scholarly journals The relations between different factors of intolerance of uncertainty and symptoms of generalized anxiety disorder: a network analysis

2021 ◽  
Author(s):  
Lei Ren ◽  
Zihan Wei ◽  
Ye Li ◽  
Long-Biao Cui ◽  
Yifei Wang ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Full Range ◽  
Intolerance Of Uncertainty ◽  
Self Report ◽  
Generalized Anxiety ◽  
Cross Sectional ◽  
Correlation Networks ◽  
Two Factors ◽  
Differential Relations

Abstract Background: Intolerance of uncertainty (IU) is considered as a specific risk factor in the development and maintenance of generalized anxiety disorder (GAD). Yet, researches have investigated the relations between IU and GAD (or worry) using total scores on self-report measures. This ignores that there are two different factors exist in IU, and clinical heterogeneity and differential relations among symptoms of GAD. In the present study, we explored the relations among different factors of IU and symptoms of GAD.Methods: A dimensional approach which take individual differences into consideration in different factors of IU along a full range of normal to abnormal symptom severity levels of GAD were used in this study. Unregularized partial-correlation networks were estimated using cross-sectional data from 624 university students. Factors of IU were measured by 12-item Intolerance of Uncertainty Scale and symptoms of GAD were measured by Generalized Anxiety Disorder 7-Item Questionnaire. Results: Five edges between two factors of IU and symptoms of GAD, including edges are between “prospective anxiety” and “nervousness or anxiety”, between “prospective anxiety” and “worry too much”, between “inhibitory anxiety” and “uncontrollable worry”, between “inhibitory anxiety” and “worry too much”, and between “inhibitory anxiety” and “restlessness”. The symptom “worry too much” had the highest strength centrality in the present network. In the community of IU, factor “inhibitory anxiety” has the higher bridge strength than factor “prospective anxiety”. And in the community of GAD symptoms, symptom “worry too much” has the higher bridge strength than other symptoms.Conclusions: This study reveals the underlying relationship between factors of IU and various symptoms of GAD. These findings may provide some references for related preventions and interventions, such as targeting “worry too much” may minimize the level of both IU and GAD symptoms and focusing on “inhibitory anxiety” may be more effective at reducing symptoms of GAD than focusing on “prospective anxiety”.

scholarly journals The relations between different components of intolerance of uncertainty and symptoms of generalized anxiety disorder: a network analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lei Ren ◽  
Zihan Wei ◽  
Ye Li ◽  
Long-Biao Cui ◽  
Yifei Wang ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Partial Correlation ◽  
Full Range ◽  
Intolerance Of Uncertainty ◽  
Self Report ◽  
Generalized Anxiety ◽  
Dimensional Approach ◽  
Cross Sectional ◽  
Item Questionnaire

Abstract Background Intolerance of uncertainty (IU) is considered as a specific risk factor in the development and maintenance of generalized anxiety disorder (GAD). Yet, researches have investigated the relations between IU and GAD (or worry) using total scores on self-report measures. This ignores that there are different components exist in IU and the heterogeneity of GAD symptoms. In the present study, we explored the relations among different components of IU and symptoms of GAD. Methods A dimensional approach which take individual differences into consideration in different components of IU along a full range of normal to abnormal symptom severity levels of GAD were used in this study. Components of IU were measured by 12-item Intolerance of Uncertainty Scale and symptoms of GAD were measured by Generalized Anxiety Disorder 7-Item Questionnaire. Regularized partial-correlation network was estimated using cross-sectional data from 624 university students. Results Four strongest edges are between components of IU, like “Unforeseen events upset me greatly” and “It frustrates me not having all the information I need”. Two strongest edges are between symptoms of GAD, like “Being so restless that it is hard to sit still” and “Feeling afraid as if something awful might happen”. Symptom “Worrying too much about different things” and component “It frustrates me not having all the information I need” have the highest expected influences in the present network. In the community of IU, component “It frustrates me not having all the information I need” has the highest bridge expected influence. And in the community of GAD, symptoms “Worrying too much about different things” and “Not being able to stop or control worrying” have the highest bridge expected influence. Conclusions This study reveals potential pathways between different components of IU and various symptoms of GAD. Understanding how putative risk factors such as different components of IU are related to symptoms of GAD may provide some references for related preventions and interventions, such as targeting component “It frustrates me not having all the information I need” may be more effective at reducing symptoms of GAD than targeting other components of IU.

Mental health impact of COVID-19 pandemic among physicians, nurses, and other healthcare providers, in the province of Alberta (Preprint)

2021 ◽  
Author(s):  
Hany ElGindi ◽  
Reham Shalaby ◽  
April Gusnowski ◽  
Wesley Vuong ◽  
Shireen Surood ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
High Stress ◽  
Well Being ◽  
Self Report ◽  
Generalized Anxiety ◽  
Cross Sectional Survey ◽  
Cross Sectional

BACKGROUND During the COVID-19 pandemic, threats to mental health, psychological safety, and well-being are evident, particularly among the first responders and the healthcare staff. OBJECTIVE This study aimed to examine the prevalence and the potential predictors of the likely stress, generalized anxiety disorder, and major depressive disorder among healthcare workers (HCW). METHODS A cross-sectional survey was used through a survey link sent to gather demographic information and responses on several self-report scales, including the Perceived Stress Scale (PSS), Generalized Anxiety Disorder 7-item (GAD-7) scale, and Patient Health Questionnaire-9 (PHQ-9) among the various HCW groupings who subscribed to the Text4Hope program. RESULTS This study revealed that the HCW expressed an estimated high prevalence of moderate/high stress rates 840 (81.2%), while the likelihood of moderate/severe anxiety and depressive symptoms were 369 (38.6%), and 317 (32.7%), respectively, during COVID-19 pandemic. Nurses and other HCW were significantly more likely to report depressive symptoms, compared to physicians, (F (2, 159.47) =15.89, 95% CI= (-5.05) -(-2.04). Younger age groups of HCW (≤30 y) were more prone to report likely stress, anxiety, and depressive symptoms, compared to HCW 41-50y and >50y (Odd’s ratio range: 1.82- 3.03). Similarly, females and those who reported a lack of social support (separated/divorced and single) among HCW, had a higher likelihood to report likely stress and depressive symptoms, respectively (OR=1.8 and 1.6). CONCLUSIONS This cross-sectional study revealed the significant impact of COVID-19 pandemic on mental health and indicated significant vulnerability among groups of HCW in Alberta. CLINICALTRIAL Ethical approval for this research was obtained through the University of Alberta Health Research Ethics Board (Pro00086163).

scholarly journals The relations among worry, meta-worry, intolerance of uncertainty and attentional bias for threat in men at high risk for generalized anxiety disorder: a network analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lei Ren ◽  
Zhou Yang ◽  
Yidi Wang ◽  
Long-Biao Cui ◽  
Yinchuan Jin ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
High Risk ◽  
Network Analysis ◽  
Generalized Anxiety Disorder ◽  
Attention Bias ◽  
Intolerance Of Uncertainty ◽  
Cognitive Factors ◽  
Generalized Anxiety ◽  
Cross Sectional ◽  
Core Feature

Abstract Background Improving the psychotherapies for generalized anxiety disorder (GAD) is dependent on a deeper understanding of the relations between GAD and its associated cognitive factors. In the present study, we investigate how the core feature of GAD (i.e., worry) and its associated cognitive factors, such as meta-worry, intolerance of uncertainty, and attention bias towards threat, relate to each other in men at high risk for GAD. Methods We used network analysis to explore the relations among these variables in a cross-sectional sample of 122 men at high risk for generalized anxiety disorder. Specifically, we computed the expected influence and predictability of each variable. Results In the final network, we found that worry and meta-worry had the highest expected influence and predictability. In contrast, attention bias towards threat showed the lowest expected influence and predictability. The estimates of the expected influence of the nodes were stable (correlation stability coefficient = 0.52). Conclusions The present study is the first to investigate the relations among worry, meta-worry, intolerance of uncertainty, and attention bias towards threat in men at high risk for generalized anxiety disorder. These findings indicate that worry and meta-worry may play important roles in the present network. The implications for clinical interventions and future studies are discussed.

(Re)examining the Factorial sstructure of the Generalized Anxiety Disorder-7 in a College Students Sample

2017 ◽  
Vol 41 (S1) ◽  
pp. S109-S109 ◽  
Author(s):  
S. Monteiro ◽  
A. Bártolo ◽  
A. Torres ◽  
A. Pereira
Keyword(s):  
College Students ◽  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Factor Structure ◽  
Factor Model ◽  
Public Health Problem ◽  
Anxiety Symptoms ◽  
Self Report ◽  
Generalized Anxiety ◽  
Cross Sectional

IntroductionGeneralized anxiety in young adults during college career is a serious public-health problem that untreated has a chronic course. Research has shown that the self-report questionnaire generalized anxiety disorder-7 (GAD-7) is a reliable and valid measure to assess generalized anxiety symptoms severity in heterogeneous psychiatric samples. However, GAD-7 is not available for non-clinical populations and their factor structure has not been re-examined.ObjectivesOur objective was to examine factor structure and measurement invariance of the GAD-7 among college students testing two alternatives models.AimsThe original model fit of single-factor was compared to two-factor model that considered in comprehensive approach of generalized anxiety the assessment of cognitive-emotional nature and somatic symptoms.MethodsIn this cross-sectional study the GAD-7 was administrated to college students (n = 1031) recruited in the six schools which compose the Polytechnic Institute of Coimbra, Portugal. Confirmatory factor analysis was used testing two models.ResultsAmong college students, 32.8% reported significant generalized anxiety symptoms. The original unidimensional structure of GAD-7 was confirmed but the two-factor model comprising cognitive–emotional and somatic factors presented better fit to the data (χ2(1) = 21.01, P < 0001). This latent factor were positively associated (r = 0.51, P < 0.001) and presented a good internal consistency (α = 0.85 and α = 0.86 for cognitive-emotional and somatic items, respectively). The invariance factor of two-factor model across gender was also confirmed.ConclusionsResults indicate that within college communities the GAD-7 integrates two stable generalized anxiety factors related but independent structure. The GAD-7 can be an adequate measure to detected generalized anxiety symptoms in this population.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Measurement Invariant but Non-Normal Treatment Responses in Guided Internet Psychotherapies for Depressive and Generalized Anxiety Disorders

Assessment ◽  
2021 ◽  
pp. 107319112110625
Author(s):  
Tom H. Rosenström ◽  
Ville Ritola ◽  
Suoma Saarni ◽  
Grigori Joffe ◽  
Jan-Henry Stenberg
Keyword(s):  
Anxiety Disorder ◽  
Treatment Response ◽  
Generalized Anxiety Disorder ◽  
Health Assessment ◽  
Psychotherapy Research ◽  
Self Report ◽  
Generalized Anxiety ◽  
Equivalence Testing ◽  
Sum Scores ◽  
Normally Distributed

Assessment of treatment response in psychotherapies can be undermined by lack of longitudinal measurement invariance (LMI) in symptom self-report inventories, by measurement error, and/or by wrong model assumptions. To understand and compare these threats to validity of outcome assessment in psychotherapy research, we studied LMI, sum scores, and Davidian Curve Item Response Theory models in a naturalistic guided internet psychotherapy treatment register of 2,218 generalized anxiety disorder (GAD) patients and 3,922 depressive disorder (DD) patients (aged ≥16 years). Symptoms were repeatedly assessed by Generalized Anxiety Disorder Assessment-7 (GAD-7) or Beck Depression Inventory. The symptom self-reports adhered to LMI under equivalence testing, suggesting sum scores are reasonable proxies for disorder status. However, the standard LMI assumption of normally distributed latent factors did not hold and inflated treatment response estimates by 0.2 to 0.3 standard deviation units compared with sum scores. Further methodological research on non-normally distributed latent constructs holds promise in advancing LMI and mental health assessment.

Cognitive Behavior Therapy Targeting Intolerance of Uncertainty Versus Selective Serotonin Reuptake Inhibitor for Generalized Anxiety Disorder: A Randomized Clinical Trial

2021 ◽  
pp. 1-13 ◽  
Author(s):  
Mehdi Zemestani ◽  
Negar Beheshti ◽  
Farzin Rezaei ◽  
Colin van der Heiden ◽  
Philip C. Kendall
Keyword(s):  
Clinical Trial ◽  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Serotonin Reuptake ◽  
Intolerance Of Uncertainty ◽  
Selective Serotonin ◽  
Generalized Anxiety ◽  
Cognitive Behavior

Abstract Given the high prevalence and adverse outcomes associated with generalized anxiety disorder (GAD), development and expansion of effective treatment modalities are important. The present study compared the effectiveness of cognitive behavior therapy targeting intolerance of uncertainty (CBT-IU) and selective serotonin reuptake inhibitors (SSRIs) for treating GAD. A total of 30 Iranian patients with GAD (Mage = 25.16 ± 6.73) were randomised to receive either CBT-IU (n = 15) or SSRI (n = 15). Measures included the Structured Clinical Interview for DSM-5 (SCID-5), Penn State Worry Questionnaire (PSWQ), Why Worry-II (WW-II), Intolerance of Uncertainty Scale (IUS), and Negative Problem Orientation Questionnaire (NPOQ). Repeated measures analysis of variance tested differential treatment outcomes. The results of intention-to-treat (ITT) analysis indicated that although both CBT-IU and SSRI were effective treatments for GAD, CBT-IU produced significantly better results than SSRI at post-treatment. This clinical trial provides preliminary cross-cultural support for the treatment of GAD using CBT-IU, with findings suggesting that this non-medication intervention reduces GAD symptoms.

scholarly journals Are Different Forms of Repetitive Negative Thinking Associated With Interpretation Bias in Generalized Anxiety Disorder and Depression?

2019 ◽  
Vol 7 (5) ◽  
pp. 969-981 ◽  
Author(s):  
Charlotte Krahé ◽  
Jessica Whyte ◽  
Livia Bridge ◽  
Sofia Loizou ◽  
Colette R. Hirsch
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Cognitive Processing ◽  
Cross Sectional Study ◽  
Interpretation Bias ◽  
Generalized Anxiety ◽  
Repetitive Negative Thinking ◽  
Cross Sectional ◽  
Negative Thinking ◽  
Negative Thought

Worry and rumination, two forms of repetitive negative thinking (RNT), are prevalent in generalized anxiety disorder (GAD) and depression. Cognitive processing biases, especially the tendency to draw negative conclusions from ambiguous information (interpretation bias), may maintain worry and rumination. Yet the relationship between interpretation bias and both forms of RNT has not been explored in clinical versus nonclinical samples. In this cross-sectional study, participants with GAD ( n = 72), depression ( n = 79), or neither disorder ( n = 71) completed two tasks assessing interpretation bias, measures of worry and rumination, and reported negative thought intrusions during a behavioral task. Interpretation bias was associated with higher levels of worry, rumination, and negative thought intrusions. Both clinical groups generated significantly more negative interpretations than healthy comparison participants. These findings link interpretation bias to worry and rumination and establish the need for research investigating the causal role of interpretation bias in maintaining RNT.

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