Generalized Anxiety
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Sorana-Maria Bucur ◽  
Adela Moraru ◽  
Beata Adamovits ◽  
Eugen Silviu Bud ◽  
Cristian Doru Olteanu ◽  

SCARED-C instrument (the child version, 41 items) is used for screening anxiety in children between 8 to 18 years old and has been first introduced by Birmaher & collab. in 1995, with good psychometric data - internal consistency from α =.74 to .93 - and good discriminative validity indices in the original versions (1997, 1999). Since then, many countries have adopted the scale, for its utility in identifying five subsets of anxiety disorders (subscales): somatic/panic disorder, generalized anxiety, separation anxiety, social phobia, and school avoidance. The present study contains the first Romanian translated and adapted version of the SCARED-C instrument on a community sample of 477 children (8-18 years old) from Mureș county schools. The instrument showed moderate to good internal consistency (α Cronbach from to .63 to .91 for the total scale) and good test-retest reliability (.70) on a subset of 85 children sample. A confirmatory factorial analysis (CFA) was conducted to test the factor structure of the Romanian version of SCARED-C; results showed that SCARED-C has good psychometric properties to be used for screening anxiety in Romanian children and adolescents. The implications for using SCARED-C in dental practice are discussed. Future studies need to be conducted for exploring convergent and discriminative validity of the instrument and the sensitivity to current DSM-V criteria. Application on a dental pediatric sample is also required.

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Xin Liu ◽  
Xiaoyan Xie ◽  
Yingjia Li ◽  
Meichen Li ◽  
Yuting Wang ◽  

Abstract Background Generalized anxiety disorder (GAD) is common among perimenopausal women. Acupuncture may be an effective treatment for GAD, but evidence is limited. The pathogenesis of GAD is not yet clear, but it is related to the hypothalamic-pituitary-adrenal axis and its excretion, cortisol (CORT), and adrenocorticotropic hormone (ACTH). The object of this study is to evaluate the efficacy of manual acupuncture (MA) versus placebo acupuncture (PA) for perimenopausal women with GAD. Methods This study is a single-center, randomized, single-blind clinical trial that will be conducted in the First Affiliated Hospital of Guangzhou University of Chinese Medicine. A total of 112 eligible GAD patients will be randomly assigned (1:1) to receive MA (n=56) or PA (n=56) three times per week for 4 weeks. The primary outcome measure will be the HAMA score. The secondary outcome measures will be the GAD-7 and PSQI scores and the levels of CORT and ACTH. The evaluation will be executed at baseline, 2 weeks, the end of the treatment, and a follow-up 3-month period. All main analyses will be carried out based on the intention-to-treat (ITT) principle. Discussion This study intends to compare the efficacy between MA and PA in the treatment of perimenopausal women with GAD and to further study the mechanisms underlying the effect. Trial registration Chinese Clinical Trial Registry ChiCTR2100046604. Registered on 22 May 2021.

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259040
Elizaveta Solomonova ◽  
Claudia Picard-Deland ◽  
Iris L. Rapoport ◽  
Marie-Hélène Pennestri ◽  
Mysa Saad ◽  

Background An upsurge in dream and nightmare frequency has been noted since the beginning of the COVID-19 pandemic and research shows increases in levels of stress, depression and anxiety during this time. Growing evidence suggests that dream content has a bi-directional relationship with psychopathology, and that dreams react to new, personally significant and emotional experiences. The first lockdown experience was an acute event, characterized by a combination of several unprecedent factors (new pandemic, threat of disease, global uncertainty, the experience of social isolation and exposure to stressful information) that resulted in a large-scale disruption of life routines. This study aimed at investigating changes in dream, bad dream and nightmare recall; most prevalent dream themes; and the relationship between dreams, bad dreams, nightmares and symptoms of stress, depression and anxiety during the first COVID-19 lockdown (April-May 2020) through a national online survey. Methods 968 participants completed an online survey. Dream themes were measured using the Typical Dreams Questionnaire; stress levels were measured by the Cohen’s Perceived Stress Scale; symptoms of anxiety were assessed by Generalized Anxiety Disorder (GAD-7) scale; and symptoms of depression were assessed using the Quick Inventory of Depressive Symptomatology. Results 34% (328) of participants reported increased dream recall during the lockdown. The most common dream themes were centered around the topics of 1) inefficacy (e.g., trying again and again, arriving late), 2) human threat (e.g., being chased, attacked); 3) death; and 4) pandemic imagery (e.g., being separated from loved ones, being sick). Dream, bad dream and nightmare frequency was highest in individuals with moderate to severe stress levels. Frequency of bad dreams, nightmares, and dreams about the pandemic, inefficacy, and death were associated with higher levels of stress, as well as with greater symptoms of depression and anxiety. Conclusions Results support theories of dream formation, environmental susceptibility and stress reactivity. Dream content during the lockdown broadly reflected existential concerns and was associated with increased symptoms of mental health indices.

2021 ◽  
Kathryn E Barber ◽  
Nur Hani Zainal ◽  
Michelle G. Newman

Background: Generalized anxiety disorder (GAD) and major depressive disorder (MDD) often precede and predict one another. Stress reactivity theories of psychopathology posit that patterns of heightened emotional reactions to stressors can result in increased vulnerability to the development of anxiety and depression. However, cross-sectional studies on this topic have hindered causal inferences. Method: The present study examined stress reactivity as a potential mediator of the sequential associations between GAD and MDD symptoms in a sample of 3,294 community-dwelling adults. GAD and MDD symptom severity (Composite International Diagnostic Interview-Short Form) was assessed at two time points (T1 and T3), approximately 18 years apart. Stress reactivity (Multidimensional Personality Questionnaire) was measured at T2. Results: Structural equation mediation modeling demonstrated that higher T1 GAD severity positively predicted more severe T3 MDD symptoms via T2 stress reactivity (d = 0.45–0.50). After controlling for T1 GAD, T2 stress reactivity was not a significant mediator in the relationship between higher T1 MDD symptoms and worse T3 GAD symptoms. Direct effects indicated that T1 GAD positively predicted T3 MDD 18 years later, and vice versa (d = 1.29–1.65). Limitations: Stress reactivity was assessed using a self-report measure, limiting conclusions to perceived (vs. behaviorally indexed) stress reactivity. Conclusions: These findings indicate that stress reactivity may be one mechanism through which GAD leads to later MDD over prolonged durations. Overall, our results suggest that targeting stress reactivity in treatments for GAD may reduce the risk of developing subsequent MDD.

2021 ◽  
pp. 134-137
Tainã Brito Siebra de Oliveira ◽  
Jorge Lucas de Sousa Moreira ◽  
Pedro Walisson Gomes Feitosa ◽  
Danielly Gonçalves Sombra Lima ◽  
Bárbara Silveira Dionízio ◽  

Background: Information on strategies adopted by Indigenous peoples against COVID-19 is scarce, and history shows that Indigenous peoples in the Amazon region may be particularly affected by the  pandemic. Method: The studies were identified in well-known international journals found in two electronic databases: Scopus and Embase. The data were cross-checked with information from the main international newspapers. Results: Mental disorders in the affective spectrum (unipolar major depression, dysthymia, bipolarity) and anxiety disorders (generalized anxiety disorder, panic attacks, social phobia) also mark the reality of Indigenous psychiatric vulnerability. Conclusions: To mitigate the impact of COVID-19 on Indigenous communities in Brazil, a health service for Indigenous groups, a crisis office, and a monitoring panel were created. In the state of Amazonas, home to more Indigenous people than any other Brazilian state, 95% of the intensive care beds are occupied.  Thus, mental health disparities between Indigenous and non-Indigenous peoples may be related to the underlying economic, social, and political inequities that are legacies of colonization and oppression of Indigenous cultures; the disproportionate rates of mental disorders must be understood in context, not as intrinsic predisposition of Indigenous peoples, but as reflecting persistent inequalities.

André Hajek ◽  
Hans-Helmut König

The aim was to clarify the prevalence and correlates of probable major depressive disorder and probable generalized anxiety disorder in the general adult population during the COVID-19 pandemic. Data were derived from a nationally representative survey (August and September 2021). In total, n = 3075 individuals took part. To quantify probable generalized anxiety disorder, the established Generalized Anxiety Disorder-7 (GAD-7; cutoff of 10) was used. Moreover, the Patient Health Questionnaire-9 (PHQ-9; cutoff of 10) was used to quantify probable major depressive disorder. The prevalence of probable major depressive disorder was 20.0% and the prevalence of probable generalized anxiety disorder was 13.4%. Particularly high prevalence rates were observed for younger individuals, individuals with migration background and individuals with at least one chronic disease. The likelihood of probable major depressive disorder was positively associated with younger age, being unmarried, having a migration background, smoking, daily alcohol intake, the presence of chronic diseases and lower self-rated health. Similarly, the likelihood of probable generalized anxiety disorder was positively associated with younger age, being unmarried, smoking, the presence of chronic diseases and lower self-rated health. In conclusion, the magnitude of probable major depressive disorder and probable generalized anxiety disorder in Germany in late summer of 2021 was highlighted. Identifying the correlates of them may help to tackle individuals at higher risk.

David B. Olawade ◽  
Ojima Z. Wada ◽  
Fiyinfoluwa T. Asaolu ◽  
Aderonke Odetayo ◽  
Oluwabusayomi O. Akeju ◽  

The emergence of the coronavirus pandemic has affected the global population in an unprecedented way, which has disrupted livelihoods, as well as social activities including the closure of schools. The effect of the pandemic and the associated lockdown measures amplified the mental status of tertiary institution students in Nigeria, which has not been taken into proper view. To this effect, this study was conducted to assess the extent to which the coronavirus pandemic and lockdown measures impacted the mental health of tertiary university students in Southwestern, Nigeria. A cross-sectional online survey, using the standardized Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) depression and anxiety questionnaires were used, and appropriate summary statistics were carried out. In all (122 respondents), more than a third (35.5%) of the respondents had daily uncontrolled worries, 6.7% had suicidal intent, and over a tenth (14.2%) and (13.9%) had depression and anxiety respectively. The psychological impact of the coronavirus pandemic and associated lockdown measures on Nigerian university students is quite significant. Therefore, the mental well-being of Nigerian students should be taken into awareness and prioritized.

2021 ◽  
Zhipeng Wu ◽  
Zhening Liu ◽  
Zhengqian Jiang ◽  
Xingzi Fu ◽  
Qian Deng ◽  

AbstractOverprotection and overcontrol from parents or other family members, which are not rare in the Chinese culture, have been suggested to be traumatic experiences for some children. However, research on overprotection/overcontrol is much rarer in China compared with other childhood trauma subtypes. One of the possible reasons for this is the lack of easy and feasible screening tools. In this study, we therefore translated and validated a Chinese version of the 33-item Childhood Trauma Questionnaire (CTQ-33), which was expanded from the widely-used 28-item CTQ with an additional overprotection/overcontrol subscale. A total of 248 young healthy participants were recruited and completed the Chinese version of CTQ-33, and 50 of them were retested after an interval of two weeks. At baseline, all participants also completed the 9-item Patient Health Questionnaire and the 7-item Generalized Anxiety Disorder Scale to assess their depression and anxiety, respectively. Our main findings include that: (1) the Chinese version of CTQ-33 showed a good internal consistency (Cronbach’s α coefficient = 0.733) and an excellent test-retest reliability over a two-week period (ICC = 0.861); (2) the previously reported significant associations between the overprotection/overcontrol and other subtypes of childhood trauma (abuse and neglect), as well as psychopathological conditions such as depression can all be replicated using the Chinese version of CTQ-33. These results suggest that the Chinese version of CTQ-33 would be a promising tool for assessing various subtypes of childhood adversities, especially the overprotection/overcontrol experiences in Chinese populations.

Bailee L. Malivoire ◽  
Naomi Koerner

Abstract Background: Interpersonal dysfunction has been proposed as an important maintenance factor in chronic worry and generalized anxiety disorder (GAD). Perceptions of problems and the problem-solving process as threatening, and unhelpful (e.g. avoidant, impulsive) problem-solving styles are implicated in worry and have also been suggested to be associated with dysfunctional interpersonal styles. Aims: The present study assessed the relationships between interpersonal dysfunction and problem-solving orientation, approach, and effectiveness in a sample of individuals high in chronic worry and investigated the indirect effect of interpersonal dysfunction on GAD symptom severity through negative problem-solving beliefs and approaches. Method: Fifty-nine community participants completed questionnaires and an interpersonal problem-solving task. Results: Greater interpersonal dysfunction was significantly associated with greater negative problem-solving orientation and greater habitual avoidant and impulsive/careless problem-solving styles. Greater interpersonal dysfunction was associated with poorer effectiveness of solutions when the task problem involved conflict with a romantic partner. Negative problem-solving orientation fully mediated the relationship between interpersonal dysfunction and GAD symptoms. Conclusions: These findings support that problem-solving processes are implicated in interpersonal dysfunction and that negative beliefs about problem-solving account for the relationship between interpersonal dysfunction and GAD symptoms. Theoretical implications are discussed.

2021 ◽  
Vol 12 ◽  
Juliane Nora Schneider ◽  
Nina Hiebel ◽  
Milena Kriegsmann-Rabe ◽  
Jonas Schmuck ◽  
Yesim Erim ◽  

Objective: The present study aimed to investigate the correlation between moral distress and mental health symptoms, socio-demographic, occupational, and COVID-19-related variables, and to determine differences in healthcare workers’ (HCW) moral distress during the first wave of the COVID-19 pandemic.Method: Data from 3,293 HCW from a web-based survey conducted between the 20th of April and the 5th of July 2020 were analyzed. We focused on moral distress (Moral Distress Thermometer, MDT), depressive symptoms (Patient Health Questionnaire-2, PHQ-2), anxiety symptoms (Generalized Anxiety Disorder-2, GAD-2), and increased general distress of nurses, physicians, medical-technical assistants (MTA), psychologists/psychotherapists, and pastoral counselors working in German hospitals.Results: The strongest correlations for moral distress were found with depressive symptoms, anxiety symptoms, occupancy rate at current work section, and contact with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Nurses and MTA experienced significantly higher moral distress than physicians, psychologists/psychotherapists, and pastoral counselors. The average level of moral distress reported by nurses from all work areas was similar to levels which before the pandemic were only experienced by nurses in intensive or critical care units.Conclusion: Results indicate that moral distress is a relevant phenomenon among HCW in hospitals during the COVID-19 pandemic, regardless of whether they work at the frontline or not and requires urgent attention.

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