Social Phobia: Diagnosis, Assessment, and Treatment

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(14)61276-9.pdf

Non-psychotic mental disorders in the perinatal period

The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is the most frequently applied test to assess obsessive compulsive symptoms. We conducted a reliability generalization meta-analysis on the Y-BOCS to estimate the average reliability, examine the variability among the reliability estimates, search for moderators, and propose a predictive model that researchers and clinicians can use to estimate the expected reliability of the Y-BOCS. We included studies where the Y-BOCS was applied to a sample of adults and reliability estimate was reported. Out of the 11,490 references located, 144 studies met the selection criteria. For the total scale, the mean reliability was 0.866 for coefficients alpha, 0.848 for test-retest correlations, and 0.922 for intraclass correlations. The moderator analyses led to a predictive model where the standard deviation of the total test and the target population (clinical vs. nonclinical) explained 38.6% of the total variability among coefficients alpha. Finally, clinical implications of the results are discussed.

The Yale-Brown Obsessive Compulsive Scale: A Reliability Generalization Meta-Analysis.

BACKGROUND The PTSD Checklist for the DSM-5 (PCL-5) may be a suitable addition for routine outcome monitoring (ROM) for patients with PTSD AIM: To determine whether the PCL-5 is worth the extra effort that administration requires from the patient METHOD: Pretest and retest measurement results of the PCL-5 and the OQ-45 were compared head-to-head in 464 patients from the Sinai Center of Arkin RESULTS: The correlations between scores on the instruments were high and analysis of variance for repeated measurements revealed no difference in responsiveness Comparison of Cohen's d (049 vs 043) and Delta T (50 vs 44), indicated a slightly better responsiveness of the PCL-5 and also the proportion of recovered patients was greater according to the PCL-5 compared to the OQ-SD CONCLUSION: At first glance, the PCL-5 and the OQ-SD were equally sensitive to detect change during treatment However, the PCL-5 provided more detailed information about the nature and severity of symptomatology in an individual patient and with the PCL-5 we were slightly better able to demonstrate clinical significant change than with the OQ-SD We recommend to add the PCL-5 to ROM for patients with PTSD

De ptss Checklist voor dsm-5 (pcl-5) voor rom: Een vergelijking van de responsiviteit met de Outcome Questionnaire (oq-45) en praktische bruikbaarheid

JOHN P. WILSON AND TERENCE M. KEANE, EDS.: Assessing Psychological Trauma and PTSD. Guilford Press, New York, 1997, 575 pp, $55.00, ISBN 1-57230162-7. The recent impressive expansion of our clinical knowledge about PTSD and psychological trauma has been paralleled by a progressive introduction of a variety of self-report measures, each one with its own emphasis and relative specificity. The array of assessment instruments related to various psychological traumas and posttrauma disorders has become overwhelming if not confusing. The need for a reference book in this area was acute and crucial not only for clinicians but also for researchers. The editors have thoughtfully addressed this issue by bringing together a group of experts who have covered all the important aspects of psychological assessment in this field. The book is divided into three main areas of assessment, each addressing a particular area of psychological trauma. The first area covers standardized measures and physiological techniques related to PTSD and child-abuse effects in adults supported by a chapter on physiological assessments and another one on psychometric theory explanatory of the degree of validity of the tests. It will be unrealistic to discuss the strength and weakness of each one of the 20 standardized tests already evaluated by the contributing authors. However, an issue affecting all these tests seems to be the questionable validity of attempting by the testdevelopers to objectify the subjective answers of the clients-patients. Like in all self-report measures, there is a subjective bias which may falsify the responses, though it may measure the degree of severity of clinical symptoms, if the specific trauma is documented independently of the client. (Trauma symptom checklist -40) Another problem with these tests is that, while they have been developed based on relatively small samples, they have not been validated against the general population. As noticed by the authors, the validation of these tests is not quite documented in terms of the discriminative validity of the PTSD measures versus other measure constructs. The second group of articles reviews the standardized assessment of the traumatic reaction among victims and survivor populations. The articles included here assess a wide variety of psychological trauma from life-threatening medical illness to bereavement, marital strife with physical aggression, child abuse or combat-related stress trauma. They empirically evaluate the impact of a particular natural or human-induced stressor on people subjected to it, without telling us why some are affected more than others or not at all. …

Assessing Psychological Trauma and PTSD

Vulnerability and resilience to pandemic-related stress among U.S. women pregnant at the start of the COVID-19 pandemic.

Pandemic-related pregnancy stress and anxiety among women pregnant during the coronavirus disease 2019 pandemic.

Cognitive behavioral theories of obsessive-compulsive disorder (OCD) have hypothesized a central role of social learning in the development of OCD. Research indicates that learning via key developmental relationships, such as parent-child interactions, may account for the emergence and maintenance of OC symptoms in adulthood. Baumrind identified three parental authority prototypes or styles, including permissive, authoritative, and authoritarian, that differ on the two dimensions of nurture and behavioral control. Permissive parents allow their children to do as they wish with little discipline, whereas authoritative parents implement reasonable guidelines while still providing a warm and nurturing environment. The third style, authoritarian, represents parenting that is rigid and values strict adherence to rules with lower levels of nurturing. To date, there has been no study examining these parenting styles and OCD symptomatology. The current investigation examined the relationships between parenting styles, obsessive-compulsive (OC) symptoms, and OC-related dysfunctional beliefs (i.e., "obsessive beliefs") in a nonclinical sample ( N = 227). Participants completed measures of these constructs, as well as a measure of general mood and anxiety symptoms. Results indicated that the authoritarian parenting style was significantly associated with both OC symptoms and OC beliefs (e.g., beliefs about the importance of thoughts and personal responsibility), even after controlling for general distress. Analyses also revealed that OC beliefs act as a partial mediator of the relationship between parenting style and OC symptoms. Findings are discussed in light of the implications for future research, particularly that pertaining to risk for OCD and the development of vulnerability factors. Keywords : obsessions ; compulsions ; obsessive-compulsive disorder ; parenting styles ; authoritarian parenting ; dysfunctional beliefs Obsessive-compulsive disorder (OCD) is a heterogeneous psychological disorder characterized by recurrent and distressing intrusive thoughts, images, or impulses (obsessions) that provoke anxiety and distress and repetitive behaviors (compulsions) performed to reduce this distress. Obsessions and compulsions may concern various themes, with the most common being contamination, harm or injury, sex, religion, violence, and order/symmetry ( McKay et al., 2004 ). Historically considered a rare disorder, epidemiological findings now indicate that OCD has a lifetime prevalence of approximately 1.6% to 3.5% ( Angst et al., 2004 ; Kessler et al., 2005 ). Research conducted during the last few decades has dramatically expanded our understanding of the phenomenology and treatment of OCD, yet many mechanisms and factors involved in the etiology and maintenance of this disorder remain unknown. Biologically based investigations, including family and twin studies, have provided evidence for the role of genetics in the development of OCD ( van Grootheest, Cath, Beekman, & Boomsma, 2005 , 2007 ; van Grootheest et al., 2008 ). What has also emerged from this research is that any number of environmental factors, working either in conjunction with one another or as modulators of certain genotypes, may play an additional role in the etiology of OCD. With respect to specific environmental factors that could be involved in the development of OCD, research has slowly begun to identify a number of variables that fall within the broad category of psychosocial factors, including certain beliefs ( Obsessive-Compulsive Cognitions Working Group [OCCWG], 2003 ), trauma ( Cromer, Schmidt, & Murphy, 2007 ), and environmental agents such as bacterial infections ( Swedo et al., 1998 ). The present study focused on another possible factor: parenting styles. Cognitive behavioral models of anxiety disorders, including OCD, posit that social learning plays a central role in the development of these conditions ( Manassis, Bradley, Goldberg, Hood, & Swinson, 1994 ; Vasey & Dadds, 2001 ). …

Parenting and obsessive compulsive symptoms: Implications of authoritarian parenting

Postpartum psychiatric disorders are widely recognized by clinicians and researchers, yet while much attention has been paid to perinatal mood disorders, considerably less has been given to anxiety and obsessive-compulsive symptoms in this population. The present study examined anxiety and obsessive-compulsive symptoms among postpartum women with mood complaints, with the aim of delineating the relationship between these symptoms. Sixty postpartum women seeking treatment in a perinatal mood disorders clinic completed measures of depression, anxiety, and obsessive-compulsive symptoms. Obsession-like thoughts and compulsive-like ("neutralizing") strategies were present among the majority of the sample, yet the severity of these symptoms ranged widely. Depressive and anxiety symptoms were associated with obsessive and neutralizing compulsive symptoms. It may be helpful to consider anxiety and depressive symptoms as part of a broad spectrum of perinatal psychiatric illness. Clinicians should assess for anxiety and obsessive-compulsive symptoms as routinely as they assess for depressive symptoms in the perinatal period.

Brittain Mahaffey

Papers

Vulnerability and resilience to pandemic-related stress among U.S. women pregnant at the start of the COVID-19 pandemic.

Pandemic-related pregnancy stress and anxiety among women pregnant during the coronavirus disease 2019 pandemic.

Parenting and obsessive compulsive symptoms: Implications of authoritarian parenting

Obsessional thoughts and compulsive behaviors in a sample of women with postpartum mood symptoms

The relationship between anxiety sensitivity and obsessive-compulsive symptom dimensions.