Bakgrund: Psykisk ohälsa är idag ett vanligt hälsoproblem hos unga svenska kvinnor. Ett växande intresse finns även för den psykiska hälsan hos elitidrottare eftersom forskning har identifierat en rad idrottsspecifika stressorer som ökar risken för psykisk ohälsa. Self-efficacy är en annan faktor som har visats kunna påverka elitidrottarens idrottsliga prestation och är tillsammans med ett gott psykiskt mående viktigt för att elitidrottaren ska lyckas. Syfte: Att undersöka förekomst och grad av generaliserat ångestsyndrom (GAD) och self-efficacy (SE) till att nå idrottsspecifika mål hos unga svenska kvinnliga elitgymnaster samt dess korrelation. Metod: Studien är en tvärsnittsstudie med en kvantitativ ansats. Generaliserat ångestsyndrom mättes med en elektronisk version av GAD-7 och SE med General Self-Efficacy Scale (GSES). Deltagarna rekryterades genom ett icke slumpmässigt bekvämlighetsurval och datan analyserades i det statistiska dataprogrammet SPSS. Resultat: 48 deltagare rekryterades till studien och av dessa rapporterade 54,3 % någon grad av GAD. Deltagarna hade ett medianvärde på 29 poäng för SE till att nå idrottsspecifika mål. Det fanns en signifikant, svag och negativ korrelation mellan GAD och SE till att nå idrottsspecifika mål. Konklusion: Studiens resultat går i linje med tidigare forskning som visar att GAD är vanligt förekommande hos kvinnliga elitidrottare. Ett svagt negativt samband kunde visas mellan GAD och SE till att nå idrottsspecifika mål hos de unga, kvinnliga svenska elitgymnasterna. Dock behövs mer forskning på en större population rekryterade från ett slumpmässigt urval för att resultatet ska kunna generaliseras. / Background: Mental illness is a common health problem among young Swedish women. There is also a growing interest for the mental health of elite athletes as previous research has identified several sport-specific stressors that can increase the risk of mental illness. Self-efficacy is another factor that has been shown to affect athletic performance and is, as well as a good mental state, important for an elite athlete to succeed.  Aim: To investigate the prevalence and severity of generalized anxiety disorder (GAD) and self-efficacy (SE) to achieve sport-specific goals in young Swedish female elite gymnasts and its correlation. Methods: The study is a cross-sectional, non-randomized study with a quantitative approach. GAD was measured using an electronic version of GAD-7 Scale and SE with the General Self-Efficacy Scale (GSES). Results: 48 participants were recruited and out of these, 54,3% reported some degree of GAD. The participants had a median value of 29 points for SE to achieve sport-specific goals. There was a significant, weak and inverse correlation between GAD and SE to achieve sport-specific goals. Conclusion: The results of the study are in line with previous research that identifies GAD as a common health problem among female elite athletes. A significant, weak and inverse correlation could be shown between GAD and SE to achieve sport-specific goals. However, more research is needed on a larger population recruited from a randomized sample for the results to be generalized.

Generalized anxiety disorder (GAD) is a prevalent anxiety disorder that is characterized by persistent excessive worrying that is often difficult to control. The pathology of GAD has been associated with abnormal neural activity and functional connectivity. This systematic review has examined the central neural correlates of GAD which are the prefrontal cortex (PFC), the anterior cingulate cortex (ACC) and the amygdala and how activation and functional connectivity in these brain areas differ between patients with GAD and healthy controls. This review also investigated how abnormal functional connectivity and activation in these brain regions relates to worry which is the most prominent psychological symptom in patients with GAD. A systematic review was conducted and seven original functional magnetic resonance imaging (fMRI) studies were included after a literature search on PubMed, Scopus and, Web of Science. The main findings from this review revealed decreased activation in the PFC and ACC and enhanced activation in the amygdala during the viewing of negative stimuli in patients with GAD. Identifying the neural correlates of GAD and how it relates to worry may provide improved treatment in the future such as developing more effective psychotropic drugs or improved psychotherapy. GAD has been associated with lower well-being and life satisfaction and may even be a risk factor for suicidal thoughts. One of the limitations from this review is that several of the included studies recruited patients with comorbidities and for that reason results from these studies cannot be generalized and applied to individuals with GAD.

No description available.

Emotional regulation may be an underaddressed therapeutic target in sex offender treatment. This article presents a case report of “Adam,” a Caucasian male referred to a prison-based sex offender treatment program. Adam’s social anxiety was recognized as an antecendent to his sexual offending, and treatment of such, as a critical adjunct to sex offender treatment, is discussed herein. Adam’s individualized treatment included aspects of rational emotive behavior therapy and time-limited dynamic psychotherapy. Adam showed an increased understanding of his anxiety and improvement in his social interactions, both in the context of treatment groups and with female staff, and was willing to continue follow-up care in the community. This case provides support for the individualized treatment of incarcerated offenders as opposed to exclusively utilizing manualized psychoeducational interventions.

No description available.

No description available.

Although social anxiety disorder is most often diagnosed during adolescence, few investigations have examined the clinical presentation of this disorder exclusively in adolescents. Prior studies have demonstrated that some clinical features of SAD in adolescents are unique relative to younger children with the condition. Furthermore, the extant literature on daily functional impairment in this population is limited. In this investigation, multiple areas of functioning were examined in adolescents with SAD (n = 16) and normal control adolescents (n = 14): specific social skills, subjective distress and physiological reactivity during one speech performance task and one social interaction task; alcohol use and expectancies; subjective and objective quality of sleep; and daily distressing social activities. No differences were observed in sleep actigraphy, self-reported sleep difficulties, alcohol use, or alcohol expectancies. Adolescents with SAD reported greater distress during both analogue tasks relative to NC adolescents. During the speech task, adolescents with SAD exhibited significantly greater speech latency (4.42 seconds vs. 1.75 seconds) and spoke significantly less (83.09 seconds vs. 167.75 seconds) than NC adolescents. Additionally, SAD participants manifested greater skin conductance during the speech task. During the social interaction, adolescents with SAD asked significantly fewer questions (2.20 vs. 7.07) and required significantly more confederate prompts (2.33 vs. 1.14) to stimulate interaction. Finally, adolescents with SAD reported more frequent anxiety-provoking situations in their daily lives and greater avoidance of these situations, including answering questions in class, assertive communication, and interacting with a group. iv The findings are discussed with respect to the current understanding of alcohol use, quality of sleep, and social functioning in adolescents with SAD.

Objective: Two significant challenges for the dissemination of social skills training programs are (a) the need to provide sufficient practice opportunities to assure skill consolidation and (b) the need to assure skill generalization (i.e., use of the skills outside the clinic setting). In the case of social anxiety disorder, virtual environments may provide one strategy to address these issues. This investigation describes the development of an interactive skills-oriented virtual school environment and evaluated its utility for the treatment of social anxiety disorder in preadolescent children (Study 1). This environment included both in-clinic and at-home solutions. In addition, a pilot replication/extension study further examined preliminary treatment efficacy between children who received a standard multi-component treatment and children who received the modified treatment with social skills practice in a virtual environment (Study 2). Method: Eleven children with a primary diagnosis of social anxiety disorder between 7 to 12 years old participated in the initial feasibility trial (Study 1). Five additional children participated in the replication/extension study (Study 2). To investigate preliminary treatment efficacy, clinical outcome measures for the Study 2 sample were compared to a comparison sample who received the standard treatment. Results: Overall, the virtual environment program was viewed as acceptable, feasible, and credible treatment components to children, parents, and clinicians alike but modifications would likely improve the current version. Additionally, although preliminary, children who received the modified treatment with virtual environment practice demonstrated significant improvement at post-treatment on clinician ratings but not parent or self-reported measures. Conclusion: Virtual environments are feasible, acceptable, and credible treatment components for clinical use. Future investigations will determine if the addition of this dose-controlled and iv intensive social skills practice results in treatment outcome equivalent to traditional cognitivebehavioral programs.

Studies suggest that sleep disturbance may be an important etiological factor in the development of comorbid anxiety and depressive disorders, whereby anxiety leads to sleep difficulties, which in turn increase the vulnerability for depression. The primary aim of this study was to determine whether the sequential comorbidity patterns observed at the disorder level (i.e., where anxiety disorders most often precede insomnia, and insomnia most often precedes depression) were also present in daily fluctuations of symptoms. The secondary aim was to explore possible moderators of any observed temporal associations. Participants were 15 patients with generalized anxiety disorder (GAD; mean age = 28.9 years, SD = 9.8) and 15 good sleeper controls (mean age = 27.1 years, SD = 8.3) who were comparable in female:male ratio (73% female vs. 67% female). For 14 days, participants wore an actigraph to objectively assess sleep quality (sleep onset latency, total sleep time, wake after sleep onset, sleep efficiency) and completed daily symptom ratings multiple times each day using their smartphones to assess symptoms of anxiety, depressed mood, and subjective sleep quality. Study aims were assessed using multilevel modeling, with daily symptoms nested within individuals. Many of the analyses were lagged such that the time-varying predictor variable preceded the time-varying outcome variable temporally. Consistent with hypotheses, results demonstrated that anxious mood was predictive of later subjective and objective sleep disturbance in individuals with GAD, and this effect was strongest among individuals with higher levels of neuroticism, negative affect, and dysfunctional beliefs about sleep. Anxious mood was not associated with later subsequent sleep disturbance in healthy controls. In the GAD group, subjective and objective sleep disturbance predicted later depressed mood; this effect was moderated by temperament and dysfunctional beliefs about sleep. For the control group, the effect of subjective sleep disturbance on later depressed mood was moderated by neuroticism and the effect of objective sleep disturbance was moderated by dysfunctional beliefs about sleep, suggesting that sleep disturbance may increase vulnerability for depressed mood even in healthy individuals. These results suggest that explicitly targeting sleep disturbance during the treatment of GAD may attenuate the experience of depressive symptoms.

Die vorliegende Arbeit befasst sich mit Folgen der COVID-19-Pandemie und der damit verbundenen Infektionsschutzmaßnahmen auf die psychische Gesundheit von Kindern und Jugendlichen. Im Mittelpunkt der Untersuchung stehen dabei Kinder und Jugendliche zwischen 2 und 17 Jahren, die in Praxen von Fachärztinnen und Fachärzten für Kinder- und Jugendmedizin behandelt wurden. Ziel einer ersten Studie war es zu klären, ob und in welchem Umfang die Gruppe dieser jungen Patientinnen und Patienten in den pädiatrischen Praxen gegenüber einem präpandemischen Vergleichszeitraum häufiger unter Störungen mit ängstlicher oder depressiver Symptomatik litten. Als Vergleichszeitraum wurde hier April 2020 bis Dezember 2020 versus April 2019 bis Dezember 2019 gewählt. Der erste Ergebnisparameter war die Anzahl der Kinder und Jugendlichen mit den Diagnosen Depression (ICD-10: F32, F33) und Angststörung (ICD-10: F41) pro Praxis. Der zweite Ergebnisparameter der Studie war die Veränderung der Prävalenz von Depressions- und Angststörungsdiagnosen im Zeitraum April 2020-Dezember 2020 gegenüber April 2019-Dezember 2019 (Studie 1). In einer zweiten Studie wurden alle psychischen Störungen des Kapitels F des ICD-10 untersucht. Hier war ein längerer Vergleichszeitraum von 2018 bis 2021 möglich. 2018 und 2019 waren präpandemische Jahre und 2020 und 2021 wurden als pandemische Jahre eingestuft. Im Zentrum stand hier die Gesamtzahl der Patienten mit psychischen Störungen und die Anzahl von Patienten mit diesen Störungsbildern in den einzelnen Praxen (Studie 2). Die Ergebnisse der ersten Studie zeigten, dass die Anzahl der Kinder und Jugendlichen mit Depressions- und Angstdiagnosen pro Praxis im Zeitraum April 2020 bis Dezember 2020 im Vergleich zum gleichen Zeitraum 2019 zugenommen hatte (Angst: +9%, Depression: +12%). Der Anstieg war bei Mädchen deutlich größer als bei Jungen (Angst: +13% vs. +5%; Depression +19% vs. +1%). Die Prävalenz der Angststörung stieg von 0,31% auf 0,59% (p<0,001), die der Depression von 0,23% auf 0,47% (p<0,001). Die größten Anstiege wurden bei Mädchen beobachtet (Angst von 0,35% auf 0,72% (+106%, p<0,001), Depression von 0,28% auf 0,72% (+132%, p<0,001) (Studie 1). In der Folgestudie zeigten die Ergebnisse, dass in den Pandemiejahren 2020 und 2021 im Vergleich zu den beiden Vorjahren signifikant mehr psychische Störungen diagnostiziert (chi2 p<0,001) wurden. Ein Anstieg von 2018 zu 2021 wurde besonders bei affektiven Störungen deutlich. Allerdings war die Zunahme der Anzahl dieser Patienten in der einzelnen Praxis mit einer durchschnittlichen Zunahme von 7 Patienten pro Praxis im Jahr sehr gering und war vermutlich für die einzelne Ärztin oder den einzelnen Arzt kaum wahrnehmbar (Studie 2). Während in der ersten Studie für einen kürzeren Zeitraum von 9 Monaten gezeigt wurde, dass die Zahl der pädiatrischen Diagnosen von Depressionen und Angststörungen im Pandemiejahr 2020 im Vergleich zum Vorjahr zugenommen hatte, konnte in der zweiten Studie für einen Zweijahreszeitraum belegt werden, dass die Summe aller psychischen Störungen des Kapitels F der ICD 10 zugenommen hatte. Beide Studienergebnisse weisen auf die Chance hin, dass wenige standardisierte Fragen zur psychischen Gesundheit z. B. in die pädiatrischen Vorsorgeuntersuchungen implementiert werden können, um ungedeckte Bedarfssituationen im Hinblick auf die psychische Gesundheit besser wahrzunehmen.:1. Einleitung 1 1.1. Hintergrund 1 1.2. Fragestellungen 2 1.3. Methoden 3 2. Publikationen 5 2.1. Zunahme von Depressions- und Angststörungsdiagnosen während der Covid-19-Pandemie bei Kindern und Jugendlichen 5 2.2. Psychische Störungen in deutschen pädiatrischen Praxen vor und während der COVID-19-Pandemie 14 3. Diskussion 19 4. Schlussfolgerungen, Implikationen für Forschung und Praxis 23 5. Zusammenfassung der Arbeit 25 5.1. Zusammenfassung 25 5.2. Studienziele 25 5.3. Ergebnisse 26 5.4. Schlussfolgerung 27 5.5. Implikationen für die weitere Forschung 27 6. Literaturverzeichnis 28 7. Anlagen 34 7.1. Darstellung des eigenen Beitrages 34 7.2. Selbstständigkeitserklärung 38 7.3. Lebenslauf 39 7.4. Wissenschaftliche Veröffentlichungen 40 7.5. Danksagung 42