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Prospective 12-month course of bipolar disorder in out-patients with and without comorbid anxiety disorders
- Authors:
- OTTO M. W., et al
- Journal article citation:
- British Journal of Psychiatry, 189(1), July 2006, pp.20-25.
- Publisher:
- Cambridge University Press
The impact of anxiety disorders has not been well delineated in prospective studies of bipolar disorder. The aim was to examine the association between anxiety and course of bipolar disorder, as defined by mood episodes, quality of life and role functioning. A thousand out-patients with bipolar disorder were followed prospectively for 1 year. A current comorbid anxiety disorder (present in 31.9% of participants) was associated with fewer days well, a lower likelihood of timely recovery from depression, risk of earlier relapse, lower quality of life and diminished role function over I year of prospective study. The negative impact was greater with multiple anxiety disorders. Anxiety disorders, including those present during relative euthymia, predicted a poorer bipolar course. The detrimental effects of anxiety were not simply a feature of mood state. Treatment studies targeting anxiety disorders will help to clarify the nature of the impact of anxiety on bipolar course.
Social anxiety disorder in first-episode psychosis: incidence, phenomenology and relationship with paranoia
- Authors:
- MICHAIL Maria, BIRCHWOOD Max
- Journal article citation:
- British Journal of Psychiatry, 195(3), September 2009, pp.234-241.
- Publisher:
- Cambridge University Press
This study aimed to compare the phenomenology of social anxiety disorder in first-episode psychosis with that in a group without psychosis. The relationship between social anxiety and psychosis symptoms was investigated. A sample of people with first-episode psychosis (FEP group) was compared with a sample with social anxiety disorder without psychosis (SaD group). Of the individuals in the FEP group (n = 80) 25% were diagnosed with an ICD–10 social anxiety disorder (FEP/SaD group); a further 11.6% reported severe difficulties in social encounters. The FEP/SaD and SaD groups reported comparable levels of social anxiety, autonomic symptoms, avoidance and depression. Social anxiety in psychosis was not related to the positive symptoms of the Positive and Negative Syndrome Scale (PANSS) including suspiciousness/persecution. However, a significantly greater percentage of socially anxious v. non-socially anxious individuals with psychosis expressed perceived threat from persecutors, although this did not affect the severity of social anxiety within the FEP/SaD group. The majority of those in the FEP/SaD group did not have concurrent persecutory delusions. It is concluded that social anxiety is a significant comorbidity in first-episode psychosis. It is not simply an epiphenomenon of psychotic symptoms and clinical paranoia, and it has more than one causal pathway. For a subgroup of socially anxious people with psychosis, anticipated harm is present and the processes that underlie its relationship with social anxiety warrant further investigation.
Social rejection in social anxiety disorder: the role of performance deficits, evoked negative emotions and dissimilarity
- Author:
- VONCKEN Marisol J.
- Journal article citation:
- British Journal of Clinical Psychology, 47(4), November 2008, pp.439-450.
- Publisher:
- Wiley
Patients with social anxiety disorder (SAD) not only fear social rejection, but accumulating evidence also shows that they are indeed less liked than their non-anxious counterparts. Three factors are hypothesized to play a role in this social anxiety-social rejection relationship: (1) social performance; (2) elicited negative emotions, and (3) perceived similarity. Patients with SAD (N=63) equation modelling (SEM), the results supported the social anxiety-social rejection relationship. More specifically, poor social performance was associated with perceived dissimilarity ratings and mediated by evoked negative emotions, both of which were in turn associated with social rejection. These results suggest that a sequence of events links social anxiety to social rejection. Treatment should aim
Low specificity of symptoms on the post-traumatic stress disorder (PTSD) symptom scale: a comparison of individuals with PTSD, individuals with other anxiety disorders and individuals without psychopathology
- Authors:
- ENGELHARD Iris M., ARNTZ Arnoud, van den HOUT Marcel A.
- Journal article citation:
- British Journal of Clinical Psychology, 46(4), November 2007, pp.449-456.
- Publisher:
- Wiley
... and those with other anxiety disorders or healthy controls. A between-participants design was employed. The participants were 65 individuals with PTSD, 40 individuals with other anxiety disorders and 40 healthy controls. They completed the PSS with respect to a range of stressful life-events. Using this instrument, 86% of individuals with PTSD and 5% of healthy controls endorsed sufficient symptoms to meet the PTSD diagnosis. This was also the case for 43% of individuals with other anxiety disorders, and self-reported symptoms related to traumatic events and aversive events that are generally not considered traumatic. The findings suggest that many people screened positive for PTSD may actually be suffering from another anxiety disorder.
Facial emotion processing in criminal psychopathy: preliminary functional magnetic resonance imaging study
- Authors:
- DEELEY Quinton, et al
- Journal article citation:
- British Journal of Psychiatry, 189(6), December 2006, pp.533-539.
- Publisher:
- Cambridge University Press
It has been suggested that people with psychopathic disorders lack empathy because they have deficits in processing distress cues (e.g. fearful facial expressions). The aim was to investigate brain function when individuals with psychopathy and a control group process facial emotion. Method Using event-related functional magnetic resonance imaging we compared six people scoring 25 on the Hare Psychopathy Checklist–Revised and nine non-psychopathic healthy volunteers during an implicit emotion processing task using fearful, happy and neutral faces. The psychopathy group showed significantly less activation than the control group in fusiform and extrastriate cortices when processing both facial emotions. However, emotion type affected response pattern. Both groups increased fusiform and extrastriate cortex activation when processing happy faces compared with neutral faces, but this increase was significantly smaller in the psychopathy group. In contrast, when processing fearful faces compared with neutral faces, the control group showed increased activation but the psychopathy group decreased activation in the fusiform gyrus. People with psychopathy have biological differences from controls when processing facial emotion, and the pattern of response differs according to emotion type.
Psychopathology in a large cohort of sexually abused children followed up to 43 years
- Authors:
- CUTAJAR Margaret C., et al
- Journal article citation:
- Child Abuse and Neglect, 34(11), November 2010, pp.813-822.
- Publisher:
- Elsevier
... for the majority of outcomes including psychosis, affective, anxiety, substance abuse, and personality disorders. Older age at sexual abuse and those exposed to more severe abuse were associated with greater risk for psychopathology. It is concluded that child sexual abuse is a substantial risk factor for a range of mental disorders in both childhood and adulthood.
Perceived responsibility for change as an outcome predictor in cognitive-behavioural group therapy
- Authors:
- DELSIGNORE Aba, et al
- Journal article citation:
- British Journal of Clinical Psychology, 47(3), September 2008, pp.281-293.
- Publisher:
- Wiley
Using a new validated instrument (Questionnaire on Control Expectancies in Psychotherapy, TBK), this study investigated whether and how perceived responsibility for change predicts favourable response to group cognitive-behavioural therapy in a sample of 49 outpatients with social anxiety disorder (SAD). Patient engagement and therapy-related self-efficacy were assessed as possible process variables. Among therapy-related control beliefs, low powerful others expectancies (towards the therapist) were found to be the strongest predictor for clinical improvement at follow-up. At a process level, analyses of mediation showed that powerful others expectancies predicted therapy engagement, which then influenced the degree of clinical improvement on social anxiety levels and global symptoms. The association between therapy-specific internality and outcome was confirmed for social anxiety at follow-up and was partially mediated by therapy-related self-efficacy. Findings confirm that therapy-related control beliefs predict psychotherapy process (patient engagement and therapy-specific self-efficacy) and outcome in cognitive-behavioural group therapy for SAD. Implications for clinicians and for future
Short-term psychodynamic psychotherapy: review of recent process and outcome studies
- Authors:
- LEWIS Andrew J, et al
- Journal article citation:
- Australian and New Zealand Journal of Psychiatry, 42(6), 2008, pp.445-455.
- Publisher:
- Blackwell Publishing
... as a treatment for generalised anxiety disorder, panic disorder and some personality disorders. However, there is very limited and inconclusive evidence on its use with eating disorders and drug dependency. Further process and outcome evaluations are needed, with broader assessment measures and longer term follow-up.
Generalised anxiety disorder
- Authors:
- GALE Christopher, DAVIDSON Oliver
- Journal article citation:
- British Medical Journal, 17.03.07, 2007, pp.579-581.
- Publisher:
- British Medical Association
Generalised anxiety disorder is a syndrome of ongoing anxiety and worry about many events or thoughts that the patient generally recognises as excessive and inappropriate. This article looks at the recent literature to gather research evidence on the diagnosis and treatment of anxiety disorder.
Dropout in institutional emotional crisis counseling and brief focused intervention
- Authors:
- MARINI M., et al
- Journal article citation:
- Brief Treatment and Crisis Intervention, 5(4), November 2005, pp.356-367.
- Publisher:
- Oxford University Press
The aim of this study was to assess which factors predict non-negotiated termination of treatment. Twenty six patients who dropped out of treatment were compared with 102 who concluded treatment. Logistic regression analysis identified borderline personality disorder as a predictor of dropout, which was associated with a mean age of less than 30 years, a prevalence of female gender, and the tendency to act out (dropout in the final sessions) and slightly correlated with a propensity for interpersonal deficits and lower resources or social support.