Genetic and pharmacological disruption of neurokinin 1 receptor function decreases anxiety-related behaviors and increases serotonergic function

Alterations in serotonin (5-hydroxytriptamine, 5-HT), norepinephrine, and γ-aminobutyric acid have been linked to the pathophysiology of anxiety and depression, and medications that modulate these neurotransmitters are widely used to treat mood disorders. Recently, the neuropeptide substance P (SP) and its receptor, the neurokinin 1 receptor (NK1R), have been proposed as possible targets for new antidepressant and anxiolytic therapies. However, animal and human studies have so far failed to provide a clear consensus on the role of SP in the modulation of emotional states. Here we show that both genetic disruption and acute pharmacological blockade of the NK1R in mice result in a marked reduction of anxiety and stress-related responses. These behavioral changes are paralleled by an increase in the firing rate of 5-HT neurons in the dorsal raphe nucleus, a major source of serotonergic input to the forebrain. NK1R disruption also results in a selective desensitization of 5-HT1A inhibitory autoreceptors, which resembles the effect of sustained antidepressant treatment. Together these results indicate that the SP system powerfully modulates anxiety and suggest that this effect is at least in part mediated by changes in the 5-HT system.

Point mutant mice with hypersensitive α4 nicotinic receptors show dopaminergic deficits and increased anxiety

Knock-in mice were generated that harbored a leucine-to-serine mutation in the α4 nicotinic receptor near the gate in the channel pore. Mice with intact expression of this hypersensitive receptor display dominant neonatal lethality. These mice have a severe deficit of dopaminergic neurons in the substantia nigra, possibly because the hypersensitive receptors are continuously activated by normal extracellular choline concentrations. A strain that retains the neo selection cassette in an intron has reduced expression of the hypersensitive receptor and is viable and fertile. The viable mice display increased anxiety, poor motor learning, excessive ambulation that is eliminated by very low levels of nicotine, and a reduction of nigrostriatal dopaminergic function upon aging. These knock-in mice provide useful insights into the pathophysiology of sustained nicotinic receptor activation and may provide a model for Parkinson's disease.

Persistent elevations of cerebrospinal fluid concentrations of corticotropin-releasing factor in adult nonhuman primates exposed to early-life stressors: implications for the pathophysiology of mood and anxiety disorders.

There is increasing evidence for an important role of adverse early experience on the development of major psychiatric disorders in adulthood. Corticotropin-releasing factor (CRF), an endogenous neuropeptide, is the primary physiological regulator of the mammalian stress response. Grown nonhuman primates who were exposed as infants to adverse early rearing conditions were studied to determine if long-term alterations of CRF neuronal systems had occurred following the early stressor. In comparison to monkeys reared by mothers foraging under predictable conditions, infant monkeys raised by mothers foraging under unpredictable conditions exhibited persistently elevated cerebrospinal fluid (CSF) concentrations of CRF. Because hyperactivity of CRF-releasing neurons has been implicated in the pathophysiology of certain human affective and anxiety disorders, the present finding provides a potential neurobiological mechanism by which early-life stressors may contribute to adult psychopathology.

Morningness-eveningness and anxiety among adults: A matter of sex/gender?

People’s health and well-being may be determined by the interaction of endogenous and external rhythms. Late chronotypes should become anxious because of the demand to perform tasks in a society oriented preferentially to morning work. In this study, we examined the relationship between morningness and anxiety in 559 adults (age range 40–63 years) from rural environments who completed morningness–eveningness and anxiety measures. Results indicated a negative correlation between morningness and anxiety in women, but not in men, suggesting the relevance of gender-related variables. When demographic characteristics were considered, women’s anxiety was predicted by low educational level and eveningness, whereas men’s anxiety was predicted by being single, having children, being unemployed, and eveningness. Some hypotheses of gender-related social roles are postulated as a possible explanation of the results.

The Impact of Shyness on Loneliness, Social Anxiety, and School Liking in Late Childhood

Author: Charity M. Walker Title: THE IMPACT OF SHYNESS ON LONELINESS, SOCIAL ANXIETY, AND SCHOOL LIKING IN LATE CHILDHOOD Advisor: Maria T. Riva, Ph.D. Degree Date: August 2011 ABSTRACT Shyness is associated with several emotional, social, and academic problems. While there are multiple difficulties that often accompany shyness, there appear to be some factors that can moderate negative effects of shyness. Research has demonstrated that certain parenting factors affect the adjustment of shy children in early childhood, but there is minimal research illuminating the effect of parenting factors in older age groups. The first purpose of this study was to examine relationships between shyness and loneliness, social anxiety, and school liking. The second purpose was to investigate whether the quality of the relationship between a parent and a 10- to 15-year-olds child influences the amount of loneliness or social anxiety a shy child experiences or how the child feels about school. Parent-child dyads served as participants and were recruited from public and private middle schools and church youth groups in Colorado and Indiana. Child participants completed several self-report surveys regarding their relationship with a parent, shyness, loneliness, social anxiety, and their attitude toward school. Parents completed a survey about their relationship with their child and responded to questions related to their perceptions of their child's shyness. Data was analyzed with a series of correlation and regression analyses. Greater degrees of self-reported shyness were found to be associated with higher levels of loneliness and social anxiety and less positive feelings about school. Due to a problem with multicollinearity during data analysis, this study was not able to explore the effect of the parent-child relationship quality on the associations between shyness and adjustment factors. Overall, these findings imply that shyness remains an important issue as children approach adolescence. Further research is needed to continue learning about the potential importance of parent-child interactions in reducing maladjustment for shy children during late childhood.

Mitigating Risk For Anxiety Among Preschool-Age Children Living In Poverty: Evaluating The Impact Of Adult-Provided Social Support On Autonomic Stress Reactivity

Poverty increases children's exposure to stress, elevating their risk for developing patterns of heightened sympathetic and parasympathetic stress reactivity. Repeated patterns of high sympathetic activation and parasympathetic withdrawal place children at risk for anxiety disorders. This study evaluated whether providing social support to preschool-age children during mildly stressful situations helps reduce reactivity, and whether this effect partly depends on children's previously assessed baseline reactivity patterns. The Biological Sensitivity to Context (BSC) theory proposes that highly reactive children may be more sensitive than less reactive children to all environmental influences, including social support. In contrast, conventional physiological reactivity (CPR) theory contends that highly reactive children are more vulnerable to the impact of stress but are less receptive to the potential benefits present within their social environments. In this study, baseline autonomic reactivity patterns were measured. Children were then randomly assigned to a high-support or neutral control condition, and the effect of social support on autonomic response patterns was assessed. Results revealed an interaction between baseline reactivity profiles and experimental condition. Children with patterns of high-reactivity reaped more benefits from the social support in the experimental condition than did their less reactive peers. Highly reactive children experienced relatively less reactivity reduction in the neutral condition while experiencing relatively greater reactivity reduction in the support condition. Despite their demonstrated stability over time, reactivity patterns are also quite susceptible to change at this age; therefore understanding how social support ameliorates reactivity will further efforts to avert stable patterns of high-reactivity among children with high levels of stress, ultimately reducing risk for anxiety disorders.

A Young Child's Anxiety and Math Performance: Enhancing Cognitive Behavioral Intervention with Conjoint Behavioral Consultation

Partnering with families, school personnel, and community resources is an important step to supporting the child and family, especially when children might suffer from debilitating anxiety concerns. However, little research examines the impact of anxiety on math performance for young children participating in school-based interventions enhanced by family components. The following research questions were addressed in the study: 1a) Will a young child with elevated levels of anxiety show a decrease in anxiety symptoms with a Cognitive Behavioral framework intervention program for children? 1b) Will anxiety be reduced with the addition of a Conjoint Behavioral Consultation with the family and teacher? 2a) Will a young child show an increase in math performance after participation in a Cognitive Behavioral framework intervention program for children? 2b) Will math performance be increased with the addition of a Conjoint Behavioral Consultation with the family and teacher? A single-subject staggered baseline across situations intervention study addressed whether the Coping Cat, an evidenced-based child-focused intervention now widely used in schools and clinics to treat childhood anxiety, combined with family and school consultation will decrease elevated anxiety levels and improve math performance in an elementary-aged student. The objective was to support mental health development and math performance with an eight-year-old, female elementary student through a collaborative effort of stakeholders in the student's life. Baseline data was collected with repeated measures of anxiety and math performance, and was compared to two intervention phases: first, a child-focused intervention and second, a family and school consultation. The study tested the theory that the Cognitive Behavioral intervention and Conjoint Behavioral Consultation intervention will influence, positively, the anxiety levels and math performance for an elementary-aged student. Results indicate that the child participant with elevated levels of anxiety showed a reduction in symptoms with the introduction of a Cognitive Behavioral framework intervention when compared to her baseline data. The participant showed further reduction in symptoms across the school and home settings with the implementation of Conjoint Behavioral Consultation when compared to baseline and the first intervention phase. Math performance began to increase with the introduction of the Cognitive Behavioral intervention, and continued to improve with the implementation of the Conjoint Behavioral Consultation. Findings suggest that consultation should begin immediately when an intervention is implemented in order to enhance outcomes.

A Meta-analytic Review of Acceptance-Based Behavioral Interventions for the Treatment of Anxiety

The relative popularity of acceptance and commitment therapy (ACT) has grown in recent years, and inspired the development of contemporary acceptance-based treatment approaches. Acceptance-based therapies differ from traditional cognitive- behavior therapy (CBT) on pragmatic grounds, the import of which implicates the purpose of therapy. CBT utilizes exposure and cognitive change techniques primarily in service of symptom change outcomes; whereas, ACT utilizes exposure and acceptance for purposes of promoting psychological flexibility in the pursuit of personal values. The purpose of this meta-analytic study was to determine the relative efficacy of acceptance- based versus symptom-change behavioral approaches with anxiety disorders and to quantify this impact. A comprehensive literature search turned up 18 studies that met inclusion criteria for this analysis. An effect size was calculated using the standardized mean gain procedure for both the acceptance-based and symptom-change approaches, along with the waitlist control groups. The results demonstrate a large effect size for the acceptance-based approach (Weighted mean ES = .83) and a medium effect size for symptom-change approach (Weighted mean ES = .60). The waitlist control groups demonstrated a small effect size (Weighted mean ES = .24). Based on this review, it is suggested that graduate and internship programs in Clinical Psychology should promote evidence-based training in the use of acceptance-inspired behavioral therapies.

Support groups and cardiac rehabilitation: Effects of partner participation on anxiety and depression

This study analyzes the effect on levels of patient anxiety and depression of a partner joining a cardiac rehabilitation program support group, also taking into account the sex of the patient. The study was undertaken using a two-group comparison design with pre-and post-test measures in non-equivalent groups. The sample comprised patients in the cardiac rehabilitation program (CRP) at the Ramón y Cajal Hospital, Madrid (Spain). Analysis of covariance (ANCOVA) showed direct effects of sex and partner participation in support groups on the anxiety trait. Similarly, interaction effects were observed between the sex variable and partner participation. These results indicate the pertinence of designing separate groups for patients and partners. © 2014 Universidad Complutense de Madrid and Colegio Oficial de Psicólogos de Madrid.

Cross-Disciplinary Collaboration Behavior of Practitioners in the Treatment of Anxiety Disorders

Current research on the collaborative behaviors of conventional and alternative health care providers for the treatment of anxiety is lacking. While there are multiple studies looking at alternative health care integration into primary care, none of them look at anxiety specifically. The purpose of this paper is to provide a preliminary exploration of possible barriers to collaboration between conventional and alternative health care providers for the treatment of anxiety. Quantitative data on collaboration behavior patterns were obtained with an anonymous survey. Data from the surveys were analyzed using a chi-square analysis. Along with these numerical data narrative data from the survey and interviews were collected in order to assess beliefs about the barriers to collaboration from different health care providers. The results indicate that conventional providers collaborate the least with alternative providers and alternative providers collaborate the least with conventional providers. The descriptive results regarding the barriers to collaboration from the study illustrated a common theme, specifically, the lack of education of conventional providers on alternative health care practices on anxiety. This is an exploratory study: therefore it would be beneficial for future researchers to look deeper into the beliefs of health care providers on the barriers to collaboration, possibly identifying the specific barriers to collaboration for each type of healthcare provider.

Social anxiety and self-concept in adolescence

This study analyzes the relationships between social anxiety and dimensions of self-concept in a sample of 2022 (50.1% males) Spanish adolescents, ranging in age from 12 to 16 year-olds. The social anxiety was assessed by the Social Phobia and Anxiety Inventory (SPAI), and self-concept was measured with the Self-Description Questionnaire II (SDQ-II). Logistic regression analyses show that adolescents with social anxiety are more likely to negatively perceive their relationship with opposite sex peers and have lower scores in self-esteem than students without social anxiety. Furthermore, in most logistic models, students with social anxiety also show a higher probability of perceiving their relation with peers of the same sex in a negative way, considering worse student, less attractive and athletic, and more emotional instable than students without social anxiety. The relevance of sex and grade in the relationship between social anxiety and self-concept in adolescence is discussed.

Psychometric properties of the School Anxiety Inventory-Short Version in Spanish secondary education students

Background: The School Anxiety Inventory (SAI) can be applied in different fields of psychology. However, due to the inventory’s administration time, it may not be useful in certain situations. To address this concern, the present study developed a short version of the SAI (the SAI-SV). Method: This study examined the reliability and validity evidence drawn from the scores of the School Anxiety Inventory-Short Version (SAI-SV) using a sample of 2,367 (47.91% boys) Spanish secondary school students, ranging from 12 to 18 years of age. To analyze the dimensional structure of the SAI-SV, exploratory and confirmatory factor analyses were applied. Internal consistency and test-retest reliability were calculated for SAISV scores. Results: A correlated three-factor structure related to school situations (Anxiety about Aggression, Anxiety about Social Evaluation, and Anxiety about Academic Failure) and a three-factor structure related to the response systems of anxiety (Physiological Anxiety, Cognitive Anxiety, and Behavioral Anxiety) were identified and supported. The internal consistency and test-retest reliability were determined to be appropriate. Conclusions: The reliability and validity evidence based on the internal structure of SAI-SV scores was satisfactory.

Subclinical social anxiety and academic performance in adolescence: analysis of theoretical and practical implications

This study analyses the relationship between self-reported social anxiety and academic performance in a sample of 1,616 Spanish students (52.1% males) in compulsory secondary education, aged 12 to 16 years old. Social anxiety was assessed by the Social Phobia and Anxiety Inventory (SPAI) and academic performance was measured with school grades and failing grades. Results reveal that adolescents with social anxiety show a similar academic performance to adolescents without social anxiety. Although t tests found some significant differences in academic grades and number of failing grades, the effect size analysis showed that these differences had no empirical relevance. These findings are discussed considering the gender and grade levels and their theoretical and practical implication.