Journal of Anxiety Disorders最新文献

Research on the emotional experience of climate change has become a hot topic. Yet uncertainties remain regarding the interplay between climate change-related emotions (i.e., eco-anxiety, eco-anger, eco-sadness), general emotions (i.e., regardless of climate change), and pro-environmental behaviors. Most previous research has focused on cross-sectional studies, and eco-emotions in everyday life have seldom been considered. In this preregistered study, 102 participants from the general population rated their eco-emotions (i.e., eco-anxiety, eco-anger, eco-sadness), general emotions (i.e., anxiety, anger, sadness), and pro-environmental intentions and behaviors daily over a 60-day period. Using a multilevel vector autoregressive approach, we computed three network models representing temporal (i.e., from one time-point to the next), contemporaneous (i.e., during the same time-frame), and between-subject (i.e., similar to cross-sectional approach) associations between variables. Results show that eco-anger was the only predictor of pro-environmental intentions and behaviors over time. At the contemporaneous level, the momentary experience of each eco-emotion was associated with the momentary emotional experience of the corresponding general emotion, indicating the distinctiveness of each eco-emotion and the correspondence between its experience and that of its general, non-climate-related emotion. Overall, our findings 1) emphasize the driving role of eco-anger in prompting pro-environmental behaviors over time, 2) suggest a functional and experiential distinction between eco-emotions, and 3) provide data-driven clues for the field's larger quest to establish the scientific foundations of eco-emotions.

Pre-event and post-event rumination have been consistently identified by cognitive models as important maintaining factors in Social Anxiety Disorder (SAD). This systematic review and meta-analysis aimed to investigate the effectiveness of psychological treatment in reducing pre-event and post-event rumination in adults with social anxiety. A comprehensive literature search identified 26 eligible studies, with 1524 total participants. Psychological treatments demonstrated large significant within-group effect sizes (from pre- to post-treatment) in reducing pre-event rumination (g = 0.86) and post-event rumination (g = 0.83). Subgroups analysed showed CBT to have large significant effect sizes in reducing pre-event rumination (g = 0.97) and post-event rumination (g = 0.85). Interventions that specifically addressed rumination were found to be significantly more effective in reducing pre-event rumination than those that did not (p = .006). Both individual and group treatment formats were equally effective in reducing pre-event rumination and post-event rumination. Meta-regressions revealed that pre-event rumination treatment effects were significantly larger in individuals with higher baseline social anxiety, meanwhile post-event rumination treatment effects were larger for those with higher baseline depression. Overall findings show that pre-event and post-event rumination are effectively reduced through psychological treatment, and clinical implications for the enhancement of evidence-based treatment protocols are discussed.

Anorexia nervosa (AN) is a serious and persistent psychiatric illness. Many individuals with AN cycle between stages of remission (i.e., relapse), with research documenting that cognitive remission generally lags behind nutritional/weight restoration. Yet, little is known about which mechanisms promote movement from partial remission in AN (defined as nutritional, but not cognitive, recovery) to full remission. Fear-based processes, including avoidance and approach behaviors, likely contribute to the persistence of cognitive-behavioral AN symptoms after nutritional restoration. The current study used intensive longitudinal data to characterize these processes during partial remission (N = 41 participants with partially remitted AN; 4306 total observations). We aimed to a) characterize frequency of fear-based processes in real-time, b) investigate associations across fear-based processes and behavioral urges, and c) test if real-time associations among symptoms differed across commonly feared stimuli (e.g., food, social situations). On average, participants endorsed moderate fear and avoidance, with weight-gain fears rated higher than other feared stimuli. Momentary fear, avoidance, approach, and distress were all positively associated with AN behavior urges at one time-point and prospectively. Central symptoms and symptom connections differed across models with different feared stimuli. These findings provide empirical support for the theorized fear-avoidance-urge cycle in AN, which may contribute to the persistence of eating pathology during partial remission. Fear approach may be associated with temporary increases in urges, which should be considered during treatment. Future research should explore these associations in large, heterogeneous samples, and test the effectiveness of exposure-based interventions during partial remission.

Eco-anxiety, which refers to the anxiety experienced in response to worsening environmental conditions, is a growing global phenomenon. Climate change anxiety, due to the escalating impact of ongoing climate change, stands out as the most commonly recognized form of eco-anxiety. Nevertheless, numerous uncertainties persist regarding the relationship of this eco-anxiety response to pro-environmental behaviors, as well as its connection with trait anxiety and the perception of the environmental crisis. In this study, we conducted an analysis with a sample size of 431 participants to elucidate the respective implications of these factors, delving into the different facets of the eco-anxiety response: worry and anxiety-related impairments. We measured eco-worry using a brief 5-item scale and assessed climate anxiety-related impairments using the Climate Change Anxiety Scale (CCAS). Our findings reveal that eco-worry acts as a mediator between the perception of the environmental crisis and the manifestation of climate anxiety-related impairments. Furthermore, eco-worry plays a constructive role in relation to the commitment to pro-environmental behaviors, with no additional contribution from the climate anxiety reaction involving impairments. In summary, our findings underscore the existence of distinct constructs within the anxiety response to climate change and environmental issues, each with different contributing factors.

The present study examined nonverbal synchrony (i.e., synchrony between individuals’ movement) during diagnostic interviews of individuals with and without social anxiety disorder (SAD). Specifically, 42 individuals with SAD and 42 individuals without SAD underwent a structured clinical interview, and videos of clinical interviews were analysed using Motion Energy Analysis (an objective machine-based video analysis) to quantify each individuals’ movement as well as dyadic synchrony. Results indicated that interviews of individuals with SAD had significantly lower levels of nonverbal synchrony compared to interviews of individuals without SAD. In addition, interviews of individuals with SAD had lower levels of pacing compared to interviews of individuals without SAD (pacing refers to synchrony in which the interviewer initiates movement to which the participant responds). Analyses with social anxiety represented as a continuum of severity (vs. a diagnostic dichotomy) resulted in similar findings. Thus, individuals with SAD synchronized with interviewers’ movement to a lesser extent compared to individuals without SAD, and social anxiety was associated with diminished synchrony. Implications for psychopathology and diagnosis of SAD are discussed.

Clinical and subclinical levels of anxiety and depression are common experiences during pregnancy for expectant women; however, despite rising awareness of significant climate change anxiety around the world, the extent to which this particular type of anxiety may be contributing to overall antenatal psychological distress is currently unknown. Furthermore, the content of concerns that expectant women may have for their existing or future children remains unexplored. To address this gap in knowledge, 103 expectant Australian women completed standardised assessments of antenatal worry and depression, climate change anxiety, and perceived distance to climate change, and responded to several open-ended questions on concerns they had for their children. Results indicated that climate change anxiety accounted for significant percentages of variance in both antenatal worry and depression scores and, unexpectedly, neither child number nor perceived distance to climate change moderated these relationships. Content analysis of qualitative data highlighted the significant health-related anxieties for participants’ children related to climate change (e.g., disease, exposure to extreme weather events, food/water insecurity). Given the escalating nature of climate change, further investigation of this relatively new stressor contributing to the experience of anxiety and distress, particularly in uniquely vulnerable groups such as expectant women, is urgently needed.

Gaze-Contingent Music Reward Therapy (GC-MRT) is an eye-tracking-based attention bias modification protocol for social anxiety disorder (SAD) with established clinical efficacy. However, it remains unclear if improvement following GC-MRT hinges on modification of threat-related attention or on more general enhancement of attention control. Here, 50 patients with SAD were randomly allocated to GC-MRT using either threat faces or shapes. Results indicate comparable reductions in social anxiety and co-morbid depression symptoms in the two conditions. Patients in the shapes condition showed a significant increase in attention control and a reduction in attention to both the trained shapes and threat faces, whereas patients in the faces condition showed a reduction in attention to threat faces only. These findings suggest that enhancement of attention control, independent of valence-specific attention modification, may facilitate reduction in SAD symptoms. Alternative interpretations and clinical implications of the current findings are discussed.

Online treatment delivery has the potential to increase access to evidence-based mental health care for children with anxiety disorders. Using a randomized controlled trial design, we evaluated the efficacy of Cool Kids Online, a family-based and therapist supported internet-delivered cognitive behavioral treatment (CBT) designed to target anxiety disorders in children. Ninety-five children aged 7–12 years with a DSM-5 anxiety disorder were randomly allocated to Cool Kids Online or a waitlist control. Children were assessed at baseline, week 11, and 6-months following treatment. Children in waitlist received treatment after week 11 and also completed assessments immediately and six months after treatment, allowing treatment maintenance to be evaluated for all children. Compared to waitlist, Cool Kids Online led to significantly greater remission of anxiety disorders (primary and all anxiety diagnoses) and greater reduction of caregiver-reported anxiety symptoms and interference at week 11. Child-reported anxiety symptoms and interference and child- and caregiver-reported depressive or externalizing symptoms did not differ significantly between conditions. Medium to large within-treatment effects were observed for all children from pre to post treatment with post treatment effects maintained until follow-up. Overall, the findings provide support for the efficacy of the program in treating anxiety. Cool Kids Online compared to waitlist for the remission of anxiety disorders in clinically anxious children; anzctr.org.au; ACTRN12615000947505.

Cyberchondria (i.e., excessive health-related Internet search linked to psychological distress) is usually associated with health anxiety, but relationships with other psychopathological symptoms were also found. However, studies are lacking in patients with hypochondriasis, and it remains unclear whether cyberchondria and its subfacets are specific to hypochondriasis (i.e., higher levels in hypochondriasis compared to other mental disorders). Patients with hypochondriasis (N = 50), a clinical (N = 70), and a healthy comparison group (N = 51) completed two questionnaires on cyberchondria whose combined 17 subscales were reduced to three relevant cyberchondria subfacets by second-order factor analysis. The cyberchondria subfacet emotional distress/negative consequences linked to health-related Internet searches showed significantly higher scores in patients with hypochondriasis than in the two comparison groups (d ≥ 1.7) and was the only predictor of dimensional health anxiety (β = .58, p ≤ .001). The two subfacets type/extent of health-related Internet searches and characteristics of the Internet (e.g., attitude toward unreliability, vast amounts of information) were less specifically associated with hypochondriasis. The results are consistent with models of cyberchondria and hypochondriasis, particularly on the anxiety-reinforcing vicious circle and maintaining factors. Based on the findings, practical implications are discussed.