Anxiety disorders and age-related changes in physiology

Background Anxiety disorders are leading contributors to the global disease burden, highly prevalent across the lifespan and associated with substantially increased morbidity and early mortality. Aims The aim of this study was to examine age-related changes across a wide range of physiological measures in middle-aged and older adults with a lifetime history of anxiety disorders compared with healthy controls. Method The UK Biobank study recruited >500 000 adults, aged 37-73, between 2006 and 2010. We used generalised additive models to estimate non-linear associations between age and hand-grip strength, cardiovascular function, body composition, lung function and heel bone mineral density in a case group and in a control group. Results The main data-set included 332 078 adults (mean age 56.37 years; 52.65% women). In both genders, individuals with anxiety disorders had a lower hand-grip strength and lower blood pressure, whereas their pulse rate and body composition measures were higher than in the healthy control group. Case-control group differences were larger when considering individuals with chronic and/or severe anxiety disorders, and differences in body composition were modulated by depression comorbidity status. Differences in age-related physiological changes between females in the anxiety disorder case group and healthy controls were most evident for blood pressure, pulse rate and body composition, whereas this was the case in males for hand-grip strength, blood pressure and body composition. Most differences in physiological measures between the case and control groups decreased with increasing age. Conclusions Findings in individuals with a lifetime history of anxiety disorders differed from a healthy control group across multiple physiological measures, with some evidence of case-control group differences by age. The differences observed varied by chronicity/severity and depression comorbidity

The efficacy of psychological interventions for PTSD in children and adolescents exposed to single vs. multiple traumas. Meta-analysis of randomized controlled trials

Background: Previous meta-analyses of psychotherapies for children and adolescents with post-traumatic stress disorder (PTSD) did not investigate whether treatment efficacy is diminished when patients report multiple (versus single) traumas. Aims: To examine whether efficacy of psychological interventions for paediatric PTSD is diminished when patients report multiple (versus single) traumas. Method: We systematically searched PsycInfo, MEDLINE, Web of Science and PTSDpubs on 21 April 2022 and included randomised controlled trials (RCTs) meeting the following criteria: (a) random allocation; (b) all participants presented with partial or full PTSD; (c) PTSD is the primary treatment focus; (d) sample mean age <19 years; (e) sample size n ≥ 20. Trauma frequency was analysed as a dichotomous (single versus ≥2 traumas) and continuous (mean number of exposures) potential moderator of efficacy. Results: Of the 57 eligible RCTs (n = 4295), 51 RCTs were included in quantitative analyses. Relative to passive control conditions, interventions were found effective for single-trauma-related PTSD (Hedges’ g = 1.09; 95% CI 0.70–1.48; k = 8 trials) and multiple-trauma-related PTSD (g = 1.11; 95% CI 0.74–1.47; k = 12). Psychotherapies were also more effective than active control conditions in reducing multiple-trauma-related PTSD. Comparison with active control conditions regarding single-event PTSD was not possible owing to scarcity (k = 1) of available trials. Efficacy did not differ with trauma exposure frequency irrespective of its operationalisation and subgroup analyses (e.g. trauma-focused cognitive–behavioural therapy only). Conclusions: The current evidence base suggests that psychological interventions for paediatric PTSD can effectively treat PTSD in populations reporting single and multiple traumas. Future trials for PTSD following single-event trauma need to involve active control conditions

Associations among posttraumatic stress disorder symptoms, life satisfaction, and well-being comparisons: A longitudinal investigation.

Publication status: PublishedMany individuals who encounter potentially traumatic events go on to develop symptoms of posttraumatic stress disorder (PTSD). Research suggests that survivors of traumatic events frequently compare their current well-being to different standards; yet, knowledge regarding the role of comparative thinking in well-being is limited to a few cross-sectional studies. We therefore examined the temporal associations among aversive well-being comparisons (i.e., comparisons threatening self-motives), PTSD symptoms, and life satisfaction in individuals exposed to traumatic events. Participants (N = 518) with a trauma history completed measures of PTSD symptoms and life satisfaction, as well as the Comparison Standards Scale for Well-being (CSS-W), at assessment points 3 months apart. The CSS-W assesses the frequency, perceived discrepancy, and affective impact of aversive social, temporal, counterfactual, and criteria-based comparisons related to well-being. All participants reported having engaged in aversive well-being comparisons during the last 3 weeks. Comparison frequency emerged as a significant predictor of PTSD symptoms, β = .24, beyond baseline PTSD symptom severity. Life satisfaction contributed unique variance to the comparison process by predicting comparison frequency, β = -.18; discrepancy, β = -.24; and affective impact, β = .20. The findings suggest that frequent aversive comparisons may lead to a persistent focus on negative aspects of well-being, thereby exacerbating PTSD symptoms, and further indicate that comparison frequency, discrepancy, and affective impact are significantly influenced by life satisfaction. Taken together, the findings support the need for a thorough examination of the role of comparative thinking in clinical populations, which may ultimately help improve clinical care

The relationship between post-traumatic stress disorder symptoms, life satisfaction, and well-being comparisons: A longitudinal investigation

Many individuals who encounter potentially traumatic events go on to develop post-traumatic stress disorder (PTSD) symptoms. Despite the well-established role of negative self-evaluations in PTSD and life satisfaction, research on comparison processes following exposure to traumatic events is limited to a few cross-sectional studies. We therefore examined the temporal relationship between aversive well-being comparisons (i.e., comparisons threatening self-motives), PTSD symptoms, and life satisfaction in individuals with a history of trauma. A sample of 518 participants with exposure to traumatic events was administered measures of PTSD, life satisfaction, and the Comparison Standards Scale for Well-being (CSS-W) at two timepoints, three months apart. The CSS-W assessed the frequency, perceived discrepancy, and affective impact of aversive well-being comparisons regarding social, temporal, counterfactual, and criteria-based comparisons. Comparison frequency emerged as significant predictor of PTSD symptoms, beyond baseline PTSD levels. Life satisfaction contributed unique variance to the comparison process by predicting comparison frequency, discrepancy, and affective impact. The findings suggest that frequent aversive comparisons may lead to a persistent focus on negative aspects of well-being, thereby exacerbating PTSD symptoms. They further indicate that comparison frequency, discrepancy, and affective impact is significantly influenced by life satisfaction. Altogether, the findings have important implications for future research on PTSD

If only… a systematic review and meta-analysis of social, temporal and counterfactual comparative thinking in PTSD

Comparative thinking is ubiquitous in human cognition. Empirical evidence is accumulating that PTSD symptomatology is linked to various changes in social, temporal and counterfactual comparative thinking. However, no systematic review and meta-analysis in this line of research have been conducted to this date. We searched titles, abstracts and subject terms of electronic records in PsycInfo and Medline from inception to January 2019 with various search terms for social, temporal and counterfactual comparative thinking as well as PTSD. Journal articles were included if they reported a quantitative association between PTSD and social, temporal and/or counterfactual comparative thinking in trauma-exposed clinical or sub-clinical samples. A total of 36 publications were included in the qualitative synthesis. The number of publications on the association between PTSD and social and temporal comparative thinking was too scarce to warrant a meta-analytic review. A narrative review of available literature suggests that PTSD is associated with distortions in social and temporal comparative thinking. A meta-analysis of 24 independent samples (n = 4423) assessing the association between PTSD and the frequency of counterfactual comparative thinking yielded a medium to large positive association of r =.464 (p <.001, 95% CI =.404; .520). Higher study quality was associated with higher magnitude of association in a meta-regression. Most studies collected data cross-sectionally, precluding conclusions regarding causality. Overall, study quality was found to be moderate. More longitudinal and experimental research with validated comparative thinking measures in clinical samples is needed to acquire a more sophisticated understanding of the role of comparative cognitions in the aetiology and maintenance of PTSD. Comparative thinking might be a fruitful avenue for a better understanding of posttraumatic reactions and improving treatment

Meta-analysis of virtual reality exposure therapy for social anxiety disorder

[no abstract available

Evaluation of the Scales for Social Comparison of Appearance (SSC-A) and Social Comparison of Well-being (SSC-W)

People constantly compare their appearance and well-being to that of other individuals. However, there is a lack of a measure of social comparisons of well-being, and existing appearance-related social comparison scales assess social comparison tendency using predefined social situations. This limits our understanding of the role of social comparison in self-evaluation and well-being. Therefore, we developed the Scale for Social Comparison of Appearance (SSC-A) and the Scale for Social Comparison of Well-being (SSC-W) that assess downward and upward social comparisons with regards to a) frequency, b) perceived discrepancy, and c) affective impact during the last three weeks. In one longitudinal and three cross-sectional studies with sample sizes ranging from 500 to 1,119 participants, we administered the SSC-A or the SSC-W alongside measures of appearance social comparisons, body satisfaction, self-concept, social rank, psychological well-being, envy, rumination, depression and anxiety. Confirmatory factor analyses supported the expected two-factor solution representing upward and downward social comparisons for both scales. Their validity was supported by significant associations with the measured constructs. Overall, upward comparisons displayed higher associations with most measured constructs than downward comparisons. The SSC-A and SSC-W offer parsimonious, reliable and valid measures of social comparisons of appearance and well-being

A brief measure of guilt and shame: Validation of the Guilt and Shame Questionnaire (GSQ-8)

Shame and guilt regulate basic human processes such as social cognition and relations. Both emotions are also involved in the aetiology and maintenance of mental disorders such as posttraumatic stress disorder (PTSD) or depression. However, concise scales that adequately capture these constructs are currently lacking, impeding research efforts to understand them more thoroughly. To this end, we developed the eight-item Guilt and Shame Questionnaire (GSQ-8); a brief measure of guilt and shame in English, German, and Dutch. We examined the reliability and validity of the GSQ-8 in a clinical sample of adults seeking treatment for childhood-trauma-related posttraumatic stress disorder (n = 209), a sample of adults who had suffered at least one traumatic life event reporting different levels of PTSD symptoms (n = 556), and a non-clinical sample of adults (n = 156). Theory-driven confirmatory factor analyses confirmed two correlated latent factors guilt and shame with four items for each factor. Across all samples, two-factor models yielded better model fit than one-factor solutions. Measurement invariance across gender, language, and the three samples was mostly established. Guilt and shame composite scores were associated with PTSD symptoms, depressive symptoms, life satisfaction, mental health-related quality of life, and self-blame, thus supporting scale validity. Importantly, both subscales predicted PTSD symptoms, depression, life satisfaction, and mental health-related quality of life over and above self-blame, bolstering support for their incremental validity. The GSQ-8 is a parsimonious, reliable, and valid tool to assess shame and guilt in clinical, sub-clinical, and non-clinical populations, allowing applications across a broad range of research questions

A brief measure of guilt and shame: validation of the Guilt and Shame Questionnaire (GSQ-8)

Background: Guilt and shame regulate basic human processes such as social cognition and relations. Both emotions are also involved in the aetiology and maintenance of trauma-related mental disorders such as posttraumatic stress disorder (PTSD). However, a concise scale that adequately captures these constructs is currently lacking, impeding research efforts to understand them more thoroughly. Objective: To this end, we developed the eight-item Guilt and Shame Questionnaire (GSQ-8) in English, German, and Dutch. Method: We examined the reliability and validity of the GSQ-8 in a clinical sample of adults seeking treatment for childhood-trauma-related posttraumatic stress disorder (n = 209), a sample of adults who had suffered at least one traumatic life event reporting different levels of PTSD symptoms (n = 556), and a non-clinical sample of adults (n = 156). Results: Theory-driven confirmatory factor analyses confirmed two correlated latent factors guilt and shame with four items for each factor. Across all samples, two-factor models yielded better model fit than one-factor solutions. Measurement invariance across the three samples, gender, and Dutch and German language was mostly established. Guilt and shame composite scores were associated with PTSD symptoms, depressive symptoms, life satisfaction, mental health-related quality of life, and self-blame, thus supporting scale validity. Importantly, both subscales predicted PTSD symptoms, depression, life satisfaction, and mental health-related quality of life over and above cognitions of self-blame. Conclusions: The GSQ-8 is a parsimonious, reliable, and valid tool to assess guilt and shame in clinical, sub-clinical, and non-clinical populations, allowing applications across a broad range of research questions