Physical Anxiety Symptoms Research Articles

The Fear of Losing Control in Social Anxiety: An Experimental Approach

Social anxiety disorder (SAD) is often conceptualized as arising from maladaptive cognitions. One cognitive domain that has received relatively little attention, despite endorsement from people struggling with social anxiety, is the belief that they may lose control over their speech/behaviour and/or their physical symptoms of anxiety. The present study aimed to evaluate the causal role of these beliefs on social anxiety symptoms in an analogue sample. Beliefs were manipulated using false feedback in undergraduate psychology students (N = 130) to induce either high or low levels of beliefs about losing control. Participants then engaged in a social interaction task with a confederate. The high beliefs about losing control (HLC) condition reported greater anxiety just before meeting the confederate than the low loss of control (LLC) condition. Further, HLC participants reported worse social performance and greater perceived failures of control than did those in the LLC condition during their interaction with a confederate. Results suggest beliefs about losing control are producing cognitive and behavioural changes which may in part explain differences in performance in social interactions. Beliefs about losing control appear to be relevant to the cognitive model of social anxiety. Future studies should consider whether these beliefs are malleable among individuals with SAD.

Associations of self-reported physical activity and anxiety symptoms and status among 7,874 Irish adults across harmonised datasets: a DEDIPAC-study

BackgroundAnxiety is an adaptive response to an objective or perceived threat; however, when symptoms become severe and chronic it that can become a maladaptive anxiety disorder. Limited evidence suggests that physical activity may be associated with prevention against anxiety. This study uses data from The Irish Longitudinal Study on Ageing (TILDA) and The Mitchelstown Cohort Study to investigate cross-sectional associations between physical activity and anxiety symptoms and status among Irish adults.MethodsBoth datasets were harmonized (n = 7874). The short form International Physical Activity Questionnaire measured physical activity. Participants were classified as meeting World Health Organization physical activity guidelines (≥150 min weekly of moderate intensity physical activity, ≥75 min weekly of vigorous intensity physical activity, or ≥ 600 MET-minutes) or not. They were also divided into three groups based on weekly MET-minutes of moderate-to-vigorous physical activity (Low: 0–599; Moderate: 600–1199; High: ≥1200), and three groups based on weekly minutes of walking (Low: 0–209; Moderate: 210–419; High: 420+). Anxiety symptoms were measured by the Hospital Anxiety and Depression Scale with a score of ≥8 indicating anxiety. Binomial logistic regression, adjusted for relevant confounders examined physical activity–anxiety associations.ResultsFemales had higher rates of anxiety than males (28.0% vs 20.0%; p < 0.001). Following adjustment for relevant covariates, meeting physical activity guidelines was associated with 13.5% (95% CI: 2.0–23.7; p = 0.023) lower odds of anxiety. Moderate and High physical activity were associated with 13.5% (− 11.0–32.6; p = 0.254) and 13.6% (1.4–4.2; p = 0.030) lower odds of anxiety compared to Low physical activity, respectively. Moderate and High walking were associated with 2.1% (− 14.5–16.3; p = 0.789) and 5.1% (− 9.3–17.6; p = 0.467) lower odds of anxiety compared to Low walking, respectively.ConclusionMeeting physical activity guidelines is associated with lower odds of anxiety, but the strength of associations did not increase considerably with increased physical activity levels.

Symptom burden in patients with cancer who are experiencing unplanned hospitalization

Inpatient supportive care programs often target patients with advanced solid tumors. To the authors' knowledge, few studies to date have characterized symptom burden in hospitalized patients with potentially curable cancers. The objective of the current study was to compare symptom burden, palliative care consultation, and readmission rates in hospitalized patients by cancer type and treatment intent. The authors conducted a single-center study of hospitalized patients with cancer between 2014 and 2017. They assessed physical symptoms using the Edmonton Symptom Assessment System and psychological distress using the Patient Health Questionnaire-4 and the Primary Care PTSD (Posttraumatic Stress Disorder) Screen. Multivariate linear regression models were used to assess symptom burden, logistic regression was used to assess palliative care use, and competing risk regression was used to compare 90-day readmission risk. A total of 1549 patients were enrolled and surveyed. The majority of patients reported moderate to severe fatigue, poor well-being, and drowsiness with no significant differences noted by cancer type and treatment intent. Compared with other groups, patients with incurable solid cancer reported higher physical symptoms (beta coefficient [B], 4.73; P<.01) and symptoms of depression (B, 0.44; P<.01) and anxiety (B, 0.39; P<.01), but no difference in posttraumatic stress disorder. Among patients in the top quartile symptom burden according to the Edmonton Symptom Assessment System, the palliative care service was consulted in 14.7%, 7.9%, 25.0%, and 49.6%, respectively, of patients with potentially curable hematologic, potentially curable solid, incurable hematologic, and incurable solid cancers (P<.001). Compared with patients with potentially curable solid cancer, patients in each group experienced a higher risk of readmission within 90days. Hospitalized patients with cancer experience substantial physical and psychological symptoms. Palliative care rarely is consulted for highly symptomatic patients with potentially curable cancers. Supportive care interventions should target the needs of symptomatic patients regardless of treatment intent.

A network analysis of culturally relevant anxiety sensitivity and posttraumatic stress disorder symptoms in Cambodians.

The Anxiety Sensitivity Index (ASI) measures fears of anxiety-related symptoms based on respondent beliefs about their harmfulness. This is the first network analysis of anxiety sensitivity and PTSD, and the first to explore an addendum of culturally salient fears in such an analysis. The purpose of our study was to test whether relations among PTSD symptoms and facets of anxiety sensitivity, observed clinically, can be visualized by this approach. Using network analysis, we examined in a Cambodian population the relationship of PTSD symptoms to the standard Anxiety Sensitivity Index (ASI) and to an ASI Cambodian Addendum (ASICA) that taps culturally salient fears of somatic symptoms among Cambodians not assessed in the standard ASI. Computing relative importance networks, we found that the ASI subscales, ASICA, and PTSD subscales were strongly interconnected, with the ASICA having the strongest outstrength centrality. In the network analysis of the ASI subscales, disaggregated ASICA, and PTSD subscales, several of the ASICA items had very high outstrength. The results show that fear of mental and physical symptoms of anxiety should be a key part of the evaluation of trauma-related disorder, and that those fears should be targeted. It also suggests the need for ASI addenda to assess concerns about anxiety symptoms salient for certain cultures that are not assessed by the standard ASI: among Cambodian populations, fear of cold hands and feet, "out of energy in the arms and legs," neck soreness, tinnitus, and dizziness on standing.

Clinically ascertained health outcomes, quality of life, and social attainment among adult survivors of neuroblastoma: A report from the St. Jude Lifetime Cohort.

The objective of this study was to characterize chronic disease, health-related quality of life (HRQOL), emotional distress, and social attainment among long-term survivors of neuroblastoma. Chronic health conditions among 136 ≥10-year neuroblastoma survivors (median age, 31.9years; range, 20.2-54.6years) and 272 community controls (median age, 34.7years; range, 18.3-59.6years) were graded with a modified version of the Common Terminology Criteria for Adverse Events (version 4.03). HRQOL and emotional distress were assessed with the Medical Outcomes Study 36-Item Short Form Health Survey and the Brief Symptom Inventory-18. Log-binomial regression and logistic regression were used to compare the prevalence of chronic conditions and the frequency of reduced HRQOL, distress, and social attainment between survivors and controls. The cumulative burden approach was used to estimate multimorbidity. By the age of 35years, survivors had experienced, on average, 8.5 grade 1 to 5 conditions (95% confidence interval [CI], 7.6-9.3), which was higher than the average for controls (3.3; 95% CI, 2.9-3.7). Compared with controls, survivors had a higher prevalence of any pulmonary (P=.003), auditory (P<.001), gastrointestinal (P<.001), neurological (P=.003), or renal condition (P<.001); were more likely to report poor physical HRQOL (P=.01) and symptoms of anxiety (P=.01) and somatization (P=.01); and were less likely to live independently (P=.01) or marry (P=.01). In analyses limited to survivors, those with 1 or more grade 3 to 5 conditions were more likely to report reduced general health (odds ratio [OR], 6.6; 95% CI, 1.6-26.9), greater bodily pain (OR, 4.2; 95% CI, 1.0-17.0), and unemployment (OR, 3.2; 95% CI, 1.2-8.5). Because of the high burden of chronic diseases and the associations of these morbidities with reduced HRQOL and social attainment, screening and interventions that provide opportunities to optimize health are important among neuroblastoma survivors.

'I have anxiety, but I have values and preferences' Experiences of users with generalized anxiety disorder: A qualitative study.

To understand the experience and perceptions of people diagnosed with generalized anxiety disorder, along the whole process and their role through the decision-making process for their treatment. A qualitative study through focus groups composed of people diagnosed with generalized anxiety disorder was carried out. Content analysis was carried out to explore the most representative issues. Five thematic categories were identified: onset of the disorder, symptoms and course; daily life with the disorder; coping with the disorder; demand of healthcare for anxiety, and treatment options and decision-making. Most of the patients reported physical symptoms of anxiety. The majority of participants perceived little social support from their environment and occupational interferences. Coping seems to differ among participant that have recovered or not recovered. The involvement of users with generalized anxiety disorder was scarce, and pharmacological treatment was always the first option offered. There is scarce orientation to elicit preferences and values of patients across the process of care for people with generalized anxiety disorder. The consequence is a biased predisposition of the healthcare system to provide pharmacological treatment as the first option and ignore the perspective of patients on how to cope with their illness.

Links Between Peer Victimization, Perceived School Safety, and Internalizing Symptoms in Middle Childhood

Extant research indicates that peer victimization is an important factor in the development of internalizing symptoms for youth. However, few studies have examined contextual factors that may impact how peer victimization contributes to these symptoms in middle childhood, especially in the form of victimization. The current study evaluated associations between relational and physical victimization and symptoms of depression and anxiety in a sample of third through fifth graders. In addition, the influence of perceived school safety as a moderator of these associations was examined. Findings indicated that relational victimization was more strongly associated with symptoms of both depression and anxiety than physical victimization. Further, low levels of perceived school safety contributed to symptoms of depression and anxiety and exacerbated the associations between relational victimization and these symptoms, particularly for anxiety. Implications for findings are discussed.

Level of Anxiety among the Elderly Adults at Western Regional Hospital, Pokhara, Nepal

Anxiety disorders are abnormal states in which most striking features are mental and physical symptoms of anxiety, whichare not caused by organic brain disease or any other psychiatric disorder. This study aimed at exploring the level of anxietyamong the elderly adults in inpatient and outpatient departments of western regional hospital, Pokhara, Nepal.This is a hospitalbased cross-sectional study conducted in the outpatient as well as inpatient departments, medical and geriatric ward of westernregional hospital, Pokhara. We interviewed 318 respondents purposively using structured interview schedule. Geriatric Anxiety Scale (GAS) – Version 2.0 was used to assess anxiety symptoms. It was found an overall 68% had anxiety. The highestfrequency 209 (65.7%) respondents had moderate anxiety whereas only 7(2.2%) had high anxiety. Sex, religion and monthlyfamily income were significantlyassociated with level of anxiety (p&lt;0.05). The burden of anxiety among elderly patients visiting tertiary level health care suggestsfocusing on evidence-based interventions by health authority.&#x0D; Key words : Anxiety, Elderly, Magnitude, Nepal

Daytime and nighttime correlates of fatigue and lack of energy in adults living with HIV

To describe correlates of fatigue and lack of energy symptoms in adults living with HIV. Adults living with HIV were recruited if they were ≥45 years old, unemployed, and reported either fatigue or lack of energy in the past week. HIV-associated correlates included CD4 cell count, viral load, and hemoglobin. Daytime correlates included physical activity, daytime sleepiness, napping behavior, and symptoms of anxiety and depression. Nighttime correlates included use of sleep medication, sleep duration, and sleep quality. Outcomes included physical and cognitive function. Most (70%) of the 53 participants were male. The mean age was 56.7 ± 6.7 years and participants had been living with HIV for a mean of 22 ± 6.4 years. Controlling for all other factors, African Americans reported less fatigue and more energy than other racial/ethnic groups. Lack of energy was associated with daytime napping and cognitive function. Fatigue was associated with shorter nighttime sleep duration, anxiety, and both physical and cognitive function. Findings highlight potential differences between lack of energy and fatigue that could influence intervention outcomes. Avoiding daytime naps and encouraging longer nighttime sleep may improve fatigue as well as physical and cognitive function in this chronic illness population.

The effects of acute yoga on anxiety symptoms in response to a carbon dioxide inhalation task in women

PurposeWe investigated the efficacy of yoga for improving cognitive and physical anxiety symptoms, and its possible respiratory mechanism, in high-anxious women. MethodsEighteen participants completed 40 min of guided yoga and a light stretching protocol in a randomized, counterbalanced order.The 7.5%CO2-inhalation task was administered before, immediately after and 1 h after the experimental conditions.State anxiety and panic were measured before and after each inhalation task.Tidal volume, ventilation and respiratory rate were measured during every 7.5%CO2-inhalation tasks. ResultsThere was no significant 3-way interaction(p > .05).There was a significant main effect of CO2-inhalation task on panic and respiratory measures(p < .05).When collapsed over inhalation task and condition, there was a small reduction in cognitive anxiety from baseline to immediately post and 1 -h post-condition(p < .05). ConclusionsThere appears to be an overall effect of general physical activity for attenuating anxiety cognitions irrespective of the physiological changes, indicating possible dissociation between the cognitive and physical symptoms of anxiety among women with anxiety sensitivity.

Prevalence and features of spontaneous recurrent images in social anxiety disorder: findings from a Korean community sample.

Previous studies have indicated that people with social anxiety disorder (SAD) often experience spontaneous, recurrent images (SRI). It was assumed that Koreans with interdependent self-views may contain more features related to social contexts in their self-images than those reported in Western cultures. In the present study, we aimed to explore the prevalence and content of SRIs in individuals with SAD in Korea. Furthermore, we investigated the relationship between features of SRIs and variables of SAD. Sixty-four individuals with SAD (27.00 ± 7.42 years, 64.1% female), diagnosed with SAD, completed self-report questionnaires related to social anxiety. Afterwards, a semi-structured interview was used to assess features and content of the individuals' SRI. Thirty (47%) of the participants reported experiencing SRIs in social situations. The content of the SRIs were classified under three themes: negative self-images, negative images of others, and abstract images. The distress level of SRIs was positively associated with social phobia scales (r = .385, p < .05) and physical anxiety symptoms (r = .478, p < .05). Frequency of SRIs was positively associated with avoidance scores (r = .402, p < .05). The results demonstrated differences in the prevalence and content of the SRIs between Western and non-Western cultures. Fewer individuals with SAD in Korea reported having SRIs, and the content of these SRIs involved people other than the self. Some features of SRIs were associated with variables of SAD.

Assessing and responding to anxiety and panic in the Emergency Department

Anxiety and panic symptoms are widespread in the general population. The physical manifestations of anxiety and panic commonly account for people presenting to Emergency Departments (EDs). It is therefore important for ED clinicians to be informed of the numerous causes of anxiety and panic and equipped to respond effectively. This paper describes the underlying pathophysiology of the physical symptoms of anxiety and panic and differential diagnoses to consider. Organic conditions that are associated with symptoms of anxiety and panic are highlighted. Brief interventions are tabled for ED clinicians to use when explaining symptoms, and to promote individual self-management.

Examination of the stability of the anxiety sensitivity index across the menstrual cycle in trauma-exposed women with and without PTSD

ABSTRACTBackground and Objectives: Anxiety sensitivity (AS), as measured by the Anxiety Sensitivity Index (ASI), has consistently been studied as a trait-level predictor of a variety of emotional and physical health conditions, including premenstrual symptoms. The menstrual cycle influences symptom expression and stress reactivity among anxiety and stress-related disorders. However, research has yet to directly evaluate the stability of AS across the various phases of the menstrual cycle, particularly in clinical populations with high levels of AS and with documented menstrual cycle differences in symptoms such as women with posttraumatic stress disorder (PTSD).Design and Methods: The current study examined whether AS fluctuates as a function of menstrual cycle phase among a community sample of trauma-exposed women (N = 48) with and without PTSD. Participants completed the ASI, including subscales assessing sensitivity to physical, cognitive, and social symptoms of anxiety, during early follicular and mid-luteal menstrual cycle phases.Results: Results revealed that ASI scores remained relatively stable across the different phases of the menstrual cycle assessed; evidence for stability was particularly strong for the subscale assessing sensitivity to physical symptoms of anxiety.Conclusion: This study provides additional support for the conceptualization of AS as a stable, trait-like, cognitive risk factor.

The relationship between physical activity levels and symptoms of depression, anxiety and stress in individuals with alopecia Areata

BackgroundAlopecia Areata (AA) is an autoimmune condition that is characterised by non-scarring hair loss. Its aesthetic repercussions can lead to profound changes in psychological well-being. Although physical activity (PA) has been associated with better mental health outcomes in diverse populations, the association in individuals with AA has not been established. The aim of this study was to examine the associations between PA and mental health outcomes in individuals with AA to inform intervention strategies for this specific population.MethodsA cross-sectional study was conducted among individuals who were diagnosed with AA. A total of 83 respondents aged (40.95 ± 13.24 years) completed a self-report questionnaire consisting of International Physical Activity Questionnaire-Short Form (IPAQ-SF) and the Depression and Anxiety Stress Scale (DASS-21). Three-way contingency Chi-square analyses were used to determine the associations between PA, mental health outcomes and participants with hair loss of more than 50% on the scalp.Results81.9% of the participants did not meet PA guidelines. Participants with hair loss of more than 50% on the scalp, and who did not meet PA guidelines, were significantly more likely to experience symptoms of severe depression (p = .003), moderate anxiety (p = .04) and mild stress (p = .003) than those who met guidelinesConclusionFindings suggest that increased PA participation in AA individuals with severe hair loss is associated with improved mental health status. Intervention efforts for this specific population should consider barriers and enablers to PA participation as they face challenges that differ from the general population.

Re-conceptualization of anorexia nervosa psychopathology: A network analysis study in adolescents with short duration of the illness.

Research evidence suggests the need to identify treatments based on a more precise characterization of psychopathology and psychiatric comorbidity in anorexia nervosa. Network analysis provides a new method to conceptualize psychopathology. We use this approach to investigate the relationships between eating disorder and general psychiatric symptoms in adolescents with anorexia nervosa. Four-hundred and five adolescents with anorexia nervosa and illness duration less than 3 years were consecutively recruited from those admitted to inpatient treatment. They completed the following questionnaires: the Eating Disorder Inventory-3, the Multidimensional Anxiety Scale for Children, the Children's Depression Inventory, and the Youth Self Report. A network analysis was conducted, including eating psychopathology measures, anxiety and depressive symptoms, and obsessive-compulsive and post-traumatic stress problems. We employ a novel approach, the bridge function, to identify symptom clusters. Depression symptoms and personal alienation were the nodes with the highest centrality in the network, followed by asceticism, post-traumatic stress problems, drive to thinness, low self-esteem, and anxiety physical symptoms. Three symptom clusters (relative to eating disorder psychopathology, self-esteem problems, and internalizing difficulties) were identified. Depression symptoms, personal alienation, low self-esteem, and interoceptive deficits showed the highest bridge centrality. Besides eating disorder core symptoms, negative affect and internalizing symptoms seem to contribute to anorexia nervosa psychopathology independently from illness duration effects. These findings suggest that anorexia nervosa is characterized by a broad psychopathological spectrum rather than the mere eating disorder core symptoms, confirm the need to re-conceptualize psychiatric comorbidity in this disorder, and provide intriguing diagnostic and therapeutic implications.

Improving continuity by bringing the cancer patient, general practitioner and oncologist together in a shared video-based consultation \u2013 protocol for a randomised controlled trial

BackgroundStrengthening the coordination, continuity and intersectoral cooperation for cancer patients’ during cancer treatment is being underlined by international guidelines and research. General practitioners have assumed a growing role in the cancer patient disease trajectory because of their roles as coordinators and the consistent health provider. However, general practitioners are challenged in providing support for cancer patients both during treatment and in the survivorship phase. General practitioners reported barriers are lack of timely and relevant communication from the oncologist and limited knowledge to guidelines, as well as lack of trust from patients.Therefore, the current study will examine whether a shared video-based consultation between the cancer patient, general practitioner and oncologist can ease general’ challenges and thereby enhance the patient-centeredness for the cancer patients and their perception of intersectoral cooperation and continuity.MethodsThe study is designed as a pragmatic randomised controlled trial for patients starting chemotherapy at the Department of Oncology, Lillebaelt Hospital, Denmark who are listed with a general practitioner in the Region of Southern Denmark. We intend to include 278 adults diagnosed with colorectal, breast, lung, gynecologic or prostate cancer.The intervention group will receive the “Partnership intervention” which consists of one or more video-consultations between the cancer patient, general practitioner and oncologist. The consultations are estimated to last between 10 and 20 min. The specific aims of the consultation are, summary of the patient trajectory, sharing of knowledge regarding comorbidity, psychosocial resources and needs, physical well-being, medicine, anxiety and depression symptoms, spouses, workability and late complication and side-effects to the cancer treatment.DiscussionVideo-based consultation that brings the cancer patient, the general practitioner and the oncologist together in the early phase of treatment may facilitate a sense of partnership that is powerful enough to improve the patient’s perception of intersectoral cooperation, continuity of cancer care and health-related quality of life.Trial registrationClincialTrials.gov Identifier: NCT02716168. Date of registration: 03.03.2016.

Teacher acceptability of progressive muscle relaxation in the classroom for the treatment of test anxiety

AbstractTest anxiety is experienced by 10–40% of students. The physical symptoms associated with test anxiety may be more likely to be exhibited by elementary students. Progressive muscle relaxation (PMR) has been demonstrated to reduce physical symptoms of anxiety and could be used in the classroom, but teacher acceptability of PMR for test anxiety has not been assessed. This study used a vignette format to survey 404 first through fifth grade teachers on their acceptability of classroom-based PMR as an intervention for test anxiety. Good levels of acceptability were found for implementation with a school psychologist or counsellor, CD player, or digital music player. Special education teachers reported slightly lower levels of acceptability for using PMR in the digital music player scenario. With good levels of teacher acceptability of PMR to address test anxiety, school psychologists and counsellors may be more likely to recommend the use of PMR in classrooms. Implications for implementation of PMR to reduce test anxiety, study limitations, and suggestions for future research are discussed.

The effects of physical activity on anxiety, depression, and quality of life in elderly people living in the community.

Health problems may negatively affect the psychological and physical aspects of life, influencing the quality of life of older adults. The objective of this study was to analyze the effects of physical activity on quality of life, anxiety, and depression in the elderly population. We performed a cross-sectional study of 200 elderly people of both genders. Subjects were divided into two groups: one with 100 senior citizens engaged in physical activities in a social center for the elderly; and another composed of 100 subjects who lived in the community but were not engaged in physical activities. The instruments used to assess physical activities, quality of life, and anxiety and depression were, respectively: the modified Baecke questionnaire; the 36-Item Short Form Health Survey (SF-36); and the Hospital Anxiety and Depression Scale (HADS). The data were analyzed using the Student's t test, Pearson's r, and analysis of variance (ANOVA), with odds ratio and a 5% significance level (p<0.05). We observed that the active group showed higher scores of physical activity and quality of life. Conversely, the sedentary group revealed higher scores of anxiety and depression. Data assessment revealed a strong correlation between the domains quality of life, level of vitality, and mental health (r=0.77). The prevalence ratio showed that physical activity is a protective factor against anxiety and depression in the elderly. The findings suggest a correlation between low levels of physical activity and symptoms of anxiety and depression in the elderly living in the community.

Relationship between pre-stroke physical activity and symptoms of post-stroke anxiety and depression: An observational study.

To explore mechanisms affecting mental health in patients with stroke. The aims were to investigate the association between pre-stroke physical activity and symptoms of anxiety and depression 3 months after stroke, and to investigate how self-reported physical activity changed from before to 3 months after the stroke. Secondary analyses of a prospective observational multicentre study. Stroke patients from 11 Norwegian stroke units. Symptoms of anxiety and depression were measured using the Hospital Anxiety and Depression Scale, and physical activity was assessed by self-report. Negative binomial regression was used to analyse associations. The analysed sample consisted of 205 patients; mean age was 74 years (standard deviation (SD) 11.5); 46% were women. Higher activity levels before stroke were associated with fewer symptoms of depression in multivariable analyses with regression coefficient of 0.84 (95% confidence interval 0.73-0.97), p = 0.015. Eighty-five (41.5%) patients reported similar activity levels before and after stroke. In this group of patients with mild symptoms of emotional distress, it seems that pre-stroke physical activity might be protective against post-stroke depression, but not anxiety. Many patients with mild-to-moderate stroke report being equally active before and after the stroke.

Anxiety disorder symptoms at age 10 predict eating disorder symptoms and diagnoses in adolescence.

Cross-sectional associations between anxiety disorders and eating disorders (EDs) have been well documented; however, limited research has examined whether symptoms of anxiety disorders are prospectively associated with EDs. Identifying these longitudinal associations can aid in discerning relationships among eating and anxiety disorders and point toward a mechanistic understanding of developmental psychopathology. This study investigated the prospective associations between parent-reported anxiety in mid-childhood (age 10) and child-reported ED behaviors and disorders in adolescence (at ages 14 and 16years) in a population-based sample. Participants were individuals enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based, prospective study of women and their children; 7,767 children whose parents provided data at age 10 were included in current analyses. An exploratory factor analysis identified latent anxiety factors at age 10, followed by a path analysis that evaluated associations between these factors and eating disorder symptoms and cognitions at age 14. Parent-reported anxiety symptoms at age 10 yielded 5 factors: obsessive-compulsive disorder (OCD) symptoms related to symmetry and checking (Factor 1); OCD symptoms associated with aversion to dirt and germs (Factor 2); physical anxiety symptoms (Factor 3); worries (Factor 4); and social phobia symptoms (Factor 5). Factors 3 and 4 showed the most consistent, positive associations with a range of ED symptoms at age 14. Factor 3 predicted diagnosis of bulimia nervosa by age 16 (OR=1.11, p=.007), whereas Factor 4 predicted diagnoses of anorexia nervosa (OR=1.10, p=.01) and disordered eating by age 16 (OR=1.08, p=.001). Results indicate that symptoms of generalized anxiety in middle childhood may predict adolescent-onset ED symptoms and ED diagnoses.