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1.
Artigo em Russo | MEDLINE | ID: mdl-35394727

RESUMO

OBJECTIVE: To provide the CBT-PS method for working with adolescents in the post-suicidal period. MATERIAL AND METHODS: Eleven adolescents who were admitted to a children's department of a Krasnoyarsk outpatient clinic after an incomplete suicide were included in the study. All adolescents had depressive or mixed anxiety-depressive symptoms confirmed by clinical and psychological methods (F32 - 36.3%; F41.2 - 36.3%; F92.0 - 18.2%; F43 - 9.1%). CBT-PS was administered following the relief of the acute condition after drug treatment. RESULTS: A cognitive behavioral therapy (CBT-SP) protocol for working with adolescents attempted suicide was presented. The main focus of emergency therapy at the initial, middle and final stages were pointed out. A working algorithm aimed at resolving an acute suicidal crisis including five tasks was described in detail, i.e. chain analysis, drawing up a safety plan, psychoeducational module, finding reasons for life and conceptualizing the case. The basic principles of planning a therapy strategy and the choice of modules of individual and family skills with regard to their relevance for each specific case were revealed. The steps of therapy aimed at preventing relapse and testing the effectiveness of the acquired skills to cope with a stressful situation in future were described in detail. CONCLUSIONS: CBT-SP is a modern method of working with adolescents attempted suicide. The method based on a cognitive-behavioral model of suicidal behavior appears to have the proven clinical efficacy, with it being quite practical for psychiatrists, psychotherapists and medical psychologists dealing with CBT.


Assuntos
Transtornos de Ansiedade/terapia , Terapia Cognitivo-Comportamental , Transtorno Depressivo/terapia , Ideação Suicida , Tentativa de Suicídio/prevenção & controle , Adolescente , Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/psicologia , Criança , Terapia Cognitivo-Comportamental/métodos , Terapia Combinada , Transtorno Depressivo/complicações , Humanos , Tentativa de Suicídio/psicologia , Resultado do Tratamento
2.
Matern Child Health J ; 26(4): 770-777, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35344149

RESUMO

OBJECTIVES: Data are scarce regarding the prevalence and predictors of perinatal mood and anxiety disorders (PMADs) among Black women. The purpose of this study was to examine the prevalence and predictors of symptoms of PMADS among Black women. METHODS: Black women completed a paper survey between August 2019 and October 2019. Binomial logistic regression was employed to examine predictors of PMAD symptoms. RESULTS: The prevalence of symptoms of PMADs was 56%. A higher proportion of women with PMADs had experienced depression (16% vs. 32%, p = 0.006); physical (18% vs. 31%, p = 0.030), emotional (35% vs. 61%, p = 0.000), or sexual abuse (12% vs. 29%, p = 0.002); and symptoms of depression or anxiety before pregnancy (18% vs. 46%, p = 0.000). After adjusting for socio-demographics in multivariate analysis, experiencing symptoms of depression or anxiety before pregnancy (adjusted odds ratio [aOR] = 3.445, p = 0.001) was positively associated with experiencing symptoms of PMADs, whereas higher levels of self-esteem (aOR = 0.837, p = 0.000) were negatively associated with experiencing symptoms of perinatal mood and anxiety disorders. CONCLUSIONS FOR PRACTICE: The prevalence of PMAD symptoms among this sample of Black women was alarmingly high. Women who experienced PMADs were more likely to report adverse childhood experiences (e.g., physical, emotional, and/or sexual abuse). By understanding the prevalence of PMADs and the factors associated with these disorders, healthcare professionals can improve diagnosis and treatment rates among this understudied and underserved population.


Assuntos
Transtornos de Ansiedade , Ansiedade , Ansiedade/epidemiologia , Ansiedade/psicologia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/psicologia , Feminino , Humanos , Transtornos do Humor/diagnóstico , Transtornos do Humor/epidemiologia , Parto , Gravidez , Prevalência
3.
J Korean Med Sci ; 37(11): e89, 2022 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-35315600

RESUMO

BACKGROUND: Hyperactivity, inattention, and impulsivity of children with attention deficit hyperactivity disorder (ADHD) increase parenting stress and familial conflict. Among parent-related factors, maternal mental health has been studied in-depth, but studies on paternal factors in this context are scarce. This cross-sectional study was conducted of children with ADHD and their parents in South Korea. We investigated the relationships between ADHD symptom severity of children and the mental health of their mothers and fathers. METHODS: The study included 70 children with ADHD and their 140 married heterosexual parents (70 fathers and 70 mothers). Children completed the Child Depression Inventory and State-Anxiety Inventory for children, and their parents completed the Korean ADHD rating scale-IV, Adult ADHD self-report scale, State-Anxiety Inventory, Patient Health Questionnaire-9, and Parental Stress Scale. RESULTS: There was a significant positive correlation between children's ADHD symptoms and maternal anxiety symptom severity, whereby more severe ADHD symptoms were associated with more severe maternal anxiety symptoms. There was also a significant positive correlation between maternal anxiety symptom severity and paternal parenting stress severity, whereby more severe maternal anxiety was associated with more severe paternal parenting stress. A mediation model showed that paternal parenting stress severity was not directly related to children's ADHD symptoms, but the severity of maternal anxiety mediated this relationship. CONCLUSION: The present study found the importance of mental health in mothers of children with ADHD and the interrelatedness of mental health within families. Future assessments and treatment of children with ADHD should include both the children and their parents.


Assuntos
Transtornos de Ansiedade/etiologia , Transtornos de Ansiedade/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Relações Familiares/psicologia , Pai/psicologia , Mães/psicologia , Poder Familiar/psicologia , Adolescente , Adulto , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Relações Pais-Filho , República da Coreia
4.
J Consult Clin Psychol ; 90(4): 339-352, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35311299

RESUMO

OBJECTIVE: This meta-analysis examined the relative efficacy of bona fide psychotherapy conditions in generalized anxiety disorder (GAD) from posttreatment to follow-up in adults. METHODS: Omnibus tests of relative efficacy across bona fide psychotherapies for primary and secondary outcomes were conducted. Longitudinal multilevel subgroup analyses investigated, (a) applied relaxation versus cognitive behavioral therapy (CBT) without applied relaxation and (b) well-established CBT versus augmented integrative CBT. RESULTS: In total, 54 repeated effect sizes nested in 23 studies were included in this meta-analysis. Omnibus test of relative efficacy indicated no significant differences among the bona fide psychotherapy contrasts in primary and some differences in secondary outcomes. When contrasting applied relaxation with CBT without applied relaxation, negligible relative efficacy differences were found at each assessment time. There were small efficacy differences in favor of augmented integrative CBT in comparison to well-established CBT. CONCLUSION: Small relative efficacy differences were found between bona fide psychotherapies in GAD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Assuntos
Terapia Cognitivo-Comportamental , Adulto , Transtornos de Ansiedade/psicologia , Transtornos de Ansiedade/terapia , Humanos , Psicoterapia
5.
Psychophysiology ; 59(6): e14050, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35324015

RESUMO

The current review focuses on our work on the relationship between the error-related negativity (i.e., ERN) and anxiety in children and adolescents. The ERN is an event-related potential (ERP) that appears as a negative deflection in the ERP waveform when individuals make errors and has been found to be increased in anxious individuals. We, and others, have extended this work into developmental populations, finding that the ERN can be measured reliably in children and that the ERN is increased among clinically anxious youth. Furthermore, we have found that the ERN predicts risk for increases in anxiety across development, among healthy and clinically anxious children. We have done work to elucidate what psychological phenomena the increased ERN among anxious children may reflect by creating a self-report measure of error sensitivity (i.e., the Child Error Sensitivity Index) that relates to the ERN. Moreover, we review our work on parenting and the ERN, which suggests that harsh or critical parenting styles may potentiate the ERN in offspring. And, building on these findings, we discuss our recent work to develop novel, computerized intervention strategies to reduce the ERN and thereby risk for anxiety.


Assuntos
Transtornos de Ansiedade , Eletroencefalografia , Adolescente , Ansiedade , Transtornos de Ansiedade/psicologia , Biomarcadores , Criança , Potenciais Evocados , Humanos , Poder Familiar/psicologia
6.
Behav Res Ther ; 152: 104017, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35316616

RESUMO

While research identifies a growing list of risk factors for anxiety and depression, it is equally important to identify potential protective factors that may prevent or reduce vulnerability to developing internalizing psychopathology. We hypothesized that forms of perseverative thinking, such as rumination and worry, act as mechanisms linking negative life experiences and prospective symptoms of anxiety and depression. More specifically, we investigated whether decentering, the meta-cognitive capacity to adopt a distanced perspective toward one's thoughts and feelings, serves as a protective factor at various points along this mediational pathway. A sample of 181 undergraduate students were recruited and assessed at five time points over a 12-week period. Multilevel modeling indicated that decentering was associated with an attenuated impact of (1) negative events on prospective depressive symptoms; (2) negative events on prospective brooding, and (3) brooding, pondering and worry on prospective internalizing symptoms. Multilevel moderated mediation analyses provided partial support for the hypothesis that perseverative thinking would mediate the longitudinal associations between negative life events and internalizing symptoms, with decentering attenuating risk at several connections of the indirect pathways. The strongest support was provided for moderated mediation models in which decentering was associated with attenuated relationships between negative events, brooding, and symptoms of depression. This study is the first to elucidate the role of decentering as a protective factor against anxiety and depressive symptoms at different points in the path from stress to perseverative thought to internalizing symptoms. Decentering therefore may be a critical target for clinical intervention to promote resilience against anxiety and depression.


Assuntos
Transtornos de Ansiedade , Ansiedade , Ansiedade/psicologia , Transtornos de Ansiedade/psicologia , Cognição , Depressão/psicologia , Humanos , Acontecimentos que Mudam a Vida , Estudos Prospectivos
7.
Psychiatry Res ; 311: 114478, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35287044

RESUMO

Distress is a characteristic of various mental disorders. The transdiagnostic construct repetitive negative thinking (RNT) has been suggested to contribute to distress. However, there is little evidence that this association can actually be found across diagnostic categories. We analyzed this association for phobias, other anxiety disorders, stress disorders, depressive disorders and substance use disorders in 194 treatment-seeking individuals. RNT was associated with distress across all diagnostic categories with high effect sizes. Except for phobias, these associations were not attributable to general emotion regulation abilities. RNT might contribute to distress in several mental disorders which underlines its potential for transdiagnostic interventions.


Assuntos
Pessimismo , Transtornos de Ansiedade/psicologia , Humanos , Pacientes Ambulatoriais , Pessimismo/psicologia , Percepção Social , Inquéritos e Questionários
8.
Compr Psychiatry ; 115: 152302, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35245889

RESUMO

AIM: We assessed the heterogeneous development of self-reported social anxiety symptoms across childhood and adolescence (ages 10 to 18; N = 701) and examined whether these groups predicted clinically derived diagnoses of social anxiety disorder (SAD), generalized anxiety disorder (GAD), depressive episodes, panic disorder (PD), agoraphobia, obsessive compulsive disorder (OCD), and substance use in adulthood (ages 19 to 22). RESULTS: Three distinct social anxiety symptom trajectories were found: a high increasing group (15.5%), a moderate group (37.3%), and a low group (47.2%). The high increasing and moderate trajectory groups were differentiated from the low trajectory group on the adult mental disorders examined: SAD (high OR = 15.74; moderate OR = 11.72), GAD (high OR = 13.08; moderate OR = 8.98), depressive episode (high OR = 19.75), PD (high OR = 8.43; moderate OR = 5.90), agoraphobia (high OR = 16.39; moderate OR = 9.68), and OCD (high OR = 3.49; moderate OR = 2.98). The high and moderate groups were not differentiated on SAD, GAD, PD, or OCD but were differentiated on depressive episodes (OR = 3.24). Relative to the low and moderate trajectory groups, the high increasing social anxiety symptoms trajectory group also predicted cannabis use, but not alcohol use in adulthood. Gender, ethnicity, household income, and parental education were accounted for when predicting adult outcomes. CONCLUSION: These results highlight the importance of early treatment of symptoms of childhood social anxiety in the prevention of mental health problems in adulthood.


Assuntos
Cannabis , Transtorno de Pânico , Adolescente , Adulto , Agorafobia/diagnóstico , Agorafobia/epidemiologia , Ansiedade , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Criança , Humanos , Transtorno de Pânico/diagnóstico , Transtorno de Pânico/epidemiologia , Transtorno de Pânico/psicologia , Adulto Jovem
9.
Sultan Qaboos Univ Med J ; 22(1): 82-90, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35299803

RESUMO

Objectives: This study aimed to assess the anxiety and depression symptoms in healthcare professionals in Pakistan as a result of the coronavirus pandemic. Methods: This cross-sectional study was conducted from May to June 2020 and included six different hospitals in Pakistan. An English-language demographics questionnaire, a validated COVID-19 fear scale, depression scale PHQ-9 and anxiety scale GAD-7 were sent to doctors, nurses and paramedical staff via WhatsApp. Data were analysed using descriptive statistics, Chi-square test and Student's t-test. Results: A total of 400 participants were included in this study (response rate: 80.0%); 263 (65.8%) were doctors and 137 (34.3%) were nurses and paramedical staff. Of the participants, 57.0% were less than 40 years old and 18.3% were aged above 50. Most of the participants (n = 262; 65.5 %) experienced moderate levels of fear and 16.5% (n = 66) experienced a high level of fear. Moreover, 19.5% feared death and 56.5% reported social media to be responsible for increasing their fears. On the depression PHQ-9 and anxiety GAD-7 scales, 21.8% (n = 87) reported moderate to severe depression and anxiety symptoms. A significant relationship was demonstrated between the depression level and age, education and profession (P <0.001 each). Similarly, anxiety and depression scores were strongly related to the availability of personal protective equipment (P <0.001). Conclusion: It was found that 21.8% of healthcare professionals are suffering from moderate to severe depression symptoms, 15.5% had moderate to severe anxiety, whereas 65.5% had moderate symptoms of fear. The predictors are age, education level and co-morbidities. These moderate to high levels of fear and anxiety and depression raise concerns about the psychological well-being of healthcare staff and should be addressed through different programmes.


Assuntos
COVID-19 , Médicos , Adulto , Idoso , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , COVID-19/epidemiologia , Estudos Transversais , Humanos , Paquistão/epidemiologia
10.
J Med Internet Res ; 24(3): e29384, 2022 03 24.
Artigo em Inglês | MEDLINE | ID: mdl-35323119

RESUMO

BACKGROUND: Therapist-supported, internet-delivered cognitive behavioral therapy (iCBT) is efficacious for generalized anxiety disorder (GAD), but few studies are yet to report its effectiveness in routine care. OBJECTIVE: In this study, we aim to examine whether a new 12-session iCBT program for GAD is effective in nationwide routine care. METHODS: We administered a specialized, clinic-delivered, therapist-supported iCBT for GAD in 1099 physician-referred patients. The program was free of charge for patients, and the completion time was not predetermined. We measured symptoms with web-based questionnaires. The primary measure of anxiety was the GAD 7-item scale (GAD-7); secondary measures were, for pathological worry, the Penn State Worry Questionnaire and, for anxiety and impairment, the Overall Anxiety Severity and Impairment Scale. RESULTS: Patients completed a mean 7.8 (SD 4.2; 65.1%) of 12 sessions, and 44.1% (485/1099) of patients completed all sessions. The effect size in the whole sample for GAD-7 was large (Cohen d=0.97, 95% CI 0.88-1.06). For completers, effect sizes were very large (Cohen d=1.34, 95% CI 1.25-1.53 for GAD-7; Cohen d=1.14, 95% CI 1.00-1.27 for Penn State Worry Questionnaire; and Cohen d=1.23, 95% CI 1.09-1.37 for Overall Anxiety Severity and Impairment Scale). Noncompleters also benefited from the treatment. Greater symptomatic GAD-7-measured relief was associated with more completed sessions, older age, and being referred from private or occupational care. Of the 894 patients with a baseline GAD-7 score ≥10, approximately 421 (47.1%) achieved reliable recovery. CONCLUSIONS: This nationwide, free-of-charge, therapist-supported HUS Helsinki University Hospital-iCBT for GAD was effective in routine care, but further research must establish effectiveness against other treatments and optimize the design of iCBT for GAD for different patient groups and individual patients.


Assuntos
Transtornos de Ansiedade , Terapia Cognitivo-Comportamental , Ansiedade/terapia , Transtornos de Ansiedade/psicologia , Humanos , Internet , Resultado do Tratamento
11.
J Pak Med Assoc ; 72(3): 554-556, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35320244

RESUMO

Several empirical researches imply that cognitive behaviour therapy can be effective in treating psychiatric disorders. In the context of Pakistan, some researches with Culturally Adapted Cognitive Behaviour Therapy were found to be effective for depression, anxiety, bipolar and psychotic disorders. The present study theoretically underpinned the model of Adapted Cognitive Behaviour Therapy (ACBT) based on the inclusion of Tasbeehs (Rosary) derived from the Quran and Sunnah to be fruitful in producing the desirable change in a single case of Dysthymia with anxious distress which was assessed with the help of the Urdu versions of Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), Beck Hopelessness Scale (BHS) and Beck Scale for Suicidal Ideation (BSS). ACBT produced profound differences in pre-test and post-test scores in a patient. The Tasbeeh or Rosary could provide a therapeutic means for treating psychiatric illnesses irrespective of the religious and cultural differences.


Assuntos
Terapia Cognitivo-Comportamental , Transtorno Depressivo , Transtornos de Ansiedade/psicologia , Transtorno Depressivo/psicologia , Transtorno Distímico/terapia , Humanos , Escalas de Graduação Psiquiátrica
12.
Praxis (Bern 1994) ; 110(4): e186-e190, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35291869

RESUMO

Due to the worldwide high prevalence of psychiatric disorders and its association with sedentary behavior and comorbid physical diseases, increasing physical activity in psychiatric populations is of high importance. Regular physical activity is associated with increased mental wellbeing and has shown to have preventive effects on depression, anxiety disorders and probably sleep disorders. Additionally, positive effects on comorbid chronic physical diseases have been found. Exercise as treatment for several weeks has shown to have an antidepressant effect. Similar positive effects on symptoms have been found in anxiety disorders and schizophrenia. Therefore, assessing and promoting physical activity is advisable in clinical psychiatric practice. Patients should be coached to reach at least a weekly average of 150 minutes of moderate and/or 75 minutes of vigorous physical activity. Establishing physical activity and exercise groups is of utmost importance for psychiatric outpatients.


Assuntos
Transtornos de Ansiedade , Saúde Mental , Transtornos de Ansiedade/psicologia , Exercício Físico , Humanos , Prevalência
13.
Praxis (Bern 1994) ; 110(4): 186-191, 2022.
Artigo em Alemão | MEDLINE | ID: mdl-35291871

RESUMO

The Importance of Physical Activity for Mental Health Abstract. Due to the worldwide high prevalence of psychiatric disorders and its association with sedentary behavior and comorbid physical diseases, increasing physical activity in psychiatric populations is of high importance. Regular physical activity is associated with increased mental wellbeing and has shown to have preventive effects on depression, anxiety disorders and probably sleep disorders. Additionally, positive effects on comorbid chronic physical diseases have been found. Exercise as treatment for several weeks has shown to have an antidepressant effect. Similar positive effects on symptoms have been found in anxiety disorders and schizophrenia. Therefore, assessing and promoting physical activity is advisable in clinical psychiatric practice. Patients should be coached to reach at least a weekly average of 150 minutes of moderate and/or 75 minutes of vigorous physical activity. Establishing physical activity and exercise groups is of utmost importance for psychiatric outpatients.


Assuntos
Exercício Físico , Saúde Mental , Transtornos de Ansiedade/psicologia , Humanos , Prevalência
14.
PLoS One ; 17(3): e0264655, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35294465

RESUMO

BACKGROUND: Isolation is an indispensable measure to contain the SARS-CoV-2 virus, but it may have a negative impact on mental health and overall wellbeing. Evidence on the isolation experience, facilitating and complicating factors is needed to mitigate negative effects. METHODS AND FINDINGS: This observational, population-based cohort study enrolled 1547 adults from the general population with SARS-CoV-2 infection reported to authorities between 27 February 2020 and 19 January 2021 in Zurich, Switzerland. We assessed the proportion of individuals reporting symptoms of depression and anxiety before, during and after isolation (by DASS-21), and queried worries, positive experiences, and difficulties. We analyzed the association of these outcomes with socio-demographics using ordinal regression. Additionally, we report free-text statements by participants to capture most important aspects of isolation. The proportion of participants affected by depression or anxiety increased during isolation from 10·0% to 17·1% and 9·1% to 17·6%, respectively. Ordinal regression showed that taking care of children increased the difficulty of isolation (OR 2·10, CI 1·43-3·08) and risk of non-compliance (OR 1·63, CI 1·05-2·53), especially in younger participants. A facilitating factor that individuals commonly expressed was receiving more support during isolation. CONCLUSION: Isolation due to SARS-CoV-2 presents a mental burden, especially for younger individuals and those taking care of children. Public health authorities need to train personnel and draw from community-based resources to provide targeted support, information, and guidance to individuals during isolation. Such efforts could alleviate the negative impact isolation has on the mental and physical health of individuals and ensure compliance of the population with recommendations.


Assuntos
Transtornos de Ansiedade/epidemiologia , COVID-19/psicologia , Depressão/epidemiologia , Isolamento Social/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Transtornos de Ansiedade/psicologia , Estudos de Coortes , Depressão/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente/psicologia , Cooperação do Paciente/estatística & dados numéricos , Análise de Regressão , Suíça/epidemiologia , Adulto Jovem
15.
Psychiatry Res ; 310: 114423, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35152068

RESUMO

INTRODUCTION: ADHD is a common neurodevelopmental disorder and is highly prevalent in adults. It is associated with several negative outcomes, impacting well-being and global functioning. ADHD is highly associated with comorbidities, anxiety disorders being probably the most frequent. The goal of our study is to assess the prevalence of anxiety disorders and their impact in adults with ADHD. METHOD: 353 individuals diagnosed with ADHD were recruited. Severity of ADHD was assessed as well as lifetime anxiety disorders and other psychiatric comorbidities. We performed logistic and linear regressions to test the impact of lifetime anxiety disorders on demographic and clinical variables. RESULTS: More than half of the patients had at least one anxiety disorder. The presence of comorbid anxiety disorders was associated with worse clinical presentation (positive history of suicide attempts, higher disposition toward anger, higher rate of hospitalization and psychotic symptoms) and with a lower level of education. CONCLUSION: Anxiety disorders are highly prevalent in ADHD and are associated with higher levels of suicidality and disposition towards anger, more severe clinical presentation and lower functioning. Comorbid anxiety needs to be evaluated and treated by clinicians to limit distress, aggression towards self and others and to improve quality of life.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Adulto , Transtornos de Ansiedade/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Comorbidade , Humanos , Qualidade de Vida , Fatores de Risco
16.
Artigo em Inglês | MEDLINE | ID: mdl-35150782

RESUMO

Anxiety and mood disorders are prevalent, disabling, and frequently difficult to treat. Such disorders are often comorbid and share similar characteristics. For more accurate diagnosis and improved treatment, a deeper understanding of the pathophysiology of anxiety and mood disorders is important. Oxytocin, a neuropeptide synthesized in the hypothalamus, affects human psychology and behaviors such as social and affiliative behaviors, fear and emotion processing, and stress regulation. Thus, oxytocin is believed to exert anxiolytic and antidepressant-like effects. This review article provides an overview of clinical studies on relationships between the oxytocin system and anxiety and mood disorders, focusing on oxytocin-related biomarker findings. Biomarkers used in such studies include central and peripheral oxytocin levels, analysis of oxytocin-related genes, and expression levels of oxytocin and oxytocin receptor genes in postmortem brains. Although a growing number of studies support the presence of oxytocinergic effects on anxiety and mood disorders, study results are heterogeneous and inconclusive. Moderating factors such as the characteristics of study populations, including sex, age, context, early life adversity, and attachment styles in patient cohorts, might affect the heterogeneity of the study results. Limitations in existing research such as small sample sizes, large dependence on peripheral sources of oxytocin, and inconsistent results between immunoassay methods complicate the interpretation of existing findings.


Assuntos
Transtornos do Humor , Ocitocina , Ansiedade/metabolismo , Transtornos de Ansiedade/psicologia , Biomarcadores , Humanos , Transtornos do Humor/tratamento farmacológico , Ocitocina/metabolismo
17.
Alcohol ; 100: 41-56, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35181404

RESUMO

Alcohol use disorder (AUD) is frequently comorbid with mood disorders, and these co-occurring neuropsychiatric disorders contribute to the development and maintenance of alcohol dependence and relapse. In preclinical models, mice chronically exposed to alcohol display anxiety-like and depressive-like behaviors during acute withdrawal and protracted abstinence. However, in total, results from studies using voluntary alcohol-drinking paradigms show variable behavioral outcomes in assays measuring negative affective behaviors. Thus, the main objective of this review is to summarize the literature on the variability of negative affective behaviors in mice after chronic alcohol exposure. We compare the behavioral phenotypes that emerge during abstinence across different exposure models, including models of alcohol and stress interactions. The complicated outcomes from these studies highlight the difficulties of assessing negative affective behaviors in mouse models designed for the study of AUD. We discuss new behavioral assays, comprehensive platforms, and unbiased machine-learning algorithms as promising approaches to better understand the interaction between alcohol and negative affect in mice. New data-driven approaches in the understanding of mouse behavior hold promise for improving the identification of mechanisms, cell subtypes, and neurocircuits that mediate negative affect. In turn, improving our understanding of the neurobehavioral basis of alcohol-associated negative affect will provide a platform to test hypotheses in mouse models that aim to improve the development of more effective strategies for treating individuals with AUD and co-occurring mood disorders.


Assuntos
Consumo de Bebidas Alcoólicas , Alcoolismo , Afeto , Abstinência de Álcool , Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/psicologia , Animais , Ansiedade/psicologia , Transtornos de Ansiedade/psicologia , Etanol , Camundongos
18.
Psychotherapy (Chic) ; 59(1): 84-95, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35113639

RESUMO

Generalized anxiety disorder (GAD) is a chronic mental health difficulty typically present in primary care settings. Cognitive-behavioral therapy (CBT) is the psychological intervention with the best evidence for its efficacy for GAD. The development of other psychological interventions can increase client choice. This feasibility trial examined an initial assessment of the efficacy of EFT in comparison to CBT in the treatment of GAD in the context of an Irish public health service. The trial provided information on recruitment, therapist training/adherence, and client retention relevant for a potential noninferiority trial. A randomized controlled trial compared the efficacy of EFT versus CBT for GAD. Both therapies were offered in a 16-20 sessions format. Therapists (n = 8) were trained in both conditions and offered both therapies. Clients were randomly assigned to the two therapies EFT (n = 29) and CBT (n = 29). Outcomes were assessed using several measures, with the Generalized Anxiety Disorder-7 (GAD-7) being the primary outcome. Clients were assessed at baseline, week 16, end of therapy, and at 6-month follow-up. Therapists were able to learn the two models after a short training and showed moderate levels of adherence. Although not statistically significant, the drop out from treatment was 10% for EFT and 27% for CBT. The two therapies showed large pre-post change and similar outcomes across all measures, with these benefits retained at 6-month follow-up. Results suggest that EFT is a potentially promising treatment for GAD. Further investigation is indicated to establish its potential to expand the available psychological therapies for GAD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Assuntos
Terapia Cognitivo-Comportamental , Terapia Focada em Emoções , Transtornos de Ansiedade/psicologia , Transtornos de Ansiedade/terapia , Terapia Cognitivo-Comportamental/métodos , Terapia Focada em Emoções/métodos , Estudos de Viabilidade , Humanos , Resultado do Tratamento
19.
Clin Child Fam Psychol Rev ; 25(1): 110-129, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35195833

RESUMO

The intergenerational transmission of psychopathology is one of the strongest known risk factors for childhood disorder and may be a malleable target for prevention and intervention. Anxious parents have distinct parenting profiles that impact socioemotional development, and these parenting effects may result in broad alterations to the biological and cognitive functioning of their children. Better understanding the functional mechanisms by which parental risk is passed on to children can provide (1) novel markers of risk for socioemotional difficulties, (2) specific targets for intervention, and (3) behavioral and biological indices of treatment response. We propose a developmental model in which dyadic social dynamics serve as a key conduit in parent-to-child transmission of anxiety. Dyadic social dynamics capture the moment-to-moment interactions between parent and child that occur on a daily basis. In shaping the developmental trajectory from familial risk to actual symptoms, dyadic processes act on mechanisms of risk that are evident prior to, and in the absence of, any eventual disorder onset. First, we discuss dyadic synchrony or the moment-to-moment coordination between parent and child within different levels of analysis, including neural, autonomic, behavioral, and emotional processes. Second, we discuss how overt emotion modeling of distress is observed and internalized by children and later reflected in their own behavior. Thus, unlike synchrony, this is a more sequential process that cuts across levels of analysis. We also discuss maladaptive cognitive and affective processing that is often evident with increases in child anxiety symptoms. Finally, we discuss additional moderators (e.g., parent sex, child fearful temperament) that may impact dyadic processes. Our model is proposed as a conceptual framework for testing hypotheses regarding dynamic processes that may ultimately guide novel treatment approaches aimed at intervening on dyadically linked biobehavioral mechanisms before symptom onset.


Assuntos
Ansiedade , Poder Familiar , Ansiedade/psicologia , Transtornos de Ansiedade/psicologia , Criança , Emoções , Humanos , Poder Familiar/psicologia , Pais
20.
Clin Child Fam Psychol Rev ; 25(1): 182-203, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35218453

RESUMO

Anxiety disorders are globally one of the most prevalent and disabling forms of psychopathology in adults and children. Having a parent with an anxiety disorder multiplies the risk of anxiety disorders in the offspring, although the specific mechanisms and processes that play a role in this intergenerational transmission remain largely unknown. According to information processing theories, threat-related biases in cognitive processing are a causal mechanism in the development and maintenance of anxiety. These theories propose that individuals with anxiety are more likely to cognitively process novel stimuli in their environment as threatening. Creswell and colleagues proposed a theoretical model that highlighted the role of these cognitive biases as a mechanism in the intergenerational transmission of anxiety (Creswell et al., in Hadwin, Field (eds) Information processing biases and anxiety: a developmental perspective, Wiley, pp 279-295, 2010). This model postulated significant associations between (1) parents' and children's threat-related cognitive biases (2) parents' threat-related cognitive biases in their own and their child's environment, (3) parents' threat-related cognitive biases and parenting behaviors that convey anxiety risk to the offspring (e.g., modeling of fear, and verbal threat information transmission), and (4) parenting behaviors and child threat-related biases. This theoretical review collated the recent empirical work testing these four core hypotheses of the model. Building on the reviewed empirical work, an updated conceptual model focusing on threat-related attention and interpretation is proposed. This updated model incorporates the links between cognition and anxiety in parents and children and addresses the potential bidirectional nature of parent-child influences.


Assuntos
Transtornos de Ansiedade , Ansiedade , Adulto , Ansiedade/etiologia , Transtornos de Ansiedade/psicologia , Viés , Cognição , Humanos , Modelos Teóricos
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