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Chen Hui 《Aging & mental health》2017,21(12):1294-1302
Objectives: China has entered the aging society, but the social support systems for the elderly are underdeveloped, which may make the elderly feel anxiety about their health and life quality. Given the prevalence of generalized anxiety disorder (GAD) in the elderly, it is very important to pay more attention to the treatment for old adults. Although cognitive behavioral therapy targeting intolerance of uncertainty (CBT-IU) has been applied to different groups of patients with GAD, few studies have been performed to date. In addition, the effects of CBT-IU are not well understood, especially when applied to older adults with GAD.

Method: Sixty-three Chinese older adults with a principal diagnosis of GAD were enrolled. Of these, 32 were randomized to receive group CBT-IU (intervention group) and 31 were untreated (control group). GAD and related symptoms were assessed using the Penn State Worry Questionnaire, Intolerance of Uncertainty Scale–Chinese Version, Beck Anxiety Inventory, Beck Depression Inventory, Why Worry-II scale, Cognitive Avoidance Questionnaire, Generalized Anxiety Disorder Questionnaire-IV, and Generalized Anxiety Disorder Severity Scale across the intervention. The changes between pre and after the intervention were collected, as well as the six-month follow-up. F test and repeated-measures ANOVA were conducted to analyze the data.

Results: Compared to control group, the measures’ scores of experimental group decreased significantly after the intervention and six-month follow-up. Besides the main effects for time and group were significant, the interaction effect for group × time was also significant. These results indicated the improvement of the CBT-IU group and the persistence of effect after six months.

Conclusion: Group CBT-IU is effective in Chinese older adults with GAD. The effects of CBT-IU on GAD symptoms persist for at least six months after treatment.  相似文献

2.

Background

It has been proposed that worry in individuals with Generalized Anxiety Disorder may be reinforced by a positive effect of worry on decision making, as reflected by a steeper learning curve on the Iowa Gambling Task (IGT). We hypothesized that this apparent positive effect of worry is dependent on the IGT parameters, in particular the absence of an opportunity to avoid decisions.

Objective

(1) To replicate previous findings on the effect of worry on IGT performance. (2) To examine the influence of avoidance opportunity on IGT performance. We hypothesized that the positive effect of worry on learning would be abolished or reversed by the opportunity to avoid.

Method

A standard IGT and a new IGT version that includes a pass (avoidance) option were completed by 78 and 79 participants, respectively.

Results

A beneficial effect of worry on learning in the standard version of the IGT was not observed. In the pass version of the IGT, worry status and avoidance were negatively associated with performance. Worry was not related, however, to pass usage. The hypothesized mediating effect of avoidance was non-significant.

Limitations

It is unclear to what extent these findings generalize to real-life decision making and how clinical status affects results.

Conclusion

The possibility to avoid a decision results in poorer IGT performance in high relative to low trait worriers. Possible explanations for these findings are discussed.  相似文献
3.

Background and objectives

Increased utilization of online medical information seeking demands investigation of potentially detrimental effects of these activities. The present study investigated whether viewing medical websites may adversely affect anxiety sensitivity (AS), a well-established risk factor for the development of psychopathology.

Methods

Participants (N = 52) were randomly assigned to view medical symptom related websites or general health and wellness control websites. AS was measured before and after the website viewing.

Results

Individuals in the medical website group reported higher AS compared to the control group at post-manipulation after controlling for baseline health anxiety and baseline AS. Additionally, intolerance of uncertainty (IU), an individual difference variable assessing negative beliefs about uncertainty, significantly moderated this effect such that medical website viewing only affected AS in participants with high IU but not in participants with low IU.

Limitations

The limitations of the current study include the lack of individualization of the website viewing and the short duration of the website viewing.

Conclusions

The results of this study provide initial evidence that exposure to online medical information could increase risk for anxiety psychopathology in individuals with elevated IU. Additionally, these results provide support for a learning based model of the etiology of AS.  相似文献
4.
Dysfunctional beliefs may contribute to the development and maintenance of obsessive-compulsive disorder (OCD) according to some cognitive theories. As little has been investigated about the pathophysiology of dysfunctional beliefs in OCD, this study aimed to determine the anatomical regions that are related to OCD-related dysfunctional beliefs. We first examined 23 non-medicated patients with OCD by magnetic resonance imaging (MRI) and assessed their dysfunctional beliefs using the Obsessive Beliefs Questionnaire-44 (OBQ-44). OBQ-44 has three factors: (1) inflated personal responsibility and the tendency to overestimate threat (OBQ-RT), (2) perfectionism and intolerance of uncertainty (OBQ-PI), and (3) over-importance and over-control of thoughts (OBQ-IC). Voxelwise analysis was used to investigate the correlation between whole brain gray matter volume and each score of OBQ-44 covarying for age, gender, education, severity, and intracranial volume. We found a significant negative correlation between gray matter volume and OBQ-IC scores in the left amygdala; there was no significant correlation with other scores. Comparison of the amygdala volume between patients with OCD and 23 matched healthy controls indicated no volume difference between groups. Taken together, the left amygdala volume may play a role in the presence of certain dysfunctional beliefs in OCD patients.  相似文献
5.
Objective: Few studies have examined health anxiety in older adults, and it is unknown which factors account for age-related differences in health anxiety. Given similarities between health anxiety and the anxiety disorders, anxiety-related constructs, including anxiety sensitivity, intolerance of uncertainty, emotion regulation, and anxiety control, were examined as mediators of the relation between age (older vs. young adults) and health anxiety. Methods: Eighty-six older adults aged 60 and older and 117 young adults aged 18 to 30 completed several self-report measures of health anxiety and anxiety-related constructs. Results: Young adults reported higher levels of health anxiety than older adults. Anxiety sensitivity and intolerance of uncertainty partially mediated the relation between age and health anxiety. Perceived anxiety control, reappraisal, and suppression did not mediate the relation between age and health anxiety. Conclusions: Anxiety sensitivity and intolerance of uncertainty are predisposing characteristics that appear to partially explain age-related differences in health anxiety. These constructs may be necessary targets for assessment and interventions among older and young adults.  相似文献
6.
Generalized anxiety disorder (GAD) is one of the most common comorbid disorders found in individuals with eating disorders. Despite this, little is known of shared vulnerability factors between the two disorders. The aim of the present study was to examine the four main components of a cognitive model for GAD in the eating disorders. One hundred and sixty-two females took part. Three groups were formed comprising of 19 participants with an eating disorder and GAD, 70 with an eating disorder without GAD and 73 healthy controls. All completed self-report questionnaires that measured eating attitudes, levels of GAD, intolerance of uncertainty, positive beliefs about worry, negative problem orientation, and cognitive avoidance. Participants with an eating disorder and GAD scored the highest on all four components when compared to healthy individuals and on most components when compared to those with an eating disorder. Participants with an eating disorder without GAD scored higher on all components compared to healthy controls. Findings extend our understanding of shared vulnerability factors between the eating disorders and GAD.  相似文献
7.
Evidence is accumulating that intolerance of uncertainty (IU) may be a transdiagnostic maintaining factor across the anxiety disorders and depression. However, psychometric studies of the most commonly used measure of IU have typically used undergraduate students, and the factor structure has been highly inconsistent. Previous studies have also tended to focus on one diagnostic subgroup or related symptom, thereby limiting transdiagnostic comparisons. The first aim of this study was to test the latent structure of a commonly used measure of IU in a treatment-seeking sample with anxiety and depression (n = 463). The second aim was to examine psychometric properties of the best fitting solution, including internal reliability, convergent validity, and discriminant validity. Confirmatory factor analysis was used to compare the goodness of fit of five models previously found with undergraduate and community samples. A two-factor solution, comprising of prospective anxiety and inhibitory anxiety, was the best fitting model. The total scale and subscales demonstrated excellent internal reliability. Convergent validity was demonstrated by the scales correlating with symptoms associated with five anxiety disorders and depression, as well as neuroticism, distress and disability. IU explained unique variance in all symptom measures, even after controlling for neuroticism and other symptom measures. Evidence of discriminant validity was also found for each IU subscale. Findings support reliability and validity of the two-factor solution, and are consistent with IU being a transdiagnostic maintaining factor.  相似文献
8.

Objective

Intolerance of uncertainty (IU) is an important concept in eating disorders (ED). Cognitive, emotional, and behavioral features of IU amongst individuals with and without ED were investigated.

Method

Participants completed the intolerance of uncertainty scale (IUS) and four versions of a data-gathering task varying in difficulty/uncertainty, and rated their Beads task experience.

Results

ED groups had significantly higher IUS scores than healthy controls (HC). Bulimia Nervosa (BN) participants requested more cues than HC and Anorexia Nervosa (AN) participants before making decisions. ED groups found the task more distressing than HC participants, with those with BN feeling more uncertain and less confident in their decisions, and those with AN attributing greater importance in making the correct decision.

Discussion

While both ED groups reported raised IUS scores only BN participants engaged in an elevated evidence requirement data gathering style. Future research might benefit from further exploration of the role of perseverative processes in BN.  相似文献
9.
Both responsibility beliefs and intolerance of uncertainty have been implicated in compulsive checking behavior. Despite this, the exact relationship of these two variables with compulsive checking behavior is yet to be determined. Using a mixed sample of individuals consisting of compulsive checkers as well as non-clinical participants, we assessed the validity of a mediation model in which the relationship between responsibility beliefs and compulsive checking was mediated by intolerance of uncertainty. Although both responsibility beliefs and intolerance of uncertainty were correlated with the frequency of compulsive checking, the relationship between responsibility and checking was fully mediated by intolerance of uncertainty. Implications for the understanding of the relationship between these constructs, as well for conceptualisation of clinical checking problems are discussed.  相似文献
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