Is parental death a selective precursor to either panic disorder or agoraphobia? : A test of the separation anxiety hypothesis

In a controlled chart-review study of the separation anxiety hypothesis (SAH) of agoraphobia or panic disorder, the incidence of parental (maternal and paternal) deaths was recorded from the histories of 40 patients, each with panic disorder, agoraphobia, and a control group of simple phobics. The overall incidence of parental loss was low in all three groups, and there were no significant differences among them either in terms of the incidence of parental death or in patient ages at the time of parental death. It is concluded from these results and on a review of other studies on the SAH that the hypothesis is not well supported and should be abandoned in the DSM-IV.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/27537/1/0000581.pd

Major depressive disorder in a family study of obsessive–compulsive disorder with pediatric probands

Objective: This study examined the comorbidity of obsessive–compulsive disorder (OCD) with major depressive disorder (MDD) in a family study of OCD with pediatric probands. Method: This study assessed the lifetime prevalence of MDD in 141 first‐degree relatives (FDR) and 452 second‐degree relatives (SDR) of pediatric probands with OCD and healthy controls, and identified variables associated with MDD in case FDR. All available FDR were directly interviewed blind to proband status; parents were also interviewed to assess the family psychiatric history of FDR and SDR. Best‐estimate diagnoses were made using all sources of information. Data were analyzed with logistic regression and robust Cox regression models. Results: Lifetime MDD prevalence was significantly higher in case than in control FDR (30.4 versus 15.4%). Lifetime MDD prevalence was significantly higher in FDR of case probands with MDD than in FDR of case probands without MDD or control FDR (46.3 versus 19.7 versus 15.4%, respectively). MDD in case FDR was significantly associated with MDD in case probands and with age and OCD in those relatives. Lifetime MDD prevalence was similar in case and control SDR. However, lifetime MDD prevalence was significantly higher in SDR of case probands with MDD than in SDR of case probands without MDD or control SDR (31.9 versus 16.8 versus 15.4%, respectively). Conclusions: MDD prevalence was significantly higher in both FDR and SDR of case probands with MDD than in relatives of case probands without MDD or control relatives, suggesting that pediatric OCD comorbid with MDD is a complex familial syndrome. Depression and Anxiety, 2011. © 2011 Wiley‐Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/87090/1/20824_ftp.pd

Group Behavioral Therapy for Adolescents With Obsessive-Compulsive Disorder: Preliminary Outcomes

A clinical trial was conducted to evaluate the efficacy of a 7-week group behavioral therapy program for adolescents with obsessive-compulsive disorder (OCD). Group sessions included therapist-assisted exposure and response prevention exercises, information regarding OCD, and the extensive use of behavioral homework assignments. An additional family session was conducted to educate families about OCD and to encourage participation in the group member's behavioral program. At the end of the group, all clients showed improvement on their Children's Yale-Brown Obsessive Compulsive Scale scores; 6-month follow-up revealed further improve ment. Our findings provide preliminary support for the efficacy of group behavioral therapy for adolescents with OCD.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68943/2/10.1177_104973159800800601.pd

Chronic medication does not affect hyperactive error responses in obsessive-compulsive disorder

Patients with obsessive-compulsive disorder (OCD) show an increased error-related negativity (ERN), yet previous studies have not controlled for medication use, which may be important given evidence linking performance monitoring to neurotransmitter systems targeted by treatment, such as serotonin. In an examination of 19 unmedicated OCD patients, 19 medicated OCD patients, 19 medicated patient controls without OCD, and 21 unmedicated healthy controls, we found greater ERNs in OCD patients than in controls, irrespective of medication use. Severity of generalized anxiety and depression was associated with ERN amplitude in controls but not patients. These data confirm previous findings of an exaggerated error response in OCD, further showing that it cannot be attributed to medication. The absence in patients of a relationship between ERN amplitude and anxiety/depression, as was found in controls, suggests that elevated error signals in OCD may be disorder-specific.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/79361/1/j.1469-8986.2010.00988.x.pd

Terapia cognitiva : aplicações de uma técnica para qualidade de vida e saúde

Esta pesquisa teve por objetivo geral aplicar e avaliar uma técnica específica de terapia cognitiva - organizada em 12 sessões grupais e denominada Tomada de Decisão e Qualidade de Vida -, destinada a promover saúde e incrementar qualidade de vida. No total, participaram 18 servidores de uma instituição pública de ensino superior. Nas etapas de admissão e de encerramento, aplicaram-se : Questionário de Qualidade de Vida, Inventário Beck de Ansiedade e Inventário Beck de Depressão. Foram identificadas melhoras significativas nos domínios físico, psicológico, meio ambiente, geral e saúde, relacionados à qualidade de vida. Não se verificaram alterações significantes nos escores de ansiedade (p=0,26). Em contrapartida, os escores de depressão indicaram melhora (p=0,02). Os resultados sugerem que a técnica pode ser empregada para promover saúde e qualidade de vida.In this study we implemented and assessed a specific cognitive therapy technique - Decision Making and Quality of Life, which is used to promote health and improve quality of life. Eighteen employees from a higher education institution participated in the study, which was organized into 12 group sessions. At the admission and concluding phases, we asked participants to complete the World Health Organization Quality of Life - Bref Questionnaire, the Beck Anxiety Inventory and the Beck Depression Inventory. Results showed significant improvement in five of the domains that measure quality of life: physical, psychological, environmental, general, and health. There were no significant changes (p=0.26) in anxiety scores. In contrast, the depression scores got significantly better (p=0.02). The results suggest that the proposed technique is conducive to health promotion and quality of life

Effects of Alcohol on the Acquisition and Expression of Fear Potentiated Startle in Mouse Lines Selectively Bred for High and Low Alcohol Preference

Rationale: Anxiety disorders and alcohol-use disorders frequently co-occur in humans perhaps because alcohol relieves anxiety. Studies in humans and rats indicate that alcohol may have greater anxiolytic effects in organisms with increased genetic propensity for high alcohol consumption. Objectives and Methods: The purpose of this study was to investigate the effects of moderate doses of alcohol (0.5, 1.0, 1.5 g/kg) on the acquisition and expression of anxiety-related behavior using a fear-potentiated startle (FPS) procedure. Experiments were conducted in two replicate pairs of mouse lines selectively bred for high- (HAP1 and HAP2) and low- (LAP1 and LAP2) alcohol preference; these lines have previously shown a genetic correlation between alcohol preference and FPS (HAP\u3eLAP; Barrenha and Chester 2007). In a control experiment, the effect of diazepam (4.0 mg/kg) on the expression of FPS was tested in HAP2 and LAP2 mice. Results: The 1.5 g/kg alcohol dose moderately decreased the expression of FPS in both HAP lines but not LAP lines. Alcohol had no effect on the acquisition of FPS in any line. Diazepam reduced FPS to a similar extent in both HAP2 and LAP2 mice. Conclusions: HAP mice may be more sensitive to the anxiolytic effects of alcohol than LAP mice when alcohol is given prior to the expression of FPS. These data collected in two pairs of HAP/LAP mouse lines suggest that the anxiolytic response to alcohol in HAP mice may be genetically correlated with their propensity toward high alcohol preference and robust FPS

Patient Preferences for Clinician Interactional Style in Treatment of Perinatal Depression

Most women with depression around the time of childbearing are not treated adequately, or at all. Clinical practice guidelines focus primarily on provision of information rather than on interaction factors. In this study, we explored clinician interactional style characteristics contributing to patient response to perinatal depression referral and treatment. Stratified purposeful sampling resulted in 23 participants selected by pregnancy, socioeconomic, and depression status. Participants completed semistructured interviews exploring their experiences with and preferences for clinician interactional style characteristics in the context of obstetrics-setting referral and delivery of depression treatment. Thematic analysis revealed a central theme related to interactional cues that influence women’s reactions to clinical encounters, summarized by the question, “Can this person help me?” Women evaluated this question in four domains: feeling heard, developing trust in the clinician, perceiving technical competence in the clinician, and feeling that the intervention focus is effectively chosen and communicated. Our results imply that, in addition to informational factors, the way in which clinicians interact with patients about depression might strongly influence patient responses