Pub Date : 2025-03-08DOI: 10.1016/j.janxdis.2025.103000
Jennifer de Rutte , Sarah Myruski , Elizabeth Davis , Abigail Findley , Tracy A. Dennis-Tiwary
The objective of this study was to determine if a novel game-based digital therapeutic intervention reduced anxiety symptom severity in adults with clinically elevated symptoms of social anxiety disorder (SAD). Participants were randomly allocated (1:1) to receive four weeks of either the active intervention, a game-based form of attention bias modification (Active ABM) for anxiety, or the sham control training (Control). Between June 2022 to June 2023, 104 participants were enrolled with 93 completing the trial per-protocol and 104 included in the final intention-to-treat analysis (54 intervention, 50 control); mean age was 38.08 (10.56) years and 79 were female. The dependent variable was reduction in SAD symptoms, measured via the Liebowitz SAD Scale (LSAS). Participants were classified as having clinically elevated SAD symptoms only, or both SAD and Generalized Anxiety Disorder (GAD) symptoms (comorbid). The Active condition induced significantly greater reductions in SAD symptoms compared to the Control condition between Baseline and Post-Treatment [Active: M = -29.71, SD = 23.68; Control: M = -14.59, SD = 21.52, d = .67, t(102) = -3.40, p < .001] across the four-week study period. While no significant between-groups differences emerged at each timepoint individually, the Active condition induced significantly greater change over time in SAD symptoms compared to the Control condition. Use of this game-based digital ABM intervention showed benefits in the reduction of anxiety symptoms.
{"title":"A randomized clinical trial investigating the clinical impact of a game-based digital therapeutic for social anxiety disorder","authors":"Jennifer de Rutte , Sarah Myruski , Elizabeth Davis , Abigail Findley , Tracy A. Dennis-Tiwary","doi":"10.1016/j.janxdis.2025.103000","DOIUrl":"10.1016/j.janxdis.2025.103000","url":null,"abstract":"<div><div>The objective of this study was to determine if a novel game-based digital therapeutic intervention reduced anxiety symptom severity in adults with clinically elevated symptoms of social anxiety disorder (SAD). Participants were randomly allocated (1:1) to receive four weeks of either the active intervention, a game-based form of attention bias modification (Active ABM) for anxiety, or the sham control training (Control). Between June 2022 to June 2023, 104 participants were enrolled with 93 completing the trial per-protocol and 104 included in the final intention-to-treat analysis (54 intervention, 50 control); mean age was 38.08 (10.56) years and 79 were female. The dependent variable was reduction in SAD symptoms, measured via the Liebowitz SAD Scale (LSAS). Participants were classified as having clinically elevated SAD symptoms only, or both SAD and Generalized Anxiety Disorder (GAD) symptoms (comorbid). The Active condition induced significantly greater reductions in SAD symptoms compared to the Control condition between Baseline and Post-Treatment [Active: <em>M</em> = -29.71, <em>SD</em> = 23.68; Control: <em>M</em> = -14.59, <em>SD</em> = 21.52, <em>d</em> = .67, <em>t</em>(102) = -3.40, <em>p</em> < .001] across the four-week study period. While no significant between-groups differences emerged at each timepoint individually, the Active condition induced significantly greater change over time in SAD symptoms compared to the Control condition. Use of this game-based digital ABM intervention showed benefits in the reduction of anxiety symptoms.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"111 ","pages":"Article 103000"},"PeriodicalIF":4.8,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143592502","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 : 2025-03-03DOI: 10.1016/j.janxdis.2025.102996
Anna-Rosa Cecilie Mora-Jensen , Christine Lykke Thoustrup , Eli R. Lebowitz , Julie Hagstrøm , Linea Pretzmann , Nicoline Løcke Jepsen Korsbjerg , Emilie Damløv Thorsen , Valdemar Funch Uhre , Sofie Heidenheim Christensen , Camilla Uhre , Melanie Ritter , Kerstin J. Plessen , Anne Katrine Pagsberg , Line Katrine Harder Clemmensen , Nicole Nadine Lønfeldt
Background
Parent-child interactive processes are important factors in pediatric OCD. Understanding biological mechanisms of parent-child interactive behaviors could help improve treatment of pediatric OCD. Oxytocin has been suggested as a biological mechanism in parent-child interactions. However, no studies in pediatric OCD exist. We used machine learning to discover latent patterns in parent-child interactive behaviors and explored associations with oxytocin in children with and without OCD.
Methods
We used parent and child salivary oxytocin levels measured with enzyme-linked immunosorbent assay (ELISA) and investigator-rated parent-child behaviors during a frustration task. Children with or without OCD and their parents – 107 mother-child and 62 father-child pairs were included. We used two machine learning techniques, principal component analysis and archetypal analysis, to generate data-driven, theory-agnostic behavioral variables, and regression to estimate their associations with oxytocin.
Results
Principal component and archetype analyses identified behavioral patterns describing the mother-child and father-child interactions. We found a positive association between child and mother oxytocin and the interaction patterns "overinvolved interaction" and "emotional interaction" and a negative association with "distant interaction". Additionally, mother oxytocin was positively associated with "supportive interaction" and "varied-coping interaction", and negatively associated with "conflictual interaction" and "negative-low support interaction". Father oxytocin was associated with “supportive interactions” only in the presence of child OCD.
Conclusion
Child and mother oxytocin appear related with mother-child interactive patterns. Fathers’ oxytocin was related with interaction patterns only in children with OCD. Our exploratory findings can be used to generate hypothesis for future research regarding the relationship between oxytocin and maladaptive family engagement in OCD and differences between mothers and fathers’ behaviors when the child has OCD.
{"title":"Computationally derived parent-child interaction patterns and oxytocin in children with and without OCD","authors":"Anna-Rosa Cecilie Mora-Jensen , Christine Lykke Thoustrup , Eli R. Lebowitz , Julie Hagstrøm , Linea Pretzmann , Nicoline Løcke Jepsen Korsbjerg , Emilie Damløv Thorsen , Valdemar Funch Uhre , Sofie Heidenheim Christensen , Camilla Uhre , Melanie Ritter , Kerstin J. Plessen , Anne Katrine Pagsberg , Line Katrine Harder Clemmensen , Nicole Nadine Lønfeldt","doi":"10.1016/j.janxdis.2025.102996","DOIUrl":"10.1016/j.janxdis.2025.102996","url":null,"abstract":"<div><h3>Background</h3><div>Parent-child interactive processes are important factors in pediatric OCD. Understanding biological mechanisms of parent-child interactive behaviors could help improve treatment of pediatric OCD. Oxytocin has been suggested as a biological mechanism in parent-child interactions. However, no studies in pediatric OCD exist. We used machine learning to discover latent patterns in parent-child interactive behaviors and explored associations with oxytocin in children with and without OCD.</div></div><div><h3>Methods</h3><div>We used parent and child salivary oxytocin levels measured with enzyme-linked immunosorbent assay (ELISA) and investigator-rated parent-child behaviors during a frustration task. Children with or without OCD and their parents – 107 mother-child and 62 father-child pairs were included. We used two machine learning techniques, principal component analysis and archetypal analysis, to generate data-driven, theory-agnostic behavioral variables, and regression to estimate their associations with oxytocin.</div></div><div><h3>Results</h3><div>Principal component and archetype analyses identified behavioral patterns describing the mother-child and father-child interactions. We found a positive association between child and mother oxytocin and the interaction patterns \"overinvolved interaction\" and \"emotional interaction\" and a negative association with \"distant interaction\". Additionally, mother oxytocin was positively associated with \"supportive interaction\" and \"varied-coping interaction\", and negatively associated with \"conflictual interaction\" and \"negative-low support interaction\". Father oxytocin was associated with “supportive interactions” only in the presence of child OCD.</div></div><div><h3>Conclusion</h3><div>Child and mother oxytocin appear related with mother-child interactive patterns. Fathers’ oxytocin was related with interaction patterns only in children with OCD. Our exploratory findings can be used to generate hypothesis for future research regarding the relationship between oxytocin and maladaptive family engagement in OCD and differences between mothers and fathers’ behaviors when the child has OCD.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"111 ","pages":"Article 102996"},"PeriodicalIF":4.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674758","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 : 2025-02-19DOI: 10.1016/j.janxdis.2025.102988
Timothy J. Geier , Kaylen Vine , Lucas Torres , Christine L. Larson , Terri A. deRoon-Cassini
Background
Posttraumatic stress disorder (PTSD) is common after traumatic injury, negatively impacting recovery. Black Americans face elevated PTSD risk following traumatic injury, yet diagnostic accuracy of assessments in trauma center settings serving this population is unknown. The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) exhibits strong psychometric properties but optimal cut-scores by race require examination.
Methods
Data were combined from three ongoing projects of injured Black American adults (N = 270). Participants completed the PCL-5 and Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) six months post-injury. Receiver operating characteristic analysis determined the PCL-5's diagnostic utility against the CAPS-5. Sensitivity, specificity, predictive values, and diagnostic efficiency were calculated across cut scores.
Results
Prevalence of CAPS-5 PTSD at 6-months post-injury was 34.4 %. The PCL-5 demonstrated good accuracy in detecting PTSD (AUC=.931). A PCL-5 cut-score of > 33 maximized diagnostic efficiency (89.1 %), with sensitivity of 89.1 % and specificity of 87.6 %.
Conclusions
The PCL-5 is an accurate PTSD screening tool for injured Black Americans using an appropriate threshold. Findings have implications for improving mental health care access in trauma settings serving marginalized groups.
{"title":"The diagnostic utility of the PCL-5 in a traumatically injured black population","authors":"Timothy J. Geier , Kaylen Vine , Lucas Torres , Christine L. Larson , Terri A. deRoon-Cassini","doi":"10.1016/j.janxdis.2025.102988","DOIUrl":"10.1016/j.janxdis.2025.102988","url":null,"abstract":"<div><h3>Background</h3><div>Posttraumatic stress disorder (PTSD) is common after traumatic injury, negatively impacting recovery. Black Americans face elevated PTSD risk following traumatic injury, yet diagnostic accuracy of assessments in trauma center settings serving this population is unknown. The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) exhibits strong psychometric properties but optimal cut-scores by race require examination.</div></div><div><h3>Methods</h3><div>Data were combined from three ongoing projects of injured Black American adults (N = 270). Participants completed the PCL-5 and Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) six months post-injury. Receiver operating characteristic analysis determined the PCL-5's diagnostic utility against the CAPS-5. Sensitivity, specificity, predictive values, and diagnostic efficiency were calculated across cut scores.</div></div><div><h3>Results</h3><div>Prevalence of CAPS-5 PTSD at 6-months post-injury was 34.4 %. The PCL-5 demonstrated good accuracy in detecting PTSD (AUC=.931). A PCL-5 cut-score of > 33 maximized diagnostic efficiency (89.1 %), with sensitivity of 89.1 % and specificity of 87.6 %.</div></div><div><h3>Conclusions</h3><div>The PCL-5 is an accurate PTSD screening tool for injured Black Americans using an appropriate threshold. Findings have implications for improving mental health care access in trauma settings serving marginalized groups.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"111 ","pages":"Article 102988"},"PeriodicalIF":4.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143463964","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 : 2025-02-10DOI: 10.1016/j.janxdis.2025.102986
Stefan G. Hofmann
Humans have an inherent need to belong to a social group, and ostracism can lead to significant personal costs. Therefore, the fear of negative evaluation by others, along with its associated consequence of social anxiety, appears to be evolutionarily adaptive. Numerous studies have demonstrated that social anxiety, as well as its clinical manifestation, social anxiety disorder (SAD), is not only linked to an intense fear of negative evaluation but also to a fear of positive evaluation. This phenomenon has been termed the Bivalent Fear of Evaluation (BFOE) model of social anxiety. While the fear of negative evaluation can be understood from an evolutionary standpoint, the fear of positive evaluation poses a challenge for such an account. Clarifying the relationship between these two fears—positive and negative evaluation—may provide new insights into the nature of social anxiety and SAD. After summarizing and reviewing studies comprising this special issue, I will conclude that any form of evaluative feedback rising self-focused attention—whether positive, negative, or even neutral—can cause distress due to heightened sensitivity to social feedback in general. However, different mechanisms and contextual factors are implicated. In line with cognitive models of SAD, the self and self-perception are central to both social anxiety and SAD. This has significant theoretical and clinical implications.
{"title":"Fear of positive evaluation and the bivalent fear of evaluation model of social anxiety: An Integration","authors":"Stefan G. Hofmann","doi":"10.1016/j.janxdis.2025.102986","DOIUrl":"10.1016/j.janxdis.2025.102986","url":null,"abstract":"<div><div>Humans have an inherent need to belong to a social group, and ostracism can lead to significant personal costs. Therefore, the fear of negative evaluation by others, along with its associated consequence of social anxiety, appears to be evolutionarily adaptive. Numerous studies have demonstrated that social anxiety, as well as its clinical manifestation, social anxiety disorder (SAD), is not only linked to an intense fear of negative evaluation but also to a fear of positive evaluation. This phenomenon has been termed the Bivalent Fear of Evaluation (BFOE) model of social anxiety. While the fear of negative evaluation can be understood from an evolutionary standpoint, the fear of positive evaluation poses a challenge for such an account. Clarifying the relationship between these two fears—positive and negative evaluation—may provide new insights into the nature of social anxiety and SAD. After summarizing and reviewing studies comprising this special issue, I will conclude that any form of evaluative feedback rising self-focused attention—whether positive, negative, or even neutral—can cause distress due to heightened sensitivity to social feedback in general. However, different mechanisms and contextual factors are implicated. In line with cognitive models of SAD, the self and self-perception are central to both social anxiety and SAD. This has significant theoretical and clinical implications.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"111 ","pages":"Article 102986"},"PeriodicalIF":4.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143403446","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 : 2025-02-07DOI: 10.1016/j.janxdis.2025.102987
Paige L. DeGennaro, Mary Blendermann, Brittany Alberts, Jennifer S. Silk, Peter J. Gianaros, Lauren S. Hallion
Perseverative thought (also known as repetitive thought) is an established transdiagnostic mechanism of internalizing psychopathology characterized primarily by its repetitive, difficult to control quality. Subjective difficulty concentrating frequently coincides with perseverative thought and may function as both mechanism and clinical consequence of perseverative thought. Although cognitive theories suggest a bidirectional relationship between perseverative thought and difficulty concentrating, experimental and longitudinal investigations provide mixed evidence. The current study addresses this gap by testing a bidirectional relationship between momentary perseverative thought and difficulty concentrating using ecological momentary assessment (EMA) (8 surveys per day for 14 days) with 200 adult community participants (N = 155 with compliance ≥ 70 %) oversampled for moderate/severe perseverative thought. Multilevel modeling tested concurrent and time-lagged associations. Difficulty concentrating and perseverative thought were concurrently and prospectively related within-person: higher difficulty concentrating at T-1 predicted higher perseverative thought at T, and higher perseverative thought at T-1 predicted higher difficulty concentrating at T (β =.19 –.20, p < .001). Findings held when controlling for the outcome at T-1 (β =.02 – .06, p < .001). These findings demonstrate covariation between difficulty concentrating and perseverative thought within-person in daily life consistent with theoretical models that predict bidirectional relationships. Findings suggest that intervening on difficulty concentrating and/or perseverative thought may reduce the “vicious cycle” of perseverative thought episodes.
{"title":"A temporal investigation of the relationship between difficulty concentrating and perseverative thought","authors":"Paige L. DeGennaro, Mary Blendermann, Brittany Alberts, Jennifer S. Silk, Peter J. Gianaros, Lauren S. Hallion","doi":"10.1016/j.janxdis.2025.102987","DOIUrl":"10.1016/j.janxdis.2025.102987","url":null,"abstract":"<div><div>Perseverative thought (also known as repetitive thought) is an established transdiagnostic mechanism of internalizing psychopathology characterized primarily by its repetitive, difficult to control quality. Subjective difficulty concentrating frequently coincides with perseverative thought and may function as both mechanism and clinical consequence of perseverative thought. Although cognitive theories suggest a bidirectional relationship between perseverative thought and difficulty concentrating, experimental and longitudinal investigations provide mixed evidence. The current study addresses this gap by testing a bidirectional relationship between momentary perseverative thought and difficulty concentrating using ecological momentary assessment (EMA) (8 surveys per day for 14 days) with 200 adult community participants (<em>N</em> = 155 with compliance ≥ 70 %) oversampled for moderate/severe perseverative thought. Multilevel modeling tested concurrent and time-lagged associations. Difficulty concentrating and perseverative thought were concurrently and prospectively related within-person: higher difficulty concentrating at <em>T</em>-1 predicted higher perseverative thought at <em>T</em>, and higher perseverative thought at <em>T</em>-1 predicted higher difficulty concentrating at <em>T</em> (<em>β =</em>.19 –.20, <em>p < .</em>001). Findings held when controlling for the outcome at <em>T</em>-1 (<em>β</em> =.02 – <em>.</em>06, <em>p</em> < .001). These findings demonstrate covariation between difficulty concentrating and perseverative thought within-person in daily life consistent with theoretical models that predict bidirectional relationships. Findings suggest that intervening on difficulty concentrating and/or perseverative thought may reduce the “vicious cycle” of perseverative thought episodes.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"111 ","pages":"Article 102987"},"PeriodicalIF":4.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-07DOI: 10.1016/j.janxdis.2025.102984
Justin W. Weeks, Andres De Los Reyes
{"title":"The Bivalent fear of evaluation model of social anxiety: The state of the science and future directions","authors":"Justin W. Weeks, Andres De Los Reyes","doi":"10.1016/j.janxdis.2025.102984","DOIUrl":"10.1016/j.janxdis.2025.102984","url":null,"abstract":"","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"111 ","pages":"Article 102984"},"PeriodicalIF":4.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386598","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 : 2025-02-05DOI: 10.1016/j.janxdis.2025.102985
Lucy J. Allbaugh , Lucas Marinack , Alison M. Pickover , Abigail Powers , Erica D. Marshall Lee , Marylène Cloitre , Nadine J. Kaslow
Posttraumatic stress disorder (PTSD) frequently co-occurs with myriad mood and anxiety disorders including generalized anxiety disorder (GAD). Despite this comorbidity’s prevalence, mechanisms underlying the co-occurrence of PTSD and GAD remains understudied. An emotion dysregulation framework routinely is used to understand both PTSD and GAD but has not been applied to the PTSD-GAD comorbidity. Using MANOVA, the present study tested domains of emotion dysregulation (DERS) and of positive emotion regulation (AEQ) as differentiators of PTSD alone versus PTSD with GAD using pre-intervention data from a randomized controlled trial including 292 women with PTSD secondary to interpersonal violence. Five of six emotion dysregulation domains differentiated the two groups: fewer regulation strategies, nonacceptance of emotional responses, impulse control difficulties, lack of emotional awareness, and lack of emotional clarity were associated with comorbidity. Of three positive emotion regulation domains, participants with PTSD alone reported more positive emotionality than those with PTSD and GAD, and those with comorbid PTSD and GAD reported more negative affective interference than those with PTSD only. Rather than specific domains underlying unique presentations, findings indicate a general dysregulation factor, where PTSD-GAD comorbidity is supported by an overall higher level of emotion dysregulation as compared to PTSD alone.
{"title":"Understanding emotion dysregulation in PTSD – GAD comorbidity","authors":"Lucy J. Allbaugh , Lucas Marinack , Alison M. Pickover , Abigail Powers , Erica D. Marshall Lee , Marylène Cloitre , Nadine J. Kaslow","doi":"10.1016/j.janxdis.2025.102985","DOIUrl":"10.1016/j.janxdis.2025.102985","url":null,"abstract":"<div><div>Posttraumatic stress disorder (PTSD) frequently co-occurs with myriad mood and anxiety disorders including generalized anxiety disorder (GAD). Despite this comorbidity’s prevalence, mechanisms underlying the co-occurrence of PTSD and GAD remains understudied. An emotion dysregulation framework routinely is used to understand both PTSD and GAD but has not been applied to the PTSD-GAD comorbidity. Using MANOVA, the present study tested domains of emotion dysregulation (DERS) and of positive emotion regulation (AEQ) as differentiators of PTSD alone versus PTSD with GAD using pre-intervention data from a randomized controlled trial including 292 women with PTSD secondary to interpersonal violence. Five of six emotion dysregulation domains differentiated the two groups: fewer regulation strategies, nonacceptance of emotional responses, impulse control difficulties, lack of emotional awareness, and lack of emotional clarity were associated with comorbidity. Of three positive emotion regulation domains, participants with PTSD alone reported more positive emotionality than those with PTSD and GAD, and those with comorbid PTSD and GAD reported more negative affective interference than those with PTSD only. Rather than specific domains underlying unique presentations, findings indicate a general dysregulation factor, where PTSD-GAD comorbidity is supported by an overall higher level of emotion dysregulation as compared to PTSD alone.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"110 ","pages":"Article 102985"},"PeriodicalIF":4.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143372698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.janxdis.2025.102981
Johann P. Hardarson , Berglind Gudmundsdottir , Gunnar S. Jonsson , Bergrun M. Johannesdottir , Kristjana Thorarinsdottir , Gunnar Tomasson , Emily A. Holmes , Arna Hauksdottir , Unnur Valdimarsdóttir , Gordon Asmundson , Andri S. Bjornsson
Background
This study examined psychological reactions to perceived threats, viewed within the context of human evolutionary history. We compared the relative weight of perceived threat to life or physical harm versus social threat, i.e., humiliation and/or rejection, in symptoms of posttraumatic stress disorder (PTSD) and social anxiety disorder (SAD).
Methods
Participants were 50 women with clinically significant posttraumatic stress symptoms (PTSS) and 59 women with little or no PTSS (control group) selected from a large, population-based cohort of women in Iceland, the SAGA Cohort. Participants rated (1) life threat, (2) physical threat, (3) humiliation, and (4) rejection during their worst trauma or stressor.
Results
Rates of both life and social threats were higher in the PTSS than control group. Among the PTSS participants, 4 % (n = 2) reported primarily life threats (vs. 6.8 %, n = 4 in controls), 36 % (n = 18) reported primarily social threats (vs. 33.9 %, n = 20 in controls), and 60 % (n = 30) reported both types of threats (vs. 15.3 %, n = 9 in controls). Those who reported dual life and social threats exhibited elevated PTSS compared to those who experienced a single type of threat. The highest levels of life or physical threat, along with humiliation, predicted PTSS severity, but rejection did not. Nearly half of the PTSS group (approximately 50 %, n = 25) also met criteria for SAD compared to roughly 14 % (n = 8) in the control group, and humiliation predicted SAD symptom severity. Notably, 18 % of the PTSS group (n = 9) linked the onset of their SAD and PTSS to a singular trauma or stressor involving a social threat.
Conclusions
The findings underscore the role of social threat in PTSD and SAD, with implications for theoretical models of both disorders.
{"title":"Association of social and life threats with symptoms of posttraumatic stress disorder and social anxiety disorder","authors":"Johann P. Hardarson , Berglind Gudmundsdottir , Gunnar S. Jonsson , Bergrun M. Johannesdottir , Kristjana Thorarinsdottir , Gunnar Tomasson , Emily A. Holmes , Arna Hauksdottir , Unnur Valdimarsdóttir , Gordon Asmundson , Andri S. Bjornsson","doi":"10.1016/j.janxdis.2025.102981","DOIUrl":"10.1016/j.janxdis.2025.102981","url":null,"abstract":"<div><h3>Background</h3><div>This study examined psychological reactions to perceived threats, viewed within the context of human evolutionary history. We compared the relative weight of perceived threat to life or physical harm versus social threat, i.e., humiliation and/or rejection, in symptoms of posttraumatic stress disorder (PTSD) and social anxiety disorder (SAD).</div></div><div><h3>Methods</h3><div>Participants were 50 women with clinically significant posttraumatic stress symptoms (PTSS) and 59 women with little or no PTSS (control group) selected from a large, population-based cohort of women in Iceland, the SAGA Cohort. Participants rated (1) life threat, (2) physical threat, (3) humiliation, and (4) rejection during their worst trauma or stressor.</div></div><div><h3>Results</h3><div>Rates of both life and social threats were higher in the PTSS than control group. Among the PTSS participants, 4 % (n = 2) reported primarily life threats (vs. 6.8 %, n = 4 in controls), 36 % (n = 18) reported primarily social threats (vs. 33.9 %, n = 20 in controls), and 60 % (n = 30) reported both types of threats (vs. 15.3 %, n = 9 in controls). Those who reported dual life and social threats exhibited elevated PTSS compared to those who experienced a single type of threat. The highest levels of life or physical threat, along with humiliation, predicted PTSS severity, but rejection did not. Nearly half of the PTSS group (approximately 50 %, n = 25) also met criteria for SAD compared to roughly 14 % (n = 8) in the control group, and humiliation predicted SAD symptom severity. Notably, 18 % of the PTSS group (n = 9) linked the onset of their SAD and PTSS to a singular trauma or stressor involving a social threat.</div></div><div><h3>Conclusions</h3><div>The findings underscore the role of social threat in PTSD and SAD, with implications for theoretical models of both disorders.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"110 ","pages":"Article 102981"},"PeriodicalIF":4.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143348798","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 : 2025-02-01DOI: 10.1016/j.janxdis.2025.102983
Jun Hu , Jinmeng Liu , Meng Meng , Yiqun Gan
Anxiety is highly prevalent among adults. Evidence suggests that perceived stress controllability and emotional growth mindsets are associated with decreased anxiety. However, whether these positive factors synergistically contribute to reducing the impact of stress on anxiety remains unclear, especially within everyday stress contexts. Multilevel models were used to investigate how perceived stress controllability and emotional growth mindsets interacted to mitigate the adverse impact of daily stress on anxiety, differentiating within- and between-person effects. Overall, 198 participants completed ecological momentary assessments of perceived stress intensity and controllability, emotional growth mindsets, and anxiety four times daily over 10–12 consecutive days. The within-person analyses showed that high emotional growth mindsets buffer the link between perceived stress intensity and anxiety. More importantly, the between-person and cross-level results suggested that the synergistic effect of emotional growth mindsets and perceived stress controllability maximally buffered the correlation between perceived stress intensity and anxiety. Additionally, these results highlighted that the positive association between perceived stress intensity and anxiety was most pronounced among participants with low emotional growth mindsets and perceived stress controllability. These findings further support a synergistic intervention approach that emphasizes anxiety alleviation through enhanced perceived stress controllability and the development of emotional growth mindsets.
{"title":"Emotional growth mindsets and stress controllability buffer the link between stress intensity and anxiety symptoms: An ecological momentary assessment study","authors":"Jun Hu , Jinmeng Liu , Meng Meng , Yiqun Gan","doi":"10.1016/j.janxdis.2025.102983","DOIUrl":"10.1016/j.janxdis.2025.102983","url":null,"abstract":"<div><div>Anxiety is highly prevalent among adults. Evidence suggests that perceived stress controllability and emotional growth mindsets are associated with decreased anxiety. However, whether these positive factors synergistically contribute to reducing the impact of stress on anxiety remains unclear, especially within everyday stress contexts. Multilevel models were used to investigate how perceived stress controllability and emotional growth mindsets interacted to mitigate the adverse impact of daily stress on anxiety, differentiating within- and between-person effects. Overall, 198 participants completed ecological momentary assessments of perceived stress intensity and controllability, emotional growth mindsets, and anxiety four times daily over 10–12 consecutive days. The within-person analyses showed that high emotional growth mindsets buffer the link between perceived stress intensity and anxiety. More importantly, the between-person and cross-level results suggested that the synergistic effect of emotional growth mindsets and perceived stress controllability maximally buffered the correlation between perceived stress intensity and anxiety. Additionally, these results highlighted that the positive association between perceived stress intensity and anxiety was most pronounced among participants with low emotional growth mindsets and perceived stress controllability. These findings further support a synergistic intervention approach that emphasizes anxiety alleviation through enhanced perceived stress controllability and the development of emotional growth mindsets.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"110 ","pages":"Article 102983"},"PeriodicalIF":4.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143232048","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 : 2025-02-01DOI: 10.1016/j.janxdis.2025.102982
Seung Yeon Baik, Michelle G. Newman
The contrast avoidance model suggests that individuals with generalized anxiety disorder (GAD) use worry to sustain negative emotionality and thus avoid a sharp increase in negative emotion. Maintenance of negative mood increases the probability of subsequent decreased negative and increased positive affect (positive emotional contrast; PEC) when worrisome outcomes are better than expected. However, occurrence of PECs via increased positive affect and its application to rumination are unclear. Using a momentary assessment design, we examined effects of worry/rumination on PECs associated with relief and positive events. Participants with GAD and/or major depressive disorder (MDD; N = 76), or without psychopathology (N = 85) rated the occurrence of relief and positive events, emotions, and repetitive thought 8x/day for 8 days. Higher vs. lower worry and rumination were associated with greater decreased anxiety and sadness, and greater increased happiness pre-to-post positive and relief events. Greater GAD and MDD symptoms predicted ongoing higher ratings on intentionally thinking pessimistically to be pleasantly surprised if something good happened. Results suggest that worry/rumination led to enhanced PECs via decreased negative and increased positive affect pre-to-post positive and relief events. Individuals with higher GAD and depression symptoms reported intentionally using worry/rumination to increase PECs in daily life.
{"title":"Why do individuals with generalized anxiety disorder and depression engage in worry and rumination? A momentary assessment study of positive contrast enhancement","authors":"Seung Yeon Baik, Michelle G. Newman","doi":"10.1016/j.janxdis.2025.102982","DOIUrl":"10.1016/j.janxdis.2025.102982","url":null,"abstract":"<div><div>The contrast avoidance model suggests that individuals with generalized anxiety disorder (GAD) use worry to sustain negative emotionality and thus avoid a sharp increase in negative emotion. Maintenance of negative mood increases the probability of subsequent decreased negative and increased positive affect (positive emotional contrast; PEC) when worrisome outcomes are better than expected. However, occurrence of PECs via increased positive affect and its application to rumination are unclear. Using a momentary assessment design, we examined effects of worry/rumination on PECs associated with relief and positive events. Participants with GAD and/or major depressive disorder (MDD; <em>N</em> = 76), or without psychopathology (<em>N</em> = 85) rated the occurrence of relief and positive events, emotions, and repetitive thought 8x/day for 8 days. Higher vs. lower worry and rumination were associated with greater decreased anxiety and sadness, and greater increased happiness pre-to-post positive and relief events. Greater GAD and MDD symptoms predicted ongoing higher ratings on intentionally thinking pessimistically to be pleasantly surprised if something good happened. Results suggest that worry/rumination led to enhanced PECs via decreased negative and increased positive affect pre-to-post positive and relief events. Individuals with higher GAD and depression symptoms reported intentionally using worry/rumination to increase PECs in daily life.</div></div>","PeriodicalId":48390,"journal":{"name":"Journal of Anxiety Disorders","volume":"111 ","pages":"Article 102982"},"PeriodicalIF":4.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394269","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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