A longitudinal investigation of anxiety sensitivity in adolescence.

Weems CF, Hayward C, Killen J, Taylor CB.

Department of Psychology, University of New Orleans, Louisiana 70148, USA. cweems uno.edu

This investigation sought to expand existing knowledge of anxiety sensitivity in a sample of high school students (N = 2,365) assessed over 4 years. The stability of anxiety sensitivity levels across assessment periods was examined, and cluster analyses were used to identify different developmental pathways in levels of anxiety sensitivity. Groups of adolescents with stable low, stable high, and escalating anxiety sensitivity levels were identified. Adolescents with stable high or escalating anxiety sensitivity were significantly more likely to report experiencing a panic attack than individuals with stable low anxiety sensitivity. Results also indicated that Asian and Hispanic adolescents tended to report higher anxiety sensitivity but that their anxiety sensitivity was less strongly associated with panic than that of Caucasian adolescents.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12150423&dopt=Abstract anxiety medicine




Does the presence of anxiety affect the validity of a screening test for depression in the elderly?

Sinoff G, Ore L, Zlotogorsky D, Tamir A.

Department of Geriatrics, Carmel Medical Center, Haifa, Israel. sinoff netvision.net.il

INTRODUCTION: Depression in the elderly is frequently detected by screening instruments and often accompanied by anxiety. We set out to study if anxiety will affect the ability to detect depression by a screening instrument. OBJECTIVE: To validate the short Zung depression rating scale in Israeli elderly and to study the affect of anxiety on its validity. DESIGN: The short Zung was validated against a psychiatric evaluation, in a geriatric inpatient and outpatient service. The overall validity was determined, as well as for subgroups of sufferers and non-sufferers of anxiety. SETTING: An urban geriatric service in Israel. PATIENTS: 150 medical inpatients and outpatients, aged 70 years and older.MEASURES: Psychiatric evaluation of modified Anxiety Disorders Interview Schedule for DSM-IV as criterion standard for anxiety and depression and short Zung instrument for depression. RESULTS: By criterion validity, 60% suffered from depression. The overall validity of the short Zung was high (sensitivity 71.1%, specificity 88.3%, PPV 90.1%, NPV 67.1%). The validity for those not suffering from anxiety was good (sensitivity 71.1%, specificity 90.2%, PPV 84.4%, NPV 80.7%). In those with anxiety, sensitivity, specificity and PPV were high (71.2%, 77.8%, 94.9% respectively), although the specificity was less than in non-suffers. However major difference was in the NPV rate being much lower (31.8%). CONCLUSION: The short Zung, an easily administered instrument for detecting depression, is also valid in the Israeli elderly. However, anxiety limits the usefulness of this instrument in correctly ruling out depression. The clinician must be aware, therefore, that those suffering from anxiety may score negatively for depression on a screening instrument, such as the short Zung. Copyright 2002 John Wiley & Sons, Ltd.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11994883&dopt=Abstract anxiety medicine




Prediction of psychological reactions to bone density screening for osteoporosis using a cognitive-behavioral model of health anxiety.

Rimes KA, Salkovskis PM.

Department of Psychology, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London, UK. k.rimes iop.kcl.ac.uk

Pre-screening measures derived from a cognitive-behavioral theory of health anxiety were significant predictors of individual differences in post-screening reactions to a health screening procedure, bone densitometry. Predictors included specific illness beliefs (vulnerability, severity/consequences, coping and treatment) and general health anxiety measures. Three months after a low bone mineral density (BMD) result, women with high levels of pre-existing general health anxiety gave higher ratings of anxiety about osteoporosis and perceived likelihood of developing osteoporosis than women with low levels of preexisting health anxiety, even though the two groups' initial ratings had not differed significantly. Women with a low BMD result generally showed "minimization" of the seriousness of low BMD but women with very high levels of pre-existing health anxiety did not. After a high BMD result, highly health anxious women were only temporarily reassured. The results were consistent with the cognitive-behavioral analysis of health anxiety.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12002895&dopt=Abstract anxiety medicine




Maternal anxiety and depression, poverty and marital relationship factors during early childhood as predictors of anxiety and depressive symptoms in adolescence.

Spence SH, Najman JM, Bor W, O'Callaghan MJ, Williams GM.

School of Psychology, University of Queensland, Brisbane, Australia. s.spence psy.uq.edu.au

BACKGROUND: This paper examines the degree to which symptoms of anxiety and depression at age 14 years are associated with early childhood experience of maternal anxiety and depression, poverty, and mother's marital relationship distress and break-up. METHODS: In a longitudinal study, 4434 families were followed-up from infancy to adolescence. RESULTS: Maternal anxiety and depression during early childhood were found to have small, but significant, influences upon the development of high anxiety-depression symptoms at age 14, after controlling for the effects of poverty and marital relationship factors. This effect was greater with repeated exposure to high maternal anxiety and depression. Poverty, distressed marital relationship and marital break-up during the child's first five years also produced small, but significant, increases in risk of high anxiety and depression symptoms in adolescence. Stable, single-parent status was not found to be a risk factor. There was no evidence of marked gender differences in risk factors, other than poverty, which had a stronger impact for girls than boys. CONCLUSIONS: Overall, the results suggest that maternal anxiety and depression, poverty, parent relationship conflict and marital break-up during early childhood are associated with small, but significant, increased risk of anxiety-depression symptoms in adolescence.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12030592&dopt=Abstract anxiety medicine




Health perception, pain, and disability as correlates of anxiety and depression symptoms in primary care patients.

Wu LR, Parkerson GR Jr, Doraiswamy PM.

Department of Community and Family Medicine, Duke University Medical Center, Durham, NC 27710, USA.

BACKGROUND: Anxiety and depression occur frequently, and recognition of their symptoms can be difficult because of comorbid medical conditions. The purpose of this study was to analyze the relations among symptoms, diagnoses, and severity of illness as indicators of anxiety and depression in primary care. METHODS: This was an observational, cross-sectional study of adult patients in a large, academic family medicine clinic. Patients completed the Duke Health Profile, which measures health-related quality of life and screens for anxiety and depression. Providers recorded patient diagnoses and assessed severity of illness. RESULTS: Patients with higher levels of anxiety and depression symptoms were more likely to have the diagnoses of headache, osteoarthritis, abdominal pain, and diabetes mellitus. These diagnoses, however, were no longer highly associated with anxiety and depression after controlling for age, sex, payer status, perceived health, pain, and disability. The indicators of high anxiety and depression symptom levels that persisted after controlling for all the other variables were female sex, low perceived health, more pain, and greater disability. CONCLUSION: In a primary care setting, female sex, self-reported perceived health, pain, and disability were more predictive of anxiety and depression than any of the most prevalent medical illnesses. Primary care providers need to be knowledgeable about these health measures so they can recognize patients at risk for anxiety and depression regardless of their medical diagnoses.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12038724&dopt=Abstract anxiety medicine




Cognitive, affective, and physiological expressions of anxiety symptomatology among Mexican migrant farmworkers: predictors and generational differences.

Hovey JD, Magana CG.

Department of Psychology, University of Toledo, OH 43606, USA. jhovey utoledo.edu

Scant research has examined the mental health of migrant farmworkers in the United States. The purposes of the present study were threefold: to assess the prevalence levels of anxiety symptoms in a sample of Mexican migrant farmworkers in the Midwest United States; to examine the relationship between acculturative stress and anxiety; and to determine the variables that significantly predict anxiety. High levels were found for overall anxiety and in the cognitive, affective, and physiological expressions of anxiety. Elevated acculturative stress, low self esteem, ineffective social support, lack of control and choice in the decision to live a migrant farmworker lifestyle, low religiosity, and high education were significantly related to high anxiety levels. The overall findings suggest that Mexican migrant farmworkers who experience high acculturative stress may be at risk for developing anxiety-related disorders. The findings highlight the necessity of establishing prevention and treatment services for migrant farmworkers that increase levels of emotional support, self esteem, and coping skills.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12046676&dopt=Abstract anxiety medicine




Anxiety, affect, and activity in teenagers: monitoring daily life with electronic diaries.

Henker B, Whalen CK, Jamner LD, Delfino RJ.

Department of Psychology, University of California, Los Angeles, USA.

OBJECTIVE: The everyday experiences of a community sample of adolescents differing in anxiety level were compared by means of electronic diaries. METHOD: One hundred fifty-five ninth-grade adolescents completed electronic diaries every 30 minutes for two 4-day intervals, reporting their moods, activities, social settings, dietary intake, smoking, and alcohol use. Teenagers were stratified into low-, middle-, or high-anxiety groups on the basis of diary ratings and, separately, questionnaire scores. RESULTS: High-anxiety teenagers, compared with low-anxiety teenagers, expressed higher levels not only of anxiety and stress but also of anger, sadness, and fatigue, along with lower levels of happiness and well-being. They reported fewer conversations and less recreational activity relative to achievement-oriented pursuits, stronger eating and smoking urges, and more tobacco use. There were few gender differences. Despite a tendency to spend less time with peers, high-anxiety teenagers were more likely to show reduced anxiety when in the company of friends. Sharper differentiations among anxiety subgroups emerged when stratification was based on diary reports rather than on questionnaire scores. CONCLUSION: Even when anxiety problems fall below diagnostic thresholds, the daily lives of anxious adolescents differ meaningfully from those of their peers in affective, behavioral, and contextual domains.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12049440&dopt=Abstract anxiety medicine




Predicting anxious response to a social challenge: the predictive utility of the social interaction anxiety scale and the social phobia scale in a college population.

Gore KL, Carter MM, Parker S.

Department of Psychology, American University, Washington, DC 20016-8062, USA. kgorepsych aol.com

Trait anxiety is believed to be a hierarchical construct composed of several lower-order factors (Adv. Behav. Res. Therapy, 15 (1993) 147; J. Anxiety Disorders, 9 (1995) 163). Assessment devices such as the Social Interaction Anxiety Scale, the Social Phobia Scale (SIAS and SPS; Behav. Res. Therapy, 36 (4) (1998) 455), and the Anxiety Sensitivity Index (ASI; Behav. Res. Therapy, 24 (1986) 1) are good measures of the presumably separate lower-order factors. This study compared the effectiveness of the SIAS, SPS, ASI-physical scale and STAI-T (State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press (1970)) as predictors of anxious response to a social challenge (asking an aloof confederate out on a date). Consistent with the hierarchical model of anxiety, the measures of trait anxiety were moderately correlated with each other and each was a significant predictor of anxious response. The specific measures of trait social anxiety were slightly better predictors of anxious response to the social challenge than was either the ASI-physical scale or the STAI-T. The results provide evidence of the predictive validity of these social trait measures and some support for their specificity in the prediction of anxious response to a social challenge.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12051487&dopt=Abstract anxiety medicine




Uncertainty, anxiety, and symptoms of posttraumatic stress in parents of children recently diagnosed with cancer.

Santacroce S.

Yale University School of Nursing, 100 Churech Street South, PO Box 9740, New Haven, CT 06536-0740, USA. sheila.santacroce yale.edu

The purpose of the study was to describe relationships between uncertainty, anxiety, and symptoms of posttraumatic stress (PTS) in parents of children recently diagnosed with cancer. The study was guided by the Uncertainty in Illness Theory. The setting was a children's hospital. Participants were 15 parents of 12 children recently diagnosed with cancer. Anxiety was measured by the State-Trait Anxiety Inventory. Uncertainty was measured by the Parent Perception of Uncertainty Scale. Symptoms of PTS were measured by the Reaction Index. Total scale scores were calculated and psychometrics estimated. Differences in uncertainty, anxiety, and symptoms of PTS by parent race were assessed using analysis of variance. The correlation matrix was estimated to assess relationships between variables. The level of uncertainty was lower than expected, but was significantly higher for black parents (p < .001). The level of anxiety was comparable to that for hospitalized persons with anxiety disorders. The level of symptoms of PTS was higher than reported for parents of childhood cancer survivors. The relationship between anxiety and symptoms of PTS was significant (r =.56, p < .02). Pediatric oncology nurses should offer parents interventions to relieve high levels of anxiety and symptoms of PTS; some parents could also benefit from interventions that target uncertainty. Copyright 2002 by Association of Pediatric Oncology Nurses

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12066262&dopt=Abstract anxiety medicine