Anxiety Difficulties Research Articles

Emotion Regulation in Couples Affected by Female Sexual Interest/Arousal Disorder.

Female sexual interest/arousal disorder (FSIAD) is associated with psychological, relational, and sexual consequences for affected women, and their romantic partners also suffer repercussions. Prior research suggests that women with FSIAD report more difficulties with emotion regulation than controls. Yet, whether emotion regulation is associated with the psychological, relational, and sexual well-being of both members of affected couples is unknown. Eighty-seven women diagnosed with FSIAD via a clinical interview and their male partners completed standardized measures of difficulties in emotion regulation, depression, anxiety, relationship satisfaction, dyadic conflict, sexual desire, and sexual distress. A subset (n = 71 couples) also completed measures of emotional suppression and reappraisal in relation to sex. Analyses used multilevel modeling guided by the actor-partner interdependence model. When women reported greater difficulties regulating negative emotion, they reported greater depression and anxiety, and when men reported more of these difficulties, they had greater depression, anxiety, and sexual distress, and the women with FSIAD reported lower relationship satisfaction. When women reported greater emotional suppression, they reported greater depression and anxiety, and lower relationship satisfaction; when they reported greater use of emotional reappraisal, they had fewer symptoms of depression and anxiety, and their partners reported lower dyadic conflict. When men reported greater emotional suppression, they had greater depression, lower relationship satisfaction, and sexual desire; when they reported greater emotional reappraisal, they had lower depression and anxiety, higher relationship satisfaction, lower dyadic conflict, higher sexual desire and women reported higher relationship satisfaction and lower dyadic conflict. Emotion regulation may be an important target for interventions to help couples cope with FSIAD.

Seeking and accessing professional support for child anxiety in a community sample

There is a lack of current data on help-seeking, and barriers to accessing professional support for child anxiety disorders. This study aimed to provide current data on the frequency and type of parental help-seeking, professional support received, and parent-reported barriers/facilitators in the context of child anxiety, and to explore factors associated with help-seeking, and parent-reported barriers among help-seekers and non help-seekers. We conducted a survey of help-seeking in parents of 222 children (aged 7–11) with elevated anxiety symptoms identified through screening in schools, 138 children of whom met diagnostic criteria for an anxiety disorder. Almost two-thirds (64.5%) of parents of children with an anxiety disorder reported seeking help from a professional; in 38.4% of cases parents reported that their child had received support from a professional to help manage and overcome their anxiety difficulties, and < 3% had received evidence-based treatment (CBT). Frequently reported parental barriers related to difficulties differentiating between developmentally appropriate and clinically significant anxiety, a lack of help-seeking knowledge, perceived negative consequences of help-seeking, and limited service provision. Non-help seekers were more likely than help seekers to report barriers related to thinking a child’s anxiety may improve without professional support, and the absence of professional recognition. Findings identify the need for (i) tools for parents and primary school staff to help identify children who may benefit from professional support to overcome difficulties with anxiety; and (ii) increased evidence-based provision for child anxiety disorders, including delivery within schools and direct support for parents.

Sensory Processing and Internalizing Behaviors in Children: A Scoping Review

Abstract Date Presented 04/06/19 This scoping review examined research on the association between sensory processing and internalizing behavior among individuals ages 1-22 years. Findings suggest that sensory processing sensitivity was positively associated with various conditions, personality characteristics, aspects of family life, anxiety, and mental health difficulties. Findings from this scoping review may inform intervention approaches that target the sensory processing underpinnings of internalizing behaviors. Primary Author and Speaker: Kasey Kotsiris Additional Authors and Speakers: Lauren Little

Spanish version of Super Skills for Life: short- and long-term impact of a transdiagnostic prevention protocol targeting childhood anxiety and depression

ABSTRACTBackground and Objectives: Super Skills for Life (SSL) is a transdiagnostic protocol based on cognitive–behavioral therapy designed for children with internalizing problems. The present study examined for the first time the impact of the Spanish-adapted version of SSL in reducing anxiety and depressive symptoms in Spanish-speaking children.Design: A quasi-experimental design with one group, pre- and posttest, and 1-year follow-up was conducted. Analyses were performed on an intent-to-treat basis.Methods: Participants were 119 children (42.9% female; 8–12 years) recruited from nine schools. Children completed assessments of anxiety, depression, emotional and behavioral difficulties, and the extent to which anxiety interfered with life before and after receiving the 8-session SSL, and 12-months post-intervention.Results: Anxiety and depressive symptoms were significantly reduced at post-test and 12-month follow-up assessments. SSL also had positive impact on other symptoms assessed (e.g., interference of anxiety with children’s life, peer problems, conduct problems). Overall, the long-term benefits of SSL appeared to be greater than the short-term benefits.Conclusions: The results of this study suggest that SSL may be useful in reducing symptoms of anxiety and depression, and a broad range of other issues, in Spanish children.

"Just keep pushing": Parents' experiences of accessing child and adolescent mental health services for child anxiety problems.

Anxiety disorders are among the most common psychopathologies in childhood; however, a high proportion of children with anxiety disorders do not access effective treatments. The aim of the present qualitative study was to understand families' experiences of seeking help and accessing specialist treatment for difficulties with childhood anxiety. Parents of 16 children (aged 7-12years) referred to a child mental health service for difficulties with anxiety were interviewed about their experiences of seeking and accessing treatment within Child and Adolescent Mental Health Service (CAMHS). All interviews were transcribed verbatim and thematically analysed for similarities and differences in families' experiences. Factors that helped and/or hindered families accessing treatment related to (a) parental recognition, (b) contact with professionals, (c) reaching CAMHS, (d) parental effort, and (e) parental knowledge and concerns. High demands on services and parents' uncertainty surrounding the help-seeking process presented key hurdles for families. The critical role of parental persistence and support from general practitioners and school staff was evident across interviews. Findings highlighted the need for information and guidance on identifying child anxiety difficulties and professional, peer, and self-help support, and ensuring sufficient provision is available to allow families prompt access to support.

ELECTROPHYSIOLOGICAL EVALUATION OF THE EFFECTIVENESS OF NEUROFEEDBACK IN AMELIORATING CHRONIC POST-RAUMATIC STRESS DISORDER

The aim of our research was to evaluate the effectiveness of neurofeedback in reducing the symptoms of chronic Post Traumatic Stress Disorder (PTSD) in a patient who had developed the syndrome following a recurrence of sphenoid wing meningioma (SOM). EEG spectra and event-related potentials (ERPs) were used to construct an individual neurofeedback protocol and to provide objective monitoring of treatment efficacy. The patient, a 34-year-old female, was diagnosed with a sphenoid wing meningioma (SOM), which had been successfully operated. Three years later, however, the SOM had overgrown at the optic foramen and extended into the optic canal, and the patient had developed blurred vision. She was repeatedly operated, and recovered well. However, due to the recurrence she developed flashbacks, anxiety and sleep difficulties, such that she was unable to continue working in her profession. The symptoms had been occurring for 4 months. ERPs in a cued NOGO task, along with EEG spectra in the resting state and during task performance were used to assess brain functioning, providing the basis for a neurofeedback protocol. Twenty sessions of individually tailored neurofeedback were performed. The patient experienced a reduction of symptoms, accompanied by normalization of ERPs parameters. The results obtained in this case point to the possible benefits of individually tailored neurofeedback protocols in the treatment of PTSD.

Impact of vitamin D fortified food on quality of life and emotional difficulties among adolescents – A randomized controlled trial

Background: The action of vitamin D on health related quality of life (HRQoL) and emotional difficulties of individuals has been extensively studied in several epidemiological studies. However, studies focusing on the effect of vitamin D fortification on these aspects among adolescents are limited. Aim: This study aims to explore the influence of vitamin D fortification on the vitamin D status and the HRQoL and emotional difficulties among adolescents. Methods: A total of 71 healthy adolescents consented to be a part of the randomized controlled trial conducted in two schools in Chennai, India. They were allocated and blinded into two groups: experimental (one vitamin D fortified ladduu (a homemade eatable with natural supplements) daily, containing 1000 IU vitamin D3) or the control group (one unfortified ladduu daily) for 12 weeks following random assignment. The vitamin D status, HRQoL and emotional difficulty parameters of anxiety and stress of the participants were evaluated both at baseline and at 12 weeks. Data were analyzed using SPSS version 12. Results: Vitamin D status of the adolescents significantly improved post supplementation (Z=-6.28; P =0.00). However, despite of significant improvement, no significant changes were observed in the other parameters. Conclusion: These findings demonstrate that although vitamin D fortification helps in improving the vitamin D status of adolescents, it does not particularly benefit their HRQoL and emotional difficulties of anxiety and stress of adolescents.

Exposure and Response Prevention for Obsessive-Compulsive Disorder: A Case Study of a Veteran With Violent Intrusive Thoughts.

Exposure and Response Prevention (ERP) is the gold standard treatment for obsessive-compulsive disorder (OCD); however, few studies have evaluated the use of ERP with veterans. This case study describes ERP and medication treatment of a veteran who experienced violent sexual thoughts, countered by compulsions of focusing on the distressing thought to ensure a negative emotion or reversing the thought to a nonviolent thought or image. The veteran had previously received supportive psychotherapy and medication for depression, anxiety, and sleep difficulties, with poor treatment adherence. Upon reengagement in treatment, the therapist provided ERP in 34 sessions over 14 months, with 15 sessions via video telehealth to home. The patient used the OCD Workbook as a resource throughout treatment. The patient developed a hierarchy of target obsessions and rituals with associated subjective units of distress; completed exposures, beginning with lower-level items; and wrote imaginal scripts. He also received zolpidem for insomnia and venlafaxine for anxiety and depression. His scores on the nine-item Patient Health Questionnaire and Yale Brown Obsessive-Compulsive Scale decreased significantly.

Mindfulness Improves Emotion Regulation and Executive Control on Bereaved Individuals: An fMRI Study.

The grief of bereavement is recognized as a severe psychosocial stressor that can trigger a variety of mental and physical disorders, and the long-lasting unresolved grief has a detrimental effect on brain functionality. Literature has documented mindfulness-based cognitive therapy (MBCT) as an efficient treatment for improving well-being, specifically related to the mood and cognition, in a variety of populations. However, little attention has been devoted to neural mechanisms with regard to bereaved individuals’ cognition after MBCT intervention. In this study, we recruited 23 bereaved participants who lost a significant relative within 6 months to 4 years to attend 8-week MBCT course. We used self-reporting questionnaires to measure emotion regulation and functional magnetic resonance imaging (fMRI) with the numerical Stroop task to evaluate the MBCT effect on executive control among the bereaved participants. The self-reported questionnaires showed improvements on mindfulness and reductions in grief, difficulties in emotion regulation, anxiety, and depression after the MBCT intervention. The fMRI analysis demonstrated two scenarios: (1) the activity of the fronto-parietal network slightly declined accompanied with significant improvements in the reaction time of incongruent trials; (2) the activities in the posterior cingulate cortex and thalamus were positively associated with the Texas Revised Inventory of Grief, implying emotional interferences on cognitive functions. Results indicated that MBCT facilitated the executive control function by alleviating the emotional interferences over the cognitive functions and suggested that the 8-week MBCT intervention significantly improved both executive control and emotion regulation in bereaved individuals.

The Difficulties in Emotion Regulation, Separation Anxiety and Impulsivity as Predictors of Women’s Intimate Partner Violence Experiences

The Difficulties in Emotion Regulation, Separation Anxiety and Impulsivity as Predictors of Women’s Intimate Partner Violence Experiences

A Case Study of Sandplay Therapy for a Boy in an Elementary School with Social and Emotional Difficulties

This study explored the internal world through sandplay therapy for an elementary school boy who had social and emotional difficulties of poor peer relations, anxiety and withdrawal. This study examined the changing processes of sandboxes, how a boy expressed his internal world by the content themes in sandplay according to Turner (2009) based on analytical psychology and sandplay theories. There were 72 sessions. The initial phase was 1-6 (The beginning of war) expressing confusing wars as the start of a long internal journey. The intermediate phase was 7-55 (Struggle), dividing by phase I 7-18 (Hero’s fight I), phase II 19-36 (Hero’s fight II), phase III 37-48 (Seeking for a male identity), and phase IV 49-55 (Centering). The client identified himself as a teenaged hero and expressed the conflict between good and bad, between death and rebirth and struggled for seeking treasures in the fight of heroes. He found identity as a male by finding a sense of existence, establishing order in the middle of confusion, and expressing strong and rational masculinity. The final phase was 56-72 (The winner of the struggle). In the fights repeating, he expressed an adventurous and positive male energy such as racing, speed contests and a union in the opposites of hero and heroine as well as the birth of a new conscious. This study provides a basic knowledge of educational guidance in school and counseling fields by expanding the understanding of a boy’s unconsciousness.

Is The Pain Real or Not?

Chronic pain (constant pain lasting 6 months or longer) is a subjective experience, which is influenced by many pre-morbid (before the onset of pain) psychological problems. However, chronic pain often can produce depression, anxiety, and marital difficulties. Although physical examination and other studies, including x-ray studies, 3D-CT, electromyelograms (EMG), nerve conduction velocity studies and MRI in many cases may document an organic basis of chronic back pain, some organic syndromes defy definition by objective tests. This may be a greater problem for women, where physician prejudice can result in a significantly less extensive evaluation of their complaints of back pain. Also, any litigation may influence symptoms and the type of litigation may influence outcomes. Therefore, there is a need to differentiate between “organic” and “functional” (negative physical and laboratory examination) back pain.

Be Your Own Superhero: A Case of a Young Boy With Selective Mutism and Complex Comorbidities

This case study outlines the treatment of a 5-year-old Caucasian male who presented with symptoms of selective mutism (SM) along with significant impairment related to comorbid anxiety and speech difficulties. To address these symptoms, Integrated Behavior Therapy for Selective Mutism (IBTSM) was utilized for the treatment of this young boy’s SM and comorbid anxiety. An attachment focus was incorporated as a framework for conceptualizing his SM symptoms. As the treatment of this young boy’s symptoms proceeded, it became clear that his underlying speech difficulties needed to be addressed as well, as these difficulties were preventing expected progress to occur. Thus, this young boy’s treatment was individualized to fit his unique difficulties. In shifting the treatment focus to “being brave like a superhero,” significant decreases were achieved in this young boy’s overall internalizing and Diagnostic and Statistical Manual of Mental Disorders ( DSM)-related anxiety symptoms, facilitating a successful transition to speech and language therapy. This case study is distinctive in its description of the complexities that may come along with treating symptoms that appear consistent with SM along with other comorbid conditions and nuanced circumstances.

Investigation of social anxiety level of migrated and not migrated secondary school student

It is thought that children whose family migrated may have a high social anxiety due to being not acepted by public and being exposed to negative evaluation. This study examines the social anxiety of migrated and nonmigrated children in terms of gender, socio-economic level and prevalence of child labour. The study group included 727 migrated and nomigrated secondary school students in Mersin. Data were collected with the Social Anxiety Scale for Children and the Personal Information Sheet. As a result, it is found that social anxiety differs depending on migration, gender, working situation and their reasons for migration. Child labour and low socio-economic level are more prevalent in the immigrant group. In this contex, it can be asserted that immigration constitutes to be a risk factor for experiencing social anxiety problems. Considering that migration is a continuing phenomenon, it would be necessary for some institutions such as the Ministry of Family and Social Policies, the Ministry of Education, the Ministry of Health, to carry out preventive studies collaboratively to ensure the children from migrant families are less affected by social anxiety and similar psychological difficulties.

Anterior cingulate activation to implicit threat before and after treatment for pediatric anxiety disorders

BackgroundResearch suggests that individuals with anxiety have difficulty ignoring threat distractors when completing tasks with competing stimuli. Studies examining the neural correlates of these emotional processing difficulties in youth anxiety highlight reduced recruitment of regions associated with goal-directed attention, such as the anterior cingulate cortex (ACC). In the current study, we examined neural activation during an emotional conflict task in youth with anxiety disorders before and after treatment. MethodsTwenty-five youth (ages 9–19 years) with generalized, separation, and/or social anxiety disorder and 25 healthy controls underwent 2 functional magnetic resonance imaging scans approximately 13 weeks apart. At each scan, participants completed a task in which they matched shapes in the context of emotional distractors (happy and threatening faces). Between scans, anxious youth were treated with the selective serotonin reuptake inhibitor (SSRI) sertraline or cognitive behavior therapy (CBT). ResultsPrior to treatment, anxious youth exhibited reduced activation of the medial prefrontal cortex, encompassing the rostral ACC, when matching shapes in the context of threat distractors relative to healthy controls. Activation in this region increased in anxious youth after treatment, but remained unchanged in the healthy control group. Increases in rostral ACC activation were related to greater reductions in social anxiety and avoidance symptoms following treatment. ConclusionsEffective treatments for pediatric anxiety may enhance rostral ACC response during attempts to filter out threat-relevant stimuli. Enhanced recruitment of this region may constitute one manner in which CBT and SSRI treatment reduce youth anxiety symptoms, particularly social anxiety and avoidance.

The Role of Shame and Self-Criticism in Social Anxiety: A Daily-Diary Study in a Nonclinical Sample

We sought to explore the daily association between shame and self-criticism, and the extent to which this association varies as a function of social anxiety symptoms. Fifty-nine undergraduate students completed a measure of social anxiety symptoms at a baseline meeting and then completed measures of shame experienced during significant social interactions and self-criticism following those interactions twice daily for 10 days. Social anxiety symptoms predicted more shame during daily social interactions and more self-criticism following them. Additionally, shame predicted subsequent self-criticism. This relationship was moderated by levels of social anxiety symptoms, such that those with higher levels of social anxiety symptoms exhibited high levels of self-criticism following daily social interactions characterized by both high and low shame, whereas those with lower levels of social anxiety symptoms showed high levels of self-criticism only after interactions with high levels of shame. These findings are consistent with the notion that self-criticism may serve as a regulatory coping method when experiencing shame, and that social anxiety difficulties are related to an inflexibly high level of self-criticism.

Barriers and facilitators to parents seeking and accessing professional support for anxiety disorders in children: qualitative interview study

Anxiety disorders are among the most common mental health disorders experienced by children, but only a minority of these children access professional help. Understanding the difficulties parents face seeking support for child anxiety disorders could inform targeted interventions to improve treatment access. The aims of the study were to identify barriers and facilitators to seeking and accessing professional support for child anxiety disorders, and ways to minimise these barriers. A qualitative interview study was conducted with parents of 16 children (aged 7–11 years) with anxiety disorders identified through screening in schools. Barriers and facilitators were identified in relation to four distinct stages in the help-seeking process: parents recognising the anxiety difficulty, parents recognising the need for professional support, parents contacting professionals, and families receiving professional support. Barriers and facilitators at each stage related to the child’s difficulties, the role of the parent, and parent perceptions of professionals and services. Findings illustrate the need (1) for readily available tools to help parents and professionals identify clinically significant anxiety in children, (2) to ensure that families and professionals can easily access guidance on the help-seeking process and available support, and (3) to ensure existing services offer sufficient provision for less severe difficulties that incorporates direct support for parents.

Psychological Treatment of Co‐occurring Anxiety Disorders in Clinical Practice: A Vignette Study

Background and ObjectivesMany individuals with anxiety difficulties present with co‐occurring anxiety disorders yet no evidence‐based guidelines exist on how to treat this presentation. The present study investigated how Australian psychologists approach treating co‐occurring anxiety disorders.MethodsA total of 169 psychologists practicing in Australia undertook an online survey consisting of open‐questions relating to the treatment of DSM‐IV anxiety disorder diagnoses and reported practice in relation to two clinical vignettes. Participant responses were coded using a directed content analysis approach.ResultsThe majority of psychologists reported utilising cognitive behaviour therapy (CBT) interventions in the treatment of single and co‐occurring anxiety disorders but not specific evidence‐based treatment guides or protocols. The majority of the psychologists surveyed reported that they adopt a transdiagnostic approach to addressing co‐occurring anxiety disorders.ConclusionsPsychologists typically do not follow a specific treatment guide in the treatment of anxiety disorders and judge a transdiagnostic approach incorporating CBT techniques as the best way to treat comorbidity. More effort may be needed to disseminate evidence‐based interventions for anxiety disorders and for authors of empirically supported treatments to provide clear guidelines regarding treating co‐occurring anxiety disorders.

Hyundai lets Amec Foster Wheeler contract for new gas-to-liquid plant in Uzbekistan

Postpartum psychiatric disorders represent a significant public health problem that has not been readily addressed, particularly in the primary care setting. As maternal mood and anxiety difficulties are associated with a number of adverse outcomes for the mother, her offspring and the family system, addressing these concerns during the perinatal period is of critical importance. Although researchers and clinicians have become increasingly aware of the problem, postpartum mood and anxiety disorders (PMADs) remain widely unrecognized and poorly understood by both patients and providers. As pediatric primary care providers encounter mothers repeatedly throughout the postpartum period, the pediatric clinician has the unique opportunity to intervene with mothers suffering from mental illness. Given the potentially devastating impact of PMADs across multiple domains, the purpose of this article is to provide guidelines for pediatric clinicians to better manage maternal mental illness within the primary care pediatric setting. As such, we review the categories and prevalence of PMADs and provide strategies for responding to a positive PMADs screen or concerns raised during surveillance of the mother–infant-dyad. In addition, we offer a summary of the literature on evidence-based treatments for PMADs to allow pediatricians to guide the parents of their patients towards the most effective interventions. Finally, we provide an overview of alternative treatment models that can facilitate the screening and treatment of behavioral health concerns within the primary care setting.

Treating postpartum mood and anxiety disorders in primary care pediatrics

Postpartum psychiatric disorders represent a significant public health problem that has not been readily addressed, particularly in the primary care setting. As maternal mood and anxiety difficulties are associated with a number of adverse outcomes for the mother, her offspring and the family system, addressing these concerns during the perinatal period is of critical importance. Although researchers and clinicians have become increasingly aware of the problem, postpartum mood and anxiety disorders (PMADs) remain widely unrecognized and poorly understood by both patients and providers. As pediatric primary care providers encounter mothers repeatedly throughout the postpartum period, the pediatric clinician has the unique opportunity to intervene with mothers suffering from mental illness. Given the potentially devastating impact of PMADs across multiple domains, the purpose of this article is to provide guidelines for pediatric clinicians to better manage maternal mental illness within the primary care pediatric setting. As such, we review the categories and prevalence of PMADs and provide strategies for responding to a positive PMADs screen or concerns raised during surveillance of the mother-infant-dyad. In addition, we offer a summary of the literature on evidence-based treatments for PMADs to allow pediatricians to guide the parents of their patients towards the most effective interventions. Finally, we provide an overview of alternative treatment models that can facilitate the screening and treatment of behavioral health concerns within the primary care setting.