Anxiety Disorder Symptoms Research Articles

Using marketing strategies to promote maternal health: an international students’ collaboration

Abstract Purpose About 1 in 8 birth parents experience symptoms of perinatal mood and anxiety disorders (PMADs). The purpose of this collaborative project was to create a social media deliverable to lower the risk of postpartum depression in pregnant and postpartum parents in Georgia, USA. Methods Using the SM 10-step model, Master of Public Health Students from Georgia Southern University (GSU), Georgia in collaboration with Creative Business students from Breda University of Applied Science (BUas), the Netherlands, designed an evidence-based SM product. They were mentored by public health and media faculty from both institutions. Roles and responsibilities according to the skill sets were divided, but briefly: students 1) identified a target audience; 2) conducted tertiary data collection; 3) set goals and objectives; 4) developed 4 P’s (product, price, place, and promotion) 5) developed marketing strategies.; 6) and used the strategy to create a specific social media deliverable. Results Utilizing the 10-step model social marketing strategy used state-of-the-art marketing and digital media techniques and evidence-based strategies to create a digital electronic booklet that focused on reducing the stigma associated with help seeking behaviors with the ultimate goal to reduce the incidence and prevalence of PMADs. The digital interactive booklet will be pilot tested in selected OBGYN offices and health departments in Southeast Georgia in July 2024. Conclusions This collaborative project demonstrates effective collaboration between disciplines from different world regions utilizing strengths from both teams: public health and digital media skills to create an SM product that will be utilized to promote social engagement among postpartum parents. Key messages • Students utilized social marketing strategies to create an electronic booklet to address postpartum depression using state-of-the-art digital media techniques and evidence-based strategies. • This collaborative project demonstrates effective collaboration between disciplines from different world regions and utilizes strengths from both teams.

Depression, anxiety and cognitive function in persons with inflammatory rheumatic diseases: cross-sectional results from the German National Cohort (NAKO)

ObjectiveTo assess the presence of mental health disorders in persons with rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PsA), systemic lupus erythematosus (SLE) and Sjögren’s disease (SjD) (all: inflammatory...

Concurrent and prospective prediction of community-dwelling adults' psychosocial functioning with the Inventory of Depression and Anxiety Symptoms-II (IDAS-II).

Mood and anxiety disorders involve defining symptoms (e.g., dysphoria, anhedonia) that can impair psychosocial functioning (e.g., self-care, work, social relationships). The present study evaluated the validity of the Inventory of Depression and Anxiety Symptoms-II (IDAS-II; Watson et al., 2012) via convergence with a semistructured interview assessing mood and anxiety disorder symptoms and, moreover, prediction of psychosocial functioning. Community-dwelling adults (N = 601) completed the self-report IDAS-II, a semistructured diagnostic interview, and self-report and interview measures of psychosocial functioning. A retest subsample (ns = 497-501) completed the functioning measures again, on average 8 months later. Supporting our hypotheses, the IDAS-II converged robustly with interview-assessed symptoms and predicted psychosocial functioning significantly, both concurrently and prospectively. Moreover, the IDAS-II predicted functioning significantly better than did the diagnostic interview. These findings support use of the IDAS-II in research and clinical settings to assess mood and anxiety symptoms and their connections to psychosocial impairment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Insomnia as a predictor of treatment outcomes in adolescents receiving concentrated exposure treatment for OCD

BackgroundResearch suggests that individuals with obsessive-compulsive disorder (OCD) frequently experience insomnia. Some previous studies have suggested that insomnia may predict treatment outcomes, but the evidence is limited, especially for adolescents. This study examined the prevalence of insomnia in an adolescent OCD patient sample, explored the correlation between OCD and insomnia, and tested whether levels of insomnia at baseline predict outcomes for adolescent patients receiving the Bergen 4-Day Treatment (B4DT) for OCD.MethodsForty-three adolescent OCD patients who received B4DT were selected for this study. Treatment outcome was quantified as change in Children Yale-Brown Obsessive Compulsive Scale (CY-BOCS) scores across time from pre- to posttreatment and 3-month follow-up. Insomnia symptoms were measured by the Bergen Insomnia Scale (BIS). Linear mixed models were used to examine the relationship between the BIS and changes in CY-BOCS scores. We controlled for symptoms of general anxiety disorder measured by the GAD-7 and depression symptoms measured by the PHQ-9.ResultsIn this sample, 68.4% of the patients scored above the cutoff for insomnia on the BIS. There was a moderate correlation between baseline CY-BOCS and BIS that did not reach statistical significance (r = .32, p = .051). High BIS scores before treatment were significantly associated with poorer treatment outcomes, as measured by changes in CY-BOCS over time (p = .002). The association between baseline insomnia and change in OCD symptoms remained significant (p = .033) while controlling for GAD-7 and PHQ-9.ConclusionInsomnia is common among adolescents with OCD, and these data suggest that these patients may be at increased risk for poor treatment outcomes. Future research to explore mechanisms and adjunctive treatments is warranted.Trial registrationThe study was approved by the Regional Committee for Medical and Health Research Ethics of Northern Norway (REK Nord: 2023/606482).

Associations between neighborhood factors and insomnia and their spatial clustering in Philadelphia, Pennsylvania

BackgroundNeighborhood-level adverse social determinants may be a risk factor for sleep health disparities. We examined the associations between neighborhood factors and insomnia and explored their spatial clustering in the city of Philadelphia, Pennsylvania. MethodsWe conducted a cross-sectional analysis of data from Philadelphia residents who participated in online screening for insomnia-related research. Participants self-reported sex, age, body mass index, anxiety, post-traumatic stress disorder, depression, and insomnia symptoms. The sample was stratified as “No Insomnia” (≤7) and “Insomnia” (>7) based on the Insomnia Severity Index (range: 0-28). Neighborhood and participant data were merged using geospatial techniques. Multiple regression models and geospatial analysis were used to identify neighborhood variables that are associated with insomnia and their spatial distribution. ResultsThe sample (N = 350) was predominantly female (53%), middle-aged (40.8 ± 13.8), overweight (body mass index=26.1 ± 5.54), and 53.7% had insomnia. The insomnia group had significantly higher depression scores (14.6 ± 5.5), a large percentage had anxiety (64.4%) and post-traumatic stress disorder symptoms (31.9%), and largely resided in high crime (p < .001) and highly deprived neighborhoods (p = .034). Within the insomnia group, a 1-point increase in the number of spiritual centers in the neighborhood was associated with lower insomnia symptoms (b=−1.02, p = .002), while a 1-point increase in depression scores (b=0.44, p < .001) and residence in a highly deprived neighborhood (b=1.49, p = .021) was associated with greater insomnia. ConclusionDisparities exist in the neighborhood determinants of insomnia and their spatial distribution in Philadelphia. Interventions targeting the spatial distribution of adverse social determinants may improve insomnia disparities.

Anxiety, depression, and post-traumatic stress disorder in nurses exposed to horizontal violence: a network analysis

BackgroundHorizontal violence can cause serious mental health problems for nurses, particularly anxiety, depression, and post-traumatic stress disorder. However, the intrinsic linkage mechanism between mental symptoms of anxiety, depression, and post-traumatic stress disorder in nurses exposed to horizontal violence is unclear. This study aims to elucidate the characteristics of anxiety, depression, and post-traumatic stress disorder networks among nurses with horizontal violence exposure.MethodsData for this cross-sectional study were obtained from the baseline portion of a short longitudinal survey conducted at four tertiary hospitals in Shandong Province, China. A total of 510 nurses with horizontal violence exposure completed the General Information Scale, the Negative Acts Questionnaire, the Seven-item Generalized Anxiety Disorder Scale, the Nine-item Patient Health Questionnaire, and the Four-item SPAN. The network model was constructed using network analysis. The expected influence and the bridge expected influence of nodes were calculated. The stability and accuracy of the network were estimated.ResultsThe results show that A4 (Trouble relaxing) and P1 (Startle) had the highest expected influence in the network. D9 (Suicidality ideation) and A5 (Restlessness) were the key bridge symptoms.Conclusions“Trouble relaxing”, “Startle”, “Suicidality ideation”, and “Restlessness” are all mental symptoms that need to be urgently improved the most in nurses exposed to horizontal violence. Nursing administrators and policymakers should implement mental health intervention programs for these symptoms as early as possible to maximize nurses’ mental health.

O IMPACTO DO USO DE CIGARROS ELETRÔNICOS NA SAÚDE MENTAL DOS ADOLESCENTES: UMA REVISÃO SISTEMÁTICA

Objective: To analyze the impact of electronic cigarette use on adolescent mental health, identifying motivational and risk factors associated with the use of these devices. Method: A systematic literature review was conducted using the PubMed and Virtual Health Library (BVS) databases, with descriptors in Portuguese and English. Studies published between 2019 and 2024 that analyzed the relationship between electronic cigarette use and the mental health of adolescents aged 12 to 24 years were included. After applying inclusion and exclusion criteria, 10 studies were selected for analysis. Results: The main motivational factors for the use of electronic cigarettes include curiosity, the perception of lower risk compared to traditional cigarettes, sensory appeal, and social influence. Risk factors include adverse childhood experiences, mental health problems, substance use, and poor academic performance. The review indicated a strong association between the use of electronic cigarettes and increased symptoms of depression, anxiety, and other mental disorders in adolescents. Additionally, the importance of stricter public policies and psychological support programs is emphasized to mitigate the negative effects of electronic cigarette use among young people.

The Psychosomatic Impact of Alcohol Consumption on Patients with Acute Coronary Syndrome

&lt;span lang="RO"&gt;Cardiovascular disease is estimated to be the leading cause of death worldwide (approximately one-third of all deaths). In 2024, the American Heart Association reported that approximately 128 million Americans over the age of 20 were diagnosed with acute myocardial infarction, heart failure, stroke, and high blood pressure. Also, in 2020, Eurostat reported that the main cause of death was represented by cardiovascular diseases representing almost a third of all deaths. In addition, excessive alcohol consumption is associated with an increased risk of cardiovascular diseases such as hypertension, myocarditis, decreased cardiac contractility, arrhythmias, thrombotic events, hypoxic acute respiratory failure, and stroke. The impact of alcohol on the cardiovascular system is dependent on the amount of alcohol consumed, thus, as alcohol consumption is constant, the risk of developing cardiovascular diseases increases, especially acute myocardial infarction. Cardiovascular emergencies, especially acute myocardial infarction and stroke, can significantly affect both the physical and mental health of patients. However, the psychological impact of these conditions is often neglected, even though studies show that they can lead to symptoms of anxiety, depression, or post-traumatic stress disorder (PTSD).&lt;/span&gt;

A Short-Term Group Telehealth Cognitive Behavioral Therapy Intervention for Youth with Autism and Anxiety: A Pilot Study.

Background: Children with autism often present with comorbid anxiety disorders. Cognitive behavioral therapy (CBT) is an effective, evidence-based approach to treating anxiety, but information on youth with autism and anxiety is limited. Coping Cat is a 16-week CBT intervention for children with anxiety but its use in a group telehealth format in an urban, predominantly Hispanic population is limited. Objectives: (a) To examine the feasibility and preliminary effectiveness of a short-term CBT telehealth group for youth with autism and anxiety disorders in an urban, predominantly Hispanic population and (b) to examine satisfaction with the intervention. Methods: Single-arm pilot study that consisted of a 16-week telehealth CBT group therapy was based on a modified Coping Cat curriculum. Youth with autism and anxiety disorders who were on a waitlist for psychotherapy at an urban developmental center were invited to participate. Anxiety was assessed pre- and posttreatment using the Screen for Child Anxiety Related Emotional Disorders, parent and self-report. Results: Eighteen children were enrolled; 16 children completed the program. Mean age was 11 ± 2.5 years (8-15 years); 89% males, 61% Hispanic. There was a significant reduction in pre-post intervention in symptoms of overall anxiety (parent: 41.0 ± 18.5 to 31.0 ± 16.3 p ≤ 0.003, self: 25.9 ± 12.8 to 14.1 ± 7.8 p ≤ 0.001), panic disorder (parent: 8.1 ± 7.0 to 4.1 ± 4.2 p = 0.013, self: 5.1 ± 4.8 to 0.8 ± 0.9 p = 0.004), and separation anxiety disorder (parent: 7.5 ± 4.8 to 5.7 ± 4.4 p = 0.041, self: 5.8 ± 3.3 to 3.8 ± 2.4 p = 0.018) as per parent and self-reports. Self-report data also revealed a significant reduction in symptoms of social anxiety disorder (6.5 ± 3.5 to 3.9 ± 2.7 p ≤ 0.001). Parents and children reported satisfaction with the group. Conclusion: In this small, predominantly Hispanic population of youth with autism and anxiety disorder, 89% of families were compliant with a group telehealth CBT intervention. Parents and youth reported a significant reduction in anxiety symptoms and program satisfaction. A modified group CBT program via telehealth represents a feasible intervention for youth with autism and anxiety disorders.

THE APPLICATION OF SPIRITUAL COUNSELING TO OVERCOME GENERALIZED ANXIETY DISORDER (GAD): A CASE STUDY ON CLIENT “I” FROM GOMBAK, SELANGOR, MALAYSIA

Generalized Anxiety Disorder (GAD) is a mental disorder involving excessive and uncontrollable fear, anxiety, and worry. Referring to this research, the focus of the study is related to the description of client “I”’s GAD, such as factors, symptoms, and level of GAD anxiety disorders. This research also explains how the spiritual counseling approach can overcome client “I” ‘s GAD problem based on Surah Al-Ma'arij from verses 19 to 32. Client “I” is the main source for this research. Therefore, this research was carried out in three meetings from 03 September 2023 to 10 January 2024 according to the type of research using field research with qualitative methods. The data from this research were obtained from interviews and observations and used data analysis for case studies that had been developed by Robert K. Yin, namely pattern matching, explanation, and time series analysis. The results of the study showed that there was a significant impact on the symptoms of anxiety disorder in a client “I”. Apart from that, the GAD level of client “I” also showed a positive change from a score of 14 to a score of 11 using the GAD-7 Rating Scale. In conclusion, a systematic spiritual counseling approach guided by the verses of the Qur'an has been proven to bring positive changes and overcome Generalized Anxiety Disorder (GAD).

Prevalence and co-occurrence of symptoms of mental and substance use disorders among people with HIV age 40 and older in low- and middle-income countries: a cross-sectional study.

Due to the increased effectiveness of and access to antiretroviral therapy (ART), people with HIV (PWH) are living longer. As a result, the population of older PWH has increased. Mental and substance use disorders (MSDs) are common and frequently co-occurring among PWH and are associated with poor HIV care outcomes. Research into the prevalence and co-occurrence of MSDs among ageing PWH remains limited, particularly in low- and middle-income countries (LMICs). We analysed data collected between 2020 and 2022 from the International epidemiology Databases to Evaluate AIDS (IeDEA) Sentinel Research Network cohort of PWH aged 40 years or older on ART at 11 HIV clinics in Brazil, Côte d'Ivoire, India, Kenya, Mexico, Uganda, Rwanda, Togo, Vietnam, Zambia and Zimbabwe. We estimated the prevalence and co-occurrence of unhealthy alcohol use (AUDIT-C ≥3 for women, ≥4 for men), unhealthy drug use (ASSIST >3 for cannabis, cocaine, amphetamines, inhalants, sedatives, hallucinogens and/or opioids), and moderate to severe symptoms of depression (PHQ-9 ≥10), anxiety (GAD-7 ≥10) and post-traumatic stress disorder (PTSD) (PCL-5 ≥33). Psychiatric multimorbidity was defined as having symptoms of two or more disorders assessed. Log binomial models assessed the association between socio-demographic and HIV care characteristics and symptoms of anxiety, depression, PTSD or unhealthy substance use. Of 2821 participants, the prevalence of unhealthy alcohol and drug use was 21% and 5%, respectively. The prevalence of moderate to severe symptoms of depression, anxiety and PTSD was 14%, 9% and 6%, respectively. Overall, the prevalence of psychiatric multimorbidity was 11%. Among those with symptoms of at least one mental health or substance use outcome assessed (n = 1036), the prevalence of psychiatric multimorbidity was 31%. In binomial models, the prevalence of symptoms of depression and anxiety was higher, while the prevalence of unhealthy alcohol and drug use was lower among women than men. Unhealthy alcohol use and symptoms of depression were most commonly reported, among this cohort of PWH aged 40 or older across 11 LMICs. Integration of MSD screening and treatment into HIV care should be prioritized. The effectiveness and implementation of transdiagnostic or multi-focus mental health treatment approaches in HIV care settings should be examined.

Mediation models of the interaction between Internet gaming disorder and psychological pain and symptoms of anxiety, depression, and borderline personality disorder

Introduction: The prevalence of Internet gaming disorder (IGD) ranges from approximately 2% to 27.5% in the world population and 5.5% in the Polish population. Research findings indicate that IGD may be associated with depression, ADHD, anxiety, autism spectrum, and aggressive behaviours. However, there is a lack of research on the relationship between IGD and borderline personality disorder and psychological pain (psychache). The aim of this study is to examine the relationships between IGD and symptoms of anxiety, depression, psychological pain, borderline personality disorder and determining the role of psychological pain as a mediator of the above-mentioned links.; Methods: A sample of Polish gamers (n=201) was assessed using clinical scales (HADS, IGD-20, BPD Checklist) to evaluate the severity of depression, anxiety, IGD, and borderline personality symptoms. Additionally, the psychological pain scale was administered to assess relationship with IGD via mediation models. Results: Regression analysis in a mediation model revealed that IGD significantly predicted anxiety and depression, while borderline personality disorder was a significant predictor of IGD. Moreover, a bidirectional relationship between IGD and psychological pain had been demonstrated–IGD was a significant predictor of psychological pain and vice versa. Psychological pain also mediated the relationship between IGD and anxiety and depression, as well as the relationship between borderline personality symptoms and IGD. Conclusions: In the diagnostic and therapeutic process of people suffering from IGD, the co-occurrence of IGD with psychological pain, depression, anxiety and borderline personality disorder should be considered. Further scientific exploration is required to assess the associations between IGD and clinical variables and psychological pain.

Outcomes of integrating livelihood into mental health and psychosocial support program among survivors of torture: A mixed-method study from western Nepal.

From 1996 to 2006, Nepal experienced a decade-long armed conflict that adversely impacted survivors of torture. The conflict posed threats to various facets of their lives, such as men-tal health, socio-economic status, human rights, and the process of reintegration into their original communities. This study was done with the survivors of torture from the armed conflict. This study aims to generate evidence on the impact of livelihood support (supporting individuals with earning their livelihood through business development, farming/animal husbandry and mi-cro-entrepreneurship) upon mental health and psychosocial wellbeing as well as social empower-ment of survivors of torture. In total, 44 out of 46 torture survivors reported improvement in their mental health and psychosocial well-being after the livelihood intervention was instituted. Significant reduction in the severity of symptoms of depression (21.7% to 2.3%), anxiety (15.2% to 6.8%), and post-traumatic stress disorder (44.4% to 4.5%) was observed with medium to high effect size. Similarly, improvement in social relationship, economic status, and autonomy (increase in self-confidence and motivation) were noticed post-intervention. Our study concludes that the livelihood intervention has significantly contributed to economic uplift, improved mental health, psychosocial well-being, social empowerment and quality of life among the survivors of torture. The data provide preliminary evidence of positive outcomes from integrating a livelihood program into an MHPSS (Mental Health and Psychosocial Support) program. Although the lack of a control group prevents us from isolating the specific impacts of the livelihood program, our qualitative data indicate that the intervention is well-received, culturally rel-evant, and promising. The study has yielded certain recommendations for further research.

Can nomophobia be a contemporary and novel cluster of symptoms of adult separation anxiety disorder?

Objective: The connection between adult separation anxiety disorder (ASAD) and nomophobia has been poorly investigated. The aim of this study is to evaluate whether there is a relationship between ASAD and nomophobia. Method: The sample consisted of 68 university students diagnosed with ASAD and 77 university students without ASAD. All participants were evaluated by a structured clinical interview, Adult Separation Anxiety Questionnaire (ASA), Separation Anxiety Symptom Inventory (SASI), Nomophobia Questionnaire (NMP-Q), and Smartphone Addiction Scale-Short Version (SAS-SV). Result: Participants with ASAD had longer daily phone usage times and had a higher frequency of checking the phone during the day and the rates of carrying a charger than controls. Compared to the control group, participants with ASAD had significantly higher ASA, SASI, NMP-Q, and SAS-SV scores and more severe nomophobia levels. The ASA scores were significantly positively correlated with SASI, NMP-Q, and SAS-SV. Regarding predictors of nomophobia, ASA, SASI, and SAS-SV scores had a positive and significant effect on nomophobia, and predicted nomophobia. Conclusion: Our research adds to the body of knowledge on nomophobia by demonstrating that people with ASAD are susceptible to developing nomophobia. Clinicians should be aware of the association between ASAD and nomophobia, and nomophobia may be an important concept that should be considered in the therapy approach to patients with ASAD.

Cognitive flexibility and emotion regulation in eating disorder patients with comorbid generalized anxiety and posttraumatic stress symptoms

ABSTRACT Research has found that difficulties in emotion regulation negatively impact mental health, whereas cognitive flexibility may promote stress resilience and positive mental health. Little is known about cognitive flexibility and emotion regulation in people with comorbid eating disorder (ED) and anxiety and stress disorders. A transdiagnostic ED population (N = 227) at an outpatient ED treatment facility completed several self-report instruments that measured cognitive flexibility, emotion regulation difficulties, posttraumatic stress disorder (PTSD) symptoms, and generalized anxiety disorder (GAD) symptoms upon admission. We investigated cognitive flexibility and emotion regulation differences for those with an ED without comorbidity and those with various combinations of comorbidity. In a one-way between-groups ANOVA, we investigated differences in cognitive flexibility for those with GAD, PTSD, neither, and both comorbidities. We found a statistically significant difference between these groups, with mean cognitive flexibility inventory scores being the lowest in the group with both comorbidities. However, when controlling for emotion regulation, a one-way between-groups ANCOVA indicated no significant differences in cognitive flexibility between comorbidity groups F(3, 222) = 1.20, p = .31 Partial η 2 = .02. Though self-reported cognitive flexibility levels differ among ED patients with and without comorbidities, it appears that these differences are better explained by emotion regulation. Therefore, addressing emotion regulation early in treatment for all individuals with EDs, regardless of comorbidity, is recommended as a future research focus to enhance treatment outcomes. Further research is needed to understand the impact of treating emotion regulation on ED treatment engagement, dropout, and effectiveness.

Measurement Invariance of the Four-Item Entrapment Scale Short-Form (E-SF): A Transnational Examination Across Race/Ethnicity, Sexual Orientation, and Suicide Attempt History Among Minoritized Adults.

Feelings of entrapment-posited to arise when attempts to escape from defeating or humiliating circumstances are blocked-may confer increased risk for psychopathology and suicidal thoughts and behaviors (STB), particularly among minoritized individuals who often have more frequent exposure to such experiences. Including entrapment in empirical models may aid research efforts in further exploring its role in minority mental health. The Entrapment Scale Short-Form (E-SF), a brief version of the 16-item Entrapment Scale, is one tool that may be utilized toward this end; however, to do so meaningfully, its psychometric properties and measurement invariance must be evaluated in diverse samples. This study aimed to examine the factor structure, measurement invariance, and convergent validity of the E-SF across race/ethnicity and sexual orientation in a combined transnational sample of minoritized adults (total N = 1,194). Results supported a one-factor model of the E-SF that was invariant across samples, race/ethnicity, sexual orientation, and history of suicide attempt. Furthermore, significant positive correlations observed between theoretically relevant constructs of anxiety, depression, and posttraumatic stress disorder symptoms supported its convergent validity. Implications include disproportionate levels of entrapment experienced by minoritized individuals-particularly by sexual minorities-which likely reflect the discrimination frequently endured by these individuals.

Alterations in fear learning as a mechanism linking childhood exposure to violence with PTSD symptoms: a longitudinal study.

Fear learning is a core component of conceptual models of how adverse experiences may influence psychopathology. Specifically, existing theories posit that childhood experiences involving childhood trauma are associated with altered fear learning processes, while experiences involving deprivation are not. Several studies have found altered fear acquisition in youth exposed to trauma, but not deprivation, although the specific patterns have varied across studies. The present study utilizes a longitudinal sample of children with variability in adversity experiences to examine associations among childhood trauma, fear learning, and psychopathology in youth. The sample includes 170 youths aged 10-13 years (M = 11.56, s.d. = 0.47, 48.24% female). Children completed a fear conditioning task while skin conductance responses (SCR) were obtained, which included both acquisition and extinction. Childhood trauma and deprivation severity were measured using both parent and youth report. Symptoms of anxiety, externalizing problems, and post-traumatic stress disorder (PTSD) were assessed at baseline and again two-years later. Greater trauma-related experiences were associated with greater SCR to the threat cue (CS+) relative to the safety cue (CS-) in early fear acquisition, controlling for deprivation, age, and sex. Deprivation was unrelated to fear learning. Greater SCR to the threat cue during early acquisition was associated with increased PTSD symptoms over time controlling for baseline symptoms and mediated the relationship between trauma and prospective changes in PTSD symptoms. Childhood trauma is associated with altered fear learning in youth, which may be one mechanism linking exposure to violence with the emergence of PTSD symptoms in adolescence.

The psychometric properties of the Swahili version of the Primary Care Post Traumatic Stress Disorder screen for DSM-5 among adults in Kenya.

The psychometric properties of the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) are undocumented in Kenya and sub-Saharan Africa (SSA) at large. This study aimed to evaluate the psychometric properties of the Swahili version of the tool, S-PC-PTSD-5, in a community sample of adults 18 years and older drawn from Nairobi, Mombasa and Kwale counties in Kenya. Analysis of cross-sectional data from 1431 adults from the community was conducted, examining the reliability, factorial structure, measurement invariance, and convergent and divergent validity of the interviewer-administered S-PC-PTSD-5. Out of 1431 adults who completed the S-PC-PTSD-5, 666 (46.5%) reported experiencing at least one traumatic event. Internal consistency of the S-PC-PTSD-5 was good overall, with alpha and omega values above 0.7. Confirmatory factor analysis (CFA) results indicated a one-factor structure of the S-PC-PTSD-5 for the overall sample. Multigroup CFA also demonstrated factorial invariance for sex for the one-factor structure of S-PC-PTSD-5. Scores for S-PC-PTSD-5 significantly correlated (positively) with those of generalized anxiety disorder (GAD7) and depressive symptoms (PHQ9), indicating convergent validity. S-PC-PTSD-5 scores also significantly correlated (negatively) with the WHO-5 wellbeing index, supporting divergent validity. The S-PC-PTSD-5 is a reliable and valid unidimensional measure. It appears to be a valuable screening measure for probable PTSD in both urban and rural community settings in Kenya. Nonetheless, to confidently identify those who may need treatment/additional support, further research on the reliability and validity of S-PC-PTSD-5 is required, especially its diagnostic accuracy at different cutoff scores.

Drug metabolizing enzymes pharmacogenetic variation-informed antidepressant therapy approach for common mental disorders: A systematic review and meta-analysis

ImportanceCurrently, 30–50 % of individuals with depression and 40 % with anxiety—collectively referred to as common mental disorders (CMDs), exhibit inadequate responses to antidepressant treatments. ObjectiveTo assess the effectiveness and safety of drug-metabolizing enzyme pharmacogenetic variation informed treatment (PGxIT) versus usual antidepressant treatment (UT) in patients with CMDs. Data sourcesA literature search was conducted in the MEDLINE, Scopus, and Cochrane Library databases from inception until January 30, 2024. Study selectionStudies were selected based on CMD diagnoses, reporting on the genetic variations of drug-metabolizing enzyme (DME) genes in relation to antidepressants, involving PGxIT and UT groups with human subjects, and published in English. Data extraction and synthesisData extraction and quality assessment were performed independently by two authors. A pooled risk ratio (RR) with 95 % CI was estimated using both random and fixed-effect models, and heterogeneity was assessed using Cochran's Q test and the I2 statistic. The publication bias of eligible studies was assessed using post hoc Doi plots and the LFK index. ResultsThis systematic review included 18 studies (n = 7021). The PGxIT demonstrated greater efficacy in the remission of symptoms of depressive disorder at 8 weeks (RR 1.523 [95 % CI: 1.255–1.843]; I2 = 48 %) and 12 weeks (RR 1.631 [95 % CI: 1.001–2.657]; I2 = 86 %; p < 0.01), and symptoms of anxiety disorder compared to UT. Additionally, the risk of adverse drug events (ADEs) was significantly lower in the PGxIT group (RR = 0.65 [95 % CI: 0.52–0.82]; I2 = 0 %) than in the UT group. The certainty of evidence for both outcomes was moderate. Conclusions and relevanceThis systematic review and meta-analysis suggest that pharmacogenetically guided antidepressant treatment, based on genetic variation in drug-metabolizing enzymes, is associated with superior efficacy in the remission of symptoms for patients with depressive disorders and a reduction in ADEs compared to usual treatment and the findings of the systematic review for remission in anxiety disorders indicate that, PGx guided treatment is also associated with increased remission of symptoms in anxiety disorders compared to usual treatment.

Responding to suicidal behaviour in children and young people with a child maltreatment history: A scoping review

Child maltreatment affects millions of children internationally every year. Development is negatively impacted by maltreatment increasing the likelihood of maladaptive behaviours. Associations between child maltreatment and suicidal behaviour and suicide in young people has been established. However, there is a research gap in understanding effective ways to respond to and intervene with suicidal behaviour in young people who have experienced child maltreatment. A scoping review was conducted in accordance with the Joanna Briggs Institute methodology to investigate interventions that may be effective in preventing and reducing suicidal behaviours in young people who have experienced child maltreatment. Inclusion criteria were studies: (a) of children and young people who engage in suicidal behaviour and have experienced child maltreatment; (b) published in English during the time period 2000–2020; and (c) focused on responses and interventions to prevent or address suicidal behaviour. Across 37 studies, several intervention targets were identified through reflexive thematic analysis including cultivation of self-compassion, gratitude and future orientation, alleviation of depression, anxiety and post-traumatic stress disorder (PTSD) symptoms and psychological distress and addressing cognitive errors and negative views of the self. Screening and clear assessment of suicidal risk by health professionals and child welfare professionals was endorsed across studies. Several evidence-based treatments were proposed to support intervening with this client group, although only Emotional Intelligence Therapy (EIT) was empirically tested with this population. Utilisation of safe systems that the child or young person is in may be beneficial in addressing and reducing suicidal behaviour, such as inclusion of families, peers and the implementation of school-based interventions strategies. Future research is needed to empirically test and assess the effectiveness of interventions.