Phobia, Specific

FRIDAY, Aug. 4, 2023 -- By age 75 years, approximately half the global population can expect to develop a mental disorder, according to a study published online July 30 in The Lancet Psychiatry . John J. McGrath, Ph.D., from Queensland Centre for Mental Health Research in Brisbane, Australia, and colleagues used data from 156,331 adult participants in the World Mental Health surveys (2001 to 2022; 29 countries) to estimate age-of-onset distributions, lifetime prevalence, and morbid risk for mental disorders. The researchers found that the lifetime prevalence of any mental disorder was 28.6 percent for male respondents and 29.8 percent for female respondents. By age 75 years, the morbid risk for any mental disorder was 46.4 percent for male respondents and 53.1 percent for female respondents. At 15 years, the conditional probabilities of first onset peaked, with a median age of onset of 19 years for male respondents and 20 years for female respondents. Alcohol use disorder and major depressive disorder were the two most prevalent disorders for male respondents, while major depressive disorder and specific phobia were most prevalent for female respondents. "By understanding the age at which these disorders commonly arise, we can tailor public health interventions and allocate resources to ensure that appropriate and timely support is available to individuals at risk," coauthor Ronald Kessler, Ph.D., from Harvard Medical School in Boston, said in a statement. Several authors disclosed ties to the pharmaceutical industry. Abstract/Full Text (subscription or payment may be required) Posted August 2023

MONDAY, March 20, 2023 -- Sometimes an anxiety disorder feels like worry and ruminating about lots of little and big things. Other times it’s focused on a specific phobia, such as a fear of flying or being in social situations. It can also be expressed as intense feelings about separation from loved ones. What’s clear is that someone experiencing anxiety disorder symptoms isn’t alone. About 40 million American adults have one or more types of anxiety disorders, according to the Anxiety and Depression Association of America (ADAA). If you think you may be among those dealing with these issues, it is possible to get help. There are a range of treatment options for anxiety disorders. A common experience The pandemic exacerbated anxiety issues, which led the U.S. Preventive Services Task Force to recommend screenings for all adults under the age of 65. "COVID has taken a tremendous toll on the mental health of Americans," panel member Lori Pbert , a clinical psychologist and professor at the University of Massachusetts Chan Medical School, said when the screening recommendations were changed . "This is a topic prioritized for its public health importance, but clearly there's an increased focus on mental health in this country over the past few years." Anxiety disorders are so common that nearly 30% of adults will experience one at some point in their lives, according to the American Psychiatric Association (APA). While anxiety itself is a normal reaction to stress , the feelings involved in anxiety disorders are excessive in relation to the circumstances. More women than men have these conditions, according to the APA. Only about 43% of people who have generalized anxiety disorder are receiving treatment, according to the ADAA. Here is a breakdown of the most common types of anxiety disorder. Generalized anxiety disorder Persistent anxious feelings can interfere with daily life over months and years, according to the U.S. National Institute of Mental Health (NIMH). You might be restless, irritable, have trouble concentrating or find it hard to control your worries. Physical symptoms can include fatigue, headaches, muscle aches, stomachaches or trouble sleeping, according to the NIMH. The worries can be about everyday issues, including job responsibilities and family health, according to the APA. Social anxiety disorder Someone might experience intense fear about social situations, causing them to avoid taking part in events or gatherings, according to the National Alliance on Mental Illness (NAMI). It can be driven by irrational worries about humiliation, according to NAMI. Symptoms can include blushing, sweating, trembling, a pounding heart, stomachaches, difficulty making eye contact, rigid body posture and feelings of self-consciousness, according to the NIMH. Separation anxiety disorder This can come with fears of being separated from those you love or worry that harm will come to them, according to the NIMH. The feelings are greater than what would be expected for a person’s age, according to the APA. Symptoms can include nightmares. Panic disorder This can include panic attacks, according to the NIMH, with a racing or pounding heart, chest pain, trembling, feeling of impending doom, tingling or sweating. Some may fear dying, feel they are choking or experience shortness of breath, according to the APA. This can happen multiple times throughout the day or only a few times a year, according to the NIMH. Not everyone who has a panic attack has a panic disorder, the NIMH noted. Phobias These can include a fear of flying, heights, injections, blood and certain animals, such as spiders or snakes. People with phobia-related disorders or specific phobias have an intense fear about these particular objects or situations that are out of proportion with their actual danger, according to the NIMH. Someone might avoid their fear or experience immediate intense anxiety when they do encounter it. Agoraphobia is the fear of a particular situation that the person feels may be difficult to escape, according to the APA. Commonly, this can include fear of being in open or enclosed spaces, being in a crowd, using public transportation or even just being outside the home. Symptoms can include avoidance of the situation or needing a companion to endure it. Anxiety disorder treatment Several different types of treatments are commonly used to treat anxiety disorders. Most will respond well to a type of talk therapy called cognitive behavioral therapy (CBT) or to anxiety medication, either used together or separately. CBT can help someone learn a new way of thinking that may include exposure to a specific fear. Acceptance and commitment therapy (ACT) is a newer alternative that uses mindfulness and goal setting to reduce these negative feelings, the NIMH said. Anxiety disorder medications include a range of anti-anxiety drugs and antidepressants that can balance brain chemicals, such as benzodiazepines, atypical antidepressants and beta blockers. Posted March 2023

The trial studied phobia patients using a headset and a smartphone app treatment programme -- a combination of Virtual Reality (VR) 360-degree video exposure therapy and cognitive behavioural therapy (CBT). Results from a University of Otago, Christchurch trial suggest fresh hope for the estimated one-in-twelve people worldwide suffering from a fear of flying, needles, heights, spiders and dogs. The trial, led by Associate Professor Cameron Lacey, from the Department of Psychological Medicine, studied phobia patients using a headset and a smartphone app treatment programme -- a combination of Virtual Reality (VR) 360-degree video exposure therapy and cognitive behavioural therapy (CBT). Participants downloaded a fully self-guided smartphone app called "oVRcome," developed by Christchurch tech entrepreneur Adam Hutchinson, aimed at treating patients with phobia and anxiety. The app was paired with a headset to immerse participants in virtual environments to help treat their phobia. The results from the trial, just published in the Australian and New Zealand Journal of Psychiatry, showed a 75 per cent reduction in phobia symptoms after six weeks of the treatment programme. "The improvements they reported suggests there's great potential for the use of VR and mobile phone apps as a means of self-guided treatment for people struggling with often-crippling phobias," Associate Professor Lacey says. "Participants demonstrated a strong acceptability of the app, highlighting its potential for delivering easily accessible, cost-effective treatment at scale, of particular use for those unable to access in-person exposure therapy to treat their phobias." A total of 129 people took part in the six-week randomised, controlled trial, between May 2021 and December 2021, with a 12-week follow-up. Participants needed to be aged between 18-64 years, have a fear of either flying, heights, needles, spiders and dogs. They were emailed weekly questionnaires to record their progress. Those experiencing adverse events could request contact from a clinical psychologist at any stage. "Participants experiencing all five types of phobia showed comparable improvements in the Severity Measures for Specific Phobia scale over the course of the trial. The average severity score decreased from 28/40 (moderate to severe symptoms) to 7/40 (minimal symptoms) after six weeks. There were no participant withdrawals due to intervention-related adverse events. "The oVRcome app involves what's called "exposure therapy," a form of CBT exposing participants to their specific phobias in short bursts, to build up their tolerance to the phobia in a clinically-approved and controlled way," Associate Professor Lacey says. "Some participants reported significant progress in overcoming their phobias after the trial period, with one feeling confident enough to now book an overseas family holiday, another lining up for a Covid vaccine and another reporting they now felt confident not only knowing there was a spider in the house but that they could possibly remove it themselves." The app programme consisted of standard CBT components including psychoeducation, relaxation, mindfulness, cognitive techniques, exposure through VR, and a relapse prevention model. Participants were able to select their own exposure levels to their particular phobia from a large library of VR videos. "This means the levels of exposure therapy could be tailored to an individual's needs which is a particular strength. The more traditional in-person exposure treatment for specific phobias have a notoriously high dropout rate due to discomfort, inconvenience and a lack of motivation in people seeking out fears to expose themselves to. With this VR app treatment, triallists had increased control in exposure to their fears, as well as control over when and where exposure occurs," says Associate Professor Lacey. The researchers say this trial was novel, due to the cost-effective availability of the app and headsets and the fact that multiple phobias were tested at once. They say most comparative VR studies to date have investigated high-end VR devices which are only available in research and limited clinical settings. One Dutch study examined a low-cost VR Dutch-language program using animated imagery that demonstrated improvement in fear-of-height symptoms, however this study only examined a single type of specific phobia. Associate Professor Lacey says public demand to take part in the trial was unprecedented, demonstrating the increasing need and desire for phobia treatment in the community. "An estimated ten per cent of New Zealanders have been hesitant to take part in the government's COVID-19 vaccination programme due to needle phobia. This hasn't been helped by a significant shortage of psychologists. A petition to Parliament last year claimed New Zealand is 1,000 psychologists short, causing ballooning wait times nationwide, making it difficult for people to access help if needed. We need to further research and explore the use of more cost-effective, easily-accessible, home-based solutions such as this oVRcome app, to provide people with the treatment and support they need." This study builds on the Department of Psychological Medicine's existing research into structured psychotherapy for mental distress.