A general anxiety-prone cognitive style in anxiety disorders

Uhlenhuth, E. H.; Starčević, Vladan; Warner, Teddy D.; Matuzas, William; McCarty, Teresita; Roberts, Brian; Jenkusky, Steven M.

doi:10.1016/s0165-0327(01)00457-8

Cited by 15 publications

(10 citation statements)

References 48 publications

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“…They suggested that the severity of panic attacks, along with a variety of anticipatory fears about the consequences of the attacks, may contribute to the development of agoraphobia. In other studies, subjects with panic disorder with agoraphobia scored significantly higher on measures of perfectionism and anxious thoughts, compared with subjects with panic disorder without agoraphobia (26,27).…”

Section: Discussionmentioning

confidence: 71%

Influence of Psychiatric Comorbidity on Recovery and Recurrence in Generalized Anxiety Disorder, Social Phobia, and Panic Disorder: A 12-Year Prospective Study

Bruce

Yonkers²,

Otto³

et al. 2005

AJP

773

564

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Objective-The authors sought to observe the long-term clinical course of anxiety disorders over 12 years and to examine the influence of comorbid psychiatric disorders on recovery from or recurrence of panic disorder, generalized anxiety disorder, and social phobia.Method-Data were drawn from the Harvard/Brown Anxiety Disorders Research Program, a prospective, naturalistic, longitudinal, multicenter study of adults with a current or past history of anxiety disorders. Probabilities of recovery and recurrence were calculated by using standard survival analysis methods. Proportional hazards regression analyses with time-varying covariates were conducted to determine risk ratios for possible comorbid psychiatric predictors of recovery and recurrence.Results-Survival analyses revealed an overall chronic course for the majority of the anxiety disorders. Social phobia had the smallest probability of recovery after 12 years of follow-up. Moreover, patients who had prospectively observed recovery from their intake anxiety disorder had a high probability of recurrence over the follow-up period. The overall clinical course was worsened by several comorbid psychiatric conditions, including major depression and alcohol and other substance use disorders, and by comorbidity of generalized anxiety disorder and panic disorder with agoraphobia.Conclusions-These data depict the anxiety disorders as insidious, with a chronic clinical course, low rates of recovery, and relatively high probabilities of recurrence. The presence of particular comorbid psychiatric disorders significantly lowered the likelihood of recovery from anxiety disorders and increased the likelihood of their recurrence. The findings add to the understanding of the nosology and treatment of these disorders.Anxiety disorders are more common than any other major group of diagnoses, with the exception of substance use disorders. According to the National Comorbidity Survey, the overall lifetime prevalence of anxiety disorders is 24.9%, including rates of 3.5%, 13.3%, 5.1%, for panic disorder with or without agoraphobia, social phobia, and generalized anxiety disorder, respectively (1). The effects of these disorders on both physical health and occupational functioning have been well documented (2-6). In the WHO Collaborative Study on Psychological Problems in General Health Care, more than one-half of the patients with panic disorder without or with agoraphobia reported moderate to severe occupational Address correspondence and reprint requests to Dr. Bruce, Department of Psychiatry and Human Behavior, Brown University, Box G-BH, Providence, RI 02906; Steven_Bruce_PhD@Brown.edu (e-mail). NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript dysfunction and physical disability (3). The severity of disability reported was similar to that reported for depressive episodes and higher than that for alcohol dependence.Despite the high prevalence of anxiety disorders and the morbidity associated with these disorders, much is yet...

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Section: Discussionmentioning

confidence: 71%

Influence of Psychiatric Comorbidity on Recovery and Recurrence in Generalized Anxiety Disorder, Social Phobia, and Panic Disorder: A 12-Year Prospective Study

Bruce

Yonkers²,

Otto³

et al. 2005

AJP

773

564

View full text Add to dashboard Cite

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“…7,14,15 The current version consists of 15 items and has adequate psychometric properties. 8,16,17 Scores were divided into high and low between values of 41 and 42, marking 2 SDs above the mean of our community sample. 16 Blood samples were drawn on each admission at 9 PM and 7 times the next day ( Fig.…”

Section: Methodsmentioning

confidence: 99%

“…3,5,6 People who tend to ''catastrophize'' their experiences, including somatic sensations, are vulnerable to anxiety disorders. 7,8 Cognitive behavioral therapy, which is effective for PD, 9 may alleviate withdrawal symptoms and/or increase success rates in discontinuing benzodiazepines. 10,11 However, very few investigators have looked for a relationship between an anxiety-prone cognitive style and withdrawal symptoms.…”

mentioning

confidence: 99%

Abrupt Discontinuation of Alprazolam and Cognitive Style in Patients With Panic Disorder

Uhlenhuth¹,

Starčević²,

Qualls³

et al. 2006

Journal of Clinical Psychopharmacology

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The objective of this study was to ascertain the relationship of alprazolam plasma levels and an anxiety-prone cognitive style to the characteristics and severity of early withdrawal after abrupt discontinuation of alprazolam in 26 patients with panic disorder. After 8 and 9 weeks of fixed-dose treatment, patients were hospitalized for 24 hours. On 1 admission, ordered at random, treatment was maintained; on the other, placebo was substituted double blind. The Anxious Thoughts and Tendencies questionnaire was administered before treatment. Alprazolam plasma levels were measured 7 times on the day after each admission. Before each blood sampling, the Profile of Mood States and performance tasks were administered, and vital signs were recorded. On the day after abrupt discontinuation of alprazolam, Profile of Mood States anxiety, depression, fatigue, and confusion increased; vigor and elation decreased; speed on the digit symbol substitution task improved; and systolic blood pressure increased substantially over time. High Anxious Thoughts and Tendencies scores were related specifically to more anxiety. Our findings (1) confirm that dysphoric mood, fatigue, low energy, confusion, and elevated systolic blood pressure are part of the early syndrome of withdrawal from alprazolam in patients with panic disorder, notably as the drop in plasma levels approaches 50%; (2) indicate a psychomotor deficit persisting beyond dose stabilization; (3) suggest that an anxiety-prone cognitive style measurable before undertaking treatment may be a risk factor for more severe anxiety upon discontinuation; and (4) provide a rationale for applying cognitive behavior therapy during benzodiazepine taper.

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“…Aportaciones de la investigación basada en un enfoque de personalidad normal en muestras con trastorno de pánico, con o sin agorafobia Desde modelos de personalidad normal se pone de manifiesto que las personas con trastornos de ansiedad tienden a ser perfeccionistas (Antony, Purdon, Huta y Swinson, 1998;Frost y Steketee, 1997;Matsunaga et al, 2000;Uhlenhuth et al, 2002), este dato se confirma también en el caso concreto de los pacientes con TP (Antony et al, 1998) y en mayor porcentaje en pacientes con TPA cuando existe comorbilidad con TPe (Iketani et al, 2002). Según Iketani y colaboradores (2002) los indicadores más robustos de perfeccionismo son la comorbilidad con el Cluster C, concretamente con TPe Evitativo y Obsesivo-compulsivo.…”

Section: Aportaciones De La Investigación Basada En Un Enfoque De Perunclassified

Personalidad y Trastorno de Pánico: Un estudio de revisión

2014

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Resumen: A través de este trabajo ofreceremos una revisión exhaustiva de las aportaciones científicas que se han realizado en las últimas tres décadas sobre la influencia de la personalidad en aspectos clínicos y psicopatológi-cos del Trastorno de pánico (TP), con o sin agorafobia (AG). Los resultados que expondremos serán representativos de dos modelos distintos de evaluación y estudio de la personalidad, el modelo de personalidad clínico y el modelo de personalidad normal. Desde ambas perspectivas, parece existir suficiente evidencia para asociar las dimensiones y rasgos patológicos de personalidad más relacionados con la emocionabilidad negativa y la desregulación emocional con el TP, con o sin AG. Entre las variables de vulnerabilidad identificadas en relación a la mayor probabilidad de inicio y mantenimiento del TP destacan: patrones familiares específicos de educación y crianza, la inhibición conductual, la sensibilididad a la ansiedad, y, más recientemente, la percepción de control de la ansiedad. Desde una perspectiva clínica es muy relevante la identificación de estos factores de vulnerabilidad psicopatológica puesto que abren la puerta al diseño e implementación de programas de promoción, prevención y tratamiento que se dirijan específicamente a los procesos psicológicos alterados y mitiguen, con mayor rapidez y eficacia, el sufrimiento de las personas que padecen estas patologías. Palabras clave: Personalidad; trastorno de pánico; revisión; agorafobia; trastornos de la personalidad; factores de riesgo.Title: Personality and panic disorder: a review. Abstract: In this work we offer a comprehensive review of the scientific contributions that have been made in the last three decades on the influence of personality in the psychopathology of panic disorder (PD) with or without agoraphobia (AG). The findings that are discussed are representative of two different theoretical models in the assessment and the study of personality, the clinical approach to personality and the dimensional approach to personality. From both perspectives, there is sufficient evidence to associate the personality factors and the pathological personality traits more related to negative emotionality and emotional dysregulation with PD, with or without AG. Among the vulnerability factors identified in relation to the onset of PD and the maintenance of its symptoms are: specific family and education patterns, behavioral inhibition, anxiety sensitivity, and, more recently, the perception of anxiety control. From a clinical perspective it is very important to identify these psychopathological vulnerabilities in order to design and implement promotion, prevention and treatment programs that specifically target the disordered psychological processes and reduce, more quickly and effectively, the suffering of people with these conditions.

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A general anxiety-prone cognitive style in anxiety disorders

Cited by 15 publications

References 48 publications

Influence of Psychiatric Comorbidity on Recovery and Recurrence in Generalized Anxiety Disorder, Social Phobia, and Panic Disorder: A 12-Year Prospective Study

Influence of Psychiatric Comorbidity on Recovery and Recurrence in Generalized Anxiety Disorder, Social Phobia, and Panic Disorder: A 12-Year Prospective Study

Abrupt Discontinuation of Alprazolam and Cognitive Style in Patients With Panic Disorder

Personalidad y Trastorno de Pánico: Un estudio de revisión

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