Children's self-talk under conditions of mild anxiety.

Lodge J, Harte DK, Tripp G.

University of Otago, Dunedin, New Zealand.

Two studies are described which used think-aloud (Study 1) and verbal thought-listing (Studies 1 and 2) procedures to assess preadolescent children's self-talk under conditions of mild anxiety. The self-talk reported was coded into six theoretically meaningful categories and the relationship between self-talk type and anxiety (state and trait) examined. Increased levels of anxiety were associated with higher rates of negative self-talk, but not clearly associated with other types of self-talk. These results suggest negative self-talk plays a role in the generation or maintenance of anxiety in normal children. From the data, it is unclear to what extent perceived task difficulty contributes to the relationship between trait anxiety and negative self-talk. Assessment of self-regulation (Study 1) identified higher levels of anxiety in children reporting awareness of strategies for managing their anxiety.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9560177&dopt=Abstract anxiety medicine




Testing the utility of the anxiety sensitivity construct in children and adolescents referred for anxiety disorders.

Weems CF, Hammond-Laurence K, Silverman WK, Ginsburg GS.

Child and Family Psychosocial Research Center, Florida International University, Miami 33199, USA.

Tested the utility of assessing anxiety sensitivity in children by investigating the incremental validity of the Childhood Anxiety Sensitivity Index (CASI) in a sample of clinic-referred children and adolescents ages 6 to 17 (N = 280). In the first test we examined whether the CASI would predict variance in trait anxiety beyond that predicted by measures of manifest anxiety and fear in children ages 6 to 11 (n = 202) and adolescents ages 12 to 17 (n = 78). In the next test, we examined whether the CASI would predict variance in fear beyond that predicted by a measure of trait anxiety for both age groups. In addition, age was tested as a continuous moderator of the CASI's incremental validity. No evidence was found to suggest that age systematically influences the CASI's incremental validity in the age ranges for which the CASI was designed. We discuss the results in terms of the utility of the CASI with younger and older age groups of children and the importance of such a measure for investigating the development of anxiety disorders in children.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9561939&dopt=Abstract anxiety medicine




The prevalence of comorbid anxiety in schizophrenia, schizoaffective disorder and bipolar disorder.

Cosoff SJ, Hafner RJ.

Royal Adelaide Hospital, Australia.

OBJECTIVE: The aim of this study to determine the prevalence of anxiety disorders in publically treated psychiatric inpatients with a DSM-IV diagnosis of schizophrenia, schizoaffective disorder or bipolar disorder. METHOD: Using the Structured Clinical Interview for DSM-III-R (SCID), 100 consecutive inpatients with a psychotic disorder were examined for the presence or absence of an anxiety disorder. Questionnaire measures of phobias, obsessive-compulsive and general anxiety symptoms were also applied. RESULTS: The prevalences of social phobia (17%), obsessive-compulsive disorder (13%) and generalised anxiety disorder in schizophrenia were relatively high, as were prevalences of obsessive-compulsive (30%) and panic disorder (15%) in bipolar disorder. The proportion of subjects with an anxiety disorder (43-45%) was almost identical across the three psychoses, with some evidence of gender differences. Although self-ratings of overall psychiatric symptoms were significantly elevated in those with anxiety disorders, hospital admission rates were not. CONCLUSIONS: Almost none of those with anxiety disorders were being treated for them, primarily because the severity of the acute psychotic illness required full diagnostic and therapeutic attention. Patients were generally discharged as soon as their psychotic episode was resolved, with little recognition of the presence of an anxiety disorder. Given that anxiety disorders are relatively responsive to treatment, greater awareness of their comorbidity with psychosis should yield worthwhile clinical benefits.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9565185&dopt=Abstract anxiety medicine




Anxiety and depression in patients receiving implanted cardioverter-defibrillators: a longitudinal investigation.

Hegel MT, Griegel LE, Black C, Goulden L, Ozahowski T.

Dartmouth Medical School, USA.

OBJECTIVE: The implantable cardioverter-defibrillator (ICD) has dramatically improved survival rates following sudden cardiac death episodes. However, researchers have devoted little attention to the psychosocial consequences of living with the device. The current study used a longitudinal design to evaluate the impact of adaptation to the ICD on incidence and severity of anxiety and depression. METHOD: ICD recipients were administered standardized anxiety and depression questionnaires as well as questions evaluating quality of life related to the ICD in two consecutive yearly assessments. A preliminary evaluation of potentially important theoretical variables, such as the perceived predictability and controllability of shock onset was also conducted. RESULTS: One-third of the study population (N = 38) had clinically significant levels of anxiety, depressed mood, and fear of symptoms of autonomic arousal. These negative affective states persisted over time, with 40 to 63 percent of subjects continuing to have ongoing difficulties over a one-year time period. Anxiety about the ICD firing was closely associated with the occurrence of depression, while avoidance of activities was associated with anxiety. "Worry" about the ICD and a belief that ICD firing can be predicted were associated with anxiety sensitivity. CONCLUSIONS: Depressive and anxiety states in ICD recipients may be frequent, clinically significant, and resistant to spontaneous resolution. Early signs of anxiety and depression in ICD recipients should be evaluated. Implications for future research are discussed.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9565714&dopt=Abstract anxiety medicine




Comorbidities and associated treatment charges in patients with anxiety disorders.

McLaughlin T, Geissler EC, Wan GJ.

Outcomes Research, NDCHealth, Phoenix, Arizona 85016, USA. Trent.McLaughlin ndchealth.com

OBJECTIVE: To describe comorbidities and treatment charges in patients receiving initial anxiolytic therapy for anxiety disorders. DESIGN: Retrospective data analysis. PATIENTS: Six thousand six hundred forty-seven patients with anxiety disorders. MEASUREMENTS AND MAIN RESULTS: Analysis was conducted using medical and pharmacy data for patients in 26 United States health plans from the PharMetrics Integrated Outcomes database. Data were collected for 12 months before and after the first anxiolytic prescription date (index date) during the study period (January 1, 1998-December 31, 2000). The sample comprised patients with a diagnosis of anxiety disorder whose original anxiolytic prescription had been refilled within 120 days. International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) codes and medical and prescription data identified the existence of comorbidities, and medical and prescription charges. The most common diagnoses of anxiety disorder were anxiety not otherwise specified (67%), panic disorder (14%), and generalized anxiety disorder (13%). The most commonly prescribed anxiolytics were benzodiazepines, such as alprazolam (43%) and lorazepam (27%). Hypertension was the most common nonpsychiatric comorbidity (22%) and depression the most common psychiatric comorbidity (37%). Other comorbidities observed were lipid disorders (17%), chronic obstructive pulmonary disease (9%), and asthma (7%). Total treatment charges 12 months before and after initial anxiety diagnosis and anxiolytic prescription were dollar 6279 and dollar 9270, respectively (p < 0.0001). CONCLUSION: Chronic conditions are commonly associated with anxiety disorders. Recognizing these psychiatric and nonpsychiatric comorbidities is important when treating patients with these disorders. Treatment charges are significantly higher when a patient is diagnosed with an anxiety disorder, highlighting the impact of anxiety on the total cost of treatment for these patients.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14594343&dopt=Abstract anxiety medicine




Worry versus anxiety. Is there really a difference?

Zebb BJ, Beck JG.

Texas Tech University, Department of Psychology, Lubbock 79409-2051, USA.

The similarities and distinctions between the constructs of worry and anxiety were examined in a sample of 189 university students. Three worry scales and four measures of anxiety were compared in relation to measures of negative affect, personal control, and problem-solving style. Although measures of worry and anxiety were highly correlated, negative affect (e.g. depression, confusion) tended to be more closely related to anxiety than to worry, whereas problem-solving style tended to be more closely related to worry than to anxiety. Personal control did not show a differential relationship to anxiety or worry. When the definition of anxiety was restricted to somatic anxiety, however, negative affect, perceived problem-solving abilities, and personal control were more strongly related to worry than to anxiety. Implications of these results are discussed in light of current definitions and measurement of these constructs.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9567736&dopt=Abstract anxiety medicine




Intimacy patterns and relationship satisfaction of women with eating problems and the mediating effects of depression, trait anxiety and social anxiety.

Evans L, Wertheim EH.

School of Psychology, La Trobe University, Bundoora, Melbourne, Australia.

The association between eating problems; and intimacy and relationship styles was examined. Young adult females (n = 360) completed the Adult Attachment Style (AAS), questionnaire; questions on satisfaction with intimacy; the Sexual Attitude Scale; items on sexual avoidance; a set of six descriptions for mother, friend, and partner; and measures of depression, general anxiety, social anxiety, and eating problems. Women with greater eating problems described more difficulties in intimate relationships including less satisfaction with closeness, more discomfort in close intimate relationships, and less positive descriptions of friend and mother. When depression, general anxiety, and social anxiety were entered first in a regression, intimacy measures no longer added unique variance. However, public self-consciousness predicted over and above general affect and social anxiety measures. Results were consistent with a mediator model in which intimacy difficulties for women with eating problems are explained by depression, trait anxiety, and public self-consciousness.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9587879&dopt=Abstract anxiety medicine




Influence of attention focus and trait anxiety on tolerance of acute pain.

James JE, Hardardottir D.

Department of Psychology, National University of Ireland, Galway, Ireland. j.james nuigalway.ie

OBJECTIVES: In light of inconsistencies in the reported effects of attention and anxiety on pain tolerance, this study examined the separate and combined effects of attention focus and trait anxiety on tolerance of acute experimental pain. DESIGN: Participants with 'high' and 'low' trait anxiety were assigned to three attention-focus conditions: pain-focused attention, 'undirected' (no experimenter-induced attempts to influence attention focus) and distraction. METHODS: Several indices of autonomic arousal (systolic and diastolic blood pressure, heart rate and EMG) were measured before and during, and several self-report inventories were completed before and after, each of two administrations of the cold pressor test. RESULTS: In general, pain tolerance was greater when participants were distracted and in low- rather than high-anxiety participants. However, attention and anxiety interacted such that low-anxiety participants were most pain tolerant, and high-anxiety participants were least pain tolerant, in the undirected condition. CONCLUSION: The results are consistent with the notion that anxiety fosters attentiveness to possible environmental threats, and might have implications for the clinical management of acute pain.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14596706&dopt=Abstract anxiety medicine




The prevalence and persistence of depression and anxiety following myocardial infarction.

Lane D, Carroll D, Ring C, Beevers DG, Lip GY.

School of Sport and Exercise Sciences, University of Birmingham, UK.

OBJECTIVES: This study was designed to assess the prevalence and persistence of symptoms of depression and anxiety during the first 12 months following acute myocardial infarction (MI). DESIGN AND METHODS: In a prospective study, 288 MI patients were assessed for symptoms of depression and anxiety using the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI) in hospital, 2-15 days following MI, and 4 and 12 months subsequently. RESULTS: During hospitalization, 89 (30.9%) and 75 (26.1%) patients registered elevated BDI scores (>/=10) and state anxiety scores (>/=40), respectively. The 4 and 12 month prevalence rates were 37.7% and 37.2% for depressive symptoms, and 41.8% and 40.0% for anxious symptoms, respectively. Depression and anxiety were highly co-morbid, with 51% of patients experiencing significant levels of depressive and anxious symptoms at baseline. More than half the patients with complete BDI and state anxiety data experienced either elevated symptoms of anxiety or depression throughout the first year following MI. CONCLUSIONS: Symptoms of depression and anxiety are prevalent, persistent problems during the first year following MI. This study highlights the importance of routine psychological assessment for MI patients both in hospital and after discharge.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14596714&dopt=Abstract anxiety medicine