Comorbidity is high and screening for and treatment of anxiety disorders is recommended in moderate to severe tinnitus, as, given the overlap in the structural and functional brain circuitries involved, theoretically, their management could improve (subjective) levels of tinnitus although further empirical research on this topic is required.
Three qualitatively different PD subtypes were identified: a severe cognitive-autonomic subtype, a moderate autonomic subtype, and a mild aspecific subtype. Qualitative and quantitative differences were related to severity and clinical properties such as comorbidity, suicide attempts, sleep, and sense of mastery.
After two years, childhood trauma is associated with chronicity of anxiety symptoms and occurrence of social phobia, rather than persistence of panic disorder. These relationships are partially accounted for by duration and severity of anxiety and depressive symptoms, and neuroticism and extraversion.
Adults with non-pulsatile tinnitus and concurrent PD show differential brain activity patterns to tinnitus only sufferers and healthy controls. Higher levels of distress may modulate brain activity in the absence of PD. Screening for distress is recommended in both clinical and research settings.
ObjectiveTo investigate the impact of childhood trauma on the clinical course of panic disorder.MethodLongitudinal data of 539 participants with a current panic disorder were collected from the Netherlands Study of Depression and Anxiety (NESDA). Childhood trauma was assessed with a structured interview and clinical course after two years with a DSM-IV-based diagnostic interview and the Life Chart Interview.ResultsAt baseline, 56.3% reported childhood trauma, but this was not predictive of persistence of panic disorder. Emotional neglect and psychological abuse were associated with higher occurrence of anxiety disorders other than panic disorder (social phobia) and with higher chronicity of general anxiety symptoms (anxiety attacks or episodes and avoidance). Baseline clinical features (duration and severity of anxiety and depressive symptoms) and personality traits (neuroticism and extraversion) accounted for roughly 30 to 60% of the total effect of childhood trauma on chronicity of anxiety symptoms and on occurrence of other anxiety disorders.ConclusionAfter two years, childhood trauma is associated with chronicity of anxiety symptoms and occurrence of social phobia, rather than persistence of panic disorder. These relationships are partially accounted for by duration and severity of anxiety and depressive symptoms, and neuroticism and extraversion.Disclosure of interestThe authors have not supplied their declaration of competing interest.
IntroductionThe literature on the neurobiology of emotional processing in panic disorder (PD) remains inconsistent. Clinical heterogeneity could be causing this.ObjectiveTo investigate differences in brain activity between PD and healthy controls using the emotional faces fMRI paradigm.AimsTo elucidate neurobiological mechanisms underlying emotional processing in PD and previously identified subtypes (Pattyn et al., 2015).MethodsThe main analysis compared the neural processing of different emotional facial expressions from a large group of PD patients (n = 73) versus healthy controls (n = 58) originating from the Netherlands Study of Depression and Anxiety (NESDA). A second analysis divided the PD group into the three previously identified subgroups: a cognitive-autonomic (n = 22), an autonomic (n = 16) and an aspecific subgroup (n = 35). The fusiform gyrus, the anterior cingulate cortex and the insula were used in a ROI approach.ResultsComparing PD patients with healthy controls, a decreased activity on angry faces was observed in the left fusiform gyrus. The subgroup analysis showed more activity in the anterior cingulate cortex on neutral faces in the cognitive-autonomic subgroup versus the autonomic subgroup and a decreased activity in the left fusiform gyrus on angry faces compared to the aspecific subgroup. Less activity was observed in the right insula on neutral faces in the autonomic subgroup versus the aspecific subgroup.ConclusionReduced activity in the left fusiform gyrus was differentiating panic disorder patients from healthy controls. In accordance with clinical subtyping, between-subtype differences are an indication that a phenomenological approach could provide more insight in underlying neurobiological mechanisms in emotional processing in PD.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Background
Belongingness has been proposed as a potential proxy for legitimate peripheral participation in medical education. Previous studies have shown good internal and external validity for tools designed to measure this variable, with potential use measuring the effectiveness of clinical teaching environments. This study examined changes in belongingness in medical students between 2019 and 2021 during covid related restrictions, and compared levels of belongingness in medical students in Belgium and the United Kingdom.
Methods
This study used a validated assessment tool that was self-administered via an online survey platform. Anonymised data was collected from undergraduate medical students from all years of training and results compared with previous data collected in 2019.
Results
The belongingness assessment tool described here good internal and external validity in undergraduate medical students in United Kingdom and Belgium, identified statistically significant changes in Belongingness (as measured with this tool) in undergraduate medical students during Covid restrictions and identified statistically significant differences between medical students in Belgium and the United Kingdom.
Conclusions
These results suggest that belongingness in in undergraduate medical students fluctuates and varies both between different demographic groups and under different conditions. The ability to measure this key facet of educational development has potential to monitor teaching environments to ensure optimal learning conditions for all students.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.