Recognition of anxiety disorders by the general practitioner: results from the DASMAP Study

Summary: Short-term stability or test-retest reliability of self-reported personality traits is likely to be biased if the respondent is affected by a depressive or anxiety state. However, in some studies, DSM-oriented self-reported instruments have proved to be reasonably stable in the short term, regardless of co-occurring depressive or anxiety disorders. In the present study, we examined the short-term test-retest reliability of a new self-report questionnaire for personality disorder diagnosis (DIP-Q) on a clinical sample of 30 individuals, having either a depressive, an anxiety, or no axis-I disorder. Test-retest scorings from subjects with depressive disorders were mostly unstable, with a significant change in fulfilled criteria between entry and retest for three out of ten personality disorders: borderline, avoidant and obsessive-compulsive personality disorder. Scorings from subjects with anxiety disorders were unstable only for cluster C and dependent personality disorder items. In the absence of co-morbid depressive or anxiety disorders, mean dimensional scores of DIP-Q showed no significant differences between entry and retest. Overall, the effect from state on trait scorings was moderate, and it is concluded that test-retest reliability for DIP-Q is acceptable.

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Outreach Psychiatric Emergency Service

Crisis ◽

10.1027/0227-5910/a000651 ◽

2020 ◽

Vol 41 (5) ◽

pp. 375-382

Author(s):

Remco F. P. de Winter ◽

Mirjam C. Hazewinkel ◽

Roland van de Sande ◽

Derek P. de Beurs ◽

Marieke H. de Groot

Keyword(s):

General Practitioner ◽

General Hospital ◽

Suicidal Behavior ◽

Emergency Service ◽

Attempted Suicide ◽

Emergency Services ◽

Psychiatric Emergency ◽

Psychiatric Emergency Services ◽

Psychiatric Emergency Service ◽

Suicidal Patients

Abstract. Background: Outreach psychiatric emergency services play an important role in all stages of a suicidal crisis; however, empirical assessment data are scarce. This study describes characteristics of patients assessed by these services and involved in suicidal crises. Method: During a 5-year period, detailed information from psychiatric emergency service assessments was recorded; 14,705 assessments were included. Characteristics of patients with/without suicidal behavior and with/without suicide attempts were compared. Outcomes were adjusted for clustering of features within individual patients. Results: Suicidal behavior was assessed in 32.2% of patients, of whom 9.2% attempted suicide. Suicidal behavior was most commonly associated with depression or adjustment disorder and these patients were referred to the service by a general practitioner or a general hospital, whereas those who attempted suicide were less likely to be referred by a general practitioner. Those who attempted suicide were more likely to be female and have had a referral by a general hospital. Self-poisoning by medication was the most common method of attempting suicide. Limitations: Bias could be due to missed or incomplete assessments. Primary diagnoses were based on clinical observation at the time of the assessment or on the primary diagnosis previously recorded. In addition, suicidal behavior or attempted suicide might have been underestimated. Conclusions: Suicidal behavior is commonplace in assessments by psychiatric emergency services. Suicidal patients with/without a suicide attempt differed with respect to demographic features, primary diagnoses, and referring entities, but not with respect to treatment policy. About 40% of the suicidal patients with/without an attempt were admitted following assessment.

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Effects of an Anxiety-Specific Psychometric Factor on Fear Conditioning and Fear Generalization

Zeitschrift für Psychologie ◽

10.1027/2151-2604/a000304 ◽

2017 ◽

Vol 225 (3) ◽

pp. 200-213 ◽

Cited By ~ 1

Author(s):

Christian Baumann ◽

Miriam A. Schiele ◽

Martin J. Herrmann ◽

Tina B. Lonsdorf ◽

Peter Zwanzger ◽

...

Keyword(s):

Risk Factor ◽

Anxiety Disorders ◽

Fear Conditioning ◽

Longitudinal Design ◽

Principal Component ◽

Anxiety And Depression ◽

Specific Factor ◽

High Anxious ◽

Two Factors ◽

Fear Generalization

Abstract. Conditioning and generalization of fear are assumed to play central roles in the pathogenesis of anxiety disorders. Here we investigate the influence of a psychometric anxiety-specific factor on these two processes, thus try to identify a potential risk factor for the development of anxiety disorders. To this end, 126 healthy participants were examined with questionnaires assessing symptoms of anxiety and depression and with a fear conditioning and generalization paradigm. A principal component analysis of the questionnaire data identified two factors representing the constructs anxiety and depression. Variations in fear conditioning and fear generalization were solely associated with the anxiety factor characterized by anxiety sensitivity and agoraphobic cognitions; high-anxious individuals exhibited stronger fear responses (arousal) during conditioning and stronger generalization effects for valence and UCS-expectancy ratings. Thus, the revealed psychometric factor “anxiety” was associated with enhanced fear generalization, an assumed risk factor for anxiety disorders. These results ask for replication with a longitudinal design allowing to examine their predictive validity.

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Effects of Psychotherapy on Brain Activation Patterns in Anxiety Disorders

Zeitschrift für Psychologie ◽

10.1027/2151-2604/a000240 ◽

2016 ◽

Vol 224 (2) ◽

pp. 62-70 ◽

Cited By ~ 2

Author(s):

Thomas Straube

Keyword(s):

Anxiety Disorders ◽

Neuronal Plasticity ◽

Functional Neuroimaging ◽

State Of The Art ◽

Methodological Issues ◽

Future Directions ◽

Activation Patterns ◽

New Learning ◽

Analytical Strategies ◽

Sample Characteristics

Abstract. Psychotherapy is an effective treatment for most mental disorders, including anxiety disorders. Successful psychotherapy implies new learning experiences and therefore neural alterations. With the increasing availability of functional neuroimaging methods, it has become possible to investigate psychotherapeutically induced neuronal plasticity across the whole brain in controlled studies. However, the detectable effects strongly depend on neuroscientific methods, experimental paradigms, analytical strategies, and sample characteristics. This article summarizes the state of the art, discusses current theoretical and methodological issues, and suggests future directions of the research on the neurobiology of psychotherapy in anxiety disorders.

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