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B. Milrod - One of the best experts on this subject based on the ideXlab platform.

Jonathan R T Davidson - One of the best experts on this subject based on the ideXlab platform.

James C. Ballenger - One of the best experts on this subject based on the ideXlab platform.

  • effects of the cholecystokinin agonist pentagastrin in patients with Generalized Anxiety Disorder
    American Journal of Psychiatry, 1997
    Co-Authors: Olga Brawmanmintzer, Rebecca G. Knapp, R B Lydiard, J Bradwejn, G Villarreal, N P Emmanuel, M R Ware, Q He, James C. Ballenger
    Abstract:

    Objective: The anxiogenic and panicogenic effects of peripheral administration of the cholecystokinin-B receptor agonist pentagastrin and placebo were evaluated in patients with Generalized Anxiety Disorder and normal comparison subjects. Method: Seven patients with Generalized Anxiety Disorder and seven age- and sex-matched normal subjects received an intravenous bolus of placebo and pentagastrin. Results: Panic attacks occurred in five patients with Generalized Anxiety Disorder (71%) and in one normal subject (14%). Patients with Generalized Anxiety Disorder were more likely to report more nonpanic Anxiety than were normal subjects. Conclusions: Patients with Generalized Anxiety Disorder appear to exhibit greater subjective sensitivity to pentagastrin than do normal subjects. (Am J Psychiatry 1997; 154:700‐702) C holecystokinin tetrapeptide (CCK-4) is a neurotransmitter that has high affinity for the cholecystokinin-B (CCK-B) receptors in the central nervous system and may play a role in the modulation of Anxiety in animals and humans (1). Specifically, in patients with panic Disorder, an intravenous bolus of CCK-4 or the synthetic analog pentagastrin reliably provokes panic attacks in the majority of subjects (2‐4). Since the administration of CCK-4 to healthy normal subjects also induces panic attacks at substantially higher doses than in patients with panic Disorder, it is hypothesized that enhanced sensitivity to CCK stimulation may be present in panic Disorder (4). To explore whether CCK sensitivity may be present in Anxiety Disorders other than panic Disorder, we compared the panicogenic and anxiogenic effects of pentagastrin and placebo infusion in patients with Generalized Anxiety Disorder and in normal subjects.

  • Somatic symptoms in Generalized Anxiety Disorder with and without comorbid psychiatric Disorders.
    American Journal of Psychiatry, 1994
    Co-Authors: Olga Brawman-mintzer, Lydiard Rb, Emmanuel Np, R. Payeur, Michael R. Johnson, Crawford M, Rebecca G. Knapp, James C. Ballenger
    Abstract:

    : The authors compared the distribution of somatic symptoms associated with Generalized Anxiety Disorder in 28 patients with "pure" Generalized Anxiety Disorder and 77 patients with Generalized Anxiety Disorder plus comorbid current or lifetime psychiatric diagnoses. They found no significant differences in individual symptom endorsement between the two groups, indicating that the basic symptoms of Generalized Anxiety Disorder are specific to the Disorder itself.

  • Psychiatric comorbidity in patients with Generalized Anxiety Disorder.
    American Journal of Psychiatry, 1993
    Co-Authors: Olga Brawman-mintzer, Lydiard Rb, Emmanuel Np, R. Payeur, Michael R. Johnson, John M. Roberts, M. P. Jarrell, James C. Ballenger
    Abstract:

    OBJECTIVE: The goal of this study was to test the validity of Generalized Anxiety Disorder as an independent diagnostic entity and to evaluate the prevalence and type of other psychiatric Disorders coexisting with Generalized Anxiety Disorder. Although a few published studies have addressed the subject, this study presents data from a larger group of subjects and excludes concurrent major depression as a potential confound. METHOD: The authors studied patients with a primary diagnosis of Generalized Anxiety Disorder assigned after evaluation with the Structured Clinical Interview for DSM-III-R. Patients with a concurrent major depressive episode were excluded. All diagnoses for which the patient met criteria were determined, including lifetime occurrence of major depressive episode and substance use. RESULTS: One hundred nine patients with Generalized Anxiety Disorder were included in the analysis. Twenty-eight (26%) of these patients were not given any other lifetime psychiatric diagnosis. The most prevalent comorbid diagnoses were social phobia (25 [23%] of the patients) and simple phobia (23 [21%] of the patients). Forty-six (42%) of the patients with Generalized Anxiety Disorder had experienced at least one major depressive episode during their lifetime. CONCLUSIONS: These results support previous findings of high rates of psychiatric comorbidity in Generalized Anxiety Disorder and validate the usefulness of Generalized Anxiety Disorder as a separate diagnostic entity.

Ronald C Kessler - One of the best experts on this subject based on the ideXlab platform.

  • impairment in pure and comorbid Generalized Anxiety Disorder and major depression at 12 months in two national surveys
    American Journal of Psychiatry, 1999
    Co-Authors: Ronald C Kessler, Robert L Dupont, Patricia A Berglund, Hans-ulrich Wittchen
    Abstract:

    Objective: Generalized Anxiety Disorder might be better conceptualized as a prodrome, residual, or severity marker of major depression or other comorbid Disorders than as an independent diagnosis. The authors questioned whether Generalized Anxiety Disorder itself is associated with role impairment or whether the impairment of patients with Generalized Anxiety Disorder is due to depression or other comorbid Disorders. Method: The authors assessed data from the National Comorbidity Survey and the Midlife Development in the United States Survey for Generalized Anxiety Disorder and major depression at 12 months by using the DSM-III-R criteria with modified versions of the Composite International Diagnostic Interview. Results: The prevalences of Generalized Anxiety Disorder at 12 months were 3.1% and 3.3%, respectively, in the National Comorbidity Survey and the Midlife Development in the United States Survey; the prevalences of major depression at 12 months were 10.3% and 14.1%. The majority of respondents with Generalized Anxiety Disorder at 12 months in the National Comorbidity Survey (58.1%) and the Midlife Development in the United States Survey (69.7%) also met the criteria for major depression at 12 months. Comparisons of respondents with one versus neither Disorder showed that both Disorders had statistically significant independent associations with impairment that were roughly equal in magnitude. These associations could not be explained by the other comorbid DSM-III-R Disorders or by sociodemographic variables. Conclusions: These results show that a substantial amount of Generalized Anxiety Disorder occurs independently of major depression and that the role impairment of Generalized Anxiety Disorder is comparable to that of major depression. (Am J Psychiatry 1999; 156:1915‐1923)

  • major depression and Generalized Anxiety Disorder same genes partly different environments
    Archives of General Psychiatry, 1992
    Co-Authors: Kenneth S Kendler, Michael C Neale, Ronald C Kessler, Andrew C Heath, Lindon J Eaves
    Abstract:

    • Bivariate twin analysis can determine the extent to which two Disorders share common genetic, familial environmental, or individual-specific environmental risk factors. We applied this method to lifetime diagnoses of major depression and Generalized Anxiety Disorder as assessed at personal interview in a population-based sample of 1033 pairs of female same-sex twins. Three definitions of Generalized Anxiety Disorder were used that varied in minimum duration (1 vs 6 months) and in the presence or absence of a diagnostic hierarchy. For all definitions of Generalized Anxiety Disorder, the best-fitting twin model was the same. Familial environment played no role in the etiology of either condition. Genetic factors were important for both major depression and Generalized Anxiety Disorder and were completely shared between the two Disorders. A modest proportion of the nonfamilial environmental risk factors were shared between major depression and Generalized Anxiety Disorder. Within the limits of our statistical power, our findings suggest that in women, the liability to major depression and Generalized Anxiety Disorder is influenced by the same genetic factors, so that whether a vulnerable woman develops major depression or Generalized Anxiety Disorder is a result of her environmental experiences.

Michelle G. Newman - One of the best experts on this subject based on the ideXlab platform.

  • Cognitive Behavioral Psychotherapy for Generalized Anxiety Disorder: A Primer
    Expert Review of Neurotherapeutics, 2020
    Co-Authors: Thane M. Erickson, Michelle G. Newman
    Abstract:

    Generalized Anxiety Disorder is a highly debilitating psychologic Disorder associated with cognitive, affective, behavioral and physiologic forms of rigidity and dysfunction. Chronic and uncontrollable worry, a future-oriented and highly negative form of verbal thought, is its hallmark symptom. Cognitive behavioral therapy, the most well-established psychologic treatment for Generalized Anxiety Disorder, entails techniques designed to target and reduce dysfunction in each of these mutually interrelating domains. This review serves as an introduction to cognitive behavioral therapy for Generalized Anxiety Disorder, including conceptualization, treatment methods and evidence for efficacy. Future directions for augmenting treatment efficacy are also discussed.

  • preliminary reliability and validity of the Generalized Anxiety Disorder questionnaire iv a revised self report diagnostic measure of Generalized Anxiety Disorder
    Behavior Therapy, 2002
    Co-Authors: Michelle G. Newman, Thane M. Erickson, Andrea R Zuellig, Kevin E Kachin, Micheal J Constantino, Amy Przeworski, Laurie Cashmanmcgrath
    Abstract:

    This study examined the Generalized Anxiety Disorder Questionnaire-IV (GAD-Q-IV), a revised self-report diagnostic measure of Generalized Anxiety Disorder (GAD) based on the fourth edition of the Diagnostic and Statistical Manual. GAD-Q-IV diagnoses were compared to structured interview diagnoses of individuals with GAD, social phobia, panic Disorder, and nonanxious controls. Using Receiver Operating Characteristics analyses, the GAD-Q-IV showed 89% specificity and 83% sensitivity. The GAD-Q-IV also demonstrated test-retest reliability, convergent and discriminant validity, and kappa agreement of .67 with a structured interview. Students diagnosed with GAD by the GAD-Q-IV were not significantly different on two measures than a GAD community sample, but both groups had significantly higher scores than students identified as not meeting criteria for GAD, demonstrating clinical validity of the GAD-Q-IV.