scholarly journals Predicting Treatment Outcomes in Guided Internet-Delivered Therapy for Anxiety Disorders—The Role of Treatment Self-Efficacy

2021 ◽  
Vol 12 ◽  
Author(s):  
Adrian Schønning ◽  
Tine Nordgreen
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Panic Disorder ◽  
Anxiety Disorders ◽  
Social Anxiety Disorder ◽  
Self Efficacy ◽  
Significant Interaction ◽  
Interaction Effects ◽  
Symptom Reduction ◽  
Disorder Treatment

Aim: Guided Internet-delivered therapy has shown to be an effective treatment format for anxiety disorders. However, not all patients experience improvement, and although predictors of treatment outcome have been identified, few are consistent over time and across studies. The current study aimed to examine whether treatment self-efficacy (self-efficacy regarding the mastery of obstacles during treatment) in guided Internet-delivered therapy for anxiety disorders in adults could be a predictor of lower dropout rates and greater symptom reduction.Method: The analyzed data comes from an open effectiveness study including 575 patients receiving guided Internet-delivered therapy for panic disorder or social anxiety disorder. Treatment self-efficacy was measured at pre-treatment. Symptom reduction was measured at 10 measurement points, including a 6-month follow-up. A mixed linear model was applied in the analysis.Results: The results showed that high treatment self-efficacy was a predictor of both lower dropout rates and greater symptom reduction. Significant interaction effects between time and treatment self-efficacy were found for several of the nine modules that constitutes the treatment program, suggesting that treatment self-efficacy could be a moderator of symptom reduction. Three of nine modules in the panic disorder treatment and six of nine in the social anxiety disorder treatment showed significant interaction effects.Conclusion: The results suggest that measuring treatment self-efficacy may be a valuable tool to identify patients at risk of dropping out, and that treatment self-efficacy could be a predictor and moderator of symptom reduction in guided Internet-delivered therapy. The implications of the results are discussed.

scholarly journals Mitral valve prolapse and anxiety disorders

2011 ◽  
Vol 199 (3) ◽  
pp. 247-248 ◽  
Author(s):  
Alaor S. Filho ◽  
Benedito C. Maciel ◽  
Minna M. D. Romano ◽  
Thiago F. Lascala ◽  
Clarissa Trzesniak ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Mitral Valve ◽  
Panic Disorder ◽  
Anxiety Disorders ◽  
Diagnostic Criteria ◽  
Social Anxiety Disorder ◽  
Mitral Valve Prolapse ◽  
Healthy Controls ◽  
The Relationship

SummaryWe investigated whether there is an association between anxiety disorders and mitral valve prolapse. We compared mitral valve prolapse prevalence in individuals with panic disorder (n = 41), social anxiety disorder (n = 89) and in healthy controls (n = 102) in an attempt to overcome the biases of previous studies. Our results show no associations between panic disorder or social anxiety disorder and mitral valve prolapse, regardless of the diagnostic criteria employed, and that the relationship between these conditions seems not to be clinically relevant.

scholarly journals Age differences in treatment response to a collaborative care intervention for anxiety disorders

2013 ◽  
Vol 203 (1) ◽  
pp. 65-72 ◽  
Author(s):  
Julie Loebach Wetherell ◽  
Andrew J. Petkus ◽  
Steven R. Thorp ◽  
Murray B. Stein ◽  
Denise A. Chavira ◽  
...  
Keyword(s):  
Older Adults ◽  
Anxiety Disorder ◽  
Social Anxiety ◽  
Panic Disorder ◽  
Anxiety Disorders ◽  
Social Anxiety Disorder ◽  
Collaborative Care ◽  
Generalised Anxiety Disorder ◽  
Younger Adults ◽  
Care Intervention

BackgroundSome data suggest that older adults with anxiety disorders do not respond as well to treatment as do younger adults.AimsWe examined age differences in outcomes from the Coordinated Anxiety Learning and Management (CALM) study, an effectiveness trial comparing usual care to a computer-assisted collaborative care intervention for primary care patients with panic disorder, generalised anxiety disorder, post-traumatic stress disorder (PTSD), and/or social anxiety disorder. This is the first study to examine the efficacy of a collaborative care intervention in a sample that included both younger and older adults with anxiety disorders. We hypothesised that older adults would show a poorer response to the intervention than younger adults.MethodWe examined findings for the overall sample, as well as within each diagnostic category (clinicaltrials.gov identifier: NCT00347269).ResultsThe CALM intervention was more effective than usual care among younger adults overall and for those with generalised anxiety disorder, panic disorder and social anxiety disorder. Among older adults, the intervention was effective overall and for those with social anxiety disorder and PTSD but not for those with panic disorder or generalised anxiety disorder. The effects of the intervention also appeared to erode by the 18-month follow-up, and there were no significant effects on remission among the older adults.ConclusionsThese results are consistent with the findings of other investigators suggesting that medications and psychotherapy for anxiety disorders may not be as effective for older individuals as they are for younger people.

scholarly journals Anxiety disorders and asthma among adolescents in urban Uganda: the role of early life exposures

2020 ◽  
Author(s):  
Harriet Mpairwe ◽  
Richard Stephen Mpango ◽  
Wilber Sembajjwe ◽  
Emily L Webb ◽  
Alison M Elliott ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anxiety Disorder ◽  
Social Anxiety ◽  
Panic Disorder ◽  
Anxiety Disorders ◽  
Social Anxiety Disorder ◽  
Early Life ◽  
Tertiary Education ◽  
Factors Associated ◽  
Early Life Exposures

AbstractBackgroundThe reasons for the association between anxiety disorders and asthma are not fully established, and data from Africa is sparse. We investigated whether the association between anxiety disorders and asthma among adolescents may be partly related to shared exposures in early life.MethodsWe conducted a case-control study among adolescents (12-17 years) with and without asthma in Wakiso District, an urban area in Uganda. Anxiety disorders were diagnosed by the Youth Inventory-4R (YI-4R), a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) referenced instrument. For this report, we focus on generalized anxiety disorder (GAD), panic disorder and social anxiety disorder. Asthma was doctor-diagnosed by study clinicians. We used questionnaires to collect data on early life exposures. The data were analysed using multiple logistic regression models.ResultsWe enrolled 162 adolescents. Adolescents with asthma were more likely to have any of three anxiety disorders (44.6%) than adolescents without asthma (21.4%) [adjusted odds ratio (AOR) 2.68, 95% confidence interval (CI) 1.30-5.53, p-value=0.007]. The association was strong for GAD (AOR 4.49, 95% CI 1.48-13.56) and panic disorder (AOR 5.43, 95% CI 2.11-14.02), but not for social anxiety disorder (1.46, 95% CI 0.63-3.37). The early life risk factors associated with anxiety disorders among adolescents were similar to asthma risk factors previously published, including urban residence at birth [AOR 3.42 (1.29-9.09)] and during most of the first five years of life [AOR 2.87 (1.07-7.66)], father’s tertiary education [AOR 2.09 (1.00-4.37)], and adolescent’s history of other allergy-related diseases [AOR 4.64 (1.66-13.00)].ConclusionWe confirm a positive association between anxiety disorders and asthma among adolescents in urban Uganda. The early life risk factors associated with anxiety disorders among adolescents were similar to those for asthma in the same age-group, suggesting shared underlying causes.

Clinical Management of Anxiety Disorders

2018 ◽  
Author(s):  
Shona Vas ◽  
Pooja N Dave
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Panic Disorder ◽  
Anxiety Disorders ◽  
Generalized Anxiety Disorder ◽  
Social Anxiety Disorder ◽  
Mood State ◽  
Behavioral Therapy ◽  
Skills Training ◽  
Generalized Anxiety

Anxiety disorders are characterized by excessive fear and anxiety accompanied by associated behavioral disturbances that cause significant impairment in social and occupational functioning. Anxiety is a complex mood state that involves physiologic, cognitive, and behavioral components. This review describes the five anxiety disorders most commonly diagnosed in adults: social anxiety disorder, panic disorder, agoraphobia, generalized anxiety disorder, and specific phobia. Diagnostic criteria for these disorders are presented along with empirically supported psychological and pharmacologic treatment approaches. Decades of evidence have indicated that for anxiety disorders of mild to moderate severity, cognitive-behavioral therapy (CBT) should be first-line treatment. CBT interventions for anxiety, including psychoeducation, cognitive restructuring, exposure, applied relaxation/breathing retraining, and skills training, are presented with descriptions of how they may be adapted to particular diagnoses, along with data for their efficacy. Data suggest that selective serotonin and norepinephrine reuptake inhibitors are pharmacologic treatments of choice for anxiety and may be used in combination with CBT for moderate to severe symptoms. d-Cycloserine is an emerging treatment that may enhance outcomes in anxiety disorders by optimizing exposure therapy through the facilitation of fear extinction. This review contains 7 figures, 12 tables, and 105 references. Key words: agoraphobia, anxiety, generalized anxiety disorder, panic disorder, phobias, social anxiety disorder

Clinical Management of Anxiety Disorders

2017 ◽  
Author(s):  
Shona Vas ◽  
Pooja N Dave
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Panic Disorder ◽  
Anxiety Disorders ◽  
Generalized Anxiety Disorder ◽  
Social Anxiety Disorder ◽  
Mood State ◽  
Behavioral Therapy ◽  
Skills Training ◽  
Generalized Anxiety

Anxiety disorders are characterized by excessive fear and anxiety accompanied by associated behavioral disturbances that cause significant impairment in social and occupational functioning. Anxiety is a complex mood state that involves physiologic, cognitive, and behavioral components. This review describes the five anxiety disorders most commonly diagnosed in adults: social anxiety disorder, panic disorder, agoraphobia, generalized anxiety disorder, and specific phobia. Diagnostic criteria for these disorders are presented along with empirically supported psychological and pharmacologic treatment approaches. Decades of evidence have indicated that for anxiety disorders of mild to moderate severity, cognitive-behavioral therapy (CBT) should be first-line treatment. CBT interventions for anxiety, including psychoeducation, cognitive restructuring, exposure, applied relaxation/breathing retraining, and skills training, are presented with descriptions of how they may be adapted to particular diagnoses, along with data for their efficacy. Data suggest that selective serotonin and norepinephrine reuptake inhibitors are pharmacologic treatments of choice for anxiety and may be used in combination with CBT for moderate to severe symptoms. d-Cycloserine is an emerging treatment that may enhance outcomes in anxiety disorders by optimizing exposure therapy through the facilitation of fear extinction. This review contains 7 figures, 12 tables, and 105 references. Key words: agoraphobia, anxiety, generalized anxiety disorder, panic disorder, phobias, social anxiety disorder

Anxiety Disorders

2017 ◽  
pp. 187-192
Author(s):  
Myrna M. Weissman ◽  
John C. Markowitz ◽  
Gerald L. Klerman
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Panic Disorder ◽  
Anxiety Disorders ◽  
Mood Disorders ◽  
Life Events ◽  
Social Anxiety Disorder ◽  
Mood States ◽  
Controlled Trials ◽  
Risk Averse

This chapter discusses the use of IPT for patients with social anxiety disorder (social phobia) and panic disorder. Anxiety and depression frequently overlap, and the focal IPT problem areas fit both categories of syndromes. Like depressed patients, anxious individuals are often risk-averse. The general IPT approach for mood disorders has seemed to need little overhaul for anxiety disorders: the usual focal problem areas and approaches still apply, simply linking life events and interpersonal circumstances to anxiety states rather than to mood states. For patients with panic disorder, IPT seems an intuitively reasonable intervention that takes a very different approach from somatically focused forms of CBT. The findings for IPT in anxiety disorders are encouraging but preliminary and need confirmation in controlled trials. A case example describes a businessman with social anxiety disorder.

Anxiety and Other Distressing Symptoms

2021 ◽  
pp. 97-111
Author(s):  
John C. Markowitz
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Panic Disorder ◽  
Anxiety Disorders ◽  
Psychiatric Disorders ◽  
Generalized Anxiety Disorder ◽  
Social Anxiety Disorder ◽  
Generalized Anxiety ◽  
Risk And Uncertainty ◽  
Case Examples

This omnibus chapter covers anxiety disorders and other psychiatric disorders that may arise or be aggravated by the pandemic. Some anxiety is of course warranted in the midst of a crisis of ongoing risk and uncertainty; therapist and patient must try to separate appropriate from symptomatic anxiety. The chapter includes a discussion of prior IPT research for these disorders, appropriate IPT adaptations, and extended, detailed case examples illustrating the application of IPT to panic disorder, generalized anxiety disorder, and social anxiety disorder. It also addresses how the pandemic may trigger or exacerbate other diagnoses for which IPT has shown benefit.

Elucidation of neurobiology of anxiety disorders in children through pharmacological challenge tests and cortisol measurements: a systematic review

2010 ◽  
Vol 26 (4) ◽  
pp. 431-442 ◽  
Author(s):  
Berta Garcia de Miguel ◽  
David J Nutt ◽  
Sean D Hood ◽  
Simon JC Davies
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Panic Disorder ◽  
Anxiety Disorders ◽  
Social Anxiety Disorder ◽  
Subsequent Development ◽  
Childhood Anxiety ◽  
Hypothalamic Pituitary Adrenal ◽  
Pharmacological Challenge ◽  
Challenge Tests

Anxiety disorders are common both in adults and children. While there have been major advances in understanding the neurobiology of anxiety disorders in adults, progress has been more limited in the elucidation of the mechanisms underlying these disorders in childhood. There is a need to delineate childhood biological models, since anxiety represents a significant clinical problem in children and is a risk factor for the subsequent development of anxiety and depression in adulthood. We conducted a review of the literature regarding pharmacological challenge tests and direct hypothalamic–pituitary–adrenal axis measurement in children with anxiety disorders, with emphasis on panic disorder and social anxiety disorder. Studies identified were contrasted with those in adult panic disorder and social anxiety disorder. Despite this broad approach few studies emerged in children, with only 22 studies meeting inclusion criteria. When contrasted with adult neurobiological models of panic disorder and social anxiety disorder, children studied showed some abnormalities which mirrored those reported in adults, such as altered baseline respiration, altered responses to CO2 challenge tests and blunted growth hormone response to yohimbine. However, results differed from adults with panic disorder and social anxiety in some aspects of noradrenergic and serotonergic function. For endpoints studied in panic disorder children, unlike adults, displayed a lack of baseline end-tidal CO2 abnormalities and a different hypothalamic–pituitary–adrenal pattern response under low-dose CO2. The biology of these anxiety disorders in children may only partially mirror that of adult anxiety disorders. However, caution is required as the evidence is limited, and many studies combined patients with panic disorder and social anxiety disorder with other disorders or non-specific anxiety. Further research is required to fully understand the biology and progression of childhood anxiety disorders.

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