The neglected relationship between social interaction anxiety and hedonic deficits: differentiation from depressive symptoms.

Kashdan TB.

Department of Psychology, University at Buffalo, State University of New York, Park Hall, Box 604110, Buffalo, NY 14260, USA. kashdan acsu.buffalo.edu

Depressive symptoms are associated with both the presence of negative subjective experiences and relative absence of positive subjective experiences. A similar affective profile of high negative affect and low positive affect (PA) has been associated with excessive social anxiety (SA). This initial cross-sectional study evaluated the incremental effects of social interaction anxiety on hedonic deficits beyond the effects of depressive and anxiety (i.e., physiological arousal, worry) symptoms. From a sample of 97 college students, a factor analysis on self-report measures of hedonic functioning derived two domains: Positive Subjective Experiences and Curiosity. Social interaction anxiety was uniquely, negatively related to Positive Subjective Experiences and Curiosity after removing variance attributable to various depressive and anxiety symptoms. In contrast, anxious arousal and nonspecific anxiety had near-zero relationships with both domains, and depressive symptoms were negatively related to Positive Subjective Experiences. These data provide some evidence for an association between social interaction anxiety and hedonic deficits that is not attributable to covariance with other internalizing conditions.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15275949&dopt=Abstract anxiety medicine




Late-life anxiety disorders.

Salzman C.

Massachusetts Mental Health Center, Boston, Massachusetts, 02115, USA. carl_salzman hms.harvard.edu.

The prevalence, natural course, risk profile, and treatment of anxiety disorders in the elderly are remarkably understudied. Anxiety disorders are less prevalent in the elderly than in younger adults, but rates of subsyndromal anxiety disorders in elderly persons are nearly as high as in their younger cohorts. The most common late-life anxiety disorders are mixed anxiety-depression and generalized anxiety disorder. Though the benzodiazepines are widely used in this population and are considered relatively safe given appropriate dosing and safety monitoring, important liabilities remain with the use of these agents. Antidepressants also are widely used in elderly patients, but there are no randomized controlled anxiety disorder treatment trials in this population. Gabapentin and low-dose atypical antipsychotics are beginning to be used and studies of the atypical antipsychotics are ongoing. Until studies are completed, treatment of late-life anxiety will continue to be guided by extrapolating data from the general adult population. Psychopharmacology Bulletin. 2004;38(Suppl 1): 25-30.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15278015&dopt=Abstract anxiety medicine




Drug development for anxiety disorders: new roles for atypical antipsychotics.

Carson WH, Kitagawa H.

Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, 30322, USA. cnemero emory.edu.

Anxiety disorders are prevalent and frequently comorbid with depression. Rates of response and remission for anxiety disorders are low despite marked improvements in treatment in the past several decades. Antidepressants and anxiolytics remain the most frequently prescribed agents for anxiety disorders, but the numbers of prescriptions for novel forms of therapy, such as anticonvulsants and atypical antipsychotics are increasing. For the atypical antipsychotics, agonist activity at the 5-HT1A receptor has been hypothesized to translate into anxiolytic effects. A small, but growing, literature suggests that atypical antipsychotics are useful as augmentation therapy for treatment of refractory anxiety disorders. The next generation antipsychotic, aripiprazole, has a unique mechanism of action (ie, combined D2 and 5-HT1A partial agonist and 5-HT2A antagonist) and improves depressive and depressive/anxiety symptoms in patients with schizophrenia. Further studies examining the effect of aripiprazole and other atypical antipsychotic drugs on depressive and anxiety symptoms in patients with refractory anxiety disorders are warranted. Psychopharmacology Bulletin. 2004;38(Suppl 1): 38-45.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15278017&dopt=Abstract anxiety medicine




Anxiety and dissection of the human cadaver: an unsolvable relationship?

Arraez-Aybar LA, Casado-Morales MI, Castano-Collado G.

Department of Human Anatomy and Embryology II, Faculty of Medicine, University of Complutense, Madrid, Spain. arraezla med.ucm.es

Anxiety is an emotional reaction frequently shown by students when a human cadaver is being dissected. Nonetheless, few studies analyze the nature of the anxiety response in this situation and the ones that do exist are mainly limited to English-speaking countries. Our research has three aims: to study the characteristic anxiety reaction to dissection practices, to determine the weight exerted by internal and environmental variables on this anxiety reaction, and to design practices aimed at reducing the state of anxiety experienced by pupils in their human anatomy practices. The studies were carried out in the dissection room of the Department of Human Anatomy and Embryology II at the Faculty of Medicine of the Complutense University, Madrid, during the 3 academic years 2000-2003. The anxiety response to the first dissection of a human cadaver is mainly determined by a situation considered to be threatening, with novelty as its main characteristic. The students' anxiety response is first determined by the situation itself and reactions depend on individual differences. Repeated or gradual exposure (detailed verbal information on the situation, visits to dissecting rooms when no cadaver is present, videos showing pictures of human dissections, etc.) before carrying out the first dissection reduce the students' anxiety response.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15278938&dopt=Abstract anxiety medicine




Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions.

Grant BF, Stinson FS, Dawson DA, Chou SP, Dufour MC, Compton W, Pickering RP, Kaplan K.

Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892-9304, USA. bgrant willco.niaaa.nih.gov

BACKGROUND: Uncertainties exist about the prevalence and comorbidity of substance use disorders and independent mood and anxiety disorders. OBJECTIVE: To present nationally representative data on the prevalence and comorbidity of DSM-IV alcohol and drug use disorders and independent mood and anxiety disorders (including only those that are not substance induced and that are not due to a general medical condition). DESIGN: Face-to-face survey. SETTING: The United States. PARTICIPANTS: Household and group quarters' residents. MAIN OUTCOME MEASURES: Prevalence and associations of substance use disorders and independent mood and anxiety disorders. RESULTS: The prevalences of 12-month DSM-IV independent mood and anxiety disorders in the US population were 9.21% (95% confidence interval [CI], 8.78%-9.64%) and 11.08% (95% CI, 10.43%-11.73%), respectively. The rate of substance use disorders was 9.35% (95% CI, 8.86%-9.84%). Only a few individuals with mood or anxiety disorders were classified as having only substance-induced disorders. Associations between most substance use disorders and independent mood and anxiety disorders were positive and significant (P<.05). CONCLUSIONS: Substance use disorders and mood and anxiety disorders that develop independently of intoxication and withdrawal are among the most prevalent psychiatric disorders in the United States. Associations between most substance use disorders and independent mood and anxiety disorders were overwhelmingly positive and significant, suggesting that treatment for a comorbid mood or anxiety disorder should not be withheld from individuals with substance use disorders.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15289279&dopt=Abstract anxiety medicine




Anxiety in children with asthma.

Butz AM, Alexander C.

School of Nursing, Johns Hopkins University, Baltimore, Maryland 21205.

The purpose of this study was to examine associations between levels of state and trait anxiety in children with asthma and increased asthma morbidity immediately following an acute asthmatic attack. A total of 155 children, aged 7-12 years, diagnosed with asthma, were administered the State-Trait Anxiety Inventory for Children (STAIC) while the State-Trait Anxiety Inventory Form Y (STAI) was administered to the mother. The mother's state and trait anxiety scores were consistently higher than the child's scores, and there was no significant correlation between child and mother anxiety levels. Almost two-thirds of children reported feeling "panic" at the beginning of the index asthma attack, which was significantly associated with child state anxiety. Health professionals must be sensitive to child as well as maternal anxiety in families of children with asthma.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8325829&dopt=Abstract anxiety medicine




[Effects of attention shifting on inhibiting anxiety: a study on a therapeutic mechanism of reciprocal inhibition]

[Article in Japanese]

Ikezuki M.

Tokyo Psychology and Counseling Service Center.

The purpose is to examine the effects of number-counting and attention paid to body parts as anxiety inhibiting responses in reciprocal inhibition. Subjects were thirty-three men and women, all complaining of anxiety. They were classified randomly, in the presence of anxiety-arousing stimuli, into three groups--(1) the number-counting groups, (2) the group paying attention to body parts, and (3) the control group--each group consisting of 11 people. After a week's training, the number-counting group showed a significant reduction in their subjective anxiety compared to the other two groups, making it clear that number-counting is effective in inhibiting anxiety. The groups paying attention to body parts showed no significant difference compared to the control group, however the former tended to reduce subjective anxiety. This suggests that the attention paid to body parts may be effective in inhibiting anxiety. In general, the present study suggests that the shift of attention serves as a factor in inhibiting anxiety.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8326690&dopt=Abstract anxiety medicine




[Anxiety, a basic human experience]

[Article in German]

Battegay R.

Psychiatrische Universitatspoliklinik, Universitat Basel, Kantonsspital.

Anxiety, unlike fear, which is strongly object-related, accompanies man all his life. This anxious condition appears especially then, when danger is imminent, also in the case of being severely ill. Anxiety and hope, even in people severely ill, do not exclude each other. Human life for many and perhaps for all is a race with time. The anxiety not being able to realize enough in a given time often is the reason for a busy and restless activity. Man often suffers from anxiety of other human beings. As ever an individual may live, it always owes something to others. Accordingly, the doctor or other helpers never are able to behave totally in the way as the patient expects and the patient cannot act as the helper truly would like it. Man experiences anxiety, however, also then, when he recognizes to remain in debts towards himself and, in the view of religion, towards a task given by God. Yet, man suffers anxiety not only because of his confrontation with death but also with life and the responsibilities which he has to take over when growing up in society. The struggle for existence described by Darwin, a result of anxiety, seems to be lost for the patient knowing he or she is severely ill, and he/she is therefore upset against a destiny which threatens to exclude him/her from the community of healthy people and perhaps soon from the living persons. Anxiety always turns also around the existence in the group.(ABSTRACT TRUNCATED AT 250 WORDS)

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8424135&dopt=Abstract anxiety medicine




[Anxiety neurosis--avoidant behavior--depression. A comparison between panic disorder and generalized anxiety disorder]

[Article in German]

Biebl W, Deisenhammer EA, Lehofer M, Muigg W, Posch C, Zeilerbauer J.

Universitatsklinik f. Psychiatrie, Innsbruck, Osterreich.

30 patients with "Anxiety disorder" were investigated with regard to their psychosocial experiences, their family history, the course of their illness, and their interpersonal relationships using a semi-structured interview. Patients with panic disorder significantly more frequently reported real fright of a parent than did patients with generalized anxiety disorder. Both groups showed a high degree of secondary depression and avoidance behavior in the course of their illness. Chronic anxiety was more frequent in patients with generalized anxiety disorder. The difference in the perception and judgement of anxiety clearly demonstrates the significance of attribution. Since the patient with panic disorder externalizes his anxiety, he has periods of complete remission, whereas the patient with generalized anxiety disorder internalizes his anxiety, thus experiencing it as an ego-syntonic feature, with which he cannot cope.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8441796&dopt=Abstract anxiety medicine