Browsing by Subject "Anxiety"
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Item Anxiety and Anhedonia in Major Depressive Disorder: The Contributing Roles of Neuroticism, Cognitive Control, and Reward Learning(2017-07-19) Liao, Allen; Walker, Robrina; Trivedi, Madhukar; Carmody, Thomas; Cooper, Crystal; Shaw, MeredithHigher levels of anxiety and higher levels of anhedonia in Major Depressive Disorder (MDD) are two clinical presentations linked to poorer depression treatment outcomes. However, the mechanisms contributing to these symptom presentations remain unclear. Neuroticism, impaired cognitive control, and blunted reward learning have been suggested to be critical processes involved in MDD, and may help to explain symptoms of anxiety and anhedonia. Using baseline data from individuals with MDD (N=296) in the Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) study, we conducted a path analysis using structural equation modeling to model hypothesized relationships between the constructs of neuroticism, cognitive control, and reward learning and symptom levels of anxiety and anhedonia. Post-hoc model modifications were performed and relative model fit was compared. Findings indicate that neuroticism was significantly and positively associated with both anhedonia (standardized coefficient = 0.26, p < .001) and anxiety (standardized coefficient = 0.40, p < .001), whereas cognitive control was significantly and negatively associated with only anxiety (standardized coefficient = -0.18, p < .05). Reward learning was not significantly associated with anxiety or anhedonia in the model. These findings suggest that neuroticism may be a potential predisposing factor to both anxiety and anhedonia in MDD, and that cognitive control may be a protective factor to anxiety in MDD. Reducing neuroticism and improving cognitive control through targeted interventions may improve treatment in MDD for those with anxiety and anhedonia.Item Development and Implementation of a Brief Video-Based Mindful Movement Intervention Prior to Pelvic Exams to Reduce Pain Intensity and State Anxiety(August 2021) Collins, Marielle Heather; Greer, Tracy L.; Evans, Harry M.; Kho, Kimberly A.; Trombello, Joseph M.; Carmody, ThomasMindfulness interventions have demonstrated efficacy for numerous health related outcomes, and been implemented in medical settings to reduce pain and anxiety prior to exams, surgeries, or procedures. This broad investigation begins with a theoretical review exploring a proposed mechanism of mindfulness, improved attention. It presents a theory of mindful movement as a type of mindfulness potentially more efficacious for individuals who struggle with mind-wandering, such as those with depression and anxiety. Mind-wandering and rumination are barriers to mindfulness, and movement has been shown to engage finite executive resources also utilized for mind-wandering. Mindfulness interventions with movement, may promote greater engagement for individuals with attentional challenges, compared to focused attention meditation. Mindful movement may provide a more accessible form of mindfulness for brief interventions, implemented in settings with a wide range of participants. The current study tests the efficacy of a 5-minute mindful movement video prior to pelvic examination in a sample of 99 women at an outpatient gynecology clinic, with the aim of reducing anxiety and pain. Participants were randomized into Treatment (5-minute mindful movement video; n=49) and Control (educative materials about mindfulness benefits; n=50). Upon arrival, women completed a PHQ-9, and baseline measurements of anxiety and pain using a visual analogue scale. They then completed the group specific activity and rated anxiety prior to examination. After examination participants rated exam pain, post-exam anxiety, and completed questionnaires assessing exam satisfaction and intervention acceptability. Physicians (n=2) rated ease of performing pelvic examination and ability to obtain clinical information. Results demonstrated clinically anxious individuals who completed the intervention reported significantly lower anxiety before pelvic examination (p=.000, partial η2=.262) and after (p= .010, partial η2=.126) compared to control group. No significant differences in pain, patient exam satisfaction, or physician perception of the exam were noted between groups. Acceptability and interest in the intervention was also high. This study demonstrates the ability to implement a brief mindful movement video into the flow of a medical clinic and reduce pelvic exam anxiety. In general, this broad investigation supports ongoing research exploring mindful movement from a mechanistic perspective, and the implementation of brief mindful movement interventions in medical settings.Item [News](1981-04-15) Williams, AnnItem [News](1989-09-28) Harrell, AnnItem [News](1984-03-28) Weeter, DeborahItem Parent-Reported Anxiety in Children with Secondary Generalized Seizures(2010-11-02) Benitez, Oscar J.; Stavinoha, Peter L.This study examined the role of seizure type in determining different levels of parent-reported anxiety, when taking demographic, medically-related, and medication-related variables into account. One-hundred nineteen children with epilepsy aged 4 to 17 years old underwent a retrospective chart review. Demographic, medically-related, and medication-related variables, such as age, gender, ethnicity, handedness, median household income, age of onset, seizure etiology, lateralization, EEG findings, MRI findings, number of antiepileptic drugs prescribed, side-effect profile of medication, and therapy regimen, were reviewed as well as parent-reported anxiety and depression on the Behavior Assessment System for Children, Second Edition (BASC-2). Findings of the current study replicated previous research suggesting that children with epilepsy have higher average levels of depression and anxiety than the normative population. Children with epilepsy had similar levels of depression, regardless of seizure type. Children with partial seizures with secondary generalization had higher levels of anxiety symptoms compared to children with generalized seizures, but similar levels to those with partial seizures. The current study’s findings could have occurred due to the possible cueing components associated with having partial seizures with secondary generalization. The findings suggest a negative impact that behavioral symptoms of depression and anxiety may have on seizure-related care. The current study expanded upon previous research by using a parent-report measure in which both depression and anxiety scales were normed with the same sample of children. Furthermore, the current study focused on children with secondary generalized seizures as a unique subtype and addressed anxiety specifically, which has been less researched than depression.Item The Role of CREB in Social Isolation and Natural Reward Behavior(2007-12-18) Wallace, Deanna Lynette; Nestler, Eric J.The role of CREB (cyclic AMP Response Element Binding protein) has been known to play a role in complex behaviors such as learning and memory, drug reward and depression. The work presented in this dissertation examines the role of CREB in an inactive stress paradigm, social isolation. Social isolation is a model which decreases CREB-mediated transcription in the nucleus accumbens and results in depressive- and anxiety- like phenotypes, all reversed by chronic but not acute administration of imipramine. In addition, aspects of social isolation can be mimicked in non-isolated animals by inhibition of CREB in the nucleus accumbens and certain deficits in isolated animals can be reversed by wildtype overexpression of CREB. However, other behavioral deficits observed in the isolated phenotype, while reversed by imipramine administration, are unaffected by CREB manipulation in the nucleus accumbens. Potential gene targets are explored by microarray analysis comparing control doublehoused animals and isolated animals, and these groups treated with wildtype CREB or chronic imipramine administration. The array analysis led to the discovery that social isolation alone increases expression of several types of potassium channels in the nucleus accumbens. Investigating the electrophysiological properties of these neurons, social isolation results in a greater hyperpolarization of the resting membrane potential, and decreased potassium channel-mediated membrane resistance. Lastly, it is shown that inhibiting CREB leads to increases of potassium channel expression, and the anxiety-like effects observed in isolated animals can be mimicked in non-isolated animals by overexpression of the inward rectifying potassium channel kir2.1. These studies further the field of depression and anxiety research with a model sensitive to chronic but not acute antidepressant treatment and reveal potential novel mechanisms for the reversal of anxiety-like behaviors.Item The Role of Mindfulness, Attachment, and Stress in Diverse Populations During Pregnancy(2017-07-27) Kirby, Joshua N.; Robinson, Richard C.; Tucker, Christy; Hynan, Linda S.; Bonsu, Mary L.; Stringer, Claude A.As stress can be detrimental to mental and physical health outcomes during pregnancy, there is a need for ongoing research of psychosocial factors, as well as underlying demographic and sociocultural variables, that may mitigate such impact. Attachment security and dispositional mindfulness have been found to predict lower stress levels in certain contexts. Additionally, mindfulness training has proven to be an effective stress reduction intervention in pregnant populations. This study aimed primarily to evaluate the relationship among demographic factors, stress, attachment, and mindfulness in a racially diverse sample of women with high-risk pregnancies. A secondary aim involved a small pilot study of mindfulness training in this population. The hypotheses were that women with more insecure attachment would have higher stress and lower levels of mindfulness, and that mindfulness would moderate the impact of attachment insecurity on stress. African-American women were hypothesized to have greater levels of stress and attachment avoidance based on a review of the literature. Participants (N = 127) completed the 10-Item Perceived Stress Scale, Experiences in Close Relationship Scale- Short Form, and Five Facet Mindfulness Questionnaire-Short Form. Analysis of variance indicated participants were more likely to have avoidant attachment and lower dispositional mindfulness if they were African-American and unmarried. Regression analyses revealed attachment and mindfulness to be predictors of stress; however, mindfulness did not buffer the relationship between attachment insecurity and stress. Negative correlations were demonstrated between attachment avoidance and facets of mindfulness. With regard to the secondary, exploratory aim, a subsample of women (N = 5) completed a one-week mindfulness intervention compared to a control group (N = 5), in which all participants were administered the abovementioned questionnaires pre- and post-test. As anticipated, no statistically significant changes were noted, although important trends were identified for participants that practiced mindfulness meditation compared to those that did not. The results highlight differences in the experience of stress between African-American and white women when considering attachment tendencies continued into adulthood. Though not a significant moderator of stress for insecurely attached participants, this study identified mindfulness as a key mechanism in the appraisal and response to stress with unique sociocultural sensitivities that deserve further attention.Item [UT Southwestern Medical Center News](2007-03-22) McKenzie, AlineItem [UT Southwestern Medical Center News](2008-06-15) Shear, Kristen HollandItem [UT Southwestern Medical Center News](2010-03-31) Ladson, LaKishaItem [UT Southwestern Medical Center News](2006-02-09) McKenzie, AlineItem [UT Southwestern Medical Center News](2009-03-09) Shear, Kristen HollandItem [UT Southwestern Medical Center News](2011-06-27) Shear, Kristen HollandItem [UT Southwestern Medical Center News](2007-10-18) McKenzie, Aline