Anxiety Stress and Coping最新文献

Background and objectives: Virtual reality exposure therapy offers a unique opportunity to treat social anxiety disorder. This meta-analysis aims to evaluate the effectiveness of virtual reality exposure therapy compared to waitlist comparators or other interventions for individuals with social anxiety disorder in alleviating anxiety symptoms.

Methods: A three-step comprehensive search for the randomized controlled trials of virtual reality exposure therapy was conducted from inception to 7 December 2023. The overall effect was measured using Hedges' g and determined using t-statistics at a significance level of p < 0.05. Sensitivity, subgroup, and meta-regression analyses were carried out.

Results: A total of 17 randomized control trials were retrieved from nine electronic databases. Virtual reality exposure therapy has greater efficacy than waitlist comparators in reducing anxiety symptoms at post-intervention and follow-up assessment. Virtual reality exposure therapy demonstrates a similar effect to other interventions at post-intervention and follow-up assessment. We observed a greater effect for participants with symptomatic social anxiety when we combined the intervention with cognitive behavioral therapy compared to its counterpart. Meta-regression analyses found no significant covariate.

Conclusions: Overall, virtual reality exposure therapy can provide supplementary therapy for improving anxiety symptoms. Additional high-quality and large-scale trials with long-term follow-up are needed.

Background: Individuals with panic disorder (PD) often exhibit a proclivity to conclude that an imminent catastrophe looms, drawing such conclusions from limited physical information. Reflection impulsivity, characterized by decision-making without adequate information, likely affects this bias. This study examines the relationship between reflection impulsivity and self-report impulsive features in individuals with PD.

Methods: Fifty patients with PD and 50 healthy controls (HC) participated to this study. Reflection impulsivity was assessed using the Information Sampling Task (IST), while trait impulsivity was measured using the Barratt Impulsiveness Scale (BIS). Participants also completed the Beck Anxiety Inventory, Panic and Agoraphobia Scale (P&A), and Anxiety Sensitivity Index-3 (ASI-3).

Results: Individuals with PD exhibited higher reflection impulsivity compared to HC. Increased reflection impulsivity correlated positively with PD severity as assessed by the P&A and cognitive concerns measured by ASI-3. No significant correlations were found with physical or social concerns. PD patients had higher BIS scores than HC. Higher trait impulsivity was linked to recurrent emergency department visits among PD patients.

Discussion: The findings of this study reveal the notion of increased impulsivity among individuals with PD and its relationship with cognitive concerns, as well as recurrent visits to the emergency department stemming from panic attacks.

Background & objectives: Worry and loss-related secondary stressors appear to be important correlates of problematic grief responses. However, the relative importance of these variables in the context of established correlates of grief responding, ranging from indicators of identity disruption and demographic characteristics of the bereaved to characteristics of the loss of quality of the relationship with the deceased, is unknown. Modeling the relative associations of these factors can be problematic, given the high degree of collinearity between these variables. This study used a machine learning approach to provide accurate estimations of the relative importance of these correlates for post-loss symptom severity.

Methods and results: A convenience sample of 428 bereaved people who had lost a parent, spouse, or child in the last 30 to 365 days completed an online survey. Random forest regression modeling examined the effects of worry and secondary stressors on symptom severity in the context of established correlates. Results indicated worry and the number of secondary stressors experienced were among the factors most strongly associated with severity of grief, depression, posttraumatic stress and problems functioning.

Conclusions: These results also provide insight into the relative importance of worry and secondary stressors affecting grief severity to guide future research.

Background: Variation in cognitive, emotional and physical performance in response to stress is attributable to environmental and genetic factors. Ability to adapt to stress is resilience.

Objectives: This study investigated genetic factors associated with resilience in soldiers exposed to severe stress due to intense physical and mental demands at Survive, Evade, Resist and Escape school, a unique environment to study acute stress and resiliency in real-world circumstances.

Design: A preliminary correlational study was conducted to identify genetic markers for resilience to stress.

Methods: Mood state, resiliency and dissociative state of 73 soldiers were assessed using: Connor-Davidson Resilience Scale (CD-RISC); Profile of Mood States (POMS); and Clinician-Administered Dissociative States Scale (CADSS). Change scores for resilience-related stress markers were computed; 116 single nucleotide polymorphisms (SNPs) associated with stress, depression, anxiety, sleep, or psychiatric disorders were assessed.

Results: A significant association between change in CD-RISC score and SNP rs4251417, present in an intron of SLC6A4, the serotonin transporter gene, was observed.

Conclusions: Individuals with the minor allele of SNP rs4251417 had a greater positive change in CD-RISC, indicating increased self-assessed resilience. This study suggests the minor allele of SNP rs4251417 of SLC6A4 is associated with resilience when individuals are exposed to high stress.

Background and objectives: Dementia-related anxiety (DRA) is the fear or anxiety about a current or future diagnosis of Alzheimer's disease or another type of dementia. The purpose of the present study was to examine management of DRA.

Methods and design: In semi-structured qualitative interviews, 50 community-dwelling adults (58-89 years old, M = 70.80, SD = 6.02) without dementia diagnoses reflected on their thoughts and feelings about dementia. A reflexive inductive thematic approach was used to examine ways people managed DRA.

Results: We identified five themes related to managing DRA: monitoring cognitive status (e.g., self-monitoring or objective assessment); active coping strategies (e.g., using external reminders, normalizing age-related change); interpersonal relationships and support (e.g., anticipating benefit of support from others); planning and preparing for potential outcomes (e.g., securing power of attorney, saying goodbyes); and personal responsibility to manage risk or accept diagnosis (e.g., lifestyle factors to reduce dementia risk, thereby reducing risk for burdening others).

Conclusions: Findings suggest internal and external means for coping with DRA that are likely to vary in degrees of usefulness. We consider findings within the context of relevant, established theories, attending to potential clinical interventions for individuals experiencing DRA.

Background: College students with ADHD have difficulties with emotion regulation and have poorer academic skills than peers without ADHD; however, less is known regarding the relation between ADHD symptoms, maladaptive cognitive emotion regulation strategies (CERS), and learning effectiveness.Objectives: We examined whether maladaptive CERS predicted learning effectiveness, and whether this relation was moderated by ADHD symptoms.Design: A cross-sectional online survey.Methods: College students (N = 4,183; M_age = 19.24; 70.1% female) at eight universities completed a battery as part of a larger study.Results: College students in our elevated ADHD group used significantly more maladaptive CERS and performed worse in three domains of learning effectiveness (i.e., Academic Self-Efficacy [ASE], Organization and Attention to Study [OAS], Stress and Time Press [STP]) than college students in our non-ADHD group. Further, ADHD symptoms moderated the relation between maladaptive CERS and OAS, such that individuals with the highest levels of ADHD symptoms were less impacted by maladaptive CERS.Conclusion: Increased use of maladaptive CERS is unique to ADHD rather than lack of adaptive CERS. Also, maladaptive CERS and low ADHD symptoms interact to predict poor OAS. Interventions for college students, regardless of ADHD status, should incorporate emotion regulation components to improve learning effectiveness.

Anxiety can have adverse effects on cognition such as impairing test performance or restricting working memory. One way of reducing anxiety is through humor, and the present research investigated if the perception of laughter, which is often seen as a reaction to humor, could impact self-reported anxiety. Participants completed the STAI battery containing subscales for both state and trait anxiety before and after one of three manipulations: a laughter sounds rating task, a neutral sounds rating task, or a working memory span task. Results showed that perceiving laughter decreased both state and trait anxiety, taking a working memory test increased state anxiety, and perceiving neutral sounds had no effect on either type of anxiety. These findings are interpreted as evidence that the positive emotions induced by hearing laughter help to regulate anxiety by undoing arousal, even when negative emotions are not present.

Background: Adopting a person-centered approach to coping potentially allows researchers to explore the multifaceted nature of the construct. However, this increasingly adopted approach also has limitations. Namely, employing cluster or latent profile analysis to investigate coping through a person-centered lens often brings a lack of generalizability and subjectivity in interpreting the generated profiles. As such, this study aimed to explore the impact of varied methodology in person-centered investigations of coping profiles.

Methods: 682 university students' (M = 21.3 years old, SD = 3.5) responses to the COPE Inventory were analyzed across item, subscale, and higher-order category levels using cluster and latent profile analysis to produce 6 finalized models for cross-method comparison.

Results: Throughout 19 analyses, approach coping, avoidance coping, low coping, and help-seeking profiles were consistently identified, alluding to the potential of universal coping trends. However, membership overlap across COPE structures and methodology was largely inconsistent, with individual participants classified into theoretically distinct profiles based on the methodology employed.

Conclusion: While evidence suggests latent profile analysis provides a more rigorous approach, the significant impact of minor methodological variations urges a reevaluation of person-centered approaches and incorporation of multi-construct data to enhance the understanding of coping profiles.

Background: Literature underscores the importance of emotion dysregulation in clinical research. However, one critical limitation of the existing investigations in this area involves the lack of psychometrically valid measures for assessing emotion dysregulation in individuals' daily lives. This study examined the factor structure and psychometric properties of momentary versions of the Difficulties in Emotion Regulation Scale (mDERS) and the Difficulties in Emotion Regulation Scale-Positive (mDERS-P).Methods: Participants were 145 community women (M age = 40.66, 40.7% white) experiencing intimate partner violence and using substances who participated in a baseline interview and then completed surveys three times a day for 30 days.Results: Analyses supported the reliability of the mDERS and the mDERS-P. The two-state, two-trait model, with separate factors for negative and positive emotion dysregulation at both the within-and between-levels, fit the data best. Momentary negative, but not positive, emotions were positively related to the mDERS; both momentary negative and positive emotions were positively related to the mDERS-P. Baseline trait negative, but not positive, emotion dysregulation, was related to greater variability in momentary negative and positive emotion dysregulation.Conclusion: Findings advance our understanding and measurement of emotion dysregulation using intensive longitudinal approaches.

Background: While the impact of climate change on mental health, especially in young people, has been acknowledged, underlying mechanisms of this relation remain elusive. Based on research on active coping, we explored effects of agency on anxiety and coping in an experimental design. We further examined the relation between mental health (i.e., psychopathology, depressiveness, trait anxiety), trait factors (i.e., climate distress, intolerance of uncertainty, trait coping), state anxiety and coping with climate distress.Methods: 244 participants (15-25 years) watched a climate anxiety inducing video, followed by an agency manipulation (high agency vs. low agency vs. control). Trait mental health, intolerance of uncertainty, and climate distress and coping were examined as predictors of state anxiety and coping.Results: State anxiety decreased in the high agency and control conditions, but not in the low agency condition. High agency led to increased meaning-focused coping and low agency to decreased meaning- and problem-focused coping. Trait mental health, problem-focused, and meaning-focused coping strategies each predicted their respective state counterparts. Emotion-focused coping was further predicted by all trait measures.Conclusion: The findings suggest a risk of low agency communication due to the lack of arousal decrease and lack of using functional coping in young people.