Journal of Anxiety Disorders最新文献_第8页

Perinatal PTSD and the mother-infant bond: A systematic review and meta-analysis. 围产期创伤后应激障碍与母婴关系：系统回顾和荟萃分析。

IF 4.5 2区医学 Q1 PSYCHIATRY

Journal of Anxiety Disorders

Pub Date : 2025-08-01 Epub Date: 2025-06-30 DOI: 10.1016/j.janxdis.2025.103050

Franciska Rehberg, Lydia Rihm, Ariane Göbel, Freya Thiel, Verena C S Büechl, Manon Even, Susan Garthus-Niegel

Background: Despite a growing body of literature, understanding of the relationship between maternal symptoms of perinatal posttraumatic stress disorder (PTSD) and the emerging mother-infant bond (MIB) remains limited. This systematic review and meta-analysis elucidates this association considering both general PTSD (gPTSD) symptoms (i.e., not originating from childbirth) as well as childbirth-related PTSD (CB-PTSD) symptoms.

Methods: A comprehensive literature search screening for articles published until 10/03/2024 was conducted. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Pooled effect sizes were estimated with random effects models.

Results: The systematic review includes 22 studies (9472 participants) and indicates a positive association between perinatal PTSD symptoms and impaired MIB. However, the relationship might be explained by confounding factors (e.g., depressive symptoms, general psychological distress). Meta-analyses suggest a small to moderate positive association (r = .32) between postnatal gPTSD symptoms and impaired MIB (n = 8) and a moderate positive association (r = .38) between CB-PTSD symptoms and impaired MIB (n = 15). Additional exploratory meta-analyses indicate that within the CB-PTSD construct, general rather than childbirth-related PTSD symptoms are more strongly related to MIB (n = 5).

Limitations: Heterogeneity across studies, methodological complexities in distinguishing perinatal PTSD subtypes, and a small number of studies should be noted.

Conclusions: The results indicate differential associations between gPTSD versus CB-PTSD and MIB. However, further research is required to fully elucidate the relationship between maternal perinatal PTSD and MIB and the role of individual symptom domains to inform the targeted development of interventions.

背景：尽管有越来越多的文献，但对围产期创伤后应激障碍（PTSD）的母亲症状与新兴的母婴纽带（MIB）之间关系的理解仍然有限。本系统综述和荟萃分析阐明了这种关联，考虑了一般创伤后应激障碍（gPTSD）症状（即，不是源于分娩）以及分娩相关的创伤后应激障碍（CB-PTSD）症状。方法：对2024年10月3日之前发表的文章进行综合文献检索筛选。报告遵循系统评价和荟萃分析（PRISMA）指南的首选报告项目。用随机效应模型估计合并效应量。结果：系统综述包括22项研究（9472名参与者），表明围产期PTSD症状与MIB受损之间存在正相关。然而，这种关系可能是由混杂因素（例如，抑郁症状，一般心理困扰）来解释的。荟萃分析表明，产后gPTSD症状与MIB受损之间存在小到中度正相关（r = .32）（n = . 8），而CB-PTSD症状与MIB受损之间存在中度正相关（r = .38）（n = . 15）。另外的探索性荟萃分析表明，在CB-PTSD结构中，一般PTSD症状与MIB的关系比与分娩相关的PTSD症状更强（n = 5）。局限性：研究的异质性，区分围产期PTSD亚型的方法复杂性，以及少数研究需要注意。结论：结果表明gPTSD与CB-PTSD和MIB之间存在差异关联。然而，需要进一步的研究来充分阐明产妇围产期PTSD与MIB之间的关系，以及个体症状域的作用，从而为有针对性的干预措施的制定提供信息。

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引用次数: 0

Memory and identity processes in ICD-11 complex posttraumatic stress disorder: Tests of a new theory ICD-11复杂创伤后应激障碍的记忆和身份过程：新理论的检验

IF 4.5 2区医学 Q1 PSYCHIATRY

Journal of Anxiety Disorders

Pub Date : 2025-07-25 DOI: 10.1016/j.janxdis.2025.103055

Philip Hyland , Marcus Broughill , Mark Shevlin , Chris R. Brewin

Background

This study empirically tested several predictions arising from the Memory and Identity (M&I) Theory of ICD-11 Complex PTSD (CPTSD). Specifically, it examined the psychometric properties of two measures—the Experiences of Traumatic Memories Questionnaire (ETMQ) and the Trauma Identity Questionnaire (TIQ)—and tested relationships between different types of trauma exposure, disturbances in memory and identity, and CPTSD symptoms.

Methods

Data were collected from a non-probability based representative sample of the general adult population of the United Kingdom (N = 975), and latent variable modelling was used to test all hypotheses.

Results

Confirmatory factor analytic results provided support for the psychometric properties of the ETMQ and TIQ as measures of traumatic memories and negative identities. Multiple traumatization and interpersonal forms of trauma were associated with more disturbances in trauma memories and negative identities. Seven of the nine model-predicted associations between trauma memories, negative identities, and CPTSD symptoms were observed, including a link between a fragmented sense of self and emotional numbing.

Conclusions

Results support core elements of the M&I Theory, highlighting trauma memory and identity disturbances as key mechanisms in CPTSD.

本研究对ICD-11复杂创伤后应激障碍（CPTSD）的记忆和身份（M&；I）理论提出的几个预测进行了实证检验。具体来说，它检查了两种测量方法的心理测量特性——创伤记忆经历问卷（ETMQ）和创伤身份问卷（TIQ）——并测试了不同类型的创伤暴露、记忆和身份障碍以及CPTSD症状之间的关系。方法数据收集自英国普通成人人群的非概率代表性样本（N = 975），并使用潜在变量模型检验所有假设。结果验证性因子分析结果支持了ETMQ和TIQ作为创伤记忆和消极身份的心理测量特性。多重创伤和人际创伤与创伤记忆和消极身份的干扰有关。在九个模型预测的创伤记忆、消极身份和CPTSD症状之间的关联中，有七个被观察到，包括支离破碎的自我意识和情感麻木之间的联系。结论创伤记忆和身份障碍是CPTSD的主要机制，支持了创伤记忆和身份障碍理论的核心要素。

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引用次数: 0

Assessing executive functioning in individuals with social anxiety disorder (SAD) across the lifespan: A systematic literature review and meta-analysis 评估社交焦虑障碍（SAD）个体的执行功能：一项系统的文献回顾和荟萃分析

IF 4.5 2区医学 Q1 PSYCHIATRY

Journal of Anxiety Disorders

Pub Date : 2025-07-25 DOI: 10.1016/j.janxdis.2025.103056

Alexandra A. Harrison, Lan Nguyen, Karen Murphy, David Neumann

Social anxiety disorder is a pervasive clinical disorder characterised by intense fear and/or avoidance of one or more social situations, and has been linked to deficits in executive functioning performance. However, methodological differences and mixed results have made it difficult to draw definitive conclusions from individual studies. The current systematic review and meta-analysis collated the results from 49 studies to examine the link between social anxiety disorder and executive functioning across the lifespan. Findings revealed that individuals with social anxiety performed significantly worse than healthy controls or low social anxiety groups on measures of executive functioning (r = -.15), specifically cognitive flexibility (r = -.20), inhibitory control (r = -.18), and global executive functioning (r = -.17). No significant association was evident between working memory and social anxiety (r = -.06). In addition, the type of measure (self-report vs cognitive task) moderated the relationship between social anxiety and executive functioning. Although age did not moderate the overall relationship, the association between the individual domains of executive functioning and social anxiety differed between youth and adults, which may reflect the different developmental timelines between the domains across the lifespan. The findings offer valuable insight into our understanding of the development of executive functions for individuals with social anxiety and could assist with forming new strategies or interventions to improve daily functioning in this clinical population.

社交焦虑障碍是一种普遍的临床障碍，其特征是对一种或多种社交场合的强烈恐惧和/或回避，并与执行功能表现的缺陷有关。然而，方法上的差异和结果的混杂使得很难从个别研究中得出明确的结论。目前的系统回顾和荟萃分析整理了49项研究的结果，以检验社交焦虑障碍与一生中执行功能之间的联系。研究结果显示，社交焦虑个体在执行功能（r = - 0.15），特别是认知灵活性（r = - 0.20）、抑制控制（r = - 0.18）和整体执行功能（r = - 0.17）方面的表现明显差于健康对照组或低社交焦虑组。工作记忆与社交焦虑无显著相关性（r = - 0.06）。此外，测量类型（自我报告vs认知任务）调节了社交焦虑和执行功能之间的关系。虽然年龄并没有调节整体关系，但执行功能的各个领域与社交焦虑之间的关联在青少年和成年人之间存在差异，这可能反映了在整个生命周期中，这些领域之间不同的发展时间表。这些发现为我们理解社交焦虑症患者执行功能的发展提供了有价值的见解，并有助于形成新的策略或干预措施，以改善临床人群的日常功能。

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引用次数: 0

Savoring meditation for emotional disorders: Targeting positive emotion regulation deficits 情绪障碍的品味冥想：针对积极情绪调节缺陷

IF 4.8 2区医学 Q1 PSYCHIATRY

Journal of Anxiety Disorders

Pub Date : 2025-07-22 DOI: 10.1016/j.janxdis.2025.103054

Tomoko Kishimoto , Ximing Hao , Jianwei Qian

Deficits in positive emotion regulation (PER) contribute to emotional disorders but are less studied than negative emotion regulation (NER). One maladaptive PER strategy, positive emotion contrast-seeking (PEC-seeking), involves sustaining negative affect to enhance later positive emotions, reinforcing anxiety and depression. This study developed and tested a savoring-based, transdiagnostic intervention to reduce PEC-seeking and alleviate emotional disorder symptoms. A single-blind RCT with 59 Chinese college students with elevated depression and anxiety (majority meeting depression criteria) compared a two-week group savoring meditation intervention to waitlist control. Changes in depression, anxiety, savoring beliefs, and PEC-seeking were assessed at Baseline (T0), MidTest (T1), PostTest (T2), and one-month Follow-up (T3). The experimental group also reported positive and negative affect before and after each group session and individual practice. Savoring meditation significantly reduced depression (T1, d = −1.11, p = .005; T2, d = −1.60, p < .001) with effects maintained at follow-up (T3, p < .001). Negative affect also declined significantly (Session 5, p < .001), though changes in positive affect were not statistically significant. The intervention increased savoring beliefs (T1, d = 1.42, T2, d = 1.41, ps =.003) and reduced PEC-seeking (T1, d = −0.92, p = .027), which in turn mediated reductions in depression. Although anxiety symptoms declined within the experimental group over time, between-group differences did not reach statistical significance. Nonetheless, the effect size was larger for the experimental group (T2, d = 0.34) than for the waitlist group (d = 0.01), suggesting a potential anxiolytic effect of the intervention. These findings suggest that targeting maladaptive PER strategies, especially PEC-seeking, via savoring meditation may effectively reduce emotional disorder symptoms. This study highlights PER’s role in transdiagnostic interventions and provides novel insights into PER-focused therapies.

积极情绪调节缺陷是导致情绪障碍的原因之一，但研究较少。一种适应不良的PER策略，积极情绪对比寻求（PEC-seeking），包括维持消极情绪以增强后来的积极情绪，强化焦虑和抑郁。本研究开发并测试了一种基于味觉的跨诊断干预，以减少寻求pec和缓解情绪障碍症状。一项对59名抑郁和焦虑程度较高的中国大学生（大多数符合抑郁标准）进行的单盲随机对照试验将两周的冥想干预组与候补组进行了比较。在基线（T0）、测试中（T1）、测试后（T2）和一个月随访（T3）时评估抑郁、焦虑、品味信念和pec寻求的变化。实验组也报告了每次小组练习前后和个人练习的积极和消极影响。品味冥想显著减少抑郁(T1, d = - 1.11, p = .005；T2, d = - 1.60, p <； .001)，随访时效果维持（T3, p <； .001）。消极情绪也显著下降（第5期，p <； .001），尽管积极情绪的变化没有统计学意义。干预增加了品味信念（T1, d = 1.42, T2, d = 1.41, ps = 0.003），减少了寻找pecc (T1, d = - 0.92, p = .027)，这反过来又介导了抑郁的减少。随着时间的推移，实验组的焦虑症状有所下降，但组间差异无统计学意义。尽管如此，实验组的效应量（T2, d = 0.34）大于等候名单组（d = 0.01），表明干预可能具有抗焦虑作用。这些发现表明，通过品味冥想，针对适应不良的PER策略，特别是寻求pec，可能有效地减少情绪障碍症状。这项研究强调了PER在跨诊断干预中的作用，并为PER重点治疗提供了新的见解。

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引用次数: 0

Emetophobia (fear of vomiting): A meta-analysis 呕吐恐惧症（害怕呕吐）：荟萃分析

IF 4.8 2区医学 Q1 PSYCHIATRY

Journal of Anxiety Disorders

Pub Date : 2025-07-19 DOI: 10.1016/j.janxdis.2025.103053

Adrian Meule, Leonie Seufert, David R. Kolar

Emetophobia refers to a specific fear of vomiting. There are only few original research studies on this condition and no study that has meta-analytically synthesized findings to describe the characteristics of persons with emetophobia. To this end, we extracted data from 31 reports and—as we examined different dependent variables—each meta-analysis was based on five to 21 samples. The pooled mean age of persons with emetophobia was 29 years but was reduced to 21–27 years when adjusting for publication bias. The pooled mean age of disorder onset was 10 years. The pooled proportion of females was 91 %. The pooled proportions of reporting fear of vomiting oneself, fear of seeing others vomit, or both, were 47 %, 11 %, and 39 %. The most common comorbid mental disorders were social anxiety disorder, depression, and generalized anxiety disorder. The pooled point prevalence of emetophobia was 5 %. Higher emetophobic symptomatology moderately related to higher disgust propensity and higher anxiety, and weakly related to higher depressive symptomatology. This meta-analysis is the first to quantify that most adults with emetophobia are in early adulthood but the disorder started in childhood, almost all are women, the primary locus of fear is vomiting oneself, the most common comorbid mental disorders are other anxiety and affective disorders, and higher emetophobic symptomatology relates to a more general tendency to be easily disgusted and to be anxious. Studies based on representative samples to obtain reliable estimates on the prevalence of emetophobia are needed.

呕吐恐惧症指的是对呕吐的特殊恐惧。关于这种情况的原始研究很少，也没有研究通过荟萃分析综合发现来描述呕吐恐惧症患者的特征。为此，我们从31份报告中提取了数据，并检查了不同的因变量，每个荟萃分析都基于5到21个样本。呕吐恐惧症患者的综合平均年龄为29岁，但经发表偏倚调整后降至21-27岁。合并平均发病年龄为10岁。女性合计比例为91% %。报告害怕自己呕吐、害怕看到别人呕吐或两者兼而有之的总比例分别为47 %、11 %和39 %。最常见的共病精神障碍是社交焦虑障碍、抑郁和广泛性焦虑障碍。呕吐恐惧症的总发生率为5. %。较高的呕吐恐惧症症状与较高的厌恶倾向和较高的焦虑中度相关，与较高的抑郁症状弱相关。这项荟萃分析首次量化了大多数有吐痰恐惧症的成年人处于成年早期，但这种疾病始于童年，几乎所有是女性，恐惧的主要来源是呕吐自己，最常见的共病精神障碍是其他焦虑和情感障碍，更高的吐痰恐惧症症状与更普遍的倾向有关，容易厌恶和焦虑。需要基于代表性样本的研究，以获得关于呕吐恐惧症患病率的可靠估计。

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引用次数: 0

Sleep disturbances predict nine-year panic disorder chronicity: The sleep-panic nexus theory with machine learning insights 睡眠障碍预测9年的慢性恐慌症：睡眠-恐慌联系理论与机器学习的见解

IF 4.8 2区医学 Q1 PSYCHIATRY

Journal of Anxiety Disorders

Pub Date : 2025-07-17 DOI: 10.1016/j.janxdis.2025.103052

Nur Hani Zainal , Natalia Van Doren

Background

Panic disorder (PD) is a chronic and impairing anxiety disorder. Individuals with more sleep disturbances might be predisposed to nine-year PD chronicity. However, linearity assumptions, small predictor sets, and analytic and design limitations have hindered optimal identification of which sleep disturbance variables are distal risk factors for PD chronicity. We thus used machine learning (ML) to predict nine-year PD chronicity using high-dimensional data.

Method

Community-dwelling adults (N = 1054) completed clinical interviews, self-reports, and seven-day sleep actigraphy at Wave 1 (W1) and the same clinical interview at Wave 2 (W2) nine years later. The baseline data comprised 43 actigraphy, self-reported sleep disturbances, clinical, and demographic variables. Seven ML models were examined. Gradient boosting machine (GBM) was the best-performing algorithm. PD chronicity was defined as the presence of a PD diagnosis at both W1 and W2.

Results

The GBM accurately predicted PD chronicity (area under the receiver operating characteristic curve [AUC] =.764). Shapley additive explanation analysis showed that the top W1 predictors of PD chronicity were comorbid major depressive disorder, low healthcare utilization, sleep medication use, lengthier wake after sleep onset, and sleep-wake circadian disruptions based on actigraphy and self-reports. Lower household income and younger age were also top predictors. Additionally, the final multivariate model was well-calibrated.

Conclusions

As proposed in our sleep-panic nexus theory, actigraphy and subjective sleep disturbances have essential prognostic value in predicting long-term PD chronicity. Harnessing ML facilitates accurate prediction by identifying complex, nonlinear relations across high-dimensional datasets, possibly improving prevention and treatment tailoring.

背景：惊恐障碍（PD）是一种慢性、损害性的焦虑障碍。睡眠障碍较多的人可能更容易患上长达9年的PD慢性疾病。然而，线性假设、小预测集以及分析和设计的局限性阻碍了最佳识别哪些睡眠障碍变量是PD慢性的远端危险因素。因此，我们使用机器学习（ML）来使用高维数据预测9年PD慢性性。方法居住在社区的成年人（N = 1054）在第一阶段（W1）完成临床访谈、自我报告和7天睡眠活动仪，9年后在第二阶段（W2）完成相同的临床访谈。基线数据包括43项活动记录、自我报告的睡眠障碍、临床和人口统计学变量。检测7个ML模型。梯度增强机（GBM）是性能最好的算法。PD慢性定义为在W1和W2均有PD诊断。结果GBM能准确预测PD的慢性性（受试者工作特征曲线下面积[AUC] =.764）。Shapley加性解释分析显示，PD慢性的前W1预测因子为共病性抑郁症、低医疗保健利用率、睡眠药物使用、睡眠开始后清醒时间延长以及基于活动图和自我报告的睡眠-觉醒昼夜节律中断。较低的家庭收入和较年轻的年龄也是主要的预测因素。此外，最终的多变量模型得到了很好的校准。结论根据睡眠-恐慌联系理论，活动描记和主观睡眠障碍在预测PD的长期慢性方面具有重要的预后价值。利用机器学习通过识别高维数据集之间复杂的非线性关系来促进准确的预测，可能会改善预防和治疗的定制。

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引用次数: 0

Bidirectional associations between PTSD symptoms and pain in daily life among women survivors of sexual assault 性侵女性幸存者PTSD症状与日常生活疼痛的双向关联

IF 4.8 2区医学 Q1 PSYCHIATRY

Journal of Anxiety Disorders

Pub Date : 2025-07-08 DOI: 10.1016/j.janxdis.2025.103051

Alexandra N. Brockdorf , Lauren E. Simpson , David DiLillo

The co-occurrence between pain and posttraumatic stress disorder (PTSD) is commonly explained by the mutual maintenance model, which proposes that each condition exacerbates the other. We tested this model by examining within-day associations between pain and PTSD using a three-week ecological momentary assessment (EMA) design. Young adult cisgender women (N = 82) who experienced sexual assault and reported PTSD symptoms and probable alcohol misuse completed three self-report surveys per day assessing momentary pain intensity and PTSD symptoms. Results from a dynamic structural equation model supported hypotheses, such that pain predicted greater PTSD symptoms four hours later and PTSD symptoms predicted greater pain. However, exploratory follow up analyses revealed differential findings by cluster, such that intrusions, negative alterations in cognition and mood, and hyperarousal each predicted subsequent pain, whereas pain predicted only later hyperarousal. Findings add nuance to our understanding of the mutual maintenance model and point to hyperarousal symptoms as a key symptom cluster linking daily pain and PTSD among women who have experienced sexual assault. Findings underscore the potential value of targeting hyperarousal symptoms in integrative interventions.

疼痛和创伤后应激障碍（PTSD）的共同发生通常用相互维持模型来解释，该模型认为每一种情况都会加剧另一种情况。我们通过使用为期三周的生态瞬时评估（EMA）设计来检查疼痛和创伤后应激障碍之间在一天内的关联来测试该模型。年轻的顺性别女性（N = 82）经历过性侵犯并报告PTSD症状和可能的酒精滥用，每天完成三次自我报告调查，评估瞬时疼痛强度和PTSD症状。动态结构方程模型的结果支持这样的假设：疼痛预示着四小时后更严重的PTSD症状，而PTSD症状预示着更大的疼痛。然而，探索性随访分析揭示了不同聚类的差异发现，例如侵入、认知和情绪的负面改变以及过度觉醒都能预测随后的疼痛，而疼痛只能预测随后的过度觉醒。研究结果增加了我们对相互维持模型的理解的细微差别，并指出，在经历过性侵犯的女性中，过度觉醒症状是将日常疼痛和创伤后应激障碍联系起来的关键症状群。研究结果强调了在综合干预中针对高觉醒症状的潜在价值。

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引用次数: 0

Understanding climate anxiety and potential impacts on pro-environment behaviours 了解气候焦虑及其对亲环境行为的潜在影响

IF 4.8 2区医学 Q1 PSYCHIATRY

Journal of Anxiety Disorders

Pub Date : 2025-06-18 DOI: 10.1016/j.janxdis.2025.103049

Zac Coates, Scott Brown, Michelle Kelly

Previous studies have identified harmful social, physical, and mental impacts due to climate change. Anxiety due to climate change or “climate anxiety” may be an adaptive or reasonable response to a real threat; however, it may also be associated with considerable functional impairment of associated behaviours. In this study, we examined the relationship between climate anxiety and pro-environment behaviours, via an online discrete choice experiment, with 374 participants recruited from prolific academic and undergraduate university recruitment program. This experiment included our discrete choice measure of pro-environment behaviours and self-report survey items examining climate anxiety, general anxiety, death anxiety, and locus of control. We found that a moderate level of climate anxiety may be optimal for making pro-environmental choices, with this group having significantly more eco-friendly choices than participants in the low or high climate anxiety groups. We also examined the relationships between climate anxiety and three other psychological concepts, locus of control, general anxiety, and death anxiety, and found that these 3 factors were positively related to climate anxiety. These findings may indicate that some additional negative mental health outcomes are associated with high levels of climate anxiety. This study provides evidence for the use of discrete choice experiments when examining pro-environment behaviours, which may allow future studies to further examine various other trade-offs or factors such as the cost that participants are willing to “pay” for an eco-friendly option.

以前的研究已经确定了气候变化对社会、身体和精神的有害影响。气候变化引起的焦虑或“气候焦虑”可能是对真实威胁的适应性或合理反应；然而，它也可能与相关行为的相当大的功能损害有关。在这项研究中，我们通过一项在线离散选择实验，研究了气候焦虑和亲环境行为之间的关系，该实验招募了374名来自多产的学术和本科大学招聘计划的参与者。本实验包括我们对亲环境行为的离散选择测量和自我报告调查项目，研究气候焦虑、一般焦虑、死亡焦虑和控制点。我们发现，适度的气候焦虑水平可能是做出亲环境选择的最佳选择，这一群体比低或高气候焦虑组的参与者有更多的环保选择。我们还研究了气候焦虑与其他三个心理概念——控制点、一般焦虑和死亡焦虑之间的关系，发现这三个因素与气候焦虑呈正相关。这些发现可能表明，一些额外的负面心理健康结果与高水平的气候焦虑有关。这项研究为在研究亲环境行为时使用离散选择实验提供了证据，这可能允许未来的研究进一步研究各种其他权衡或因素，如参与者愿意为环保选择“支付”的成本。

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引用次数: 0

Altered resting-state amygdala-cerebellar functional connectivity is associated with intolerance of uncertainty in patients with obsessive-compulsive disorder: A longitudinal study 静息状态杏仁核-小脑功能连接的改变与强迫症患者对不确定性的不耐受有关：一项纵向研究

IF 4.8 2区医学 Q1 PSYCHIATRY

Journal of Anxiety Disorders

Pub Date : 2025-06-13 DOI: 10.1016/j.janxdis.2025.103048

Qihui Guo , Rongrong Zhu , Huixia Zhou , Dongmei Wang , Xiangyang Zhang

Objectives

Intolerance of uncertainty (IU) plays an important role in the pathology of obsessive-compulsive disorder (OCD). The amygdala and anterior insula (AI) appear to be important neural correlates of IU. However, the relationship between altered resting-state functional connectivity (rsFC) and IU in OCD patients has not been reported.

Methods

This study recruited 39 patients with OCD and 45 healthy controls (HC). IU was measured using the Intolerance of Uncertainty Scale (IUS). The seed-to-voxel method was used to construct rsFC maps. Between-group differences in rsFC and their correlations with IU were analyzed. Following an eight-week psychological intervention, OCD patients underwent a second assessment. The association between rsFC changes and IU changes was investigated.

Results

OCD patients exhibited significantly higher IUS scores. Significant alterations in rsFC were observed between the left amygdala and the left cerebellum posterior lobe (CPL), as well as between the left AI and the left cuneus in OCD patients. In the OCD group, only the left amygdala - left CPL rsFC significantly correlated with IUS scores. No significant correlations were found between rsFC and IUS scores in the HC group. Longitudinal analysis revealed that changes in the left amygdala - left CPL rsFC were significantly associated with changes in IUS scores.

Conclusions

This study establishes amygdala-cerebellar rsFC as a specific neural signature of IU in patients with OCD, patterns absent in healthy controls. Moreover, the amygdala-cerebellar rsFC displayed longitudinal coupling with IU changes. These findings provide novel insights into the neural mechanisms of OCD pathology.

目的不确定性不耐受（IU）在强迫症（OCD）病理中起重要作用。杏仁核和前岛（AI）似乎是IU的重要神经关联。然而，OCD患者静息状态功能连接改变（rsFC）与IU之间的关系尚未报道。方法招募强迫症患者39例，健康对照45例。IU采用不确定度不耐受度量表（IUS）测量。采用种子到体素的方法构建rsFC地图。分析rsFC的组间差异及其与IU的相关性。经过8周的心理干预后，强迫症患者接受了第二次评估。研究了rsFC变化与IU变化之间的关系。结果socd患者IUS评分明显增高。在强迫症患者中，左杏仁核和左小脑后叶（CPL）、左AI和左楔叶之间的rsFC发生了显著变化。在强迫症组中，只有左杏仁核-左CPL rsFC与IUS评分显著相关。HC组rsFC与IUS评分无显著相关性。纵向分析显示，左杏仁核-左CPL rsFC的变化与IUS评分的变化显著相关。结论本研究确立了杏仁核-小脑rsFC是强迫症患者IU的特异性神经特征，而这种特征在健康对照组中不存在。此外，杏仁核-小脑rsFC表现出与IU变化的纵向耦合。这些发现为强迫症病理的神经机制提供了新的见解。

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引用次数: 0

PTSD and cognition in older adults: A systematic literature review 老年人PTSD与认知：系统文献综述

IF 4.8 2区医学 Q1 PSYCHIATRY

Journal of Anxiety Disorders

Pub Date : 2025-06-11 DOI: 10.1016/j.janxdis.2025.103047

Jasmijn E. van Rossum , Semmy Op den Camp , Renske Uiterwijk , Kay Deckers , Vasiliki Orgeta , Bernice J.A. Gulpers , Sjacko Sobczak

Post-traumatic stress disorder (PTSD) is a disabling mental health disorder affecting psychosocial functioning and quality of life. This systematic review is the first to summarize existing global literature on the relationship between PTSD and specific domains of cognitive function in the general population of older adults. We searched PsycINFO, Medline and CINAHL up until November 1st 2024. Studies were included if they were longitudinal cohort or cross-sectional studies of adults aged 60 years and over with a clinical diagnosis of PTSD or subthreshold PTSD symptoms, reporting on any domain of cognitive functioning using a standardised measure. Eighteen good or satisfactory quality articles met criteria for this review, of which three were longitudinal cohort studies and fifteen were cross-sectional studies. PTSD was associated with significant accelerated general cognitive decline and possible accelerated decline in attention and memory over time. Older adults with PTSD additionally performed significantly worse on measures of global cognitive function and memory compared to those without PTSD. For executive function results were mixed; two studies showed significant negative associations, whereas four other studies showed no significant differences between individuals with and without PTSD. Proactive screening of individuals with PTSD for cognitive decline and an additional focus of PTSD treatment on cognitive functioning are needed.

创伤后应激障碍（PTSD）是一种影响社会心理功能和生活质量的致残性精神健康障碍。本系统综述首次总结了现有的全球文献中关于PTSD与老年人特定认知功能领域之间关系的研究。我们检索了PsycINFO， Medline和CINAHL，直到2024年11月1日。研究包括对60岁及以上的成年人进行的纵向队列或横断面研究，这些成年人临床诊断为PTSD或阈下PTSD症状，使用标准化测量报告任何领域的认知功能。18篇质量良好或令人满意的文章符合本综述的标准，其中3篇为纵向队列研究，15篇为横断面研究。随着时间的推移，创伤后应激障碍与显著加速的一般认知能力下降以及可能加速的注意力和记忆力下降有关。此外，与没有PTSD的老年人相比，患有PTSD的老年人在整体认知功能和记忆方面的表现明显更差。执行功能的结果好坏参半；两项研究显示了显著的负相关，而另外四项研究显示患有和没有创伤后应激障碍的个体之间没有显著差异。需要对PTSD患者进行认知能力下降的主动筛查，并将PTSD治疗的额外重点放在认知功能上。

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引用次数: 0