Extensive functional connectivity between brain areas implicated in mental imagery production and phobic fear during both emotional and neutral mental imagery.

Mental imagery is used by most people in their day-to-day cognition, for example, in planning, daydreaming, or remembering. Importantly, mental imagery has a powerful influence on emotion and is critically involved in many mental disorders. Thus, understanding the link between mental imagery and emotion is of clinical interest. For example, exposure therapy can be successfully conducted using mental imagery of fear-provoking stimuli, i.e., imaginal exposure. In this vein, accumulating evidence shows that mental imagery of a fearful stimulus produces a similar physiological and neural response as actual perception of the stimulus. Alas, knowledge of the neural processes underlying the link between mental imagery and emotion is limited. Functional magnetic resonance imaging data from a previous study on imaginal exposure (N = 30) was used to examine the functional connectivity during the production of phobic and neutral mental imagery. Regions of interest were selected from meta-analyses on brain regions consistently recruited during mental imagery production and phobic fear, respectively. Results showed that these regions were positively correlated during both phobic and neutral mental imagery production. Very few differences in functional connectivity between phobic and neutral imagery were found. Specifically, weaker functional connectivity between the supplemental motor area and a region including parts of the left insula and inferior frontal gyrus was observed during phobic (vs neutral) imagery. In conclusion, our findings suggest that brain regions previously implicated in mental imagery production and phobic fear are highly interconnected during the production of both phobic and neutral imagery.

Trypophobia, skin disease, and the visual discomfort of natural textures.

In the last decade, the behavioral sciences have described the phenomenon of trypophobia, which is the discomfort felt by some individuals when viewing images containing clusters of bumps or holes. One evolutionary hypothesis for this phenomenon is that this visual discomfort represents an adaptation which helps organisms avoid skin disease and/or ectoparasites. Even though trypophobic imagery and disease imagery are both examples of visual textures, to date there has been no comparison of the visual discomfort elicited by these two specific kinds of textures within the larger context of the visual comfort elicited by natural texture imagery more generally. In the present study, we administered the Trypophobia Questionnaire (TQ) and recorded the visual comfort ratings elicited by a large set of standard natural texture images, including several trypophobic and skin disease images. In two independent samples, we found that while all observers find skin diseases uncomfortable to view, only those scoring high on the TQ rated trypophobic imagery equally uncomfortable. Comparable effects were observed using both standard ANOVA procedures as well as linear mixed effects modeling. Comparing the ratings of both high-TQ and low-TQ participants to the standard textures, we find remarkably consistent rank-order preferences, with the most unpleasant textures (as rated by both groups) exhibiting qualitative similarities to trypophobic imagery. However, we also find that low-level image statistics which have been previously shown to affect visual comfort are poor predictors of the visual comfort elicited by natural textures, including trypophobic and disease imagery. Our results suggest that a full understanding of the visual comfort elicited by natural textures, including those arising from skin disease, will ultimately depend upon a better understanding of cortical areas specialized for the perception of surface and material properties, and how these visual regions interact with emotional brain areas to evoke appropriate behavioral responses, like disgust.

Tocophobia experience and its impact on birth choices among Nigerian women: a qualitative exploratory study.

INTRODUCTION: while pregnancy is a very beautiful and memorable experience for most women, some women may experience apathy towards childbirth and have feelings of fear and anxiety (tocophobia). Tocophobia can be far reaching with adverse physiologic and emotional consequences for mothers, infants and families. This study therefore explored tocophobia experiences among primigravid women and explored its influence on birth choices among antenatal women. METHODS: the study employed a qualitative exploratory research design. Participants who were primigravida (women who had never experienced childbirth), were selected using purposive sampling technique on antenatal clinic days. Data was obtained using semi-structured interview questions. Data was analyzed using content analysis approach and thematic categorization. RESULTS: results showed that few of the women experienced tocophobia and these fears were not strong enough to make them opt for caesarian section. Reasons attributed to tocophobia experience among the participants included "horror stories" told in the neighborhood, "past experiences" of close acquaintance and "entertainment videos" broadcast. Furthermore, all the participants preferred to have vaginal delivery. CONCLUSION: few of the primigravid women in Ekiti State, Nigeria, experience tocophobia and this experience does not influence their choice of delivery option, as all participant´s preferred vaginal delivery to caesarian section. It is important for midwives to be aware of their role in counselling and identifying women with tocophobia in order to promote good and safe transition from pregnancy to motherhood.

Experiences of health care providers on pregnancy and childbirth care during the COVID-19 pandemic in Iran: a phenomenological study.

BACKGROUND: Coronavirus currently cause a lot of pressure on the health system. Accordingly, many changes occurred in the way of providing health care, including pregnancy and childbirth care. To our knowledge, no studies on experiences of maternity care Providers during the COVID-19 Pandemic have been published in Iran. We aimed to discover their experiences on pregnancy and childbirth care during the current COVID-19 pandemic. METHODS: This study was a qualitative research performed with a descriptive phenomenological approach. The used sampling method was purposive sampling by taking the maximum variation possible into account, which continued until data saturation. Accordingly, in-depth and semi-structured interviews were conducted by including 12 participants, as 4 gynecologists, 6 midwives working in the hospitals and private offices, and 2 midwives working in the health centers. Data were analyzed using Colaizzi's seven stage method with MAXQDA10 software. RESULTS: Data analysis led to the extraction of 3 themes, 9 categories, and 25 subcategories. The themes were as follows: "Fear of Disease", "Burnout", and "Lessons Learned from the COVID-19 Pandemic", respectively. CONCLUSIONS: Maternal health care providers experience emotional and psychological stress and work challenges during the current COVID-19 pandemic. Therefore, comprehensive support should be provided for the protection of their physical and mental health statuses. By working as a team, utilizing the capacity of telemedicine to care and follow up mothers, and providing maternity care at home, some emerged challenges to maternal care services can be overcome.

Real-life dental examination elicits physiological responses different to visual and auditory dental-related stimuli.

BACKGROUND: Previous studies on dental anxiety have examined the psychophysiological responses evoked in dentally anxious subjects by dental-related stimuli, but not during a real-life dental examination, which was achieved in the present study. METHODS: The heart rate, skin conductance level, and heart rate variability of 25 subjects with dental anxiety and 25 healthy controls were examined. Anxiety was determined by the Modified Dental Anxiety Scale and the Dental Anxiety Scale-Revised. The psychophysiological reactions of the two groups were compared during exposure to dental-related pictures, dental-related sounds, and an actual examination in a dental surgery. RESULTS: All the dental-related stimuli provoked an increase in heart rate, i.e. visual stimuli (p<0.001; 95% CI 0.98-3.95 bpm), auditory stimuli (p<0.001; 95% CI 1.34-4.99 bpm), and a dental examination (p<0.001; 95% CI 1.26-5.39 bpm). Dental-related pictures provoked inferior skin conductance level changes compared to dental-related sounds and the dental examination (visual modality vs auditory p<0.001; 95% CI 0.039-0.152; visual modality vs examination p<0.001; 95% CI 0.083-0.275). Heart rate variability manifested in a complex pattern of responses to the dental examination. However, when exposed to all three dental-related stimuli presentation conditions, the heart rate (F = 0.352, p = 0.556), skin conductance level (F = 0.009, p = 0.926), and heart rate variability parameters of subjects with dental anxiety did not differ in comparison to the healthy controls. CONCLUSIONS: This pilot study represents an evaluation of psychophysiological reactions during a real-life dental examination compared to single modality stimuli, and shows that a real-life dental examination provokes an increase in heart rate, heart rate variability and skin conductance level. Additionally, autonomic responses did not differ between the experimental and control groups. The key issue for future studies is the effect of real-life situations on the physiological and psychological state of the subjects, which should be considered when planning new research and studied in depth.

Cognitive Behavioral Therapy, Mindfulness-Based Cognitive Therapy and Acceptance Commitment Therapy for Anxiety Disorders: Integrating Traditional with Digital Treatment Approaches.

Anxiety disorders are an enormous societal burden given their high lifetime prevalence among adult populations worldwide. A variety of anxiety disorders can be successfully treated with psychological treatments such as cognitive behavioral therapy (CBT), mindfulness-based cognitive therapy (MBCT), and acceptance and commitment therapy (ACT), either as stand-alone individual or group treatment or as adjunctive treatment to pharmacotherapy. Furthermore, a growing body of evidence suggests that therapist-guided Internet-delivered CBT (iCBT) and, to some degree, digitalized mindfulness- and acceptance-based interventions may be an efficacious complement to traditional face-to-face therapy. In view of the current advances regarding the integration of traditional and innovative treatment approaches, this chapter provides an overview on the theory and evidence base for different delivery modes of CBT-related interventions for specific phobia, panic disorder, agoraphobia, social anxiety disorder, and generalized anxiety disorder in adults. Finally, implications for clinical practice and research will be derived, and future directions for the psychological treatment of anxiety disorders will be outlined.

Fear of cancer recurrence among breast cancer survivors could be controlled by prudent dietary modification with polyunsaturated fatty acids.

BACKGROUND: The pathophysiology of fear of cancer recurrence (FCR), the leading unmet psychological need of cancer survivors, may involve the dysfunctional processing of fear memory. n-3 polyunsaturated fatty acids (PUFAs) have beneficial effects on psychiatric disorders, including depressive disorder and anxiety disorders, and are involved in fear memory processing. We hypothesized that n-3 PUFA composition is associated with FCR in cancer survivors. METHODS: We conducted a cross-sectional study to examine the relationship between n-3 PUFAs and FCR among breast cancer survivors. Adults who had been diagnosed with invasive breast cancer and were not undergoing chemotherapy were asked to participate. Blood PUFA composition was evaluated by using capillary blood. We directly administered the Concerns About Recurrence Scale (CARS) to assess the grade of FCR. RESULTS: Among 126 participants used for the analysis, the mean age (SD) was 58 (11) years and 47% had stage I cancer. Multiple regression analysis controlling for possible confounders, depressive symptoms, and post-traumatic stress disorder (PTSD) symptoms revealed that the alpha-linolenic acid (ALA) level was significantly inversely associated with the average score on the CARS overall fear index (beta = -0.165, p = 0.04). No significant associations were found for other PUFAs. LIMITATIONS: Our findings were obtained from a cross-sectional study in a single institute. CONCLUSION: These findings provide the first evidence of a beneficial effect of ALA on FCR and indicate the need for prospective study of this association. FCR among breast cancer survivors might be controllable by prudent selection of ALA-containing cooking oil.

Cannabidiol enhancement of exposure therapy in treatment refractory patients with phobias: study protocol of a randomized controlled trial.

BACKGROUND: Phobic anxiety disorders are among the most prevalent psychiatric disorders and are burdensome in terms of loss of quality of life and work productivity. Evidence-based treatments are relatively successful in the majority of patients, especially exposure therapy. However, a substantial subset of patients fails to achieve or stay in remission. Preclinical and genetic research have yielded evidence that the cannabinoid system is involved in the extinction of fear, presumed to underlie the beneficial effects of exposure therapy in phobic disorders. A cannabinoid constituent that may enhance endocannabinoid signaling is cannabidiol (CBD), a non-psychoactive component of cannabis. Hence, the addition of CBD to exposure therapy is expected to strengthen effects of treatment. To determine the added benefit of CBD on exposure therapy, we conduct a randomized controlled trial, in which patients in whom previous treatment as usual has not yielded sufficient response receive either CBD or placebo preceding 8 exposure sessions in a double-blind fashion. A subsidiary aim is to explore which (combination of) clinical, behavioral and genetic profiles of patients are related to treatment response. METHODS/DESIGN: This is an 8-week multicenter, randomized, double-blind, placebo-controlled trial. Seventy-two patients with social phobia or panic disorder with agoraphobia with incomplete response to earlier treatment will be included from outpatient clinics in the Netherlands. Patients are randomized to augmentation of exposure therapy with 300 mg CBD or placebo. The study medication is administered orally, 2 h preceding each of the eight 90 min exposure sessions. Measurements will take place at baseline, first administration of medication, every session, mid-treatment, last administration of medication, post-treatment and at 3 and 6 months' follow-up. The primary outcome measure is the score on the Fear Questionnaire (FQ). In addition, determinants of the expected treatment enhancing effect of CBD will be explored. DISCUSSION: This is the first trial to investigate whether the addition of CBD to exposure therapy is effective in reducing phobic symptoms in treatment refractory patients with social phobia or panic disorder with agoraphobia. TRIAL REGISTRATION: Netherlands Trial Register NTR5100 . Registered 13 March 2015. Protocol version: issue date 17 Jan 2018, protocol amendment number 7.

Association between happiness and psychopathology in an elderly regional rural population in Crete.

Research has shown that socio-demographic profile and psychopathology symptoms are related to levels of happiness in old age. The aims of this cross-sectional study were: 1) to investigate the effect of recent stressful life events and socio-demographic factors on psychopathological symptoms in elderly residents in mountain regions of Crete, Greece and 2) to explore the mechanism which underlies the relationship between socio-demographic factors and psychopathological symptoms, with levels of happiness in old age. To this end, we used the nine psychopathology dimensions of symptoms as defined in the Symptom Checklist-90-R (SCL-90), while the Holmes and Rahe stress inventory was administered to quantify the stressful life events. A sample of 205 elderly men and women (age=77.1±6.7 years) living in 10 remote rural and isolated villages participated in this study. Data was collected through questionnaires completed upon individual meetings with each participant, with the interviewer's assistance. Each questionnaire included the two aforesaid scales alongside questions on individual socio-demographic characteristics. Analysis of variance was applied to detect socio-demographic factors that have a significant effect on specific psychopathological symptoms. Then, path analysis was applied to quantify the direct and indirect effect of the selected socio-demographic factors on happiness levels. Stressful life events were found to have no statistically significant effect on the presence of specific symptoms (somatization, psychoticism, anxiety) in elderly adults. Furthermore, certain socio-demographic factors (marital status, smoking, family income and social activity) were found to influence happiness, which varied according to the level of psycho-emotional tension. The results suggest that somatization, psychoticism, and phobic anxiety symptoms are psychic reactions independent of recent stressful life events. Our study,despite its regional character, may contribute in the development of appropriate clinical assessment tools and interventions, helping primary care practitioners to approach elderly people living in remote villages in a more appropriate and holistic manner, improving thereby the effectiveness of their interventions.

Gain through pain: Augmenting in vivo exposure with enhanced attention to internal experience leads to increased resilience to distress.

Recent variants of exposure therapy ask clients to directly engage with the distress associated with avoided experiences in order to become more resilient to future anxiety-provoking situations. In this study, we consider how this engagement impacts behavioral willingness. Forty-eight participants with high fear of cockroaches completed in vivo exposures while either mindfully attending externally to the feared object (Ext), or to both the object and their internal distress (Int/Ext). While both groups showed improvement, behavioral, subjective and physiological measures revealed different patterns of change. Immediate testing showed that participants in the Ext condition improved more in subjective distress, with no other differences between groups. A second testing a week later in an ecologically valid environment showed that participants the Int/Ext intervention continued to improve behaviorally, regardless of their reported subjective discomfort. These findings highlight the importance of explicit engagement with distress during exposures, that forego immediate subjective relief for long-term behavioral improvement.

Utilization of health care services in cancer patients with elevated fear of cancer recurrence.

BACKGROUND: Cancer patients commonly report experiencing fear of cancer recurrence (FCR), which may lead to several negative consequences. This study aimed at examining whether clinical levels of FCR are linked to a greater use of health care services. METHOD: This is a secondary analysis of a longitudinal study of 962 cancer patients on the epidemiology of cancer-related insomnia. They completed the Fear of Cancer Recurrence Inventory-Short form (FCRI-SF) and reported information on their consultations (medical, psychosocial, and complementary and alternative medicine [CAM]) and medication usage (anxiolytics/hypnotics and antidepressants) at 6 time points over an 18-month period. RESULTS: Results indicated that clinical FCR at baseline was associated with greater consultation rates of medical and psychosocial professionals and a greater usage of anxiolytics/hypnotics and antidepressants. No significant association was found between the FCR level and use of CAM services. While consultation rates of medical and CAM professionals and usage of antidepressants generally increased over time, consultation rates of psychosocial professionals and usage of anxiolytics/hypnotics tended to decrease. CONCLUSIONS: Cancer patients with clinical levels of FCR are more likely to consult health care providers and to use psychotropic medications, which may translate into significant costs for society and the patients themselves.

Mind-body interventions for fear of cancer recurrence: A systematic review and meta-analysis.

OBJECTIVE: Fear of cancer recurrence (FCR) is a common existential concern and source of distress among adults with a cancer history. Multiple randomized controlled trials (RCTs) have examined mind-body approaches to mitigating FCR. We summarized characteristics of these trials and calculated their pooled effects on decreasing FCR. METHODS: Six electronic databases were systematically searched from inception to May 2017, using a strategy that included multiple terms for RCTs, cancer, mind-body medicine, and FCR. Data extraction and reporting followed Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Pooled effect sizes on self-report measures of FCR were computed by using random-effects models. RESULTS: Nineteen RCTs (pooled N = 2806) were included. Most studies (53%) were published since 2015 and targeted a single cancer type (84%; mostly breast). Intervention sessions (median = 6, mode = 4) tended to last 120 minutes and occur across 1.5 months. Delivery was predominantly in-person (63%) to either groups (42%) or individuals (42%). Most interventions incorporated multiple mind-body components (53%), commonly cognitive-behavioral skills (58%), or meditative practices (53%). Small-to-medium pooled effect sizes were observed postintervention (Hedges' g = -0.36, 95% CI = -0.49, -0.23, P < .001) and at follow-up assessments (median = 8 months, P < .001). Potential modifiers (control group design, group/individual delivery, use of cognitive-behavioral or mindfulness skills, number of mind-body components, cancer treatment status, and number of sessions) did not reach statistical significance. CONCLUSIONS: Mind-body interventions are efficacious for reducing FCR, with small-to-medium effect sizes that persist after intervention delivery ends. Recommendations include testing effects among survivors of various cancers and exploring the optimal integration of mind-body practices for managing fundamental uncertainties and fears during cancer survivorship.

The impact of affect labelling on responses to aversive flying-cues.

Individuals with flying phobia experience increases in subjective anxiety in response to flying-related cues. However, the cognitive processes that contribute to cue-reactive anxiety in individuals with flying-related anxiety remain poorly understood. Preliminary research suggests that changes in visual imagery and volitional control may contribute to this cue-reactive anxiety. Engaging in affect labelling during exposure therapy has been shown to reduce cue-reactive anxiety in individuals with fears relating to a variety of stimuli but has not been investigated in the fear of flying. The present study recruited 110 participants with a range of flying-related anxiety scores to complete an online cue-reactivity experiment. The study sought to evaluate whether an aversive flying cue triggered changes in imagery, volitional control and anxiety, and whether changes in imagery and volitional control predicted level of cue-reactive anxiety. Participants were randomly allocated to an affect labelling or non-affect labelling condition to additionally assess whether engaging in labelling one's emotion following exposure to an aversive flying cue would attenuate cue-reactive changes in anxiety relative to a group who did not. Significant cue-reactive changes in anxiety, and volitional control were observed from neutral to aversive flying cue were observed. After accounting for the effects of flying anxiety severity, only volitional control significantly improved the prediction of cue-reactive anxiety. Participants in the affect labelling condition reported significantly smaller increases in anxiety than the non-affect labelling group following exposure to the aversive flight cue. This is the first study to indicate affect labelling may help to regulate aspects of cue-reactive anxiety in response to aversive flying stimuli.

Treatment of Storm Fears Using Virtual Reality and Progressive Muscle Relaxation.

BACKGROUND: The present study examined the efficacy of virtual reality (VR) exposure therapy for treating individuals with storm fears by comparing a one-session VR exposure treatment with a one-session progressive muscle relaxation (PMR) and psychoeducation session. AIMS: It was predicted that there would be a reduction in storm-related fear post-treatment for individuals in both conditions, but that this reduction would be greater for those in the VR exposure condition. It was predicted that improvements would be maintained at 30-day follow-up only for those in the VR exposure condition. METHOD: Thirty-six participants each received one of the two treatment conditions. Those in the PMR treatment group received approximately 30 minutes of PMR and approximately 15 minutes of psychoeducation regarding storms. Those in the VR treatment group received approximately 1 hour of VR exposure. Additionally, participants were asked to complete a pre-treatment and post-treatment 5-minute behavioural approach test to assess changes in storm fears. They were also asked to complete a measure assessing storm phobia. RESULTS: There was a significant interaction between treatment group and self-reported fear at post-treatment, such that fear decreased for both groups, although the reduction was stronger in the VR group. Results also showed that reductions in storm fear were maintained at 30-day follow-up for both groups. CONCLUSIONS: Although this study used a small non-clinical sample, these results offer preliminary support for the use of VR exposure therapy in the treatment of storm-related fear.

Play-Modified One-Session Treatment for Young Children with a Specific Phobia of Dogs: A Multiple Baseline Case Series.

The one-session treatment (OST) approach for SPs is deemed well-established, and has been found to be highly effective for older children and adults; however, has not yet been trialled with very young children. The present study examines the preliminary effectiveness of play-modified OST for young children with a SP of dogs, using a multiple baseline controlled case series design. Treatment involved play modified one-session of intensive cognitive-behavioural therapy (OST plus Play) which was followed by brief telephone delivered maintenance calls over the 3 weeks immediately following treatment. Four young children (4 years of age) participated and symptoms were assessed at pre-treatment, across a 1-3 week baseline phase, immediately following the OST plus Play, and at 1 and 3 months follow-up. Visual inspection provided evidence for stability of symptoms across the baseline phase, followed by reductions in symptoms over the course of treatment and follow-up. Non-parametric analyses offered further support, with significant improvements in following the intensive OST plus Play intervention.

Individual Differences in the Relationship Between Attachment and Nomophobia Among College Students: The Mediating Role of Mindfulness.

BACKGROUND: There is a growing interest in nomophobia, which is defined as the fear of being out of cellular phone contact, or "feelings of discomfort or anxiety experienced by individuals when they are unable to use their mobile phones or utilize the affordances these devices provide". However, only limited research can be found in terms of its determinants at present. Contemporary literature suggests that the relationships among attachment styles, mindfulness, and nomophobia have not been investigated. OBJECTIVE: This study aims to investigate the mediating effect of mindfulness on the relationship between attachment and nomophobia. In addition, the study also focuses on gender differences in attachment, mindfulness, and nomophobia. A theory-based structural model was tested to understand the essentials of the associations between the constructs. METHODS: The Experiences in Close Relationships Scale, Nomophobia Questionnaire, and Mindful Attention Awareness Scale were used to collect data from undergraduate students (N=450; 70.9% women [319/450]; mean age=21.94 years [SD 3.61]). Two measurement models (ie, attachment and mindfulness) and a structural model were specified, estimated, and evaluated. RESULTS: The structural equation model shows that the positive direct effects of avoidant (.13, P=.03) and anxious attachment (.48, P<.001) on nomophobia were significant. The negative direct effects of avoidant (-.18, P=.01) and anxious attachment (-.33, P<.001) on mindfulness were also significant. Moreover, mindfulness has a significant negative effect on nomophobia for women only (-.13, P=.03). Finally, the Sobel test showed that the indirect effects of avoidant and anxious attachment on nomophobia via mindfulness were significant (P<.001). The direct and indirect effects of anxious attachment, avoidant attachment, and mindfulness altogether accounted for 33% of the total variance in nomophobia. Gender comparison results show that there is a significant difference in attachment based on gender (F2,447=6.97, P=.01, Wilk λ=.97, partial η2=.03). Women (mean 68.46 [SD 16.96]) scored significantly higher than men (mean 63.59 [SD 15.97]) in anxious attachment (F1=7.93, P=.01, partial η2=.02). Gender differences in mindfulness were not significant (F4,448=3.45, P=.69). On the other hand, results do show significant gender differences in nomophobia (F4,445=2.71, P=.03, Wilk λ=.98, partial η2=.02) where women scored significantly higher than men. CONCLUSIONS: In general, individuals who are emotionally more dependent and crave more closeness and attention in the relationship tend to display higher levels of fear or discomfort when they have no access to their mobile phones. However, gender has a differential impact on the relationship between avoidant attachment and nomophobia. This study establishes the impact of mindfulness on nomophobia for women; therefore, future studies should test the effectiveness of mindfulness-based therapy approaches and confirm whether they are effective and efficient. On the basis of significant gender difference in nomophobia and attachment, we conclude that gender should be taken into account in mindfulness-based treatments dealing with nomophobia.

Anorexia: Anormal Phobia of Normal Weight.

Anorexia nervosa is a disorder of feeding behavior associated with distortion of body image, mood disturbance and a wide variety of hormonal and metabolic abnormalities. It is supposed that the disease could be the consequence of a combination of cultural-social, psychological and biological factors. Our study confirmed that anorexia mentalis is a serious, life threatening disorder which in our country appears earlier than it was expected and that is strongly related to environmental factors (family, school, fashion, society). We showed that specific personality traits are characteristic for both, young patients and mothers. Sublimation of emotional stress by exceptional performances, accompanied by food restrictive consumption together with hypersensitivity, oppositional behavior and aggression are specific for this disorder. High levels of self-imposed standards increase the risk for psychological distress, especially for eating disorder symptomatology. Both genders could be involved as patients. Boys must be especially followed for possible psychiatric manifestation. We confirmed that the biofeedback as additional therapeutic modality is very useful.

Psychophysiological and self-reported reactivity associated with social anxiety and public speaking fear symptoms: Effects of fear versus distress.

This study examines psychophysiological and subjective reactivity to anxiety-provoking situations in relation to social anxiety and public speaking fear. We hypothesized that social anxiety symptoms would be associated with similar reactivity across types of imaginary anxiety scenes and not specifically to social anxiety-related scenes. This would be attributed to co-existing depression symptoms. Public speaking fear was expected to be associated with more circumscribed reactivity to survival-threat scenes, due to its association with fearfulness. Community participants imagined standardized anxiety situations, including social anxiety and animal fear scenes, while their physiological reactivity and self-reported emotions were assessed. Findings supported that social anxiety was associated with undifferentiated physiological reactivity across anxiety-provoking situations, except with regards to skin conductance level, which was higher during social anxiety imagery. Public speaking fear was associated with increased reactivity to animal phobia and panic scenes. Covariance analyses indicated that the lack of response specificity associated with social anxiety could be attributed to depression levels, while the specificity associated with public speaking fear could be explained by fearfulness. Findings highlight the need to assess not only primary anxiety symptoms but also depression and fearfulness, which likely predict discrepant reactions of individuals to anxiogenic situations.