Attentional Bias in Children with Social Anxiety Disorder

Previous research stated a robust attentional bias to threat in adult anxiety. However, the number of studies analyzing attentional biases in clinically anxious children is limited and results are inconsistent. The present study aims to assess attentional biases in children with social anxiety disorder (n?=?37) and healthy control children (n?=?42) using a free-viewing eye-tracking paradigm. Children viewed different picture pairs consisting of social and non-social stimuli under two conditions (with/without a stressor to activate social threat perception). We found the direction of gaze regarding threatening stimuli to be context-dependent. Both groups showed a hypervigilance-avoidance pattern to angry faces when they were paired with houses. In face–face trials, angry faces were less often initially fixated than neutral or happy faces in both groups. However, schema activation differentially affected initial fixations in angry-neutral face pairs across groups. Children with social anxiety disorder more often initially directed their gaze to angry faces than did healthy control children, indicating a lack of inhibiting threat representations rather than a hypervigilance to threat.     

Memory dysfunction in panic disorder: an investigation of the role of chronic benzodiazepine use

Background: Studies of the neurocognitive effects of long‐term benzodiazepine use have been confounded by the presence of neurocognitive deficits characterizing the clinical conditions for which these medications are taken. Similarly, studies of the neurocognitive effects of anxiety disorders have been confounded by the inclusion of chronically benzodiazepine‐medicated patients. This study was designed to tease apart the potentially confounding effects of long‐term benzodiazepine use and panic disorder (PD) on memory and visuoconstructive abilities. Methods: Twenty chronically benzodiazepine‐medicated and 20 benzodiazepine‐free patients with PD with agoraphobia were compared with a group of 20 normal control participants, group‐matched for age, education, and gender on a battery of neuropsychological tests assessing short‐term, episodic long‐term, and semantic memory, as well as visuoconstructive abilities. Results: Results indicated that benzodiazepine‐free panic patients were relatively impaired in nonverbal short‐term and nonverbal episodic long‐term memory and visuoconstructive abilities, whereas verbal short‐term and verbal episodic memory and semantic memory were preserved. Only limited evidence was found for more pronounced impairments in chronically benzodiazepine‐medicated PD patients. Conclusions: This study provides evidence that patients with PD are characterized by relative impairments in nonverbal memory and visuoconstructive abilities, independent of benzodiazepine use. Nonetheless, we found evidence that chronic treatment with benzodiazepines is associated with intensification of select relative impairments in this realm. Documentation of these deficits raises questions about the broader etiology of neurocognitive impairment in PD as well as its impact on daily functioning. Depression and Anxiety, 2011. © 2011 Wiley Periodicals, Inc.     

Perfil Clínico e Desfechos em 30 Dias de Pacientes Portadores de Valva Aórtica Bicúspide Submetidos à Cirurgia em Valva Aórtica e/ou Aorta

BackgroundThe bicuspid aortic valve (BAV) affects 0.5 to 2% of the population and is associated with valve and aortic alterations. There is a lack of studies on the profile of these patients in the Brazilian population.ObjectiveTo describe the profile of patients with BAV undergoing valve and/or aortic surgery in a tertiary cardiology center, in addition to the outcomes related to the intervention.MethodsRetrospective cohort including 195 patients (mean age 54±14 years, 73.8% male) diagnosed with BAV who underwent surgical approach (valvular and/or aorta) from 2014 to 2019. Clinical data, echocardiographic and tomographic studies were evaluated, as well as characteristics of the intervention and events in 30 days. A value of p<0.05 was considered statistically significant.ResultsWe found a high prevalence of aortic aneurysm (56.5%), with a mean diameter of 46.9±10.2 mm. Major aortic regurgitation was found in 25.1% and major aortic stenosis in 54.9%. Isolated aortic valve surgery was performed in 48.2%, isolated aortic surgery in 6.7% and combined surgery in 45.1%. The 30-day mortality was 8.2%. In the multivariate analysis, the predictors of the combined outcome at 30 days (death, atrial fibrillation and reoperation) were age (OR 1.044, 95% CI 1.009-1.081, p=0.014) and left ventricular mass index (OR 1.009, 95% CI 1.000-1.018, p=0.044).ConclusionPatients with BAV approached in our service have a higher incidence of aortopathy, with the additional need to evaluate the aorta with computed tomography or magnetic resonance imaging.     

Visuospatial abilities, memory, and executive functioning in trichotillomania and obsessive-compulsive disorder

Few studies have compared neuropsychological functioning in trichotillomania (TTM) and obsessive-compulsive disorder (OCD). In OCD, most studies suggest abnormal visuospatial abilities, memory, and executive functioning. We compared 23 TTM, 21 OCD and 26 healthy control individuals on neuropsychological tasks assessing these abilities. Neither the TTM nor the OCD groups suffered from generalized neuropsychological deficits compared to the healthy control group. TTM participants showed increased perseveration on the Object Alternation Task suggesting difficulties with response flexibility. OCD participants showed impaired ability to learn from feedback on the Wisconsin Card Sorting Test. Other executive functions, as well as memory and visuospatial abilities were unimpaired in TTM and OCD. Our data suggest that TTM and OCD are characterized by different patterns of neuropsychological dysfunction.     

Emotion recognition deficits in body dysmorphic disorder

Patients with Body Dysmorphic Disorder (BDD) are characterized by excessive concerns about imagined defects in their appearance, most commonly, facial features. In this study, we investigated (1) the ability to identify facial expressions of emotion, and (2) to discriminate single facial features in BDD patients, Obsessive-Compulsive Disorder (OCD) patients, and in healthy control participants. Specifically, their ability for general facial feature discrimination was assessed using the Short Form of the Benton Facial Recognition Test (Benton AL, Hamsher KdeS, Varney NR, Spreen O. Contributions to neuropsychological assessment: a clinical manual. New York: Oxford University Press; 1983). However, findings of the BFRT indicate no differences among the groups. Moreover, participants were presented with facial photographs from the Ekman and Friesen (Ekman P, Friesen W. Unmasking the face: a guide to recognizing emotions from facial cues. Englewood Cliffs, NJ: Prentice-Hall; 1975 and Ekman P, Friesen W. Pictures of facial affect. Palo Alto: Consulting Psychologists Press, 1976) series and were asked to identify the corresponding emotion. The BDD group was less accurate than the control group, but not the OCD group, in identifying facial expressions of emotion. Relative to the control and OCD groups, the BDD group more often misidentified emotional expressions as angry. In contrast to the findings of Sprengelmeyer et al. [Proc. Royal Soc. London Series B: Biol. Sci. 264 (1997),1767], OCD patients did not show a disgust recognition deficit. Poor insight and ideas of reference, common in BDD, might partly result from an emotion recognition bias for angry expressions. Perceiving others as angry and rejecting might reinforce concerns about one's personal ugliness and social desirability.     

Maternal Parenting and Child Behaviour: An Observational Study of Childhood Social Anxiety Disorder

Etiological models of social anxiety disorder (SAD) suggest parenting is involved in the development of SAD. However, previous studies have often neglected potential contributions of child behaviour to parenting behaviour. Further, parent–child interaction has often been assessed in artificial laboratory settings thereby impairing ecological validity. Children (aged 9–13 years) with SAD (n?=?27) and healthy controls (HC, n?=?27) completed a puzzle task with mothers present at home. Parent–child interactions were analysed for parenting (e.g., negativity, involvement) and child behaviour (e.g., dependence, helplessness). Mothers of children with SAD showed more involvement than mothers of HC children. Maternal involvement was related to child dependence in HC dyads only, while maternal negativity was correlated with negative child behaviour in both groups. The study indicates maternal over-involvement in their interactions with children with SAD at home. The lack of relation to child behaviour in SAD dyads points to inflexibility in mother–child interactions.     

Psychophysiological responses to idiosyncratic stress in bulimia nervosa and binge eating disorder

This study examined psychophysiological stress responses to idiosyncratically relevant stress in bulimia nervosa (BN) and binge eating disorder (BED), in relation to autonomic cardiac control and nutritional status. A total of 81 women with BN, BED and healthy controls (HC) took part in an in sensu exposure to idiosyncratic stress. Psychological and peripheral physiological parameters were measured, and tonic heart rate variability, nutritional status, and types of stress were determined. In response to stress exposure, both eating disordered groups showed a stronger reactivity of sadness, and the BED group showed a stronger reactivity of insecurity than the HC group. Desire to binge was increased in the context of interpersonal stress. Stress exposure led to increased cardiovascular activity and reduced electrodermal activity that did not differ by group. The BN-specific symptomatology moderated the association between autonomic cardiac control and psychophysiological stress responses. The results suggest common and specific psychophysiological processes in symptom maintenance through life stress in BN and BED.     

Electrocortical processing of food and emotional pictures in anorexia nervosa and bulimia nervosa

Objective To compare the electrocortical processing of food pictures in participants with anorexia nervosa (n = 21), bulimia nervosa (n = 22), and healthy controls (HCs) (n = 32) by measuring the early posterior negativity, an event-related potential that reflects stimulus salience and selective attention. Methods We exposed these three groups to a rapid stream of high- and low-calorie food pictures, as well as standard emotional and neutral pictures. Results Event-related potentials in the time range of 220 milliseconds to 310 milliseconds on posterior electrodes differed between groups: patients with eating disorders showed facilitated processing of both high- and low-calorie food pictures relative to neutral pictures, whereas HC participants did so only for the high-calorie pictures. Subjective palatability of the pictures was rated highest by patients with anorexia nervosa, followed by the HC and bulimia nervosa groups. Conclusions Patients with eating disorders show a generalized attentional bias for food images, regardless of caloric value. This might explain the persistent preoccupation with food in these individuals.