The Role of Anger in Symptoms and Processes of Generalized Anxiety Disorder

Research investigating the associations between anger and symptoms of generalized anxiety disorder (GAD) is limited. The goals of the current program of research were to examine the various forms of anger associated with GAD as well as the cross-over effects of worry and anger on cognitive mechanisms characteristic of GAD and high trait anger. In Study 1, participants (N = 381) completed a series of questionnaires assessing various aspects of anger and GAD diagnostic criteria via self-report. Our results indicated that GAD analogues reported higher levels of trait anger, anger suppression, and hostility than less anxious participants. In Study 2, the effects of laboratory-induced anger on negative style, negative beliefs about uncertainty, and worry were examined. Participants were randomized to an anger induction condition (n = 43) or a control condition (n = 34). An interpretation bias task, questionnaire items assessing beliefs about uncertainty, and a structured worry task were administered following the manipulation. Participants in the anger condition reported greater increases in negative interpretive style and in the belief that uncertainty is unfair and spoils everything than participants in the control condition; however no group differences were found with worry. In Study 3, the effects of anger and worry on interpretive style and hostile attributions were examined. Participants were randomized to a worry induction (n = 51), anger induction (n = 50), or control condition (n = 49). We also examined whether GAD analogues reported greater hostile interpretations of ambiguous intent than less anxious participants, and whether GAD analogue status interacted with the worry and anger experimental conditions in predicting increased hostile and threatening interpretations of ambiguous information. Although we found no effects of condition or interactions between GAD and condition on interpretive style or hostile attributions, we found that GAD symptoms were associated with greater negative interpretive style and greater hostile attributions. Together, findings from these studies suggest that elevated levels of multiple dimensions of anger, as well as hostile attributions, characterize individuals who meet diagnostic criteria for GAD and provide some, albeit limited, support for the notion that elevated anger contributes to cognitive vulnerabilities underlying GAD

Initial Mainstream Cultural Orientations Predict Early Social Participation In The Mainstream Cultural Group

This work adopts a perspective that construes acculturation as a dynamic intergroup process and social contact with members of the new community as a key mechanism underlying cultural adaptation. We argue that migrants' initial self-reported mainstream cultural orientation constitutes an important antecedent of early social participation in the new community. Results from two longitudinal studies of newly arrived international students (N=98 and N=60) show that more positive initial mainstream cultural orientations prospectively predict higher social participation specifically in the mainstream group over the following months. This relation held after controlling for important alternative predictors, namely extraversion/shyness, mainstream language proficiency, and respiratory sinus arrhythmia, a physiological index of social engagement capacity. These studies focus on the very initial stages of the temporal dynamics of acculturation, contribute to bridging research on acculturation and on intergroup relations, and establish a link between cultural orientations, a subjective attitudinal construct, and concrete social engagement behaviors

Neighbourhood characteristics and socioeconomic inequalities in child mental health: Cross-sectional and longitudinal findings from the Growing Up in Ireland study.

This study examined the role of neighbourhood characteristics in explaining socioeconomic inequalities in child mental health (the total difficulties score from the Strengths and Difficulties Questionnaire) using data from Cohort '08 of Growing Up in Ireland Waves 3 (age 5; baseline) and 5 (age 9; follow-up). Twenty neighbourhood items were grouped into neighbourhood safety, built environments, cohesion, interaction, and disorder. Data were analysed using regression, single and multiple mediation, and network psychometric analyses. We found that neighbourhood safety, cohesion, interaction, and disorder were associated with child mental health. These four domains separately (by up to 18 %) or in concert (by up to 23 %) partially explained socioeconomic inequalities in child mental health. Built environments may explain socioeconomic inequalities in mental health in urban children only. Findings from network analysis indicated that specific concerns over "people being drunk or taking drugs in public" and "this is a safe neighbourhood" had the strongest connections with child mental health. Improving neighbourhood characteristics may be important to reduce socioeconomic inequalities in child mental health in Ireland

Measurement Invariance Testing of the Patient Health Questionnaire-9 (PHQ-9) across People with and without Diabetes Mellitus from the NHANES, EHMS and UK Biobank datasets

Background The prevalence of depression is higher among those with diabetes than in the general population. The Patient Health Questionnaire (PHQ-9) is commonly used to assess depression in people with diabetes, but measurement invariance of the PHQ-9 across groups of people with and without diabetes has not yet been investigated. Methods Data from three independent cohorts from the USA (n=1,886 with diabetes, n=4,153 without diabetes), Quebec, Canada (n= 800 with diabetes, n= 2,411 without diabetes), and the UK (n=4,981 with diabetes, n=145,570 without diabetes), were used to examine measurement invariance between adults with and without diabetes. A series of multiple group confirmatory factor analyses were performed, with increasingly stringent model constraints applied to assess configural, equal thresholds, and equal thresholds and loadings invariance, respectively. One-factor and two-factor (somatic and cognitive-affective items) models were examined. Results Results demonstrated that the most stringent models, testing equal loadings and thresholds, had satisfactory model fit in the three cohorts for one-factor models (RMSEA = .063 or below and CFI = .978 or above) and two-factor models (RMSEA = .042 or below and CFI = .989 or above). Limitations Data were from Western countries only and we could not distinguish between type of diabetes. Conclusions Results provide support for measurement invariance between groups of people with and without diabetes, using either a one-factor or a two-factor model. While the two-factor solution has a slightly better fit, the one-factor solution is more parsimonious. Depending on research or clinical needs, both factor structures can be used

Investigating the longitudinal association between diabetes and anxiety: a systematic review and meta-analysis

Objectives: Previous research has indicated that there is an association between diabetes and anxiety. However, no synthesis has determined the direction of this association. Therefore, the aim of this study was to determine the longitudinal relationship between anxiety and diabetes. Method: We searched seven databases for studies examining the longitudinal relationship between anxiety and diabetes. Two independent reviewers screened studies from a population aged 16 or older that either a) examined anxiety as a risk factor for incident diabetes or b) examined diabetes as a risk factor for incident anxiety. Studies that met eligibility criteria were put forward for data extraction and meta-analysis. Results: In total 14 studies (n=1,760,800) that examined anxiety as a risk factor for incident diabetes and 2 studies (n=88,109) that examined diabetes as a risk factor for incident anxiety were eligible for inclusion in the review. Only studies examining anxiety as a risk factor for incident diabetes were put forward for the meta-analysis. The least adjusted (unadjusted or adjusted for age only) estimate indicated a significant association between baseline anxiety with incident diabetes (OR 1.47: 1.23-1.75). Furthermore, most-adjusted analyses indicated a significant association between baseline anxiety and incident diabetes. Included studies that examined diabetes to incident anxiety found no association. Conclusions: There was an association between baseline anxiety with incident diabetes. Results also indicate the need for more research to examine the direction of association from diabetes to incident anxiety. This work adds to the growing body of evidence that poor mental health increases the risk of developing diabetes.</p

Associations between coping strategies and mental health in individuals with type 2 diabetes: Prospective analyses.

Objective: Individuals with type 2 diabetes are at greater risk of developing a number of mental health conditions, including depression, anxiety, and diabetes-related distress, than individuals without type 2 diabetes. Cross-sectional studies suggest that some coping strategies may increase the risk of mental health conditions in individuals with diabetes, whereas others may be protective. [...]Similar patterns of results were observed for elevated anxiety symptoms and diabetes-related distress. Conclusions: Cross-sectional results differed from prospective results. Only emotion-oriented coping appears to play a role in the development of depressive symptoms, anxiety symptoms, and diabetes-related distress. Results underscore the importance of examining prospective associations and suggest that interventions targeting specific coping strategies might alleviate mental health problems in individuals with type 2 diabetes

Associations between Depressive Symptoms and Indices of Obesity in Adults with Prediabetes and Normal Blood Glucose Levels: Results From the Emotional Health and Wellbeing Study

Objectives: This study describes associations between depressive symptoms and indices of obesity in a community sample of adults with prediabetes. The strengths of these associations were compared to those observed in individuals with normal blood glucose levels. Methods: Cross-sectional data came from the baseline assessment of the Emotional Health and Wellbeing Study. Participants were classified as meeting the American Diabetes Association criteria for prediabetes (n=1,152) or normal blood glucose levels (n=1,567). Indices of obesity included body mass index, waist circumference and fat mass index. Results: After adjusting for sociodemographic covariates, greater depressive symptoms were associated with greater body mass index, waist circumference and fat mass index. These associations were stronger in participants with prediabetes compared to participants with normal blood glucose levels. The pattern of results observed for body mass index and waist circumference held after controlling for self-reported fruit and vegetable consumption, physical activity and sedentary time, but the strength of the interaction was attenuated for fat mass index. Conclusions: Depressive symptoms were more strongly associated with indices of obesity in people with prediabetes than in people with normal blood glucose levels. Depressive symptoms may be a barrier to weight management in people with prediabetes

Trajectories of anxiety symptoms and associations with incident cardiovascular disease in adults with type 2 diabetes

Background Trajectories of anxiety symptoms in people with type 2 diabetes (T2D) and their associations with diabetes health outcomes have not been investigated. This study examined latent longitudinal trajectories of anxiety symptoms in adults with T2D and their associations with incident cardiovascular disease (CVD). Methods Data were from the Evaluation of Diabetes Treatment Study, a community-based cohort study of adults aged 40–76 years with T2D. Anxiety and CVD were assessed by self-report at baseline and at four annual follow-up assessments. N = 832 participants without cardiovascular disease at baseline and 12-month follow-up were included in the present study. Group-based trajectories of anxiety at baseline, 12-month follow-up, and 24-month follow-up were modelled using latent class growth modeling. Associations between anxiety trajectories and CVD reported at 24-, 36-, or 48-month follow-ups were examined with logistic regression analysis adjusted for sociodemographic and lifestyle characteristics. Results Four distinct anxiety trajectories were identified, reflecting chronically low (39.4%), chronically moderate-low (47.4%), chronically moderate-high (11.1%), and chronically high (2.2%) anxiety. The likelihood of CVD was greater for the chronically moderate-low (OR = 2.23, 95% CI = 1.36–3.66), chronically moderate-high (OR = 3.05, 95% CI = 1.54–6.02), and chronically high (OR = 3.61, 95% CI = 1.09–12.00) anxiety trajectory groups compared to the chronically low anxiety group. Conclusion The identified latent trajectories reflected three groups with chronic courses of anxiety symptoms at different levels of severity and one group with chronically low levels of anxiety. Chronic anxiety, even at subthreshold levels, was associated with an increased risk of CVD among people with T2D

Comorbid depressive and anxiety symptoms and the risk of type 2 diabetes: Findings from the Lifelines Cohort Study

Background: Prior studies indicate that depression is a risk factor for type 2 diabetes (T2D), though there is considerable heterogeneity in reported estimates. Identifying homogeneous subgroups of depression strongly associated with T2D may be beneficial. This study examined associations between depression and anxiety comorbidity with the risk of T2D. Methods: 78,025 participants from the Lifelines Cohort Study (age range = 30–75 years) without diabetes at baseline were included in this study. The Mini-International Neuropsychiatric Interview assessed depressive and anxiety symptoms at baseline. Incident T2D was assessed by self-report or hemoglobin A1c levels during an approximately 3.8-year follow-up period. Risk of T2D was compared across four groups (no depressive or anxiety symptoms, depressive symptoms alone, anxiety symptoms alone, comorbid depressive/anxiety symptoms) using mixed effects logistic regression analyses adjusted for sociodemographic, lifestyle, and cardiometabolic characteristics. Results: 1,096 participants developed diabetes. Compared to those without depressive or anxiety symptoms (n = 74,467), those with comorbid depressive and anxiety symptoms (n = 743) were more likely to develop T2D (n = 28, OR = 2.12, 95% CI = 1.22–3.68). Depressive symptoms alone (n = 650) and anxiety symptoms alone (n = 2,165) were not significantly associated with T2D (n = 23 and n = 24, respectively, developed diabetes). Those with comorbid symptoms were also more likely to develop T2D compared to those with depressive symptoms alone (OR = 2.86, 95% CI = 1.25–6.54). Limitations: Depressive and anxiety symptom assessments were based on a screening tool. Hemoglobin A1c data were only available for a subset of participants. Conclusions: Depression with comorbid anxiety may be a subgroup of depression that is strongly associated with the risk of T2D