FERGUSSON David M., HORWOOD L. John, BODEN Joseph M.
Journal article citation:
British Journal of Psychiatry, 189(6), December 2006, pp.540-546.
Publisher:
Cambridge University Press
Debate surrounds the underlying structure of internalising disorders including major depression, generalised anxiety disorder, phobias and panic disorders. The aim was to model the within-time and across-time relationships of internalising symptoms, incorporating effects from generalised internalising and disorder-specific components of continuity. Data were gathered from a 25-year longitudinal
Debate surrounds the underlying structure of internalising disorders including major depression, generalised anxiety disorder, phobias and panic disorders. The aim was to model the within-time and across-time relationships of internalising symptoms, incorporating effects from generalised internalising and disorder-specific components of continuity. Data were gathered from a 25-year longitudinal study of a birth cohort of 953 New Zealand children. Outcome measures included DSM–IV symptom scores for major depression, generalised anxiety disorder, phobia and panic disorder at the ages of 18, 21 and 25 years. Structural equation modelling showed that, within-times, a common underlying measure of generalised internalising explained symptom score comorbidities. Across-time correlation of symptom scores was primarily accounted for by continuity over time in generalised internalising. However, for major depression and phobia there was also evidence of across-time continuity in the disorder-specific components of symptoms. Internalising symptoms can be partitioned into components reflecting both a generalised tendency to internalising and disorder-specific components.
British Journal of Psychiatry, 179, November 2001, pp.456-459.
Publisher:
Cambridge University Press
Many patients with phobia/panic find it hard to access effective treatment. This study aims to test the feasibility of computer-guided exposure therapy for phobia/panic. Self-referrals were screened for 20 minutes and, if suitable, had six sessions of computer-guided self-help. At pre-treatment, computer-guided cases were slightly less severe than clinician-guided patients. In a post-treatment intent-to-treat analysis, both groups improved comparably but computer-guided patients spent 86% less time with a clinician than did purely clinician-guided patients, who had no access to the computer system. Concludes that computer-guided self-exposure therapy appeared feasible and effective for self-referrals and a controlled study is now needed.
Many patients with phobia/panic find it hard to access effective treatment. This study aims to test the feasibility of computer-guided exposure therapy for phobia/panic. Self-referrals were screened for 20 minutes and, if suitable, had six sessions of computer-guided self-help. At pre-treatment, computer-guided cases were slightly less severe than clinician-guided patients. In a post-treatment intent-to-treat analysis, both groups improved comparably but computer-guided patients spent 86% less time with a clinician than did purely clinician-guided patients, who had no access to the computer system. Concludes that computer-guided self-exposure therapy appeared feasible and effective for self-referrals and a controlled study is now needed.
Subject terms:
information technology, phobias, self-help groups, treatment, therapy and treatment, computers;
International Journal of Geriatric Psychiatry, 34(3), 2019, pp.397-407.
Publisher:
Wiley
Objectives: To provide an estimate of 12‐month and lifetime prevalence of Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM‐IV) anxiety disorders in older adults based on published studies on this topic and to identify the impact of gender and age. Methods/Design: A systematic review and meta‐analysis was performed. Six databases were searched, and manual searches through reference lists of selected articles and reviews were performed. When the information was available, summary effects were calculated for the prevalence of each anxiety disorder and for every age and gender subgroups. Summary odd ratios (OR) were calculated to compare the prevalence of an anxiety disorder according to age and gender. Results: A total of 6464 studies were identified, and 16 studies were included in the meta‐analyses. Prevalence was significantly higher in women than men for generalized anxiety disorder (12 month OR = 6.10, P = 0.001; lifetime OR = 1.96, P = 0.001), 12‐month social anxiety disorder (OR = 2.07, P = 0.01), and lifetime post‐traumatic stress disorder (OR = 1.93, P = 0.002). The prevalence of specific phobia was significantly lower in both the 75 to 84 and 85 years and above age groups when compared with the 65 to 74 years age group (OR = 0.70, P = 0.004 and OR = 0.63, P = 0.01, respectively). Conclusions: Our results suggest that the tendency for women to experience a greater prevalence of anxiety disorders remains present in older adults. Specific phobia was the only disorder to be less frequent with advancing age. This is likely to change with the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM‐5) criteria because this new DSM version now indicates that fear of falling is a possible type of specific phobia and fear of falling is generally more frequent in the oldest age groups.
(Edited publisher abstract)
Objectives: To provide an estimate of 12‐month and lifetime prevalence of Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM‐IV) anxiety disorders in older adults based on published studies on this topic and to identify the impact of gender and age. Methods/Design: A systematic review and meta‐analysis was performed. Six databases were searched, and manual searches through reference lists of selected articles and reviews were performed. When the information was available, summary effects were calculated for the prevalence of each anxiety disorder and for every age and gender subgroups. Summary odd ratios (OR) were calculated to compare the prevalence of an anxiety disorder according to age and gender. Results: A total of 6464 studies were identified, and 16 studies were included in the meta‐analyses. Prevalence was significantly higher in women than men for generalized anxiety disorder (12 month OR = 6.10, P = 0.001; lifetime OR = 1.96, P = 0.001), 12‐month social anxiety disorder (OR = 2.07, P = 0.01), and lifetime post‐traumatic stress disorder (OR = 1.93, P = 0.002). The prevalence of specific phobia was significantly lower in both the 75 to 84 and 85 years and above age groups when compared with the 65 to 74 years age group (OR = 0.70, P = 0.004 and OR = 0.63, P = 0.01, respectively). Conclusions: Our results suggest that the tendency for women to experience a greater prevalence of anxiety disorders remains present in older adults. Specific phobia was the only disorder to be less frequent with advancing age. This is likely to change with the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM‐5) criteria because this new DSM version now indicates that fear of falling is a possible type of specific phobia and fear of falling is generally more frequent in the oldest age groups.
(Edited publisher abstract)
Subject terms:
systematic reviews, older people, anxiety, gender, ageing, mental health problems, post traumatic stress disorder, phobias;
This guidance from the Department of Health follows NICE guidelines for people suffering from depression and anxiety disorders and is intended to help primary care trusts (PCTs) in commissioning or improving stepped care psychological therapies for this groups of patients.
This guidance from the Department of Health follows NICE guidelines for people suffering from depression and anxiety disorders and is intended to help primary care trusts (PCTs) in commissioning or improving stepped care psychological therapies for this groups of patients.
Subject terms:
phobias, treatment, therapies, therapy and treatment, access to services, behaviour therapy, commissioning, computers, Department of Health, depression;
Lancaster University. Institute for Health Research
Publication year:
2003
Pagination:
257p.
Place of publication:
Lancaster
This report draws on interviews with members of the United Kingdom National Phobics Society to explore the implications of the contested nature of specific phobias for their experience and perception. In common with other chronic and contested conditions such as Chronic Fatigue Syndrome, phobias are stigmatised and subjected to widespread judgmental attitudes in both medical and lay populations. In contrast, however, phobic experience is rarely characterised by difficulty in describing symptoms and obtaining a diagnosis: core fearful reaction to and avoidance of particular objects is usually obvious and uncontested. The crucial difference is that phobias are constituted by emotions and behaviours considered irrational and inconsequential, and it is their (perceived absence of) significance
This report draws on interviews with members of the United Kingdom National Phobics Society to explore the implications of the contested nature of specific phobias for their experience and perception. In common with other chronic and contested conditions such as Chronic Fatigue Syndrome, phobias are stigmatised and subjected to widespread judgmental attitudes in both medical and lay populations. In contrast, however, phobic experience is rarely characterised by difficulty in describing symptoms and obtaining a diagnosis: core fearful reaction to and avoidance of particular objects is usually obvious and uncontested. The crucial difference is that phobias are constituted by emotions and behaviours considered irrational and inconsequential, and it is their (perceived absence of) significance that raises questions and eyebrows. In other words, what does it matter and who cares if you happen to be scared of snakes? Using phobics’ own words as far as possible, the paper explores the processes through which phobic emotions are constructed as contested, and examines phobic means of managing experience and perception of these emotions. It reveals that many respondents are resourceful and resistant, continually renegotiating their positioning as irrational, incapable and emotionally weak.
Subject terms:
long term conditions, phobias, attitudes, behaviour, chronic fatigue syndrome, diagnosis, emotions, evidence;
The aim of the implementation guidance is to help the NHS make decisions on how they will implement NICE computerised cognitive behavioural therapy (cCBT) technology appraisal (TA097). TA097 was published in February 2006 and recommended the use of specific cCBT products for the management of mild and moderate depression as well as panic and phobia. PCTs are expected to be able to offer these products by 31 March 2007 and they are are: “Beating the Blues” for people with mild and moderate depression; and “FearFighter” for people with panic and phobia. The Guidance has been published by the Department of Health’s Improving Access to Psychological Therapies programme. It gives advice and timely support on how primary care trusts (PCTs) may provide cCBT to their local communities.
The aim of the implementation guidance is to help the NHS make decisions on how they will implement NICE computerised cognitive behavioural therapy (cCBT) technology appraisal (TA097). TA097 was published in February 2006 and recommended the use of specific cCBT products for the management of mild and moderate depression as well as panic and phobia. PCTs are expected to be able to offer these products by 31 March 2007 and they are are: “Beating the Blues” for people with mild and moderate depression; and “FearFighter” for people with panic and phobia. The Guidance has been published by the Department of Health’s Improving Access to Psychological Therapies programme. It gives advice and timely support on how primary care trusts (PCTs) may provide cCBT to their local communities.
Subject terms:
phobias, treatment, therapies, therapy and treatment, access to services, behaviour therapy, cognitive behavioural therapy, computers, Department of Health, depression;
British Journal of Psychiatry, 190(2), February 2007, pp.123-128.
Publisher:
Cambridge University Press
Although effective therapies for social phobia exist, many individuals refrain from seeking treatment owing to the embarrassment associated with help-seeking. Internet-based cognitive–behavioural self-help can be an alternative, but adherence is a problem. The aim was to evaluate a 9-week programme of internet-based therapy designed to increase treatment adherence by the addition of short weekly telephone calls, nine in all, with a total duration of 95 min. In a randomised controlled trial the effects of internet-based cognitive–behavioural therapy in the treatment group (n=29) were compared with a waiting-list control group (n=28). Compared with the control group the treated participants experienced greater reductions on measures of general and social anxiety, avoidance and depression. Adherence to treatment was high, with 93% finishing the complete treatment package. One year later all improvements were maintained. This study provides evidence to support the use of internet-based treatment supplemented by short, weekly telephone calls.
Although effective therapies for social phobia exist, many individuals refrain from seeking treatment owing to the embarrassment associated with help-seeking. Internet-based cognitive–behavioural self-help can be an alternative, but adherence is a problem. The aim was to evaluate a 9-week programme of internet-based therapy designed to increase treatment adherence by the addition of short weekly telephone calls, nine in all, with a total duration of 95 min. In a randomised controlled trial the effects of internet-based cognitive–behavioural therapy in the treatment group (n=29) were compared with a waiting-list control group (n=28). Compared with the control group the treated participants experienced greater reductions on measures of general and social anxiety, avoidance and depression. Adherence to treatment was high, with 93% finishing the complete treatment package. One year later all improvements were maintained. This study provides evidence to support the use of internet-based treatment supplemented by short, weekly telephone calls.
British Journal of Psychiatry, 184(5), May 2004, pp.448-449.
Publisher:
Cambridge University Press
In an open study, ten people with phobia or panic disorder who could not travel repeatedly to a therapist accessed a computer-aided exposure self-help system (FearFighter) at home on the internet with brief therapist support by telephone.They improved significantly, and their outcome and satisfaction resembled those in patients with similar disorders who used FearFighter in clinics with brief face-to-face therapist support.
In an open study, ten people with phobia or panic disorder who could not travel repeatedly to a therapist accessed a computer-aided exposure self-help system (FearFighter) at home on the internet with brief therapist support by telephone.They improved significantly, and their outcome and satisfaction resembled those in patients with similar disorders who used FearFighter in clinics with brief face-to-face therapist support.
Subject terms:
information technology, outcomes, phobias, psychiatry, self-help groups, therapies, therapy and treatment, agoraphobia;
British Medical Journal, 28.6.97, 1997, pp.1886-1889.
Publisher:
British Medical Association
Discusses the different characteristics of a number of anxiety disorders including agoraphobia, social phobia, panic disorder and post-traumatic stress disorder. Also summarises the treatment available.
Discusses the different characteristics of a number of anxiety disorders including agoraphobia, social phobia, panic disorder and post-traumatic stress disorder. Also summarises the treatment available.
Subject terms:
mental health, mental health problems, phobias, post traumatic stress disorder, stress, treatment, therapy and treatment, anxiety, depression, diagnosis;
NICE guideline offers best practice advice on the care of children and young people and adults (aged 18 years and older) with social anxiety disorder. Recommendations are provided in the following areas: improving access to services in mental health and general medical settings; identification and assessment for adults; intervention and treatment for adults; and interventions for children and young people. Both psychological and pharmacological interventions are covered. The guideline also provides recommendations for future research, which include CBT for children and young people with social anxiety disorder; the role of parents in the treatment of children and young people; and combined interventions for adults with social anxiety disorder. The guideline was developed by the National Collaborating Centre for Mental Health, based at the Royal College of Psychiatrists.
(Original abstract)
NICE guideline offers best practice advice on the care of children and young people and adults (aged 18 years and older) with social anxiety disorder. Recommendations are provided in the following areas: improving access to services in mental health and general medical settings; identification and assessment for adults; intervention and treatment for adults; and interventions for children and young people. Both psychological and pharmacological interventions are covered. The guideline also provides recommendations for future research, which include CBT for children and young people with social anxiety disorder; the role of parents in the treatment of children and young people; and combined interventions for adults with social anxiety disorder. The guideline was developed by the National Collaborating Centre for Mental Health, based at the Royal College of Psychiatrists.
(Original abstract)
Subject terms:
assessment, therapy and treatment, anxiety, phobias, intervention, cognitive behavioural therapy, adults, children, young people, medication, psychotherapy;