Susan D. Raffa

Bio: Susan D. Raffa is an academic researcher from Duke University. The author has contributed to research in topics: Panic disorder & Anxiety. The author has an hindex of 12, co-authored 29 publications receiving 969 citations. Previous affiliations of Susan D. Raffa include Boston University & Durham University.

Fear and Avoidance of Internal Experiences in GAD: Preliminary Tests of a Conceptual Model

Abstract: The tendency to fear and avoid internal experiences may be an important characteristic of individuals with generalized anxiety disorder (GAD). We review here theory and research suggesting that individuals with GAD may be experientially avoidant, and present preliminary evidence to support this model. Findings from both a non-clinical and clinical sample suggest that worry and generalized anxiety disorder may be associated with a tendency to try to avoid or control (versus accept) internal experiences, as well as a tendency to fear losing control over one’s own emotional responses (particularly anxiety). The clinical implications of these findings, along with directions for future research, are discussed.

Prevalence of anxiety disorders in men and women with established coronary heart disease.

Abstract: PURPOSE: Anxiety has been associated with the development and recurrence of coronary heart disease (CHD). The objective of this study was to estimate the prevalence of anxiety disorders in men and women with established CHD. METHODS: One hundred fifty CHD patients were evaluated via a semistructured, psychiatric interview to assess both current and lifetime prevalence rates of anxiety disorders. RESULTS: Approximately 36.0% (n = 54) of cardiac patients met the diagnostic criteria for at least 1 current anxiety disorder, and 45.3% (n = 68) presented with an anxiety disorder at some point in their lifetime. Social phobia and generalized anxiety disorder were the most prevalent anxiety disorders observed, with current prevalence rates of 21.3% and 18.7%, respectively, and a lifetime prevalence of 26%. In addition, the current prevalence rate of specific phobia was approximately 14.7%, whereas 15.3% met the lifetime criteria. Lower prevalence rates for panic disorder (current = 4.7%, lifetime = 5.3%), agoraphobia (current = 3.3%, lifetime = 4.7%), posttraumatic stress disorder (current = 0%, lifetime = 1.5%), and obsessive compulsive disorder (current = 0%, lifetime = 0.7%) were observed. Female cardiac patients evidenced significantly higher current (women = 58.3% vs. 25.5%, P < .001) and lifetime (women = 70.8% vs. men = 33.3%, P < .001) rates of anxiety disorders compared with their male counterparts. CONCLUSIONS: A considerable number of CHD patients evidence a significant history of anxiety. Greater efforts to identify and treat anxiety in outpatient cardiology and cardiac rehabilitation settings are needed.

Weight management and physical activity throughout the cancer care continuum

Abstract: Mounting evidence suggests that weight management and physical activity (PA) improve overall health and well being, and reduce the risk of morbidity and mortality among cancer survivors. Although many opportunities exist to include weight management and PA in routine cancer care, several barriers remain. This review summarizes key topics addressed in a recent National Academies of Science, Engineering, and Medicine workshop entitled, "Incorporating Weight Management and Physical Activity Throughout the Cancer Care Continuum." Discussions related to body weight and PA among cancer survivors included: 1) current knowledge and gaps related to health outcomes; 2) effective intervention approaches; 3) addressing the needs of diverse populations of cancer survivors; 4) opportunities and challenges of workforce, care coordination, and technologies for program implementation; 5) models of care; and 6) program coverage. While more discoveries are still needed for the provision of optimal weight-management and PA programs for cancer survivors, obesity and inactivity currently jeopardize their overall health and quality of life. Actionable future directions are presented for research; practice and policy changes required to assure the availability of effective, affordable, and feasible weight management; and PA services for all cancer survivors as a part of their routine cancer care. CA Cancer J Clin 2018;68:64-89. © 2017 American Cancer Society.

Anxiety in middle adulthood: effects of age and time on the 14-year course of panic disorder, social phobia and generalized anxiety disorder.

Abstract: BackgroundMuch about the long-term course of anxiety disorders is unknown. The present study utilizes a naturalistic, longitudinal, short-interval follow-up design to elucidate the course of anxiety disorders over 14 years in a largely middle-aged adult sample recruited from out-patient psychiatry and primary care facilities.MethodThe sample consisted of 453 participants with a diagnosis of panic disorder (PD), social phobia (SP) and/or generalized anxiety disorder (GAD). Anxiety symptom ratings were tracked using weekly psychiatric status ratings (PSRs). Controlling for demographic and clinical variables, the course of PD, GAD and SP were examined using longitudinal growth models, with the most severe PSR at each follow-up point as the main outcome variable.ResultsPSRs significantly decreased in severity over time in each of the three disorders. In the interaction effects models, age×time had a significant effect on course for PD and GAD, but not for SP, in that older age was associated with lower PSRs over time.ConclusionsThe present findings suggest that the severity of anxiety disorders declines over time, although this decline is modest and depends on the specific disorder being assessed. Older individuals with PD and GAD have a better prognosis than their younger counterparts, as their course is characterized by a steeper decline in severity. The present findings provide important information about the course of anxiety disorders in mid-life.

Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable

Abstract: PurposeThe number of cancer survivors worldwide is growing, with over 15.5 million cancer survivors in the United States alone—a figure expected to double in the coming decades. Cancer survivors face unique health challenges as a result of their cancer diagnosis and the impact of treatments

Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders

Abstract: Anxiety and related disorders are among the most common mental disorders, with lifetime prevalence reportedly as high as 31%. Unfortunately, anxiety disorders are under-diagnosed and under-treated. These guidelines were developed by Canadian experts in anxiety and related disorders through a consensus process. Data on the epidemiology, diagnosis, and treatment (psychological and pharmacological) were obtained through MEDLINE, PsycINFO, and manual searches (1980–2012). Treatment strategies were rated on strength of evidence, and a clinical recommendation for each intervention was made, based on global impression of efficacy, effectiveness, and side effects, using a modified version of the periodic health examination guidelines. These guidelines are presented in 10 sections, including an introduction, principles of diagnosis and management, six sections (Sections 3 through 8) on the specific anxiety-related disorders (panic disorder, agoraphobia, specific phobia, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder), and two additional sections on special populations (children/adolescents, pregnant/lactating women, and the elderly) and clinical issues in patients with comorbid conditions. Anxiety and related disorders are very common in clinical practice, and frequently comorbid with other psychiatric and medical conditions. Optimal management requires a good understanding of the efficacy and side effect profiles of pharmacological and psychological treatments.