Symptom Dimensions Of Anxiety Research Articles

Anhedonia is associated with overgeneralization of conditioned fear during late adolescence and early adulthood

BackgroundPavlovian fear paradigms involve learning to associate cues with threat or safety. Aberrances in Pavlovian fear learning correlate with psychopathology, especially anxiety disorders. This study evaluated symptom dimensions of anxiety and depression in relation to Pavlovian fear acquisition and generalization. Methods256 participants (70.31 % female) completed a Pavlovian fear acquisition and generalization paradigm at ages 18–19 and 21–22 years. Analyses focused on indices of learning (self-reported US expectancy, skin conductance). Multilevel models tested associations with orthogonal symptom dimensions (Anhedonia-Apprehension, Fears, General Distress) at each timepoint. ResultsAll dimensions were associated with weaker acquisition of US expectancies at each timepoint. Fears was associated with overgeneralization only at age 21–22. General Distress was associated with overgeneralization only at age 18–19. Anhedonia-Apprehension was associated with overgeneralization at ages 18–19 and 21–22. ConclusionsAnhedonia-Apprehension disrupts Pavlovian fear acquisition and increases overgeneralization of fear. These effects may emerge during adolescence and remain into young adulthood. General Distress and Fears also contribute to overgeneralization of fear, but these effects may vary as prefrontal mechanisms of fear inhibition continue to develop during late adolescence. Targeting specific symptom dimensions, particularly Anhedonia-Apprehension, may decrease fear generalization and augment interventions built on Pavlovian principles, such as exposure therapy.

Sensory Processing Difficulties in Children and Adolescents with Obsessive-Compulsive and Anxiety Disorders

Altered sensory processing has been linked to symptoms of obsessive-compulsive disorder (OCD) and anxiety disorders (ADs) in youth, but few studies have examined sensory processing in clinical samples and no study has analyzed self-report data from youth meeting diagnostic criteria for OCD or ADs. This study included 86 youth with OCD, 82 youth with ADs, and 46 youth without psychiatric disorders. Participants completed the adolescent version of the Sensory Profile and scales measuring three symptom dimensions of OCD, four symptom dimensions of anxiety, and symptoms of major depression. Results showed that different forms of sensory processing difficulties (sensitivity, avoidance, low registration) were adequately captured by one broad sensory processing factor. Youth with OCD and ADs reported statistically significantly more sensory difficulties than youth without psychiatric disorders, but the two clinical groups did not differ from each other. Altered sensory processing in the clinical groups was not explained by the presence of neurodevelopmental disorders. Sensory difficulties were moderately to strongly related to all self-reported symptom dimensions, and uniquely related to the OCD dimension of symmetry/ordering and the anxiety dimensions of panic and social anxiety. Most youth in the clinical groups were classified as having difficulties with sensory processing. The present study shows that sensory processing difficulties are common in youth with OCD and ADs, not explained by co-occurring neurodevelopmental disorders, and linked to a host of internalizing symptoms. More research is needed to identify whether sensory processing difficulties precede, follow, or mutually reinforce the development of OCD and ADs in youth.

Fear-potentiated startle predicts longitudinal change in transdiagnostic symptom dimensions of anxiety and depression

BackgroundElevated defensive responding, through startle reflex (SR) and skin conductance response (SCR), may contribute to onset and maintenance of depression and anxiety. Most work examining SR and SCR has predicted psychiatric diagnoses. There is a paucity of research examining links between SR or SCR and dimensional measures of psychopathology. MethodsWe used latent growth curve modeling to predict longitudinal change in three symptom factors (i.e., General Distress, Fears, Anhedonia-Apprehension) from SR and SCR measured during a fear-potentiated startle paradigm among adolescents oversampled for neuroticism (N = 129). ResultsElevated SCR in danger phases before and after an unpleasant muscle contraction predicted increasing Fears over time. Elevated SR in safe phases post-contraction also predicted increasing Fears over time. Attenuated SR in safe phases post-contraction predicted elevated General Distress longitudinally. Attenuated SCR pre-contraction in danger phases predicted elevated Anhedonia-Apprehension over time. LimitationsOur non-clinical sample may limit generalizability of results. Additionally, we did not assess change in SR and SCR over time. ConclusionsThe present study demonstrates that SR and SCR during a fear-potentiated startle paradigm predict longitudinal change in dimensional anxiety and depression symptom factors and relatedly, that SR and SCR may represent risk factors for the exacerbation of symptomatology.

Symptom dimensions of anxiety and depression in patients receiving peritoneal dialysis compared to haemodialysis

Differences in symptom burden, treatment satisfaction and autonomy between patients receiving peritoneal dialysis and haemodialysis could be reflected by a difference in symptom dimensions of anxiety and depression. The aim of this study is to assess differences in prevalence and symptom dimensions of anxiety and depression between patients receiving peritoneal dialysis and haemodialysis. Baseline data from the Depression Related Factors and Outcomes in Dialysis Patients With Various Ethnicities and Races Study were used. Symptoms of anxiety and depression were measured with the Beck Anxiety Inventory and Beck Depression Inventory- second edition. Linear and logistic regression models were used to compare anxiety and depression total scores and somatic and subjective/cognitive symptom dimension scores between patients receiving peritoneal dialysis and haemodialysis, adjusted for potential confounders. In total, 84 patients receiving peritoneal dialysis and 601 patients receiving haemodialysis were included. Clinically significant symptoms of anxiety and depression were present in respectively 22% and 43% of the patients, with no differences between dialysis modality. Both modalities scored high on the somatic symptom dimensions and on individual somatic items. Almost all patients reported symptoms related to loss of energy and sleep. No differences in symptom dimensions of anxiety and depression were found between patients receiving peritoneal dialysis and haemodialysis. The high prevalence of somatic symptom dimensions in both groups underscores the possible interaction between somatic and psychiatric symptoms in dialysis patients and the need for early recognition and treatment of symptoms of anxiety and depression regardless of treatment modalities.

Individual differences in threat and reward neural circuitry activation: Testing dimensional models of early adversity, anxiety and depression.

Altered functioning of the brain's threat and reward circuitry has been linked to early life adversity and to symptoms of anxiety and depression. To date, however, these relationships have been studied largely in isolation and in categorical‐based approaches. It is unclear to what extent early life adversity and psychopathology have unique effects on brain functioning during threat and reward processing. We examined functional brain activity during a face processing task in threat (amygdala and ventromedial prefrontal cortex) and reward (ventral striatum and orbitofrontal cortex) regions of interest among a sample (N = 103) of young adults (aged 18–19 years) in relation to dimensional measures of early life adversity and symptoms of anxiety and depression. Results demonstrated a significant association between higher scores on the deprivation adversity dimension and greater activation of reward neural circuitry during viewing of happy faces, with the largest effect sizes observed in the orbitofrontal cortex. We found no significant associations between the threat adversity dimension, or symptom dimensions of anxiety and depression, and neural activation in threat or reward circuitries. These results lend partial support to theories of adversity‐related alterations in neural activation and highlight the importance of testing dimensional models of adversity and psychopathology in large sample sizes to further our understanding of the biological processes implicated.

Dysregulation of threat neurocircuitry during fear extinction: the role of anhedonia

Dimensional models of anxiety and depression highlight common and distinct symptom clusters that are thought to reflect disruptions in underlying functional processes. The current study investigated how functioning of threat neurocircuitry relates to symptom dimensions of anxiety and depression. Participants were aged 18–19 years (n = 229, 158 female) and were selected to ensure a range of scores on symptom measures. Symptom dimensions of “General Distress” (common to anxiety disorders and depression), “Fears” (more specific to anxiety disorders), and “Anhedonia-apprehension” (more specific to depression) were evaluated. Participants underwent functional magnetic resonance imaging during a Pavlovian fear conditioning paradigm. Multilevel modeling analyses estimated relationships between symptom dimensions and activation in threat neural circuitry. Exploratory whole brain analyses were also conducted. Threat-related neural activity was not associated with General Distress or Fears. Anhedonia-apprehension was associated with activation of bilateral amygdala, anterior insula and dACC during late extinction. We found no evidence to support an association between symptom dimensions of General Distress or Fears with threat circuitry activation in a large sample of young adults. We did, however, find that the symptom dimension of Anhedonia-apprehension was significantly associated with threat-related neural activation during fear extinction. This effect requires replication in future work but may reflect anhedonic impairments in learning when contingencies are altered, possibly linked to the rewarding relief of an unexpectedly absent threat.

Symptom dimensions of anxiety in Parkinson’s disease: Replication study in a neuropsychiatric patient population

IntroductionAnxiety disorders occur in approximately one third of people with Parkinson’s disease (PD), and have a major impact on patient and caregiver wellbeing. In order to better understand and diagnose anxiety in PD patients, we investigated the generalizability of the results of a previous factor analysis on anxiety symptoms to a sample of PD patients with neuropsychiatric symptoms. MethodsIn this cross-sectional study, anxiety symptoms were measured with the Beck Anxiety Inventory (BAI) in 123 PD patients who were referred for neuropsychiatric diagnostics and treatment. Subscales of anxiety were analyzed through principal component analysis of BAI items. The associations between BAI subscales and symptoms of motor and cognitive function and depression were assessed through regression analyses. ResultsSimilar to the previous factor analysis, we found one psychological (affective) and four somatic subscales of anxiety in the BAI. The affective subscale was the principal component explaining 35.9% of the variance. The scores on the total BAI and the affective subscale were significantly associated with depressive symptoms. In a post-hoc analysis, the affective subscale had equal power as compared to the total BAI in predicting whether or not participants were diagnosed with an anxiety disorder after psychiatric evaluation. ConclusionIn this study, we replicated our previous findings of one affective and multiple somatic subscales of the BAI. The 7-item affective subscale of the BAI shows potential as a screening tool for non-episodic anxiety in PD. However, in clinical practice, we recommend evaluating anxiety symptoms in the context of other PD symptoms, including motor, autonomic, and other (neuro)psychiatric symptoms.

Dimensions of anxiety and depression and neurophysiological indicators of error-monitoring: Relationship with delta and theta oscillatory power and error-related negativity amplitude.

Error-monitoring processes may be affected by transdiagnostic dimensions of psychopathology symptoms including trait anxiety, worry, and severity of depressive symptoms. We tested the relationship between continuous measures of anxiety and depressive symptomology and neural correlates of error-monitoring as measured by time-frequency domain delta and theta oscillatory power and time-domain error-related negativity (ERN) amplitude extracted from the electroencephalogram (EEG). Secondary analyses tested for diagnostic group differences in error-related neural responses in individuals with generalized anxiety disorder (GAD), major depressive disorder (MDD), and comorbid psychiatric disorders. About 178 participants (104 female, M[SD]age =21.7[4.6]) with a wide range of psychopathology symptoms completed a modified version of the Eriksen flanker task and symptom questionnaires. Residualized difference values between correct and error trials for delta/theta power and error/correct ERN amplitude were used as dependent variables. Linear regression analyses adjusted for age, sex, and task accuracy showed nonsignificant associations of symptom dimension measures with error-related residualized delta/theta power or residualized ERN amplitude. Subset analyses on those with confirmed psychopathology diagnoses also did not predict residualized error-related delta/theta power nor residualized ERN amplitude (nGAD =14, nMDD =28, nComorbid =19, nControl =85). Taken in the context of the previous literature, results suggest a heterogeneous relationship between depressive and anxiety symptom dimensions and neurophysiological indices of error-monitoring.

Relationship Between Threat- and Reward-Related Brain Structure and Symptom Dimensions of Anxiety and Depression

Shared and unique neuroanatomical profiles of depression and anxiety are not well established. Depression has been associated with hippocampal, amygdala, and basal ganglia gray matter volume (GMV) reductions, while anxiety has been associated with amygdala GMV increases, hippocampal GMV decreases, and basal ganglia abnormalities. The present study extends this work by examining the relationship between GMV and individuals with depression, anxiety, or comorbid depression-anxiety. We then examine the relationship between GMV and empirically derived symptom profiles from the Tri-level Model of depression and anxiety.

Symptom dimensions of anxiety and their association with mortality, hospitalization and quality of life in dialysis patients

ObjectiveSymptoms of anxiety are highly prevalent in dialysis patients and are associated with adverse clinical outcomes. Identifying symptom dimensions may help to understand the pathophysiology, improve screening and guide treatment. Currently, there are no data on symptom dimensions of anxiety in dialysis patients. This study aimed to identify the best fitting dimensional model for anxiety in dialysis patients and assess the association between symptom dimensions of anxiety and adverse clinical outcomes. MethodsThis study is a prospective observational cohort study including patients from 10 urban dialysis centers between 2012 and 2017. Anxiety symptoms were measured using the self-reported questionnaire Beck Anxiety Inventory. Confirmatory factor analysis was used to identify symptom dimensions. The association between dimensions and mortality, hospitalization and quality of life was investigated using stepwise cox, poisson and lineair regression models. Multivariable models included demographic, social, laboratory and clinical variables to adjust for possible confounding. ResultsIn total 687 chronic dialysis patients were included. A Somatic and Subjective anxiety dimension were identified. Only Somatic anxiety symptoms showed an association with increased risk of hospitalization and mortality (Rate Ratio 1.73 (1.45–2.06) p = .007 and Hazard Ratio 1.65 (1.15–2.37) p = .007 respectively). These associations were independent from somatic comorbidity. All symptom dimensions of anxiety showed an association with Quality of Life. ConclusionThis study shows that anxiety is common in chronic dialysis patients and comprises of a somatic, subjective, and a total score. The discrimination between anxiety dimensions can be useful for clinical practice, as they are related to different clinical outcomes.

Working Memory Load and Negative Picture Processing: Neural and Behavioral Associations With Panic, Social Anxiety, and Positive Affect

BackgroundInternalizing disorders such as anxiety may be characterized by an imbalance between bottom-up (stimulus-driven) and top-down (goal-directed) attention. The late positive potential (LPP) can be used to assess these processes when task-irrelevant negative and neutral pictures are presented within a working memory paradigm. Prior work using this paradigm has found that working memory load reduces the picture-elicited LPP across participants; however, anxious individuals showed a reduced effect of working memory load on the LPP, suggesting increased distractibility. MethodsThe current study assessed transdiagnostic associations between specific symptom dimensions of anxiety, the LPP, and behavior in a clinically representative, heterogeneous group of 76 treatment-seeking patients with internalizing disorders, who performed a working memory task interspersed with negative and neutral pictures. ResultsAs expected, negative pictures enhanced the LPP, and working memory load reduced the LPP. Participants with higher social anxiety showed increased LPPs to negative stimuli during early and late portions of picture presentation. Panic symptoms were associated with reduced LPPs to negative pictures compared with neutral pictures as well as a reduced effect of working memory load on the LPP during the late time window. Reduced positive affect was associated with greater behavioral interference from negative pictures. ConclusionsHypervigilance for negative stimuli was uniquely explained by social anxiety symptoms, whereas panic symptoms were associated with the opposing effect—blunted processing/avoidance of these stimuli. Panic symptoms were uniquely associated with reduced top-down control. Results reveal distinct associations between neural reactivity and anxiety symptom dimensions that transcend traditional diagnostic boundaries.

Distinct Associations Between Low Positive Affect, Panic, and Neural Responses to Reward and Threat During Late Stages of Affective Picture Processing

BackgroundAbnormal patterns of attention to threat and reward have been proposed as potential mechanisms of dysfunction in anxiety and mood disorders. However, research on this topic has been inconsistent, perhaps because of both clinical heterogeneity in the samples assessed and measurement of attentional biases that is temporally imprecise. MethodsThe present study measured transdiagnostic symptoms of anxiety and depression in 205 young adults and recorded affect-modulated event-related potentials in response to task-irrelevant pictures in a speeded response task. ResultsLow positive affect was uniquely associated with reduced modulation of later event-related potentials (i.e., the P300 and the late positive potential) by rewarding images, suggesting deficits in sustained attention to reward. Low positive affect was also associated with a blunted threat-elicited late positive potential. Symptoms of panic were associated with an increased N1 to rewarding images, as well as an increased late positive potential to all picture types. ConclusionsThese data suggest that dysfunction in neural markers of sustained attention to threat and reward relate in specific ways to transdiagnostic symptom dimensions of anxiety and depression. Moreover, event-related potentials are likely to be useful in investigations of the time course of attentional abnormalities associated with these symptom dimensions.

A positron emission tomography study of the serotonergic system in relation to anxiety in depression

Symptoms of anxiety are highly comorbid with major depressive disorder (MDD) and are known to alter the course of the disease. To help elucidate the biological underpinnings of these prevalent disorders, we previously examined the relationship between components of anxiety (somatic, psychic and motoric) and serotonin 1A receptor (5-HT1A) binding in MDD and found that higher psychic and lower somatic anxiety was associated with greater 5-HT1A binding. In this work, we sought to examine the correlation between these anxiety symptom dimensions and 5-HTT binding. Positron emission tomography with [11C]-3-amino-4-(3-dimethylamino-methylphenylsulfanyl)-benzonitrile ([11C]DASB) and a metabolite-corrected arterial input function were used to estimate regional 5-HTT binding in 55 subjects with MDD and anxiety symptoms. Somatic anxiety was negatively correlated with 5-HTT binding in the thalamus (β=−.33, p=.025), amygdala (β=−.31, p=.007) and midbrain (β=−.72, p<.001). Psychic anxiety was positively correlated with 5-HTT binding in midbrain only (β=.46, p=.0025). To relate to our previous study, correlation between 5-HT1A and 5-HTT binding was examined, and none was found. We also examined how much of the variance in anxiety symptom dimensions could be explained by both 5-HTT and 5-HT1A binding. The developed model was able to explain 68% (p<.001), 38% (p=.012) and 32% (p=.038) of the total variance in somatic, psychic, and motoric anxiety, respectively. Results indicate the tight coupling between the serotonergic system and anxiety components, which may be confounded when using aggregate anxiety measures. Uncovering serotonin's role in anxiety and depression in this way may give way to a new generation of therapeutics and treatment strategies.

The “weakest link” as an indicator of cognitive vulnerability differentially predicts symptom dimensions of anxiety in adolescents in China

This multiwave longitudinal study examined the cognitive vulnerability-stress component of hopelessness theory to differentially predict symptom dimensions of anxiety using a “weakest link” approach in a sample of adolescents from Hunan Province, China. Baseline and 6-month follow-up data were obtained from 553 middle-school students. During an initial assessment, participants completed measures of assessing their weakest links, anxious symptoms, and the occurrence of stress. Participants subsequently completed measures assessing stress, and anxious symptoms one a month for six months. Higher weakest link scores were associated with greater increases in the harm avoidance and separation anxiety/panic dimensions, but not the physical or social anxiety dimension, of anxious symptoms following stress in Chinese adolescents. These results support the applicability of the “weakest link” approach, derived from hopelessness theory, in Chinese adolescents. Weakest link scores as cognitive vulnerability factors may play a role in the development of anxious symptoms, especially in the cognitive dimensions (e.g., harm avoidance and separation anxiety/panic). Our findings also have potential value in explaining the effectiveness of cognitive relevant therapy in treating the cognitive dimensions of anxious symptoms.

The Relationship Between Worry and Dimensions of Anxiety Symptoms in Children and Adolescents.

Worry is a common feature across many anxiety disorders. It is important to understand how and when worry presents from childhood to adolescence to prevent long-term negative outcomes. However, most of the existing studies that examine the relationship between worry and anxiety disorders utilize adult samples. The present study aimed to assess the level of worry in children and adolescents and how relationships between worry and symptoms of separation anxiety disorder (SAD) and social anxiety disorder (Soc) may present differently at different ages. 127 children (age 8-12 years) and adolescents (age 13-18 years), diagnosed with any anxiety disorder, presenting at a child anxiety out-patient clinic, completed measures of worry, anxiety and depression. Worry scores did not differ by age group. Soc symptoms were significantly correlated with worry in both age groups; however, SAD symptoms were only significantly correlated with worry in younger participants. After the inclusion of covariates, SAD symptoms but not Soc symptoms remained significant in the regression model with younger children, and Soc symptoms remained significant in the regression model with older children. The finding that worry was comparable in both groups lends support for worry as a stable construct associated with anxiety disorders throughout late childhood and early adolescence.

Anxiety and Depression Symptom Dimensions Demonstrate Unique Relationships with the Startle Reflex in Anticipation of Unpredictable Threat in 8 to 14Year-Old Girls.

There is growing evidence that heightened sensitivity to unpredictability is a core mechanism of anxiety disorders. In adults, multiple anxiety disorders have been associated with a heightened startle reflex in anticipation of unpredictable threat. Child and adolescent anxiety has been linked to an increased startle reflex across baseline, safety, and threat conditions. However, it is unclear whether anxiety in youth is related to the startle reflex as a function of threat predictability. In a sample of 90 8 to 14year-old girls, the present study examined the association between anxiety symptom dimensions and startle potentiation during a no, predictable, and unpredictable threat task. Depression symptom dimensions were also examined given their high comorbidity with anxiety and mixed relationship with the startle reflex and sensitivity to unpredictability. To assess current symptoms, participants completed the self-report Screen for Child Anxiety Related Emotional Disorders and Children's Depression Inventory. Results indicated that social phobia symptoms were associated with heightened startle potentiation in anticipation of unpredictable threat and attenuated startle potentiation in anticipation of predictable threat. Negative mood and negative self-esteem symptoms were associated with attenuated and heightened startle potentiation in anticipation of unpredictable threat, respectively. All results remained significant after controlling for the other symptom dimensions. The present study provides initial evidence that anxiety and depression symptom dimensions demonstrate unique associations with the startle reflex in anticipation of unpredictable threat in children and adolescents.

Anxiety in Parkinson's disease: Symptom dimensions and overlap with depression and autonomic failure.

Anxiety disorders are highly prevalent in patients with Parkinson's disease (PD) and have a major impact on wellbeing. They nevertheless receive limited scientific attention. This study aimed to establish the symptom dimensions of anxiety in PD, and their relationship with depression, autonomic failure and motor symptoms. In this cross-sectional observational study, symptoms of anxiety were measured with the Beck Anxiety Inventory (BAI) in 294 PD patients. Symptom dimensions of anxiety in PD were explored through principal component analysis (PCA) of BAI items. The relationship between anxiety and depressive, autonomic and motor symptoms was assessed through PCA and regression analyses. Clinically relevant symptoms of anxiety were present in 45% of patients. PCA of the BAI resulted in five subscales, corresponding to a single affective and four somatic symptom dimensions (thermoregulation, hypotension, hyperventilation and trembling) of anxiety. Symptoms of anxiety and depression displayed a large overlap. All somatic BAI subscales were significantly influenced by motor and autonomic symptoms, while the affective subscale was not. Anxiety in PD comprises affective and somatic symptom dimensions. The affective subscale of the BAI is not influenced by motor or autonomic symptoms, and may therefore prove useful for future research. Scores on the somatic subscales of the BAI were associated with autonomic failure and motor impairment, demonstrating a strong interplay between motor and non-motor symptoms in PD. These results stress the importance of a holistic approach of anxiety in PD.

Anxiety Symptoms in African American Youth

This study examined the effects of pubertal status, pubertal timing (actual and perceived), and youth biological sex on symptom dimensions of anxiety (i.e., social, separation, harm avoidance, physical) in African Americans ( n = 252; ages 8-12). For girls, results indicated that pubertal status and timing (actual) exerted similar effects for some symptom dimensions of anxiety but not others. Early pubertal timing predicted high levels of physical symptoms, whereas beginning puberty (i.e., no menarche, but either breasts or pubic hair growth) and early pubertal timing predicted high levels of harm avoidance. For boys, only perceived pubertal timing predicted high levels of social, separation, harm avoidance, and physical symptoms. Pubertal effects (status and timing [actual]) on harm avoidance and physical symptoms were stronger for girls than for boys. These findings extend the literature on anxiety in African American youth and may help identify novel, high-risk subgroups of this population for targeted prevention and intervention programs.

Symptom dimensions of anxiety following myocardial infarction: Associations with depressive symptoms and prognosis.

Differential associations of symptom dimensions with prognosis in myocardial infarction (MI) patients have been shown for depression, but no studies have focused on anxiety dimensions. The aim of this study was to assess the association between somatic and psychological symptoms of anxiety following acute MI with adverse prognosis and to assess the overlap between anxiety and depression dimensions. Patients (n = 418) were assessed on demographic and clinical variables. The Hamilton Anxiety and Depression Rating Scales were used to measure anxiety and depression 2 months post-MI. Mean follow-up period was 3.8 years and the endpoint consisted of all-cause mortality and recurrent MI. After adjustment for demographic and clinical variables, somatic anxiety was significantly associated with recurrent MI and mortality (HR: 1.32; 95% CI [1.03, 1.69]; p = .03), and a trend was shown for an association between psychological anxiety and outcome (HR: 1.29; 95% CI [0.99, 1.67]; p = .06). The total anxiety score of the HARS was the strongest predictor of recurrent MI and mortality (HR: 1.38; 95% CI [1.07, 1.78]; p = .02). The HARS and the HDRS were highly correlated (r = .86; p < .01). Dimensions consisting of psychological distress (HR: 1.29; 95% CI [1.02, 1.63]; p = .03) and cardiopulmonary/autonomic symptoms (HR: 1.36; 95% CI [1.06, 1.75]; p = .02) also predicted outcome in adjusted analyses. Anxiety was associated with adverse prognosis in MI patients with significant associations for somatic anxiety and total anxiety. When combining anxiety and depression items, psychological distress and cardiopulmonary/autonomic symptoms predicted recurrent MI and mortality. Future research might better focus on dimensions of anxiety and depression simultaneously in MI patients.

Symptom dimensions of anxiety following myocardial infarction and the association with recurrent myocardial infarction and mortality

Symptom dimensions of anxiety following myocardial infarction and the association with recurrent myocardial infarction and mortality