Social anxiety symptoms across diagnoses among outpatients attending a tertiary care mood and anxiety disorders service

2009 ◽  
Vol 114 (1-3) ◽  
pp. 305-309 ◽  
Author(s):  
H.J. Graystone ◽  
M.J. Garner ◽  
D.S. Baldwin
Keyword(s):  
Social Anxiety ◽  
Anxiety Disorders ◽  
Tertiary Care ◽  
Anxiety Symptoms ◽  
Mood And Anxiety Disorders

scholarly journals Evaluation of the Clinical Global Impression Scale among individuals with social anxiety disorder

2003 ◽  
Vol 33 (4) ◽  
pp. 611-622 ◽  
Author(s):  
T. I. ZAIDER ◽  
R. G. HEIMBERG ◽  
D. M. FRESCO ◽  
F. R. SCHNEIER ◽  
M. R. LIEBOWITZ
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Anxiety Disorders ◽  
Social Anxiety Disorder ◽  
Clinical Global Impression ◽  
Severity Of Illness ◽  
Anxiety Symptoms ◽  
Self Report ◽  
Clinical Global Impression Scale ◽  
Additional Variance

Background. The clinical Global Impression Scale (CGI) is commonly used as a primary outcome measure in studies evaluating the efficacy of treatments for anxiety disorders. The current study evaluated the psychometric properties and predictors of clinicians' ratings on an adapted version of the CGI among individuals with social anxiety disorders.Method. An independent assessor administered the CGI Severity of Illness and Improvement ratings to 123 patients at baseline and the subset of treated patients again mid- and post-treatment.Results. Improvement ratings were strongly related to both concurrent Severity of Illness and changes in Severity of Illness ratings from baseline. Additionally, both CGI ratings were positively correlated with both self-report and clinician-administered measures of social anxiety, depression, impairment and quality of life. Measures of social anxiety symptoms accounted for a large portion of the variance in Severity of Illness ratings, with significant additional variance accounted for by measures of impairment and depression. Changes in social anxiety symptoms from baseline accounted for significant variance in Improvement ratings, but no significant additional variance was accounted for by changes in impairment and depressive symptoms.Conclusions. Our findings support the utility of the CGI as an index of global severity and symptom-specific improvement among individuals with social anxiety disorder.

scholarly journals The impact of stress on financial decision-making varies as a function of depression and anxiety symptoms

2014 ◽  
Author(s):  
Oliver J Robinson ◽  
Rebecca Bond ◽  
Jonathan P Roiser
Keyword(s):  
Decision Making ◽  
Anxiety Disorders ◽  
Trait Anxiety ◽  
Anxiety Symptoms ◽  
Financial Decision Making ◽  
Individual Vulnerability ◽  
Mood And Anxiety Disorders ◽  
Financial Decision ◽  
The Impact ◽  
Selection Of

Stress can precipitate the onset of mood and anxiety disorders. This may occur, at least in part, via a modulatory effect of stress on decision-making. Some individuals are, however, more resilient to the effects of stress than others. The mechanisms underlying such vulnerability differences are nevertheless unknown. In this study we attempted to begin quantifying individual differences in vulnerability by exploring the effect of experimentally induced stress on decision-making. Threat of unpredictable shock was used to induce stress in healthy volunteers (N=47) using a within-subjects, within-session design, and its impact on a financial decision-making task (the Iowa Gambling Task) was assessed alongside anxious and depressive symptomatology. As expected, participants learned to select advantageous decks and avoid disadvantageous decks. Importantly, we found that stress provoked a pattern of harm-avoidant behaviour (decreased selection of disadvantageous decks) in individuals with low levels of trait anxiety. By contrast, individuals with high trait anxiety demonstrated the opposite pattern: stress-induced risk-seeking (increased selection of disadvantageous decks). These contrasting influences of stress depending on mood and anxiety symptoms might provide insight into vulnerability to common mental illness. In particular, we speculate that those who adopt a more harm-avoidant strategy may be better able to regulate their exposure to further environmental stress, reducing their susceptibility to mood and anxiety disorders. The threat of shock paradigm we employed might therefore hold promise as a ‘stress-test’ for determining individual vulnerability to mood and anxiety disorders.

scholarly journals Back-translating a rodent measure of negative bias into humans: the impact of induced anxiety and unmedicated mood and anxiety disorders

2017 ◽  
Author(s):  
Jessica Aylward ◽  
Claire Hales ◽  
Emma Robinson ◽  
Oliver J Robinson
Keyword(s):  
Reaction Time ◽  
Anxiety Disorders ◽  
Computational Model ◽  
Treatment Options ◽  
Reaction Times ◽  
Current Treatment ◽  
Anxiety Symptoms ◽  
Mood And Anxiety Disorders ◽  
Affective Bias ◽  
The Impact

AbstractBackgroundMood and anxiety disorders are ubiquitous but current treatment options are ineffective for large numbers of sufferers. Moreover, recent years have seen a number of promising pre-clinical interventions fail to translate into clinical efficacy in humans. Improved treatments are unlikely without better animal-human translational pipelines. Here, we directly adapt–i.e. back-translate - a rodent measure of negative affective bias into humans, and explore its relationship with a)pathological mood and anxiety symptoms (study one) and b)transient induced anxiety (study two).MethodParticipants who met criteria for mood or anxiety disorder symptomatology according to a face-to-face neuropsychiatric interview were included in the symptomatic group. N = 77(47 asymptomatic; Female = 21; 30 symptomatic; Female = 25) participants completed study one and N = 47 asymptomatic participants (25 female) completed study two. Outcome measures were choice ratios, reaction times and parameters recovered from a computational model of reaction time; the drift diffusion model (DDM).ResultsSymptomatic individuals demonstrated increased negative affective bias relative to asymptomatic individuals (proportion high reward = 0.42(SD = 0.14), and 0.53(SD = 0.17), respectively) as well as reduced DDM drift rate (p = 0.004). No significant effects were observed for the within-subjects anxiety-induction in study 2.ConclusionHumans with pathological anxiety symptoms directly mimic rodents undergoing anxiogenic manipulation. The lack of sensitivity to transient anxiety suggests the paradigm may, moreover, be primarily sensitive to clinically relevant symptoms. Our results establish a direct translational pipeline (and candidate therapeutics screen) from negative affective bias in rodents to pathological mood and anxiety symptoms in humans, and link it to a computational model of reaction time.

A longitudinal examination of psychosocial impairment across the anxiety disorders

2013 ◽  
Vol 44 (8) ◽  
pp. 1691-1700 ◽  
Author(s):  
K. Naragon-Gainey ◽  
M. W. Gallagher ◽  
T. A. Brown
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Anxiety Disorders ◽  
Behavioral Therapy ◽  
Clinical Sample ◽  
Anxiety Symptoms ◽  
Latent Growth ◽  
Psychosocial Impairment ◽  
Co Morbidity

BackgroundAnxiety disorders are highly prevalent disorders associated with substantial psychosocial impairment, but few studies have examined impairment within specific anxiety disorders. Furthermore, it is unclear how change in different types of anxiety has an impact on change in impairment, particularly given high rates of co-morbidity. The current study assessed the temporal associations of impairment and symptoms of three common anxiety disorders in a large, diagnostically heterogeneous clinical sample.MethodData were collected from 606 treatment-seeking individuals at an anxiety clinic, most of whom subsequently enrolled in cognitive-behavioral therapy. Symptoms of panic, social anxiety and generalized anxiety disorder (GAD), as well as levels of impairment, were assessed three times over 2 years. In addition to examining levels of impairment across diagnostic groups, latent growth modeling was used to evaluate the longitudinal associations of anxiety symptoms and impairment.ResultsThose with a principal diagnosis of GAD reported higher levels of impairment in some domains at baseline; however, at follow-up assessments individuals with social anxiety disorder reported greater impairment than those with panic disorder. Anxiety symptoms and impairment both declined over time. Change in all three anxiety symptoms was closely associated with change in impairment, but only GAD remained a significant (positive) predictor of change in impairment after accounting for co-morbidity.ConclusionsImpairment and all three anxiety disorders were closely associated, both cross-sectionally and longitudinally. Because change in GAD was most specifically related to change in impairment, treatment for those with multiple anxiety disorders could focus on treating GAD symptoms first or treating transdiagnostic processes.

scholarly journals Translating a rodent measure of negative bias into humans: the impact of induced anxiety and unmedicated mood and anxiety disorders

2019 ◽  
Vol 50 (2) ◽  
pp. 237-246 ◽  
Author(s):  
Jessica Aylward ◽  
Claire Hales ◽  
Emma Robinson ◽  
Oliver J. Robinson
Keyword(s):  
Anxiety Disorders ◽  
Treatment Options ◽  
Reaction Times ◽  
Current Treatment ◽  
Anxiety Symptoms ◽  
Mood And Anxiety Disorders ◽  
Affective Bias ◽  
Asymptomatic Individuals ◽  
Anxiety Induction ◽  
The Impact

AbstractBackgroundMood and anxiety disorders are ubiquitous but current treatment options are ineffective for many sufferers. Moreover, a number of promising pre-clinical interventions have failed to translate into clinical efficacy in humans. Improved treatments are unlikely without better animal–human translational pipelines. Here, we translate a rodent measure of negative affective bias into humans, exploring its relationship with (1) pathological mood and anxiety symptoms and (2) transient induced anxiety.MethodsAdult participants (age = 29 ± 11) who met criteria for mood or anxiety disorder symptomatology according to a face-to-face neuropsychiatric interview were included in the symptomatic group. Study 1 included N = 77 (47 = asymptomatic [female = 21]; 30 = symptomatic [female = 25]), study 2 included N = 47 asymptomatic participants (25 = female). Outcome measures were choice ratios, reaction times and parameters recovered from a computational model of reaction time – the drift diffusion model (DDM) – from a two-alternative-forced-choice task in which ambiguous and unambiguous auditory stimuli were paired with high and low rewards.ResultsBoth groups showed over 93% accuracy on unambiguous tones indicating intact discrimination, but symptomatic individuals demonstrated increased negative affective bias on ambiguous tones [proportion high reward = 0.42 (s.d. = 0.14)] relative to asymptomatic individuals [0.53 (s.d. = 0.17)] as well as a significantly reduced DDM drift rate. No significant effects were observed for the within-subjects anxiety-induction.ConclusionsHumans with pathological anxiety symptoms directly mimic rodents undergoing anxiogenic manipulation. The lack of sensitivity to transient anxiety suggests the paradigm might be more sensitive to clinically relevant symptoms. Our results establish a direct translational pipeline (and candidate therapeutics screen) from negative affective bias in rodents to pathological mood and anxiety symptoms in humans.

scholarly journals Preprint: Altered decision-making under uncertainty in unmedicated mood and anxiety disorders

2018 ◽  
Author(s):  
Oliver Joe Robinson
Keyword(s):  
Decision Making ◽  
Anxiety Disorders ◽  
Anxiety Symptoms ◽  
Slot Machines ◽  
Decision Making Under Uncertainty ◽  
Mathematical Framework ◽  
Negative Outcomes ◽  
Mood And Anxiety Disorders ◽  
Uncertain Outcomes ◽  
Pathological Group

In daily life we are constantly faced with decisions that have uncertain outcomes. This uncertainty can lead to feelings of anxiety. However, the reciprocal role that anxiety plays in altering the decisions made under uncertainty is not fully understood. This is important, because psychological treatments for anxiety disorders attempt to alter anxiety-related decision-making. In this study we therefore probed the computational basis of decision-making under uncertainty in individuals with high levels of mood and anxiety symptoms. Specifically, healthy individuals (N=88) and individuals with mood and anxiety disorders (N=44) were asked to choose between four competing slot machines (‘four armed bandit’) with fluctuating, uncertain, outcomes (i.e. rewards and/or punishments, or neither). Decisions were made during periods of safety and environmental stress (threat of unpredictable shock). We predicted that anxious individuals under stress would learn faster about punishments, and exhibit choices that were more affected by them. We formalized these hypotheses in terms of parameter values – punishment learning rate and punishment sensitivity respectively - in reinforcement learning accounts of behaviour. We found no evidence for an effect on punishment choice sensitivity in the pathological group, even under elevated stress. However individuals with high anxiety symptoms did have higher learning rates for punishment across all conditions. The behaviour of the pathological group was also apparently more random, with a greater influence of a lapse parameter in the model across conditions. Overall, these data suggest that anxious individuals do not weigh negative outcomes more heavily; rather they are quicker to update their behaviour in response to negative (but not positive) outcomes. This suggests that, when treating anxiety, we should not seek to blunt responses to negative outcomes, but instead encourage anxious individuals to integrate information over longer horizons when bad things happen. As such, these findings provide a formal mathematical framework for developing psychological treatment strategies for mood and anxiety disorders.

scholarly journals The impact of stress on financial decision-making varies as a function of depression and anxiety symptoms

2014 ◽  
Author(s):  
Oliver J Robinson ◽  
Rebecca Bond ◽  
Jonathan P Roiser
Keyword(s):  
Decision Making ◽  
Anxiety Disorders ◽  
Trait Anxiety ◽  
Anxiety Symptoms ◽  
Financial Decision Making ◽  
Individual Vulnerability ◽  
Mood And Anxiety Disorders ◽  
Financial Decision ◽  
The Impact ◽  
Selection Of

Stress can precipitate the onset of mood and anxiety disorders. This may occur, at least in part, via a modulatory effect of stress on decision-making. Some individuals are, however, more resilient to the effects of stress than others. The mechanisms underlying such vulnerability differences are nevertheless unknown. In this study we attempted to begin quantifying individual differences in vulnerability by exploring the effect of experimentally induced stress on decision-making. Threat of unpredictable shock was used to induce stress in healthy volunteers (N=47) using a within-subjects, within-session design, and its impact on a financial decision-making task (the Iowa Gambling Task) was assessed alongside anxious and depressive symptomatology. As expected, participants learned to select advantageous decks and avoid disadvantageous decks. Importantly, we found that stress provoked a pattern of harm-avoidant behaviour (decreased selection of disadvantageous decks) in individuals with low levels of trait anxiety. By contrast, individuals with high trait anxiety demonstrated the opposite pattern: stress-induced risk-seeking (increased selection of disadvantageous decks). These contrasting influences of stress depending on mood and anxiety symptoms might provide insight into vulnerability to common mental illness. In particular, we speculate that those who adopt a more harm-avoidant strategy may be better able to regulate their exposure to further environmental stress, reducing their susceptibility to mood and anxiety disorders. The threat of shock paradigm we employed might therefore hold promise as a ‘stress-test’ for determining individual vulnerability to mood and anxiety disorders.

Anxiety and Schizophrenia: The Interaction of Subtypes of Anxiety and Psychotic Symptoms

CNS Spectrums ◽  
2005 ◽  
Vol 10 (9) ◽  
pp. 721-731 ◽  
Author(s):  
Jonathan D. Huppert ◽  
Thomas E. Smith
Keyword(s):  
Social Anxiety ◽  
Anxiety Disorders ◽  
Negative Symptoms ◽  
Rating Scales ◽  
Anxiety Symptoms ◽  
Self Report ◽  
Psychotic Symptoms ◽  
Formal Thought Disorder ◽  
Obsessive Compulsive ◽  
Comorbid Anxiety

AbstractObjectiveTo examine the interaction of specific anxiety subtypes and psychosis.IntroductionAccumulating evidence suggests that anxiety and its disorders play a significant role in patients with schizophrenia, but few studies have examined multiple types of anxiety and how they interact with different symptoms of schizophrenia.MethodsThirty-two patients diagnosed with schizophrenia or schizoaffective disorder were assessed through self-report measures and interviewer rating scales to examine symptoms of psychosis and anxiety.ResultsA majority of patients (62%) were diagnosed with at least one comorbid anxiety disorder. Obsessive-compulsive symptoms and social anxiety symptoms were related to positive symptoms, bizarre behavior, and quality of life (QOL). Furthermore, panic and social anxiety were related to suspiciousness/paranoia. No consistent relationship was found with negative symptoms. Finally, severity of anxiety disorders was negatively correlated with the severity of formal thought disorder.DiscussionThis is one of the first studies to simultaneously examine the interrelationships of different types of anxiety symptoms and psychotic symptoms. The present findings are consistent with the studies that have suggested relationships between panic and paranoia and comorbid anxiety disorders and impaired QOL. These data suggest that further research into anxiety in schizophrenia, including the cognitive and neurobiological correlates, may help elucidate the mechanisms involved in the manifestation of these psychopathologiesConclusionAnxiety disorders are common in patients with schizophrenia. The presence of such symptoms may influence the presence of core psychotic symptoms and QOL. More information is needed in terms of the relationship between treatment of these symptoms and changes in psychotic symptoms and/or relapse prevention.

Sign in / Sign up

Export Citation Format

Share Document