Pub Date : 2025-05-08DOI: 10.1016/j.janxdis.2025.103025
Aleiia J.N. Asmundson , Michelle M. Paluszek , Jordana L. Sommer , Shay-Lee Bolton , Jitender Sareen , Tracie O. Afifi , Renée El-Gabalawy , Gordon J.G. Asmundson
Background
Posttraumatic stress disorder (PTSD) and chronic pain are highly prevalent, comorbid, and debilitating conditions in the military. The present study was designed to examine the prevalence of chronic pain conditions (i.e., migraines, back problems, arthritis) across PTSD courses (i.e., no PTSD, remitted, new onset, persistent/recurrent) and examine the association between PTSD course and the presence and onset of chronic pain conditions in a population-representative sample of Canadian military members. Methods: Cross-tabulations and logistic regressions were conducted on data (n = 2941) from the 2002 Canadian Community Health Survey Mental Health and Well-being Canadian Forces Supplement and the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-Up Survey. Results: The prevalence of chronic pain conditions across PTSD courses ranged from 8 % to 61 %, with no PTSD consistently having the lowest prevalence. After adjusting for covariates, respondents with new onset PTSD had elevated odds of back problems (AOR=1.43, 95 % CI [1.10–1.90], p < .05), arthritis (AOR=1.46, 95 % CI [1.06–2.00], p < .05), and a new onset chronic pain condition more broadly (AOR=1.66, 95 % CI [1.15–2.39], p < .01), compared to those with no PTSD. Those with remitted PTSD had greater odds of migraines (AOR=2.43, 95 % CI [1.29–4.58], p < .01), while those with persistent PTSD had lower odds of back problems (AOR=0.45, 95 % CI [0.23–0.88], p < .05), compared to those with no PTSD. Conclusion: Findings indicate that the prevalence and type of chronic pain that co-occurs with PSTD in Canadian military members varies as a function of the course of PTSD. This underscores the importance of evaluating pain in those with PTSD and suggests that the course of PTSD is a relevant consideration in case conceptualization and treatment planning.
背景：创伤后应激障碍（PTSD）和慢性疼痛是军队中非常普遍、合并症和衰弱性疾病。本研究旨在研究慢性疼痛状况（如偏头痛、背部问题、关节炎）在创伤后应激障碍病程（即无创伤后应激障碍、缓解、新发、持续/复发）中的患病率，并研究PTSD病程与慢性疼痛状况的存在和发作之间的关系。方法：对2002年加拿大社区卫生调查《加拿大军人心理健康与福祉补编》和2018年加拿大武装部队成员和退伍军人心理健康随访调查的数据（n = 2941）进行交叉表列和logistic回归分析。结果：创伤后应激障碍病程中慢性疼痛的患病率从8% %到61% %不等，无创伤后应激障碍的患病率始终最低。协变量调整后,受访者与新出现创伤后应激障碍的几率升高背部问题(优势比= 1.43,95 % CI [1.10 - -1.90], p & lt; . 05),关节炎(优势比= 1.46,95 % CI [1.06 - -2.00], p & lt; . 05),和一个新的出现慢性疼痛条件更广泛(优势比= 1.66,95 % CI [1.15 - -2.39], p & lt; . 01),而那些没有创伤后应激障碍。与无PTSD患者相比，PTSD缓解者偏头痛发生率更高（AOR=2.43, 95 % CI [1.29-4.58], p <； .01），而持续性PTSD患者背部问题发生率更低（AOR=0.45, 95 % CI [0.23-0.88], p <； .05）。结论：研究结果表明，加拿大军人PTSD并发慢性疼痛的患病率和类型随PTSD病程的变化而变化。这强调了评估创伤后应激障碍患者疼痛的重要性，并表明创伤后应激障碍的病程是病例概念化和治疗计划的相关考虑因素。
{"title":"Longitudinal course of posttraumatic stress disorder and chronic pain conditions: A population-based study of Canadian military personnel over 16 years","authors":"Aleiia J.N. Asmundson , Michelle M. Paluszek , Jordana L. Sommer , Shay-Lee Bolton , Jitender Sareen , Tracie O. Afifi , Renée El-Gabalawy , Gordon J.G. Asmundson","doi":"10.1016/j.janxdis.2025.103025","DOIUrl":"10.1016/j.janxdis.2025.103025","url":null,"abstract":"<div><h3>Background</h3><div>Posttraumatic stress disorder (PTSD) and chronic pain are highly prevalent, comorbid, and debilitating conditions in the military. The present study was designed to examine the prevalence of chronic pain conditions (i.e., migraines, back problems, arthritis) across PTSD courses (i.e., no PTSD, remitted, new onset, persistent/recurrent) and examine the association between PTSD course and the presence and onset of chronic pain conditions in a population-representative sample of Canadian military members. Methods: Cross-tabulations and logistic regressions were conducted on data (n = 2941) from the 2002 Canadian Community Health Survey Mental Health and Well-being Canadian Forces Supplement and the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-Up Survey. Results: The prevalence of chronic pain conditions across PTSD courses ranged from 8 % to 61 %, with no PTSD consistently having the lowest prevalence. After adjusting for covariates, respondents with new onset PTSD had elevated odds of back problems (AOR=1.43, 95 % CI [1.10–1.90], <em>p</em> < .05), arthritis (AOR=1.46, 95 % CI [1.06–2.00], <em>p</em> < .05), and a new onset chronic pain condition more broadly (AOR=1.66, 95 % CI [1.15–2.39], <em>p</em> < .01), compared to those with no PTSD. Those with remitted PTSD had greater odds of migraines (AOR=2.43, 95 % CI [1.29–4.58], <em>p</em> < .01), while those with persistent PTSD had lower odds of back problems (AOR=0.45, 95 % CI [0.23–0.88], <em>p</em> < .05), compared to those with no PTSD. Conclusion: Findings indicate that the prevalence and type of chronic pain that co-occurs with PSTD in Canadian military members varies as a function of the course of PTSD. This underscores the importance of evaluating pain in those with PTSD and suggests that the course of PTSD is a relevant consideration in case conceptualization and treatment planning.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"113 ","pages":"Article 103025"},"PeriodicalIF":4.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144088960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-08DOI: 10.1016/j.janxdis.2025.103024
Tomoko Kishimoto , Ximing Hao , Qiyu Bai
Anxiety disorders are often characterized by excessive sympathetic activation and dysfunction. While breathing relaxation reliably reduces anxiety by dampening sympathetic activity and enhancing parasympathetic tone, the autonomic signatures underlying positive emotion interventions, such as savoring meditation, remain less understood. In this pilot randomized controlled trial, we recruited 44 participants with probable generalized anxiety disorders (GAD) by questionnaires (GAD-7 score ≥ 10, which represents moderate or higher anxiety severity), who were assigned to a savoring meditation (n = 22) or a breathing relaxation (n = 22) intervention. We measured heart rate variability (HRV) indicators (respiratory sinus arrhythmia, RSA; low-frequency HRV, LF; the low-frequency/high-frequency ratio, LF/HF) and self-reported emotional states (happiness, anxiety, sadness, calmness) before and after the intervention. Linear mixed models with multiple imputation examined outcome change between and within conditions. The savoring group exhibited increased sympathetic and decreased parasympathetic activity (significantly lower RSA, higher LF and LF/HF), contrasting with the relaxation group’s pattern. Both interventions resulted in significant and similar reductions in anxiety after worrying. These preliminary results suggest that savoring meditation for anxiety reduction may have unique autonomic signatures, offering novel insights for positive emotion interventions in anxiety research.
{"title":"The unique autonomic signatures of savoring meditation for anxiety reduction: A pilot randomized controlled trial","authors":"Tomoko Kishimoto , Ximing Hao , Qiyu Bai","doi":"10.1016/j.janxdis.2025.103024","DOIUrl":"10.1016/j.janxdis.2025.103024","url":null,"abstract":"<div><div>Anxiety disorders are often characterized by excessive sympathetic activation and dysfunction. While breathing relaxation reliably reduces anxiety by dampening sympathetic activity and enhancing parasympathetic tone, the autonomic signatures underlying positive emotion interventions, such as savoring meditation, remain less understood. In this pilot randomized controlled trial, we recruited 44 participants with probable generalized anxiety disorders (GAD) by questionnaires (GAD-7 score ≥ 10, which represents moderate or higher anxiety severity), who were assigned to a savoring meditation (<em>n</em> = 22) or a breathing relaxation (<em>n</em> = 22) intervention. We measured heart rate variability (HRV) indicators (respiratory sinus arrhythmia, RSA; low-frequency HRV, LF; the low-frequency/high-frequency ratio, LF/HF) and self-reported emotional states (happiness, anxiety, sadness, calmness) before and after the intervention. Linear mixed models with multiple imputation examined outcome change between and within conditions. The savoring group exhibited increased sympathetic and decreased parasympathetic activity (significantly lower RSA, higher LF and LF/HF), contrasting with the relaxation group’s pattern. Both interventions resulted in significant and similar reductions in anxiety after worrying. These preliminary results suggest that savoring meditation for anxiety reduction may have unique autonomic signatures, offering novel insights for positive emotion interventions in anxiety research.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"113 ","pages":"Article 103024"},"PeriodicalIF":4.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-24DOI: 10.1016/j.janxdis.2025.103022
Siyuan Wang , Madeline M. Rodenbaugh , Casey Straud , Nicole H. Weiss , Ateka A. Contractor
Emerging research indicates an important role of positive emotion processes in posttraumatic stress disorder (PTSD) symptomatology. To extend this research, we utilized a network approach to examine associations between PTSD symptom clusters (intrusions, avoidance, negative alterations in cognition and mood [NACM], alterations in arousal and reactivity [AAR]) and dysregulated positive emotion processes (levels of positive affect, self-focused positive rumination, emotion-focused positive rumination, dampening, impulse control difficulties, difficulties engaging in goal-directed behaviors, nonacceptance of positive emotions). Specifically, we examined differential relations between PTSD symptom clusters and positive emotion processes, and symptoms that most strongly connected these constructs (i.e., communities). The sample included 191 trauma-exposed adults recruited from Amazon’s MTurk ( Mage = 38.54 ± 10.99 years, 53.4 % women, 63.4 % with probable PTSD). A regularized Guassian Graphic Model consisting of four nodes representing the PTSD symptom clusters’ community and seven nodes representing the positive emotion processes' community was generated. The strongest positive associations across communities were the NACM-dampening and the AAR-dampening edges. Bridge symptoms with the highest inter-community connectivity were dampening, AAR, intrusions, NACM, and impulse control difficulties. Overall, this study indicates the importance of incorporating positive emotion processes in the conceptualization of PTSD. Our results also highlight that dampening of positive emotions and difficulties with impulse control while experiencing positive emotions may be meaningful targets in PTSD treatment.
{"title":"Exploring the co-occurrence of posttraumatic stress disorder symptoms and dysregulated positive emotion processes: A network analysis","authors":"Siyuan Wang , Madeline M. Rodenbaugh , Casey Straud , Nicole H. Weiss , Ateka A. Contractor","doi":"10.1016/j.janxdis.2025.103022","DOIUrl":"10.1016/j.janxdis.2025.103022","url":null,"abstract":"<div><div>Emerging research indicates an important role of positive emotion processes in posttraumatic stress disorder (PTSD) symptomatology. To extend this research, we utilized a network approach to examine associations between PTSD symptom clusters (intrusions, avoidance, negative alterations in cognition and mood [NACM], alterations in arousal and reactivity [AAR]) and dysregulated positive emotion processes (levels of positive affect, self-focused positive rumination, emotion-focused positive rumination, dampening, impulse control difficulties, difficulties engaging in goal-directed behaviors, nonacceptance of positive emotions). Specifically, we examined differential relations between PTSD symptom clusters and positive emotion processes, and symptoms that most strongly connected these constructs (i.e., communities). The sample included 191 trauma-exposed adults recruited from Amazon’s MTurk ( <em>M</em><sub>age</sub> = 38.54 ± 10.99 years, 53.4 % women, 63.4 % with probable PTSD). A regularized Guassian Graphic Model consisting of four nodes representing the PTSD symptom clusters’ community and seven nodes representing the positive emotion processes' community was generated. The strongest positive associations across communities were the NACM-dampening and the AAR-dampening edges. Bridge symptoms with the highest inter-community connectivity were dampening, AAR, intrusions, NACM, and impulse control difficulties. Overall, this study indicates the importance of incorporating positive emotion processes in the conceptualization of PTSD. Our results also highlight that dampening of positive emotions and difficulties with impulse control while experiencing positive emotions may be meaningful targets in PTSD treatment.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"113 ","pages":"Article 103022"},"PeriodicalIF":4.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-23DOI: 10.1016/j.janxdis.2025.103023
Mariel Emrich , Camille L. Garnsey, Erika K. Osherow, Crystal L. Park
Background
Sexual trauma survivors commonly experience feelings of betrayal. Betrayal has largely been studied as a static trauma characteristic that is determined by a survivor’s closeness to the perpetrator. This approach overlooks survivors’ subjective feelings and experiences. This study examines whether: 1) degree of perceived betrayal differs by type of survivor-perpetrator relationship, 2) perceived betrayal in the early aftermath of trauma predicts subsequent PTSD symptoms, and 3) emotion dysregulation mediates the relationship between perceived betrayal and PTSD symptoms.
Methods
Women (N = 203; ages 19–86) who experienced sexual trauma within a month of recruitment completed questionnaires on Prolific at T1 (within 30 days of trauma), T2 (4 weeks post-T1), and T3 (8 weeks post-T1). Descriptive statistics and an independent samples t-test examined differences in perceived betrayal across survivor-perpetrator relationship characteristics. Structural equation models assessed perceived betrayal at T1 predicting PTSD symptoms at T3 and the potential mediating effect of T2 emotion dysregulation.
Results
Although betrayal was highest among survivors who knew the perpetrator prior to the trauma (M = 76.8, range 0–100), average perceived betrayal was high across the sample (M = 70.5), and the quarter of survivors who identified the perpetrator as a stranger also reported elevated betrayal (M = 51.6). T1 perceived betrayal significantly predicted T3 PTSD symptoms with increases in emotion dysregulation partially mediating this effect (p = .01).
Conclusions
Findings support moving towards a subjective conceptualization of betrayal that incorporates survivors’ perceptions. Moreover, emotion dysregulation may be an important intervention target in the early aftermath of sexual trauma and warrants further empirical research.
{"title":"Moving towards a subjective conceptualization of betrayal: Examining associations between perceived betrayal, emotion dysregulation, and PTSD symptoms in sexual trauma survivors","authors":"Mariel Emrich , Camille L. Garnsey, Erika K. Osherow, Crystal L. Park","doi":"10.1016/j.janxdis.2025.103023","DOIUrl":"10.1016/j.janxdis.2025.103023","url":null,"abstract":"<div><h3>Background</h3><div>Sexual trauma survivors commonly experience feelings of betrayal. Betrayal has largely been studied as a static trauma characteristic that is determined by a survivor’s closeness to the perpetrator. This approach overlooks survivors’ <em>subjective feelings and experiences</em>. This study examines whether: 1) degree of perceived betrayal differs by type of survivor-perpetrator relationship, 2) perceived betrayal in the early aftermath of trauma predicts subsequent PTSD symptoms, and 3) emotion dysregulation mediates the relationship between perceived betrayal and PTSD symptoms.</div></div><div><h3>Methods</h3><div>Women (<em>N</em> = 203; ages 19–86) who experienced sexual trauma within a month of recruitment completed questionnaires on Prolific at T1 (within 30 days of trauma), T2 (4 weeks post-T1), and T3 (8 weeks post-T1). Descriptive statistics and an independent samples t-test examined differences in perceived betrayal across survivor-perpetrator relationship characteristics. Structural equation models assessed perceived betrayal at T1 predicting PTSD symptoms at T3 and the potential mediating effect of T2 emotion dysregulation.</div></div><div><h3>Results</h3><div>Although betrayal was highest among survivors who knew the perpetrator prior to the trauma (<em>M</em> = 76.8, range 0–100), average perceived betrayal was high across the sample (<em>M</em> = 70.5), and the quarter of survivors who identified the perpetrator as a stranger also reported elevated betrayal (<em>M</em> = 51.6). T1 perceived betrayal significantly predicted T3 PTSD symptoms with increases in emotion dysregulation partially mediating this effect (<em>p</em> = .01).</div></div><div><h3>Conclusions</h3><div>Findings support moving towards a subjective conceptualization of betrayal that incorporates survivors’ perceptions. Moreover, emotion dysregulation may be an important intervention target in the early aftermath of sexual trauma and warrants further empirical research.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"112 ","pages":"Article 103023"},"PeriodicalIF":4.8,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-19DOI: 10.1016/j.janxdis.2025.103021
Jeremy K. Fox , Lauren E. Fleming
Given the well-established link between maladaptive parenting behaviors (e.g., control, accommodation) and the development and maintenance of child anxiety, it is important to understand parental cognitions that may underlie these parenting behaviors. The goal of this systematic review was to examine the extent to which parental cognitions are associated with child anxiety. A systematic electronic database search of PubMed, PsycINFO, ProQuest Psychology, and EBSCO Child Development and Adolescent Studies was conducted in February 2024. In total, 31 studies met inclusion criteria from 9867 abstracts initially identified. The review revealed that a large number of studies have consistently found associations between child anxiety and two types of parental cognitions, negative beliefs about child anxiety and negative expectations of the child’s anxiety. In contrast, studies investigating parental worries about threats to their child and cognitions about parenting are more limited and have produced mixed findings and smaller effects. Future research should examine the directionality and mechanisms of relations between parental cognitions and child anxiety using longitudinal designs, as well as explore the role of cultural factors. Findings suggest that parental cognitions may be an important factor in understanding child anxiety and a potential target for prevention and early intervention.
{"title":"Parental cognitions and child anxiety: A systematic review","authors":"Jeremy K. Fox , Lauren E. Fleming","doi":"10.1016/j.janxdis.2025.103021","DOIUrl":"10.1016/j.janxdis.2025.103021","url":null,"abstract":"<div><div>Given the well-established link between maladaptive parenting behaviors (e.g., control, accommodation) and the development and maintenance of child anxiety, it is important to understand parental cognitions that may underlie these parenting behaviors. The goal of this systematic review was to examine the extent to which parental cognitions are associated with child anxiety. A systematic electronic database search of PubMed, PsycINFO, ProQuest Psychology, and EBSCO Child Development and Adolescent Studies was conducted in February 2024. In total, 31 studies met inclusion criteria from 9867 abstracts initially identified. The review revealed that a large number of studies have consistently found associations between child anxiety and two types of parental cognitions, negative beliefs about child anxiety and negative expectations of the child’s anxiety. In contrast, studies investigating parental worries about threats to their child and cognitions about parenting are more limited and have produced mixed findings and smaller effects. Future research should examine the directionality and mechanisms of relations between parental cognitions and child anxiety using longitudinal designs, as well as explore the role of cultural factors. Findings suggest that parental cognitions may be an important factor in understanding child anxiety and a potential target for prevention and early intervention.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"112 ","pages":"Article 103021"},"PeriodicalIF":4.8,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-17DOI: 10.1016/j.janxdis.2025.103018
Haochong Yang , Yuan Hong Sun , Kang Lee
Rapidly assessing anxiety disorder risk is crucial for effective mental health screen and intervention. However, traditional survey tools such as DASS-42 are time-consuming in responding and scoring. We used a novel advanced machine learning approach to create a concise anxiety disorder scale based on DASS-42. By applying advanced ML techniques and feature selection, we created a concise version of the anxiety risk scale while maintaining high validity. The resulting model requires fewer questions to predict anxiety risk levels effectively. This optimized scale was implemented in an online tool for quick self-screening and clinical use. This innovation holds significant societal implications, offering scalable, efficient, and accurate methods that facilitate faster and earlier anxiety disorder detection and intervention, especially among underserved and high-risk populations. The study highlights how machine learning can create practical, accessible mental health assessment tools, contributing to improved well-being outcomes.
{"title":"Concise multi-class anxiety disorder risk assessment: A novel advanced machine learning approach","authors":"Haochong Yang , Yuan Hong Sun , Kang Lee","doi":"10.1016/j.janxdis.2025.103018","DOIUrl":"10.1016/j.janxdis.2025.103018","url":null,"abstract":"<div><div>Rapidly assessing anxiety disorder risk is crucial for effective mental health screen and intervention. However, traditional survey tools such as DASS-42 are time-consuming in responding and scoring. We used a novel advanced machine learning approach to create a concise anxiety disorder scale based on DASS-42. By applying advanced ML techniques and feature selection, we created a concise version of the anxiety risk scale while maintaining high validity. The resulting model requires fewer questions to predict anxiety risk levels effectively. This optimized scale was implemented in an online tool for quick self-screening and clinical use. This innovation holds significant societal implications, offering scalable, efficient, and accurate methods that facilitate faster and earlier anxiety disorder detection and intervention, especially among underserved and high-risk populations. The study highlights how machine learning can create practical, accessible mental health assessment tools, contributing to improved well-being outcomes.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"112 ","pages":"Article 103018"},"PeriodicalIF":4.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Major Depression (MD) and General Anxiety Disorder (GAD) are the most common mental health disorders, which typically are assessed quantitatively by rating scales such as PHQ-9 and GAD-7. However, recent advances in natural language processing (NLP) and machine learning (ML) have opened up the possibility of question-based computational language assessment (QCLA). Here we investigate how accurate open-ended questions, using descriptive keywords or autobiographical narratives, can discriminate between participants that self-reported diagnosis of depression and anxiety, or health control. The results show that both language and rating scale measures can discriminate well, however, autobiographical narratives discriminate best between healthy and anxiety (ϕ = 1.58), as well as healthy and depression (ϕ = 1.38). Descriptive keywords, and to a certain extent autobiographical narratives, also discriminate better than summed scores of GAD-7 and PHQ-9 (ϕ=0.80 in discrimination between anxiety and depression), but not when individual items of these scales were analyzed by ML (ϕ=0.86 and ϕ=0.91 in item-level analysis of PHQ-9 and GAD-7, respectively). Combining the scales consistently elevated the discrimination even more (ϕ=1.39 in comparison between depression and anxiety), both in item-level and sum-scores analyses. These results indicate that QCLA measures often, but not in all cases, are better than standardized rating scales for assessment of depression and anxiety. Implication of these findings for mental health assessments are discussed.
{"title":"Question-based computational language approach outperform ratings scale in discriminating between anxiety and depression","authors":"Mona Tabesh , Mariam Mirström , Rebecca Astrid Böhme , Marta Lasota , Yousef Javaherian , Thibaud Agbotsoka-Guiter , Sverker Sikström","doi":"10.1016/j.janxdis.2025.103020","DOIUrl":"10.1016/j.janxdis.2025.103020","url":null,"abstract":"<div><div>Major Depression (MD) and General Anxiety Disorder (GAD) are the most common mental health disorders, which typically are assessed quantitatively by rating scales such as PHQ-9 and GAD-7. However, recent advances in natural language processing (NLP) and machine learning (ML) have opened up the possibility of question-based computational language assessment (QCLA). Here we investigate how accurate open-ended questions, using descriptive keywords or autobiographical narratives, can discriminate between participants that self-reported diagnosis of depression and anxiety, or health control. The results show that both language and rating scale measures can discriminate well, however, autobiographical narratives discriminate best between healthy and anxiety (ϕ = 1.58), as well as healthy and depression (ϕ = 1.38). Descriptive keywords, and to a certain extent autobiographical narratives, also discriminate better than summed scores of GAD-7 and PHQ-9 (ϕ=0.80 in discrimination between anxiety and depression), but not when individual items of these scales were analyzed by ML (ϕ=0.86 and ϕ=0.91 in item-level analysis of PHQ-9 and GAD-7, respectively). Combining the scales consistently elevated the discrimination even more (ϕ=1.39 in comparison between depression and anxiety), both in item-level and sum-scores analyses. These results indicate that QCLA measures often, but not in all cases, are better than standardized rating scales for assessment of depression and anxiety. Implication of these findings for mental health assessments are discussed.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"112 ","pages":"Article 103020"},"PeriodicalIF":4.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-11DOI: 10.1016/j.janxdis.2025.103019
Ateka A. Contractor
{"title":"From research to real-world global applications: Advancing team science in the study of anxiety disorders","authors":"Ateka A. Contractor","doi":"10.1016/j.janxdis.2025.103019","DOIUrl":"10.1016/j.janxdis.2025.103019","url":null,"abstract":"","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"112 ","pages":"Article 103019"},"PeriodicalIF":4.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A large and growing number of published meta-analyses have examined the efficacy of psychological interventions for post-traumatic stress disorder (PTSD). Conclusions drawn from these meta-analyses on treatment efficacy greatly influence clinical practice. This study aimed to provide a comprehensive review of meta-analyses of randomized controlled trials (RCTs) on psychological interventions for adult PTSD, focusing on their content, methodology, and reporting quality.
Method
Systematic database searches were conducted in March 2024 using MEDLINE, PsycInfo, PTSDpubs, Web of Science, and the Cochrane Database of Systematic Reviews. The quality of meta-analyses was assessed using AMSTAR 2. The systematic review was registered on PROSPERO (CRD42020151234).
Results
Overall, 55 meta-analyses with 93 meta-analytic comparisons at treatment endpoint and 28 comparisons at follow-up were included. Meta-analyses most consistently showed superiority of psychological interventions over control conditions. However, beneficial long-term effects exceeding one-month post-treatment were limited to trauma-focused cognitive behavior interventions (TF-CBT) and eye movement desensitization and reprocessing (EMDR). There was a substantial overlap of primary RCTs, indicating redundancy between meta-analyses. Furthermore, the quality of meta-analyses varied substantially.
Conclusions
There is a need to enhance the methodological and reporting quality of meta-analyses, avoid the production of redundant meta-analyses, and conduct more high-quality, large RCTs with long-term assessments.
目的：越来越多已发表的荟萃分析研究了心理干预对创伤后应激障碍（PTSD）的疗效。这些荟萃分析得出的疗效结论对临床实践有很大影响。本研究旨在对成人创伤后应激障碍心理干预的随机对照试验（RCTs）的荟萃分析进行全面回顾，重点关注其内容、方法和报告质量。方法于2024年3月使用MEDLINE、PsycInfo、PTSDpubs、Web of Science和Cochrane系统综述数据库进行系统检索。采用AMSTAR 2评估meta分析的质量。该系统评价已在PROSPERO注册（CRD42020151234）。结果共纳入55项荟萃分析，其中治疗终点荟萃分析比较93项，随访期荟萃分析比较28项。荟萃分析最一致地显示心理干预优于对照条件。然而，治疗后超过一个月的有益长期效果仅限于以创伤为重点的认知行为干预（TF-CBT）和眼动脱敏和再加工（EMDR）。主要随机对照试验存在大量重叠，表明meta分析之间存在冗余。此外，meta分析的质量差异很大。结论需要提高meta分析的方法学和报告质量，避免产生冗余的meta分析，开展更多高质量的大型随机对照试验，并进行长期评估。
{"title":"Psychological interventions for adult posttraumatic stress disorder: A systematic review of published meta-analyses","authors":"Ahlke Kip , Linnea Ritter , Thole H. Hoppen , Davide Papola , Giovanni Ostuzzi , Corrado Barbui , Nexhmedin Morina","doi":"10.1016/j.janxdis.2025.103017","DOIUrl":"10.1016/j.janxdis.2025.103017","url":null,"abstract":"<div><h3>Objective</h3><div>A large and growing number of published meta-analyses have examined the efficacy of psychological interventions for post-traumatic stress disorder (PTSD). Conclusions drawn from these meta-analyses on treatment efficacy greatly influence clinical practice. This study aimed to provide a comprehensive review of meta-analyses of randomized controlled trials (RCTs) on psychological interventions for adult PTSD, focusing on their content, methodology, and reporting quality.</div></div><div><h3>Method</h3><div>Systematic database searches were conducted in March 2024 using MEDLINE, PsycInfo, PTSDpubs, Web of Science, and the Cochrane Database of Systematic Reviews. The quality of meta-analyses was assessed using AMSTAR 2. The systematic review was registered on PROSPERO (CRD42020151234).</div></div><div><h3>Results</h3><div>Overall, 55 meta-analyses with 93 meta-analytic comparisons at treatment endpoint and 28 comparisons at follow-up were included. Meta-analyses most consistently showed superiority of psychological interventions over control conditions. However, beneficial long-term effects exceeding one-month post-treatment were limited to trauma-focused cognitive behavior interventions (TF-CBT) and eye movement desensitization and reprocessing (EMDR). There was a substantial overlap of primary RCTs, indicating redundancy between meta-analyses. Furthermore, the quality of meta-analyses varied substantially.</div></div><div><h3>Conclusions</h3><div>There is a need to enhance the methodological and reporting quality of meta-analyses, avoid the production of redundant meta-analyses, and conduct more high-quality, large RCTs with long-term assessments.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"112 ","pages":"Article 103017"},"PeriodicalIF":4.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Social anxiety disorder (SAD) is a highly prevalent and debilitating affliction that typically manifests during childhood and adolescence. While theoretical models of adult SAD emphasize the role of attentional biases, little is known about maintaining factors during childhood and adolescence. The objective of our eye-tracking study was to determine whether youth with SAD exhibit a hypervigilance-avoidance pattern of visual attention for faces. To this end, we used a free-viewing paradigm to present angry, happy, and neutral faces, and non-social object stimuli to three groups of adolescents aged 10–15 years: SAD (n = 57), specific phobia (SP; n = 41), and healthy controls (HC; n = 65). A screen-based eye tracker recorded gaze behavior and pupil dilation. Among participants, only older adolescents with SAD exhibited shorter latencies of first fixation to the eye region compared to HC. Contrary to our expectations, there were no differences in duration of first fixation to the eye region among the groups. Instead, compared to HC, older adolescents with SAD showed longer dwell times on the eye region during the first 1000 – 3000 ms of stimulus presentation. No significant differences among the groups were found regarding scanpath length or pupillary reactivity. Taken together, our findings suggest early hypervigilance followed by sustained attention to the eye region in older adolescents with SAD, which may indicate difficulties in disengaging attention. We discuss the theoretical and practical implications in detail.
{"title":"Early hypervigilance and sustained attention for the eye region in adolescents with social anxiety disorder","authors":"Vera Hauffe , Anna-Lina Rauschenbach , Eva-Maria Fassot , Julian Schmitz , Brunna Tuschen-Caffier","doi":"10.1016/j.janxdis.2025.103016","DOIUrl":"10.1016/j.janxdis.2025.103016","url":null,"abstract":"<div><div>Social anxiety disorder (SAD) is a highly prevalent and debilitating affliction that typically manifests during childhood and adolescence. While theoretical models of adult SAD emphasize the role of attentional biases, little is known about maintaining factors during childhood and adolescence. The objective of our eye-tracking study was to determine whether youth with SAD exhibit a hypervigilance-avoidance pattern of visual attention for faces. To this end, we used a free-viewing paradigm to present angry, happy, and neutral faces, and non-social object stimuli to three groups of adolescents aged 10–15 years: SAD (<em>n</em> = 57), specific phobia (SP; <em>n</em> = 41), and healthy controls (HC; <em>n</em> = 65). A screen-based eye tracker recorded gaze behavior and pupil dilation. Among participants, only older adolescents with SAD exhibited shorter latencies of first fixation to the eye region compared to HC. Contrary to our expectations, there were no differences in duration of first fixation to the eye region among the groups. Instead, compared to HC, older adolescents with SAD showed longer dwell times on the eye region during the first 1000 – 3000 ms of stimulus presentation. No significant differences among the groups were found regarding scanpath length or pupillary reactivity. Taken together, our findings suggest early hypervigilance followed by sustained attention to the eye region in older adolescents with SAD, which may indicate difficulties in disengaging attention. We discuss the theoretical and practical implications in detail.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"112 ","pages":"Article 103016"},"PeriodicalIF":4.8,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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