Naturalistic Partial Sleep Deprivation Leads to Greater Next-Day Anxiety: The Moderating Role of Baseline Anxiety and Depression

The detrimental effects of insufficient sleep on emotional functioning have been well established. Total sleep deprivation usually leads to increased anxiety and depressive symptoms the following day. However, no study has yet examined the relationships between unmanipulated partial sleep deprivation and next-day symptoms of anxiety and depression in everyday life, which this study sought to characterize. Participants (N = 94) completed daily diary surveys twice per day for 2 weeks without instructions to alter their sleep in any way. Nights of spontaneous, naturally occurring partial sleep deprivation were followed by increased levels of self-reported symptoms of anxious arousal the next day, but were unrelated to next-day symptoms of anhedonic depression or general distress. The relationship between partial sleep deprivation and next-day anxious arousal was found to be moderated by both baseline depressive symptoms and anxiety such that individuals reporting higher levels of depression or anxiety at baseline showed relatively greater increases in symptoms of anxiety following partial sleep deprivation. These results suggest that partial sleep deprivation occurring in everyday life can lead to higher next-day levels of anxious arousal, a relationship that is particularly deleterious for individuals with higher overall levels of anxiety or depressive symptoms.     

Anxiety and Depression in Medically Ill Older Adults

Anxiety and depression are extremely common in the elderly with medical problems. They can manifest not only as symptoms of a primary psychiatric illness, but also as physiologic sequelae of medical illnesses and medical treatments. Recognition and treatment of depression and anxiety in the medically ill is especially difficult. If these states go untreated, they result in higher morbidity and mortality, higher health care costs and utilization, and poorer functional status and outcomes. Three of the most common medical illnesses that afflict geriatric patients, cardiovascular disease, pulmonary disease, and rheumatoid arthritis, will be presented to illustrate the difficulty in recognizing depression and anxiety and the impact of treating these symptoms in the medically ill elderly. Multidisciplinary approaches combining optimal medication regimens and psychosocial interventions can be effective for treatment of anxiety and depression in the medically ill elderly.     

自我调节失败与抑郁和焦虑症状的关系：纵向追踪研究

对200名不同调节定向的大学生进行为期6个月的追踪调查以探索长期自我调节失败与抑郁和焦虑症状及两者共存的关系。结果发现：(1)促进定向组在抑郁、焦虑以及自我调节失败得分上低于预防定向组;(2)控制基线期抑郁和焦虑症状,促进和预防定向系统的自我调节失败均可正向预测3个月后抑郁–焦虑症状共存;(3)抑郁症状的维持和发展与促进目标失败有关,焦虑症状的维持和发展与预防目标失败有关;(4)基线期抑郁不仅通过促进目标失败程度来维持和发展,还通过促进和预防目标失败程度来正向预测继发的焦虑;基线期焦虑不仅通过预防目标失败程度来维持和发展,还能正向预测继发的抑郁。     

Prospective Associations Between Sleep Disturbance and Repetitive Negative Thinking: The Mediating Roles of Focusing and Shifting Attentional Control

Although considerable evidence has linked sleep disturbance to symptoms of psychopathology, including repetitive negative thinking, few studies have examined how sleep disturbance may predict repetitive negative thinking over time. Further, no study to date has examined specific mechanisms that may account for this relationship. The present study sought to address these gaps in the literature by testing focusing and shifting attentional control as two potential mediators of the relationship between sleep disturbance and repetitive negative thinking over a 6-month period. A final sample of 445 unselected community participants completed measures of sleep disturbance and repetitive negative thinking at Time 1, measures of focusing and shifting attentional control 3 months later, and measures of repetitive negative thinking again 6 months later. Results revealed that focusing, but not shifting, attentional control mediated the relationship between sleep disturbance and repetitive negative thinking, specifically, worry, rumination, and obsessions. These findings provide preliminary evidence for focusing attentional control as a candidate mechanism that may explain the causal role of sleep disturbance in the development of repetitive negative thinking observed in various disorders.     

Self-Report Differentiation of Anxiety and Depression in a Mood Disorders Sample

Several lines of research suggest there is considerable overlap between anxiety and depression and that it is difficult to distinguish between these two constructs. However, a few studies utilizing factor analytic procedures have provided evidence that anxiety and depression can be differentiated when measures of these constructs are considered at the item level. In addition, there is some evidence that differentiation can be accomplished in samples experiencing high levels of anxiety (i.e., a clinically anxious sample; B. J. Cox, R. P. Swinson, L. Kuch, & J. Reichman, 1993). In the present study, this research strategy was extended to a sample of patients with high levels of depressed mood (i.e., a mood disorders sample; N = 378). Their responses to widely used measures of depression (i.e., Beck Depression Inventory; A. T. Beck, C. H. Ward, M. Mendelson, J. Mock, & J. Erbaugh, 1961) and anxiety (i.e., Spielberger State-Trait Anxiety Inventory—State subscale; C. D. Spielberger, R. L. Gorsuch, & R. E. Lushene, 1970) were entered into a principal-components analysis with oblique rotation. A 4-factor solution was retained. This solution was comprised of factors representing anxiety, anxiety absent (a reverse scored factor), cognitive symptoms of depression, and somatic/vegetative symptoms of depression. These findings indicated that anxiety and depression, as emotional states, can be differentiated within a mood disorders sample, using existing popular self-report measures. The clinical and research implications of these findings are briefly discussed.     

Early Adversity and the Prospective Prediction of Depressive and Anxiety Disorders in Adolescents

The current study was a prospective exploration of the specificity of early childhood adversities as predictors of anxiety and depressive disorders in adolescents. Participants were 816 adolescents (414~males, 402 females) with diagnostic information collected at age 15; information on early adversities had been collected from the mothers during pregnancy, at birth, age 6 months, and age 5~years for a related study. Adolescents with pure anxiety disorders were compared with adolescents with pure depressive disorders (major depressive disorder, dysthymia), and these groups were compared to never-ill controls. Analyses controlled for gender and maternal depression and anxiety disorders. Results indicated that adolescents with anxiety disorders were more likely than depressed youth to have been exposed to various early stressors, such as maternal prenatal stress, multiple maternal partner changes, and more total adversities, whereas few early childhood variables predicted depressive disorders. Even when current family stressors at age 15 were controlled, early adversity variables again significantly predicted anxiety disorders. Results suggest that anxiety disorders may be more strongly related to early stress exposure, while depressive disorders may be related to more proximal stressors or to early stressors not assessed in the current study.     

慢性腰背痛患者和抑郁症患者的情绪、睡眠及疼痛症状

本研究对慢性腰背痛患者、抑郁症患者和对照人群的疼痛、抑郁水平、焦虑水平和睡眠质量进行测评,发现慢性腰背痛患者的抑郁、焦虑程度增高,失眠较常见;抑郁症患者的焦虑和失眠现象严重,疼痛是其常见症状。结果提示临床上对慢性疼痛患者和抑郁症患者的疼痛、情绪和睡眠问题予以评定和治疗具有重要意义。     

流动儿童压力应对方式与抑郁感、社交焦虑的关系:一项追踪研究

为了探讨流动儿童压力应对方式与抑郁感、社交焦虑的变化特点及其动态关系,本研究通过整群抽样法从5所北京市公立学校和1所打工子弟学校选取1164名流动儿童,采用问卷调查的形式对其进行为期一年的追踪测查,追踪时回收有效数据680份.对前、后测均参加调查的680名被试的数据进行分析,结果发现:(1)经过一年的城市适应,流动儿童整体的积极应对增多,消极应对减少,抑郁感下降,但社交焦虑水平无明显变化;(2)流动儿童个体在压力应对、抑郁感、社交焦虑的发展上均表现出两极分化的现象,年龄越小、来京时间越短、低年级及女生流动儿童群体的发展趋势更为良好;(3)流动儿童压力应对方式与抑郁感、社交焦虑间存在相互作用的动态关系,前测压力应对方式、抑郁感、社交焦虑均能显著预测后测相应变量的水平,前后测压力应对方式对抑郁感、社交焦虑均有即时预测作用,而前测抑郁感和社交焦虑对后测压力应对方式有不同的延时性影响.     

抑郁和焦虑与心律失常

焦虑抑郁广泛存在于各种心血管疾病中已成共识。心律失常患者合并心理问题在临床上十分常见,焦虑抑郁导致的自主神经对心脏的调节失衡会进一步促使心律失常的发生与发展。对于非器质性心脏病,β受体阻滞剂与抗焦虑药物合用有很好的疗效;器质性心脏病患者并发心律失常时患者的焦虑抑郁会进一步加重,甚至导致恶性室性心律失常的发生,增加器质性心脏病患者的病死率;心律失常介入治疗引起的焦虑抑郁更为常见。临床上对焦虑抑郁症状要有充分的重视,积极识别并诊断,以期进一步提高心律失常患者的生活质量,减少病死率。     

The Comorbidity of Conduct Problems and Depression in Childhood and Adolescence

An extensive body of research documents the high prevalence of comorbidity among child and adolescent disorders in general and between conduct problems and depression in particular. These problems co-occur at significantly higher rates than would be expected by chance and their comorbidity may have significant implications for nosology, treatment, and prognosis. Four main hypotheses have been put forth to account for these high rates of comorbidity. First, comorbidity may be a result of shortcomings associated with referral or informant biases. Second, comorbidity may be an artifact of overlapping definitional criteria. Third, one disorder may cause the other disorder by influencing the developmental trajectory and placing an individual at increased risk for further difficulties. Finally, comorbidity between two disorders may be explained by shared underlying causal or risk factors. The purpose of this review is to explore these possibilities, concentrating primarily on the common risk factors of parent psychopathology, emotion regulation, and cognitive biases that may underlie the co-occurrence of these two disorders. Based on our review, we propose a model for the development of comorbidity between these two disorders.     

青少年早期网络欺凌/受欺凌对睡眠质量的影响：社交焦虑和抑郁情绪的链式中介作用

基于压力认知失眠模型,采用网络欺凌/受欺凌问卷、青少年社交焦虑问卷、流调中心抑郁问卷和匹兹堡睡眠质量指数问卷,对582名中小学生进行三次追踪测查,每次间隔半年,并运用结构方程模型考察社交焦虑和抑郁情绪在网络欺凌/受欺凌对睡眠质量的影响的中介作用及其性别差异。结果表明：(1)社交焦虑和抑郁情绪在网络欺凌/受欺凌影响睡眠质量的路径中均起到链式中介作用;(2)网络欺凌/受欺凌影响睡眠质量的链式中介模型存在性别差异。这启示要改善网络欺凌者与受欺凌者的睡眠质量,应关注网络欺凌给他们带来的情绪困扰,只有从根本上解决其情绪问题,才能最终有效促进其睡眠质量。     

Stress Mediates the Within-Person Longitudinal Associations Between Depression and Different Anxiety Syndromes in Youth

Research on Child and Adolescent Psychopathology - Depressive symptoms predict within-person change in physical symptoms of anxiety and social anxiety symptoms; however, potential mediators of...     

Associations Between Anxiety and Marital Adjustment

Cognitive-behavioral theories of marital functioning and contextual models of close relationships highlight the importance of proximal affect states such as anxiety in couple functioning. Despite these assertions, research examining the role of state anxiety is lacking in the literature on intimate relationships. In this study, the authors examined state anxiety and marital adjustment in a sample of 45 couples. Hierarchical regression analyses indicated that husbands' Time 1 anxiety can predict their own and their wives' subsequent reports of marital adjustment. Wives' Time 1 anxiety did not predict their own or their husbands' subsequent reports of marital adjustment. In this study, the authors focused on the role of husband anxiety in marital adjustment and on implications for further study of the contextual model of close relationships.     

The Relation Between Anxiety Sensitivity and Attachment Style in Adolescence and Early Adulthood

Given the accumulating evidence for a role of anxiety sensitivity in the etiology of panic, it is important to understand the developmental origins of anxiety sensitivity. To this end, this study examined the relation between attachment beliefs and anxiety sensitivity in a sample of high school students (n = 203; mean age 15.7 years) and university students (n = 324; mean age 21.7 years). The Experiences in Close Relationships (ECR; K. Brennan, C. Clark, &; P. Shaver, 1998) was used to assess attachment beliefs and to classify participants into attachment groups. The Anxiety Sensitivity Index (ASI; R. A. Peterson &; S. Reiss, 1987) was used to assess participants' levels of anxiety sensitivity. Results supported the hypothesis that individuals with insecure attachment, specifically those classified as preoccupied and fearful (i.e., those with a negative model of self), had significantly higher anxiety sensitivity scores than securely attached individuals in both the high school and college samples.     

Screening HIV-Infected Patients with Chronic Pain for Anxiety and Mood Disorders with the Beck Anxiety and Depression Inventory-Fast Screens for Medical Settings

The Beck Anxiety (BAI-FS) and Depression (BDI-FS) Inventory-Fast Screens for Medical Settings were administered to 63 HIV-infected outpatients seeking treatment at a chronic pain clinic to evaluate how effectively these 7-item instruments would, respectively, differentiate those who were and were not diagnosed with DSM-IV anxiety, mood, or both disorders. The Anxiety and Mood Modules from the Primary Care Evaluation of Mental Disorders (PRIME-MD) were employed to establish the diagnoses. The coefficient 's for the BAI- and BDI-FS were, respectively, .80 and .84. A BAI-FS cut-off score of 4 and above yielded 82% sensitivity and 59% specificity rates for identifying patients with and without anxiety disorders, whereas a BDI-FS cut-off score of 4 and above had 90% sensitivity and 74% specificity rates for detecting patients with and without mood disorders. It was concluded that the BDI-FS was a useful instrument for screening HIV-infected patients with chronic pain for mood disorders.     

Depression and Anxiety in Roman Catholic Secular Clergy

A nationally selected random sample of Roman Catholic secular priests was investigated using the Center for Epidemiological Studies-Depression scale and the State-Trait Anxiety Inventory Form Y. Additionally, a Self-Report Inventory requested information regarding participants' demographics as well as four categories of predictor variables (i.e., Vocational Satisfaction, Social Support, Spiritual Activities, Physical Environment) potentially associated with depression and anxiety. The study yielded a return rate of 64%. Secular clergy reported significantly greater depression and anxiety (both state and trait) than are reported in the general population. Low Vocational Satisfaction was found to be predictive of depression as well as both state and trait anxiety. Additionally, low Social Support was found to be predictive of state and trait anxiety. When the significant predictor variables were conceptually collapsed, it appeared that both people and place were significantly related to Roman Catholic secular priests' experience of depression and anxiety.     

Peer Rejection in Childhood: Effects on Maternal Depression and Behavior Problems in Toddlers

The aim of this study was to develop a conceptual model that would clarify how a woman's recollections of peer and parent rejection in childhood influence her emotional well-being and, resultantly, her own child's behavior problems. Given current interest in peer versus parent influences, the authors used a design and analysis to reveal the unique contributions of peer and parent rejection. The participants were a community sample of 88 mothers and their 2 1/2-year-old children. The study found that mothers' recollections of peer rejection in childhood were significantly associated with depressive symptomatology, but recollections of parental rejection in childhood were unrelated to current depressive symptoms. Recollections of peer rejection during childhood, internal representation of self, and depressive symptoms made significant, unique contributions to the variance in behavior problems in their children. Together, these variables significantly explained 27% of the variance in the final model.     

抑郁和焦虑与心血管疾病

抑郁焦虑与心血管疾病的关系最能体现身与心两者相互影响、不可分割的特点。但临床上,心血管疾病患者抑郁焦虑的诊疗率不足1％。这说明现有的诊疗理念和方式没有将心血管疾病和精神障碍联系起来,给患者全面全程的干预和管理。这样的缺陷不仅增加患者的痛苦和功能障碍,也增加心血管疾病的发病率和病死率,还增加患者及社会的医疗负担。本文结合临床经验,从心身一体的诊疗理念,谈谈抑郁焦虑与心血管疾病。     

冠心病患者的抑郁和焦虑

许多临床研究表明,冠心病患者常发生抑郁及焦虑。而在严重精神症状（如抑郁或/和焦虑）者中有较高的冠心病发生率。抑郁增加冠心病患者的不良心血管事件发生率,影响预后。其机制有如下几个方面：对医疗措施及生活方式改变的依从性差、血小板功能异常、血管内皮功能紊乱以及心率变异性降低。选择性5-羟色胺再摄取抑制剂由于其较好的耐受性且无明显的心血管副作用而应用于冠心病合并抑郁及焦虑的药物治疗并改善患者的生活质量。但仍需要更大规模的临床研究以确定抑郁及焦虑对冠心病预后的影响。临床上应更加关注焦虑对冠心病的影响,进一步探讨焦虑能否作为冠心病的危险因素。