Click on links below:

ASDI Communications

Other Communications

Anxiety Disorders in the News

Click here for Latest Research News about Anxiety Disorders from ADAA.

Click here for New York Times series on anxiety.

Best Location for OCD Treatment?

Location is not a factor when it comes to effective treatment of obsessive-compulsive disorder, according to a recent study. Researchers examined whether exposure with response prevention (ERP) is more effective administered in a therapist's office or at home or other environments where symptoms tend to occur. The 28 participants in the study randomly received ERP in a therapist's office or where their symptoms usually occurred. Each received 14 individual sessions and regular assessments, which included self-report and clinician-rated indicators. Results show that regardless of where treatment took place, participants improved significantly. (Behavior Research and Therapy, 2007;45:1883-1892)

Can Medication Prevent PTSD After Trauma?

On 12/01/2006, CBS's 60 Minutes broadcast a segment about recent research suggesting that administration of the beta-blocker, propranolol, immediately after a traumatic experience may prevent the development of PTSD. By following this link, you can view the segment or read the transcript.

Enduring Effects For Cognitive Behavior Therapy

in the Treatment of Depression and Anxiety

Steven D. Hollon, ­Michael O. Stewart, and ­Daniel Strunk
­ Annual Review of Psychology, 2006, Vol. 57: 285-315

Abstract: Recent studies suggest that cognitive and behavioral interventions have enduring effects that reduce risk for subsequent symptom return following treatment termination. These enduring effects have been most clearly demonstrated with respect to depression and the anxiety disorders. It remains unclear whether these effects are a consequence of the amelioration of the causal processes that generate risk or the introduction of compensatory strategies that offset them and whether these effects reflect the mobilization of cognitive or other mechanisms. No such enduring effects have been observed for the psychoactive medications, which appear to be largely palliative in nature. Other psychosocial interventions remain largely untested, although claims that they produce lasting change have long been made. Whether such enduring effects extend to other disorders remains to be seen, but the capacity to reduce risk following treatment termination is one of the major benefits provided by the cognitive and behavioral interventions with respect to the treatment of depression and the anxiety disorders.

Thicker Brain, Less Fear?

Thickness of a Specific Brain Area May Help Defeat Fear

By Miranda Hitti
WebMD Medical News, 7/11/2005

Some people handle fear better than others. Now, research shows one possible reason why. It's not about nerves of steel, but the thickness of a specific brain area. That area is called ventromedial prefrontal cortex. It took center stage in a recent fear test. When some people started showing fear, others stayed calmer. Their secret: a thicker ventromedial prefrontal cortex an area of the lower surface of the brain. The study appears online in the Proceedings of the National Academy of Sciences.

Finding May Tie In With Anxiety
"We've always wondered why some people who are exposed to traumatic experiences go on to develop anxiety disorders like posttraumatic stress disorder and others do not," states researcher Mohammed Milad, PhD, in a news release. "We think this study provides some potential answers," he continues. Milad is a research fellow in the psychiatry department of Massachusetts General Hospital in Boston. Creating, Then Destroying Fear Milad's study included 14 healthy young adults. Subjects sat in front of a computer monitor. They wore electrodes on the second and third fingers of their dominant hand. On the screen, they saw photos of a conference room with a blue or red lighted lamp. Meanwhile, they got "highly annoying but not painful" electric shocks through the electrodes. That happened five times. Then, the pictures were shown 10 more times, without the shock. The researchers' goal: Build up fear by linking the photos and the shocks, and then break the pattern to extinguish fear.

Fear, Defeated
The subjects returned the next day. This time, there were no shocks. Instead, they wore skin monitors as they viewed the same pictures as the previous day. Monitoring the skin was an indirect measure of the participants' reaction to the photos and the subsequent electric shock which had followed them in earlier parts of the experiment.
The researchers used brain scans to measure ventromedial prefrontal cortex thickness, a brain area implicated in fear extinction. Those with a thicker brain region were apparently less disturbed by the pictures. They showed smaller skin reactions to the photos, the data shows. Such thickness varies from person to person. That variability "may account for risk [or resilience] factors for anxiety disorders," write the researchers. Future studies should test whether brain thickness predicts therapeutic response to behavioral therapies for anxiety disorders, they write.

Three OCD Behaviors May Represent Distinct Syndromes:

Actions Found to Originate in Different Areas of Brain

By Jamie Talan Newsday (reprinted in The Baltimore Sun) July 23, 2004
Scientists say they have unearthed a clue to solving the mystery of obsessive-compulsive disorder - the trait characterized with humor on the TV detective series Monk. But OCD, as it's known, is rarely a laughing matter. Rather, its hallmarks are three behaviors: hand-washing, checking and hoarding, each carried out in the extreme. Now a study points to an understanding of the condition - and goes on to say the different behaviors might represent distinctly different syndromes. Scientists have demonstrated that each of the three behaviors activated a different brain region.
Their study was published in the latest issue of the Archives of General Psychiatry. They found that patients with hand-washing obsessions experienced activity in one brain region when presented with thoughts of dirty toilets and other germ-infested objects. The brains of patients called "hoarders" experienced activity in a different brain region when presented with piles of papers. "Checkers," who compulsively check on such things as whether appliances have been turned off, experienced activity in yet another brain region when shown pictures of kettles and irons. The researchers expressed hope the findings could lead to new ways to understand and treat this condition, which is thought to affect from 1 percent to 3 percent of the population.
"Experts have always viewed OCD as one condition," said David Mataix-Cols of the Institute of Psychiatry in London. He and his colleagues studied 16 OCD patients, 11 being treated in the London hospital, along with 17 healthy volunteers. The scientists conducted brain scans as the participants viewed pictures and were asked to think about specific events. A simultaneous recording would instruct them to "Imagine touching the following objects" as pictures of dirty toilet bowls, money and a door knob appeared. "Imagine you forgot to turn off the following appliances," with pictures of a tea kettle, an iron and car brakes. And "Imagine the objects belong to you but must be thrown away forever," with a display of stacks of newspapers and empty containers. Washing, checking and hoarding provoked different brain circuits, and OCD patients showed more activity in these regions than did the volunteers. Interestingly, washing and checking triggered some overlapping activity, but the checking behavior called on another region that regulates motor activity.

40% of People Have a Fear of Flying;

Men and Women Have Different Reasons

July 28, 2004
Norwich, UK--Four out of ten people have a fear of flying. But men and women have different reasons for their phobia, according to psychologist Lucas van Gerwin of the University of Leiden in Holland. He studied 5,000 people with a fear of flying and found that women tend to be afraid of crashing and losing control of their emotions. But men are afraid because they cannot control the plane and fear heights. People aged over 54, particularly men, had the biggest fear of flying. They had a fear of heights, a need to stay in control of the plane, and were prone to panic attacks--and they were most likely to avoid flying altogether.

Anxiety Control vs. Anxiety Acceptance

Eifert GH, Heffner M.Journal of Behavioral Therapy and Experimental Psychiatry. 2003; 34:293-312.

The present study compared the effects of creating an acceptance versus a control treatment context on the avoidance of aversive interoceptive stimulation. Sixty high anxiety sensitive females were exposed to two 10-min periods of 10% carbon dioxide enriched air, an anxiogenic stimulus. Before each inhalation period, participants underwent a training procedure aimed at encouraging them either to mindfully observe (acceptance context) or to control symptoms via diaphragmatic breathing (control context). A third group was given no particular training or instructions. We hypothesized that an acceptance rather than control context would be more useful in the reduction of anxious avoidance. Compared to control context and no-instruction participants, acceptance context participants were less avoidant behaviorally and reported less intense fear and cognitive symptoms and fewer catastrophic thoughts during the CO(2) inhalations. We discuss the implications of our findings for an acceptance-focused vs. control-focused context when conducting clinical interventions for panic and other anxiety disorders.

ASDI: Serving the Baltimore Area & Central Maryland