Eating pathology among women with alcoholism and/or anxiety disorders.

Sinha R, Robinson J, Merikangas K, Wilson GT, Rodin J, O'Malley S.

Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06511, USA.

Two hundred one non-treatment seeking women with alcoholism, anxiety disorders, alcoholism and anxiety disorders, or neither alcoholism nor anxiety disorders were interviewed to assess core psychopathology associated with eating disorders using the Eating Disorders Examination and DSM-IIIR psychiatric diagnoses using the Schedule of Affective Disorders and Schizophrenia-Lifetime version. Alcoholic women had significantly higher mean scores on each of the Eating Disorders Examination subscales of Restraint, Overeating, Eating Concern, Shape Concern, and Weight Concern compared with nonalcoholic women. Women with anxiety disorders had significantly elevated scores on subscales of Overeating, Eating Concern, and Weight Concern compared with women without anxiety disorders. Women with both alcoholism and anxiety disorders had higher rates of bulimia nervosa and/or eating disorder NOS compared with women with either disorder alone. Implications of these findings are discussed in the context of the co-morbid association between alcoholism, eating disorders, and anxiety disorders.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8904968&dopt=Abstract anxiety medicine




Intestinal transit in anxiety and depression.

Gorard DA, Gomborone JE, Libby GW, Farthing MJ.

Digestive Diseases Research Centre, St Bartholomew's, London.

BACKGROUND: Patients with anxiety and depression often have bowel symptoms. Until now, studies investigating a link between altered bowel habit and psychological illness have focused on patients with disturbed defecation presenting to gastroenterologists. AIMS: To determine whether patients with anxiety and depression have objective evidence of abnormal intestinal transit irrespective of any bowel symptoms. METHODS: 21 psychiatric outpatients fulfilling research criteria for generalised anxiety disorder and/or major depression, and 21 healthy volunteers were studied. Orocaecal transit time (OCTT) was measured by lactulose hydrogen breath test. Whole gut transit time (WGTT) was measured by abdominal radiography after ingestion of radio-opaque markers. RESULTS: Median (range) WGTT was shorter in patients with anxiety (14 (6-29) hours) than in patients with depression (49 (35-71) hours) (p < 0.001), and controls (42 (10-68) hours) (p < 0.001). In patients with anxiety, orocaecal transit time was shorter (60 (10-70) minutes) than in patients with depression (110 (60-180) minutes) (p < 0.01), and shorter than in controls (75 (50-140)) minutes (p < 0.05). The prolongation of transit times in depression compared with controls was not significant. However, WGTT correlated with both the Beck Depression Inventory score (r = 0.59, p < 0.01) and the depression score of the Hospital Anxiety and Depression scale (r = 0.66, p < 0.001). CONCLUSIONS: These objective measurements of intestinal transit in affective disorders are consistent with clinical impressions that anxiety is associated with increased bowel frequency, and depressed patients tend to be constipated; mood has an effect on intestinal motor function.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8944564&dopt=Abstract anxiety medicine




Psychometric properties of four anxiety measures in older adults.

Stanley MA, Beck JG, Zebb BJ.

University of Texas Health Science Center, Houston 77030-3497, USA.

Despite relatively high prevalence rates of anxiety disorders in older adults, little attention has been paid to the establishment of psychometrically sound measures for this population. The current study addresses this issue by examining the psychometric properties of four self-report anxiety measures: the Spielberger State-Trait Anxiety Inventory (STAI), Worry Scale (WS), Fear Questionnaire (FQ), and Padua Inventory (PI). Two older adult community subsamples were assessed, one with Generalized Anxiety Disorder (GAD; n = 50) and the other with no anxiety complaints (Normal Controls: NC; n = 94). Descriptive data revealed that mean scores in the GAD sample were similar to those reported in studies of younger GAD patients. Mean scores in the NC sample, however, were lower than those reported in studies of younger control samples. Internal consistency for all measures generally was adequate in both the GAD and NC subsamples, although alpha coefficients for two of the FQ subscales were marginal. Test-retest reliability over a 2-4 week interval (assessed in a subgroup of NC subjects) was mixed, with some measures apparently assessing stable, trait-like dimensions of fear and anxiety, and others estimating more state-like clinical features. Intercorrelations among subscales for all four measures in both the GAD and NC groups generally were high and consistent with findings from prior research. Finally, some support for the convergent validity of the four anxiety measures was obtained, particularly in the NC sample. Results are discussed in terms of the utility of these instruments for future investigations of the psychopathology and treatment of anxiety disorders in the elderly.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8952126&dopt=Abstract anxiety medicine




Dental anxiety among Australians.

Thomson WM, Stewart JF, Carter KD, Spencer AJ.

AIHW Dental Statistics and Research Unit, University of Adelaide, South Australia, Australia.

This study aimed to estimate the prevalence of dental anxiety and examine its associations among a representative sample of Australians aged 18 and over. A random sub-sample of participants in a national dental telephone interview survey completed a follow-up postal questionnaire (response rate 85.2 per cent) which included Corah's Dental Anxiety Scale (DAS). The prevalence of dental anxiety (defined by a DAS score of 13 or more) in the sample was 14.9 per cent, with overall severity represented by the mean score of 9.04 (sd, 3.45). The prevalence and severity of dental anxiety were greater among women than men, and in the 35-44 age group. High-anxiety individuals reported more deferring of dental care, and more frequently reported an episodic dental visiting pattern. Although there were no differences in dental anxiety by self-reported dental status, individuals who reported impact from their oral conditions had higher dental anxiety. These associations with social impacts and deferment of care indicate that dental anxiety may be an important dental public health problem in Australia.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9147119&dopt=Abstract anxiety medicine




Relationship between ADHD and anxiety in boys: results from a family study.

Perrin S, Last CG.

Center for Psychological Studies, Nova Southeastern University, Coral Springs, FL, USA.

OBJECTIVE: Recent studies have found an increased risk for both anxiety disorder and attention-deficit hyperactivity disorder (ADHD) in the adult relatives of children with ADHD in comparison with adult relatives of normal controls. Such findings may account for the high rates of comorbid anxiety found in children with ADHD, and they suggest a relationship between the two disorders. However, additional studies are needed to address this relationship that include both anxiety disorder and normal control groups. METHOD: The first- (n = 239) and second-degree relatives (n = 1,266) of clinically referred boys with ADHD (n = 49), clinically referred boys with anxiety disorder (n = 46), and controls who have never been psychiatrically ill (NPI controls) (n = 37) were assessed with structured interview and diagnosed according to DSM-III-R criteria. Lifetime rates of ADHD and anxiety disorder were then compared for relatives in the three proband groups. RESULTS: Female relatives of ADHD probands had significantly higher rates of anxiety disorder than female relatives of NPI controls. However, relatives of anxious probands and NPI controls did not differ for ADHD. Furthermore, no evidence of cosegregation of anxiety disorder with ADHD was found in the relatives of probands in the two patient groups. CONCLUSIONS: ADHD and anxiety may share common risk factors but appear to be independently transmitted in families. The high rate of anxiety in female relatives of ADHD probands was comparable with that found in relatives of anxious probands and warrants further investigation.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8755795&dopt=Abstract anxiety medicine




Anxiety sensitivity and depression: how are they related?

Taylor S, Koch WJ, Woody S, McLean P.

Department of Psychiatry, University of British Columbia, Vancouver, Canada. taylor unixg.ubc.ca

Anxiety sensitivity is the fear of anxiety-related bodily sensations, which arises from beliefs that the sensations have harmful somatic, psychological, or social consequences. Elevated anxiety sensitivity, as assessed by the Anxiety Sensitivity Index (ASI), is associated with panic disorder. The present study investigated the relationship between anxiety sensitivity and depression. Participants were people with panic disorder (n = 52), major depression (n = 46), or both (n = 37). Mean ASI scores of each group were elevated, compared to published norms. Principal components analysis revealed 3 factors of anxiety sensitivity: (a) fear of publicly observable symptoms, (b) fear of loss of cognitive control, and (c) fear of bodily sensations. Factors 1 and 3 were correlated with anxiety-related measures but not with depression-related measures. Conversely, factor 2 was correlated with depression-related measures but not with anxiety-related measures.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8772020&dopt=Abstract anxiety medicine




Effects of myocardial infarction and captopril therapy on anxiety-related behaviors in the rat.

Prickaerts J, Raaijmakers W, Blokland A.

Department of Psychiatry and Neuropsychology, University of Limburg, Maastricht, The Netherlands.

The angiotensin-converting enzyme inhibitor, captopril, is used in the treatment of heart failure after myocardial infarction. This study evaluated whether different behavioral parameters of anxiety are affected by captopril therapy after myocardial infarction in rats. Myocardial infarction was induced by ligation of the left coronary artery and captopril therapy was started after 3 weeks. After 2 weeks of captopril therapy, anxiety-related behaviors were successively measured in four different tests: open field, elevated plus maze, home cage emergence, and open field escape. Myocardial infarction and captopril therapy affected behavior in the home cage emergence test and open field escape test. On the basis of the data from the open field escape test, captopril therapy appeared to decrease anxiety in infarcted rats and increase anxiety in sham rats. Because myocardial infarction and captopril therapy did not affect anxiety-related behaviors in the open field and elevated plus maze tests, it is assumed that these interventions affect anxiety-related behaviors depending on the type of test. This was partially supported by correlation analysis, which suggested that the behavior of the rats in the different tests of anxiety may reflect different anxiety-related traits.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8804641&dopt=Abstract anxiety medicine




Fear of injections and report of negative dentist behavior among Caucasian American and Taiwanese adults from dental school clinics.

Moore R, Brodsgaard I, Mao TK, Kwan HW, Shiau YY, Knudsen R.

Department of Oral Medicine, University of Washington, Seattle, USA.

Fear of injections and reports of negative dentist behavior and associations with dental anxiety and avoidance of treatment were explored among 951 adults from dental school clinics in Iowa City, Iowa and Taipei, Taiwan. Use and fear of anesthetic injections and negative dentist behavior were assessed by written questionnaire to test associations with demographics, overall dental anxiety (Dental Anxiety Scale or "DAS") and utilization behaviors. Frequency and logistic regression analyses showed that use of dental anesthetics for routine treatment was much greater overall among caucasian Americans than Taiwanese, as was fear of injections. Taiwanese and Americans with high dental anxiety (DAS 12) had similar high fear of injections, but inspite of similar fears about dental drilling, high anxiety Taiwanese reported using much less local anesthesia for routine treatments than did high anxiety Americans. Report of condescending remarks to patients ("put downs") by dentists was mainly an American phenomenon associated with high dental anxiety. Avoidance of appointment making was high for persons afraid of injections and for Americans reporting negative dentist behavior. Avoidance was highest in subjects with high dental anxiety. That predominant characteristics or etiologies of dental anxiety can differ by cultural differences in dental health care systems, dentist beliefs and/or expectations of patients within those systems was discussed in relation to the literature.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8871040&dopt=Abstract anxiety medicine




[A study on the mechanism of anxiety reduction through training: a comparison and examination of the stress-model and the distraction-model]

[Article in Japanese]

Ikezuki M, Yamagnechi S.

Tokyo Psychology and Counseling Service Center, Japan.

This study was carried out on the basis of Wolpe's principle of reciprocal inhibition. The stress-model asserts that the essence of anxiety reduction is the shift from the ergotropic to the trophotropic state, while the distraction-model asserts that distraction is the essence of anxiety reduction. The present experiment brings light to the following points not clarified in previous studies: (1) the effects of training vary with the symptoms of clients suffering from generalized anxiety disorders. The anxiety reducing effects of relaxation training is higher among those who complain of emotional syndromes than in those who complain of behavioral syndromes; (2) in both generalized anxiety disorders and social phobias, the mechanism of anxiety reduction matches the distraction model more than the stress model; (3) the effects of anxiety reduction by relaxation training and stress-relieving training carried out in the counseling room or in the client's home is higher in cases of generalized anxiety disorders than in social phobias.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8699645&dopt=Abstract anxiety medicine