Development and Validation of a Smartphone-Based App for the Longitudinal Assessment of Anxiety in Daily Life.

Current methods to assess human anxiety often ignore that anxiety is a dynamic process and have limitations such as high recall bias and low generalizability to real life. Smartphone apps using ecological momentary assessment (EMA) may overcome such limitations. We developed a smartphone app for the longitudinal evaluation of anxiety symptoms using EMA.

Diagnostic biomarkers for obsessive-compulsive disorder: A reasonable quest or ignis fatuus?

Obsessive-compulsive disorder (OCD) has been associated with a wide range of biological and neurocognitive findings, which could assist in the search for biomarkers. We conducted an umbrella review of systematic reviews and meta-analyses to assess and grade the strength of the evidence of the association between OCD and several potential diagnostic biomarkers while controlling for several potential biases. Twenty-four systematic reviews and meta-analyses were included, comprising 352 individual studies, more than 10,000 individuals with OCD, and covering 73 potential biomarkers.

Risk factors for posttraumatic stress disorder: An umbrella review of systematic reviews and meta-analyses.

Approximately one third of individuals who experience a severe traumatic event will develop posttraumatic stress disorder (PTSD). It is crucial to identify what factors may be associated with increased or decreased risk for PTSD. We conducted an umbrella review of systematic reviews and meta-analyses of risk/protective factors for PTSD and assessed and graded the evidence of the association between each factor and PTSD.

Risk and protective factors for anxiety and obsessive-compulsive disorders: an umbrella review of systematic reviews and meta-analyses.

Background: A multitude of risk/protective factors for anxiety and obsessive-compulsive disorders have been proposed. We conducted an umbrella review to summarize the evidence of the associations between risk/protective factors and each of the following disorders: specific phobia, social anxiety disorder, generalized anxiety disorder, panic disorder, and obsessive-compulsive disorder, and to assess the strength of this evidence whilst controlling for several biases.

Methods: Publication databases were searched for systematic reviews and meta-analyses examining associations between potential risk/protective factors and each of the disorders investigated.

Deterioration rates in Virtual Reality Therapy: An individual patient data level meta-analysis.

Ample evidence supports the use of Virtual Reality (VR) for anxiety disorders. Nonetheless, currently there is no evidence about moderators or potential negative effects of VR treatment strategies. An Individual Patient Data (IPD) approach was employed with 15 retrieved datasets.

Relationship between effortful control and facets of mindfulness in meditators, non-meditators and individuals with borderline personality disorder.

As dimensions of effortful control (EC), activation control, attentional control, and inhibitory control could mediate the relationship between mindfulness meditation practice and the facets of mindfulness (i.e., observing, describing, acting with awareness, non-judging and non-reacting to inner experience).

Attentional Control and Fear Extinction in Subclinical Fear: An Exploratory Study.

Attentional control (AC) and fear extinction learning are known to be involved in pathological anxiety. In this study we explored whether individual differences in non-emotional AC were associated with individual differences in the magnitude and gradient of fear extinction (learning and recall). In 50 individuals with fear of spiders, we collected measures of non-emotional AC by means of self-report and by assessing the functioning of the major attention networks (executive control, orienting, and alerting).

Does fear extinction in the laboratory predict outcomes of exposure therapy? A treatment analog study.

Fear extinction models have a key role in our understanding of anxiety disorders and their treatment with exposure therapy. Here, we tested whether individual differences in fear extinction learning and fear extinction recall in the laboratory were associated with the outcomes of an exposure therapy analog (ETA). Fifty adults with fear of spiders participated in a two-day fear-learning paradigm assessing fear extinction learning and fear extinction recall, and then underwent a brief ETA.

An Internet-based treatment for flying phobia (NO-FEAR Airlines): study protocol for a randomized controlled trial.

Background: Flying phobia (FP) is a common and disabling mental disorder. Although in vivo exposure is the treatment of choice, it is linked to a number of limitations in its implementation. Particularly important, is the limited access to the feared stimulus (i.

NO-FEAR Airlines: A Computer-aided Self-help Treatment for Flying Phobia.

In vivo exposure is the treatment of choice for specific phobias. However, this treatment is linked to a number of limitations in its implementation. Therefore, it is important to develop strategies for improving treatment adherence, acceptance, and dissemination of evidence-based treatments.

Long range temporal correlations in EEG oscillations of subclinically depressed individuals: their association with brooding and suppression.

Long-range temporal correlations (LRTC) in brain oscillations have been found to be associated with depression severity in clinically depressed patients. Less is known, however, about the relationships between LRTC and proneness to engage in depression-related cognitive emotion regulation (ER) strategies which characterize both clinically and subclinically depressed (SBD) people. In this study we applied detrended fluctuation analysis to the amplitude envelope of broad band, theta band, and alpha band spontaneous EEG oscillations of a group of SBD individuals and a group of non-depressed individuals (both groups from a sample of healthy adults, N = 120), to whom brooding and thought suppression questionnaires were administered.

Heart rate complexity and attentional orienting: a new look at the role of vagal tone.

This study is aimed at elucidating (a) whether heart rate (HR) complexity measures are associated with the attentional orienting function, and (b) which of these measures better predicts orienting efficiency indexes. Vagal tone, sample entropy, scaling exponents ?1 and ?2, and fractal dimension (FD) were calculated in HR time series (n=109). Vagal tone, entropy, and FD were positively associated with orienting, while this association was negative for ?2.

Spontaneous emotion regulation and attentional control.

The current study aimed to explore whether self-reported attentional control (AC) and the attentional network functioning would predict spontaneous emotion downregulation after emotional induction. A total of 117 healthy volunteers were asked to continuously rate their discomfort while looking at affective pictures, as well as for a period of time after exposure. After controlling for trait anxiety, higher self-reported AC significantly predicted a greater spontaneous emotional downregulation after exposure to aversive pictures.

Attentional control, attentional network functioning, and emotion regulation styles.

Attentional network functioning in emotionally neutral conditions and self-reported attentional control (AC) were analysed as predictors of the tendency to engage in dysfunctional emotion regulation strategies. Diminished attentional orienting predicted an increased tendency to engage in brooding rumination, and enhanced alertness predicted a greater chance of suppression, beyond trait anxiety and self-reported AC, which were not predictive of either rumination or suppression. This is the first study to show that some forms of dysfunctional emotion regulation are related to the attentional network functioning in emotionally neutral conditions.

Complexity of everyday life heart rate dynamics and attentional control in healthy students.

Effective regulation of emotions requires the ability to voluntarily manage attention, i.e. attentional control (AC), which has been related to heart rate variability and vagal tone in laboratory based research.

Resting parietal electroencephalogram asymmetries and self-reported attentional control.

Research on electroencephalogram (EEG) asymmetries and anxiety proneness has recently spread to emotion regulation capabilities. We studied whether attentional control (AC), a temperamental construct related to emotional regulation, was associated with asymmetrical patterns of resting EEG activity at the frontal and parietal regions, reflected not only in the α frequency band (8-13 Hz) but also in higher bands β1 (13-20 Hz) and β2 (20-30 Hz). Self-reports of AC and trait anxiety, and resting EEG recordings, were obtained from 58 healthy participants.

Resting parietal EEG asymmetry and cardiac vagal tone predict attentional control.

The present study explores both resting cortical EEG asymmetry and vagally-mediated heart rate variability (HRV), as an index for vagal tone, as physiological correlates of self-reported attentional control in a sample of 53 healthy young adults. Regression analyses indicate that higher vagally-mediated HRV and lower right-sided parietal activity in the β2 frequency range (20-30Hz) are significant predictors of larger attentional control. Results are in line with some of the basic features of the neurovisceral integration model and stress the role of parietal areas in attentional control capabilities, thus aiming to consider attentional control as a trait-like disposition.

Effects of temperament and emotion regulation styles in determining negative emotional states.

Introduction: The interplay of reactive and regulatory temperamental processes appears to be essential for a better understanding of emotional states and disorders. In this study we explored the prospective relationship between reactive temperament (negative affect), regulatory temperament (effortful control), negative emotion regulation styles (rumination and suppression) and self-recorded anxiety, worry, and avoidance in naturalistic conditions.

Method: Thirty-two young adults were first assessed through questionnaires on negative affectivity, effortful control, and two forms of negative emotion regulation (rumination and suppression).

Distinguishing youths at risk for anxiety disorders from self-reported BIS sensitivity and its psychophysiological concomitants.

The aim of the study was to explore the psychophysiological concomitants of self-reported behavioral inhibition system (BIS) sensitivity in adolescents (12 to 17 years old) supposed to be at risk for anxiety disorders. Twenty participants with high scores in self-reported BIS sensitivity (at-risk group) were matched in age and sex to 20 participants scoring in the normal range in BIS sensitivity (control group). Negative affect, negative emotion regulation style, and anxiety symptomatology were assessed by means of self-reported measures.

Self-focused cognitive emotion regulation style as associated with widespread diminished EEG fractal dimension.

The cognitive regulation of emotions is important for human adaptation. Self-focused emotion regulation (ER) strategies have been linked to the development and persistence of anxiety and depression. A vast array of research has provided valuable knowledge about the neural correlates of the use of specific self-focused ER strategies; however, the resting neural correlates of cognitive ER styles, which reflect an individual's disposition to engage in different forms of ER in order to manage distress, are largely unknown.

Heart rate variability profiles and exposure therapy treatment outcome in flight phobia.

The goal of this study was to explore why certain patients in a previous study on exposure therapy for flight phobia did not experience an improvement in their conditions. Participants from a treatment study (N = 45) were selected according to post-treatment results and divided into two groups: the unsatisfactory treatment outcome group (UTO, N = 10) and the satisfactory treatment outcome group (STO, N = 10). The differences between these two groups prior to receiving exposure therapy were analyzed at the behavioral, physiological, and cognitive levels.

Slope of change throughout exposure treatment for flight phobia: the role of autonomic flexibility.

This study tested the hypothesis that flight-phobic patients experience change at different rates even when they are receiving identical treatment. Faster within-session rates of change (WSRC) were expected for patients who required fewer exposure sessions. The study also tested the theoretical role of autonomic flexibility on WSRC.

Virtual reality versus computer-aided exposure treatments for fear of flying.

Evidence is growing that two modalities of computer-based exposure therapies--virtual reality and computer-aided psychotherapy--are effective in treating anxiety disorders, including fear of flying. However, they have not yet been directly compared. The aim of this study was to analyze the efficacy of three computer-based exposure treatments for fear of flying: virtual reality exposure therapy (VRET), computer-aided exposure with a therapist's (CAE-T) assistance throughout exposure sessions, and self-administered computer-aided exposure (CAE-SA).

Relationships between negative affectivity, emotion regulation, anxiety, and depressive symptoms in adolescents as examined through structural equation modeling.

The relationship between negative affectivity (NA) and emotion regulation (ER) in determining anxiety and depressive symptomatology was examined in a large (n=1441) sample of adolescents (12-17 years old). Two models, diverging only as to inclusion or exclusion of a path from NA to negative ER, were analyzed through structural equation modeling; the goal was to explore the mediational or non-mediational role of ER in determining anxiety symptoms. The models yielded similar adequate fit to data, indicating that both NA and negative ER contribute to anxiety symptoms which, in turn, significantly determine depressive symptomatology.

Efficacy of a brief school-based program for selective prevention of childhood anxiety.

Anxiety sensitivity (AS) is recognized as an early risk factor for the development of anxiety disorders. This study evaluates whether a brief school-based selective prevention program reduces AS and anxious and depressive symptoms in children and youth. Participants scoring high in AS but without any current psychopathological disorder were selected from a sample of 613 individuals (61% female, 11-17 years old) and randomly assigned to the prevention program (n=47) or to a waiting-list control (WLC) (n=45) group.