Risk Factor For Anxiety Disorders Research Articles

The Moderation Role of Neuroticism for Anxiety among Burdened Dementia Caregivers: A Study on Care Giver-Recipient Dyads

ABSTRACT Caregiving burden proves to be a risk factor of anxiety disorders and anxiety affection. The current study investigates how an endogenous personality dimension – neuroticism – moderates the association between caregiving burden and anxiety affection. Between 2015 and 2017, the study deployed a cross-sectional survey of 674 (response rate = 89%) older adults who were hospitalized for dementia at two hospitals. From all primary caregivers of these patients, 661 agreed to participate in the survey which yielded 661 matched dyads as the final sample. Caregiving burden, neuroticism, and anxiety affection were each measured by established assessment instruments. We employed multivariate OLS regression to test the moderator and regressor effects. We found that care burden is a significant risk factor of higher levels of anxiety affection (β = .17, p < .001), and accounts for 4.6% of the variance in anxiety. Neurotic personality is also significantly associated with a greater level of anxiety (β = .26, p < .001). Neurotic personality moderates the association between anxiety and care burden (β = .24, p < .001). Our findings suggest that social and healthcare workers should assess caregiver personality and burden as well as provide support, resources, and coping strategies to those with neurotic personality traits or high care burden in an effort to reduce anxiety among caregivers.

Mitophagy in the basolateral amygdala mediates increased anxiety induced by aversive social experience

Psychosocial stress is a common risk factor for anxiety disorders. The cellular mechanism for the anxiogenic effect of psychosocial stress is largely unclear. Here, we show that chronic social defeat (CSD) stress in mice causes mitochondrial impairment, which triggers the PINK1-Parkin mitophagy pathway selectively in the amygdala. This mitophagy elevation causes excessive mitochondrial elimination and consequent mitochondrial deficiency. Mitochondrial deficiency in the basolateral amygdalae (BLA) causes weakening of synaptic transmission in the BLA-BNST (bed nucleus of the stria terminalis) anxiolytic pathway and increased anxiety. The CSD-induced increase in anxiety-like behaviors is abolished in Pink1-/- and Park2-/- mice and alleviated by optogenetic activation of the BLA-BNST synapse. This study identifies an unsuspected role of mitophagy in psychogenetic-stress-induced anxiety elevation and reveals that mitochondrial deficiency is sufficient to increase anxiety and underlies the psychosocial-stress-induced anxiety increase. Mitochondria and mitophagy, therefore, can be potentially targeted to ameliorate anxiety.

The role of anxiety sensitivity in anger symptomatology: Results from a randomized controlled trial

Anger is often overlooked in the assessment and treatment of pathological anxiety, despite there being evidence that anger is elevated across all anxiety disorders. Anxiety sensitivity (AS), a major risk factor of anxiety disorders, has been shown to modulate anger in response to threat induced hyperarousal. The current study therefore examined if reductions in anxiety sensitivity (AS) mediate reductions in anger symptoms. Outcomes from a randomized control trial evaluating the efficacy of a brief AS mitigation intervention were analyzed. Patients with anxiety and comorbid conditions were randomly assigned to AS reduction (n = 58) or a repeated contact control condition (n = 60) and followed up with for three months. Analyses evaluated whether treatment related change in AS mediated later reductions in anger, hostility, verbal aggression, and physical aggression. Results revealed that reductions in AS temporally mediated the effects of treatment on later reductions in anger, hostility, verbal aggression, and physical aggression. Specificity analyses provided further support for the direction and specific variables examined in these models. Results suggest that AS may be a promising treatment target for anger symptoms among those with elevated anxiety symptoms.

An exploration of the relationships of experiential avoidance (as measured by the aaq-ii and meaq) with negative affect, perceived stress, and avoidant coping styles.

BackgroundCurrent psychotherapies seek to reduce experiential avoidance (EA) which has also been put forth as a risk factor for anxiety disorders, depression, and post-traumatic stress disorder. EA is a potentially maladaptive self-regulatory tendency to avoid negative thoughts, feelings, memories, physical sensations, and other internal experiences. One unresolved issue with the most commonly used measures of EA, the Acceptance and Action Questionnaire-II (AAQ-II) which measures EA as a single factor and the Multidimensional Experiential Avoidance Questionnaire (MEAQ) which measures EA as six subdimensions, is what exactly is being measured. The AAQ-II appears to measure negative affect (NA), some aspects of avoidant coping, and psychological distress. In addition, the relationships of all the MEAQ subscales have not been thoroughly examined with these other constructs. In the current study, the relationships of AAQ-II and MEAQ scores with NA, avoidant coping styles, and perceived stress were examined.MethodsTwo-hundred undergraduates (154 females and 46 males) completed the AAQ-II and MEAQ, the Distressed Type D Personality Scale (DS-14) which includes a measure of NA, the Brief COPE which measures coping styles, and the Perceived Stress Scale.ResultsScores on the AAQ-II had moderate positive relationships with the MEAQ total score and all MEAQ subscales with the exception of distress endurance which had a moderate negative relationship. The AAQ-II had a stronger relationship with NA, avoidant coping, and perceived stress than did the MEAQ. All MEAQ subscales had a positive relationship to NA, avoidant coping, and perceived stress with the exception of distress endurance which had a negative relationship with these constructs. While the AAQ-II is limited as a unitary measure of EA the multiple dimensions of the MEAQ may involve an extraneous factor of distress endurance. Future work should examine the relationships of the MEAQ with NA, avoidant coping and perceived stress with clinical populations.

Global, regional and national burden of anxiety disorders from 1990 to 2019: results from the Global Burden of Disease Study 2019.

Anxiety disorders are widespread across the world. A systematic understanding of the disease burden, temporal trend and risk factors of anxiety disorders provides the essential foundation for targeted public policies on mental health at the national, regional, and global levels. The estimation of anxiety disorders in the Global Burden of Disease Study 2019 using systematic review was conducted to describe incidence, prevalence and disability-adjusted life years (DALYs) in 204 countries and regions from 1990 to 2019. We calculated the estimated annual percentage change (EAPC) to quantify the temporal trends in anxiety disorders burden by sex, region and age over the past 30 years and analysed the impact of epidemiological and demographic changes on anxiety disorders. Globally, 45.82 [95% uncertainty interval (UI): 37.14, 55.62] million incident cases of anxiety disorders, 301.39 million (95% UI: 252.63, 356.00) prevalent cases and 28.68 (95% UI: 19.86, 39.32) million DALYs were estimated in 2019. Although the overall age-standardised burden rate of anxiety disorders remained stable over the past three decades, the latest absolute number of anxiety disorders increased by 50% from 1990. We observed huge disparities in both age-standardised burden rate and changing trend of anxiety disorders in sex, country and age. In 2019, 7.07% of the global DALYs due to anxiety disorders were attributable to bullying victimisation, mainly among the population aged 5-39 years, and the proportion increased in almost all countries and territories compared with 1990. Anxiety disorder is still the most common mental illness in the world and has a striking impact on the global burden of disease. Controlling potential risk factors, such as bullying, establishing effective mental health knowledge dissemination and diversifying intervention strategies adapted to specific characteristics will reduce the burden of anxiety disorders.

Long-Term Decreases in the Expression of Calcineurin and GABAA Receptors Induced by Early Maternal Separation Are Associated with Increased Anxiety-Like Behavior in Adult Male Rats

Introduction: Early life stress is a well-described risk factor of anxiety disorders in adulthood. Dysfunction in GABA/glutamate receptors and their functional regulator, calcineurin, is linked to anxiety disorders. Here, we investigated the effect of early life stress, such as repeated maternal separation (MS; 3 h per day from postnatal day [P] 2 to 11), on changes in the expression of calcineurin as well as the ionotropic glutamatergic and GABAergic receptors including α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA), N-methyl-D-aspartate (NMDA) and GABA_A receptors in the hippocampus and prefrontal cortex (PFC) of adolescent (P35) and adult (P62) male Wistar rats and their correlations with anxiety-like behavior in adulthood. Methods: The protein levels were assessed by Western blot analysis. Anxiety-like behavior was measured in the elevated plus maze (EPM) and open field (OF) tests. Results: MS induced a regional transient decrease of glutamate receptors expression at P35, with decreased NMDA and AMPA receptor levels, respectively, in the hippocampus and PFC, suggesting a possible decrease in excitatory synaptic strength. In contrast to glutamate receptors, MS had long-lasting influence on GABA_A receptor and calcineurin levels, with reduced expression of GABA_A receptor and calcineurin in both brain regions at P35 that continued into adulthood. These results were accompanied by increased anxiety behavior in adulthood, shown by lower percentage of number of total entries and time spent in the open arms of the EPM, and by lower time spent and number of entries in the OF central area. Conclusions: Together, our study suggests that GABA_A receptors via calcineurin-dependent signaling pathways may play an important role in the expression of stress-induced anxiety-like behavior.

Device-measured sedentary behaviour and anxiety symptoms during adolescence: a 6-year prospective cohort study.

Sedentary behaviour is potentially a modifiable risk factor for anxiety disorders, a major source of global disability that typically starts during adolescence. This is the first prospective study of associations between repeated, device-based measures of sedentary behaviour and anxiety symptoms in adolescents. A UK cohort with 4257 adolescents aged 12 at baseline (56% female). Main exposures were sedentary behaviour and physical activity measured using accelerometers for 7-days at ages 12, 14, and 16. Primary outcome was anxiety symptom scores at age 18 from a Clinical Interview Schedule-Revised. We used adjusted negative binomial regression and iso-temporal substitution methods to analyse the data. We found a positive association between sedentary behaviour at ages 12, 14, and 16, with anxiety symptoms at age 18, independent of total physical activity volume. Theoretically replacing an hour of daily sedentary behaviour for light activity at ages 12, 14, and 16, was associated with lower anxiety symptoms by age 18 by 15.9% (95% CI 8.7-22.4), 12.1% (95% CI 3.4-20.1), and 14.7% (95% CI 4-24.2), respectively. Whereas, theoretically replacing an hour of sedentary behaviour with moderate-to-vigorous physical activity was not associated with differences in anxiety symptoms. These results were robust to a series of sensitivity analyses. Sedentary behaviour is a possible risk factor for increasing anxiety symptoms during adolescence, independent of total physical activity volume. Instead of focusing on moderate-to-vigorous activity, replacing daily sedentary behaviour with light activity during adolescence could be a more suitable method of reducing future anxiety symptoms.

Psychosocial and biological risk factors of anxiety disorders in adolescents: a TRAILS report

Anxiety disorders are a common problem in adolescent mental health. Previous studies have investigated only a limited number of risk factors for the development of anxiety disorders concurrently. By investigating multiple factors simultaneously, a more complete understanding of the etiology of anxiety disorders can be reached. Therefore, we assessed preadolescent socio-demographic, familial, psychosocial, and biological factors and their association with the onset of anxiety disorders in adolescence. This study was conducted among 1584 Dutch participants of the TRacking Adolescents’ Individual Lives Survey (TRAILS). Potential risk factors were assessed at baseline (age 10–12), and included socio-demographic (sex, socioeconomic status), familial (parental anxiety and depression), psychosocial (childhood adversity, temperament), and biological (body mass index, heart rate, blood pressure, cortisol) variables. Anxiety disorders were assessed at about age 19 years through the Composite International Diagnostic Interview (CIDI). Univariate and multivariate logistic regression analyses were performed with onset of anxiety disorder as a dependent variable and the above-mentioned putative risk factors as predictors. Of the total sample, 25.7% had a lifetime diagnosis of anxiety disorder at age 19 years. Anxiety disorders were twice as prevalent in girls as in boys. Multivariate logistic regression analysis showed that being female (OR = 2.38, p < .01), parental depression and anxiety (OR = 1.34, p = .04), temperamental frustration (OR = 1.31, p = .02) and low effortful control (OR = 0.76, p = .01) independently predicted anxiety disorders. We found no associations between biological factors and anxiety disorder. After exclusion of adolescents with an onset of anxiety disorder before age 12 years, being female was the only significant predictor of anxiety disorder. Being female was the strongest predictor for the onset of anxiety disorder. Psychological and parental psychopathology factors increased the risk of diagnosis of anxiety, but to a lesser extent. Biological factors (heart rate, blood pressure, cortisol, and BMI), at least as measured in the present study, are unlikely to be useful tools for anxiety prevention and intervention strategies.

Effects of psychosocial and socio-environmental factors on anxiety disorder among adolescents in Bangladesh.

BackgroundAnxiety is a common psychiatric disorder among adolescents in developing countries. This study aimed to examine the risk factors of anxiety disorder and the adverse consequences of anxiety disorder among adolescents in Bangladesh.MethodsA total of 2,989 adolescent data of the 2014 Global School‐based Student Health Survey (GSHS), Bangladesh, was analyzed WHO. The prevalence of anxiety disorder across psychosocial and socio‐environmental factors was calculated as descriptive statistics, whereas their effects on occurring anxiety disorder were determined using the unadjusted and adjusted multivariable binary logistic regression model. The consequences of anxiety disorder were also determined using the multivariable binary logistic regression model.ResultsThe prevalence of anxiety disorder was 4.7%, which was found higher among female than their male counterparts. The psychosocial factors were found associated with the anxiety disorder are loneliness (AOR: 2.26, 95% CI: 1.08–4.72), being bullied (AOR: 6.00, 95% CI: 3.14–11.47), and physical abuse (AOR: 2.12, 95% CI: 1.07–4.21). Moreover, poor understandings with parents (AOR: 1.75, 95% CI: 1.02–3.01) and lack of peer support (AOR: 2.23, 95% CI: 1.18–4.23) were the socio‐environmental factors that found associated with the anxiety disorder. Subgroup analysis across gender found these associations were consistent for adolescent male and female. Moreover, the likelihood increased with the increasing number of the adverse psychosocial, or socio‐environmental factors.ConclusionsAround 5% of school‐going adolescents in Bangladesh reported anxiety associated with the exposure of single or multiple adverse psychosocial and socio‐environmental factors including bullying and physical abuse. Early screening and interventions are essential, targeted to adolescent at risk, which could reduce the rate of anxiety disorder among adolescent in Bangladesh.

Understanding the nature of association between anxiety phenotypes and anorexia nervosa: a triangulation approach

BackgroundEvidence from observational studies suggests an association between anxiety disorders and anorexia nervosa (AN), but causal inference is complicated by the potential for confounding in these studies. We triangulate evidence across a longitudinal study and a Mendelian randomization (MR) study, to evaluate whether there is support for anxiety disorder phenotypes exerting a causal effect on AN risk.MethodsStudy One assessed longitudinal associations of childhood worry and anxiety disorders with lifetime AN in the Avon Longitudinal Study of Parents and Children cohort. Study Two used two-sample MR to evaluate: causal effects of worry, and genetic liability to anxiety disorders, on AN risk; causal effects of genetic liability to AN on anxiety outcomes; and the causal influence of worry on anxiety disorder development. The independence of effects of worry, relative to depressed affect, on AN and anxiety disorder outcomes, was explored using multivariable MR. Analyses were completed using summary statistics from recent genome-wide association studies.ResultsStudy One did not support an association between worry and subsequent AN, but there was strong evidence for anxiety disorders predicting increased risk of AN. Study Two outcomes supported worry causally increasing AN risk, but did not support a causal effect of anxiety disorders on AN development, or of AN on anxiety disorders/worry. Findings also indicated that worry causally influences anxiety disorder development. Multivariable analysis estimates suggested the influence of worry on both AN and anxiety disorders was independent of depressed affect.ConclusionsOverall our results provide mixed evidence regarding the causal role of anxiety exposures in AN aetiology. The inconsistency between outcomes of Studies One and Two may be explained by limitations surrounding worry assessment in Study One, confounding of the anxiety disorder and AN association in observational research, and low power in MR analyses probing causal effects of genetic liability to anxiety disorders. The evidence for worry acting as a causal risk factor for anxiety disorders and AN supports targeting worry for prevention of both outcomes. Further research should clarify how a tendency to worry translates into AN risk, and whether anxiety disorder pathology exerts any causal effect on AN.

The Anxiety Disorder Among the Healthcare Providers During The COVID-19 Infection Pandemic: A Systematic Review

Background: The outbreak of the new coronavirus disease (COVID-19) imposes a considerable psychological burden on the medical staff working in central hospitals for COVID-19. In this systematic review, we will discuss the Prevalence and the risk factors of anxiety disorder among the frontline medical staff dealing with COVID-19 patients. Methods: PubMed, Scopus, Embase, Web of Science databases systematically searched from December 1, 2019, to April 30, 2020, for related published articles. In all electronic databases, the following search strategy implemented, and these keywords (in the title/abstract) used: "COVID-19" OR "novel Coronavirus" AND "anxiety" OR "psychology" OR "psychiatry" OR "psychological distress" AND "nurses" or "clinicians." We included only the cross-sectional studies. Results: Through the search strategy, we could identify eight related cross-sectional articles about anxiety among the healthcare workers in central hospitals for COVID-19 infection. However, the authors scanned the reference lists of the included studies and identified multiple references. According to our findings, the frontline medical staff are at risk of developing an anxiety disorder, which is mainly mild. Additionally, female nurses are more susceptible to experience anxiety during the COVID-19 pandemic. Conclusion: Regarding the outbreak of COVID-19 worldwide and the workload of the frontline medical staff dealing with COVID-19 patients, particular attention should be given on the mental health of the healthcare provides.

Evidence for inhibited temperament as a transdiagnostic factor across mood and psychotic disorders

BackgroundThe conceptualization of risk for psychiatric illness is moving from risk factors for specific psychiatric disorders to factors that confer risk for multiple disorders. One potential transdiagnostic risk factor is inhibited temperament, a trait characterized by a fearful or avoidant response to novelty. Inhibited temperament is an established risk factor for anxiety disorders, and evidence suggests inhibited temperament is elevated in schizophrenia, bipolar disorder, and major depressive disorder. MethodsIn the current study, we tested the hypothesis that inhibited temperament is a transdiagnostic factor in 490 participants including individuals with schizophrenia (n=184), psychotic bipolar disorder (n=61), major depression disorder (n=53), or no disorders (n=192). Participants completed assessments of temperament, personality, clinical symptoms, cognition, and functioning. An ANOVA was used to test for group differences in inhibited temperament scores. Regressions were used to test whether inhibited temperament scores were associated with the current measures and whether the associations were similar across disorders. ResultsInhibited temperament was similarly elevated in all patient groups compared to controls. Inhibited temperament was similarly associated with anxiety, depression, negative affect, and quality of life across patient groups. Inhibited temperament was not associated with cognition or functional impairment. LimitationAlthough the inhibited temperament measure is commonly used, it is a retrospective self-report which may be susceptible to biases. ConclusionsThe current study provides evidence that inhibited temperament is a transdiagnostic factor impacting affective systems across mood and psychotic disorders. Inhibited patients may especially benefit from treatments that specifically target anxiety and depression.

Social approach and social vigilance are differentially regulated by oxytocin receptors in the nucleus accumbens

Oxytocin is currently being considered as a novel therapeutic for anxiety disorders due to its ability to promote affiliative behaviors. In the nucleus accumbens (NAc) activation of oxytocin receptors (OTR) promotes social approach (time spent near an unfamiliar individual). Here, we show that stressful social experiences reduce the expression of NAc OTR mRNA, coinciding with decreases in social approach. Social stressors also increase social vigilance, characterized as orienting to an unfamiliar individual without approaching. Vigilance is a key component of behavioral inhibition, a personality trait that is a risk factor for anxiety disorders. To understand whether NAc OTR can modulate both social approach and vigilance, we use pharmacological approaches to assess the impact of activation or inhibition of NAc OTR downstream pathways on these behaviors. First, we show that in unstressed male and female California mice, inhibition of OTR by an unbiased antagonist (L-368,899) reduces social approach but does not induce social vigilance. Next, we show that infusion of Atosiban, an OTR-Gq antagonist/OTR-Gi agonist, has the same effect in unstressed females. Finally, we show that Carbetocin, a biased OTR-Gq agonist, increases social approach in stressed females while simultaneously inhibiting social vigilance. Taken together these data suggest that OTR in the NAc differentially modulate social approach and social vigilance, primarily through an OTR-Gq mechanism. Importantly, pharmacological inhibition of OTR alone is insufficient to induce vigilance in unstressed mice, suggesting that mechanisms modulating social approach may be distinct from mechanisms modulating social vigilance.

Intergenerational transmission of anxiety: linking parental anxiety to infant autonomic hyperarousal and fearful temperament.

BackgroundAutonomic hyperarousal has been proposed as a dispositional risk factor for anxiety disorders (ADs). Therefore, we studied physiological arousal in offspring of fathers and mothers with and without ADs and whether infant hyperarousal predicts subsequent fearful temperament.MethodsInfants (N = 128; age = 4 months) did a novel stimuli task (exposure to visual, olfactory, and acoustic stimuli and an unfamiliar male) and a habituation task (exposure to a repeated acoustic stimulus). Heart rate (HR) and heart rate variability (HRV) were measured during baseline, stimuli and post‐stimuli rest. Parents’ AD status and severity were measured using a diagnostic interview and their fearful temperament using a questionnaire. Child fearful temperament was measured at 4 months, 1 year and 2.5 years with observations during structured tasks.ResultsParents’ fearful temperament (significant in the habituation task), AD status (significant in the novel stimuli task) and AD severity (significant in both tasks) predicted a higher HR in their infants. Infants’ higher HR reactivity to novel stimuli and diminished HR recovery at 4 months predicted a more fearful temperament during infancy and toddlerhood. Infants’ higher HR at 4 months predicted a more fearful temperament at 2.5 years.ConclusionsParental prenatal anxiety (disorders) predicted infants’ autonomic arousal, which in turn predicted later fearful temperament in children. Outcomes suggest that autonomic hyperarousal is a dispositional risk factor of ADs.

Generalization of Conditioned Contextual Anxiety and the Modulatory Effects of Anxiety Sensitivity

Anxiety patients overgeneralize fear responses, possibly because they cannot distinguish between cues never been associated with a threat (i.e., safe) and threat-associated cues. However, as contexts and not cues are discussed as the relevant triggers for prolonged anxiety responses characterizing many anxiety disorders, we speculated that it is rather overgeneralization of contextual anxiety, which constitutes a risk factor for anxiety disorders. To this end, we investigated generalization of conditioned contextual anxiety and explored modulatory effects of anxiety sensitivity, a risk factor for anxiety disorders. Fifty-five participants underwent context conditioning in a virtual reality paradigm. On Day 1 (acquisition), participants received unpredictable mildly painful electric stimuli (unconditioned stimulus, US) in one virtual office (anxiety context, CTX+), but never in a second office (safety context, CTX−). Successful acquisition of conditioned anxiety was indicated by aversive ratings and defensive physiological responses (i.e., SCR) to CTX+ vs CTX−. On Day 2 (generalization), participants re-visited both the anxiety and the safety contexts plus three generalization contexts (G-CTX), which were gradually dissimilar to CTX+ (from 75 to 25%). Generalization of conditioned anxiety was evident for ratings, but less clear for physiological responses. The observed dissociation between generalization of verbal and physiological responses suggests that these responses depend on two distinct context representations, likely elemental and contextual representations. Importantly, anxiety sensitivity was positively correlated with the generalization of reported contextual anxiety. Thus, this study demonstrates generalization gradients for conditioned contextual anxiety and that anxiety sensitivity facilitates such generalization processes suggesting the importance of generalization of contextual anxiety for the development of anxiety disorders.

Differences in dimensional personality features in depressive and anxious adolescents

Objective: Dimensional properties of personality are new field which is placed under DSM-5 Section-3 for further research. DSM-5 Personality Inventory (PID-5) is an effective instrument to assess and implement personality dimensions in psychiatric diagnosis and treatment among adolescents; but the researches are limited. To address this issue, we aimed to compare the dimensional personality features between depressive and anxious adolescents using PID-5. Methods: Participants were recruited after they were evaluated with semi-structured psychiatric interviews. Patients with comorbid psychiatric disorders were excluded and total 280 subjects (70 male and 70 female in each group) were included in depression (DG) and anxiety (AG) groups. Results: Total PID-5 scores and all of the personality dimension scores, except those for negative affectivity (NA), were found to be significantly higher in DG than AG. We found positive correlation between all personality scores and the severity of depression and anxiety. Discussion: Our study showed that, even after excluding the cases with comorbidities, no difference was found between the DG and AG regarding NA; and this result could be the proof of the individually elevated NA in both groups bypassing a possible genetic influence. We found that DG had higher disinhibition scores than AG; and the lower disinhibition of anxious children may reflect higher behavioral inhibition levels, which is considered to be a risk factor for anxiety disorders. Cross-sectional design of our study makes it difficult to evaluate causality be-tween the personality dimensions and psychopathology; so further longitudinal studies using these new personality dimensions are needed.

Anxiety Disorders In Pregnant Women During Covid-19 Pandemic

COVID-19 causes various manifestations to human, especially for groups that have high risks, including pregnant women. Pregnancy during pandemic could be a risk factor for anxiety disorders in pregnant women. The purpose of this article is to know more about anxiety disorders in pregnant women during the COVID-19 pandemic. The method of this article is a literature review with literature sources from research journal articles such as from NCBI, Elseiver, and websites such as CDC and WHO, amounting to 28 published in 2017-2020 with the keywords which are used for this literature searching are pregnancy, anxiety, psychology disorder, COVID-19, and Coronavirus. The analytical method used is systematic literature review which include identifying, evaluating, and developing systematically with a specific focus on appropriate and relevant topics. The results of the analysis of several studies show that anxiety in pregnant women during the COVID-19 pandemic has increased. Pregnant women easily experience feelings of worry about something that will happen to her and her child. Another factor that affects the level of anxiety is the presence or absence of support from her family and nurses to help reduce the perception of the risk in causing anxiety disorders.

Individual differences in human fear generalization\u2014pattern identification and implications for anxiety disorders

Previous research indicates that anxiety disorders are characterized by an overgeneralization of conditioned fear as compared with healthy participants. Therefore, fear generalization is considered a key mechanism for the development of anxiety disorders. However, systematic investigations on the variance in fear generalization are lacking. Therefore, the current study aims at identifying distinctive phenotypes of fear generalization among healthy participants. To this end, 1175 participants completed a differential fear conditioning phase followed by a generalization test. To identify patterns of fear generalization, we used a k-means clustering algorithm based on individual arousal generalization gradients. Subsequently, we examined the reliability and validity of the clusters and phenotypical differences between subgroups on the basis of psychometric data and markers of fear expression. Cluster analysis reliably revealed five clusters that systematically differed in mean responses, differentiation between conditioned threat and safety, and linearity of the generalization gradients, though mean response levels accounted for most variance. Remarkably, the patterns of mean responses were already evident during fear acquisition and corresponded most closely to psychometric measures of anxiety traits. The identified clusters reliably described subgroups of healthy individuals with distinct response characteristics in a fear generalization test. Following a dimensional view of psychopathology, these clusters likely delineate risk factors for anxiety disorders. As crucial group characteristics were already evident during fear acquisition, our results emphasize the importance of average fear responses and differentiation between conditioned threat and safety as risk factors for anxiety disorders.

Multi-omics analysis identifies mitochondrial pathways associated with anxiety-related behavior.

Stressful life events are major environmental risk factors for anxiety disorders, although not all individuals exposed to stress develop clinical anxiety. The molecular mechanisms underlying the influence of environmental effects on anxiety are largely unknown. To identify biological pathways mediating stress-related anxiety and resilience to it, we used the chronic social defeat stress (CSDS) paradigm in male mice of two inbred strains, C57BL/6NCrl (B6) and DBA/2NCrl (D2), that differ in their susceptibility to stress. Using a multi-omics approach, we identified differential mRNA, miRNA and protein expression changes in the bed nucleus of the stria terminalis (BNST) and blood cells after chronic stress. Integrative gene set enrichment analysis revealed enrichment of mitochondrial-related genes in the BNST and blood of stressed mice. To translate these results to human anxiety, we investigated blood gene expression changes associated with exposure-induced panic attacks. Remarkably, we found reduced expression of mitochondrial-related genes in D2 stress-susceptible mice and in exposure-induced panic attacks in humans, but increased expression of these genes in B6 stress-susceptible mice. Moreover, stress-susceptible vs. stress-resilient B6 mice displayed more mitochondrial cross-sections in the post-synaptic compartment after CSDS. Our findings demonstrate mitochondrial-related alterations in gene expression as an evolutionarily conserved response in stress-related behaviors and validate the use of cross-species approaches in investigating the biological mechanisms underlying anxiety disorders.

Life stress moderates the effects of preschool behavioral inhibition on anxiety in early adolescence.

Although a robust body of literature implicates temperamental behavioral inhibition (BI) as a prominent risk factor for anxiety disorders, many children with heightened BI do not develop anxiety. The current study examines the role of two forms of life stress (life events and natural disaster exposure) in moderating the relationship between BI in preschoolers and anxiety in early adolescence. A community sample of 392 3-year-old children was administered a laboratory observational assessment of temperament. When children were a mean age 10, the region was struck by a devastating hurricane and exposure to disaster-related stress was assessed. In early adolescence, youth and a parent were administered the UCLA Life Stress Interview (LSI) to assess behaviorally independent and dependent negative life events during the prior year and youth completed the Screen for Child Anxiety Related Emotional Disorders (SCARED). The association between early childhood BI and anxiety symptoms in early adolescence was moderated by both independent life events and disaster-related stress. Children high in BI at age 3 reported greater anxiety symptoms at age 12 after exposure to higher levels of both forms of stress. Stress moderated the association between early BI and later anxiety. Importantly, this was evident for two different kinds of stressors that were independent of the child's behavior that increases confidence in the causal role of stress in the development of anxiety in high BI children.