Here are seven recent papers on panic, attention training, and the effects of childhood sexual abuse (all details & abstracts to these studies are listed further down this blog post).  Pfaltz & colleagues report on a novel ambulatory respiratory monitoring system that seems to demonstrate that panic sufferers are not routinely suffering from breathing abnormalities (e.g. hyperventilation) when they go about their daily lives.  The CBT theory of panic disorder would go along with this - panic being seen as due, in part, to catastrophizing about the meaning of experienced physical sensations rather than due to simply having unusual physical sensations.  Shelby et al's paper extends this understanding concluding that with sufferers from non-cardiac chest pain (NCCP) "Chest pain and anxiety were directly related to greater disability and indirectly related to physical and psychosocial disability via pain catastrophizing.

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 papers relevant to psychotherapy.   The first two throw some light on the question of whether it matters which form of established psychotherapy one uses to treat a particular depression sufferer - bearing in mind Cuijpers et al's recent meta-analysis suggesting that " ...

Here are a series of assessment questionnaires and handouts for Generalized Anxiety Disorder:

GAD, 2 question screen - answering "yes" to either of the two screening questions on this sheet suggests it's worth checking for a diagnosis of full Generalized Anxiety Disorder (GAD) - for example by using the GADQ (see below).

GAD, questionnaire (GADQ) - a simple questionnaire for making a full diagnosis of GAD.

GAD, assessment (GADSS) and scoring - the GAD Severity Scale.  Useful, and pays more attention to GAD's associated physical symptoms than the more purely worry-focussed scales that are often used.

GAD, metacognitions (Wells) - GAD assessment scale developed by Wells.  Includes measures of safety behaviours and metacognitions.

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.

“

Things should be made as simple as possible, but no simpler.

” - Einstein

Generalized anxiety disorder (GAD)

“

The self may be said to be made up of reflected appraisals.

” - Harry Stack Sullivan

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."  

“ Be kind whenever possible.  It is always possible. ” - Dalai Lama

Here are a series of assessment questionnaires and handouts for Generalized Anxiety Disorder and Health Anxiety Disorder.  Note that the 2010 Increasing Access to Psychological Therapies "IAPT Data Handbook" recommends using the GAD-7 to monitor progress in Generalized Anxiety Disorder and the short 18-item version of the Health Anxiety Questionnaire to monitor Health Anxiety progress. 

GAD, 2 question screen - answering "yes" to either of the two screening questions on this sheet suggests it's worth checking for a diagnosis of full Generalized Anxiety Disorder (GAD) - for example by using the GADQ (see below).