Angst Wetenschap

Examining anxiety sensitivity as a mediator of the association between PTSD symptoms and suicide risk among women firefighters.

J Anxiety Disord. 2017 Jun 13;50:94-102

Authors: Stanley IH, Hom MA, Spencer-Thomas S, Joiner TE

Abstract
OBJECTIVE: Posttraumatic stress disorder (PTSD) symptoms are associated with increased suicide risk. Anxiety sensitivity (AS)-the fear of anxiety-related sensations-is both a vulnerability factor for and consequence of PTSD symptoms. AS also predicts suicide risk. To our knowledge, no study has examined whether AS concerns account for the association between PTSD symptoms and suicide risk.
METHOD: A total of 254 women firefighters completed a web-based mental health survey. The Life Events Checklist for DSM-5 (LEC-5) was administered as a prelude to the PTSD Checklist for DSM-5 (PCL-5) to assess for exposure to a Criterion A event. The PCL-5, Anxiety Sensitivity Index-3 (ASI-3), and Suicidal Behaviors Questionnaire-Revised (SBQ-R) were utilized to assess PTSD symptoms, AS concerns, and suicide risk, respectively. Bootstrap mediation analyses were conducted, controlling for depression symptoms as measured by the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R).
RESULTS: Global and cognitive AS concerns, but neither physical nor social AS concerns, were statistically significant mediators of the relationship between PTSD symptoms (total score, re-experiencing and numbing clusters) and suicide risk. Alternate mediation models testing PTSD symptoms as a mediator of the relationship between AS concerns and suicide risk were not statistically significant, supporting the specificity of our proposed model.
CONCLUSIONS: Anxiety sensitivity concerns-specifically, cognitive AS concerns-account for the link between PTSD symptoms and suicide risk among women firefighters. Among firefighters with elevated PTSD symptoms, interventions that address cognitive AS concerns may thwart the trajectory to suicidal thoughts and behaviors.

PMID: 28645017 [PubMed - as supplied by publisher]

Treatment of avoidant/restrictive food intake disorder in a cohort of young patients in a partial hospitalization program for eating disorders.

Int J Eat Disord. 2017 Jun 23;:

Authors: Ornstein RM, Essayli JH, Nicely TA, Masciulli E, Lane-Loney S

Abstract
OBJECTIVE: Avoidant/restrictive food intake disorder (ARFID) is a recently named condition to classify patients who present with restricted nutritional intake without body image distortion or fear of weight gain. We sought to compare treatment outcomes of patients with ARFID in a family-centered partial hospital program (PHP) to those with other eating disorders (ED).
METHODS: A retrospective chart review of 130 patients 7 to 17 years of age admitted to the program from 2008 to 2012 was performed. Intake and discharge data included: length of stay; percentage median body mass index (%MBMI); and scores on the Children's Eating Attitudes Test (ChEAT) and Revised Children's Manifest Anxiety Scale (RCMAS). Between and within group effects were measured for intake and discharge data.
RESULTS: Patients with ARFID spent significantly fewer weeks in program than those with anorexia nervosa (AN) and experienced a similar increase in %MBMI as patients with AN and other specified/unspecified feeding and eating disorders. All patients exhibited significant improvements in psychopathology over the course of treatment as measured by scores on the ChEAT and RCMAS.
DISCUSSION: Our findings suggest that patients with ARFID can be successfully treated in the same PHP as patients with other ED, with comparable improvements in weight and psychopathology over a shorter time period. Results are limited to patients with ARFID who exhibit an acute onset of severe food restriction. Future research should incorporate measures relevant to the diagnosis of ARFID and explore how patients with different ARFID subtypes may respond to various treatments.

PMID: 28644568 [PubMed - as supplied by publisher]

Assessing cancer-specific anxiety in Chinese men with prostate cancer: psychometric evaluation of the Chinese version of the Memorial Anxiety Scale for Prostate Cancer (MAX-PC).

Support Care Cancer. 2017 Jun 22;:

Authors: Huang Q, Jiang P, Zhang Z, Luo J, Dai Y, Zheng L, Wang W

Abstract
PURPOSE: The Memorial Anxiety Scale for Prostate Cancer (MAX-PC) was developed to identify and assess cancer-specific anxiety among men with prostate cancer (PCa); however, there is no Chinese version. The aim of our study was to translate the English version of MAX-PC into Chinese and evaluate the psychometric properties of it.
METHODS: The study cohort comprised 254 participants. Internal consistency including the Cronbach's alpha coefficient and item-total correlations were used to measure the reliability of the scale. Factor structure was analyzed by exploratory factor analysis and concurrent validity by comparing MAX-PC scores with anxiety subscale scores of the Hospital Anxiety and Depression Scale (HADS). Divergent validity was assessed by correlating MAX-PC with HADS depression subscale, while discriminant ability by comparing differences in MAX-PC scores between different patient groups.
RESULTS: The Chinese version of MAX-PC demonstrated good reliability; the Cronbach's alpha coefficient for the total and three subscales (prostate cancer anxiety, PSA anxiety, and fear of recurrence) being 0.94, 0.93, 0.82, and 0.85, respectively. Exploratory factor analysis supported the three-factor structure of the scale established in the original version. Despite the somewhat underperformed divergent validity, the scale demonstrated good concurrent validity with a strong correlation with the HADS anxiety subscale (r = 0.71, p < 0.01). Moreover, discriminant ability was demonstrated by ability to differentiate between disease stages.
CONCLUSIONS: The MAX-PC Chinese version was confirmed to be a valid, reliable instrument and is thus appropriate for identifying and quantifying cancer-specific anxiety in Chinese PCa patients.

PMID: 28643193 [PubMed - as supplied by publisher]

Object Phobia and Altered RhoA Signaling in Amygdala of Mice Lacking RICH2.

Front Mol Neurosci. 2017;10:180

Authors: Sarowar T, Grabrucker S, Boeckers TM, Grabrucker AM

Abstract
RICH2 knockout (RICH2 KO) mice exhibit neophobia in the novel object test. To gain further insight into their anxiety-related phenotype, we subjected these mice to additional behavioral tests to elucidate whether the behavioral abnormality in these mice is a consequence of reduced exploratory motivation, and whether the neophobia is linked specifically to objects or also present for other modalities. RICH2 KO mice engage in normal exploration in a novel environment, suggesting that the anxiety-related phenotype is not due to reduced exploratory drive. Increased fear response was not observed using novel olfactory cues, but restricted to objects. Given that the amygdala is an important brain region mediating anxiety-related behaviors and a prime target for anxiety-related therapeutics, and RICH2 is a Rho-GTPase activating protein (GAP) regulating synaptic spine plasticity via small GTPases, we analyzed spine formation, morphology and receptor composition in amygdala. We found disinhibition of RhoA in the amygdala of RICH2 KO mice, along with a decreased ability for actin polymerization and a reduction in mature spines. However, we detected increased neuronal activation in the amygdala evidenced by c-fos labeling. Thus, we conclude that despite unaltered baseline activity, RICH2 KO mice show heightened amygdala response after exposure to objects, which, however, does not result in homeostatic strengthening of excitatory synapses.

PMID: 28642683 [PubMed - in process]

Assessing the efficacy of imagery-enhanced cognitive behavioral group therapy for social anxiety disorder: Study protocol for a randomized controlled trial.

Contemp Clin Trials. 2017 Jun 19;:

Authors: McEvoy PM, Moulds ML, Grisham JR, Holmes EA, Moscovitch DA, Hendrie D, Saulsman LM, Lipp OV, Kane RT, Rapee RM, Hyett MP, Erceg-Hurn DM

Abstract
Cognitive behavior group therapy (CBGT) is effective for social anxiety disorder (SAD), but a substantial proportion of patients do not typically achieve normative functioning. Cognitive behavioral models of SAD emphasize negative self-imagery as an important maintaining factor, and evidence suggests that imagery is a powerful cognitive mode for facilitating affective change. This study will compare two group CBGT interventions, one that predominantly uses verbally-based strategies (VB-CBGT) and another that predominantly uses imagery-enhanced strategies (IE-CBGT), in terms of (a) efficacy, (b) mechanisms of change, and (c) cost-effectiveness. This study is a parallel groups (two-arm) single-blind randomized controlled trial. A minimum of 96 patients with SAD will be recruited within a public outpatient community mental health clinic in Perth, Australia. The primary outcomes will be self-reported symptom severity, caseness (SAD present: yes/no) based on a structured diagnostic interview, and clinician-rated severity and life impact. Secondary outcomes and mechanism measures include blind observer-rated use of safety behaviors, physiological activity (heart rate variability and skin conductance level) during a standardized speech task, negative self-beliefs, imagery suppression, fear of negative and positive evaluation, repetitive negative thinking, anxiety, depression, self-consciousness, use of safety behaviors, and the EQ-5D-5L and TiC-P for the health economic analysis. Homework completion, group cohesion, and working alliance will also be monitored. The outcomes of this trial will inform clinicians as to whether integrating imagery-based strategies in cognitive behavior therapy for SAD is likely to improve outcomes. Common and distinct mechanisms of change might be identified, along with relative cost-effectiveness of each intervention.

PMID: 28642208 [PubMed - as supplied by publisher]