Differences Between Latino Individuals With Posttraumatic Stress Disorder and Those With Other Anxiety Disorders

The goal of this study was to examine differences between Latino individuals with anxiety disorder diagnoses that include posttraumatic stress disorder (PTSD) and those with anxiety disorders without PTSD, in regards to comorbidity, psychosocial impairment, physical functioning, and treatment participation. The sample consisted of 150 adult Latinos participating in the Harvard/Brown Anxiety Research Project-Phase-II (HARP-II). Participants had at least one of the anxiety disorders included in the study (generalized anxiety disorder, panic disorder with and without agoraphobia, social phobia, and/or PTSD). Forty-five (30%) participants had PTSD which was lower than rates of generalized anxiety disorder (n = 90, 60%), social anxiety (n = 86, 57.3%), and panic disorder with agoraphobia (n = 83, 55.3%), and higher than panic disorder without agoraphobia, (n = 10, 6.6%). Those with PTSD compared with those with other anxiety disorders had a statistically significant higher number of comorbid Axis I diagnoses, higher rates of psychiatric hospitalizations, and poorer overall social adjustment than participants with other anxiety disorders. Clinical implications for assessment and treatment planning of Latino individuals with anxiety disorders are discussed

Two-year course of generalized anxiety disorder, social anxiety disorder, and panic disorder with agoraphobia in a sample of Latino adults.

OBJECTIVE: It is imperative to study the clinical course of anxiety disorders among Latinos, given the implications for culturally-sensitive treatment in this population. The current study is the first prospective, observational, longitudinal study of anxiety disorders among Latinos. METHOD: Data are reported on 139 adult Latinos (mean age 34.65, SD =10.98, 70.5% female) diagnosed with social anxiety disorder (SAD, n = 86), generalized anxiety disorder (GAD, n = 90) or panic disorder with agoraphobia (PDA, n = 62). The participants were interviewed with standardized clinical interviews at intake and annually over two years of follow-up. Probabilities of recovery were calculated using standard survival analysis methods. RESULTS: The two-year recovery rates in this study were 0.07 for SAD, 0.14 for GAD, 0.03 for PDA, and 0.50 for major depressive disorder (MDD). Overall functioning, social adjustment and life satisfaction in this sample were poor. CONCLUSIONS: The recovery rates for anxiety disorders in this Latino sample were markedly low. Although caution must be used in comparing these data with prior longitudinal studies, these recovery rates seem to be much lower than in non-Latino White samples. However, the clinical course of MDD in this sample was similar to its course among non-Latino Whites, invoking the pressing question of whether there is something about the experience of anxiety disorders (but not MDD) among Latinos that makes them more impairing and persistent. The answer to that question should inform future treatment development for this population

Development and Preliminary Psychometric Evaluation of Decisional Balance and Self-Efficacy Measures for Managing Anxiety in a National Sample of Clinically Anxious Adults

Purpose: Anxiety is the most common and costly mental illness in the United States. Reducing avoidance is a core element of evidence-based treatments. Past research shows readiness to address avoidance affects outcomes. Investigating avoidance from a transtheoretical model (TTM) perspective could facilitate tailored approaches for individuals with low readiness. This study developed and examined psychometric properties of TTM measures for addressing anxiety-based avoidance. Design: Cross-sectional survey. Setting: Community centers, online survey. Participants: Five hundred ninety-four individuals aged 18 to 70 with clinically significant anxiety. Measures: Overall Anxiety Severity Questionnaire, stages of change, decisional balance, and self-efficacy. Analysis: The sample was randomly split into halves for principal component analyses (PCAs) and confirmatory factor analyses (CFAs) to test measurement models. Further analyses examined relationships between constructs. Results: For decisional balance, PCA indicated two 5-item factors (pros and cons). Confirmatory factor analysis supported a 2-factor correlated model, Satorra-Bentler scaled chi-square (XSB2[35]=80:82), comparative fit index (CFI = 0.94), root mean square error of approximation (RMSEA = 0.07), pros: α = 0.87, ρ = 0.87, cons: α = 0.75, and ρ = 0.75. For self-efficacy, PCA indicated one 6-item factor supported by CFA, XSB2(9)=30:39, P \u3c.01, CFI = 0.98, RMSEA = 0.09, α = 0.90, ρ = 0.87. As hypothesized, significant cross-stage differences were observed for pros and self-efficacy, and significant relationships between anxiety severity and pros, cons, and self-efficacy were found. Conclusion: Findings show strong psychometric properties and support the application of a readiness-based model to anxiety. In contrast to findings of other behaviors, cons remain high in action and maintenance. These measures provide a solid empirical foundation to develop TTM-tailored interventions to enhance engagement in treatment