Journal of Anxiety Disorders最新文献

Although intolerance of uncertainty (IU) is associated with negative outcomes, studies focusing on older adults are still emerging. Specifically, the relationship between IU and psychological health in this population remains unclear. Moreover, no review has focused on understanding the unique contributions of IU and aging to anxiety and mental health in older adults. This scoping review and meta-analysis addressed this gap and provided a comprehensive understanding of the relationship between IU, aging, and mental health. Among 45 studies reviewed, 37 were included in the meta-analysis using mixed effect analysis to examine the relationship between IU and age across adulthood. The remaining eight studies, along with seven selected from the meta-analysis, were included in the scoping review to evaluate the relationship between IU, anxiety, and mental health. Among these, 12 studies focused on late adulthood, two on overall adulthood, and one included both late and overall adulthood. Results of the meta-analysis revealed an overall significant age difference in IU throughout adulthood. Moreover, results of the scoping review indicated a direct correlation between IU and anxiety, and other psychological issues in elderly. These findings provide insights for future research and interventions aimed at reducing IU and improving mental health among older adults.

Mindfulness- and acceptance-based programmes (MABPs) in the treatment of obsessive-compulsive disorder (OCD) are increasingly gaining research interest, yet a comprehensive systematic review and meta-analysis is missing. To fill this gap, we analysed 46 trials involving 2221 patients. Two independent reviewers screened records, extracted data, assessed risk of bias, and rated overall quality of evidence. MABPs were associated with large reductions in OCD-severity in between-group analysis in randomised controlled trials (k = 33; g = -.87; CI = -1.13,-.60) and within-group pre-post analysis in all MABPs (k = 49; g = -1.72; CI = -2.00,-1.44). Depressive symptoms decreased between- and within-group with a small to moderate effect, with maintained reductions at follow-up for both OCD and depression. Moderate to large pre-post improvements were also observed in anxiety, obsessive beliefs, and quality of life. MABPs did not differ from cognitive behavioural therapy and exposure and response prevention (k = 9; g=.02; CI = -.23,.26) but were superior to medication (k = 5; g = -.77; CI = -1.44,-.11) and waitlist (k = 16; g = -1.66; CI = -2.1,-1.24). Symptom reductions were observed across world regions, but to varying degrees. When combined, increases in mindfulness and psychological flexibility predicted reductions in OCD symptoms. Outcomes were not moderated by treatment duration, samples', and therapists' characteristics. MABPs can reduce OCD-severity, but further high-quality trials with long-term follow-ups are needed to confirm results.

Anxiety symptoms are among the most prevalent mental health disorders in adolescents, highlighting the need for scalable and accessible interventions. As anxiety often co-occurs with perceived stress during adolescence, stress interventions may offer a promising approach to reducing anxiety. Previous stress interventions have largely focused on the view that stress is harmful, aiming to manage and mitigate its negative effects. Stress optimization presents a novel intervention perspective, suggesting that stress can also lead to positive outcomes. However, it remains unclear whether stress optimization can effectively reduce anxiety symptoms in adolescents. We developed a single-session stress optimization intervention and investigated the conditions under which it was most effective. A large-scale randomized controlled trial was conducted (N = 1779, aged 12-18 years), with participants reporting their perceived stress, stress mindset, and anxiety over a two-month follow-up period. Machine learning is a promising approach for assessing personalized intervention effects. Conservative Bayesian causal forest analysis was employed to detect both treatment and heterogeneous intervention effects. The findings revealed that the intervention effectively reduced anxiety symptoms in the school context over a two-month follow-up (0.87 posterior probability). Furthermore, adolescents with higher anxiety and perceived stress at baseline experienced the most significant reductions in anxiety outcomes (standard deviations of -0.18 and -0.11 respectively). The single-session stress optimization intervention demonstrated potential for cost-effective scaling.

Introduction: Information regarding the prevalence of potentially traumatic events (PTEs), DSM-5 posttraumatic stress disorder (PTSD) and ICD-11 complex PTSD (CPTSD) in the Netherlands is currently lacking, as is data on treatment uptake and treatment barriers. We aimed to provide prevalence estimates for potentially traumatic events, PTSD and CPTSD in the Netherlands, describe treatment seeking behavior and explore associated risk factors.

Method: We included a sample of 1690 participants aged 16 years and older across the Netherlands via the Longitudinal Internet studies for the Social Sciences panel, a true probability sample of households drawn from the population register by Statistics Netherlands. We recruited participants between September 1st, 2023, and November 1st 2023. All participants completed online self-report questionnaires, and a subset consented to an interview (n = 204). Instruments included the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), the PTSD Checklist for DSM-5 (PCL-5) and the International Trauma Questionnaire (ITQ).

Results: The lifetime prevalence of any PTE was 81.5 %. The estimated lifetime prevalence of DSM-5 PTSD was 11.1 % and current prevalence 1.3 %. The estimated current prevalence of ICD-11 PTSD was 1.0 % and ICD-11 complex PTSD was 1.6 %. Especially females, younger adults, those with a lower education and those with a non-Dutch cultural background were at risk for PTSD. About half of the people with probable lifetime PTSD sought professional help and one-third received first-line PTSD treatment. Common reasons for refraining from seeking professional support included a lack of knowledge, shame and avoidance.

Conclusions: PTEs, PTSD and CPTSD are common in the Netherlands and disproportionately distributed in society. Although evidence-based treatments for PTSD are available, only about one-third of those with lifetime PTSD receive first-line treatment. Findings underscore the need for targeted screening and preventative interventions, alongside public health campaigns aimed at enhancing knowledge and mitigating stigma about PTSD.

Graded exposure successfully reduces fear in specific phobias and anxiety disorders, yet social exposure in daily life often fails to mitigate social anxiety. Post-event processing, perseverative, negative, self-referential thinking that occurs following a social-evaluative event, may partly explain inhibited desensitization to social fears. Post-event processing has been studied extensively since its first description by Clark and Wells (1995) and previously reviewed (e.g., Brozovich & Heimberg, 2008; Wong, 2016). However, these reviews are now dated or limited in scope. In the present scoping review, we pay particular attention to contemporary research that addresses unanswered questions raised in past reviews (e.g., Brozovich & Heimberg, 2008), synthesizing existing knowledge. Specifically, we discuss post-event processing's evolving role in cognitive models of social anxiety disorder, its core features, its eliciting situations (e.g., performance vs. social interactions), its relation to other cognitive and affective constructs (e.g., memory, performance appraisal, self-focused attention), and its assessment. Our findings indicate that post-event processing is more frequent after performance situations than social interactions, is related to negative memory biases, is bi-directionally related to worsening performance appraisals, and may be precipitated by self-focused attention. Future research directions include elucidating post-event processing's course, clarifying post-event processing's potential causal role in the development of social anxiety disorder, and identifying factors that underlie post-event processing's deleterious nature.

Background: This paper reports on the outcomes of a proof-of-principle study for the Exposure Therapy Consortium, a global network of researchers and clinicians who work to improve the effectiveness and uptake of exposure therapy. The study aimed to test the feasibility of the consortium's big-team science approach and test the hypothesis that adding post-exposure processing focused on enhancing threat reappraisal would enhance the efficacy of a one-session large-group interoceptive exposure therapy protocol for reducing anxiety sensitivity.

Methods: The study involved a multi-site cluster-randomized controlled trial comparing exposure with post-processing (ENHANCED), exposure without post-processing (STANDARD), and a stress management intervention (CONTROL) in students with elevated anxiety sensitivity. Feasibility was assessed using site performance metrics (e.g., timeline, sample size, missing data). Efficacy was assessed up to 1-month follow-up using the Anxiety Sensitivity Index-3.

Results: Despite challenges posed by unforeseen global crises, a standardized protocol for screening, assessment, and treatment at 12 research sites across four continents was successfully implemented, resulting in a total sample size of 400 with minimal missing data. Challenges in recruitment and adherence to the projected timelines were encountered. Significant reductions in anxiety sensitivity were observed in all conditions. Contrary to hypotheses, group differences were only observed at post-treatment, when ENHANCED and CONTROL outperformed STANDARD but were not significantly different from each other.

Conclusions: This study demonstrates the feasibility of the Exposure Therapy Consortium. Findings raise questions regarding the efficacy of large group exposure interventions and underscore the importance of careful research site selection and an iterative approach to treatment development.

Emerging evidence suggests that certain individuals are unable to address others by name, presumably owing to anxiety experienced in social situations. This fear of using personal names has been termed alexinomia and occurs in all forms of relationships and communication. The symptoms of alexinomia show large overlap with the symptoms typically associated with social anxiety, raising the question of whether social anxiety could be the main driving factor of this type of name avoidance. Here, we investigated the relationship between alexinomia and social anxiety by testing name avoidance behavior in a sample of 190 participants with varying degrees of social anxiety. Results showed a strong positive relationship between these two variables. High levels of social anxiety, as measured by two independent standardized psychological instruments (i.e., the Social Interaction Anxiety Scale and the Liebowitz Social Anxiety Scale), were associated with higher degrees of fear-based name avoidance. This was shown by regression analysis as well as analyses of group differences. The findings indicate that alexinomia could be a common symptom in socially anxious individuals that so far has not been discussed in the psychological literature on social anxiety.

There are well-established theoretical and empirical foundations for a negative association between trait positive affectivity and anxiety symptoms in anxiety disorders and a positive association between trait negative affectivity and anxiety symptoms, respectively. However, no previous meta-analysis systematically estimated to what extent trait positive and negative affectivity are associated with anxiety symptoms in anxiety disorders. The aim of this study was to conduct a systematic review and meta-analysis to obtain an evidence-based estimate of the associations between trait positive and negative affectivity with anxiety symptoms in anxiety disorders. We performed a systematic search including studies reporting estimates of the associations between trait positive and negative affectivity measures and anxiety measures in clinical populations that suffer from at least one anxiety disorder. We identified 13 and 14 eligible studies, documenting 19 and 21 mainly unpublished effect sizes from 1489 individuals that suffer from an anxiety disorder. We estimated an overall correlational effect size (r) using multilevel meta-analytic models accounting for within- and between-study variance components. The results of the omnibus models showed a small to moderate negative association between positive affectivity and anxiety symptoms (r = -0.19, 95 % CI [-0.30, -0.09]) and a strong positive association between negative affectivity and anxiety symptoms respectively (r = 0.53, 95 % CI [0.44, 0.61]). These associations are different from each other (r = .35, p < .001). The results are consistent with theoretical claims that anxiety disorders are highly associated with negative affectivity but to a lesser extent with positive affectivity. More research and systematic documentation are necessary to determine moderators of these overall associations.

Social anxiety disorder (SAD) is a prevalent anxiety disorder marked by strong fear and avoidance of social scenarios. Early detection of SAD lays the foundation for the introduction of early interventions. However, due to the nature of social avoidance in social anxiety, the screening is challenging in the clinical setting. Classic questionnaires also bear the limitations of subjectivity, memory biases under repeated measures, and cultural influence. Thus, there exists an urgent need to develop a reliable and easily accessible tool to be widely used for social anxiety screening. Here, we developed the Social Artificial Intelligence Picture System (SAIPS) based on generative multi-modal foundation artificial intelligence (AI) models, containing a total of 279 social pictures and 118 control pictures. Social scenarios were constructed to represent core SAD triggers such as fear of negative evaluation, social interactions, and performance anxiety, mapping to specific dimensions of social anxiety to capture its multifaceted nature. Pictures devoid of social interactions were included as a control, aiming to reveal response patterns specific to social scenarios and to improve the system's precision in predicting social anxiety traits. Through laboratory and online experiments, we collected ratings on SAIPS from five dimensions. Machine learning results showed that ratings on SAIPS robustly reflected and predicted an individual's trait of social anxiety, especially social anxiety and arousal ratings. The prediction was reliable, even based on a short version with less than 30 pictures. Together, SAIPS may serve as a promising tool to support social anxiety screening and longitudinal predictions.