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The use of analogue samples, as opposed to clinical groups, is common in mental health research, including research on social anxiety disorder (SAD). Recent observational and statistical evidence has raised doubts about the validity of current methods for establishing analogue samples of individuals with clinically significant social anxiety. Here, we used data from large community samples of clinical and nonclinical participants to determine new cutoff scores on self-report measures of social anxiety symptoms and symptom-related impairment. We then examined whether using these newly determined cutoff scores alone or in combination improves the identification of individuals who have SAD from those who do not, revealing the most ideal cutoff combination to be 34 or above on the Social Phobia Inventory and 11 or above on the Sheehan Disability Scale. Finally, we compared the effects of our new cutoff scores with old cutoff scores by extracting analogue samples of participants with high social anxiety from historical data on seven large groups of undergraduate Psychology research participants from the authors' institution spanning the past 5 years (2018–2023). We observed that the new combined cutoff scores identified markedly fewer students as having high social anxiety, lending credibility to their utility. We also observed a striking increase in levels of social anxiety symptoms in the undergraduate population from before to after the COVID-19 pandemic. Of note, most participants were under 30 and identified as Caucasian or Asian women, indicating that future research is needed to examine whether our findings generalize to diverse populations. Public Significance Statement: To gain insights into clinical syndromes, mental health researchers routinely use cutoff scores on symptom questionnaires to study people from the population whose characteristics resemble those of people with mental disorders. The present study recommends the use of new, combined cutoff scores on commonly used measures of social anxiety symptoms and anxiety-related impairment to increase the validity and quality of research on social anxiety disorder, a prevalent and disabling problem. [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic skin disease associated with lower quality of life and higher risk of anxiety and depression in adults. We investigate whether adolescents with psoriasis also experience poorer mental health than their peers. In this cross-sectional study, we included questionnaire data on psoriasis and mental health from the 18-year follow-up of the Danish National Birth Cohort. We estimated odds ratios (OR) and 95 % confidence intervals (CI) using a logistic regression with inverse probability weighting to account for potential selection bias, adjusted for potential confounders identified a priori. We estimated associations between self-reported psoriasis and multiple aspects of mental health (self-rated health, life satisfaction, mental well-being, loneliness, overall and internalizing behavioral difficulties, depressive symptoms, and anxiety symptoms). In sensitivity analyses, we examined doctor-diagnosed psoriasis and psoriasis with and without joint pain. Of the 44,838 included in this study, 1147 (2.6 %) reported psoriasis. Adolescents with psoriasis had a higher risk of nearly all outcomes, including depressive symptoms (OR 1.38; 1.19–1.58) and panic/agoraphobia among both males (OR 1.72; 1.33–2.19) and females (OR 1.60; 1.33–1.92). Associations attenuated when restricted to doctor-diagnosed psoriasis. Associations with poor mental health were mainly observed for adolescents with psoriasis also reporting joint pain. We could not establish temporality and lacked data on joint pain in referents. Psoriasis is associated with poor mental health in adolescents. This appears to be driven by adolescents with psoriasis also reporting joint pain and is less evident in those with a doctor-confirmed diagnosis. • Psoriasis is associated with poor mental health in adolescents. • Even milder forms of psoriasis can impact young people's mental health. • Joint pain has a negative impact on the mental health of adolescents with psoriasis. [ABSTRACT FROM AUTHOR]

Objectives: Inequities in physical health outcomes exist for people with mental health and substance use conditions and for Indigenous populations (Māori in Aotearoa New Zealand). These inequities may be partly explained by poorer quality of physical healthcare services, including discrimination at systemic and individual levels. This study investigated the experiences of people with mental health and substance use conditions accessing physical healthcare and differences in service quality for non-Māori relative to Māori. Methods: A cross-sectional online survey of people with mental health and substance use conditions in New Zealand asked about four aspects of service quality in four healthcare settings: general practice, emergency department, hospital and pharmacy. The quality domains were: treated with respect; listened to; treated unfairly due to mental health and substance use conditions; mental health and substance use condition diagnoses distracting clinicians from physical healthcare (diagnostic and treatment overshadowing). Results: Across the four health services, pharmacy was rated highest for all quality measures and emergency department lowest. Participants rated general practice services highly for being treated with respect and listened to but reported relatively high levels of overshadowing in general practice, emergency department and hospital services. Experiences of unfair treatment were more common in emergency department and hospital than general practice and pharmacy. Compared to Māori, non-Māori reported higher levels of being treated with respect and listened to in most services and were more likely to report 'never' experiencing unfair treatment and overshadowing for all health services. Conclusion: Interventions to address discrimination and poor-quality health services to people with mental health and substance use conditions should be tailored to the physical healthcare setting. More needs to be done to address institutional racism in systems that privilege non-Māori. [ABSTRACT FROM AUTHOR]

This paper investigates the application of Virtual Reality Exposure Therapy (VRET) to treat agoraphobia, focusing on two pivotal research questions derived from identified gaps in current therapeutic approaches. The first question (RQ1) addresses the development of complex VR environments to enhance therapy's effectiveness by simulating real‐world anxiety triggers. The second question (RQ2) examines the differential impact of these VR environments on agoraphobic and nonagoraphobic participants through rigorous comparative analyses using t‐tests. Methodologies include advanced data processing techniques for electrodermal activity (EDA) and eye‐tracking metrics to assess the anxiety levels induced by these environments. Additionally, qualitative methods such as structured interviews and questionnaires complement these measurements, providing deeper insights into the subjective experiences of participants. Video recordings of sessions using Unity software offer a layer of data, enabling the study to replay and analyze interactions within the VR environment meticulously. The experimental results confirm the efficacy of VR settings in eliciting significant physiological and psychological responses from participants, substantiating the VR scenarios' potential as a therapeutic tool. This study contributes to the broader discourse on the viability and optimization of VR technologies in clinical settings, offering a methodologically sound approach to the practicality and accessibility of exposure therapies for anxiety disorders. [ABSTRACT FROM AUTHOR]

Background: Individuals with anxiety disorders (ADs) often display hypervigilance to threat information, although this response may be less pronounced following psychotherapy. This study aims to investigate the unconscious recognition performance of facial expressions in patients with panic disorder (PD) posttreatment, shedding light on alterations in their emotional processing biases. Methods: Patients with PD (n=34) after (exposure-based) cognitive behavior therapy and healthy controls (n=43) performed a subliminal affective recognition task. Emotional facial expressions (fearful, happy, or mirrored) were displayed for 33 ms and backwardly masked by a neutral face. Participants completed a forced choice task to discriminate the briefly presented facial stimulus and an uncovered condition where only the neutral mask was shown. We conducted a secondary analysis to compare groups based on their four possible response types under the four stimulus conditions and examined the correlation of the false alarm rate for fear responses to non-fearful (happy, mirrored, and uncovered) stimuli with clinical anxiety symptoms. Results: The patient group showed a unique selection pattern in response to happy expressions, with significantly more correct "happy" responses compared to controls. Additionally, lower severity of anxiety symptoms after psychotherapy was associated with a decreased false fear response rate with nonthreat presentations. Conclusion: These data suggest that patients with PD exhibited a "happy-face recognition advantage" after psychotherapy. Less symptoms after treatment were related to a reduced fear bias. Thus, a differential facial emotion detection task could be a suitable tool to monitor response patterns and biases in individuals with ADs in the context of psychotherapy. [ABSTRACT FROM AUTHOR]

Anxiety disorders are among the most common disorders in early childhood. Although many older children and adolescents with anxiety disorders recover and remain well, little is known about the continuity of early childhood anxiety and the factors that predict persistence/recurrence in later childhood and adolescence. We followed 129 children who met anxiety disorder criteria at age 3 and/or 6 and determined how many continued to experience an anxiety disorder between age 7 and 15, as well as the continuity of specific anxiety disorders. We explored whether biological sex, number of anxiety disorders, early childhood persistence (i.e., anxiety diagnosis at both age 3 and 6), childhood comorbidities, temperamental behavioral inhibition, a maternal history of anxiety, and authoritarian and overprotective parenting predicted persistence/recurrence of an anxiety disorder from age 7 to 15. Sixty-five (50.4%) of the adolescents with an early childhood anxiety disorder met anxiety disorder criteria during the age 7–15 interval. Homotypic continuity from early childhood to school-age/mid-adolescence was observed for social anxiety disorder, separation anxiety disorder, and generalized anxiety disorder (GAD). Early childhood agoraphobia predicted school-age/mid-adolescent GAD and early childhood GAD predicted school-age/mid-adolescent specific phobia. In bivariate analyses, number of anxiety disorders, persistence of anxiety from age 3 to 6, and having a mother with a history of anxiety predicted the persistence/recurrence of anxiety disorders from age 7 to 15. Only early childhood persistence of anxiety uniquely predicted the persistence/recurrence of an anxiety disorder over and above the other predictors. Early intervention efforts should focus on identifying and intervening with young children who demonstrate a protracted course of anxiety. [ABSTRACT FROM AUTHOR]

Cardiac arrest (CA)-induced cerebral ischemia remains challenging with high mortality and disability. Neural stem cell (NSC) engrafting is an emerging therapeutic strategy with considerable promise that, unfortunately, is severely compromised by limited cell functionality after in vivo transplantation. This groundbreaking report demonstrates that metabolic glycoengineering (MGE) using the "Ac5ManNTProp (TProp)" monosaccharide analog stimulates the Wnt/β-catenin pathway, improves cell adhesion, and enhances neuronal differentiation in human NSCs in vitro thereby substantially increasing the therapeutic potential of these cells. For the first time, MGE significantly enhances NSC efficacy for treating ischemic brain injury after asphyxia CA in rats. In particular, neurological deficit scores and neurobehavioral tests experience greater improvements when the therapeutic cells are pretreated with TProp than with "stand-alone" NSC therapy. Notably, the TProp-NSC group exhibits significantly stronger neuroprotective functions including enhanced differentiation, synaptic plasticity, and reduced microglia recruitment; furthermore, Wnt pathway agonists and inhibitors demonstrate a pivotal role for Wnt signaling in the process. These findings help establishMGE as a promising avenue for addressing current limitations associated with NSC transplantation via beneficially influencing neural regeneration and synaptic plasticity, thereby offering enhanced therapeutic options to boost brain recovery following global ischemia. [ABSTRACT FROM AUTHOR]

This study aimed to detect alterations in interhemispheric interactions in patients with panic disorder (PD), determine whether such alterations could serve as biomarkers for the diagnosis and prediction of therapeutic outcomes, and map dynamic changes in interhemispheric interactions in patients with PD after treatment. Fifty-four patients with PD and 54 healthy controls (HCs) were enrolled in this study. All participants underwent clinical assessment and a resting-state functional magnetic resonance imaging scan at (i) baseline and (ii) after paroxetine treatment for 4 weeks. A voxel-mirrored homotopic connectivity (VMHC) indicator, support vector machine (SVM), and support vector regression (SVR) were used in this study. Patients with PD showed reduced VMHC in the fusiform, middle temporal/occipital, and postcentral/precentral gyri, relative to those of HCs. After treatment, the patients exhibited enhanced VMHC in the lingual gyrus, relative to the baseline data. The VMHC of the fusiform and postcentral/precentral gyri contributed most to the classification (accuracy = 87.04%). The predicted changes were accessed from the SVR using the aberrant VMHC as features. Positive correlations (p < 0.001) were indicated between the actual and predicted changes in the severity of anxiety. These findings suggest that impaired interhemispheric coordination in the cognitive–sensory network characterized PD and that VMHC can serve as biomarkers and predictors of the efficiency of PD treatment. Enhanced VMHC in the lingual gyrus of patients with PD after treatment implied that pharmacotherapy recruited the visual network in the early stages. [ABSTRACT FROM AUTHOR]

Objective: Few long‐term studies have examined the life‐time prevalence of comorbid psychiatric conditions in patients with obsessive‐compulsive disorder (OCD). We therefore studied the frequency of comorbid psychiatric disorders, and their relation to onset and prognosis, in patients with OCD who were followed for almost half a century. Methods: During 1947–1953, 285 OCD patients were admitted as inpatients to a university hospital in Gothenburg, Sweden. Among those, 251 (88%) accepted a structured comprehensive psychiatric examination in 1954–1956. In 1989–1993, 176 survivors were eligible and 144 (response rate 82%) were re‐examined. The same psychiatrist performed both examinations. OCD was diagnosed according to the Schneider criteria, and other mental disorders according to DSM‐IV. Mean follow‐up since onset was 47 years. Results: The lifetime frequency of depressive disorders was 84.7% (major depression 43.8%), generalized anxiety disorder (GAD) 71.5%, panic anxiety disorder 47.9%, agoraphobia 52.1%, specific phobias 64.6%, social phobia 47.9%, paranoid conditions 40.3% (29.1% paranoid ideation), psychotic disorders 15.3%, alcohol abuse 13.2% (men 39%, women 3%) and substance abuse 17.4%. Specific phobia most often started before OCD, while depression had a varied onset in relation to OCD. Social phobia, agoraphobia, GAD, alcohol and substance abuse, psychotic disorders and paranoid conditions most often started after OCD. Presence of GAD, psychotic disorder and substance abuse worsened prognosis of OCD. Conclusion: Comorbid psychiatric conditions are common in OCD patients, and have onset throughout the course. OCD signals vulnerability for other psychiatric conditions, which are important to detect in clinical practice as they negatively affect the outcome. [ABSTRACT FROM AUTHOR]

Anxiety-related disorders feature elevated negative affect (NA), and in some cases, diminished positive affect (PA). It remains unclear how well extant psychotherapies for anxiety-related disorders improve PA versus NA. We systematically searched the Cochrane Central Register of Controlled Trials, PubMed, PsychInfo, and Web of Science databases. Records included studies involving (1) patients with a principal or co-principal diagnosis of at least one anxiety-related disorder (i.e., generalized anxiety, social anxiety, panic, agoraphobia, health anxiety, specific phobia, obsessive-compulsive disorder, or posttraumatic stress disorder), and (2) pre- and post-treatment PA and NA scores or a change index between pre- and post-treatment PA and NA scores. Effect sizes were calculated for meta-analyses. Fourteen studies with 1001 adults with an anxiety-related disorder were included. Psychotherapeutic interventions included cognitive behavioral, present-centered, and imagery-based approaches. Treatments reduced NA (g = −0.90; 95%CI [−1.19, −0.61]) to a greater extent than they improved PA (g = 0.27; 95%CI [0.05, 0.59]), Z = −5.26, p <.001. The limited number of studies available precluded analyses of the relationship between changes in affect and symptoms. Results should be considered with caution given the small number and heterogeneity of included studies. Current psychotherapeutic interventions for anxiety-related disorders may not improve PA and NA to comparable levels. • Systematic review and meta-analysis of the effect of psychotherapies on affective change for anxiety-related disorders. • There is a large effect of improvement in negative affect (g = −0.90). • There is a small effect of improvement in positive affect (g = 0.27). • Extant psychotherapies for anxiety-related disorders repair negative affect to a greater extent than positive affect. [ABSTRACT FROM AUTHOR]

Background: The ever-increasing spread of Internet-based systems for common mental disorders has generated the need for brief online screening methods. This study aims to test the psychometric properties of the Web Screening Questionnaire (WSQ) to examine its suitability for screening for common mental health problems among a community sample of Italian adults. Methods: A total of 1282 subjects (F = 819; mean age = 42.05) answered the WSQ. Its discriminant characteristics were examined with other validated selected scales for measuring mental health widely used in the Italian population using sensitivity, specificity, and area under the curve (AUC), as well as positive (PPV) and negative predictive values (NPV). Results: Most of the WSQ subscales exhibited moderate to high specificity values. Specifically, the scales of 'agoraphobia' (0.947; 95%CI [0.934, 0.960]), 'anxiety' (0.959; 95%CI [0.946, 0.970]), and 'panic disorder' (0.973; 95%CI [0.964, 0.981]) showed the highest values whilst the 'obsessive-compulsive' dimension had the lowest value at 0.838, 95%CI [0.815, 0.861]. With exceptions observed for 'depression' (0.716; 95%CI [642, 798]) and 'alcohol abuse' (0.760; 95%CI [560, 920]), instead, the WSQ demonstrated critical sensitivity values (<0.6) in all dimensions. Conclusions: The WSQ was appropriate for discriminating between people with and without a psychiatric condition, as it helps to confirm the absence of disorders. However, further diagnostic procedures are required, in case of a positive WSQ screening result. [ABSTRACT FROM AUTHOR]

This paper describes the anxiety evoked in a patient threatened by invasion or engulfment by his object on the one hand, and the fears of isolation and abandonment on the other. The author illustrates the patient's strugles to find a distance between himself and his object he can tolerate. The analyst has also to cope with the anxieties evoked by the patient's projections, and find a distance between himself and his patient that enables him to think and work. [ABSTRACT FROM AUTHOR]

Sleep and physical activity suggestions for panic disorder (PD) are critical but less surveyed. This two-year prospective cohort study aims to predict panic attacks (PA), state anxiety (SA), trait anxiety (TA) and panic disorder severity (PDS) in the upcoming week. We enrolled 114 PD patients from one general hospital. Data were collected using the DSM-5, the MINI, clinical app questionnaires (BDI, BAI, PDSS-SR, STAI) and wearable devices recording daily sleep, physical activity and heart rate from 16 June 2020 to 10 June 2022. Our teams applied RNN, LSTM, GRU deep learning and SHAP explainable methods to analyse the data. The 7-day prediction accuracies for PA, SA, TA, and PDS were 92.8 %, 83.6 %, 87.2 %, and 75.6 % from the LSTM model. Using the SHAP explainable model, higher initial BDI or BAI score and comorbidities with depressive disorder, generalized anxiety disorder or agoraphobia predict a higher chance of PA. However, PA decreased under the following conditions: daily average heart rate, 72–87 bpm; maximum heart rate, 100–145 bpm; resting heart rate, 55–60 bpm; daily climbing of more than nine floors; total sleep duration between 6 h 23 min and 10 h 50 min; deep sleep, >50 min; and awake duration, <53 min. Moderate sample size and self-report questionnaires were the limitations. Deep learning predicts recurrent PA and various anxiety domains with 75.6–92.8 % accuracy. Recurrent PA decreases under adequate daily sleep and physical activity. • LSTM deep learning achieves 75.6–92.8 % accuracy in PA prediction. • Optimal sleep and activity ranges for PA prevention identified via SHAP. • Baseline depression and anxiety impact PD prognosis negatively. • Common PA symptoms: chest tightness, dizziness, palpitations, breathlessness. [ABSTRACT FROM AUTHOR]

Introduction: Elderly prisoners are a minority in the prison population but their number is increasing compared to other groups. Mental health problems in elderly prisoners can be caused by the length of the detention period, being separated from family and partners, and conflicts that occur between inmates in prison which worsen the mental health conditions of elderly prisoners. Research on mental health problems in elderly prisoners is also still limited. Method: A scoping review study design was used. Articles searched through PubMed, EBSCO, ProQuest, Sage Journal, and Google Scholar. Articles published from 2000 to 2023. The keywords used in English are "Elderly", "Mental Health Problems", and "Prisoners. Results: Of the nine articles analyzed, we found the mental health problems of elderly prisoners were anxiety, agoraphobia, depression, bipolar, personality disorders, post-traumatic stress disorder, suicide risk, mood disorders, psychosis spectrum disorders or schizophrenia, and alcohol abuse or dependence. Conclusions: Based on several findings, it is recommended for further research focus on providing appropriate interventions for elderly prisoners who experience mental health problems, as well as identifying the extent of mental health services for elderly prisoners. [ABSTRACT FROM AUTHOR]

Introduction: The role of catechol-O-methyltransferase (COMT) in catecholamine neurotransmitter metabolism has led to the investigation of variants of the corresponding gene in the etiology of different psychiatric disorders, but the results are inconclusive. Methods: We have examined the relationship between COMT Val158Met single nucleotide polymorphism (rs4680) and the occurrence of psychiatric disorders in a highly representative birth cohort sample of young adults in the Estonian Children Personality Behaviour and Health Study (original n = 1,238). The lifetime occurrence of psychiatric disorders at the age of 25 years was assessed with the Mini-International Neuropsychiatric Interview. Results: Both Val- and Met-alleles of the COMT Val158Met were associated with specific psychiatric disorders. Met-allele carriers had a significantly higher occurrence of agoraphobia (3.2% vs. 0.5%; χ2 = 4.10; p < 0.05) compared to Val/Val homozygotes. Also, the occurrence of panic disorder was significantly higher in female Met-allele carriers than in Val/Val homozygote females (10.2% vs. 3.6%; χ2 = 4.62 p = 0.03). In contrast, the occurrence of generalized anxiety disorder was higher in Val/Val females when compared to Met-allele carriers (12.7% vs. 6.8%; χ2 = 4.16; p = 0.04). Also, female Val/Val homozygotes (15.5%) had a higher occurrence of eating disorders than Met-allele carriers (6.1%) of the COMT Val158Met polymorphism (χ2 = 10.39; p = 0.002). In the whole sample, Met-allele homozygotes had a higher occurrence of alcohol use and substance use disorders than Val-allele carriers (χ2 = 3.62 and 3.68, respectively; p < 0.05). Conclusion: In a regional highly birth cohort representative sample, either COMT rs4680 variant was observed in association with specific psychiatric disorders. [ABSTRACT FROM AUTHOR]

Background: This study was developed to determine the effectiveness of transcutaneous auricular vagus nerve stimulation and Jacobson relaxation technique on agoraphobia among subjects with post neurological ill-patients. Purpose: The purpose of the study is to compare and evaluate the effectiveness of two non-pharmacological methods of treatment for Agoraphobia patients with Post neurological ill-patients. Methods: The research project was conducted as a pilot study in a private hospital in Chennai. The experimental group (group A) received transcutaneous auricular vagus nerve stimulation for approximately 20 minutes (30 seconds ON and 5 minutes OFF) and a conventional Jacobson relaxation technique for 10 minutes. Group B got conventional cognitive behavioral therapy (20 minutes) and the Jacobson relaxation technique (10 minutes). Following the four-week treatment period, a post-test analysis was performed using the Severity measure of agoraphobia. Results: The study found that there is a positive impact of transcutaneous auricular vagus nerve stimulation and Jacobson relaxation technique on agoraphobia in post neurological ill patients. The analysis obtained a mean value of about 18 and an SD of 26 for group A, whereas group B revealed 24.8 ± 4.40, mean ± SD, and a significant P value of <0.001. Conclusion: When compared to group B, those in group A who received transcutaneous auricular vagus nerve stimulation improved more significantly when dealing with agoraphobia of post neurological ill patients. As a result, non-invasive transcutaneous auricular vagus nerve stimulation and Jacobson relaxation technique have been proven to be effective approaches for preventing agoraphobia. [ABSTRACT FROM AUTHOR]

Virtual reality (VR) has become a widely used tool in neuroscience, with applications in enhancing spatial memory. VR can simulate real-world environments, helping individuals with navigation difficulties such as neurodegenerative disorders, brain damage, and psychological diseases. It can also be used in educational settings to improve spatial memory and learning. The use of VR in healthcare, architecture, education, and entertainment has extensive benefits, improving spatial memory and cognitive skills. This special issue includes studies on VR and spatial memory, investigating factors that affect spatial navigation and the use of VR in diagnosing and treating agoraphobia. [Extracted from the article]

Although panic disorder has been frequently associated with increased suicidal ideation and behaviors, there are multiple explanations for this association in the literature. For example, some research has demonstrated panic disorder symptoms to mediate agoraphobia and suicidal ideation, while other researchers have hypothesized that comorbid depression symptoms contribute to suicidal ideation across anxiety disorders. Of note, none of these studies were completed in veterans, a population at higher risk for suicide relative to civilian samples. The present study investigated relations between the symptoms of panic, agoraphobia, depression, and suicidal ideation in 58 veterans diagnosed with panic disorder via correlations, hierarchical regression, and exploratory path analyses. Multiple models were investigated based on prior research. The final path model demonstrated that symptoms of panic disorder predicted agoraphobia symptoms, with agoraphobia predicting symptoms of depression. Symptoms of depression, then, predicted suicidal ideation. Discussion of the findings related to comorbid depressive symptoms highlight considerations for the assessment and treatment practices for panic disorder, with a particular focus on veterans receiving care within Veterans Affairs Healthcare System. [ABSTRACT FROM AUTHOR]

The current conceptualization of anxiety in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)—which includes 11 anxiety disorders plus additional anxiety-related conditions—does not align with accumulating evidence that anxiety is transdiagnostic and dimensional in nature. Transdiagnostic dimensional anxiety models have been proposed, yet they measure anxiety at either a very broad (e.g., "anxiety") or very narrow (e.g., "performance anxiety") level, overlooking intermediate properties of anxiety that cut across DSM disorders. Using indicators from a well-validated semistructured interview of anxiety-related disorders, we constructed intermediate-level transdiagnostic dimensions representing the intensity, avoidance, pervasiveness, and onset of anxiety. We captured these content-agnostic dimensions in a sample representing varying levels and forms of anxiety (N = 268), including individuals with generalized anxiety disorder, social anxiety disorder, panic disorder, agoraphobia, specific phobia, separation anxiety disorder, posttraumatic stress disorder, and obsessive–compulsive disorder (n = 205) and individuals with no psychopathology (n = 63). In preregistered analyses, our dimensional anxiety model showed noninferiority to DSM-5 diagnoses in predicting concurrent and prospective measures of anxiety-related impairment, anxiety vulnerabilities, comorbid depression, and suicidal ideation. These results held regardless of whether the dimensions were combined into a single composite or retained as separate components. Our transdiagnostic dimensional model offers meaningful gains in parsimony over DSM, with no loss of predictive power. This project provides a methodological framework for the empirical evaluation of other transdiagnostic dimensional models of psychopathology that have been proposed as alternatives to the DSM. General Scientific Summary: The current classification of anxiety is cumbersome; does not align with evidence that anxiety problems cut across disorder categories; and fails to acknowledge that the severity of anxiety matters, even at low levels. We developed a new classification that distills key features of anxiety—intensity, avoidance, pervasiveness, and onset—across disorders, allowing any individual to be located along a gradient from none to severe for each feature. This transdiagnostic dimensional approach is much simpler than the current Diagnostic and Statistical Manual of Mental Disorders (DSM) approach to anxiety, incorporates information about severity, and performs just as well as DSM diagnoses in predicting important clinical outcomes. [ABSTRACT FROM AUTHOR]

Background: High resistance-to-treatment rates in obsessive-compulsive disorder (OCD) and various treatments remain significant obstacles to psychiatric disorder treatments. Objectives: The current study used network analysis to predict treatment response by psychiatric symptoms in the contamination/cleaning and danger/checking OCD subtypes. Methods: We evaluated 136 patients (mean age: 30.50 ± 5.25) who finished a 12-week selective serotonin reuptake inhibitor (SSRI) course. We used the convenience sampling method. All patients completed structured clinical interviews for the diagnostic and statistical manual of mental disorders, fifth edition research version (SCID-5-RV) at baseline and post-test. After treatment completion, the patients were categorized as responders and resistant according to their OCD severity scores (at the post-test). We used a network approach to determine the network structure of patients before and after the treatment. Network analysis was used by "the Rprogramming language" to compare patterns of psychiatric symptoms. Additionally, we contrasted treatment-responsive patients' network structure with treatment-resistant OCD patients in each subtype. Results: In baseline, dysthymia, insomnia, binge eating, agoraphobia, and panic were the most central (important) nodes in the danger/checking subtype. However, hoarding, ADHD, insomnia, depression, and panic were the most central nodes in the contamination/cleaning group at baseline. Also, global strength and symptom connectivity were higher in the contamination/cleaning subtype than in the danger/check subtype (P < 0.05). In the contamination/cleaning subtype, "insomnia" was the most significant predictor for categorizing patients as resistant at the post-test. For contamination/cleaning, panic and binge eating played similar roles in treatment outcomes. Conclusions: Psychiatric symptoms can predict treatment responses in OCD subtypes. So, it is necessary to consider psychiatric comorbidities regarding OCD subtypes. [ABSTRACT FROM AUTHOR]

Background: Anxiety disorders are commonly diagnosed and cause substantial functional impairment. A mixture of pharmaco)logic and psychosocial treatments currently exists, but these treatments are not always tolerable and effective. For patients with anxiety resistant to standard therapy, psychedelics may be a promising alternative. This review assesses the therapeutic benefits and safety of psychedelics in treating anxiety disorders. Methods: We searched PubMed, Embase, PsycInfo, and CINAHL for clinical trials investigating psychedelics in patients with clinician-diagnosed generalized anxiety disorder, social anxiety disorder, specific phobia, separation anxiety disorder, selective mutism, panic disorder, agoraphobia, and anxiety attributable to another medical condition. We analyzed data from 9 indepen)dent psychedelic-assisted trials testing ayahuasca (1 study), ketamine (4 studies), lysergic acid diethylamide (LSD) (2 studies), 3,4- methylenedioxymethamphetamine (MDMA) (1 study), and psilocybin (1 study). Efficacy was assessed by measuring the change in outcome measures and the quality of life from baseline. Results: The reviewed studies demonstrated encouraging efficacy in reducing anxiety symptoms, increasing self-perception, and increasing social function in patients with generalized anxiety disorder, social anxiety disorder, or anxiety attributable to another medical condition while establishing feasibility and evidence of safety. For many patients, the therapeutic effects of the psychedelic treatment lasted weeks, and no severe adverse events were reported. Conclusion: Based on the evidence of symptom reduction and safety, the current literature (2011 to 2021) shows that psychedelics could be considered for treating clinician-diagnosed anxiety disorders. Psychedelics may provide an alternative therapeutic option for patients resistant to current standard treatments. [ABSTRACT FROM AUTHOR]

Autistic people experience high rates of co-occurring psychiatric diagnoses. Current prevalence estimates vary considerably due to an over-reliance on clinical cohorts and the longitudinal stability of diagnoses from childhood into adolescence is poorly understood. This study aims to provide prevalence rates of co-occurring DSM-5 psychiatric diagnosis for autistic adolescence and investigate, for the first time, the stability of diagnoses from childhood. Using a longitudinal stratified sample of autistic youth (N = 77; 13–17 years; 60% male), selected from a larger community-derived sample of those with pre-existing autism diagnoses (N = 277) weighted prevalence estimates of emotional (anxiety, depression), behavioural (oppositional and conduct disorders) and ADHD diagnoses were calculated based on semi-structured psychiatric interview. Prediction of adolescent psychiatric diagnosis based on childhood diagnostic status, sex, childhood IQ (both assessed at age 4–10 years) was tested. Emotional and behavioural disorders in adolescence were particularly prevalent, and significantly predicted by childhood disorder status. Attention-deficit/hyperactivity-disorder (ADHD) was prevalent but not predicted by childhood ADHD diagnosis. Neither sex nor childhood IQ predicted diagnostic outcomes. Autistic youth have high levels of co-occurring psychiatric conditions, which are broadly persistent across childhood and adolescence. Emotional disorders are particularly prevalent and remain persistent from childhood to adolescence. Greater diagnostic variability was found for ADHD with more adolescents moving across diagnostic thresholds. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to compare the clinical features of panic disorder (PD) with comorbid agoraphobia to those of PD alone. We focused on autonomic nervous system (ANS) alterations reflected in heart rate variability (HRV) and executive function deficits reflected in the Stroop test. Materials and Methods: We retrospectively compared psychometric features, Stroop test results, and resting-state HRV across three groups: a subclinical group with anxiety attack history, a PD group without agoraphobia, and a PD group with agoraphobia. The subclinical group included 10 male and 34 female, the PD without agoraphobia group included 17 male and 19 female, and the PD with agoraphobia group included 11 male and 18 female. Results: The PD with agoraphobia group had higher Symptom Checklist–95 scores than the other groups. Both PD groups had longer reaction times in the Stroop test than the subclinical group. There were no significant differences in HRV parameters between the PD groups with and without agoraphobia. Compared with the subclinical group, the PD with agoraphobia group showed significantly lower values of the natural logarithm of low-frequency HRV. Conclusion: Our results do not support that executive function deficits and ANS alterations are more pronounced with comorbid agoraphobia among PD groups. However, PD with agoraphobia patients showed more complex and severe clinical symptoms in their self-reports. Compared with the subclinical group, PD patients with agoraphobia showed specific features in the natural logarithm of low-frequency HRV. Our findings suggest that agoraphobia comorbidity should be considered when evaluating or treating patients with PD. [ABSTRACT FROM AUTHOR]

Anxiety disorders are the most prevalent disorders among youth and understanding cognitive vulnerabilities for these disorders is crucial for early prevention and treatment. The present study examined the role of intolerance of uncertainty (IU) in predicting the severity of anxiety disorder symptoms among a sample of Iranian youth. The relationships between IU and anxiety disorder symptoms among youth [N = 683, ages 8–18, M (SD)age= 14.02 (2.43); 58.07% girls] with and without anxiety disorders, and their parents [N = 676, ages 27–58, M (SD)age= 40.63 (5.72); 61.8% female], were examined. Significant associations were found between youth- and parent-report IU and youth anxiety disorder symptoms. Youth with higher scores on total IU and prospective/inhibitory IU dimensions had significantly higher levels of anxiety disorder symptoms. Furthermore, youth-reported prospective/inhibitory IU were significantly related to specific youth anxiety and related disorder symptoms including generalized anxiety, separation anxiety, physical injury fears, obsessive-compulsive, social anxiety and panic/agoraphobia disorder symptoms. Findings provide cross-sectional support for the role of IU as a transdiagnostic feature in predicting a wide range of anxiety disorder symptoms in youth. Implications for future clinical applications are discussed. [ABSTRACT FROM AUTHOR]

Objective: To investigate the processes that make people with panic disorder more vulnerable to the anxiety brought on by exposure to carbon monoxide. Study Design: Randomized, Cross-over Design. Setting: Hayatabad Medical Complex and Khyber Girls Medical College. Period: April 2022 to December 2022. Material & Methods: Patients with anxietyrelated conditions and volunteers in good health who underwent CO2 testing were included in the research. Various gas mixtures, including air, 5% CO2, and 7.5% CO2, were administered to participants in a random order. Behavioral measures, physiological parameters, and biochemical markers were assessed during and after CO2 inhalation. Results: Panic episodes were elicited in both patients with panic disorder and healthy controls by inhaling 5% CO2. Panic disorder patients experienced significantly higher anxiety, nervousness, dread, and sadness levels during 5% CO2 inhalation compared to healthy subjects. Physiological effects, such as increased pulse rate, contrasted those with panic disorder with those without it. No significant changes were seen in either group as a result of inhaling CO2 with respect to bloodstream levels of "free 3-methoxy-4-hydroxyphenylglycol, cortisol, growth hormone, or prolactin". Conclusion: The inhaling of CO2 may trigger panic episodes and cause more intense behavioral and physicological reactions in those with panic disorder. [ABSTRACT FROM AUTHOR]

Background: Personalization is considered an important principle in virtual reality (VR) exposure therapy. We aimed to identify whether personalized VR exposure could provoke increased anxiety in patients with panic disorder and agoraphobia as it is considered the first step in successful treatment for anxiety. Methods: We performed a double-arm, one-day preliminary study among 28 patients with panic disorder and agoraphobia. Three sessions of VR exposure, including a theater, train, and elevator scenario, were conducted in two groups. In the personalized group (n = 14), the brightness and crowd density were customized based on a pre-assessment. In the control group (n = 14), these conditions were fully randomized. Self-reported anxiety, heart rate, skin conductance, and electroencephalography were measured before, during, and after the VR sessions. Results: In the later VR sessions, higher self-reported anxiety levels measured by the Visual Analogue Scale were observed in the personalized exposure group. Increased heart rates during and after the VR sessions were observed in the personalized group. The changes in skin conductance peaks were not significantly different between the groups, but the increase in skin conductance was associated with the participants' perception of presence. The electroencephalogram showed widespread increases in alpha waves in the frontal and temporal areas of the brain in the personalized group than in the control group. Conclusion: Personalized VR exposure elicits stronger anxiogenic effects in patients with panic disorder and agoraphobia as suggested by self-report and neurophysiological data. Personalization of VR exposure has the potential for effective behavioral therapy.