Anxiety and depression of mothers of children undergoing bone marrow transplant: Symptom prevalence and use of the Beck Depression and Beck Anxiety Inventories as screening instruments.

This study examined anxiety and depressive symptoms among 115 mothers of children undergoing bone marrow transplant and evaluated the ability of the Beck Anxiety Inventory (BAI; A. T. Beck, N. Epstein, et al., 1988) and the Beck Depression Inventory (BDI; A. T. Beck, 1978) to serve as screening tools for assessing generalized anxiety disorder (GAD), panic disorder (PD), and major depressive disorder (MDD). Mothers with BAI or BDI scores greater than or equal to 14 were administered a structured clinical interview. An additional 20% was randomly selected for interview to determine whether the scale cutoff was an accurate screening method. Among the 64 mothers interviewed, 20% received at least 1 of the 3 diagnoses. Although the BAI did not demonstrate predictive accuracy in assessing GAD and PD, the BDI did in assessing MDD. The results suggest that a subset of mothers may have an anxiety or depressive disorder and that investigators should use caution before using the BAI as a screening instrument for anxiety disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Further validation of the IDAS: Evidence of convergent, discriminant, criterion, and incremental validity.

The authors explicated the validity of the Inventory of Depression and Anxiety Symptoms (IDAS; D. Watson et al., 2007) in 2 samples (306 college students and 605 psychiatric patients). The IDAS scales showed strong convergent validity in relation to parallel interview-based scores on the Clinician Rating version of the IDAS; the mean convergent correlations were .51 and .62 in the student and patient samples, respectively. With the exception of the Well-Being Scale, the scales also consistently demonstrated significant discriminant validity. Furthermore, the scales displayed substantial criterion validity in relation to Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) mood and anxiety disorder diagnoses in the patient sample. The authors identified particularly clear and strong associations between (a) major depression and the IDAS General Depression, Dysphoria and Well-Being scales, (b) panic disorder and IDAS Panic, (c) posttraumatic stress disorder and IDAS Traumatic Intrusions, and (d) social phobia and IDAS Social Anxiety. Finally, in logistic regression analyses, the IDAS scales showed significant incremental validity in predicting several DSM-IV diagnoses when compared against the Beck Depression Inventory-II (A. T. Beck, R. A. Steer, & G. K. Brown, 1996) and the Beck Anxiety Inventory (A. T. Beck & R. A. Steer, 1990). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapists, therapist variables, and cognitive-behavioral therapy outcome in a multicenter trial for panic disorder.

The relationship between therapists and treatment outcome was examined in 14 highly trained therapists who participated in the Multicenter Collaborative Study for the Treatment of Panic Disorder. Overall, therapists yielded positive outcomes in their caseloads; yet, therapists significantly differed in the magnitude of change among caseloads. Effect sizes for therapist impact on outcome measures varied from 0% to 18%. Overall experience in conducting psychotherapy was related to outcome on some measures, whereas age, gender, gender match, and experience with cognitive-behavioral therapy (CBT) were not. Therapists with above- and below-average outcomes were rated similarly on measures of adherence and competency. The results suggest that therapists make a contribution to outcome in CBT for panic disorder, even when patients are relatively uniform, treatment is structured, and outcome is positive. Implications for future clinical outcome studies and for training clinicians are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Questionnaire for Eating Disorder Diagnoses: Reliability and validity of operationalizing DSM—IV criteria into a self-report format.

The Questionnaire for Eating Disorder Diagnoses (Q-EDD) operationalizes eating disorder criteria of the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders and differentiates (a) between those with and without an eating disorder diagnosis, (b) among eating-disordered, symptomatic, and asymptomatic individuals, and (c) between those with anorexia and bulimia diagnoses. Three studies examined the Q-EDD"s psychometric properties. Convergent validity was supported by correspondence between Q-EDD diagnoses and established inventory scores. Criterion validity was supported by high correspondence between Q-EDD and interview or clinician diagnoses. Incremental validity was supported by greater accuracy of Q-EDD diagnoses than those yielded by an established inventory. Test-retest reliability and interscorer agreement were very good. Future use is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Panic and Comorbid Anxiety Symptoms in a National Anxiety Screening Sample: Implications for Clinical Interventions.

Questionnaire data from 2,033 participants in the National Anxiety Disorders Screening Day sample were used to assess the presence of panic and comorbid anxiety problems. These participants were selected from more than 15,000 attendees on the basis of never having received treatment for a psychiatric disorder and meeting screening criteria for panic disorder. With each comorbid anxiety problem (generalized anxiety disorder, posttraumatic stress disorder, social phobia, and obsessive-compulsive disorder), participants had a corresponding increase in interference in daily living as well as readiness to seek treatment. The addition of generalized anxiety or depression with panic symptoms resulted in marked increases in interference scores. Clinical treatment implications for panic disorder are discussed in terms of the effects of comorbid anxiety problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Extensive apoptosis of bone marrow cells as evaluated by the in situ end-labelling (ISEL) technique may be the basis for ineffective haematopoiesis in patients with myelodysplastic syndromes

By using data from the Bremer Adolescent Study, this report presents findings on the frequency, comorbidity, and psychosocial impairment of panic disorder and panic attacks among 1,035 adolescents. The adolescents were randomly selected from 36 schools in the province of Bremen, Germany. Panic disorder and other psychiatric disorders were coded based on DSM-IV criteria using the computerized-assisted personal interview of the Munich version of the Composite International Diagnostic Interview. Panic disorder occurred rather rare, with only 0.5% of all the adolescents met the DSM-IV criteria for this disorder sometimes in their live. Panic attack occurred more frequently, with 18% of the adolescents reported having had at least one panic attack. Slightly more girls than boys had panic attack and panic disorder. The occurrence of panic attack and panic disorder were the greatest among the 14-15 year olds. The experience of having a panic attack was associated with a number of problems, the most frequent being avoiding the situation for fear of having another attack. Four most common symptoms associated with a panic attack were that of palpitations, trembling/shaking, nausea or abdominal distress, and chills or hot flushes. Panic disorder comorbid highly with other psychiatric disorder covered in our study, especially with that of major depression. Among those with a panic disorder, about 40% of them were severely impaired during the worst episode of their illness. Only one out of five adolescents with panic disorder sought professional help for emotional and psychiatric problems. The implication of our findings for research and clinical practice are discussed.     

Review of Panic disorder: Assessment and treatment through a wide-angle lens.

Reviews the book, Panic disorder: Assessment and treatment through a wide-angle lens by Frank M. Dattilio and Jesus A. Salas-Auvert (see record 2000-08332-000). Dattilio and Salas-Auvert have done a fine job providing a panoramic view of clinicians' current knowledge of panic disorder and a comprehensive summary of state-of-the-art assessment and treatment. For the clinician unfamiliar with or inexperienced in treating panic disorder, this book is an excellent place to begin. The volume is well organized, with sections covering the nature of panic, an overview of the various theoretical conceptualizations of panic, diagnosis and assessment, professional treatment options, and self-help interventions. Although the authors are firmly rooted in the cognitive-behavioral tradition, and are proponents of a biopsychosocial perspective, the underlying message of the book is to make a comprehensive assessment and to customize treatment; that is, to remain open and flexible to doing whatever works for the patient and the situation. This book is a valuable resource for clinicians at all levels of experience with panic disorder. Weaknesses are few. For the veteran and novice alike, it provides a thorough and organized presentation of an enormous literature. Particularly valuable are the demonstrations of integrated treatment technique that are illustrated by short case vignettes and an in-depth case study. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anxiety sensitivity and the anxiety disorders: A meta-analytic review and synthesis.

There has been significant interest in the role of anxiety sensitivity (AS) in the anxiety disorders. In this meta-analysis, we empirically evaluate differences in AS between anxiety disorders, mood disorders, and nonclinical controls. A total of 38 published studies (N = 20,146) were included in the analysis. The results yielded a large effect size indicating greater AS among anxiety disorder patients versus nonclinical controls (d = 1.61). However, this effect was maintained only for panic disorder patients compared to mood disorder patients (d = 0.85). Panic disorder was also associated with greater AS compared to other anxiety disorders except for posttraumatic stress disorder (d = 0.04). Otherwise the anxiety disorders generally did not differ from each other in AS. Although these findings suggest that AS is central to the phenomenology of panic disorder and posttraumatic stress disorder, causal inferences regarding the role of AS in these anxiety disorders cannot be made. Moderator analyses showed that a greater proportion of female participants was associated with larger differences in AS between anxiety and nonclinical control groups. However, more female participants were associated with a smaller AS difference between anxiety and mood disorder groups. This finding suggests that AS is less robust in distinguishing anxiety from mood disorders among women. Age also moderated some observed effects such that AS was more strongly associated with anxiety disorders in adults compared to children. Type of AS measure used also moderated some effects. Implications of these findings for the conceptualization of AS in anxiety-related disorders are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Catastrophic misinterpretations as a predictor of symptom change during treatment for panic disorder.

Objective: Cognitive models of panic disorder suggest that change in catastrophic misinterpretations of bodily sensations will predict symptom reduction. To examine change processes, we used a repeated measures design to evaluate whether the trajectory of change in misinterpretations over the course of 12-week cognitive behavior therapy is related to the trajectory of change in a variety of panic-relevant outcomes. Method: Participants had a primary diagnosis of panic disorder (N = 43; 70% female; mean age = 40.14 years). Race or ethnicity was reported as 91% Caucasian, 5% African American, 2.3% biracial, and 2.3% “other.” Change in catastrophic misinterpretations (assessed with the Brief Body Sensations Interpretation Questionnaire; Clark et al., 1997) was used to predict a variety of treatment outcomes, including overall panic symptom severity (assessed with the Panic Disorder Severity Scale [PDSS]; Shear et al., 1997), panic attack frequency (assessed with the relevant PDSS item), panic-related distress/apprehension (assessed by a latent factor, including peak anxiety in response to a panic-relevant stressor—a straw breathing task), and avoidance (assessed by a latent factor, which included the Fear Questionnaire–Agoraphobic Avoidance subscale; Marks & Mathews, 1979). Results: Bivariate latent difference score modeling indicated that, as expected, change in catastrophic misinterpretations predicted subsequent reductions in overall symptom severity, panic attack frequency, distress/apprehension, and avoidance behavior. However, change in the various symptom domains was not typically a significant predictor of later interpretation change (except for the distress/apprehension factor). Conclusions: These results provide considerable support for the cognitive model of panic and speak to the temporal sequence of change processes during therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On the Usefulness of Measures of Normal Personality for Clinical Assessment: Evidence of the Incremental Validity of the Revised NEO Personality Inventory.

As a means of examining the incremental validity of a normal personality measure in the prediction of selected Axis I and II diagnoses, 1,342 inpatient substance abusers completed the Revised NEO Personality Inventory (NEO-PI-R) and the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and were assessed with structured clinical interviews to determine diagnostic status. Results demonstrated that scores from the NEO-PI-R (a) were substantially related to the majority of diagnoses, accounting for between 8% and 26% of the variance in the diagnostic criteria; (b) explained an additional 3% to 8% of the variability beyond 28 selected MMPI-2 scale scores; (c) increased diagnostic classification an additional 7% to 23% beyond MMPI-2 scale scores; and (d) were significantly more useful when examined at the facet trait level than at the domain trait level. Implications for incorporating measures of normal personality into clinical assessment batteries are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting attention-deficit/hyperactivity disorder and oppositional defiant disorder from preschool diagnostic assessments.

The present study examined the power of measures of early preschool behavior to predict later diagnoses of attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD)/conduct disorder (CD). Participants were 168 children with behavior problems at age 3 who underwent a multimethod assessment of ADHD and ODD symptoms and were followed annually for 3 years. Fifty-eight percent of 3-year-old children with behavior problems met criteria for ADHD and/or ODD/CD 3 years later. Using a diagnostic interview and rating scales at age 3, the authors could accurately predict later diagnostic status for 3/4 of children for ADHD and for 2/3 of children for ODD/CD. Predictive power of the best models did not increase significantly at age 4 and age 5 compared with age 3. Results provide support for the validity of early diagnoses of ADHD, although caution is needed in making diagnoses because a significant minority of children with early hyperactivity and inattention do outgrow their problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Specificity of treatment effects: Cognitive therapy and relaxation for generalized anxiety and panic disorders": Correction.

Reports an error in "Specificity of treatment effects: Cognitive therapy and relaxation for generalized anxiety and panic disorders" by Jedidiah Siev and Dianne L. Chambless (Journal of Consulting and Clinical Psychology, 2007[Aug], Vol 75[4], 513-522). The individual measures were not listed in the domains labeled "Panic" and "Cognitive" for the ?st and Westling (1995) citation in Table 3. The corrected table is included, with the added text appearing in bold font. (The following abstract of the original article appeared in record 2007-11558-001.) The aim of this study was to address claims that among bona fide treatments no one is more efficacious than another by comparing the relative efficacy of cognitive therapy (CT) and relaxation therapy (RT) in the treatment of generalized anxiety disorder (GAD) and panic disorder without agoraphobia (PD). Two fixed-effects meta-analyses were conducted, for GAD and PD separately, to review the treatment outcome literature directly comparing CT with RT in the treatment of those disorders. For GAD, CT and RT were equivalent. For PD, CT, which included interoceptive exposure, outperformed RT on all panic-related measures, as well as on indices of clinically significant change. There is ample evidence that both CT and RT qualify as bona fide treatments for GAD and PD, for which they are efficacious and intended to be so. Therefore, the finding that CT and RT do not differ in the treatment of GAD, but do for PD, is evidence for the specificity of treatment to disorder, even for 2 treatments within a CBT class, and 2 disorders within an anxiety class. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Questionnaire for Eating Disorder Diagnoses: Reliability and validity of operationalizing DSM—IV criteria into a self-report format: Correction.

Reports an error in the original article by L. B. Mintz et al (Journal of Counseling Psychology, 1997 [Jan], Vol 44[1], 63–79). On page 78, a reference to work by C. G. Fairburn et al was cited incorrectly and is corrected here. Also, there were 3 text citations that contained errors which are corrected here. (The following abstract of this article originally appeared in record 1997-02519-008.) The Questionnaire for Eating Disorder Diagnoses (Q-EDD) operationalizes eating disorder criteria of the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders and differentiates (a) between those with and without an eating disorder diagnosis, (b) among eating-disordered, symptomatic, and asymptomatic individuals, and (c) between those with anorexia and bulimia diagnoses. Three studies examined the Q-EDD's psychometric properties. Convergent validity was supported by correspondence between Q-EDD diagnoses and established inventory scores. Criterion validity was supported by high correspondence between Q-EDD and interview or clinician diagnoses. Incremental validity was supported by greater accuracy of Q-EDD diagnoses than those yielded by an established inventory. Test-retest reliability and interscorer agreement were very good. Future use is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Specificity of treatment effects: Cognitive therapy and relaxation for generalized anxiety and panic disorders.

[Correction Notice: An erratum for this article was reported in Vol 76(5) of Journal of Consulting and Clinical Psychology (see record 2008-13625-021). In the article, "Specificity of Treatment Effects: Cognitive Therapy and Relaxation for Generalized Anxiety and Panic Disorders," by Jedidiah Siev and Dianne L. Chambless (Journal of Consulting and Clinical Psychology, 2007, Vol. 75, No. 4, pp. 513-522), the individual measures were not listed in the domains labeled "Panic" and "Cognitive" for the ?st and Westling (1995) citation in Table 3. The corrected table is included, with the added text appearing in bold font.] The aim of this study was to address claims that among bona fide treatments no one is more efficacious than another by comparing the relative efficacy of cognitive therapy (CT) and relaxation therapy (RT) in the treatment of generalized anxiety disorder (GAD) and panic disorder without agoraphobia (PD). Two fixed-effects meta-analyses were conducted, for GAD and PD separately, to review the treatment outcome literature directly comparing CT with RT in the treatment of those disorders. For GAD, CT and RT were equivalent. For PD, CT, which included interoceptive exposure, outperformed RT on all panic-related measures, as well as on indices of clinically significant change. There is ample evidence that both CT and RT qualify as bona fide treatments for GAD and PD, for which they are efficacious and intended to be so. Therefore, the finding that CT and RT do not differ in the treatment of GAD, but do for PD, is evidence for the specificity of treatment to disorder, even for 2 treatments within a CBT class, and 2 disorders within an anxiety class. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessing acute stress disorder: Psychometric properties of a structured clinical interview.

This study presents the development of a structured clinical interview to diagnose acute stress disorder (ASD). The Acute Stress Disorder Interview (ASDI) is a 19-item, dichotomously scored interview schedule that is based on criteria from the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994). It was validated against clinician-based diagnoses of ASD on 65 trauma survivors assessed between 1 and 3 weeks posttrauma. It possessed good internal consistency (r?=?.90), sensitivity (91%), and specificity (93%). Test-retest reliability was evaluated on 60 trauma survivors between 1 and 3 weeks posttrauma, with a readministration interval of 2 to 7 days. Test-retest reliability of ASDI severity scores was strong (r?=?.88), and diagnostic agreement for presence (88%) and absence (94%) of ASD diagnosis was high. The ASDI appears to be a useful tool to identify those individuals who suffer ASD and are at risk of long-term posttraumatic stress disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Validation canadienne-fran?aise de l'échelle d'évaluation de la panique et de l'agoraphobie.

The objective of this study was to explore the psychometric properties of the French Canadian adaptation of the Panic and Agoraphobia Scale (B. Bandelow, 1995). The scale measures severity of panic disorder with or without agoraphobia and is composed of 5 subscales: Panic attacks, phobic avoidance, anticipatory anxiety, disability, and worries about health. Participants (N=122) showed moderate to severe levels of panic disorder with agoraphobia. The results showed 2 main factors for the factor analysis and a stability coefficient of .64 (p     

Validation of a mental health assessment in an African conflict population.

We studied the validity of the assessment of posttraumatic stress disorder (PTSD) and depression within the context of an epidemiological mental health survey among war-affected adolescents and young adults in northern Uganda. Local language versions of the Posttraumatic Diagnostic Scale (PDS) and the Depression section of the Hopkins Symptom Checklist (DHSCL) were administered by trained local interviewers. Correlations with probable predictor variables (i.e., trauma exposure), outcomes (e.g., impaired functioning), and local idioms of distress (i.e., spirit possession) were determined to estimate criterion-related construct validity. To assess convergent validity, expert clinicians reinterviewed a subsample using structured interviews (the Clinician Administered PTSD Scale [CAPS] and the Mini International Neuropsychiatric Interview [MINI]). Depression and PTSD symptoms as assessed by the local interviewers correlated with the context variables as predicted. After optimizing the scoring algorithm, we found good agreement between the PDS-based diagnoses and expert diagnoses. However, the concordance for depression diagnoses was not satisfactory. Results show that mental health assessments in African languages can produce reliable and valid data but that caution is warranted in the unevaluated transfer of cutoff scores and scoring algorithms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Morbidity of DSM-IV Axis I disorders in patients with noncardiac chest pain: Psychiatric morbidity linked with increased pain and health care utilization.

The present study examined current and lifetime psychiatric morbidity, chest pain, and health care utilization in 229 patients with noncardiac chest pain (NCCP), angina-like pain in the absence of cardiac etiology. Diagnostic interview findings based on the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) revealed a psychiatrically heterogeneous sample of whom 44% had a current Axis I psychiatric disorder. A total of 41% were diagnosed with a current anxiety disorder, and 13% were diagnosed with a mood disorder. Overall, 75% of patients had an Axis I clinical or subclinical disorder. Lifetime diagnoses of anxiety (55%) and mood disorders (44%) were also prevalent, including major depressive disorder (41%), social phobia (25%), and panic disorder (22%). Patients with an Axis I disorder reported more frequent and more painful chest pain compared with those without an Axis I disorder. Presence of an Axis I disorder was associated with increased life interference and health care utilization. Findings reveal that varied DSM-IV Axis I psychiatric disorders are prevalent among patients with NCCP, and this psychiatric morbidity is associated with a less favorable NCCP presentation. Implications for early identification of psychiatric disorders are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marijuana use and panic psychopathology among a representative sample of adults.

This study examined the relations between marijuana use and panic attacks and panic disorder using a large representative survey of adults (N = 5,672; 53% women; Mage = 45.05 years, SD = 17.9) conducted in the United States (Kessler et al., 2004). After adjusting for sociodemographic variables (age, marital status, income, education, race, and sex) and the presence of a lifetime substance use disorder, lifetime marijuana use was significantly associated with increased odds of a lifetime panic attack history. Lifetime marijuana use also was significantly associated with an increased risk of current (past-year) panic attacks; however, this relation was not significant when controlling for nicotine dependence. Lifetime marijuana use was significantly associated with increased odds of a lifetime diagnosis of panic disorder as well as a current (past-year) diagnosis of panic disorder. Current (past-year) marijuana use was significantly associated with both lifetime and current panic attacks, but not current or lifetime panic disorder. Results are discussed in relation to the novel information they offer in regard to understanding the putative marijuana use–panic psychopathology association(s). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between panic disorder and major depression. A new family study

OBJECTIVE: The comorbidity between panic disorder and major depression (MDD) in individuals has been amply documented. However, data from family studies to determine whether panic disorder and MDD aggregate separately or together in families have been inconclusive, in part because of the absence of studies with the full range of proband groups. This report presents results from a family study with the necessary mutually exclusive groups: panic disorder without MDD, panic disorder with MDD, MDD without panic disorder, and normal controls. METHODS: Diagnostic information was obtained from 193 probands and 1047 of their adult relatives with the Schedule for Affective Disorders and Schizophrenia--Lifetime Version for Anxiety Disorders by direct interview, and/or from multiple informants, without knowledge of proband diagnoses. Best-estimate diagnoses were based on all available information by clinicians independently of data collection and without knowledge of probands' and other relatives' status. RESULTS: Findings indicated the specific and independent transmission of panic disorder and MDD, the separation of panic disorder from MDD, and the nonfamilial nature of late-onset MDD. The pattern of results was unaffected by the use of different diagnostic criteria, number of informants, interview status of relatives, presence of substance abuse or agoraphobia or the sequence of MDD and panic disorder in probands, or whether probands were selected from treatment clinics or community sample. CONCLUSIONS: We conclude that panic disorder and MDD are separate disorders with substantial co-occurrence in individuals, and that panic comorbid with MDD is not a single, distinct disorder. Finally, we illustrate an approach to examining comorbidity in family data through analysis of mutually exclusive, parallel diagnoses in probands and relatives.