Using the Penn State Worry Questionnaire to identify individuals with generalized anxiety disorder: a receiver operating characteristic analysis

ABSTRACT Objective: The Penn State Worry Questionnaire (PSWQ) is a commonly used measure of treatment outcome for late-life generalized anxiety disorder (GAD). However, there is considerable variability in the definitions used to define treatment response and remission. This study aimed to provide empirically derived guidelines for assessing treatment response and remission among older adults with GAD using the PSWQ and the abbreviated PSWQ (PSWQ-A). Design: Longitudinal assessment of GAD symptoms pre- and posttreatment. Participants: Participants were 259 older adults aged 60–86 years with a diagnosis of GAD who were assessed before and after treatment. Intervention: Participants were randomly assigned to cognitive behavioral therapy or control (waitlist, discussion group, or supportive therapy) conditions. Measurements: Signal-detection analyses using receiver operating characteristic (ROC) methods were used to determine optimal agreement between structured diagnostic interviews and scores on the PSWQ and PSWQ-A. Results: Results suggest that a score of ≤51 was optimal for defining diagnostic remission status on the PSWQ, and a score of ≤24 was optimal on the PSWQ-A. A 9% reduction or ≥4-point reduction was optimal for assessing treatment response on the PSWQ. The PSWQ-A was poor at identifying treatment response status. Conclusions: Findings suggest that most of the previously used definitions have underestimated the treatment effects for late-life GAD. However overall, the PSWQ and PSWQ-A are suboptimal for assessing treatment outcome for late-life GAD. The standardization of response and remission criteria has implications for comparison between treatment trials, and for the benchmarking of outcomes in clinical practice.

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Efficacy of Virtual Reality Based Worry Exposure Therapy on the Anxiety Severity and Worry in Generalized Anxiety Disorder

Advances in Bioscience and Clinical Medicine ◽

10.7575/aiac.abcmed.v.9n.2p.21 ◽

2021 ◽

Vol 9 (2) ◽

pp. 21

Author(s):

Neda Keshavarz ◽

Touraj Hashemi Nosrat Abad ◽

Mansour Beyrami ◽

Majid Mahmoud alilou ◽

Abbas Bakhshipour Roudsari

Keyword(s):

Virtual Reality ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Exposure Therapy ◽

Reliable Change Index ◽

Single Subject ◽

Generalized Anxiety ◽

Penn State Worry Questionnaire ◽

Penn State ◽

State Worry

Background: Generalized anxiety disorder is one of the most common anxiety disorders observed in clinical centers and the general population. This study aimed to evaluate the efficacy of virtual reality-based worry exposure therapy on the Anxiety Severity and worry in patients with symptoms of generalized anxiety disorder. Materials and Methods: This study was conducted in the framework of a single-subject experimental design using Multiple baselines with a 6-week follow-up. Three women with GAD were selected through a structured clinical interview based on the criteria of Diagnostic and Statistical Manual of Mental Disorders 5 by Convenience Sampling among those who referred to the Counseling centers in Tabriz. The protocol of this study followed the manual by Becker and Margraf which describes imaginal exposure for GAD applied in 15 sessions. The only difference was that in this research exposure to virtual reality replaced with imagination. In this study, three 360-degree films were made by the researcher used for exposure. The content made in the form of 360-degree videos and displayed to patients through virtual reality tools. The scales to assess changes in Anxiety Severity and worry include The Penn State Worry Questionnaire and The Overall Anxiety Severity and Impairment Scale. Data analyzed with visuals inspection, improvement percentage, and reliable change index strategies. Results: Results showed that virtual reality-based worry exposure therapy has significant efficiency on the reduction of Anxiety Severity and worry clinically and statistically (p<0.05). Conclusion: Virtual reality-based worry exposure therapy has appropriate efficacy in reducing GAD symptom severity.

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A Receiver Operating Characteristic Analysis of Simultaneous and Sequential Lineups

PsycEXTRA Dataset ◽

10.1037/e571212013-330 ◽

2013 ◽

Author(s):

Laura Mickes ◽

John T. Wixted ◽

Heather Flowe

Keyword(s):

Receiver Operating Characteristic ◽

Operating Characteristic ◽

Receiver Operating Characteristic Analysis ◽

Characteristic Analysis ◽

Sequential Lineups ◽

Receiver Operating

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419. Diagnostic Utility of a Ferritin to Procalcitonin Ratio to Differentiate Patients with COVID-19 from Those with Bacterial Pneumonia

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.613 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S277-S277

Author(s):

Katherine C Jankousky ◽

Peter Hyson ◽

Jin Huang ◽

Daniel B Chastain ◽

Carlos Franco-Paredes ◽

...

Keyword(s):

Receiver Operating Characteristic ◽

Host Response ◽

Bacterial Pneumonia ◽

Operating Characteristic ◽

Receiver Operating Characteristic Analysis ◽

University Hospital ◽

Characteristic Analysis ◽

The Us ◽

Test Probability ◽

Receiver Operating

Abstract Background Accurate, rapid, inexpensive biomarkers are needed to differentiate COVID-19 from bacterial pneumonia, allowing effective treatment and antibiotic stewardship. We hypothesized that the ratio of ferritin to procalcitonin (F/P) reflects greater viral activity and host response with COVID-19 pneumonia, while bacterial pneumonia would be associated with less cytolysis (lower ferritin) and more inflammation (higher procalcitonin), thus a lower F/P ratio. Methods We conducted a retrospective study of adult patients admitted to a single University hospital in the US through May 2020, during the COVID-19 pandemic. We compared F/P ratio of patients diagnosed with COVID-19 or bacterial pneumonia, excluding patients with COVID-19 and bacterial co-infections. In a logistic regression, we controlled for age, sex, body mass index (BMI), diabetes (DM), and hypertension (HTN). We used a receiver operating characteristic analysis to calculate the sensitivity and specificity of F/P values for the diagnosis of COVID-19 versus bacterial pneumonia. Results Of 218 patients with COVID-19 and 17 with bacterial pneumonia, COVID-19 patients were younger (56 vs 66 years, p=0.04), male (66% vs 24%, p=0.009), had higher BMI (31 vs 27 kg/m2, p=0.03), and similar rates of HTN (59% vs 45%, p=0.3) and DM (32% vs 18%, p=0.2). The median F/P ratio was significantly higher in patients with COVID-19 (3195 vs 860, p=0.0003, Figure 1). An F/P ratio cut-off of ≥ 1250 generated a sensitivity of 78% and a specificity of 59% to correctly classify a COVID-19 case (Figure 2). When adjusted for age, gender, BMI, DM, and HTN, a ratio ≥ of 1250 was associated with significantly greater odds of COVID-19 versus bacterial pneumonia (OR: 4.9, CI: 1.5, 16.1, p=0.009). Figure 1. Ferritin to Procalcitonin Ratios of patients with COVID-19 and patients with Bacterial Pneumonia (controls). Figure 2. Receiver Operating Characteristic Analysis of Ferritin to Procalcitonin Ratio Cut-off Values Predicting COVID-19 Diagnosis. Conclusion We observed an elevated F/P ratio in patients with COVID-19 compared to those with bacterial pneumonia. A F/P ratio ≥ 1250 provides a clinically relevant increase in pre-test probability of COVID-19. Prospective studies evaluating the discriminatory characteristics of F/P ratio in larger cohorts is warranted. Disclosures All Authors: No reported disclosures

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