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03/23/2012 06:21 AM

ANXIETY articles ongoing(page 5)

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Computer-Based Treatment Eases Anxiety Symptoms in Children

Small Clinical Trial Supports Larger Scale Testing

Science Update • March 13, 2012

Source: iStock

A computer-based training method that teaches a person with anxiety to shift attention away from threatening images reduced symptoms of anxiety in a small clinical trial in children with the condition.

The results of this first randomized clinical trial of the therapy in children with anxiety suggest that the approach warrants more extensive testing as a promising therapy.


As many as a quarter of 13- to 18-year-olds have met the criteria for an anxiety disorder at some point.

Currently available treatments—including cognitive behavioral therapy and medication—relieve symptoms of anxiety in about 70 percent of children treated.

Most children with clinical anxiety do not receive treatment, partly because of difficulties in access to care, including distance and financial resources.

Scientists are searching for additional approaches, including therapies that do not involve medication with its associated side effects.

A treatment called attention bias modification (ABM) has emerged from the observation that people with anxiety unconsciously pay more attention than others to anything that seems threatening.

One way of detecting such a bias is a dot probe test. In the test, people view a computer screen on which angry and neutral faces are flashed briefly, adjacent to each other.

After the faces disappear, a test image of dots appears where either one or the other face was, and the person has to respond by pushing a button.

People with anxiety consistently respond more quickly to dots that appear where the angry face was located.

ABM presents patients with an exercise similar to the dot probe test, but the dots always appear where the neutral face was, and thus consistently draw the attention of the participant to this non-threatening image.

A recent meta-analyses of ABM in adults by some of the same investigators who carried out this work suggested its potential as a treatment.

This Study

Researchers at Tel Aviv University (TAU) in Israel carried out a clinical trial on ABM as an outcome of a three-year collaboration with scientists at the National Institute of Mental Health and the University of Maryland, College Park, Maryland.

Yair Bar-Haim of TAU led the study, which appears in the American Journal of Psychiatry.

The study enrolled 40 children, 8 to 14 years old, who had sought help for anxiety.

For children receiving ABM, after faces appeared on a screen, two dots appeared on the screen; children had to determine whether the dots were side by side, or one above the other. In every case, dots appeared only where the neutral face had been.

There were also two control groups:

in the first, dots appeared equally frequently where angry and neutral faces appeared;

in the second, the only faces that appeared throughout were neutral, so the dots always appeared in the location of a neutral face.

The object of the second control group was to help confirm that any therapeutic effect was from the ABM training, and not from desensitizing the children to threatening faces.

Children in the study were randomly assigned to receive treatment, or to be in one of two control groups.

All children had four training sessions over 4 weeks, with 480 dot-probe trials per session.

Although the trial was small, there was a “reasonably robust” decrease in the severity of anxiety, according to the authors. Following ABM, both the number and severity of symptoms were reduced.


An important feature of ABM, says NIMH author Daniel Pine, is that it addresses the fundamental neurological function underlying anxiety: attention. Changes in attention happen very quickly—in milliseconds.

“We know from neuroscience that if you want to change behaviors that happen very quickly, you have to practice. You can't just tell someone how to drive, or throw a ball. You have to practice,” says Pine.

Longitudinal studies that follow children into adulthood suggest that most chronic mood and anxiety disorders in adults begin as high levels of anxiety in children.

In fact, childhood anxiety is as important in predicting adult depression as it is for adult anxiety.

The ability to influence attention biases early in development might provide a powerful means of prevention for both of these disorders later in life.

The approach requires no medication and in practical terms, the computer-based nature of ABM lends itself to large-scale dissemination, in a medium children are comfortable with.

Larger-scale trials will be able to provide more information on the efficacy of the treatment in children and how it works to reduce symptoms of anxiety.


Eldar, S., Apter, A., Lotan, D., Perez-Edgar, K., Naim, R, Fox, N.A., Pine, D.S., and Bar-Haim, Y. American Journal of Psychiatry. 2012 Feb 1;169(2):213-30.


Charlotte Armstrong

NIMH Press Office

(301) 443-4536

The National Institute of Mental Health (NIMH) is part of the National Institutes of Health (NIH), a component of the U.S. Department of Health and Human Services.

“NIH… Turning Discovery into Health”

This page last reviewed: March 14, 2012. treatment-eases-anxiety-symptoms-in-children.shtml


04/10/2012 02:52 PM
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Anxiety Might Help People Sniff Out Threats

Small study finds feeling anxious heightens the ability to detect potentially threatening odors

By Robert Preidt

Friday, April 6, 2012

FRIDAY, April 6 (HealthDay News) --

Anxiety improves a person's ability to smell potentially threatening odors, according to a new study.

Smell is essential to animals in order to detect, locate and identify predators.

Odors also trigger powerful emotional responses in humans, the study authors pointed out.

Researchers Elizabeth Krusemark and Wen Li of the University of Wisconsin-Madison exposed 14 young adults to different types of odors while they underwent MRI brain scans. The participants' anxiety levels and breathing patterns were also recorded.

As the volunteers' anxiety levels rose, so did their ability to detect negative odors.

The investigators also found that communication between the sensory and emotional areas of the brain increased in response to negative odors, particularly when people were anxious.

This heightened communication between these brain areas could be an important mechanism to boost awareness of potential threats, the researchers said.

The study was published in a recent online issue of the journal Chemosensory Perception.

SOURCE: Chemosensory Perception, news release, March 22, 2012 fullstory_123832.html

Copyright (c) 2012 HealthDay. All rights reserved.

04/10/2012 02:55 PM
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Depression, Anxiety Tied to Physical Disabilities in Seniors

But exercise may help shield against physical decline, study adds

By Robert Preidt

Thursday, April 5, 2012

THURSDAY, April 5 (HealthDay News) --

Seniors with psychological distress such as depression or anxiety are more likely to have physical disabilities, a new Australian study says.

Regular physical activity, however, can protect against such problems.

Researchers examined data from nearly 100,000 Australian men and women, aged 65 and older, and found that 8.4 percent of them were experiencing psychological distress.

Compared to those with no psychological distress, the risk of physical disability was more than four times higher among those with any level of psychological distress and nearly seven times higher among those with moderate levels.

The researchers also found that seniors who were more physically active were less likely to have physical disabilities.

The study appears April 5 in the Journal of the American Geriatrics Society.

"Our findings can influence the emphasis that we place on older adults to remain active," study leader Gregory Kolt, dean of the School of Science and Health at the University of Western Sydney, said in a journal news release.

"With greater levels of physical activity, more positive health gains can be achieved, and with greater physical function (through physical activity), greater independence can be achieved."

Previous research has linked psychological distress to reduced physical activity and increased physical disability in many age groups.

SOURCE: Journal of the American Geriatrics Society, news release, April 3, 2012 fullstory_123770.html

Copyright (c) 2012 HealthDay. All rights reserved.

04/18/2012 12:54 AM
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Worried Sick-- Living with Anxiety Disorders

Anxiety is an uneasy feeling that something may harm you or a loved one. This feeling can be normal and sometimes even helpful.

If you're starting a new job or taking a test, it might make you more alert and ready for action. But sometimes anxiety can linger or become overwhelming. When it gets in the way of good health and peace of mind, it's called an anxiety disorder.

If you have an anxiety disorder, you're not alone.

Each year, tens of millions of Americans of all ages suffer from long-term anxiety.

Among children, anxiety disorders are the most common form of mental illness—one they may carry into adulthood.

“Everybody has anxiety,” says Dr. Daniel Pine, an NIH neuroscientist and psychiatrist. “The tricky part is how to tell the difference between normal and abnormal anxiety.”

For those with anxiety disorders, fears, worries and anxieties can cause so much distress that they interfere with daily life. The anxiety grows out of proportion to the stressful situation or occurs when there is no real danger.

Anxiety activates the body's stress response. Nearly all the cells, tissues and organs in your body go on high-alert.

This stress response can wear your body down over time. People with chronic (long-term) anxiety have a higher risk of both physical and mental health problems.

Some people visit their doctors because of headaches, racing heart or Other physical complaints without realizing that these symptoms may be connected to how anxious they feel.

NIH-funded researchers are working to learn more about anxiety disorders. They have discovered that these conditions are caused by some combination of your genes and your environment.

However, the precise events that lead to anxiety disorders are still unknown. Scientists are also searching for better ways to diagnose, prevent and treat these conditions.

There are several kinds of anxiety disorders. The major types include:

Phobias. Intense, irrational fears triggered by things that pose little or no real danger, such as heights, dogs or spiders. Among the anxiety disorders, specific phobias are the most common.

Social anxiety disorder. Leads to extreme anxiety and self-consciousness in everyday social situations. Also known as social phobia.

Post-traumatic stress disorder. Caused by trauma. This condition leads to flashbacks, nightmares and insomnia. Often accompanied by depression or substance abuse, post-traumatic stress disorder can occur at any age, including childhood.

Generalized anxiety disorder. Excessive worry about a variety of everyday problems.

Panic disorder. Sudden attacks of terror accompanied by physical symptoms that may include heart palpitations, shortness of breath, dizziness, or abdominal distress. Panic disorder is one of the most treatable of anxiety disorders.

Obsessive-compulsive disorder. Persistent, upsetting thoughts (obsessions) and repetitive rituals (compulsions), like hand washing, counting, checking or cleaning. These behaviors are done in the hope of preventing the thoughts or making them go away.

Treatment for anxiety disorders usually includes both medication and cognitive behavioral therapy (CBT). CBT is a form of talk therapy.

It helps people change both the thinking patterns that support their fears and the way they react to anxiety-provoking situations. Current treatments can be highly effective for most people.

Dr. Denise Chavira, a psychologist at the University of California, San Diego, works with anxious youth in underserved, rural areas.

Her team is studying ways to make CBT more accessible to these children, who may have trouble getting to therapy sessions.

To help make up for the lack of in-person contact, the researchers are examining telephone and self-help approaches that focus on teaching parents how to use CBT skills with their children.

In one study, the scientists are comparing CBT training delivered to parents by phone versus in-person CBT provided to anxious youth and their parents.

With a therapist's help, parents and kids create lists of anxiety-producing situations.

They learn how to face their fears gradually while using CBT coping skills.

Both methods encourage parents to model brave behaviors for kids, and to let kids learn how to be independent.

“Some parents do this naturally, but others need some practice” says Chavira.

“The phone is a less intense form of treatment, given that it only involves the parents and sessions are shorter. But even that mode can be really effective,” Chavira says.

NIH-funded researchers are also using advanced imaging tools to pinpoint the areas in the brain that underlie anxiety disorders.

Still in its very early stages, this approach represents a major shift from how doctors usually diagnose mental illness, which is by looking at symptoms and behaviors.

Using an imaging technique called functional MRI (fMRI), scientists are scanning the brain in action—as it thinks, remembers, feels emotion and regulates the body's reactions to things that cause anxiety.

By measuring changes in blood flow related to brain activity, fMRI scans produce full-color images of trouble spots in real time.

Dr. Sonia Bishop of the University of California-Berkeley uses fMRI to study people at high risk for anxiety disorders. Her team hopes to prevent anxiety disorders before patients enter a downward spiral.

The researchers are working to develop a new type of CBT-related treatment that helps to retrain how patients regulate their emotions and attention.

Scientists are especially curious about brain regions called the amygdala and the hippocampus.

The amygdala plays an important role in fear and anxiety by alerting the brain to danger.

The hippocampus translates threatening events into memories.

Once scientists discover if and how these areas contribute to illness, they might be able to develop better treatments.

“These disorders put a huge burden on the individual, the family and society,” Bishop says. “Anxiety disorders are one of the most common reasons that people visit their primary health care provider.”

If you are troubled by anxiety, the first person to see is your family doctor or nurse practitioner.

He or she can check for any underlying physical illness or a related condition.

You may be referred to a mental health specialist, who might help to identify the specific type of anxiety disorder and the appropriate treatment.

With proper care, most people with anxiety disorders can lead normal, fulfilling lives.

Consider joining a self-help or support group to share problems and achievements with others. Stress management techniques and meditation can also help.


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04/25/2012 12:54 AM
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Anxiety Linked to Smarts in Brain Study

Tendency to worry may have evolved along with intelligence in humans, researchers say

By Robert Preidt

Wednesday, April 18, 2012

WEDNESDAY, April 18 (HealthDay News) --

Worrying may have co-evolved with intelligence as an important survival trait in humans, new research suggests.

For the study, researchers looked at 26 people with generalized anxiety disorder and compared them to a group of 18 healthy volunteers without the disorder.

The investigators found that both worry and high intelligence were associated with brain activity measured by the depletion of the nutrient choline in the brain's white matter.

This suggests that worry may have co-evolved with intelligence, said Dr. Jeremy Coplan, a professor of psychiatry at the State University of New York Downstate Medical Center in New York City.

"While excessive worry is generally seen as a negative trait and high intelligence as a positive one, worry may cause our species to avoid dangerous situations, regardless of how remote a possibility they may be," Coplan said in a center news release.

"In essence, worry may make people 'take no chances,' and such people may have higher survival rates. Thus, like intelligence, worry may confer a benefit upon the species," he added.

The study was published in a recent issue of the journal Frontiers in Evolutionary Neuroscience.

SOURCE: State University of New York Downstate Medical Center, news release, April 12, 2012 fullstory_124225.html

Copyright (c) 2012 HealthDay. All rights reserved.

05/22/2012 09:39 PM
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general anxiety disorder brochure anxiety-disorder-gad/gad-trifold.pdf

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06/21/2012 03:15 AM
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Anxiety, Depression May Raise Stroke Risk

Screening for psychological distress could save patients' lives, researchers say

By Mary Elizabeth Dallas

Monday, June 18, 2012

MONDAY, June 18 (HealthDay News) --

People suffering from anxiety, depression, sleeplessness or other forms of psychological distress are at greater risk of death from a stroke, according to a new study.

Researchers from University College London pointed out that psychological distress affects about 15 percent to 20 percent of the general population. Previous research has linked these common mental conditions with coronary artery disease, but an association with stroke and other cardiovascular diseases has not been established, they said.

The researchers examined information from a study of 68,652 adults who participated in the Health Survey for England. The vast majority of participants were white, 45 percent were men and the average was about 55.

Nearly 15 percent of the people questioned said they were affected by psychological distress, most of them women.

Those who reported having psychological distress also tended to be younger, smokers and taking medication for high blood pressure. They also tended to have lower incomes, the researchers added.

After following the participants for an average of about eight years, the study's authors found 2,367 deaths from ischemic heart disease (blocked artery), stroke and other cardiovascular problems.

The study was published June 18 in CMAJ.

"Psychological distress was associated with death from cardiovascular disease, and the relation remained consistent for specific disease outcomes, including ischemic heart disease and cerebrovascular disease," Dr. Mark Hamer, of the college department of epidemiology and public health, and his co-authors said in a journal news release.

"We saw an association between psychological distress and risk of cerebrovascular disease among our participants, all of whom had been free from cardiovascular disease at baseline.

This association was similar in size to the association between psychological distress and ischemic heart disease in the same group."

The researchers concluded that questionnaires could help doctors screen their patients for common mental illnesses, which could reduce their risk of death from heart disease and stroke.

SOURCE: Canadian Medical Association Journal, news release, June 18, 2012 fullstory_126377.html

Copyright (c) 2012 HealthDay. All rights reserved.

07/14/2012 11:42 PM
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Chronic Anxiety Speeds Aging

By Crystal Phend, Senior Staff Writer, MedPage Today

Published: July 12, 2012

Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner

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Chronic panic, phobia, and similar anxiety disorders may contribute to premature aging by shortening telomeres.

Point out that for women with the most severe phobia, the magnitude of the difference in telomere length was comparable to that for women 6 years apart in age.

Chronic panic, phobia, and similar anxiety disorders may contribute to premature aging by shortening telomeres, an observational study suggested.

Women with the most severe phobic anxiety had telomere length 0.09 standardized units below average (P=0.02 versus less phobic women), Olivia I. Okereke, MD, of Brigham and Women's Hospital and Harvard in Boston, and colleagues reported online in PLoS ONE.

"The magnitude of this difference was comparable to that for women 6 years apart in age," they noted.

While lesser degrees of chronic anxiety showed a trend for shorter telomeres as well, the researchers called it primarily a threshold effect.

Shortening of telomeres -- a gradual process of loss of the repetitive DNA sequences capping off chromosomes that occurs when cells divide -- isn't reversible.

Prior studies have suggested that oxidative stress and inflammation accelerates the process, leading to DNA damage linked to cancer, cardiovascular disease, cognitive decline, and dementia.

However, "phobic anxiety is treatable; thus, any potential impacts on telomere shortening may be amenable to prevention through early identification and treatment," the researchers explained.

They used phobic anxiety as a typically chronic form of anxiety to look for correlation with telomere length in peripheral blood leukocytes among 5,243 women from the Nurses' Health Study, controls in prior case-control studies of telomeres and disease, and a random group of healthy women in a cognitive function sub-study.

Higher levels of long-term general anxiety as measured on the Crown-Crisp phobic index, which focuses on 'fear' disorders like panic and agoraphobia, showed a trend for lower age-adjusted relative telomere length z-scores (P=0.09).

But the more anxious women tended to be less healthy on a wide range of characteristics. After adjustment for significant factors -- paternal age at birth, smoking, body mass index, and physical activity -- the trend was further attenuated (P=0.15).

Women with a high anxiety score of 6 points or greater (range up to 16) appeared to account for the effect.

Whereas women with scores under 6 had an adjusted mean telomere length z-score of 0.02 standard units, the mean was -0.09 for women with higher scores, yielding a significant 0.10 standard-unit difference between groups (P=0.02).

By comparison, 1 additional year of age was associated with a -0.015 lower mean relative telomere length z-score.

The impact of high chronic anxiety levels appeared to be particularly strong among nonsmokers, which the researchers called counterintuitive, although smokers had shorter telomeres to start with.

The difference in telomere length among nonsmokers with a score of 6 or more versus 5 or less was -0.25 standard units (P<0.001).

Excluding women with cardiovascular disease, diabetes or obstructive airway diseases -- "chronic diseases that may act as intermediates ... and also may be associated with telomere shortening" -- attenuated the difference for high anxiety levels to a nonsignificant trend, at a mean of -0.07 standard units (P=0.12).

This finding suggested that the "findings may be partly explained by influences of phobic anxiety on risk of development of serious chronic diseases," Okereke's group noted.

They cautioned that women in the highest phobic symptom category that was linked to telomere shortening wouldn't necessarily meet diagnostic criteria for an anxiety disorder, "although this appears plausible."

Another limitation was that the study design didn't allow for determining whether the phobic anxiety predated the telomere shortening.

Causality is possible in either direction, the group pointed out.

Lack of data on anxiety duration and treatments, depression, or other residual confounders as well as the predominantly white population studied were also limitations.

The study was supported by National Institutes of Health grants.

The researchers reported having no conflicts of interest to disclose.

Primary source: PLoS ONE

Source reference:

Okereke OI, et al "High phobic anxiety is related to lower leukocyte telomere length in women" PLoS ONE 2012;7: DOI: 0.1371/journal.pone.0040516. utm_content=&utm_medium=email&utm_campaign=DailyHeadlines& utm_source=

© 2012 Everyday Health, Inc. All rights reserved.

07/17/2012 02:20 PM
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Phobic Anxiety May Link to Premature Aging

But the association doesn't prove that stress causes your chromosomes to deteriorate, researchers say

By Robert Preidt

Friday, July 13, 2012

FRIDAY, July 13 (HealthDay News) --

People suffering from a common form of psychological stress known as phobic anxiety may also experience premature aging, new research suggests.

For the study, scientists looked at telomere length in more than 5,200 women, aged 42 to 69. Telomeres are structures that protect the ends of chromosomes from deterioration.

Shortened telomeres have been linked to an increased risk of cancer, heart disease, dementia and death.

The team at Brigham and Women's Hospital (BWH) in Boston found that phobic anxiety was associated with shorter telomeres in the women.

The difference in telomere lengths for women with high levels of phobic anxiety compared to those without this type of stress disorder was similar to what was seen for an additional six years of age.

The findings suggest that phobic anxiety is a possible risk factor for premature aging, according to the study published online July 11 in the journal PLoS One.

According to experts, phobic anxiety disorders, like agoraphobia or claustrophobia, involve intense fear triggered by common circumstances that would not bother others.

"Many people wonder about whether -- and how -- stress can make us age faster," study author Dr. Olivia Okereke of the BWH department of psychiatry, said in a hospital news release.

"So, this study is notable for showing a connection between a common form of psychological stress -- phobic anxiety -- and a plausible mechanism for premature aging. However, this type of study design cannot prove cause-and-effect or which problem came first -- the anxiety or shorter telomeres."

The findings open the door to further research into the link between anxiety and changes in telomere length.

SOURCE: Brigham and Women's Hospital, news release, July 11, 2012 fullstory_127219.html

Copyright (c) 2012 HealthDay. All rights reserved.

07/17/2012 02:22 PM
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Math Anxiety Takes Bigger Toll on Girls: Study

But overall they perform as well as boys in the subject, British researchers found

By Mary Elizabeth Dallas

Tuesday, July 10, 2012

TUESDAY, July 10 (HealthDay News) --

Although both boys and girls may experience math anxiety, which is a discomfort solving math problems, the girls' math achievements are more likely to suffer as a result, according to a new study.

Researchers from Cambridge University in England said that math anxiety could explain why few students of either sex continue studying math at the college level.

The study appeared July 8 in the journal Behavioral and Brain Functions.

"Mathematics anxiety warrants attention in the classroom because it could have negative consequences for later mathematics education, particularly as it is thought to develop during the primary school years," said lead study author Denes Szucs in a news release from BioMed Central, the journal publisher.

The researchers examined 433 British high school students to find out if math anxiety took a toll on their academic performance in math.

After accounting for general test anxiety, they found that students with higher math anxiety had lower math performance than other children. Girls were more likely than boys to have higher levels of math anxiety.

However, math performance for girls was the same as for boys, the researchers found. They concluded that girls could do better in math if they didn't have so much anxiety surrounding the subject.

SOURCE: BioMed Central, news release, July 8, 2012

Copyright (c) 2012 HealthDay. All rights reserved. fullstory_127088.html


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