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1.
Br J Nurs ; 32(2): 82-87, 2023 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-36715530

RESUMO

BACKGROUND: The COVID-19 pandemic affected cancer patients regardless of the stage of their diagnosis or treatment. AIMS: To understand the experiences of cancer patients who were referred for a clinical trial at that time. METHOD: Cancer patients who attended their initial research outpatient appointment to discuss the possibility of taking part in a clinical trial were asked to complete the Generalised Anxiety Disorder Assessment questionnaire, and take part in semi-structured interviews. FINDINGS: Data indicated that, on average, patients had moderate levels of anxiety. Three major themes emerged from patients' interviews, which gave an insight into what they experienced during this challenging period. CONCLUSION: This study gives an insight into the experiences of cancer patients who were referred for a clinical trial at the height of the COVID-19 pandemic. It illustrated the impact of social distancing and the effect of virus-related fear on cancer patients' mental health.


Assuntos
COVID-19 , Neoplasias , Humanos , Pandemias , Neoplasias/terapia , Ansiedade , Transtornos de Ansiedade
2.
BMC Psychiatry ; 23(1): 7, 2023 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-36597066

RESUMO

BACKGROUND: Many refugees suffer from mental health problems due to stressful and traumatic events before, during, and after migration. However, refugees are facing a wide variety of barriers, limiting their access to mental health care. Internet-based tools, available in several languages, could be one way to increase the availability of mental health services for refugees. The present study aimed to develop and test a screening tool to screen for clinically relevant symptoms of psychiatric disorders common among refugees (i.e. Depression, Anxiety, Post-traumatic stress disorder, and Insomnia). We, designed, translated, and adapted an internet-based tiered screening procedure suitable for use with the largest refugee populations residing in Sweden. The tool aims to accurately identify symptoms of mental distress (Tier 1), differentiate between symptoms of specific psychiatric disorders (Tier 2), and assess symptom severity (Tier 3). We tested the overall efficiency of using a tiered screening procedure. METHODS: Seven hundred fifty-seven refugees residing in Sweden, speaking any of the languages Arabic, Dari, Farsi, English, or Swedish, completed an online questionnaire following a three-tiered procedure with screening instruments for each tier. In this study, the Tier 3 scales were used as reference standards for clinically relevant symptoms, to evaluate screening efficiency in terms of accuracy and reduction of item burden in previous tiers. RESULTS: The results show that the tiered procedure could reduce the item burden while maintaining high accuracy, with up to 86% correctly assessed symptoms and few false negatives with moderate symptoms and above (at most 9%), and very few with severe symptoms (at most 1.3%). DISCUSSION: This study generated an accurate screening tool that efficiently identifies clinically relevant symptoms of common psychiatric disorders among refugees. Using an adapted online tiered procedure to screen for multiple mental health issues among refugees has the potential to facilitate screening and increase access to mental health services for refugees. We discuss the utility of the screening tool and the necessity of further evaluation.


Assuntos
Refugiados , Transtornos de Estresse Pós-Traumáticos , Humanos , Saúde Mental , Refugiados/psicologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologia , Ansiedade , Transtornos de Ansiedade/diagnóstico
3.
PLoS One ; 18(1): e0280054, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36603005

RESUMO

BACKGROUND: Infertility is a very distressing condition. It is often associated with long-term stress, which can emerge as anxiety and depression. AIM: To understand the effect of socio-demographic variables, reproductive trajectories, and lifestyle variables on stress, depression, and anxiety independently and to understand the relationship of psychological variables with each other among infertile and fertile women. METHODS: This cross-sectional study recruited 500 women which included 250 primary infertile cases and 250 age-matched fertile controls of the age group 22-35 years. A pretested modified interview schedule was administered which included demographic variables, lifestyle variables, and reproductive trajectories. In addition, psychological tools like PSS, GAD-7, and PHQ-9 were used to collect the data pertaining to Stress, anxiety, and depression, respectively. Data analysis was performed with the statistical software version SPSS, IBM version 24. RESULTS: Infertile women are more prone to various psychological disorder (stress, anxiety and depression). None of the demographic and lifestyle variables were associated with stress, anxiety, and depression among infertile women. Only reproductive trajectories were found to be causing stress, anxiety, and depression respectively among infertile women. In addition, stress is leading to both anxiety and depression among infertile women but only to depression in fertile women. CONCLUSION: Infertile women should be counselled by medical experts regarding reproductive trajectories. Infertile couples should be guided and counselled to incorporate mental health screening and treatment in their routine check-up.


Assuntos
Infertilidade Feminina , Infertilidade , Transtornos Mentais , Humanos , Feminino , Adulto Jovem , Adulto , Infertilidade Feminina/terapia , Estudos Transversais , Transtornos Mentais/complicações , Transtornos Mentais/epidemiologia , Infertilidade/epidemiologia , Infertilidade/psicologia , Ansiedade/epidemiologia , Ansiedade/etiologia , Transtornos de Ansiedade/psicologia , Depressão/epidemiologia , Depressão/etiologia
4.
Behav Ther ; 54(1): 1-13, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36608967

RESUMO

Although studies have identified differences between fear and disgust conditioning, much less is known about the generalization of conditioned disgust. This is an important gap in the literature given that overgeneralization of conditioned disgust to neutral stimuli may have clinical implications. To address this knowledge gap, female participants (n = 80) completed a Pavlovian conditioning procedure in which one neutral food item (conditioned stimulus; CS+) was followed by disgusting videos of individuals vomiting (unconditioned stimulus; US) and another neutral food item (CS-) was not reinforced with the disgusting video. Following this acquisition phase, there was an extinction phase in which both CSs were presented unreinforced. Importantly, participants also evaluated generalization stimuli (GS+, GS-) that resembled, but were distinct from, the CS after each conditioning phase. As predicted, the CS+ was rated as significantly more disgusting and fear inducing than the CS- after acquisition and this pattern persisted after extinction. However, disgust ratings of the CS+ after acquisition were significantly larger than fear ratings. Participants also rated the GS+ as significantly more disgusting, but not fear inducing, than the GS- after acquisition. However, this effect was not observed after extinction. Disgust proneness did predict a greater increase in disgust and fear ratings of the CS+ relative to the CS- after acquisition and extinction. In contrast, trait anxiety predicted only higher fear ratings to the CS+ relative to the CS- after acquisition and extinction. Disgust proneness nor trait anxiety predicted the greater increase in disgust to the GS+ relative to the GS- after acquisition. These findings suggest that while conditioned disgust can generalize, individual difference variables that predict generalization remain unclear. The implications of these findings for disorders of disgust are discussed.


Assuntos
Asco , Humanos , Feminino , Individualidade , Extinção Psicológica , Condicionamento Clássico , Transtornos de Ansiedade
5.
Behav Ther ; 54(1): 77-90, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36608979

RESUMO

Although youth anxiety treatment research has focused largely on severe and impairing anxiety levels, even milder anxiety levels, including levels that do not meet full criteria for a diagnosis, can be impairing and cause for concern. There is a need to develop and test viable treatments for these concerning anxiety levels to improve functioning and reduce distress. We present findings from a randomized controlled efficacy trial of attention bias modification treatment (ABMT) and attention control training (ACT) for youths with concerning anxiety levels. Fifty-three clinic-referred youths (29 boys, M age = 9.3 years, SD age = 2.6) were randomized to either ABMT or ACT. ABMT and ACT consisted of attention-training trials in a dot-probe task presenting angry and neutral faces; probes appeared in the location of neutral faces in 100% of ABMT trials and 50% of ACT trials. Independent evaluators provided youth anxiety severity ratings; youths and parents provided youth anxiety severity and global impairment ratings; and youths completed measures of attention bias to threat and attention control at pretreatment, posttreatment, and 2-month follow-up. In both arms, anxiety severity and global impairment were significantly reduced at posttreatment and follow-up. At follow-up, anxiety severity and global impairment were significantly lower in ACT compared with ABMT. Attention control, but not attention bias to threat, was significantly improved at follow-up in both arms. Changes in attention control and attention focusing were significantly associated with changes in anxiety severity. Findings support the viability of attention training as a low-intensity treatment for youths with concerning anxiety levels, including levels that do not meet full criteria for a diagnosis. Superior anxiety reduction effects in ACT highlight the critical need for mechanistic research on attention training in this population.


Assuntos
Viés de Atenção , Terapia Cognitivo-Comportamental , Masculino , Humanos , Adolescente , Criança , Pré-Escolar , Resultado do Tratamento , Transtornos de Ansiedade/terapia , Ansiedade/terapia
6.
Trials ; 24(1): 15, 2023 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-36609355

RESUMO

BACKGROUND: Globally, around 13% of children experience dental anxiety (DA). This group of patients frequently miss dental appointments, have greater reliance on treatment under general anaesthesia (GA) and have poorer oral health-related quality of life (OHRQoL) than their non-dentally anxious peers. Recently, a low-intensity cognitive behavioural therapy (CBT)-based, self-help approach has been recommended for management of childhood anxiety disorders. A feasibility study conducted in secondary care found this guided self-help CBT resource reduced DA and a randomised controlled trial was recommended. The present study aims to establish the clinical and cost-effectiveness of a guided self-help CBT intervention to reduce DA in children attending primary dental care sites compared to usual care. METHODS: This 4-year randomised controlled trial will involve 600 children (aged 9-16 years) and their parent/carers in 30 UK primary dental care sites. At least two dental professionals will participate in each site. They will be assigned, using random allocation, to receive the CBT training and deliver the intervention or to deliver usual care. Children with DA attending these sites, in need of treatment, will be randomly allocated to be treated either by the intervention (CBT) or control (usual care) dental professional. Children will complete questionnaires relating to DA, OHRQoL and HRQoL before treatment, immediately after treatment completion and 12 months post-randomisation. Attendance, need for sedation/GA and costs of the two different approaches will be compared. The primary outcome, DA, will be measured using the Modified Child Dental Anxiety Scale. Scores will be compared between groups using a linear mixed model. DISCUSSION: Treating dentally anxious patients can be challenging and costly. Consequently, these children are frequently referred to specialist services for pharmacological interventions. Longer waiting times and greater travel distances may then compound existing healthcare inequalities. This research will investigate whether the intervention has the potential to reduce DA and improve oral health outcomes in children over their life-course, as well as upskilling primary dental healthcare professionals to better manage this patient group. TRIAL REGISTRATION: This clinical trial has been registered with an international registry and has been allocated an International Standard Randomised Controlled Trial Number (ISRCTN27579420).


Assuntos
Terapia Cognitivo-Comportamental , Qualidade de Vida , Humanos , Criança , Ansiedade ao Tratamento Odontológico/diagnóstico , Ansiedade ao Tratamento Odontológico/prevenção & controle , Transtornos de Ansiedade , Inquéritos e Questionários , Análise Custo-Benefício , Resultado do Tratamento , Ensaios Clínicos Controlados Aleatórios como Assunto
7.
Transl Psychiatry ; 13(1): 4, 2023 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-36609484

RESUMO

The authors sought to characterize adverse posttraumatic neuropsychiatric sequelae (APNS) symptom trajectories across ten symptom domains (pain, depression, sleep, nightmares, avoidance, re-experiencing, anxiety, hyperarousal, somatic, and mental/fatigue symptoms) in a large, diverse, understudied sample of motor vehicle collision (MVC) survivors. More than two thousand MVC survivors were enrolled in the emergency department (ED) and completed a rotating battery of brief smartphone-based surveys over a 2-month period. Measurement models developed from survey item responses were used in latent growth curve/mixture modeling to characterize homogeneous symptom trajectories. Associations between individual trajectories and pre-trauma and peritraumatic characteristics and traditional outcomes were compared, along with associations within and between trajectories. APNS across all ten symptom domains were common in the first two months after trauma. Many risk factors and associations with high symptom burden trajectories were shared across domains. Both across and within traditional diagnostic boundaries, APNS trajectory intercepts, and slopes were substantially correlated. Across all domains, symptom severity in the immediate aftermath of trauma (trajectory intercepts) had the greatest influence on the outcome. An interactive data visualization tool was developed to allow readers to explore relationships of interest between individual characteristics, symptom trajectories, and traditional outcomes ( http://itr.med.unc.edu/aurora/parcoord/ ). Individuals presenting to the ED after MVC commonly experience a broad constellation of adverse posttraumatic symptoms. Many risk factors for diverse APNS are shared. Individuals diagnosed with a single traditional outcome should be screened for others. The utility of multidimensional categorizations that characterize individuals across traditional diagnostic domains should be explored.


Assuntos
Smartphone , Transtornos de Estresse Pós-Traumáticos , Humanos , Ansiedade/psicologia , Transtornos de Ansiedade , Fatores de Risco , Sobreviventes/psicologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico
8.
Artigo em Inglês | MEDLINE | ID: mdl-36613122

RESUMO

Globally, depression and anxiety are major public health concerns with onset during adolescence. While rural Australia experiences overall lower health outcomes, variation in mental health prevalence rates between rural and urban Australia is unclear. The aim of this paper was to estimate the pooled prevalence rates for depression and anxiety among young Australians aged between 10 and 24 years. Selected studies from a systematic literature search were assessed for risk of bias. Random effects model using DerSimonian and Laird method with Freeman-Tukey Double Arcsine Transformation was fitted. Sensitivity analyses were performed. Prevalence estimates were stratified by region and disorder. The overall pooled prevalence of depression and anxiety was 25.3% (95% CI, 19.9-31.0%). In subgroup analysis, anxiety prevalence was 29.9% (95% CI, 21.6-39.0%); depression: 21.3% (95% CI, 14.9-28.5%); and depression or anxiety: 27.2% (95% CI, 20.3-34.6%). Depression and anxiety prevalence were higher in urban 26.1% (95% CI, 17.3-35.9%) compared to rural areas 24.9% (95% CI, 17.5-33%), although the difference was not statistically significant. The heterogeneity was high with an I2 score of 95.8%. There is need for further research on healthcare access, mental health literacy and help-seeking attitude in Australia.


Assuntos
Transtornos de Ansiedade , Depressão , Adolescente , Humanos , Criança , Adulto Jovem , Adulto , Depressão/epidemiologia , Prevalência , Austrália/epidemiologia , Transtornos de Ansiedade/epidemiologia , Ansiedade/epidemiologia
9.
Medicine (Baltimore) ; 102(1): e32614, 2023 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-36607868

RESUMO

BACKGROUND: To assess the effect of acupoint stimulation for Alcohol use disorders (AUD). METHODS: AUD is a complex disease that threatens the health of the global population. Acupoint stimulation, a sort of therapy applying stimulation on acupoints to produce a therapeutic effect without side effects, has been widely used in AUD patients, but its efficacy remains controversial. Electronic databases (the Cochrane Library, EMBASE, PubMed, CNKI, VIP, Wan-Fang) were systematically searched for randomized controlled trials (RCTs) on acupoint stimulation for AUD from database inception to September 30, 2022. A meta-analysis was performed using Review Manager 5.4 software. Continuous data (scales) were expressed as mean differences (MDs) or standardized mean difference (SMD) with 95% confidence intervals (95% CI). Study methodological quality was assessed according to the Cochrane risk-of-bias tool for trials. The grading of recommendations assessment, development and evaluation was used to assess the certainty of evidence for outcomes. RESULTS: A total of 16 RCTs with 1097 participants were included. Compared to psychotherapy or drug therapy alone, the combination of acupoint stimulation and other sorts of therapies presented advantages in alleviating alcohol craving (SMD = -1.09, 95% CI = -1.40 to -0.77, df = 2, P < .00001, grading of recommendations assessment, development and evaluation very low certainty), (SMD = -2.25, 95% CI = -3.17 to -1.34, df = 3, P < .00001, low certainty) and the severity of alcohol withdrawal symptoms (MD = -1.21, 95% CI = -2.32 to -0.1, df = 2, P = .03, low certainty), as well as improving anxiety (MD = -3.41, 95% CI = -4.06 to -2.76, df = 4, P < .00001, very low certainty) and depression levels (MD = -3.27, 95% CI = -4.92 to -1.62, df = 4, P = .0001, very low certainty) on patients with AUD. In addition, a greater effect was also found with the 4-week treatment courses in reducing craving (SMD = -2.18, 95% CI = -2.61 to -1.75, P < .00001, low certainty). CONCLUSION: Acupoint stimulation and its combined therapy may better relieve AUD symptoms effectively and the treatment duration should be set at more than 2 weeks. However, due to the low-quality of the included RCTs, high-quality studies are needed to further confirm it in the future.


Assuntos
Alcoolismo , Humanos , Alcoolismo/terapia , Pontos de Acupuntura , Psicoterapia , Consumo de Bebidas Alcoólicas , Transtornos de Ansiedade
10.
BMC Public Health ; 23(1): 161, 2023 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-36694166

RESUMO

BACKGROUND: Mental disorders are conditions that affect the usual function of the brain, causing a huge burden on societies. The causes are often unclear, but previous research has pointed out, as is the case with many other diseases, that nutrition could have a major role in it. Amino acids, the building blocks of proteins, are the main precursor of neurotransmitters (the chemical messengers in the brain) malfunction of which is heavily associated with a wide range of brain disorders. METHODS: We assumed different sources of dietary protein could have different impacts on mental well-being. Hence, we decided to collect the nutritional data (with a validated and reliable semi-quantitative food-frequency questionnaire) from a sample of 489 Iranian women and investigate the association between animal and plant protein sources and the risk of depression, anxiety, and stress. Symptoms of these mental disorders were assessed using a validated Depression, Anxiety, and Stress Scales (DASS) questionnaire with 21 items. RESULTS: After multivariable adjustment, it was shown that women in the highest tertile of animal protein intake were more likely to show symptoms of depression (OR: 2.63; 95% CI: 1.45, 4.71; P = 0.001), anxiety (OR: 1.83; 95% CI: 1.04, 3.22; P = 0.03), and stress (OR: 3.66; 95% CI: 2.06, 6.50; p < 0.001). While no significant association was seen between plant protein and any of the studied mental disorders. CONCLUSION: Overall, our findings suggest that a diet high in animal protein could predispose individuals to mental illnesses.


Assuntos
Ansiedade , Depressão , Feminino , Humanos , Animais , Depressão/epidemiologia , Depressão/etiologia , Irã (Geográfico)/epidemiologia , Ansiedade/epidemiologia , Ansiedade/etiologia , Transtornos de Ansiedade , Dieta , Proteínas de Plantas , Inquéritos e Questionários
11.
BMC Med Educ ; 23(1): 57, 2023 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-36694199

RESUMO

INTRODUCTION: Imposter phenomenon is common among medical trainees and may influence learning and professional development. The authors sought to describe imposter phenomenon among internal medicine residents. METHODS: In 2020, using emailed invites we recruited a convenience sample of 28 internal medicine residents from a teaching hospital in Baltimore, Maryland to participate in an exploratory qualitative study. In one-on-one interviews, informants described experiences of imposter phenomenon during residency training. Using thematic analysis to identify meaningful segments of text, the authors developed a coding framework and iteratively identified and refined themes. Informants completed the Clance Imposter Phenomenon Scale. RESULTS: Informants described feelings and thoughts related to imposter phenomenon, the contexts in which they developed and the impact on learning. Imposter phenomenon has profound effects on residents including: powerful and persistent feelings of inadequacy and habitual comparisons with others. Distinct contexts shaping imposter phenomenon included: changing roles with increasing responsibilities; constant scrutiny; and rigid medical hierarchy. Learning was impacted by inappropriate expectations, difficulty processing feedback, and mental energy diverted to impression management. DISCUSSION: Internal medicine residents routinely experience imposter phenomenon; these feelings distort residents' sense of self confidence and competence and may impact learning. Modifiable aspects of the clinical learning environment exacerbate imposter phenomenon and thus can be acted upon to mitigate imposter phenomenon and promote learning among medical trainees.


Assuntos
Internato e Residência , Médicos , Humanos , Autoimagem , Transtornos de Ansiedade , Medicina Interna/educação
12.
BJS Open ; 7(1)2023 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-36694387

RESUMO

BACKGROUND: Informed consent is an ethical and legal requirement in healthcare and supports patient autonomy to make informed choices about their own care. This review explores the impact of digital technology for informed consent in surgery. METHODS: A systematic search of EBSCOhost (MEDLINE/CINAHL), Embase, Cochrane Central Register of Controlled Trials and Web of Science was performed in November 2021. All RCTs comparing outcomes of both digital and non-digital (standard) consent in surgery were included. Each included study underwent an evaluation of methodological quality using the Cochrane risk of bias (2.0) tool. Outcomes assessed included comprehension, level of satisfaction and anxiety, and feasibility of digital interventions in practice. RESULTS: A total of 40 studies, across 13 countries and 15 surgical specialties were included in this analysis. Digital consent interventions used active patient participation and passive patient participation in 15 and 25 studies respectively. Digital consent had a positive effect on early comprehension in 21 of 30 (70 per cent) studies and delayed comprehension in 9 of 20 (45 per cent) studies. Only 16 of 38 (42 per cent) studies assessed all four elements of informed consent: general information, risks, benefits, and alternatives. Most studies showed no difference in satisfaction or anxiety. A minority of studies reported on feasibility of digital technology in practice. CONCLUSION: Digital technologies in informed consent for surgery were found to have a positive effect on early comprehension, without any negative effect on satisfaction or anxiety. It is recommended that future studies explore the feasibility of these applications for vulnerable patient groups and busy surgical practice.


Assuntos
Tecnologia Digital , Consentimento Livre e Esclarecido , Humanos , Participação do Paciente , Compreensão , Transtornos de Ansiedade
13.
Am J Nurs ; 123(2): 16, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36698345

RESUMO

Nurses can play a vital role in implementing this recommendation during primary care visits.


Assuntos
Ansiedade , Programas de Rastreamento , Criança , Humanos , Ansiedade/diagnóstico , Transtornos de Ansiedade , Comitês Consultivos
14.
Am J Nurs ; 123(2): 62, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36698368

RESUMO

According to this study: Mindfulness-based stress reduction is well tolerated and has comparable effectiveness to a first-line medication for people who have anxiety disorders.At least one study-related adverse event occurred in 78.6% of patients in the escitalopram group and in 15.4% of those in the mindfulness-based stress reduction group.


Assuntos
Atenção Plena , Humanos , Estresse Psicológico/terapia , Depressão , Ansiedade/terapia , Transtornos de Ansiedade/tratamento farmacológico
15.
J Exp Anal Behav ; 119(1): 209-230, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36597188

RESUMO

This tribute to Howard Rachlin speculates about scholarly work that might have been. It explores how behavioral data might bear on philosophical issues, with examples that might be called case studies in experimental philosophy. In 1964, an issue of the Proceedings of the American Philosophical Society served a similar function. It was entitled "Psychology: A Behavioral Interpretation"; the papers included "Will," "Experience," "Appetite," "Humors," "Anxiety," and "Man." This presentation imagines what a contemporary project devoted to philosophical and behavior analytic perspectives on the topics of causation, freedom and volition, good and evil, time, words, and mind might have looked like. Along the way it notes how the project would have benefitted from Howard Rachlin's seminal contributions to both behavior analysis and philosophy. If ever such a project comes to pass, it will inevitably bear the stamp of his contributions.


Assuntos
Ansiedade , Filosofia , Masculino , Humanos , Estados Unidos , Transtornos de Ansiedade
16.
J Affect Disord ; 324: 370-378, 2023 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-36587909

RESUMO

BACKGROUND: Severe health anxiety is a disorder characterized by a persistent preoccupation with one's health. In behavioral studies, biases in the processing of health-related stimuli (e.g., pictures, words) are consistently associated with health anxiety symptoms. The neural correlates of the observed behavioral abnormalities remain however poorly understood. METHODS: In this functional magnetic resonance imaging study, 22 treatment-seeking patients with severe health anxiety and 22 control participants performed a resting-state and a picture matching task. Immediately after the resting-state, participants completed a questionnaire quantifying their thoughts and feelings during rest along several dimensions. The picture task included images of health-related and neutral scenes and of disgusted and neutral faces. RESULTS: Compared to controls, patients with health anxiety showed increased functional connectivity in the dorsolateral prefrontal cortex within the left fronto-parietal resting-state network, which correlated positively with the self-reported thought dimensions of Self, Health Concern, and Thought Suppression. In the picture matching task, no significant group differences were found in the hypothesised regions (amygdala and insula) or at a whole-brain level in response to either health-related versus neural scenes or disgust versus neutral faces contrasts. LIMITATIONS: A relatively small sample size and that no information about patients declining to participate was obtained. CONCLUSIONS: Our findings suggest that behavioral biases in health anxiety may be related to aberrant left dorsolateral prefrontal cortex functional connectivity at rest. In contrast, the health anxiety patients did not show significant hyperactivations of amygdala and insula during processing of emotional stimuli, contrasting findings in other anxiety disorders.


Assuntos
Emoções , Imageamento por Ressonância Magnética , Humanos , Imageamento por Ressonância Magnética/métodos , Emoções/fisiologia , Ansiedade/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Transtornos de Ansiedade
17.
Int J Psychophysiol ; 184: 110-117, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36621629

RESUMO

Threat-related attentional bias is thought to have a causal influence on the etiology of social anxiety. However, there is uncertainty on whether attention dwells on or diverts away from threats, and the measurements typically utilized to explore attentional bias cannot continuously quantify changes in attention. Here, we used steady-state visual evoked potentials (ssVEPs) as a continuous neurophysiological measure of visual attentional processing to examine the time course of attentional bias in social anxiety. Participants with high (n = 18) and low (n = 18) social anxiety passively viewed two faces flickering at 15 and 20 Hz frequency to evoke ssVEPs, and completed Attentional Control Scale. The results showed that angry faces, as compared to happy and neutral faces, elicited larger ssVEP amplitudes for the time window of 180-500 ms after facial stimuli onset only in the high socially anxious individuals, and the effect extended to the next two periods of 500-1000 ms and 1000-1500 ms. The ssVEP amplitudes differed most when individuals with high social anxiety viewed angry-neutral expression combinations. Additionally, attentional control was negatively correlated with social anxiety and threat-related attentional bias. The results suggested that individuals with social anxiety initially oriented attention toward the threat and subsequently exhibited difficulty in disengaging attention from it, possibly due to impaired attentional control.


Assuntos
Viés de Atenção , Potenciais Evocados Visuais , Humanos , Medo , Ansiedade , Transtornos de Ansiedade , Expressão Facial
19.
J Med Internet Res ; 25: e42672, 2023 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-36656625

RESUMO

BACKGROUND: Anxiety and depression are the most common mental disorders worldwide. Owing to the lack of psychiatrists around the world, the incorporation of artificial intelligence (AI) into wearable devices (wearable AI) has been exploited to provide mental health services. OBJECTIVE: This review aimed to explore the features of wearable AI used for anxiety and depression to identify application areas and open research issues. METHODS: We searched 8 electronic databases (MEDLINE, PsycINFO, Embase, CINAHL, IEEE Xplore, ACM Digital Library, Scopus, and Google Scholar) and included studies that met the inclusion criteria. Then, we checked the studies that cited the included studies and screened studies that were cited by the included studies. The study selection and data extraction were carried out by 2 reviewers independently. The extracted data were aggregated and summarized using narrative synthesis. RESULTS: Of the 1203 studies identified, 69 (5.74%) were included in this review. Approximately, two-thirds of the studies used wearable AI for depression, whereas the remaining studies used it for anxiety. The most frequent application of wearable AI was in diagnosing anxiety and depression; however, none of the studies used it for treatment purposes. Most studies targeted individuals aged between 18 and 65 years. The most common wearable device used in the studies was Actiwatch AW4 (Cambridge Neurotechnology Ltd). Wrist-worn devices were the most common type of wearable device in the studies. The most commonly used category of data for model development was physical activity data, followed by sleep data and heart rate data. The most frequently used data set from open sources was Depresjon. The most commonly used algorithm was random forest, followed by support vector machine. CONCLUSIONS: Wearable AI can offer great promise in providing mental health services related to anxiety and depression. Wearable AI can be used by individuals for the prescreening assessment of anxiety and depression. Further reviews are needed to statistically synthesize the studies' results related to the performance and effectiveness of wearable AI. Given its potential, technology companies should invest more in wearable AI for the treatment of anxiety and depression.


Assuntos
Inteligência Artificial , Depressão , Humanos , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Depressão/diagnóstico , Depressão/terapia , Ansiedade/diagnóstico , Ansiedade/terapia , Transtornos de Ansiedade , Algoritmos
20.
Artigo em Inglês | MEDLINE | ID: mdl-36673854

RESUMO

The presence of anxiety during pregnancy is associated with adverse consequences for both mothers and their babies. The aim of this study was to review the prevalence of anxiety in European pregnant women in order to find out which countries have published the most studies in respect to the presence of anxiety during pregnancy, which countries are the most and least prevalent in terms of anxiety within pregnant women, and which are the most common tools used to assess anxiety during this stage. As such, a literature review was conducted regarding the studies that were published in the last twenty years in the PsycInfo, Medline, and SCOPUS databases. Thirty-eight studies were selected for the purposes of this review. The prevalence of anxiety in pregnancy and generalized anxiety disorder (GAD) varies considerably between studies. The European countries that have carried out the most research on this issue are Spain, Italy, and the United Kingdom. The most widely used assessment instrument is the State Trait Anxiety Inventory (STAI). The lowest prevalence rate of anxiety, using the STAI-E, was found in Poland, 7.7%, and the highest was found in Italy, 36.5%. The prevalence of GAD ranges from 0.3% to 10.8%. This indicates that anxiety in pregnant women is a very relevant mental health problem. It is therefore important to detect and intervene early in order to promote the well-being of both mothers and children.


Assuntos
Ansiedade , Complicações na Gravidez , Criança , Feminino , Humanos , Gravidez , Prevalência , Ansiedade/psicologia , Transtornos de Ansiedade/psicologia , Gestantes/psicologia , Mães/psicologia , Complicações na Gravidez/psicologia
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