AN ETIOLOGICAL UNDERSTANDING OF BIPOLAR DISORDER-ANXIETY DISORDER COMORBIDITY: THE ROLE OF ANXIETY SENSITIVITY AND TRAIT ANXIETY
AuthorO'Garro-Moore, Jared K.
AdvisorAlloy, Lauren B.
Committee memberMcCloskey, Michael S.
Heimberg, Richard G.
Drabick, Deborah A.
Weisberg, Robert W.
Fauber, Robert L.
Social Rhythm Disruption
Permanent link to this recordhttp://hdl.handle.net/20.500.12613/2040
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AbstractLittle to no research has evaluated factors that explain the manifestation and maintenance of bipolar disorder-anxiety disorder (BD-AD) comorbidity. The literature has shown that disruption of social and circadian rhythms is associated with mood episode onset. This association is especially pronounced among individuals who have a sensitive behavioral approach system (BAS). Inasmuch as anxiety sensitivity and trait anxiety have been associated both with BD and social rhythm disruption, it is worth examining whether anxiety sensitivity and trait anxiety confer risk for mood episode onset. The aims of this project were to: 1) evaluate trait anxiety and anxiety sensitivity as predictors of social rhythm disruption and BD-AD comorbidity, 2) examine social rhythm disruption (SRD) as a mediator of the association between trait anxiety and anxiety sensitivity and BD-AD comorbidity status, and 3) explore behavioral approach system sensitivity in these processes as contributing to the vulnerability to BD-AD comorbidity. A sample of 156 young adults participated in a multi-wave study in which they completed diagnostic interviews, symptom measures, and life event interviews which assessed the occurrence of positive and negative life events and the degree of SRD following these events every six months. Partial support for the hypotheses was found. Initial anxiety sensitivity, but not trait anxiety, positively predicted SRD for rewarding life events and follow-up bipolar symptoms. Additionally, SRD following positive life events predicted increases in depressive symptoms, but not hypomanic symptoms. SRD mediated the relationship between anxiety sensitivity and depressive symptoms. Furthermore, this relationship was stronger for healthy controls than for those with a bipolar disorder (BD) diagnosis or at-risk for developing BD. Moreover, individuals with a comorbid BD-AD diagnosis tended to have greater social rhythm disruption following negative life events than BD only or healthy individuals. Unexpectedly, individuals with comorbid BD-AD did not exhibit greater anxiety sensitivity or trait anxiety. Overall, the results suggest that anxiety sensitivity is a factor that may help to identify individuals who are vulnerable to bipolar symptoms. Furthermore, SRD is a mechanism that may partially explain this relationship.
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Somatic Complaints in Anxious YouthKendall, Philip C.; Fauber, Robert L.; Brown, Ronald T.; Giovannetti, Tania; McCloskey, Michael S.; Ginsburg, Golda (Temple University. Libraries, 2011)Objective: This study examined (a) the distribution of physical symptoms in youth with specific primary anxiety disorders (i.e. separation anxiety disorder [SAD], generalized anxiety disorder [GAD], and social phobia [SP]) and (b) their response to treatment with cognitive-behavioral therapy (CBT; 14 sessions of CBT over the course of 12 weeks), medication, combination therapy (CBT + medication), or pill placebo in a sample. Method: Anxiety disordered youth (N = 488, age 7-17) who met criteria for a primary diagnosis of GAD, SAD, and/or SP as part of the Child/Adolescent Anxiety Multimodal Study (CAMS; Walkup et al. 2008) were included in this study. The sample was diverse and included children with comorbid secondary diagnoses. Results: The most common somatic complaints were headache, stomach pain or aches, feeling drowsy or too sleepy, head cold or sniffles, and sleeplessness. The distribution of these complaints did not differ across diagnostic groups. The number and severity of physical symptoms decreased over the course of treatment. Treatment condition, including placebo, was unrelated to the number and severity of physical symptoms posttreatment. Conclusions: Treatment of anxiety leads to a decrease in the number and severity of physical symptoms experienced in anxiety-disordered youth, irrespective of treatment type.
The Youth Anxiety Measure for DSM-5 (YAM-5): Development and First Psychometric Evidence of a New Scale for Assessing Anxiety Disorders Symptoms of Children and AdolescentsMuris, P; Simon, E; Lijphart, H; Bos, A; Hale, W; Schmeitz, K; Albano, AM; Bar-Haim, Y; Beesdo-Baum, K; Beidel, D; Bender, P; Borelli, J; Broeren, S; Cartwright-Hatton, S; Craske, M; Crawford, E; Creswell, C; DeSousa, D; Dodd, H; Eley, T; Hoff Esbjørn, B; Hudson, J; de Hullu, E; Farrell, L; Field, A; Fliek, L; Garcia-Lopez, LJ; Grills, A; Hadwin, J; Hogendoorn, S; Holly, L; Huijding, J; Ishikawa, SI; Kendall, P; Knappe, S; LeBeau, R; Leikanger, E; Lester, K; Loxton, H; McLellan, L; Meesters, C; Nauta, M; Ollendick, T; Pereira, A; Pina, A; Rapee, R; Sadeh, A; Spence, S; Storch, EA; Vreeke, L; Waite, P; Wolters, L (2017-02-01)© 2016, The Author(s). The Youth Anxiety Measure for DSM-5 (YAM-5) is a new self- and parent-report questionnaire to assess anxiety disorder symptoms in children and adolescents in terms of the contemporary classification system. International panels of childhood anxiety researchers and clinicians were used to construct a scale consisting of two parts: part one consists of 28 items and measures the major anxiety disorders including separation anxiety disorder, selective mutism, social anxiety disorder, panic disorder, and generalized anxiety disorder, whereas part two contains 22 items that focus on specific phobias and (given its overlap with situational phobias) agoraphobia. In general, the face validity of the new scale was good; most of its items were successfully linked to the intended anxiety disorders. Notable exceptions were the selective mutism items, which were frequently considered as symptoms of social anxiety disorder, and some specific phobia items especially of the natural environment, situational and other type, that were regularly assigned to an incorrect category. A preliminary investigation of the YAM-5 in non-clinical (N = 132) and clinically referred (N = 64) children and adolescents indicated that the measure was easy to complete by youngsters. In addition, support was found for the psychometric qualities of the measure: that is, the internal consistency was good for both parts, as well as for most of the subscales, the parent–child agreement appeared satisfactory, and there was also evidence for the validity of the scale. The YAM-5 holds promise as a tool for assessing anxiety disorder symptoms in children and adolescents.
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