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Diogo A DeSousa, André L Moreno, Flávia L Osório, José Alexandre S Crippa, Richard LeBeau, Gisele G Manfro, Giovanni A Salum, Silvia H Koller
The DSM-5 highlights the use of dimensional assessments of mental health as a supplement to categorical diagnoses. This study investigated the psychometric properties of the DSM-5 Dimensional Anxiety Scales in a Brazilian community sample. Dimensional scales for generalized anxiety disorder, social anxiety disorder, panic disorder, agoraphobia, and specific phobia were administered to 930 adults aged 18 to 70, 64.2% female. Psychometric properties investigated were: unidimensionality; measurement invariance; internal consistency; composite reliability; test-retest reliability; convergent and divergent validity; category thresholds and item performance analyses...
October 16, 2016: International Journal of Methods in Psychiatric Research
Hissei Imai, Aran Tajika, Peiyao Chen, Alessandro Pompoli, Toshi A Furukawa
BACKGROUND: Panic disorder is common and deleterious to mental well-being. Psychological therapies and pharmacological interventions are both used as treatments for panic disorder with and without agoraphobia. However, there are no up-to-date reviews on the comparative efficacy and acceptability of the two treatment modalities, and such a review is necessary for improved treatment planning for this disorder. OBJECTIVES: To assess the efficacy and acceptability of psychological therapies versus pharmacological interventions for panic disorder, with or without agoraphobia, in adults...
October 12, 2016: Cochrane Database of Systematic Reviews
Shaun Gallagher, Dylan Trigg
We review the distinction between sense of agency and sense of ownership, and then explore these concepts, and their reflective attributions, in schizophrenic symptoms and agoraphobia. We show how the underlying dynamics of these experiences are different across these disorders. We argue that these concepts are complex and cannot be reduced to neural mechanisms, but involve embodied and situated processes that include the physical and social environments. We conclude by arguing that the subjective and intersubjective dimensions of agency and ownership cannot be considered in isolation from one another, but instead form an interdependent pairing...
2016: Frontiers in Human Neuroscience
Jorge Osma, Juan Ramón Barrada, Azucena García-Palacios, María Navarro-Haro, Alejandra Aguilar
Perceived control has shown predictive value for anxiety severity symptoms as well as cognitive-behavior therapy outcomes. The most commonly used measure of perceived control is the Anxiety Control Questionnaire (ACQ), and more recently the ACQ Revised (ACQ-R). However, both questionnaires have shown structural inconsistencies among several studies. Also, although the ACQ and ACQ-R seem to be multidimensional instruments, a single total score have been commonly used. This study examined the internal structure of the ACQ-R Spanish version using exploratory factor and exploratory bi-factor analysis in a sample of 382 college students and 52 people diagnosed of panic disorder (with or without agoraphobia)...
October 3, 2016: Spanish Journal of Psychology
A Schat, M S van Noorden, M J Noom, E J Giltay, N J A van der Wee, R de Graaf, M Ten Have, R R J M M Vermeiren, F G Zitman
Early onset is regarded as an important characteristic of anxiety disorders, associated with higher severity. However, previous findings diverge, as definitions of early onset vary and are often unsubstantiated. We objectively defined early onset in social phobia, panic disorder, agoraphobia, and generalised anxiety disorder, using cluster analysis with data gathered in the general population. Resulting cut-off ages for early onset were ≤22 (social phobia), ≤31 (panic disorder), ≤21 (agoraphobia), and ≤27 (generalised anxiety disorder)...
September 9, 2016: Journal of Anxiety Disorders
Alicia E Meuret, David Rosenfield, Lavanya Bhaskara, Richard Auchus, Israel Liberzon, Thomas Ritz, James L Abelson
OBJECTIVE: No simple way to augment fear extinction has been established. Cortisol has shown to enhance memory extinction and preliminary evidence suggest that extinction learning maybe more successful in the morning when cortisol is high. The aim was to determine whether exposure sessions conducted earlier in the day are associated with superior therapeutic gains in extinction-based psychotherapy. We also examined the role of cortisol levels as a mediator between time of day and therapeutic gains...
September 15, 2016: Psychoneuroendocrinology
Cord Benecke, Dorothea Huber, Hermann Staats, Johannes Zimmermann, Miriam Henkel, Heinrich Deserno, Silke Wiegand-Grefe, Henning Schauenburg
OBJECTIVES: Anxiety disorders, most notably panic disorders and agoraphobia, are common mental disorders, and there is a high comorbidity with personality disorders. Randomized controlled trails addressing this highly relevant group of patients are missing. DESIGN: The multicenter Anxiety and Personality Disorders (APD) study investigates 200 patients with panic disorder and/or agoraphobia with comorbid personality disorder in a randomized control-group comparison of psychoanalytic therapy (PT) and cognitive behavioral therapy (CBT), including 100 patients in each group...
September 2016: Zeitschrift Für Psychosomatische Medizin und Psychotherapie
Declan T Barry, Christopher J Cutter, Mark Beitel, Robert D Kerns, Christopher Liong, Richard S Schottenfeld
OBJECTIVE: Psychiatric comorbidities complicate treatment of patients with chronic pain and opioid use disorder, but the prevalence of specific comorbid psychiatric disorders in this population has not been systematically investigated. METHODS: 170 consecutive participants entering a treatment research program for co-occurring chronic pain and opioid use disorder between March 2009 and July 2013 were evaluated with the Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID-I/P) and the Diagnostic Interview for DSM-IV Personality Disorders (DIPD-IV)...
August 30, 2016: Journal of Clinical Psychiatry
Vasiliki Michopoulos, Abigail Powers, Charles F Gillespie, Kerry J Ressler, Tanja Jovanovic
The study of inflammation in fear- and anxiety- disorders has gained interest as a growing literature indicates that pro-inflammatory markers can directly modulate affective behavior. Indeed, heightened concentrations of inflammatory signals, including cytokines and C-reactive protein (CRP), have been described in posttraumatic stress disorder (PTSD), generalized anxiety disorder (GAD), panic disorder (PD), and phobias (agoraphobia, social phobia, etc.). However, not all reports indicate a positive association between inflammation and fear- and anxiety- symptoms, suggesting that other factors are important in future assessments of inflammation's role in the maintenance of these disorders (ie sex, comorbid conditions, types of trauma exposure, behavioral sources of inflammation)...
August 11, 2016: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
Tobias Teismann, Thomas Forkmann, Dajana Rath, Heide Glaesmer, Jürgen Margraf
Perceived burdensomeness is considered a proximal risk factor for suicide ideation. However, there is a lack of prospective studies. Furthermore, it is unclear in as much psychotherapy for anxiety disorders is associated with a decrease in suicide ideation. A total of 105 adult outpatients suffering from panic disorder, agoraphobia, or specific phobia received manualized exposure-therapy. Perceived burdensomeness was considered as predictor of suicide ideation concurrently, after the fourth and the tenth therapy session and posttreatment - controlling for baseline symptom distress, suicide ideation, number of therapy sessions and age...
October 2016: Behaviour Research and Therapy
Barbara Milrod, Dianne L Chambless, Robert Gallop, Fredric N Busch, Michael Schwalberg, Kevin S McCarthy, Charles Gross, Brian A Sharpless, Andrew C Leon, Jacques P Barber
OBJECTIVE: To compare cognitive-behavioral therapy (CBT), panic-focused psychodynamic psychotherapy (PFPP), and applied relaxation training (ART) for primary DSM-IV panic disorder with and without agoraphobia in a 2-site randomized controlled trial. METHOD: 201 patients were stratified for site and DSM-IV agoraphobia and depression and were randomized to CBT, PFPP, or ART (19-24 sessions) over 12 weeks in a 2:2:1 ratio at Weill Cornell Medical College (New York, New York) and University of Pennsylvania ("Penn"; Philadelphia, Pennsylvania)...
July 2016: Journal of Clinical Psychiatry
Yazan Abu Ghazal, Devon E Hinton
During the 1860s, Berlin's exterior physiognomy transformed radically. The city eroded the surrounding rural areas, and the frontiers of the old city centre were abolished. These transformations led to the disappearance of the visible frontiers that once demarcated the limits of the old residential Prussian city. In this context, the description of the clinical picture of agoraphobia by the Berlin psychiatrist Carl Westphal in 1872 marked a turning point, not only in psychiatric theories on anxiety but also in the conceptualization of our experience of space...
July 22, 2016: History of Psychiatry
Asle Hoffart, Tuva Øktedalen, Pål Ulvenes, Sverre Urnes Johnson
In this study, we investigated the factor structure of situational fears in agoraphobia by examining four models of the Avoidance Alone items in the Mobility Inventory for Agoraphobia. A main sample of 327 agoraphobic patients and an independent control sample of 64 agoraphobic patients were studied. A confirmatory factor analysis supported a four-factor model including a public places, an enclosed spaces, a public transportation, and an open spaces factor both for pre- and posttreatment data. The convergent and divergent validity of subscales derived from the four factors were supported by an expected pattern of correlations with interview-based measures...
July 22, 2016: Assessment
Sanne M Hendriks, Jan Spijker, Carmilla M M Licht, Florian Hardeveld, Ron de Graaf, Neeltje M Batelaan, Brenda W J H Penninx, Aartjan T F Beekman
BACKGROUND: This longitudinal study aims to investigate differences in long-term disability between social anxiety disorder (SAD), panic disorder with agoraphobia (PDA), panic disorder without agoraphobia (PD), generalized anxiety disorder (GAD) and multiple anxiety disorders (multiple AD), focusing on the effects of different course trajectories (remission, recurrence and chronic course) and specific symptom dimensions (anxiety arousal and avoidance behaviour). METHODS: Data were used from participants with no psychiatric diagnosis (healthy controls, n = 647) or with a current anxiety disorder (SAD, n = 191; PDA, n = 90; PD, n = 84; GAD, n = 110; multiple AD, n = 480)...
2016: BMC Psychiatry
Ken Inoue, Hisanobu Kaiya, Naomi Hara, Yuji Okazaki
OBJECTIVE: The quality of life of individuals with panic disorder and agoraphobia can be improved by the alleviation of agoraphobia. In other words, examining panic disorder in terms of whether agoraphobia is present is crucial. The current study examined panic disorder from this perspective. METHODS: Subjects were 253 patients who met the diagnostic criteria for panic disorder (lifetime) according to the Mini International Neuropsychiatric Interview (MINI). Of those patients, 179 had agoraphobia and 74 did not...
August 2016: Comprehensive Psychiatry
Cary S Kogan, Dan J Stein, Mario Maj, Michael B First, Paul M G Emmelkamp, Geoffrey M Reed
Anxiety disorders are highly prevalent worldwide and engender substantial economic costs and disability. The World Health Organization is currently developing the Eleventh Revision of the International Classification of Diseases and Related Health Problems (ICD-11), which represents the first opportunity to improve the validity, clinical utility, and global applicability of the classification in more than 25 years. This article describes changes in the organization and diagnostic guidelines for anxiety and fear-related disorders proposed by the ICD-11 Working Group on the Classification of Mood and Anxiety Disorders and the rationale and evidence base for the proposals...
July 13, 2016: Depression and Anxiety
Katarzyna Jakuszkowiak-Wojten, Jerzy Landowski, Mariusz S Wiglusz, Wiesław Jerzy Cubała
BACKGROUND: It is unclear whether hypothalamic-pituitary-adrenal axis is involved in the pathophysiology of panic disorder (PD). The findings remain inconsistent. Cortisol awakening response (CAR) is a noninvasive biomarker of stress system activity. We designed the study to assess CAR in drug-naïve PD patients. MATERIALS AND METHODS: We assessed CAR in 14 psychotropic drug-naïve outpatients with PD and 14 healthy controls. The severity of PD was assessed with Panic and Agoraphobia Scale...
2016: Neuropsychiatric Disease and Treatment
Claude Bélanger, Catherine Courchesne, Andrea G Leduc, Caroline Dugal, Ghassan El-Baalbaki, André Marchand, Natacha Godbout, Roger Marcaurelle, Michel Perreault
Panic disorder and agoraphobia are both characterized by avoidance behaviors, which are known correlates of treatment discontinuation. The aim of this exploratory study is to distinguish the profile of participants suffering from panic disorder with agoraphobia that complete treatment from those who discontinue therapy by assessing four categories of predictor variables: the severity of the disorder, sociodemographic variables, participants' expectations, and dyadic adjustment. The sample included 77 individuals diagnosed with panic disorder with agoraphobia who completed a series of questionnaires and participated in a cognitive-behavioral group therapy consisting of 14 weekly sessions...
July 5, 2016: Behavior Modification
Hans-Peter Kapfhammer, Werner Fitz, Doreen Huppert, Eva Grill, Thomas Brandt
The course of illness, the degree of social impairment, and the rate of help-seeking behavior was evaluated in a sample of individuals with visual height intolerance (vHI) and acrophobia. On the basis of a previously described epidemiological sample representative of the German general population, 574 individuals with vHI were identified, 128 fulfilled the DSM-5 diagnostic criteria of acrophobia. The illness of the majority of all susceptible individuals with vHI ran a year-long chronic course. Two thirds were in the category "persistent/worse", whereas only one third was in the category "improved/remitted"...
October 2016: Journal of Neurology
Eline L Möller, Susan M Bögels
With DSM-5, the American Psychiatric Association encourages complementing categorical diagnoses with dimensional severity ratings. We therefore examined the psychometric properties of the DSM-5 Dimensional Anxiety Scales, a set of brief dimensional scales that are consistent in content and structure and assess DSM-5-based core features of anxiety disorders. Participants (285 males, 255 females) completed the DSM-5 Dimensional Anxiety Scales for social anxiety disorder, generalized anxiety disorder, specific phobia, agoraphobia, and panic disorder that were included in previous studies on the scales, and also for separation anxiety disorder, which is included in the DSM-5 chapter on anxiety disorders...
September 2016: International Journal of Methods in Psychiatric Research
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