on the associations between individual symptoms which are hypothesized to mutually interact with each other. The current study represents the first network analysis conducted with treatment-seeking military veterans in UK. The study aimed to examine the network structure of posttraumatic stress disorder (PTSD) symptoms and four domains of functional impairment by identifying the most central (i.e., important) symptoms of PTSD and by identifying those symptoms of PTSD that are related to functional impairment...
May 28, 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
Tatiana Bielak, David A Moscovitch, Stephanie Waechter
Forty participants with social anxiety disorder (SAD) and 42 healthy controls (HCs) were randomized to watch a confederate deliver a speech in either a visibly anxious or confident manner. Participants rated their perception of the presenter's desirability across five attributes and compared themselves to the presenter along these same dimensions. Participants then delivered their own speeches, and were rated in a similar manner by trained research assistants who were naïve to participants' group status and study objectives...
June 2018: Journal of Anxiety Disorders
K Meyerbröker, N Morina, P M G Emmelkamp
BACKGROUND: Recent research indicates that pharmacological agents may enhance psychotherapeutic outcome. Yet, empirical results have not been conclusive with respect to two pharmacological agents, yohimbine hydrochloride (YOH) and propranolol. YOH is suggested to enhance emotional memory by elevating norepinephrine, whereas the β-adrenergic receptor antagonist propranolol might help better cope with feared situations by reducing accompanying bodily sensations. METHODS: In this controlled trial, fifty-six participants with specific phobia were randomly assigned to either 1) virtual reality exposure therapy (VRET) plus YOH, 2) VRET plus Propranolol, or 3) VRET plus placebo...
June 2018: Journal of Anxiety Disorders
Sarah M Kennedy, Niza A Tonarely, Jamie A Sherman, Jill Ehrenreich-May
Various efficacious treatment packages exist for youth anxiety, and cognitive behavior therapy (CBT) is now considered to be a well-established treatment for child anxiety disorders (Higa-McMillan, Francis, Rith-Najarian, & Chorpita, 2016). Improving outcomes for the significant proportion of anxious youth who demonstrate inadequate response to CBT is imperative, but our understanding of who does and does not benefit is incomplete. Further, there are no known empirical studies of predictors of treatment response for youth who receive a transdiagnostic intervention for anxiety or depression, and it is therefore unclear whether predictors of response to a transdiagnostic treatment for children are similar to those found in previous studies of anxiety-specific treatments...
June 2018: Journal of Anxiety Disorders
Ryan L Rahm-Knigge, Mark A Prince, Bradley T Conner
Individuals with social interaction anxiety, a facet of social anxiety disorder, withdraw from or avoid social encounters and generally avoid risks. However, a subset engages in health risk sexual behavior (HRSB). Because sensation seeking, emotion dysregulation, and impulsivity predict engagement in HRSB among adolescents and young adults, the present study hypothesized that latent classes of social interaction anxiety and these personality traits would differentially predict likelihood of engagement in HRSB...
June 2018: Journal of Anxiety Disorders
Clara Strauss, Laura Lea, Mark Hayward, Elizabeth Forrester, Tamara Leeuwerik, Anna-Marie Jones, Claire Rosten
BACKGROUND: Only about half of people with obsessive compulsive disorder (OCD) show clinically significant improvement following the recommended therapy, exposure and response prevention (ERP), partly due to poor therapy acceptability. A mindfulness-based approach to ERP (MB-ERP) has the potential to improve acceptability and outcomes. METHODS: This was an internal pilot randomised controlled trial (RCT) of group MB-ERP compared to group ERP. 37 participants meeting DSM-IV OCD criteria were randomly allocated to MB-ERP or ERP...
June 2018: Journal of Anxiety Disorders
E Pepperdine, C Lomax, M H Freeston
Intolerance of Uncertainty is a transdiagnostic risk and maintenance factor in a range of anxiety disorders and major depressive disorder. However, the mechanism of action in the development and maintenance of anxiety disorders is poorly understood, with the relationship between the constructs of uncertainty and threat appraisal remaining unclear. Most research to date has investigated IU in situations that are explicitly or implicitly threatening (i.e. where they have a negative outcome), which makes it difficult to establish whether it is the uncertainty or the prospect of a negative outcome (or threat) that people find aversive...
June 2018: Journal of Anxiety Disorders
Richard G Heimberg, Rachel M Butler
Asmundson and Asmundson (2018) reported that publication of research on anxiety disorders, including social anxiety disorder (SAD), has seen rapid growth in the period between 2006 and 2016. In fact, the uptick in publication rate of SAD research was unexpectedly high given previous predictions by Boschen (2008), who reviewed publication trends from 1980 to 2005. In this commentary, we consider potential factors involved in the continued increase in publication of research on SAD. We examine the roles that empathy and evolutionary factors may play in our ability to relate to those with SAD and in our motivation to research it...
May 2018: Journal of Anxiety Disorders
Dean McKay
There has been impressive growth in scholarly research on obsessive-compulsive disorder (OCD). As a general rule, this can be construed as a sign of health in the subspecialty within anxiety disorder research. One factor that likely contributed to the growth in research on OCD was the observation that obsessional experiences can be placed on a dimension from normal to abnormal (or non-clinical to clinical) (Rachman and de Silva, 1978). While the dramatic growth in OCD research has led to increased sophistication in clinical conceptualization of various presentations of this heterogeneous condition, it has not led to a commensurate increase in the availability of efficacious treatment...
May 2018: Journal of Anxiety Disorders
Richard J McNally
Asmundson and Asmundson's (2018) bibliometric study demonstrates that the anxiety disorders remain a major focus of clinical research. Yet striking differences emerged among these syndromes. For example, in contrast to panic disorder, posttraumatic stress disorder has increasingly flourished as a major focus of publications. The purpose of my commentary is to discuss the basis for the remarkable success of traumatology relative to other areas (e.g., panic disorder research).
May 2018: Journal of Anxiety Disorders
Michelle G Newman, Amy Przeworski
Generalized Anxiety Disorder (GAD) is one of the most common anxiety disorders. It is associated with functional impairment and is unlikely to spontaneously remit. As identified by Asmundson and Asmundson (2018), published research studies on GAD have increased in number over the last decade. We propose that this is due to the high prevalence of the diagnosis and symptoms, interest in transdiagnostic processes, such as worry, increased interest in emotion dysregulation as a principle underlying diagnoses, and new methods of treating and disseminating treatment that may be particularly well suited to GAD...
May 2018: Journal of Anxiety Disorders
Gordon J G Asmundson, Aleiia J N Asmundson
The relative health of a field of research can be approximated by assessing peer-reviewed journal publication trends for articles pertinent to that field. The most recent comprehensive assessment of publication trends in the anxiety disorders indicated that the field was on a continuing trajectory of growth (Boschen, 2008). We conducted an updated search of Medline for publications on each of the anxiety disorders from 2006 to 2016. Results indicated that there was continuing growth in anxiety disorders research overall and, particularly, for posttraumatic stress disorder, social anxiety disorder, generalized anxiety disorder, and obsessive compulsive disorder...
May 2018: Journal of Anxiety Disorders
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