Here are half a dozen papers with anxiety relevance.  The first couple are about the interaction between genetic vulnerability (or resilience) and childhood experience.  The Stevens et al paper is an update on the large body of research looking at psychological genetic vulnerability/resilience in macaque monkeys and how this interacts with parenting quality to lead, or not lead, to emotional and neurophysiological disturbances in adulthood.  The Battaglia paper particularises this gene/environment investigation by looking at the connections between early human childhood separation anxiety, loss of a parent, and panic disorder in adulthood.  

Here are half a dozen recent studies involving cognitive therapy (CBT).  The first by Craigie et al explores the use of mindfulness-based cognitive therapy (MBCT) to treat generalized anxiety disorder (GAD).  Although, as one would expect, MBCT helped GAD sufferers, it was noteworthy that results "fall well short of outcomes achieved by past research".  This adds to my concern that mindfulness training may at times be being over-hyped - see a blog I wrote in September for for more on this.  The next study by Cuijpers et al also suggests limitations to the march of CBT with interpersonal psychotherapy looking a somewhat better candidate for prevention of depression onset.  I guess one could argue that CBT can - and probably more often should - include  behavioural interventions to promote improved relationships.  Click here for tools that can help this approach.   The third piece of research by Grey et al is exciting.  It challenges the Alice in Wonderland dodo bird suggestion that "everyone has won, and all must have prizes"

The "Improving Access to Psychological Therapies" (IAPT) initiative is very ambitious and exciting.  It states its principal aim is to support English Primary Care Trusts in implementing "National Institute for Health and Clinical Excellence" (NICE) guidelines for people suffering from depression and anxiety disorders.  IAPT go on to say that "At present, only a quarter of the 6 million people in the UK with these conditions are in treatment, with debilitating effects on society."

One aspect of this carefully planned initiative is strong encouragement to assess and monitor the progress of those who are getting help.  Visiting the IAPT "Outcomes Toolkit and FAQ" web page provides access to several freely downloadable documents.  The emphasis is on good assessment measures that are free to use.  See below:

IAPT Outcomes Toolkit 2008/9 PDF - this 81 page 1.1Mb Adobe PDF is the September 08 version with amended IAPT Paper Based Data Set Questionnaires.

“

... the current system for bringing promising biomedical research to the bedside is operating at an obsolete level of efficiency, causing great delay, and consequently resulting in the loss of many lives.

” - Roger Rosenberg (JAMA 2003;289:1305-6)

Panic disorder

I've been working on the 'Panic & depersonalization' handouts list in the Good Knowledge section of this website.  The list contains most of the handouts and questionnaires I currently use when working with people suffering from panic disorder, agoraphobia or depersonalization/ derealization disorder.  Here they are with brief descriptions: 

“ Those who think they have not time for bodily exercise will sooner or later have to find time for illness. ” - Edward Stanley, 15th Earl of Derby

The US DSM IV diagnostic system describes the "essential features" of agoraphobia in the following way: "There is intense fear of, or discomfort in, settings from which escape is difficult or embarrassing, or in which help (e.g. to alleviate a panic attack) is not available."  It then adds the following three criteria:

I'm gradually adding content to the 'Good Knowledge' database.  I've just put in some information on agoraphobia.  It reads: 

Manber, R., J. D. Edinger, et al. (2008).

“ There is more to life than increasing its speed. ” - Gandhi

The "Improving Access to Psychological Therapies" (IAPT) initiative is very ambitious and exciting.  It states its principal aim is to support English Primary Care Trusts in implementing "National Institute for Health and Clinical Excellence" (NICE) guidelines for people suffering from depression and anxiety disorders.  It comments "The Improving Access to Psychological Therapies (IAPT) programme began in 2008 and has transformed treatment of adult anxiety disorders and depression in England. Over 900,000 people now access IAPT services each year, and the 'five year forward view for mental health' committed to expanding services further, alongside improving quality."  

“

The past is beautiful because one never realises an emotion at the time.  It expands later, & thus we don't have complete emotions about the present, only about the past.

” - Virginia Woolf

Here are many of the handouts and questionnaires I use currently (autumn '09) when working with people suffering from panic disorder, agoraphobia, OCD or depersonalization/derealization disorder.