Generalized Anxiety Research Articles

Brain electrical activity in Newly diagnosed Generalized Anxiety Disorder: A Quantitative EEG analysis

Background: Generalized Anxiety Disorder (GAD) is one of the most common global mental disorders with negative impact on social life. Quantitative EEG can objectively estimate the anxiety status. Relatively increase beta activity along with decrease alpha activity is associated with GAD. Objectives:To evaluate power of all brain waves in female patients with GAD. Methods:This observational study was conducted on 20 female patients with GAD (age 20-40 years),For comparison, 20 healthy female volunteers of same age were enrolled as control. In this study, EEG was recorded for 3 minutes by placing electrodes on scalp according to 10-20 system. To assess brain electrical activities, the band power of delta, theta, alpha and beta brainwave was recorded from an EEG data acquisition device, EEG Traveler Brain Tech 32+ CMEEG -01, India. Power spectral analysis of EEG data was done by BT40 analysis software. Data were expressed as median (Inter Quartile Range). Statistical analysis was done by Mann-Whitney U test.Results: The significantly higher absolute power of beta was found in most of the electrodes of prefrontal, frontal and temporal region as well as significantly lower power of alpha, theta and delta werefound in all cortical regions in female GAD patients compared to healthy controls at baseline. Conclusion: This study concluded that GAD patients had high excitable state in most of cortical region associated with lack of relaxing ability. J Bangladesh Soc Physiol 2023;18(2): 78-88

Effect of lemongrass (Cymbopogoncitratus) essential oil on cardiac autonomic function in female Generalized Anxiety Disorder:A poincaré analysis of heart rate variability

Background:Generalized anxiety disorder (GAD) is a worldwide, one of most prevalent mental disorder and associated with autonomic dysfunction. Poincaré plot of heart rate variability (HRV) is anonlinear method to assess cardiac autonomic nerve function (CANF).Lemongrass (Cymbopogoncitratus) essential oil (LEO) has been reported with anxiolytic effect and autonomic improvement in human. Objective: To assess the effect of LEO inhalation on CANF in female patients with GAD by analysis of poincaré plot of HRV.Method: This Quasi experimental study was conducted on 60 newly diagnosed female GAD patients with 20-40 years of age. Among them, 30 patients were treated with LEO inhalation for 15 min for once a week for one month (30days)along conventional treatment and 30 patients were without LEO inhalation and continued only conventional treatment for 30days.Thirty (30) apparently healthy subjects were control group.HRV data of all patients and control were recorded at baseline and after 30days of intervention or follow up respectively. HRV was recorded by a data acquisition device, Power Lab 8/35 and Poincaré plot analysis was done by lab chart software. For statistical analysis ANOVA followed by post-hoc test and paired sample ‘t’ test were done.Results: In this study, at baseline, the standard deviation of the short-term RR interval variability (minor axis of the cloud, SD1),the standard deviation of the long-term RR interval variability (major axis of the cloud, SD2) and SD1/SD2 were found significantly lower (p<0.001) in all GAD patients compared to control group. After 30 days of intervention with LOE, significant increase of SD1(p<0.001) and SD2, SD1/SD2 (p<0.01) were found in GAD patients whereas no significant difference was found in patients without LEO after 30 days. Moreover, significantly higher values of SD1 and SD2 were observed in GAD patients after aroma therapy with LEO compared to GAD patients not under aroma therapy. Furthermore, LEO could restore the BP of the GAD to the control level. Conclusion: This study concluded that, aromatherapy with LEO inhalation may be effective to improve cardiac autonomic dysfunction in female GAD patients. J Bangladesh Soc Physiol 2023;18(1): 19-26

Association of Fast-Food Intake with Depressive and Anxiety Symptoms among Young Adults: A Pilot Study.

Background: High intake of fast food has been linked to increased risks of both depressive and anxiety disorders. However, associations between individual fast-food items and depressive/anxiety disorders are rarely examined. Method: Using cross-sectional survey the association between common fast-food items and depressive/anxiety symptoms among 142 young Hong Kong adults aged 18-27 years old was examined. A qualitative food frequency questionnaire was employed to measure the intake frequency of 22 common fast-food items found in Hong Kong. Occurrence of significant depressive and anxiety symptoms was measured by the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), respectively. Primary measures were multivariate-adjusted odds ratios for occurrence of depressive and anxiety symptoms compared with the low intake frequency group for common fast-food items. Results: Our observations suggest that frequent intake of high-fat, -sugar, and -sodium fast-foods increased depressive symptoms, while frequent high-fat fast-food intake was associated with anxiety symptoms. However, frequent intake of sugar-free beverages reduced the risk of depressive symptoms. Conclusions: Habitual intake of certain fast foods were related to depressive/anxiety symptoms in young adults.

Acute Augmented Effect of Virtual Reality (VR)-Integrated Relaxation and Mindfulness Exercising on Anxiety and Insomnia Symptoms: A Retrospective Analysis of 103 Anxiety Disorder Patients With Prominent Insomnia.

Anxiety disorder is one of the most common mental disorders and often accompanied with sleep disturbance which can in turn exacerbate anxiety symptoms, creating a vicious cycle. In addition to psychopharmacological therapy, the effectiveness of psychotherapy as cognitive behavioral therapy (CBT) for treating anxiety disorders and insomnia has been well documented and widely accepted, but it is labor-intensive and costly. However, virtual reality (VR)-integrated CBT may improve this condition but needs more evidences to support its extensive application in routine clinical practice. This explorative study was aimed to conduct a retrospective analysis to evaluate the acute (2 weeks) augmented effect of VR-integrated relaxation and mindfulness exercising in improving anxiety and insomnia symptoms for patients who were diagnosed with anxiety disorders and concurrently with prominent insomnia symptoms and admitted to the Department of Psychiatry, The Affiliated Guangdong Second Provincial General Hospital of Jinan University during January 2021 to June 2021. All patients who were admitted to the department of psychiatry during January 1, 2021 to June 30, 2021 were screened with inclusion criteria and exclusion criteria, and the sociodemographic and clinical data of those included patients were collected from the electronic medical record system of the hospital using a self-designed case report form (CRF). Subjects who were administrated with medication alone were designated as conventional group, and those receiving treatment of medication combined with VR-integrated CBT (VR relaxation and mindfulness exercising) as VR group. The baseline and 2-week posttreatment data were compared between the two groups. In total, there were 103 patients (70 female, 68%) included in the study. Among all, 68 (66.02%) were designated as the "VR group," and 35 (33.98%) as the "conventional group." The majority of patients (67%) were diagnosed with generalized anxiety disorder (GAD). Twenty-three (22.3%) patients had a comorbid diagnosis with primary insomnia, and insomnia was just one of the accompanying symptoms with anxiety for the rest 80 subjects. No statistically significant differences were found between VR and conventional groups in all baseline sociodemographic and clinical characteristics except for occupation. There were statistically significant differences for the remission rates of anxiety symptoms or insomnia symptoms and reduction of Hamilton Anxiety Rating Scale or Insomnia Severity Index total scores between conventional and VR groups. Greater remission rates or score reductions were found in VR group than in conventional group either for anxiety or for insomnia. Robust differences still existed when controlled for the variable "occupation." Two-week augmented VR-integrated relaxation and mindfulness exercising is acutely beneficial for relieving both anxiety and insomnia symptoms and worth being recommended for routine clinical practice. Further prospective and randomized study compared to traditional CBT to explore its acute and long-term effect on anxiety and insomnia is needed.

Association between Physical Activity Levels and Generalized Anxiety Disorder in Adolescents

Association between Physical Activity Levels and Generalized Anxiety Disorder in Adolescents

A study protocol for a randomized controlled trial on immediate effect of cooling breathing techniques in generalized anxiety disorder

A study protocol for a randomized controlled trial on immediate effect of cooling breathing techniques in generalized anxiety disorder

Protocol of a randomized controlled trial into guided internet-delivered cognitive behavioral therapy for insomnia in autistic adults (i-Sleep Autism)

BackgroundSleep problems, especially insomnia, are prevalent among autistic adults, affecting about 60 %, and significantly impact their quality of life. Internet-based cognitive behavioral therapy for insomnia (iCBT-I) could provide accessible and scalable treatment. Given the unique sensory- and information processing, and social challenges at play in autism, a tailored treatment approach may be essential to tackle sleep problems. Yet, interventions developed and tested specifically for autistic adults were scarce. Addressing this gap is crucial to meet the urgent need for effective insomnia treatments in this population. MethodsWith this two-arm, parallel, superiority randomized controlled trial, we will assess the effectiveness of a guided iCBT-I intervention for adults (N = 160) with autism and insomnia (i-Sleep Autism). In co-creation, i-Sleep Autism has been adjusted from an existing intervention (i-Sleep). Inclusion criteria are: age ≥ 18, an ASD diagnosis, and at least sub-threshold insomnia (Insomnia Severity Index ≥10). Participants are randomly assigned to either i-Sleep Autism or an information only waitlist control condition (online psychoeducation and sleep hygiene). After 6 weeks, the control group receives the intervention. Insomnia severity is the primary outcome. Secondary outcomes include pre-sleep arousal, general mental health, depression, anxiety, daily functioning, and quality of life. Assessments will occur at baseline, mid-intervention (3 weeks), post-intervention (6 weeks), and at 6-month follow-up (the intervention group). Linear mixed-effect regression models are employed to evaluate the effectiveness of i-Sleep Autism, alongside exploration of potential moderators and mediators. ConclusionThis trial can reveal whether autistic adults with insomnia benefit from a guided e-health intervention.Trial registration: NL-OMON56692.

A CROSS-SECTIONAL STUDY TO FIND THE ASSOCIATION OF MIGRATION ON DEPRESSIVE AND ANXIETY DISORDERS AMONG NURSING STUDENTS IN A TERTIARY CARE HOSPITAL IN BANGALORE

Objectives:To determine the prevalence of depression and anxiety disorders among Nursing students and their association with migration. Methodology: A cross-sectional study was conducted at Sapthagiri Institute of Medical Sciences from December 2023 to January 2024. The study included 60 BSc nursing students, using Generalised Anxiety Disorder-7 Item Score and Zung Self Rating Scales to assess anxiety and depression. Migrant students were compared with local students to explore the impact of migration. Results: Out of 75 students, 60 participated, with 62% female and 48% male. The majority (73%) were from Kerala, with 87% being migrants. The prevalence of depressive disorders was 11.7%, with a higher proportion (87.5%) among migrants. Anxiety disorders affected 57.5% of the participants, with 78% being migrants. Migrants had a significantly higher prevalence of mild to moderate anxiety symptoms compared to non-migrants. Statistical analysis showed a positive correlation between migration and Generalised Anxiety Disorder-7 Item Score, and it was indicated that migrants had a 3.63 times higher likelihood of developing depressive or anxiety disorders. Conclusion: Migration significantly impacts the mental health of nursing students, with a notable increase in anxiety disorders among migrants. Depression rates were lower than expected. Further research with larger sample sizes and longer study periods is needed to validate these findings.

Analysis of Differences in Sleep Time according to Generalized Anxiety Disorder in Korean Adolescents

Analysis of Differences in Sleep Time according to Generalized Anxiety Disorder in Korean Adolescents

Different effects of migraine associated features on headache impact, pain intensity, and psychiatric conditions in patients with migraine

Migraine is a multifactorial brain disorder characterized by recurrent disabling headaches and their associated features. Several studies have suggested that these features are related to headache impact, pain intensity, and psychiatric conditions. However, differences in the relationship between each associated feature and headache impact, pain intensity, or psychiatric conditions remain unclear. This study aimed to assess the impact of migraine-associated features on headache impact, pain intensity, and psychiatric conditions in patients with migraine. In this two-centered study, patients with migraine without aura (MwoA) were enrolled to exclude those without headaches and avoid the influence of medication overuse, which is commonly associated with chronic migraine. We used multiple logistic regression to analyze the headache impact, pain intensity, and psychiatric conditions measured using the Headache Impact Test (HIT-6), Visual Analog Scale (VAS), Generalized Anxiety Disorder 7-item scale (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). Patients’ likelihood of experiencing symptoms such as nausea, vomiting, photophobia, phonophobia, osmophobia, and allodynia were also recorded. A total of 1103 patients with MwoA were enrolled in this study, and 164 patients were excluded from the study because of missing data. Finally, 939 patients with MwoAs were included. On multiple logistic regression analyses, nausea (odd ratios [OR] 1.87, confidence interval [CI]: 1.37–2.54), vomiting (OR 1.57, CI: 1.11–2.23), photophobia (OR 1.67, CI: 1.18–2.35), and allodynia (OR 1.56, CI: 1.06–2.28) were independent positive predictors of higher HIT-6 scores, and nausea (OR 1.72, CI: 1.22–2.43), vomiting (OR 1.84, CI: 1.29–2.63), phonophobia (OR 1.58, CI: 1.10–2.25), photophobia (OR 1.49, CI: 1.07–2.08), and allodynia (OR 1.81, CI: 1.24–2.66) were independent positive predictors of higher VAS score. Nausea (OR 1.49, CI: 1.09–2.02), phonophobia (OR 2.00, CI: 1.42–2.82), and allodynia (OR 1.81, CI: 1.24–2.63) were independent positive predictors of GAD-7 score. Nausea (OR 1.66, CI: 1.21–2.28), phonophobia (OR 1.49, CI: 1.05–2.11), and allodynia (OR 1.68, CI: 1.16–2.45) were independent positive predictors and vomiting (OR 0.54, CI: 0.37–0.78) was an independent negative predictor of PHQ-9 score. Our results suggest that nausea, vomiting, photophobia, phonophobia, and osmophobia have distinct effects on headache impact, pain intensity, and psychiatric conditions. Understanding these differences can aid in the personalized management of patients with MwoA.

Psychological Impact of the Northern Ethiopia War on Tigray Athletes

The war in northern Ethiopia (November 4, 2020-November 2, 2022) caused unimaginable suffering to the people of Tigray. Psychological suffering is among the many. It is well known that war affects all people living in the war zone and alters life dramatically, as its effects can be both physical injury of varying degrees of severity and the dangerous invisible wounds caused by psychological trauma and stress. As far as this issue is concerned, numerous research results have shown the psychological impact of war on the general population. However, no research has been carried out on the psychological impact of war on athletes. So, the main objective of this study was to assess the psychological impact of the Northern Ethiopia civil war on Tigray Athletes. To achieve the purpose of this study, a total of 144 athletes from various clubs in the Tigray area were selected using the convenience sampling method. The anxiety symptom was assessed using the Generalized Anxiety Disorder Scale (GAD-7) and the depression symptom was assessed using the Centre for Epidemiologic Studies (CES-D) depression scale. The data gathered was analyzed using the SPSS statistical package (version 25 for Windows). Of 144 participants, 1 (0.7%) showed minimal anxiety; 4 (2.8%) showed mild anxiety; 29 (20.1%) showed moderate anxiety; and 110 (76.4%) showed severe anxiety. And regarding depression, all of the participants were shown symptoms of depression as their score was higher than 16 points. As the result shows, almost all participants have a risk of anxiety and depression. It can thus be concluded that the two-year war in northern Ethiopia had a negative psychological impact on Tigray athletes.

Task-specific writing anxiety and self-efficacy are separate from general L2 writing anxiety and self-efficacy and they have differential associations with the effects of written corrective feedback in pre-task and within-task planning

This study examines the validity of task-specific anxiety and self-efficacy and the joint effects of task-specific and general second language (L2) writing anxiety and self-efficacy on learning gains resulting from different task conditions formed based on two types of written corrective feedback and two types of task planning. 115 high school EFL learners in South Korea were divided into two groups and received either direct correction or metalinguistic feedback on their wrong use of English articles and past tense in their written narratives. After receiving feedback, each of the two large groups was further divided into three subgroups, each performing a second writing task under three conditions: pre-task planning, within-task planning, and no planning. The learners responded to questionnaires that aimed to measure task-specific and L2 general anxiety and self-efficacy. The results demonstrated that task-specific anxiety and self-efficacy were distinct from general L2 writing anxiety and self-efficacy and that they played different roles in L2 development under the different treatment conditions. Specifically, general L2 writing anxiety was a negative predictor of learning gains regardless of learning condition; task-specific anxiety showed a positive effect in metalinguistic explanation + within-task planning but a negative effect in all other task conditions; neither task-specific nor general L2 self-efficacy was a significant predictor of treatment effects. This study demonstrates the importance of investigating task-specific individual difference variables and shows the differential associations between general and task-specific individual difference variables on one hand and different types of task-based instruction on the other.

Effects of Applied Relaxation Treatment Program for Relieving Generalized Anxiety Symptoms

Effects of Applied Relaxation Treatment Program for Relieving Generalized Anxiety Symptoms

Sex differences in insomnia and hypersomnia complaints during major depressive episode: Results from a national sample

BackgroundSex differences in sleep disturbances during major depressive episodes (MDE) have been suggested. This study compares the prevalence, sociodemographic characteristics, and psychiatric comorbidity associated with sleep complaints specific to each sex among adults with MDE. These findings are crucial for precise diagnosis, personalized treatment, and improved clinical outcomes. MethodsIn a large nationally representative prospective survey, we used multi-adjusted logistic regression models including sociodemographic characteristics, psychiatric comorbidity, and depression severity to examine whether associations differ between men and women. ResultsAmong women, 93.3 % reported at least one type of sleep complaints (i.e., trouble falling asleep, early morning awakening or hypersomnia) while 91.0 % of men did, with respectively 78.3 % and 77.2 % of insomnia complaints, and 46.2 % and 41.3 % of hypersomnia complaints. Women with sleep complaints were more likely to be black, with lower individual incomes, have histrionic personality disorder or a specific phobia. Conversely, men with sleep complaints were more likely to have a lifetime diagnosis of mania spectrum disorder, generalized anxiety disorder, drug use disorder, as well as dependent and schizotypal personality disorders. Surprisingly, being “never married” has emerged as a protective factor against sleep complaints in women, while posing as a risk factor in men compared to other marital statuses. Differences and specificities were also noted concerning subtypes of insomnia and hypersomnia complaints. LimitationsThe cross-sectional design means the associations found do not imply causality. ConclusionsThese findings provide insights into the complex relationship between sleep and depression in men and women, highlighting the need for personalized interventions.

What Mattered Most: Personal, Work-Related, and Psychopathological Characteristics Associated with Healthcare Workers’ Impairment of Functioning during COVID-19

Background: The COVID-19 pandemic greatly impacted healthcare workers (HWs) around the world. Italy was the first Western country hit by the pandemic, and several studies have been published targeting the mental health burden held by Italian HWs. Notwithstanding, only a few studies focused on the impact of COVID-19 on HWs’ levels of functioning. Methods: An online survey was distributed to HWs in Italy through physicians’ and nurses’ associations, social networks, and researchers’ direct contacts, between 4 April and 13 May 2020. Participants provided sociodemographic, work-related, and pandemic-related data and filled out a set of psychometric questionnaires (Patient Health Questionnaire-9—PHQ-9, General Anxiety Disorder-7—GAD-7, Impact of Event Scale—Revised—IES-R, and Work and Social Adjustment Scale—WSAS). Results: The final sample included 1041 HWs (mean age 45.01 ± 11.62, 63.9% females). In total, 58.1% of the subjects screened positive on the GAD-7, 27.5% on the PHQ-9, and 25.9% on the IES-R. Furthermore, 67.4% showed a significant level of impairment in functioning according to the WSAS, while 35.8% reached scores of moderate or worse impairment. In the multiple linear regressions, screening positive on any of the psychometric scales and being exposed to unusual suffering significantly predicted worse scores in all WSAS domains (p < 0.05). Having a history of mental disorders significantly predicted worse scores in the WSAS domain of work ability (p = 0.002), while being the parent of children younger than 18 years significantly predicted worse WSAS family functioning scores (p < 0.001). Conclusions: Our results corroborate extant data about the impact of the COVID-19 pandemic on HWs’ mental health and shed light on its detrimental effect on functioning. Tailored interventions should be designed in order to support HWs during times of crisis.

ROLE OF THE EMOTIONAL-MOTIVATIONAL COMPONENT IN THE DYNAMICS OF CNS FUNCTIONAL CAPACITY IN SECONDARY SCHOOL STUDENTS

The main clinical syndromes of chronic cerebral ischemia (CCI) are impaired gait and balance disorders, High morbidity level among school children, which has been recorded over the past decade in our country, necessitates a review of the contributing causes, mechanisms and factors. Objective. The purpose of the study is to assess CNS functional capacity in secondary school students taking into account anxiety and the motivational component. Materials and Methods. The study enrolled 424 secondary school students aged 10–17, living in Astrakhan. Simple and complex visual-motor reaction test was carried out. To study personality traits, anxiety and motivation levels of the participants, the authors used Junior Eysenck Personality Questionnaire (JEPQ), School Anxiety Test (Phillips Test), and Spielberg-Andreeva motivation questionnaire. Results. A significant decrease in the level of CNS functional capacity was noted when compared with the age norm. CNS functional level increases with age, while its values in the examined 12–13 and 14–15 year-old participants are below the average age ones. A decrease in the motivation level was revealed among the trial subjects. A positive attitude towards learning and effective motivation was revealed in 53.6 % of secondary school students aged 10–11; 38,6 % aged 12–13; 30,3 % aged 14–15 and 30 % aged 16–17. A high level of general anxiety was revealed in 40.9 % of secondary school students aged 10–11; 63.6 % aged 12–13; 12.8 % aged 14–15 and 6 % aged 16–17. Conclusion. The parameters of CNS functional capacity in most cases are characterized by below average values. The anxiety level significantly decreases with age, which indicates an adequate influence of learning environment on students. The highest anxiety level was revealed in the trial subjects aged 12–13. Motivation for learning decreases with age, which is probably due to psychological and motivational age-related changes in adolescence.

Criterion validity of a single-item measure of fear avoidance behavior following mild traumatic brain injury

Maladaptive coping such as fear avoidance behavior can prolong recovery from mild traumatic brain injury (mTBI). Routine assessment of fear avoidance may improve management of mTBI. This study aimed to validate a single-item measure of fear avoidance to make its assessment more pragmatic. The present study is a secondary analysis of a clinical trial that involved adults with persistent post-concussion symptoms (N = 90, 63% female). Participants completed the single-item fear avoidance rating, a validated legacy measure of fear avoidance (Fear Avoidance Behavior after Traumatic Brain Injury; FAB-TBI), and measures of anxiety (General Anxiety Disorder-7), depression (Patient Health Questionnaire-9), post-concussion symptoms (Rivermead Postconcussion Symptoms Questionnaire), and disability (World Health Organization Disability Assessment Schedule 12.0). Questionnaires were completed twice, at baseline (mean 18.1 weeks post injury) and again 12–16 weeks later following study-delivered rehabilitation in addition to usual care. We analyzed the associations (Spearman’s correlations) and agreement (weighted Kappa) between the single-item and FAB-TBI at baseline, posttreatment, individual FAB-TBI item scores, and the change in scores between baseline and posttreatment. In addition, we examined correlations between the single-item fear avoidance measure and related constructs, including anxiety, depression, post-concussion symptoms, and disability. The single-item fear avoidance measure correlated strongly with the FAB-TBI both at baseline and following treatment (ρ = 0.63 − 0.67, p < .001), and moderately with FAB-TBI item scores (ρ = 0.4 − 0.6). The correlation between the change in these scores from baseline to posttreatment was moderate (ρ = 0.45, p < .001). Agreement between the single-item fear avoidance measure and discretized FAB-TBI scores was moderate (κ = 0.45 − 0.51). Before and after treatment, the single-item fear avoidance measure correlated moderately with anxiety (ρ = 0.34), depression (ρ = 0.43), post-concussion symptoms (ρ = 0.50), and disability (ρ = 0.43). The FAB-TBI was more strongly correlated with these measures (ρ = 0.53 − 0.73). In summary, the present study supports the criterion validity of the single-item fear avoidance measure. This measure may be a useful screening and monitoring tool for patients with mTBI but is not a substitute for the FAB-TBI questionnaire.

Construction and evaluation of two nomograms for screening major depressive disorder and subthreshold depression individuals based on anxiety, depression, and sleep items

BackgroundCurrent evidence is insufficient to support specific tools for screening Major Depressive Disorder (MDD). Early detection of subthreshold depression (SD) is crucial in preventing its progression to MDD. This study aims to develop nomograms that visualize the weights of predictors to improve the performance of screening tools. MethodsParticipants were recruited from Peking University Sixth Hospital and Beijing Physical Examination Center between October 2022 and April 2024. The Mini-International Neuropsychiatric Interview (MINI) 5.0.0 was employed as the diagnostic gold standard, and Generalized Anxiety Disorder questionnaire-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Pittsburgh Sleep Quality Index (PSQI) were employed to assess anxiety, depression, and sleep state. The nomograms were constructed by incorporating optimal predictors, selected through the Least Absolute Shrinkage and Selection Operator (LASSO), into a multivariate logistic regression model to estimate the probability of MDD and SD. ResultsAfter matching age and education, 164 participants were included in each group for analysis. Both nomograms demonstrated superior discrimination, calibration, and clinical applicability compared to PHQ-9. Anxiety emerged as a most significant predictor for SD, while sleep problems exhibited high rankings for both SD and MDD. The two predictors subsequently affect concentration and daytime functioning. LimitationsWith a lack of external validation data, the performance of nomograms may be overestimated. ConclusionsThis study is the first attempt to develop a nomogram for predicting SD, while also providing a nomogram for MDD. The crucial predictors offer valuable insights into potential variables for clinical intervention.

Internet-based therapist-supported interpersonal psychotherapy for depression: A randomized controlled trial

BackgroundDepression is a common disorder for which there are several treatments options including different psychological treatments. The aim of this study was to investigate the effects of internet-based interpersonal psychotherapy (IPT) for symptoms of depression in randomized controlled trial. MethodsFollowing recruitment via advertisement a total of 113 participants with mild to moderate symptoms of depression were included and randomized to either a ten-week internet-based IPT with weekly therapist guidance or a waitlist control condition. The primary outcome was symptoms of depression measured weekly with the Montgomery Åsberg Depression Rating Scale (MADRS-S) and at pre- and post-treatment assessment with the Beck's Depression Inventory (BDI-II). Secondary outcomes were self-rated quality of life and symptoms of generalized anxiety disorder. We also measured therapeutic alliance and treatment credibility. Outcomes were evaluated with a latent growth curve model (for MADRS-S) and robust linear regression models (for the other measures). The trial was conducted during the Covid-19 pandemic in the spring of 2021. ResultsSignificant differences favoring the treatment group were found on three of the four outcomes: BDI-II, quality of life ratings, and ratings of generalized anxiety. Between-group effect sizes for these outcomes were moderate (BDI-II, quality of life) or small (generalized anxiety). The latent growth curve model did not indicate a significant difference on the weekly MADRS-S ratings. Exploratory analyses did not show an association between therapeutic alliance, treatment credibility and outcome. LimitationsMissing data at post-treatment was high in the treatment group (37 %), though the missingness was not significantly related to observed ratings at pre-treatment or estimated trajectories during the treatment. Few participants completed all modules. The Covid-19 pandemic situation may have affected both effects and dropout rates. ConclusionsInternet-based IPT can lead to significant improvements, though the reductions in symptoms of depression were not consistent across the two measures used. Completion rates and dropout patterns suggest a need for improved acceptability. Trial registrationThe trial was preregistered at Clinicaltrials.gov (Identifier: NCT04721678). Registered January 2021.https://clinicaltrials.gov/study/NCT04721678

Development and validation of experimental induction tasks for worry and rumination: A comparison of scripted and personalized approaches.

Worry and rumination are two forms of repetitive negative thoughts. Prior studies have identified similarities and differences between these two states. For a more comprehensive understanding of these thought processes, researchers need reliable methods to induce them experimentally. Traditionally, researchers have used either scripted or personalized approaches to trigger worry and rumination, but it remains unclear which method is more effective. Additionally, the potential impact of preexisting disorders like generalized anxiety disorder (GAD) or major depression (MDD) on these inductions is not well understood. This study aimed to compare scripted and personalized induction methods to identify which was more effective for eliciting worry and rumination, while also considering the potential influence of generalized anxiety and depression. Participants (N = 355) included individuals with GAD, depression, or healthy controls. They were randomly assigned to either scripted or personalized induction tasks designed to induce worry or rumination. Findings revealed that personalized induction methods were consistently more effective than scripted methods for inducing both worry and rumination, regardless of participants' group characteristics. In addition to the general underperformance of scripted induction methods, the scripted rumination induction was notably less successful, failing to induce rumination to a greater extent than the scripted worry induction. Given these findings, personalized approaches are recommended for experimental studies that aim to compare worry and rumination. Limitations of the study and implications for future research are also discussed.