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1.
medRxiv ; 2024 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-38712129

RESUMEN

The COVID-19 pandemic had a significant impact on mental health, straining an already overburdened healthcare system. A modular, transdiagnostic approach to treating psychopathology may be ideal to target common transdiagnostic risk factors for emotional distress and related disorders likely to be impacted by circumstances related to this once-in-a-lifetime environmental stressor. Anxiety sensitivity (AS), or fear of anxious arousal, intolerance of uncertainty (IU), or distress when confronted with uncertainty, and loneliness are three transdiagnostic risk factors impacted by the pandemic and robust predictors of emotional distress beyond that. We completed a pilot feasibility, acceptability, and utility trial of Coping Crew, our group, telehealth-delivered transdiagnostic treatment protocol in 17 participants who completed the intervention (M age = 22.00, SD = 4.46; 71% female). The intervention and study protocol were feasible to deliver and were rated as acceptable and useful to address intervention targets. Evidence was mixed regarding feasibility, acceptability, and usefulness of the mobile app component. Sixteen of 17 participants (94%) completed at least one survey a day on 80% of the days but only 6 participants (35%) completed at least 80% of the mobile app surveys delivered over the course of the intervention. Most participants rated use of the app as acceptable and relevant to psychological improvements made due to the intervention. Sizeable effect size reductions in transdiagnostic risk factors were found at post-intervention and maintained at 1- and 3-month follow-up, supporting next steps in the development of this modular transdiagnostic treatment.

2.
Cogn Behav Ther ; 53(2): 190-206, 2024 03.
Artículo en Inglés | MEDLINE | ID: mdl-38014462

RESUMEN

Social anxiety disorder is one of the most prevalent anxiety disorders. There is a need to develop brief, virtual, single-session interventions targeting constructs associated with social anxiety, such as anxiety sensitivity social concerns (ASSC). ASSC is the maladaptive belief about consequences arising from observable symptoms of anxious arousal. This study was designed to evaluate the initial acceptability and feasibility of a brief ASSC reduction program (Brief Observable Anxiety Sensitivity Treatment [BOAST]) which included a single clinician-led intervention session followed by a two-week ecological momentary intervention (EMI), delivered via mobile app. Participants (N = 36) were adults with elevated ASSC who were randomly assigned to receive BOAST (n = 19) or a waitlist control (n = 17). The trial was prospectively registered at clinicaltrials.gov (NCT04859790). Results supported the acceptability of BOAST with mixed findings for feasibility. Feasibility metrics for the EMI component were below pre-defined thresholds; however, there was evidence that homework completion was associated with symptom reduction. Preliminary efficacy metrics indicated that participants in the BOAST condition had large reductions in ASSC and one measure of social anxiety at 1-month follow-up. This study provides preliminary support for the acceptability of BOAST and elucidates avenues for future clinical and research efforts.


Asunto(s)
Ansiedad , Intervención en la Crisis (Psiquiatría) , Adulto , Humanos , Estudios de Factibilidad , Proyectos Piloto , Ansiedad/terapia , Ansiedad/diagnóstico , Trastornos de Ansiedad/terapia
3.
Br J Clin Psychol ; 62(4): 717-730, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37493004

RESUMEN

BACKGROUND: Perseverative thought (PT) is a transdiagnostic construct associated with internalizing disorders. Bifactor models have shown that PT can be split into a general PT factor and lower-order factors for specific forms of PT, such as rumination and worry. No bifactor study to date has investigated if the structure of PT differs across sexes. METHODS: The study consisted of 280 individuals recruited for a larger study targeting risk factors for suicidal ideation and behaviours. Participants completed a diagnostic interview and self-report questionnaires. RESULTS: A two-factor model of PT fit best in males, whereas a bifactor model fit best in females. In a structural equation model, worry was associated with generalized anxiety disorder diagnoses in females, but not males. Rumination was associated with depressive disorder diagnoses in females, but not males. CONCLUSIONS: The present study contributes to a growing literature on PT; we found that dimensionality of PT varied by sex. We also found that relations between PT factors and generalized anxiety disorder differed by sex. Sex differences in the internalizing spectrum and related risk factors need to be considered when examining the structure and function of risk factors.


Asunto(s)
Ansiedad , Caracteres Sexuales , Humanos , Masculino , Femenino , Trastornos de Ansiedad , Ideación Suicida , Encuestas y Cuestionarios
4.
Cogn Behav Ther ; 51(3): 217-228, 2022 05.
Artículo en Inglés | MEDLINE | ID: mdl-34698606

RESUMEN

Intolerance of uncertainty (IU) and anxiety sensitivity (AS) predict distress during the COVID-19 pandemic. However, little is known about how AS and IU jointly predict COVID-19 worries and behaviors. Structural equation modeling was used to examine the direct and interactive effects of AS and IU as related to COVID-19 worries and behaviors in two samples of community adults recruited in April 2020 (N = 642; M age = 38.50 years, SD = 10.00) and May 2020 (N = 435; M age = 34.92 years, SD = 14.98). In sample 1, there was a significant AS by IU interaction predicting COVID-19-related catastrophizing worries, stockpiling, and cleaning behaviors such that the relationship of AS to COVID-19-related behaviors was stronger at high levels of IU. However, although AS predicted some COVID-19 related worries and behaviors, AS and IU did not interact in sample 2. Across samples, AS was directly related to financial and health worries, whereas IU was not a significant predictor after controlling for AS. These findings suggest AS consistently impacts COVID-19 worries and behaviors, particularly among individuals with high IU. Brief interventions targeting AS and IU may help people cope during the COVID-19 pandemic and reintegrate following the pandemic.


Asunto(s)
COVID-19 , Adulto , Ansiedad , Humanos , Pandemias , Factores de Riesgo , Incertidumbre
5.
J Psychopathol Behav Assess ; 44(2): 326-343, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34518734

RESUMEN

In addition to impacting the physical health of millions of Americans, the novel-coronavirus (COVID-19) pandemic is a significant psychological stressor due to both the threat of the illness itself and the mitigation strategies used to contain the spread. To facilitate understanding of the impact of COVID-19, validated measures are needed. Using a stepwise procedure in line with best-practice measurement procedures, the current report summarizes the procedures employed to create the COVID-19 Impact Battery (CIB). Two independent samples recruited via Amazon Mechanical Turk (N = 175, N = 642) and a third community sample (N = 259) were used for reliability and validity testing. Validation procedures yielded a battery consisting of three scales assessing COVID-19 related behaviors, worry, and disability. The behaviors scale contains three subscales assessing stockpiling, cleaning, and avoidance. The worry subscale also contains three subscales assessing health, financial and catastrophic concerns. In addition, we created a short version of the battery (CIB-S) to allow for more flexibility in data collection. In summary, we have provided reliability and validity information for the CIB and CIB-S, demonstrating that these measures can facilitate evaluation of the broad impact of COVID-19 on mental health functioning.

6.
Psychiatry Res ; 304: 114144, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34364010

RESUMEN

Public health measures enacted early in response to the COVID-19 pandemic resulted in unprecedented physical isolation. Social isolation, or the objective experience of being alone, and loneliness, the subjective feeling of being lonely, are both implicated in suicidal ideation. Anxiety sensitivity (i.e., fear of somatic anxiety) and intolerance of uncertainty (distress due to uncertainty), may also be heightened in response to the pandemic increasing risk for suicidal ideation in response to social isolation and loneliness. The direct and interactive relations loneliness, anxiety sensitivity, and intolerance of uncertainty shared with suicidal ideation were examined using structural equation modeling across two samples. Sample 1 comprised 635 people (M age = 38.52, SD = 10.00; 49.0% female) recruited using Mechanical Turk in May 2020. Sample 2 comprised 435 people (M age = 34.92, SD = 14.98; 76.2% female) recruited from faculty, staff, and students at a midwestern university in June 2020. Loneliness and anxiety sensitivity were positively, uniquely associated with suicidal ideation across samples. Results of this study were cross-sectional and included only self-report measures. These findings highlight loneliness and anxiety sensitivity as important correlates of suicidal ideation. Modular treatments should be employed to target these mechanisms to reduce COVID-19-related suicidal ideation.


Asunto(s)
COVID-19 , Ideación Suicida , Adulto , Ansiedad/epidemiología , Estudios Transversales , Femenino , Humanos , Soledad , Masculino , Pandemias , Factores de Riesgo , SARS-CoV-2 , Incertidumbre
7.
Cogn Behav Ther ; 50(3): 246-260, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33787448

RESUMEN

The COVID-19 pandemic has resulted in dramatic changes to sleep patterns and higher prevalence of insomnia, which threaten overall mental and physical health. We examined whether safety behaviors in response to COVID-19, worry in response to COVID-19, and depression predicted insomnia, with age, race, and sex as covariates. A community sample from the United States (n = 321, Mage = 40.02, SD = 10.54; 53.6% female) recruited using online crowdsourcing completed self-report measures in May of 2020 and again three months later. At baseline, our model accounted for 68.1% of the variance in insomnia, with depression as the only significant predictor (ß = .70, p < .001). In the longitudinal analyses, only baseline insomnia symptoms predicted 3-month follow-up insomnia symptoms (ß = .70, p < .001; 67.1% of variance). Of note, COVID-19 worry and some COVID-19 safety behaviors were related to 3-month follow-up safety behaviors, but not insomnia. Our findings demonstrated that depression is an important factor to consider for concurrent insomnia symptoms. Our results have implications regarding the development of interventions for insomnia during the COVID-19 pandemic and suggest that clinicians should consider depression when assessing for and treating insomnia symptoms.


Asunto(s)
Ansiedad/epidemiología , COVID-19/psicología , Depresión/epidemiología , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Adulto , Ansiedad/fisiopatología , Depresión/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Prevalencia , Factores de Riesgo , Autoinforme , Sueño/fisiología , Trastornos del Inicio y del Mantenimiento del Sueño/psicología
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