The current study examines how the aging relevance of anxiety triggers, particularly those tied to physical threat, influences the expression of anxiety in older and younger adults. It was expected that older adults would exhibit less anxiety than younger adults in response to nonphysical triggers but that this age-related difference would diminish when faced with physical triggers. Anxiety responses were measured in older (N = 49, ages 60-85) and younger (N = 49, ages 17-34) adults in response to (a) physical and social anxiety provocations, and (b) a threat interpretation measure. Consistent with hypotheses, results for the anxiety provocations indicated less anxiety among older (vs. younger) adults on a range of anxiety measures (affective, cognitive, physiological) when triggers did not concern physical health, but this age difference diminished when physical health was threatened. Older adults actually reported more threat interpretations than younger adults to physical threat scenarios. Findings are discussed in terms of the aging relevance of anxiety triggers and theoretical accounts of age-related changes in emotional processing.

Background-Little is known about how family-level factors are associated with duration of untreated psychosis (DUP), especially in ethnic/racial minority groups, such as African Americans. This study involved African American first-episode patients and their family members who initiated evaluation and treatment for them. It was hypothesized that a longer DUP would be predicted by family members' endorsement of: (1) less knowledge about schizophrenia, (2) greater perceptions of stigma, (3) lower levels of insight, (4) fewer family strengths, (5) more limited family coping capacity, and (6) lower levels of caregiver strain.Methods-From a sample of 109 patients, 42 African American patients with family-level data were included. Cox proportional hazards models quantified associations between family-level predictors and DUP, and analyses controlled for effects of three previously determined patient-level predictors of DUP-mode of onset of psychosis, living with family members versus alone or with others, and living above versus below the federal poverty level.Results-The median DUP was 24.5 weeks. Greater family strengths and a better family coping capacity were associated with a shorter DUP, whereas higher insight among informants and greater level of perceived caregiver strain were associated with a longer DUP.Conclusions-Whereas family strengths and coping likely account for a significant portion of variability in DUP, both insight and caregiver strain probably evolve as a consequence of DUP. Efforts to strengthen families and tap into existing strengths of families in specific cultural groups would likely enhance early treatment-seeking for psychotic disorders.

There is a need for early intervention efforts to be directed to families (and their loved ones who live with them with emerging psychotic disorders or frank untreated psychotic syndromes), particularly families facing major socioeconomic challenges.

Ethnic group differences in affective, behavioral, and cognitive measures of anxiety were examined to better characterize the unique triggers and modes of anxious responding across different groups. Using an ethnically diverse sample ( N = 112; 39 African Americans, 34 Asian Americans, and 39 European Americans), the study examined differences in anxious responding following three anxiety provocations (physical, social interpersonal, and social performance), each hypothesized to be a primary anxiety trigger for one of the groups. African Americans and European Americans demonstrated greater behavioral avoidance during a physical provocation designed to elicit shortness of breath sensations relative to Asian Americans. Asian Americans reported a higher number of anxious cognitions than African Americans during a social provocation designed to trigger performance concerns. These findings suggest ethnicity should be carefully considered when assessing the predominant triggers of anxiety and modes of anxious responding.

Objective The duration of untreated psychosis is associated with poor outcomes in multiple domains in the early course of nonaffective psychotic disorders, although relatively little is known about determinants of this critical period, particularly health services–level determinants. This study examined three hypothesized predictors of duration of untreated psychosis (lack of insurance, financial problems, and broader barriers) among urban, socioeconomically disadvantaged African Americans, while controlling for the effects of three patient-level predictors (mode of onset of psychosis, living with family versus alone or with others before hospitalization, and living above versus below the federally defined poverty level). Methods Analyses included data from 42 patient–family member dyads from a larger sample of 109 patients with a first episode of nonaffective psychosis. The duration of untreated psychosis and all other variables were measured in a rigorous, standardized fashion in a study designed specifically to examine determinants of treatment delay. Survival analyses and Cox regression assessed the effects of the independent predictors on time from onset of psychosis to hospital admission for initial evaluation and treatment. Results The median duration of untreated psychosis was 24.5 weeks. When the analyses controlled for the three patient-level covariates, patients without health insurance, with financial problems, or with barriers to seeking help had a significantly longer duration of untreated psychosis. Conclusions Health services–related factors, such as lack of insurance, are predictive of longer treatment delay. Efforts to eliminate uninsurance and underinsurance, as well as minimize barriers to treatment, would be beneficial for improving the prognosis of young patients with emerging nonaffective psychotic disorders. (Psychiatric Services 60:1489–1494, 2009)

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Objective-The duration of untreated psychosis is associated with poor outcomes in multiple domains in the early course of nonaffective psychotic disorders, although relatively little is known about determinants of this critical period, particularly health services-level determinants. This study examined three hypothesized predictors of duration of untreated psychosis (lack of insurance, financial problems, and broader barriers) among urban, socioeconomically disadvantaged African Americans, while controlling for the effects of three patient-level predictors (mode of onset of psychosis, living with family versus alone or with others before hospitalization, and living above versus below the federally defined poverty level). Methods-Analyses included data from 42 patient-family member dyads from a larger sample of 109 patients with a first episode of nonaffective psychosis. The duration of untreated psychosis and all other variables were measured in a rigorous, standardized fashion in a study designed specifically to examine determinants of treatment delay. Survival analyses and Cox regression

Doses of initial, untreated hallucinations and delusions add substantively, though differentially, to the prediction of early-course symptomatology and functioning. Findings suggest a need for focused research on frequency/severity of pretreatment psychotic symptoms beyond duration measures.