Pub Date : 2025-05-20DOI: 10.1016/j.janxdis.2025.103026
Bingyi Wang , Qiqiao Zhang , Ke Liu , Leiwen Fu , Cailing Ao , Peng Zhang , Chaohua Lan , Qiongfang Wu , Fang Yang , Yong Lu , Xiaobing Fu , Yan Li
Background
Despite anxiety disorders being a significant public health concern, studies assessing their global burden among older adults are limited. We aimed to analyse trends in the global burden of anxiety disorders in older adults aged ≥ 55 years.
Methods
Data on the incidence and disability-adjusted life-years (DALYs) for anxiety disorders were retrieved from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. Temporal trends were quantified using estimated annual percentage changes.
Results
In 2021, global DALYs for anxiety disorders were estimated at 8.21 million (95 % UI 5.62–11.48 million), nearly 2.5 times higher than in 1990, with an age-standardised rate of 552.7 DALYs (95 % UI 378.1–772.5) per 100,000 population. Between 1990 and 2021, the age-standardised DALY rate (ASDR) remained stable (−0.05 % [95 % CI −0.16–0.05]), with minimal differences between men (0.04 % [−0.05–0.12]) and women (−0.08 % [−0.21–0.05]). The 55–59 age group showed the highest ASDR (538.5 [361.3–767.7] per 100,000 population). The highest increases in ASDR were observed in the low-middle (0.15 % [0.03–0.28]) and low sociodemographic index regions (0.09 % [0.02–0.15]). The regions with the highest ASDRs were Latin America, Western Europe, and High-income North America.
Conclusion
While global trends in anxiety disorders among older adults remained stable, the total burden increased significantly, with marked regional disparities. Tailored mental health interventions, early detection, and treatment in primary care are essential to reduce the future burden of anxiety disorders in older adults, especially in low and middle-income countries.
{"title":"Burden of anxiety disorders among older adults aged ≥ 55 years in 204 countries and territories, 1990–2021: A population-based study","authors":"Bingyi Wang , Qiqiao Zhang , Ke Liu , Leiwen Fu , Cailing Ao , Peng Zhang , Chaohua Lan , Qiongfang Wu , Fang Yang , Yong Lu , Xiaobing Fu , Yan Li","doi":"10.1016/j.janxdis.2025.103026","DOIUrl":"10.1016/j.janxdis.2025.103026","url":null,"abstract":"<div><h3>Background</h3><div>Despite anxiety disorders being a significant public health concern, studies assessing their global burden among older adults are limited. We aimed to analyse trends in the global burden of anxiety disorders in older adults aged ≥ 55 years.</div></div><div><h3>Methods</h3><div>Data on the incidence and disability-adjusted life-years (DALYs) for anxiety disorders were retrieved from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. Temporal trends were quantified using estimated annual percentage changes.</div></div><div><h3>Results</h3><div>In 2021, global DALYs for anxiety disorders were estimated at 8.21 million (95 % UI 5.62–11.48 million), nearly 2.5 times higher than in 1990, with an age-standardised rate of 552.7 DALYs (95 % UI 378.1–772.5) per 100,000 population. Between 1990 and 2021, the age-standardised DALY rate (ASDR) remained stable (−0.05 % [95 % CI −0.16–0.05]), with minimal differences between men (0.04 % [−0.05–0.12]) and women (−0.08 % [−0.21–0.05]). The 55–59 age group showed the highest ASDR (538.5 [361.3–767.7] per 100,000 population). The highest increases in ASDR were observed in the low-middle (0.15 % [0.03–0.28]) and low sociodemographic index regions (0.09 % [0.02–0.15]). The regions with the highest ASDRs were Latin America, Western Europe, and High-income North America.</div></div><div><h3>Conclusion</h3><div>While global trends in anxiety disorders among older adults remained stable, the total burden increased significantly, with marked regional disparities. Tailored mental health interventions, early detection, and treatment in primary care are essential to reduce the future burden of anxiety disorders in older adults, especially in low and middle-income countries.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"113 ","pages":"Article 103026"},"PeriodicalIF":4.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189851","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 : 2025-05-20DOI: 10.1016/j.janxdis.2025.103028
Philippe Landreville , Patrick Gosselin , Sébastien Grenier , Pierre-Hugues Carmichael
Treatments for generalized anxiety disorder (GAD) that circumvent the barriers to accessing mental health care in older adults are needed. The main goal of this multisite randomized controlled trial was to evaluate the efficacy of CBT-based self-help guided by a lay provider (LP) for generalized anxiety (i.e., threshold or subthreshold GAD) in older adults. Participants (≥ 60 years) were block randomized based on diagnosis to an experimental (n = 75) or wait-list control group (n = 75). Experimental group participants used a manual presenting CBT-based readings and exercises and received brief weekly support calls by LPs. Groups were similar in terms of sociodemographic characteristics and initially did not differ significantly on outcomes. At post-treatment, the experimental group showed greater improvement across both primary outcomes (i.e., worry tendency, p < .0001, Standardized mean difference [SMD] = −1.5971, and GAD severity, p < .0001, SMD = −1.1639) and most additional outcomes (e.g., targeted psychological vulnerabilities, depressive symptoms, sleep difficulties, and GAD diagnosis) with small to large effect sizes (SMD = −0.4358 to −1.5402). The experimental group also showed maintenance of treatment effects or other improvements at 6- and 12-month follow-up. Participants in the control group who completed the treatment after their waiting period also improved on worry tendency (SMD = −1.2477) and GAD severity (SMD = −0.8443) and most of the other variables (SMD = −0.3728 to −1.0154). Results demonstrate that self-help guided by a LP is effective for treating GAD in older adults and that the improvements are sustained after treatment.
{"title":"CBT-based self-help guided by a lay provider for generalized anxiety in older adults: A randomized controlled trial","authors":"Philippe Landreville , Patrick Gosselin , Sébastien Grenier , Pierre-Hugues Carmichael","doi":"10.1016/j.janxdis.2025.103028","DOIUrl":"10.1016/j.janxdis.2025.103028","url":null,"abstract":"<div><div>Treatments for generalized anxiety disorder (GAD) that circumvent the barriers to accessing mental health care in older adults are needed. The main goal of this multisite randomized controlled trial was to evaluate the efficacy of CBT-based self-help guided by a lay provider (LP) for generalized anxiety (i.e., threshold or subthreshold GAD) in older adults. Participants (≥ 60 years) were block randomized based on diagnosis to an experimental (<em>n</em> = 75) or wait-list control group (<em>n</em> = 75). Experimental group participants used a manual presenting CBT-based readings and exercises and received brief weekly support calls by LPs. Groups were similar in terms of sociodemographic characteristics and initially did not differ significantly on outcomes. At post-treatment, the experimental group showed greater improvement across both primary outcomes (i.e., worry tendency, <em>p</em> < .0001, Standardized mean difference [SMD] = −1.5971, and GAD severity, p < .0001, SMD = −1.1639) and most additional outcomes (e.g., targeted psychological vulnerabilities, depressive symptoms, sleep difficulties, and GAD diagnosis) with small to large effect sizes (SMD = −0.4358 to −1.5402). The experimental group also showed maintenance of treatment effects or other improvements at 6- and 12-month follow-up. Participants in the control group who completed the treatment after their waiting period also improved on worry tendency (SMD = −1.2477) and GAD severity (SMD = −0.8443) and most of the other variables (SMD = −0.3728 to −1.0154). Results demonstrate that self-help guided by a LP is effective for treating GAD in older adults and that the improvements are sustained after treatment.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"113 ","pages":"Article 103028"},"PeriodicalIF":4.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189852","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 : 2025-05-14DOI: 10.1016/j.janxdis.2025.103027
Elizabeth Alpert , Annie B. Fox , Tara E. Galovski
Standardized measures have typically been used to assess symptom change during treatment in psychological research and practice. However, standardized measures may not fully capture patients' experiences of therapeutic change. Patients' global reports of their improvement during treatment across domains of symptoms and functioning are also important and may provide distinct information from standardized measures. The current study compared both types of patient reports of improvement during cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD). We also examined process-level predictors of improvement assessed using both methods. Participants were 254 adult survivors of interpersonal violence receiving CPT. Patients' global reports of improvement in each domain (PTSD symptoms, relationships, health concerns, sexual functioning, school/work performance, and life satisfaction), each rated on a Likert scale via the Treatment Outcome Questionnaire, were significantly correlated with the corresponding standardized measure of improvement in the same domain, with most effect sizes in the small-to-medium range. Patients' perceptions of the therapy (helpfulness, likability) significantly predicted both global ratings and standardized measures of improvement, while patients' perceptions of the therapeutic relationship, patients' perceptions of barriers to therapy attendance, and objective indices of attendance did not predict improvement. Results highlight the importance of patients' experiences with treatment and suggest that assessing patients' global ratings of their improvement during treatment provides distinct information from standardized measures of improvement, and both are important to include when measuring therapeutic change.
{"title":"Who defines improvement? Patients' global reports of improvement compared to standardized measures of improvement in cognitive processing therapy for posttraumatic stress disorder","authors":"Elizabeth Alpert , Annie B. Fox , Tara E. Galovski","doi":"10.1016/j.janxdis.2025.103027","DOIUrl":"10.1016/j.janxdis.2025.103027","url":null,"abstract":"<div><div>Standardized measures have typically been used to assess symptom change during treatment in psychological research and practice. However, standardized measures may not fully capture patients' experiences of therapeutic change. Patients' global reports of their improvement during treatment across domains of symptoms and functioning are also important and may provide distinct information from standardized measures. The current study compared both types of patient reports of improvement during cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD). We also examined process-level predictors of improvement assessed using both methods. Participants were 254 adult survivors of interpersonal violence receiving CPT. Patients' global reports of improvement in each domain (PTSD symptoms, relationships, health concerns, sexual functioning, school/work performance, and life satisfaction), each rated on a Likert scale via the Treatment Outcome Questionnaire, were significantly correlated with the corresponding standardized measure of improvement in the same domain, with most effect sizes in the small-to-medium range. Patients' perceptions of the therapy (helpfulness, likability) significantly predicted both global ratings and standardized measures of improvement, while patients' perceptions of the therapeutic relationship, patients' perceptions of barriers to therapy attendance, and objective indices of attendance did not predict improvement. Results highlight the importance of patients' experiences with treatment and suggest that assessing patients' global ratings of their improvement during treatment provides distinct information from standardized measures of improvement, and both are important to include when measuring therapeutic change.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"113 ","pages":"Article 103027"},"PeriodicalIF":4.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071501","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.2025.103025
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}
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