Penn State Worry Questionnaire Scores Research Articles

Psychological Distress and Treatment Outcome in Patients With Early-Stage Mycosis Fungoides.

Skin diseases have been shown to worsen psychological distress, which, in turn, may be detrimental to treatment outcomes. Both the impact of psychological distress on response to treatment in mycosis fungoides (MF) and the effect of treatments on psychological well-being are unclear. To evaluate (1) the association between pretreatment psychological morbidity and treatment outcome in early-stage MF and (2) the impact of response to treatment on psychological well-being. This was a prospective cohort study of patients with early-stage MF who started a new stage-directed treatment for their disease. The response was determined using the modified severity-weighted assessment tool, and psychological distress was assessed using the 12-item General Health Questionnaire (GHQ-12) and Penn State Worry Questionnaire (PSWQ). Participants were followed for 1 year. In all, 24 consecutive patients were recruited. Objective response rate was 71% (17/24), consistent with existing literature. Prior to treatment, 9 patients (38%) had clinically significant psychological distress on the GHQ-12, while 8 (33%) demonstrated high-level worry on the PSWQ. Of these patients, 6 had pathologic scores on both instruments. Patients with significantly less baseline anxiety/depression on the GHQ-12 responded better to treatment than patients with higher levels (P = .004). In addition, responders' mean GHQ-12 scores decreased by 39% and their PSWQ scores by 17%, whereas nonresponders' GHQ-12 scores increased by 93% (P = .042) and their PSWQ scores by 11% (P = .019). These findings suggest that (1) baseline psychological distress is associated with worse outcomes in patients with early-stage MF and that (2) effective treatment improves psychological morbidity.

Associations between ruminative brooding and white matter change amongst healthy middle‐aged and older adults

AbstractBackgroundRepetitive Negative Thinking (RNT) includes negative thoughts about the future (worry) and past (ruminative brooding). RNT has been associated with Alzheimer’s disease (AD) pathology (Marchant et al. Alzheimers Dement. 2020;16(7)) and different patterns of functional connectivity of the triple network of attention, namely, the default mode, executive control and anterior salience networks (Solé‐Padullés et al. Front Aging Neurosci. 2022;14). However, the association between RNT and white matter microstructure is unclear (Demnitz‐King et al. Psychiatry Res Neuroimaging. 2021;316) and no existing studies have examined this association longitudinally among non‐clinical adults.MethodHealthy adults (age range: 50‐70, 51.2% women) from the Barcelona Brain Health Initiative (Cattaneo et al. Front Aging Neurosci. 2018 11;10) completed the Perseverative Thinking Questionnaire (PTQ), Rumination Response Scale (RRS), and Penn‐State Worry Questionnaire (PSWQ) at baseline to measure RNT levels. Participants underwent a magnetic resonance imaging (MRI) with T1 and T2‐weighted acquisitions to assess volume of white matter hypointensities (WMH) at baseline (N = 588) and two years later (N = 425). Change in WMH was computed taking into account time interval between scans. Stepwise linear regression analyses were conducted to investigate associations between change in WMH and baseline age, sex, PTQ, PSWQ and RRS subscale scores (brooding, reflection and depression).ResultBaseline age (t = 3.71, p<0.0001) and brooding (t = 2.82, p = 0.005) were associated with increased WMH across scans (see partial regression plots, Fig 1A/B). No cross‐sectional associations were observed between volume of WMH and RNT‐related variables.ConclusionBrooding was associated with increase of WMH in healthy adults. Brooding, a maladaptive form of emotion regulation, enhances repetitive focus on one’s distress and is associated with altered connectivity of attentional networks and greater asymmetry of the Superior Longitudinal Fasciculus in depressed adults (Pisner et al. Neuroimage Clin. 2019;24). Our results are of importance considering that: WMH correlate with CSF‐amyloid in cognitively unimpaired older adults (Wei et al. Brain Behav. 2019;9(12)) and this is the first longitudinal study focusing on white matter change as related to psychological variables linked to cognitive decline and AD‐related pathology. The putative impact of psychological factors on brain integrity can be detected even at sub‐clinical levels and in earlier stages within the dementia continuum.

Impact of Intolerance of Uncertainty on Brain Structural Changes in Panic Disorder.

This study investigated the impact of intolerance of uncertainty (IU) on structural changes in the brain and symptom severity in patients with panic disorder. This study included 90 participants diagnosed with panic disorder. The IU Scale, Panic Disorder Severity Scale (PDSS), Beck Depression Inventory-II (BDI-II), Penn State Worry Questionnaire (PSWQ), Self-Forgiveness Scale (SFS), and Short Form 36 Health Survey (SF) were used. A voxel-wise correlation analysis was conducted to investigate the structural differences in the gray matter. As IU increased, the cortical thickness of the right lingual gyrus decreased significantly, while the gray matter volume of the right pars triangularis increased. The cortical thickness of the right lingual gyrus showed a significant negative correlation with the BDI-II score and a positive correlation with the SFS. Additionally, the gray matter volume of the right pars triangularis was positively correlated with the PDSS, PSWQ, and BDI-II scores and negatively correlated with the mental health domain of the SF. According to our findings, elevated IU in participants with panic disorder was associated with cortical thinning in the lingual gyrus and increased gray matter volume in the pars triangularis. These structural alterations may also have an impact on perceived quality of life, as well as high levels of depression and anxiety.

Evaluation of the effectiveness of sleep hygiene education and FITBIT devices on quality of sleep and psychological worry: a pilot quasi-experimental study among first-year college students.

College students report disturbed sleep patterns that can negatively impact their wellbeing and academic performance. This study examined the effect of a 4-week sleep hygiene program that included sleep education and actigraph sleep trackers (FITBITs) on improving sleep quality and reducing psychological worry without control group. A pilot quasi-experimental design, participants were randomly selected medical and health sciences from a university students in the United-Arab-Emirates. Students were asked to wear FITBITs and log their daily sleep data and completed the Pittsburgh Sleep Quality Index (PSQI) and Penn State Worry Questionnaire (PSWQ). Extensive sleep hygiene education was delivered via lectures, a WhatsApp group, and the Blackboard platform. In total, 50 students completed pre-and post-assessments and returned FITBIT data. There was a significant difference in the prevalence of good sleep postintervention compared with pre-intervention (46% vs. 28%; p = 0.0126). The mean PSQI score was significantly lower post-intervention compared with pre-intervention (6.17 ± 3.16 vs. 7.12.87; p = 0.04, Cohen's d 0.33). After the intervention, subjective sleep quality, sleep latency, and daytime dysfunction were significantly improved compared with pre-intervention (p < 0.05). In addition, FITBIT data showed total sleep time and the number of restless episodes per night were significantly improved postintervention compared with pre-intervention (p = 0.013). The mean PSWQ score significantly decreased from pre-intervention to p = 0.049, Cohen' d = 0.25. The correlation between PSQI and PSWQ scores was significant post-intervention (β = 0.40, p = 0.02). Our results may inform university educational policy and curricular reform to incorporate sleep hygiene awareness programs to empower students and improve their sleep habits.

Comparison of Metacognitive Therapy Versus Cognitive Behavioral Therapy for Generalized Anxiety Disorder: A Meta-Analysis of Randomized Control Trials.

The aim of this meta-analysis is to compare the efficacy of meta-cognitive therapy (MCT) and cognitive behavioral therapy (CBT) in patients with generalized anxiety disorder (GAD). This study is reported according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic electronic literature search was conducted on April 20, 2023, to find studies reporting on the efficacy of MCT for GAD. The search keywords included "Generalized anxiety disorders," "meta-cognitive therapy," "cognitive behavior therapy," and "randomized control trials.: The following databases were searched to find relevant articles: PubMed, PsychInfo, CINAHL, and SCOPUS. Outcomes assessed in the present meta-analysis included the change in the Penn State Worry Questionnaire (PSWQ) from baseline to completion of treatment and after two years of follow-up. The PSWQ measures the trait of worry in adults. Worry is regarded as a dominant feature of GAD. Secondary outcomes assessed in this meta-analysis included symptom severity using the Beck anxiety inventory (BAI). Change in BAI was scored from baseline to completion of treatment and after two years of follow-up. A total of three studies were included in this meta-analysis. The results show that patients treated with MCT had greater reductions in PSWQ and BAI scores post-treatment and after two years of treatment, as well as higher rates of recovery compared to those treated with CBT. These findings suggest that MCT is a promising approach for treating GAD and may have advantages over traditional CBT approaches.

Faculty caring behavior and effect on dental hygiene students' worry or anxiety.

Studies in health professional students have shown the students' perception of instructor caring behaviors had a positive impact on student behaviors and their anxiety. Health professional students are under high emotional and academic demands during entry-level programs which can lead to higher anxiety. The purpose of this study was to measure the relationship between worry or anxiety and dental hygiene students' perceptions of faculty caring behaviors. Cross-sectional survey research was conducted with a convenience sample of dental hygiene students (n = 355) in the United States using a web-based survey. The validated instruments Nursing Students' Perceptions of Instructor Caring (NSPIC) and Penn State Worry Questionnaire (PSWQ) were used for data collection. The NSPIC contains five subscales including instilling confidence through caring (CTC), supportive learning climate, appreciation of life's meanings, control versus flexibility (F), and respectful sharing (RS). Data analysis included descriptive, correlation, and multiple linear regression. The completion rate was 66% (n = 235). Findings showed the NSPIC subscale, CTC had a statistically significantly higher median score than other NSPIC sub-scales (p < 0001). The NSPIC subscale RS had the second-highest median score. The results of the PSWQ showed that 48% of participants were in the chronic worrier category. Regression analysis showed CTC was a significant predictor of worry (p < 0.001) and a one-unit increase in CTC resulted in a 0.21 decrease in the PSWQ score. Our findings suggested instilling CTC behaviors was the most significant faculty caring behavior and was associated with lower levels of student worry. The results from this study may aid in identifying and developing effective caring behaviors for faculty to support students during stressful dental and allied dental curricula.

Correlation Between Intolerance of Uncertainty and Post-Operative Regret in Otolaryngology Patients.

To determine if intolerance of uncertainty, depression, anxiety, worry, or stress are related to post-op regret in otolaryngology patients. Adult patients or parents giving consent for pediatric patients meeting criteria for otolaryngologic surgery were recruited and completed the Intolerance of Uncertainty Scale (IUS-12), Penn State Worry Questionnaire (PSWQ), and Depression, Anxiety and Stress Scale-21 (DASS-21) preop and the Decisional Regret (DR) scale 1-month post-op. Pearson correlations were calculated. The cohort included 109 patients, 73 (67%) males and 36 (33.3%) females. 43 (39.5%) were college graduates and 66 (60.9%) were not. Mean IUS-12 score was 22.9 (95% CI 21.0-24.8), mean PSWQ score was 46.9 (95% CI 44.5-49.3). DASS-21 mean score was 11.9 (95% CI 9.6-14.3). Mean DR score was 11.1 (95% CI 8.6-13.6). IUS-12 subscales Prospective Anxiety mean score was 14.2 (95% CI 12.8-15.5) and Inhibitory Anxiety mean score was 16.5 (95% CI 14.5-18.6). The Pearson correlation coefficient for post-op DR and total preop IUS was .188 (P = .027) and the correlation coefficient for post-op DR and preop Prospective Anxiety subscale of IUS score was .174 (P = .037). Correlations with PSWQ and DASS-21 scores and DR were not statistically significant. Intolerance of uncertainty is a psychological construct that is associated with post-op DR. More work is needed to determine whether screening for IU and behavior modification directed at IU for those with high levels would improve post-op decisional regret.

What\u2019s Worrying Our Students? Increasing Worry Levels over Two Decades and a New Measure of Student Worry Frequency and Domains

BackgroundThe frequency and severity of mental health problems in student populations have been a growing cause for concern worldwide, and studies have identified measures of a number of mental health symptoms that have been steadily increasing in frequency and intensity over the past 20–25 years.MethodsIn two studies we investigate the levels and domains of pathological worrying in university student participants. Study 1 is a retrospective study of Penn State Worry Questionnaire (PSWQ) data collected between 2001 and 2019. Study 2 describes the development of the Student Worry Questionnaire, a short and easily delivered measure of student worrying that identifies both frequency of worry as well as the student-relevant domains across which worrying occurs.ResultsStudy 1 revealed a steady increase in student worry scores of around 20% between 2001 and 2019, with a significant positive correlation between year of data collection and mean PSWQ score. The domain scores in Study 2 indicated that academic work was a significantly higher worry than any of the other domains, and worries about intimate relationships and ‘what people think of me’ were also worries that scored higher than either financial or health worries.ConclusionsThe present studies indicate that pathological worrying can be added to the list of anxiety- and stress-related symptoms that have been shown to be on the increase in student populations in recent decades, and we discuss whether these increases represent a greater willingness to report symptoms or a genuine increase in experienced symptoms over time.

Impact of Human-Animal Interactions on Psychological and Physiological Factors Associated With Veterinary School Students and Donkeys.

There has been an increased interest in evaluating human–animal interactions and assessing the mutual health and wellbeing. In this study, first-year female and male veterinary school students not paired (n = 58) or paired (n = 25) with immature (≤9 mo) donkeys (n = 13) were engaged in three different types of interactions (1st, hands-off remote learning, 2nd, hands-on passive learning, and 3rd, hands-on active learning) for 30 min each during Week 2 (Time 1), Weeks 5–8 (Time 2), and Week 12 (Time 3) over three, 15-week periods. Student psychological data involved the Penn State Worry Questionnaire (PSWQ) scores collected from the interactive (student-donkey pairs) and non-interactive (no student-donkey pairs) groups and modified Comfort from Companion Animals Scale (CCAS) scores collected from the interactive group during Times 1, 2, and 3. Donkey physiological data involved collection of saliva within 10 min pre- and post-interaction during Times 1, 2, and 3 in association with the different types of interactions for immunoanalysis of cortisol. There were no significant effects of the various times and types of interactions on CCAS scores. While there were no significant effects of group and types of interactions on PSWQ scores, there was an effect (P = 0.01) of time. Overall mean PSWQ scores were significantly lower during Week 12 versus Week 2. Correspondingly, while there were no effects pre- vs. post-interaction within or among times on saliva cortisol concentrations in donkeys, there was an effect (P = 0.02) of the type of interaction. Mean concentrations were significantly lower with the hands-on passive and hands-on active learning versus the hands-off remote learning. In conclusion, while this study provides preliminary evidence surrounding student donkey interactions, future studies are required with more comprehensive designs to clarify these benefits and better understand the advantages and challenges surrounding student-donkey interactions.

Associations of Thyroid Hormones Profile During Normal Pregnancy and Postpartum With Anxiety, Depression, and Obsessive/Compulsive Disorder Scores in Euthyroid Women.

ObjectiveThyroid dysfunction (overt and subclinical) has been consistently linked to pregnancy adversity and abnormal fetal growth and development. Mood disorders such as anxiety, depression, and obsessive-compulsive disorder (OCD) are frequently diagnosed during pregnancy and at postpartum, and emerging evidence suggests association with impaired offspring neurodevelopment and growth. This study aimed to examine potential associations between thyroid function and mood symptoms during pregnancy and postpartum.DesignThis is a prospective study measuring thyroid hormones and assessing mood symptoms by employing specific questionnaires in the same cohort of 93 healthy pregnant women at the 24th (2nd trimester) and 36th (3rd trimester) gestational weeks and at the 1st postpartum week.MethodsSerum thyroid hormones, TSH, anti-TPO, and anti-Tg antibodies were measured at the 24th (2nd trimester) and 36th (3rd trimester) gestational weeks and at the 1st postpartum week. Specific validated questionnaires were employed at the same time-points to assess separately symptoms of anxiety [Generalized Anxiety Disorder Inventory (GADI), Penn State Worry Questionnaire (PSWQ), STAI-State Anxiety inventory (STAI-S), STAI-Trait Anxiety Inventory (STAI-T)], depression [Edinburgh Postnatal Depression Scale (EPDS), Stein’s Blues Scale (BLUES), Beck Depression Inventory (BDI)], and obsessive compulsive disorder (OCD) [Yale-Brown Obsessive Compulsive scale (Y-BOCS)].ResultsAt the 2nd trimester, GADI score correlated negatively with FT3 (p < 0.010, r = −0.545) and positively with TSH (p < 0.050, r = 0.837) concentrations; GADI, PSWQ, EPDS and Y-BOCS scores correlated negatively with FT4 concentrations (p < 0.010, r = −0.768; p < 0.010, r = −0.384; p < 0.050, r = −0.364; p < 0.010, r = −0.544, respectively). At the 3rd trimester, BLUES score correlated positively with rT3 concentrations (p = 0.00, r = 0.89); GADI, EPDS, and Y-BOCS scores correlated negatively with FT4 concentrations (p = 0.001, r = − 0.468; p = 0.036, r = −0.39; p = 0.001, r = −0.625, respectively); GADI, STAI-S, and Y-BOCS scores correlated positively with TSH concentrations (p = 0.015, r = 0.435; p = 0.024, r = 0.409 p = 0.041, r = 0.389, respectively). At postpartum, PSWQ, STAI-T, EPDS, and BDI scores correlated positively with rT3 concentrations (p = 0.024, r = 0.478; p = 0.014, r = 0.527; p = 0.046, r = 0.44; p = 0.021, r = 0.556, respectively, Y-BOCS score correlated positively with TSH (p = 0.045, r = 0.43), and BLUES score correlated positively with anti-TPO antibody concentrations (p = 0.070, r = 0.586).ConclusionThe reported findings demonstrate positive associations between low-normal thyroid function at the 2nd and 3rd trimesters of pregnancy and postpartum with anxiety, depression, and OCD scores.

Evaluation of worry level in healthcare professionals and mental symptoms encountered in their children during the COVID-19 pandemic process.

This study was conducted to evaluate the worry level in healthcare professionals and the mental symptoms encountered in their children during the Coronavirus Disease 2019 (COVID-19) pandemic. The study was designed in a cross-sectional, descriptive and relational screening model. Target population of the study comprised healthcare professionals living in Turkey who had children aged 6 to 16 years. The study data was obtained from 457 healthcare professionals who were accessible online between June 15 and August 15, 2020. The Introductory Information Form, the Penn State Worry Questionnaire (PSWQ) and the Pediatric Symptom Checklist-17 (PSC-17) were used as data collection method. The mean age of the healthcare professionals was 39.82 ± 4.83 years and 88.6% of them were female, 58.6% were nurses, 9.0% were doctors and 54.3% were working in the pandemic service. The mean total PSWQ score of the healthcare professionals was 53.53 ± 11.82 and the mean total PSC-17 score of their children was 10.74 ± 5.68. The mean PSWQ score of the healthcare professionals who had a psychological disease and provided care to COVID-19 patients was significantly higher. The PSC-17 scores were significantly higher in children with a mental disorder. There was a statistically significant positively correlation between the mean total PSWQ score of the healthcare professionals and the mean total PSC-17 score of their children. The study showed that children of healthcare professionals who experience all aspects of the pandemic, comprise an important risk group because they are unable to have physical contact with their parents and they experience the pandemic-related measures more.

875-P: Breathe Diabetes Management Program: A Personalized App to Assist Type 2 Diabetics in India to Achieve Healthy Outcomes

Introduction: Use of Digital therapeutics can act as a valuable tool enabling more personalized care among diabetics. The Breathe Diabetes Management Program (BDMP) delivers personalized interventions encouraging them to track their blood glucose level, weight, and physical activity. Objective: To assess BDMP app in type 2 diabetics in achieving healthy outcomes in Indian population. Methodology: The group of participants (N=181, A1C &amp;gt;6.5%) was divided into 3 groups - (1) patients treated with the BDMP plus Doctor-prescribed medication (n=60), (2) patients treated with the BDMP plus Doctor-prescribed medication plus Stress Reduction module (n=61) and (3) patients only taking the Doctor-prescribed medication (control group with n=60). Results: At the end of the 16 weeks, patients from Group 1 showed 81.6% program completion rate, 46.01% program adherence, an average of 5.64% of baseline body weight loss, an average of 0.68% reduction in A1C and Penn State Worry Questionnaire (PSWQ) score average change from 56.3 to 44.5 (score ranges 16-80, higher score indicates higher worry). Patients from Group 2 showed 88.5% program completion rate, 51.95% program adherence, an average of 6.02% of baseline body weight loss, average of 0.74% reduction in A1C and a PSWQ score average change from 58.6 to 40.8. Patients from Group 3 showed an average of 0.38% of baseline body weight loss, average of 0.28% reduction in A1C and a PSWQ score average change from 56.2 to 55.5. The difference between all the groups was found to be statistically significant (p&amp;lt;0.05). Conclusion: The BDMP helped the patients of Group 1 in significant weight loss, reduction in A1C, and improved stress levels. BDMP along with the Stress Reduction module in Group 2 produced even better outcomes. The results suggest that Digital Therapeutics is a scalable and sustainable solution to the growing problem of type 2 diabetes, and that mental well-being should be considered a part of the solution. Disclosure P. K. Goyal: None. R. Verma: None. A. Kaicker: None. S. Deka: None. S. Palukuri: None. B. Chandolia: None.

Randomized pilot trial of cognitive-behavioral therapy and acceptance-based behavioral therapy in the treatment of Spanish-speaking Latino primary care patients with generalized anxiety disorder.

The evidence base supporting the usefulness of traditional cognitive-behavioral therapy (CBT) and newer acceptance-based CBT treatments for generalized anxiety disorder (GAD) has grown over the past decades. GAD is prevalent among several Latino subgroups, particularly Puerto Ricans. However, there remains uncertainty regarding the appropriateness of these interventions for Spanish-speaking Latinos since they have been routinely excluded in both efficacy and effectiveness studies. As an initial step to bridge this gap, this pilot study examined the potential efficacy of two CBT interventions for GAD, traditional CBT and acceptance-based behavioral therapy (ABBT), in a sample of Spanish-speaking Latinos. Ninety primary care patients with GAD were randomly assigned to receive CBT (n=30), ABBT (n=30), or treatment as usual (TAU) (n=30). Excessive worry, the core feature of GAD, was assessed with the Penn State Worry Questionnaire (PSWQ), which is considered the gold standard measure of GAD-related worry. At follow-up, PSWQ scores for participants in the CBT and ABBT groups were statistically lower than those of the TAU group and statistically comparable to each other. CBT and ABBT reduced worry level to a greater degree than usual care by follow-up. Our findings provide preliminary, yet crucial data, which support the potential of both interventions targeting GAD symptoms among Spanish-speaking Latino primary care patients.

Depression and Intolerance of Uncertainty: Association with Decisional Conflict in Otolaryngology Patients.

To determine if anxiety, stress, depression, worry, and intolerance of uncertainty were related to pre-operative decisional conflict (DC), shared decision making (SDM), or demographic variables in adult otolaryngology surgical patients. Consecutive adult patients meeting criteria for otolaryngological surgery were recruited and completed DC and SDM scales, Penn State Worry Questionnaire (PSWQ), Intolerance of Uncertainty Scale (IUS-12), and Depression, Anxiety and Stress Scale-21 (DASS-21). The cohort included 118 patients, 61 (51.7%) males and 57 (48.3%) females. Surgery was planned for a benign process in 90 (76.3%) and 46 (39.3%) had previous otolaryngologic surgery. SDM and DC scores did not significantly differ across gender, age, education level, previous otolaryngologic surgery or whether or not surgery was for malignancy. Patients with no malignancy had significantly higher DASS-21 Stress scores (mean 12.94 vs 8.15, P < .05) and total IUS-12 scores (mean 28.63 vs 25.56, P = .004). Women had lower PSWQ scores (41.56 vs 50.87 for men, P = .006). IUS-12 and PSWQ declined with age. DC scores correlated positively with DASS-21 Depression (r = .256, P = .008) and IUS-12 scores (r = .214, P = .024). SDM correlated negatively with DASS-21 Depression (r = -.208, P = .030). Linear regression model for DC scores revealed a significant relationship with DASS depression (B = 0.674, P = .048). Preoperative decisional conflict is associated with increased depression and intolerance of uncertainty in adults undergoing otolaryngologic surgery. Screening for and management of depression, anxiety, and related concerns may improve surgical outcomes in this group.

The Penn State Worry Questionnaire Is Invariant Across Age Groups

Prevalence of GAD is between 3 to 5% with onset in the early to mid-twenties (Kessler et al. 2009). The Penn State Worry Questionnaire (PSWQ) is a 16-item self-report instrument assessing generalized anxiety symptoms (Meyers, et al., 1990; Molina & Borkovec, 1994). Brown (2003) and Olatunji et al. (2007) conducted Confirmatory Factor Analyses identifying a two factor model of Worry Engagement and Absence of Worry. No published studies have examined the factor structure of the PSWQ across age groups. The current study presents data from 612 people across three groups: 221 young adults (Mage = 19.31, SD = 1.21), 283 middle-age adults (Mage = 48.27, SD = 5.13), and 108 older adults (Mage = 72.95, SD = 7.19). An ordinal confirmatory factor analysis (CFA) using robust weighted least squares (WLSMV) tested for invariance across groups. Results showed CFI/TLI values of .983/.981, 984/.983, and .981/.984 for Configural (CI), Metric (MI), and Scalar (SI) models. The RMSEA for CI, MI, and SI models was .064, .061, and .059. Based upon Cheung and Rensvold (2002), Sass (2011), and Chen (2007), a cutoff of ΔCFI ≥ 0.01 was established as evidence of invariance. The ΔCFI between CI and MI models was < .01 so analysis continued with the SI test. The ΔCFI between MI and SI models was < 0.01 and did not justify rejection of the null hypothesis. These analyses suggest PSWQ scores are valid across age groups and provide additional support for the multidimensional nature of the PSWQ.

A Three-Arm Randomized Clinical Trial Comparing the Efficacy of a Mindfulness-Based Intervention with an Active Comparison Group and Fluoxetine Treatment for Adults with Generalized Anxiety Disorder

Introduction: Mindfulness-based interventions have been studied as an alternative treatment for anxiety disorders, but there are only a few studies comparing these with established treatments. Objective: To evaluate the efficacy of a Body in Mind Training (BMT) program for adults with generalized anxiety disorder (GAD), an active comparison protocol called Quality of Life and Psychoeducation (QoL), and treatment with fluoxetine (FLX). Methods: This study comprises a 3-arm parallel-group, randomized clinical trial (ClinicalTrials.gov ID: NCT03072264). Adults with a primary diagnosis of GAD and no current treatment were recruited from the community and randomized in a ratio 1:1:1. The primary outcomes were assessed by means of the Hamilton Anxiety Rating Scale (HAM-A) and the Penn State Worry Questionnaire (PSWQ) at week 8. Data were analyzed using a superiority analysis (BMT vs. QoL) and a noninferiority analysis (BMT vs. FLX). Results: A total of 249 participants were included and 223 were analyzed (76 BMT, 79 FLX, and 68 QoL). All groups improved after intervention. However, BMT was not superior to QoL at week 8 (mean difference = –1.36; p = 0.47), nor was it noninferior to FLX as assessed with theHAM-A (mean difference = 3.5; 95% CI –0.06 to 7.06; noninferiority margin = –2.43; p = 0.054). QoL (mean difference = 3.54; p = 0.04) and FLX (mean difference = –7.72; 95% CI –10.89 to –4.56; noninferiority margin = –2.09; p < 0.001) were superior to BMT in reducing PSWQ score. Conclusion: Our data suggest that BMT, in its current format, cannot be considered an effective mindfulness protocol to improve GAD.

Information Processing and Decision-Making in Pathological Worriers and their Potential Role in Mechanisms of Generalized Anxiety Disorder.

Systematic information processing and decision-making under uncertainty are key constructs of new conceptions explaining the severity of pathological worry. The current study attempted to analyze their usefulness in subclinical and clinical groups. In the first phase of the study (N = 251) participants were examined with the Penn State Worry Questionnaire (PSWQ), a GP consultationrelated survey, and a screening survey for generalized anxiety disorder (GAD). In the second phase (N = 220), the State-Trait Anxiety Inventory, the PSWQ, and tasks measuring systematic information processing (SIP) versus heuristic reasoning (HR) were applied. In the third phase (N = 60), GAD (n = 30) and healthy control (n = 30) groups were examined with the above methods and the Iowa Gambling Task (IGT). In the low risk group, a relationship between mood and the representativeness heuristic (ρ = 0.50), as well as anchoring and adjustment heuristic (anxiety-related stimuli) was found (ρ = −0.53). In the GAD group, significant correlations between the PSWQ score, the IGT loss avoidance score (ρ = 0.40), and total IGT score (ρ = 0.48) were found. The results did not confirm a particular usefulness of the systematic/heuristic information processing construct in subclinical and clinical groups. Theory-consistent results were rather found in the nonclinical groups. Nevertheless, the data revealed some interesting findings supporting potential explanatory power of some theoretical models.

An investigation of genetic variability of DNA methyltransferases DNMT3A and 3B does not provide evidence for a major role in the pathogenesis of panic disorder and dimensional anxiety phenotypes.

While DNA methylation patterns have been studied for a role in the pathogenesis of anxiety disorders, the role of the enzymes establishing DNA methylation-DNA methyltransferases (DNMTs)-has yet to be investigated. In an effort to investigate DNMT genotype-specific effects on dimensional anxiety traits in addition to the categorical phenotype of panic disorder, 506 panic disorder patients and 3112 healthy participants were assessed for anxiety related cognition [Agoraphobic Cognitions Questionnaire (ACQ)], anxiety sensitivity [Anxiety Sensitivity Index (ASI)] as well as pathological worry [Penn State Worry Questionnaire (PSWQ)] and genotyped for five single nucleotide polymorphisms (SNPs) in the DNMT3A (rs11683424, rs1465764, rs1465825) and DNMT3B (rs2424932, rs4911259) genes, which have previously been found associated with clinical and trait-related phenotypes. There was no association with the categorical phenotype panic disorder. However, a significant association was discerned between DNMT3A rs1465764 and PSWQ scores in healthy participants, with the minor allele conveying a protective effect. In addition, a marginally significant association between questionnaire scores (PSWQ, ASI) in healthy participants and DNMT3B rs2424932 was detected, again with the minor allele conveying a protective effect. The present results suggest a possible minor role of DNMT3A and DNMT3B gene variation in conveying resilience towards anxiety disorders. As the observed associations indicated a protective effect of two SNPs particularly with pathological worry, future studies are proposed to explore these variants in generalized anxiety disorder rather than panic disorder.

0454 Sleep Disruptive Cognitions in Deployment-Related Insomnia

Abstract Introduction Sleep disturbance is common following military deployment, and insomnia is associated with many adverse psychiatric and medical outcomes. Deployment to a threatening environment can engender nocturnal vigilance, which may be a salient feature of sleep disturbance in formerly deployed Veterans. Cognitive behavioral therapy for insomnia (CBTI) is an effective treatment; however, CBTI emphasizes targeting dysfunctional beliefs about sleep (DBAS) and generalized worries rather than vigilance. The goal of the present study was to investigate the role of vigilance, in relation to other potential types of sleep-interfering cognitions in formerly deployed Veterans with sleep disturbance. Methods Thirty-nine formerly deployed Veterans with disturbed sleep completed measures prior to an intervention. Insomnia was measured with the Insomnia Severity Index (ISI) and measures derived from actigraphy and morning sleep diaries administered for one week. Measures for sleep interfering cognitions included Dysfunctional Beliefs about Sleep (DBAS), the Penn State Worry Questionnaire (PSWQ), a measure of generalized worry, and the Fear of Loss of Vigilance (FLV) subscale of the Fear of Sleep Inventory (FOSI). Results All of the measures of sleep-interfering cognitions were significantly associated with ISI score. Generalized worries (PSWQ scores) were strongly and significantly correlated with both FLV and DBAS, which were not significantly correlated with each other. FOSI FLV explained 7.1% more variance in ISI score than DBAS alone (p = .04) while DBAS explained 23.1% additional variance in ISI score over FOSI FLV alone (p &amp;lt; .001). Conclusion It may be important to target both nocturnal vigilance and dysfunctional beliefs about sleep in the treatment of insomnia in formerly deployed Veterans. Support Supported by W81XWH-14-1-0066 from the Congressionally Directed Peer-Reviewed Medical Research Program of the Department of Defense.

Acute Exercise Effects among Young Adults with Analogue Generalized Anxiety Disorder.

This study replicated initial findings of positive effects of acute vigorous-intensity aerobic exercise on worry, state anxiety, and feelings of energy and fatigue among young adult women with analogue GAD, examined responses among young adult men with analogue GAD, and explored sex-related differences and moderation by physical activity level, trait anxiety, depression, and poor sleep status. Thirty-five young adults (21.4 ± 2.3 yr; 19 males; 16 females) with Penn State Worry Questionnaire scores ≥45 (60 ± 8) completed two counterbalanced 30-min conditions: treadmill running at ~71.2% ± 0.04% HR reserve and seated quiet rest. Outcomes included worry, worry engagement, absence of worry, state anxiety, and feelings of energy and fatigue. No outcome or moderator differed at baseline between sexes. Exercise significantly improved state anxiety (P < 0.04; d = 0.27) and feelings of energy (P < 0.001; d = 1.09). Small nonsignificant improvements were found for worry (d = 0.22), worry engagement (d = 0.18), and feelings of fatigue (d = 0.21). The magnitude of improvements in worry, worry engagement, absence of worry, and feelings of energy were stronger among females. Significant large, potentially clinically meaningful increases in feelings of energy were found among women (d = 1.35) and men (d = 0.92). A nonsignificant, but potentially clinically meaningful, moderate reduction in worry (d = 0.53) was found among women. High-trait anxiety and poor sleep quality were supported as moderators. Findings replicated positive effects of acute aerobic exercise among young adult women with analogue GAD, and extended to support for positive effects among young adult men with analogue GAD.