Anxiety and Related Disorders in People with Intellectual Disability

2020 ◽  
pp. 129-140
Author(s):  
Sherva Cooray ◽  
Avinash Hiremath
Keyword(s):  
Anxiety Disorder ◽  
Separation Anxiety ◽  
Separation Anxiety Disorder ◽  
Post Traumatic Stress ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Cognitive Limitations ◽  
Treatment Models ◽  
Post Traumatic ◽  
People With Intellectual Disabilities

This chapter provides an overview of anxiety and related disorders including, generalized anxiety disorder, panic disorder, agoraphobia, specific phobia, social anxiety disorder, separation anxiety disorder, hypochondriasis, obsessive compulsive disorder (OCD) and post traumatic stress disorder (PTSD). It covers the diagnosis, clinical features, epidemiology, aetiology, pathophysiology, risk factors, treatment, and prognosis. Due to the cognitive limitations and needs profile of people with intellectual disabilities (ID), the diagnosis of these conditions is particularly challenging, due to which they are under-recognized and poorly treated. The approaches to management are largely modelled on treatment models used in the mainstream populations without ID, although these models have to be adapted appropriately to the needs of the individual’s psychological, biological, and social circumstances.

TMS in the study and treatment of anxiety disorders

2012 ◽  
Author(s):  
Benjamin Greenberg ◽  
Sarah H. Lisanby
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Therapeutic Effects ◽  
Post Traumatic Stress ◽  
Obsessive Compulsive ◽  
Systematic Testing ◽  
Compulsive Disorder ◽  
Current State ◽  
Post Traumatic ◽  
Disorder Treatment

A few studies of transcranial magnetic stimulation (TMS) as an anxiety disorder treatment have been reported. In treatment studies, the focal application of TMS in the treatment of anxiety disorders has been guided by the present understanding of the neurocircuitry underlying these disorders. This article reviews the current state of the literature on the uses of TMS in the study and treatment of anxiety disorders, and discusses the implications for understanding their patho-etiology. Investigation of the possible therapeutic effects of repetitive TMS in obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), or any anxiety disorder remains at a preliminary stage. There have been promising initial observations in OCD, which require systematic testing in controlled studies. As far as PTSD is concerned, the available data suggest that additional TMS work is required. The observations need to be replicated in controlled settings to determine whether this approach will have value in treating anxiety disorders.

The relationship between obsessive–compulsive disorder and anxiety and affective disorders: results from the Johns Hopkins OCD Family Study

2001 ◽  
Vol 31 (3) ◽  
pp. 481-487 ◽  
Author(s):  
G. NESTADT ◽  
J. SAMUELS ◽  
M. A. RIDDLE ◽  
K.-Y. LIANG ◽  
O. J. BIENVENU ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Obsessive Compulsive Disorder ◽  
Affective Disorders ◽  
Substance Dependence ◽  
Separation Anxiety ◽  
Family Study ◽  
Separation Anxiety Disorder ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
The Relationship

Objective. This study investigates the relationship of specific anxiety and affective disorders to obsessive–compulsive disorder (OCD) in a blind, controlled family study.Method. Eighty case and 73 control probands, as well as 343 case and 300 control first-degree relatives of these probands, participated in the study. Subjects were examined by psychologists or psychiatrists using the Schedule for Affective Disorder and Schizophrenia-Lifetime Anxiety version (SADS-LA). Two experienced psychiatrists independently reviewed all clinical materials, and final diagnoses were made according to DSM-IV criteria, by consensus procedure.Results. Except for bipolar disorder, all anxiety and affective disorders investigated were more frequent in case than control probands. Substance dependence disorders were not more frequent. Generalized anxiety disorder (GAD), panic disorder, agoraphobia, separation anxiety disorder (SAD) and recurrent major depression were more common in case than control relatives. These disorders occurred more frequently if the relative was diagnosed with OCD. Only GAD and agoraphobia were more frequent in case relatives independent of OCD.Conclusion. GAD and agoraphobia share a common familial aetiology with OCD. The other anxiety and affective disorders, when comorbid with OCD, may emerge as a consequence of the OCD or as a more complex syndrome.

scholarly journals A Brazilian version of the "Children's Interview for Psychiatric Syndromes" (ChIPS)

2009 ◽  
Vol 58 (2) ◽  
pp. 115-118 ◽  
Author(s):  
Isabella G. S. de Souza ◽  
Maria Antonia Serra-Pinheiro ◽  
Renata Mousinho ◽  
Paulo Mattos
Keyword(s):  
Anxiety Disorder ◽  
Psychotic Disorders ◽  
Separation Anxiety ◽  
Child And Adolescent Psychiatry ◽  
Brazilian Portuguese ◽  
Separation Anxiety Disorder ◽  
Obsessive Compulsive ◽  
Children And Adolescent ◽  
Compulsive Disorder ◽  
Oppositional Defiant

OBJETIVE: The advance of research in child and adolescent psychiatry in Brazil heavily depends on the existence of instruments for the investigation of psychiatric syndromes adapted to Brazilian Portuguese. METHODS: This article describes a careful process of translation of the Children's Interview for Psychiatric Syndromes for the purpose of use in research in Brazil. The Children's Interview for Psychiatric Syndromes has a version for parents (P-ChIPs) and a version for children (ChIPS). In this article, the sections of P-ChIPS referring to attention-deficit hyperactivity disorder, oppositional-defiant disorder, conduct disorder, mania/hypomania, anorexia nervosa, bulimia nervosa and psychotic disorders were translated to Brazilian Portuguese. The sections of the ChIPS referring to substance use disorders, social anxiety disorder, specific phobias, obsessive-compulsive disorder, generalized anxiety disoder, separation anxiety disorder, post-traumatic disorders and depression/dysthimia were also adapted. Each section was translated by two independent translators and later discussed in a committee composed of experts in the field of Psychiatry and a professional of the field of linguistics. RESULT: A final version containing an interview for the main psychiatric syndromes was defined. CONCLUSION: The translated P-ChIPS is a helpful instrument in children and adolescent clinical evaluation.

scholarly journals Translation and Adaptation of the Spence Children’s Anxiety Scale (SCAS)-Parent Version at a Tertiary Level Hospital

2018 ◽  
Vol 7 (1) ◽  
pp. 40-45
Author(s):  
B.S. Gurung ◽  
M. Rana ◽  
S. Shakya
Keyword(s):  
Anxiety Disorder ◽  
Internal Consistency ◽  
Separation Anxiety ◽  
Separation Anxiety Disorder ◽  
Clinical Samples ◽  
Clinical Group ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Metric Properties ◽  
Specificity And Sensitivity

Introduction: The study has examined the psycho-metric properties of the Nepali translation of SCAS-PV in terms of internal consistency and criterion validity Material and Method: Non probability sampling method was used. Participants were selected purposively under two groups of samples called clinical group and non clinical group. Study population of the study was the patient visiting outdoor and inpatient services of Department of Psychiatry and Mental Health, TUTH. Results: Among 200 (clinical= 98 and a non-clinical=102) sample of Nepalese children and adolescents. The specificity and sensitivity of the tool was assessed. Cronbach Alpha for the total scale (α =0.89), panic disorder (α =0.78), physical injury fear (α =0.72) and separation anxiety disorder (α =0.76) were of acceptable to good range. However, internal consistency of generalized anxiety disorder (α =0.67), obsessive compulsive disorder (α =0.59) and social anxiety disorder (α =0.68) were in questionable range. AUC statistic for total scale was in fair range, with optimum cut off score of 19.5 for the total scale with sensitivity of 65.3% and specificity of 64.7%. Conclusion: The study supports the utility of the SCAS-PV as a measure of anxiety symptoms in children. It can be used to directly compare symptom reporting across children in clinical. Because of the psychometric properties of the SCAS-PV that have been demonstrated in community and clinical samples, it is recommended that the SCAS-PV can be used in clinical and research contexts.

Ketamine’s dose-related effects on anxiety symptoms in patients with treatment refractory anxiety disorders

2017 ◽  
Vol 31 (10) ◽  
pp. 1302-1305 ◽  
Author(s):  
Paul Glue ◽  
Natalie J Medlicott ◽  
Sarah Harland ◽  
Shona Neehoff ◽  
Bridie Anderson-Fahey ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Post Traumatic Stress ◽  
Treatment Resistant ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Post Traumatic ◽  
Resistant Depression

The N-methyl-D-aspartate receptor antagonist ketamine has rapid onset activity in treatment-resistant depression, post-traumatic stress disorder and obsessive compulsive disorder. Due to similarities in brain network activity in depression and anxiety disorders, we hypothesized that ketamine might also be active in other refractory anxiety disorders. We evaluated the efficacy and safety of ketamine in 12 patients with refractory generalized anxiety disorder and/or social anxiety disorder who were not currently depressed, using an ascending single dose study design (0.25, 0.5, 1 mg/kg administered subcutaneously) at weekly intervals. Within 1 h of dosing, patients reported reduced anxiety, which persisted for up to seven days. A dose-response profile was noted for anxiolytic effects, dissociative side effects, and changes in blood pressure and heart rate, with minor changes at 0.25 mg/kg, and progressively greater and more durable changes at the higher doses. Ten of 12 patients were treatment responders at 0.5–1 mg/kg. Ketamine was safe and well tolerated in this population. Ketamine may be a potential therapeutic alternative for patients with refractory generalized anxiety disorder/social anxiety disorder. Along with its demonstrated effectiveness in patients with treatment-resistant depression, obsessive compulsive disorder and post-traumatic stress disorder, these data raise the intriguing possibility that ketamine may have broad efficacy in disorders characterized by negative emotional states, and that these disorders may share a common precipitating neurobiology.

scholarly journals Exploring the Lived-Experience of Limerence: A Journey toward Authenticity

2015 ◽  
Author(s):  
Lynn Willmott ◽  
Evie Bentley
Keyword(s):  
Lived Experience ◽  
Interpretative Phenomenological Analysis ◽  
Separation Anxiety ◽  
Acute Onset ◽  
Anxiety And Depression ◽  
Post Traumatic Stress ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Past Life ◽  
Post Traumatic

Limerence is an acute onset, unexpected, obsessive attachment to one person, the Limerent Object, which is rarely reported in scientific literature. Presented here is an interpretative phenomenological analysis to explore the livedexperience of six international Limerent respondents. The condition's unique and common journey is conceptualised in a Limerence Trajectory, which is characterized by generally sequential yet overlapping super-ordinate themes. The themes primarily regard experiences of ruminative thinking, free floating anxiety and depression temporarily fixated and the disintegration of the self. These themes are further linked to an inclination to reintegrate unresolved past life(s) experiences and to progress to a state of greater authenticity (i.e., being truer to one's inner self). A paradigm shift is identified in the realization that both a real and idealized Limerent Object are involved which may relate to attachment anxieties. Symptomology relating to Obsessive Compulsive Disorder, addiction, separation anxiety and depression, Post Traumatic Stress Disorder, disassociated states and maladaptive fantasy are discussed. The study authors and respondents collective aim is to promote awareness, research and resources for Limerent Experiencers and those who seek to support them.

Adult Hippocampal Neurogenesis, Pattern Separation, and Generalization

2016 ◽  
Author(s):  
Kristen C. Klemenhagen ◽  
Franklin R. Schneier ◽  
Abby J. Fyer ◽  
H. Blair Simpson ◽  
René Hen
Keyword(s):  
Anxiety Disorder ◽  
Hippocampal Neurogenesis ◽  
Adult Hippocampal Neurogenesis ◽  
Pattern Separation ◽  
Post Traumatic Stress ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Evidence Based Treatments ◽  
Post Traumatic ◽  
Pathological Anxiety

Almost one-third of adult Americans will have an anxiety disorder in their lifetime, with enormous personal, societal, and financial costs. Among the most disabling of these disorders are post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), social anxiety disorder, generalized anxiety disorder, and panic disorder. Although there are evidence-based treatments for these disorders, as many as 50% of patients do not respond, and there is a considerable need for new therapies. This chapter proposes that the excessive generalization seen in patients with pathological anxiety is due to impaired hippocampal functioning, specifically a deficit in the neural process of pattern separation, which relies upon the dentate gyrus and is sensitive to neurogenesis. Preclinical findings indicate that stimulating DG neurogenesis improves pattern separation and reduces anxiety behaviors in mice. As a result the authors hypothesize that pharmacological or environmental manipulations aimed at stimulating neurogenesis will be beneficial for the treatment of anxiety disorders.

THE RELATIONSHIP BETWEEN ANXIETY DISORDER SYMPTOMS AND NEGATIVE SELF-STATEMENTS IN NORMAL CHILDREN

1998 ◽  
Vol 26 (3) ◽  
pp. 307-316 ◽  
Author(s):  
Peter Muris ◽  
Harald Merckelbach ◽  
Birgit Mayer ◽  
Nienke Snieder
Keyword(s):  
Anxiety Disorder ◽  
Emotional Disorders ◽  
Separation Anxiety ◽  
Child Anxiety ◽  
Separation Anxiety Disorder ◽  
Generalized Anxiety ◽  
Obsessive Compulsive ◽  
Normal Children ◽  
Compulsive Disorder ◽  
The Relationship

The current study examined the relationship between anxiety disorder symptoms and negative self-statements in a sample of normal children (N=119). Children were asked to complete the Screen for Child Anxiety Related Emotional Disorders (SCARED) and the Negative Affect Self-Statement Questionnaire (NASSQ). Results showed that, in normal children, there is a positive relationship between anxiety disorder symptoms, as indexed by the SCARED, and negative self-statements, as measured by the NASSQ. In particular, anxious self-statements were more often present in children who exhibited relatively high levels of anxiety symptoms. Furthermore, depressive and anxiousdepressive self-statements were found to be positively associated with the presence of symptoms of generalized anxiety disorder, obsessive-compulsive disorder, separation anxiety disorder, and panic disorder.

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