Generalized Anxiety Disorder In Adolescents Research Articles

The Influence of Family Relationships on Adolescent Generalized Anxiety Disorder

This comprehensive review synthesizes a wide array of studies investigating the intricate relationship between family dynamics and adolescent Generalized Anxiety Disorder (GAD) using a literature review approach. Briefly analyzed and summarized the relationship between Generalized Anxiety Disorder and theories such as social learning theory, psychodynamic theory, and Bronfenbrenners ecological systems theory. The consensus across numerous investigations suggests a substantial impact of family relationships on the prevalence and manifestation of GAD among adolescents. Notably, findings consistently underscore the significance of parent-adolescent interactions and the quality of inter-parental relationships in shaping adolescent anxiety levels. However, most studies employ cross-sectional designs, limiting the establishment of conclusive long-term causal links. Also, prevalent self-report evaluations for anxiety disorders among adolescents pose limitations, lacking comprehensive, objective assessments that may affect research outcomes. Addressing these limitations in future studies is critical to comprehensively elucidate the nuanced relationship between adolescent GAD and family dynamics.

Association between watching eating broadcasts like mukbang and cookbang and generalized anxiety disorder among Korean adolescents

BackgroundAnxiety disorders are common during adolescence; therefore, detecting anxiety disorders among adolescents and providing appropriate treatment are crucial. Studies have suggested that watching online audiovisual broadcasts like mukbang and cookbang (hereafter mukbang), where hosts eat or cook food, may influence anxiety disorders. However, there is insufficient research on the association between watching mukbang and generalized anxiety disorder (GAD). Therefore, we investigated the association between watching mukbang and GAD among Korean adolescents.MethodsWe analyzed 51,764 adolescents who participated in the 2020 Korea Youth Risk Behavior Web-Based Survey (KYRBS). The participants were asked how frequently they watched mukbang per week over the past 12 months. Anxiety disorders were assessed using the generalized anxiety disorder-7 (GAD-7) questionnaire. A multiple logistic regression analysis was performed after adjusting for confounding variables.ResultsThe prevalence of GAD was higher among adolescents who watched mukbang compared to those who did not (aOR: 1.100, 95% CI: 1.026–1.180, P = 0.008 in male participants; aOR: 1.090, 95% CI: 1.003–1.185, P = 0.042 in female participants). The frequency of watching mukbang showed a dose-dependent relationship with a greater likelihood of GAD in female adolescents.ConclusionThis study’s results showed that watching mukbang is associated with GAD in Korean adolescents. Proper interventions for mental health are needed for adolescents who watch mukbang.

Grey matter alterations in generalized anxiety disorder: A voxel-wise meta-analysis of voxel-based morphometry studies.

Grey matter, a crucial component of the brain, has been found altered in generalized anxiety disorder (GAD) of several voxel-based morphometry studies. The conclusive and consistent grey matter alterations in GAD have not been confirmed. Eleven voxel-based morphometry studies of GAD patients were included in the current systematic review and meta-analysis. The linear model of anxiety severity scores was applied to explore the relationship of grey matter alterations and anxiety severity. The subgroup analysis of adult GAD and adolescent GAD was also performed. Significantly modest grey matter alterations in the left superior temporal gyrus of patients with GAD were found. The anxiety severity score was significantly correlated with grey matter alterations in the right insula, lenticular nucleus, putamen and striatum. The subgroup analysis of adult GAD and adolescent GAD all failed to show significant grey matter alterations. However, in the adult GAD subgroup, anxiety severity score was significantly correlated with grey matter alterations in the right insula. GAD might have the modest grey matter alterations in the left superior temporal gyrus. Anxiety severity might be related to the grey matter alterations in the limbic regions, such as the right insula, lenticular nucleus, putamen and striatum. This kind of correlation might be related to the effects of adult GAD. Future studies with adequate sample sizes and sophisticated GAD categories will be needed.

Differences in risk of generalized anxiety disorder according to physical activity type in Korea adolescents: The Korea youth risk behavior web-based survey, 2020–2021

Objective This study aimed to analyze the association between the types of physical activity (PA) and the level of generalized anxiety disorder (GAD) in Korean adolescents. Methods This study analyzed data from the Korea Youth Risk Behavior Web-based Survey (KYRBS) for, 2020–2021. The dependent variable was the level of generalized anxiety disorder-7 (GAD-7). The GAD-7 scores were divided into four levels: normal, mild, moderate, and severe. The independent variables were moderate PA, vigorous PA, and strength exercises. Sex, school grade, body mass index, stress, depression, suicidal thoughts, violent victimization, drinking, smoking, substance abuse, sleep satisfaction, and sedentary time were selected as confounding variables. Results The independent variable and all confounding variables showed significant differences with the level of GAD-7 (all p < .001). After adjusting for all confounding variables, we observed a 1.062 elevation in mild anxiety disorders, a 1.147 increase in moderate anxiety disorders, and a 1.218 increased incidence of severe anxiety disorders in the absence of vigorous PA. In the absence of strength exercises, there was a 1.057 elevation in mild anxiety disorders, a 1.110 increase in moderate anxiety disorders, and a 1.351 increased incidence of severe anxiety disorders. However, in the case of moderate PA, after adjusting for confounding variables, there was no significant association with GAD-7 levels. Conclusion To prevent anxiety disorders among Korean adolescents, the type of PA should be considered. Vigorous PA or strength exercises may help prevent GAD in Korean adolescents.

Brain development mediates the relationship between self-reported poor parental monitoring and adolescent anxiety

Adolescence is the peak period for the onset of generalized anxiety disorder (GAD). Brain networks of cognitive and affective control in adolescents are not well developed when their exposure to external stimuli suddenly increases.Reasonable parental monitoring is especially important during this period.To examine the role of parental monitoring in the development of functional brain networks of GAD, we conducted a cross-validation-based predictive study based on the functional brain networks of 192 participants. We found that a set of functional brain networks, especially the default mode network and its connectivity with the frontoparietal network, could predict the ages of adolescents, which was replicated in three independent samples.Importantly, the difference between predicted age and chronological age significantly mediated the relationship between parental monitoring and anxiety levels. These findings suggest that inadequate parental monitoring plays a crucial role in the delayed development of specific brain networks associated with GAD in adolescents. Our work highlights the important role of parental monitoring in adolescent development.

Do You See What I See? Longitudinal Associations Between Mothers’ and Adolescents’ Perceptions of Their Relationship and Adolescent Internalizing Symptoms

This 6-year community study examined how discrepancies in mothers’ and adolescents’ perceptions of their relationship were longitudinally associated with adolescent internalizing symptoms, and vice versa. 497 adolescents (57% boys, Mage T1 = 13.03, SDage = 0.46) and their mothers reported in 6 annual waves on conflict and warmth in the mother-adolescent relationship and adolescents reported on their depressive and Generalized Anxiety Disorder (GAD) symptoms. Latent Congruence Models suggested that both adolescent depressive and GAD symptoms significantly predicted higher levels of conflict as well as stronger discrepancies in perceptions of conflict 1-year later. In turn, higher levels of conflict significantly predicted both adolescent depressive and GAD symptoms 1-year later. For warmth, lower levels significantly predicted adolescent depressive symptoms 1-year later. Concluding, these findings suggest (1) more systematic evidence for longitudinal associations between conflict than warmth in the mother-adolescent relationship and adolescent internalizing symptoms; (2) support for a transactional model, including support for both interpersonal scar or symptom-driven effects (concerning both levels of and mother-adolescent discrepancies in conflict) and interpersonal risk or relationship-driven effects (concerning levels of both conflict and warmth); (3) longitudinal effects from adolescent internalizing symptoms to mother-adolescent discrepancies, but not vice versa; and (4) strong consistency in patterns of findings across both adolescent depressive and GAD symptoms, with few differential longitudinal associations with aspects of mother-adolescent relationship quality. Thereby, this study provides a more nuanced understanding of the direction of effects between adolescent internalizing symptoms and both levels of and discrepancies in mothers’ and adolescents’ perceptions of their relationship.

Exploring the Major Factors Affecting Generalized Anxiety Disorder in Korean Adolescents: Based on the 2021 Korea Youth Health Behavior Survey.

(1) Background: Recently, the prevalence of generalized anxiety disorder (GAD) among adolescents has been higher than in adults. Early detection is important for treatment. Accordingly, although various factors affecting adolescents’ GAD have been studied, the body of research is fragmented, and an integrated analysis of the influencing factors is needed. Therefore, in this study, we intended to analyze various factors affecting GAD. (2) Methods: Using data from the Korea Youth Health Behavior Survey (2021), sociodemographic factors, negative emotion, and physical activity factors were selected. Correlation analysis, t-test, ANOVA, and multiple regression analysis were performed using SPSS 26.0. (3) Results: Perceived stress was found to be the factor that had the greatest influence on GAD. (4) Conclusions: The risk of GAD in Korean adolescents was found to increase in female students who had higher levels of perceived stress, and participated in less high-intensity or muscle-strengthening exercise.

Disruption of functional and structural networks in first-episode, drug-naïve adolescents with generalized anxiety disorder

BackgroundIndividuals with generalized anxiety disorder (GAD) tend to worry exaggeratedly and uncontrollably about various daily routines. Previous studies have demonstrated that the GAD patients exhibited widespread alternations in both functional networks (FN) and structural networks (SN). However, the simultaneous alternations of the topological organization of FN, SN, as well as their couplings in GAD still remain unknown. MethodsUsing multimodal approach, we constructed FN from resting-state functional magnetic imaging (R-fMRI) data and SN from diffusion magnetic resonance imaging (dMRI) data of 32 adolescent GAD patients and 25 healthy controls (HC). Graph theory analysis was employed to investigate the topological properties of FN, SN, and FN-SN coupling. ResultsCompared to HC, the GAD patients showed disruptions in global (i.e., decreased clustering coefficient, global, and local efficiency) and subnetwork (i.e., reduced intermodular connections, rich club, and feeder connections) levels in FN. Abnormal global level properties (i.e., increased characteristic path length and reduced global efficiency) were also observed in SN. Altered FN-SN couplings in normalized characteristic path length and feeder connections were identified in the GAD patients. The identified network measures were correlated with anxiety severity in the GAD patients. LimitationsThe sample size of the current study is small and the cross-sectional nature can not infer causal relationship. ConclusionsOur findings identified GAD-related topological alternations in both FN and SN, together with the couplings between FN and SN, providing us with a novel perspective for understanding the pathophysiological mechanisms of GAD.

Reduced top-down attentional control in adolescents with generalized anxiety disorder.

BackgroundGeneralized anxiety disorder (GAD) can significantly impair quality of life and is associated with a relatively poor long‐term prognosis. Anxiety disorders are often associated with hyper‐responsiveness to threat, perhaps coupled with impaired executive functioning. However, GAD, particularly adolescent GAD, has been the focus of little functional neuroimaging work compared to other anxiety disorders. Here, we examine the neural association of adolescent GAD with responsiveness to threat and response control.MethodsThe study involved 35 adolescents with GAD and 34 healthy comparison individuals (N = 69) matched on age, gender, and IQ. Participants were scanned during an affective number Stroop task.ResultsWe found significant Group‐by‐Task Condition interactions in regions involved in response control/motor responding (bilateral precentral gyri and cerebellum) and/or cognitive control/attention (dorsomedial and lateral frontal cortex, posterior cingulate cortex, cuneus, and precuneus). In line with predictions, the youth with GAD showed significantly less recruitment during task trials than the healthy comparison individuals. However, no indications of specific heightened responses to threat were seen.ConclusionsGAD involves reduced capacity for engaging regions involved in response control/motor responding and/or cognitive control/attention. This might reflect either a secondary consequence of the patient's worry or an early risk factor for the development of worry.

Examination of Systemic Inflammation Related Hemogram Biomarkers in Children and Adolescents with Generalized Anxiety Disorder

Objective: In this study, we aimed to examine the complete blood count parameters and blood-based systemic inflammatory markers in children with generalized anxiety disorder (GAD). Method: Retrospectively, complete blood count of 48 GAD diagnosed children and adolescents and age-gender matched 46 healthy controls were compared in terms of hemoglobin (Hb), erythrocyte distribution width (RDW), platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), white blood cell count (WBC), neutrophil, lymphocyte and monocyte counts and neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), and platelet to lymphocyte ratios (PLR). Chi-square test, independent samples t-test and Mann-Whitney U test were used for statistical evaluation. Results: MPV levels were found to be significantly higher (p=0.020), while PLT and PDW levels were found to be significantly lower (p=0.018 and p=0.011, respectively) in children and adolescents with GAD. There was no statistically significant difference in terms of hemoglobin (Hb), erythrocyte distribution width (RDW), plateletcrit (PCT), white blood cell count (WBC), neutrophil, lymphocyte and monocyte counts and neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), platelet to lymphocyte ratios (PLR) between case and control groups. Conclusion: Platelet parameters that have been postulated to be associated with inflammation, such as MPV and PDW may be related to possible inflammatory background of GAD in children and adolescents and comprehensive prospective studies are required on this subject.An Erratum to this article was published on 17 March 2021. https://dergipark.org.tr/en/pub/ktd/issue/60658/897382

Adolescent Endorsement of the "Weak-Not-Sick" Stereotype for Generalised Anxiety Disorder: Associations with Prejudice, Discrimination, and Help-Giving Intentions toward Peers.

Stigma, comprising negative stereotypes, prejudice (negative affective reactions) and discrimination towards a member of a particular group, is of increasing interest in the context of mental illness. However, studies examining clinical anxiety stigma are lacking, particularly with regard to generalised anxiety disorder (GAD). There is also a lack of research into adolescent anxiety stigma, despite adolescence being a key period for early intervention for anxiety disorders, and research showing that stigma has been implicated in low rates of help-seeking and problematic peer relationships among adolescents with mental illness. Stigma has also been negatively associated with help-giving responses toward those with mental illness. Initial studies suggest that the ‘weak-not-sick’ (WNS) stereotype may be central to anxiety stigma. The present study aims to examine the endorsement of the WNS stereotype in the context of GAD, and its relationship to prejudice, discrimination, and help-giving responses among adolescents. A vignette-based survey measure was completed by 242 adolescents (74 male, 165 female, and three participants who recorded their gender as “other”) in Ireland aged between 15 and 19 years. The results of the study found that endorsement of the WNS stereotype was significantly associated with higher prejudice and discrimination, as well as lower levels of help-giving intentions. A multiple mediator model is presented showing both a direct relationship between endorsement of WNS and help-giving, and an indirect relationship between WNS and help-giving mediated by the prejudicial components of anger, fear and pity, and discrimination as assessed by desired social distance. This study adds to the limited knowledge base on stigma towards GAD in adolescents and provides a model for how anxiety stigma may relate to help-giving. This has implications for interventions to reduce stigmatising and increase help-giving responses.

Depression and anxiety as emerging contributors to increased hospital length of stay after posterior spinal fusion in patients with adolescent idiopathic scoliosis

Background ContextThe diagnosis of generalized anxiety disorder (GAD) and major depressive disorder (MDD) amongst adolescents is rising worldwide. Rates of these disorders are higher in those with adolescent idiopathic scoliosis. PurposeTo elucidate whether or not depression and anxiety are associated with increased length of stay and total cost after posterior spinal fusion for adolescent idiopathic scoliosis. Study Design/Setting, Patient SampleThis study utilized the Nationwide Inpatient Sample (NIS) to obtain a sample of n = 564 in the depression and anxiety cohort and n = 5,185 in the cohort without concomitant diagnosis of depression and anxiety. Outcome MeasuresLength of stay and total cost after posterior spinal fusion for adolescent idiopathic scoliosis. MethodsThe Nationwide Inpatient Sample (NIS) was queried for patients undergoing posterior spinal fusion (PSF) for adolescent idiopathic scoliosis with either the concomitant diagnosis of major depressive disorder or generalized anxiety disorder. Comorbidities and other confounders were controlled for using multivariate regression analysis to determine the effect of having either mood disorder on cost and length of stay (LOS) after PSF. ResultsWe determined that after controlling for confounding variables and comorbidities through multivariate regression analysis, patients with either depression or anxiety had increased odds ratios for increased LOS but not for cost. ConclusionsThe emergence of adolescent MDD and GAD may have significant implications on the inpatient stay for patients undergoing major surgery, including PSF for adolescent idiopathic scoliosis.

Generalized anxiety disorder: Prevalence, predictors, and comorbidity in children and adolescents

Generalized anxiety disorder (GAD) is one of the most prevalent anxiety disorders among children and adolescents. ObjectivesThe purpose of this study is to determine the prevalence, sociodemographic variables, and comorbidity of GAD among children and adolescents to suggest the main predictors, using an analytical cross-sectional study. MethodData were collected via a multistage random-cluster sampling method from 29,709 children and adolescents aged 6–18 years old in Iran. We used the Persian present and lifetime version of the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-PL). Then, we analyzed the data via descriptive analysis and multivariate logistic regression analysis methods. ResultsThe lifetime prevalence rate for GAD was 2.6 % (95 % Cl, 2.4%–2.8%). Overall, logistic regression analyses revealed five variables with significant unique contributions to the prediction of GAD. Significant predictors were: age, sex, mother history of psychiatric hospitalization, mother education, and residence. Participants with these risk factors were between 0.23–2.91 times more likely to present with GAD. Besides, the highest and lowest comorbidity rates of psychiatric disorder with GAD was 57.6 % and 0.3 % related to anxiety and eating disorders, respectively. Age or sex also affects the comorbidity of GAD and some mental disorders including behavioral, neurodevelopmental, elimination, and mood disorders. ConclusionThis study, which was conducted in Iran, is located at the low end of the range of international estimates for GAD. Awareness of the predictors and comorbidity of GAD could be used in the prevention of GAD in children and adolescents.

Decreased Intrinsic Functional Connectivity in First-Episode, Drug-Naive Adolescents With Generalized Anxiety Disorder.

Generalized anxiety disorder (GAD) is characterized by excessive and uncontrollable worry about everyday life. Prior neuroimaging studies have demonstrated that GAD is associated with disruptions in specific brain regions; however, little is known about the global functional connectivity maps in adolescents with GAD. Here, first-episode, medication-naive, adolescent GAD patients (N = 36) and healthy controls (N = 28) (HCs) underwent resting-state functional MRI (R-fMRI) and completed a package of questionnaires to assess clinical symptoms. Functional connectivity strength and seed-based functional connectivity were employed to investigate the functional connectivity architecture. GAD patients showed reduced functional connectivity strength in right supramarginal gyrus (SMG) and right superior parietal gyrus (SPG) compared with HCs. Further seed-based functional connectivity analysis revealed that GAD patients displayed decreased functional connectivity between right SMG and left fusiform gyrus, inferior temporal gyrus, parahippocampal gyrus, bilateral precuneus and cuneus, and between right SPG and bilateral supplementary motor area and middle cingulate gyrus, as well as between the SMG-based network and the SPG-based network. Moreover, the disrupted intra-network connectivity (i.e., the SMG-based network and the SPG-based network) and inter-network connectivity between the SMG-based network and the SPG-based network accounted for 25.5% variance of the State and Trait Anxiety Inventory (STAI) and 39.5% variance of the trait subscale of STAI. Our findings highlight the abnormal functional architecture in the SMG-based network and the SPG-based network in GAD, providing novel insights into the pathological mechanisms of this disorder.

Alexithymia in parents and adolescents with generalised anxiety disorder

BackgroundThe relationship between generalised anxiety disorder (GAD) and alexithymia has been poorly studied in adolescents. The present study examined the alexithymia levels in adolescents with GAD and their parents compared with healthy control participants (adolescents and their parents).MethodThe sample included 300 participants: 50 adolescents with GAD and 50 healthy adolescents, 13–18 years of age, and their 200 parents (100 mothers and 100 fathers). The Schedule for Affective Disorders and Schizophrenia for School‐Age Children was performed to evaluate adolescents’ mental health while the 20‐item Toronto Alexithymia Scale was performed to assess alexithymia levels in both adolescents and their parents.ResultsAdolescents with GAD showed a significantly higher rate of alexithymia when compared with control adolescents. The mothers of adolescents with GAD showed an alexithymia score higher than did the controls’ mothers. The fathers of the two groups showed no differences of in their rate of alexithymia. Moreover, in the clinical sample, adolescent and maternal alexithymia scores were not correlated, while significant directed correlations were found between these adolescents and their own fathers.ConclusionsOur findings show an association between GAD and alexithymia in adolescents. A significant presence of alexithymic traits in the mothers of the patients with GAD was shown. An intergenerational transmission of alexithymia could be supposed but this cannot be a linear mechanism. The assessment of alexithymia in adolescents with psychological disorders, and in their parents, could be useful to plan a more targeted therapeutic approach.

Frequency-Specific Functional Connectivity Density as an Effective Biomarker for Adolescent Generalized Anxiety Disorder.

Several neuropsychiatric diseases have been found to influence the frequency-specific spontaneous functional brain organization (SFBO) in resting state, demonstrating that the abnormal brain activities of different frequency bands are associated with various physiological and psychological dysfunctions. However, little is known about the frequency specificities of SFBO in adolescent generalized anxiety disorder (GAD). Here, a novel complete ensemble empirical mode decomposition with adaptive noise method was applied to decompose the time series of each voxel across all participants (31 adolescent patients with GAD and 28 matched healthy controls; HCs) into four frequency-specific bands with distinct intrinsic oscillation. The functional connectivity density (FCD) of different scales (short-range and long-range) was calculated to quantify the SFBO changes related to GAD within each above frequency-specific band and the conventional frequency band (0.01–0.08 Hz). Support vector machine classifier was further used to examine the discriminative ability of the frequency-specific FCD values. The results showed that adolescent GAD patients exhibited abnormal alterations of both short-range and long-range FCD (S-FCD and L-FCD) in widespread brain regions across three frequency-specific bands. Positive correlation between the State Anxiety Inventory (SAI) score and increased L-FCD in the fusiform gyrus in the conventional frequency band was found in adolescents with GAD. Both S-FCD and L-FCD in the insula in the lower frequency band (0.02–0.036 Hz) had the highest classification performance compared to all other brain regions with inter-group difference. Furthermore, a satisfactory classification performance was achieved by combining the discrepant S-FCD and L-FCD values in all frequency bands, with the area under the curve (AUC) value of 0.9414 and the corresponding sensitivity, specificity, and accuracy of 87.15, 92.92, and 89.83%, respectively. This study indicates that the alterations of SFBO in adolescent GAD are frequency dependence and the frequency-specific FCD can potentially serve as a valuable biomarker in discriminating GAD patients from HCs. These findings may provide new insights into the pathophysiological mechanisms of adolescent GAD.

An Effective Method to Identify Adolescent Generalized Anxiety Disorder by Temporal Features of Dynamic Functional Connectivity.

Generalized anxiety disorder (GAD) is one of common anxiety disorders in adolescents. Although adolescents with GAD are thought to be at high risk for other mental diseases, the disease-specific alterations have not been adequately explored. Recent studies have revealed the abnormal functional connectivity (FC) in adolescents with GAD. Most previous researches have investigated the static FC which ignores the fluctuations of FC over time and focused on the structures of “fear circuit”. To figure out the alterations of dynamic FC caused by GAD and the possibilities of dynamic FC as biomarkers, we propose an effective approach to identify adolescent GAD using temporal features derived from dynamic FC. In our study, the instantaneous synchronization of pairwise signals was estimated as dynamic FC. The Hurst exponent (H) and variance, indicating regularity and variable degree of a time series respectively, were calculated as temporal features of dynamic FC. By leave-one-out cross-validation (LOOCV), a relatively high accuracy of 88.46% could be achieved when H and variance of dynamic FC were combined as features. In addition, we identified the disease-related regions, including regions belonging to default mode (DM) and cerebellar networks. The results suggest that temporal features of dynamic FC could achieve a clinically acceptable diagnostic power and serve as biomarkers of adolescent GAD. Furthermore, our work could be helpful in understanding the pathophysiological mechanism of adolescent GAD.

Hypothalamus–pituitary–adrenal axis daily fluctuation, anxiety and age interact to predict cortisol concentrations in boys with an autism spectrum disorder

There is considerable evidence of a confound between symptoms of generalised anxiety disorder (GAD) and autism spectrum disorder (ASD) in children who have an ASD. Although there have been several attempts to describe how these two disorders overlap and interact to influence the assessment and diagnosis of children with an ASD, principally by reference to cortisol assayed from these children's saliva, the overall evidence is inconsistent. Because previous models of these relationships have focused upon cortisol and GAD to the exclusion of age, diurnal fluctuation in the HPA axis and the source of GAD data, these variables were examined in a sample of 150 young males with an ASD. Results indicated that there was a significant interaction between these variables, with the association between GAD and cortisol demonstrated for children but not for adolescents, with an interaction between the source of GAD information (self- vs parent-ratings) and whether the child's cortisol concentrations followed the expected diurnal reduction during the day. These data suggest that the validity of cortisol as a biomarker of GAD in children and adolescents with an ASD may be established for only selected subgroups of this population.

White matter abnormalities in adolescents with generalized anxiety disorder: a diffusion tensor imaging study

BackgroundPrevious neuroimaging studies have suggested an abnormal neural circuitry of emotion regulation including the amygdala and prefrontal cortex in both adult and adolescent generalized anxiety disorder (GAD) patients. Aberrant integrity of white matter in this neural circuitry has been verified in adult GAD patients. White matter abnormalities in adolescent GAD patients have not been detected.MethodsTwenty-five adolescents with GAD and 24 healthy controls underwent a diffusion tensor imaging scan. Fractional anisotropy (FA) was compared between groups with a voxel-wise Tract-Based Spatial Statistics (TBSS) analysis method.ResultsCompared with healthy controls, adolescents with GAD showed significantly reduced FA in bilateral uncinate fasciculus, inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, and corona radiata.ConclusionsThe findings in the present study suggest a neural basis of emotion dysregulation in adolescent GAD patients.

Lack of gender effects on gray matter volumes in adolescent generalized anxiety disorder

BackgroundPrevious epidemiological and clinical studies have reported gender differences in prevalence and clinical features of generalized anxiety disorder (GAD). Such gender differences in clinical phenomenology suggest that the underlying neural circuitry of GAD could also be different in males and females. This study aimed to explore the possible gender effect on gray matter volumes in adolescents with GAD. MethodsTwenty-six adolescent GAD patients and 25 healthy controls participated and underwent high-resolution structural magnetic resonance scans. Voxel-based morphometry (VBM) was used to investigate gray matter alterations. ResultsOur study revealed a significant diagnosis main effect in the right putamen, with larger gray matter volumes in GAD patients compared to healthy controls, and a significant gender main effect in the left precuneus/posterior cingulate cortex, with larger gray matter volumes in males compared to females. No gender-by-diagnosis interaction effect was found in this study. LimitationsThe relatively small sample size in this study might result in a lack of power to demonstrate gender effects on brain structure in GAD. ConclusionsThe results suggested that there are differences in gray matter volumes between males and females, but gray matter volumes in GAD are not influenced by gender.