Background. Cross-sectional findings in community surveys of adults suggest that adolescent anxiety disorders are strong predictors of the subsequent onset of alcohol use, abuse and dependence. However, prospective data that follow a sample of adolescents into adulthood are needed to confirm these associations. Method. Baseline and 4-year follow-up data from the EDSP-Study, a prospective community survey of 3021 (2548 at follow-up) adolescents and young adults aged 14 to 24 years at baseline carried out in Munich, were used. DSM-IV anxiety disorders, alcohol use and alcohol use disorders were assessed with the Munich-Composite-International-Diagnostic-Interview (M-CIDI). Multiple logistic regression analysis, controlling for age, gender, other mental disorders, substance use disorders and antisocial behaviour was used to study the associations of baseline anxiety disorders with the subsequent onset and course of alcohol use and alcohol disorders. Results. Baseline social phobia significantly predicts the onsets of regular use and hazardous use and the persistence of dependence. Panic attacks significantly predict the onsets of hazardous use and abuse as well as the persistence of combined abuse/dependence. Panic disorder significantly predicts the persistence of combined abuse/dependence. Other anxiety disorders do not significantly predict any of the outcomes. Conclusions. Panic and social phobia are predictors of subsequent alcohol problems among adolescents and young adults. Further studies are needed to investigate the underlying mechanisms and the potential value of targeted early treatment of primary panic and social phobia to prevent secondary alcohol use disorders.

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.

Bakgrund Depression och ångestsyndrom är idag ett växande folkhälsoproblem där psykofarmaka är den vanligaste behandlingen med vanliga biverkningar som trötthet och dålig sömn. Fysisk aktivitet är något som visat sig ha många hälsofördelar och fungerar bra som kompletterande behandling till psykofarmaka. Arbetsmetoden Fysisk aktivitet på recept (FaR) möjliggör för sjuksköterskan att främja fysisk aktivitet som alternativ behandlingsmetod vid depression och ångestsyndrom. Syfte Syftet var att beskriva individers erfarenheter och upplevelser av fysisk aktivitet vid depression och ångestsyndrom. Metod Detta arbete var en icke-systematisk litteraturöversikt där resultatet var baserat på 15 olika vetenskapliga artiklar som söktes via databaserna PubMed, CINAHL och PsycInfo. Urvalskriterier som användes var att artiklarna ej skulle vara publicerade tidigare än 2010, vara peer reviewed samt skrivna på engelska. Data analyserades med Kristenssons (2014) integrerade analysmetod. Resultat Fysisk aktivitet har visats ha en positiv påverkan på depression och ångestsyndrom. Patienter upplever att fysisk aktivitet ger en ökad energi samt att depressionssymtom minskar. Motiverande faktorer för att bibehålla träningen visade sig vara individanpassat stöd från en vårdkontakt samt att den fysiska aktiviteten skulle bidra till ökad energi och välbefinnande. Negativa effekter som uppmärksammades kring fysisk aktivitet kom av att aktiviteten ej var tillräckligt individanpassad. Slutsats Fysisk aktivitet som upplevdes tillfredsställande och givande gav många positiva effekter hos individer med depression och ångestsyndrom. Stöd från en vårdkontakt samt en individanpassad fysisk aktivitet sågs öka motivationen. En ej tillräckligt individanpassad fysisk aktivitet samt ej uppnådda förväntade känslor var orsaker till negativa upplevelser. Viktigt för upplevelse av positiva känslor kring fysisk aktivitet var att aktiviteten utformades på en individanpassad nivå. / Background Depression and anxiety disorders are today a growing public health problem where antidepressant drugs are the most common treatment where the drugs can cause side effects as fatigue and poor sleep. Physical activity is something that has been shown to have many health benefits and works well as a complementary treatment to antidepressant drugs. The working method Physical activity on prescription (PaP) enable the nurse to promote physical activity as an alternative treatment for depression and anxiety disorder. Aim The aim was to describe individuals’ experiences of physical activity in depression and anxiety disorder. Method This work was a non-systematic literature review where the results are based on 15 different scientific articles that were searched in the databases PubMed, CINAHL and PsycInfo. The established selection criteria were that the articles should not be published earlier than 2010, be peer reviewed and written in English. Data were analyzed with Kristensson's (2014) integrated analysis method. Results Physical activity has been shown to have a positive effect on depression and anxiety disorders. Patients experience that physical activity provides increased energy and decreases depressive symptoms. Motivating factors for maintaining exercise turned out to be individualized support from a care contact and that the physical activity would contribute to increased energy and well-being. Negative effects that were noticed about the physical activity came from the fact that the activity was not sufficiently individualized. Conclusions Physical activity that was perceived as satisfying and rewarding had many positive effects in individuals with depression and anxiety disorders. Support from a care contact and an individualized physical activity were seen to increase motivation. Insufficiently individualized physical activity and unattainable expected emotions were causes of negative experiences. It was important for the experiences of positive emotions about the physical activity that the activity was designed on an individualized level.

Bakgrund: Depressions- och ångestsyndrom är de vanligaste förekommande psykiska sjukdomarna och leder i stor utsträckning till sjukskrivningar. Patientgruppen utgör en stor del av samhället, samt är en vårdsökande grupp som kommer påträffas inom alla instanser av vården. Det finns en stark korrelation mellan ångest och depression samt fysisk sjukdom, vilket innebär att patientgruppen blir allt vanligare förekommande inom vården. För att kunna förbättra vården blir det därför av stor vikt att förstå vård-upplevelsen utifrån patientens perspektiv. Syfte: att beskriva patienters erfarenheter av faktorer som påverkar vården vid depressions och/eller ångestsyndrom. Metod: En litteraturöversikt över elva artiklar med kvalitativ ansats genomfördes. Resultat: Sex huvudkategorier identifierades: copingstrategier som bidragande faktorer, faktorer som patienten upplever främjar vården, faktorer som patienten upplever försvårar vården, stigmatiseringens konsekvenser för vården, attityder till läkemedelsbehandling av depressions- och ångestsyndrom samt hur patientens självbild påverkar vården. Resultatet redovisar att patienters erfarenheter av försvårande faktorer förekom i större utsträckning än främjande. Erfarenheter som framträdde var bristande bemötande, brister i organisationen, okunskap kring sjukdomsbild samt hur stigmatiseringen påverkar patienten och dennes självbild. Erfarenheter av främjande aspekter var familj och anhöriga som stödjande samt deras eller den egna individens tidigare positiva erfarenheter av vården. Slutsats: Personcentrerad vård kan både underlätta vård och öka följsamheten för denna patientgrupp. För att uppnå en god omvårdnad behöver det etableras en förtroendefull och fördomsfri relation mellan sjuksköterska och patient. Med en personcentrerad omvårdnad stärks patientsäkerheten och sjuksköterskan skapar lättare en förtroendefull relation med patienten. / Background: Depressive and anxiety disorder are the most common mental illnesses and largely contribute to sick leave. The patient group constitutes a large part of society and is a care-seeking group that will be encountered in all instances of healthcare. There is a strong correlation between anxiety and depression as well as physical illness, this means that the patient group is becoming increasingly common in healthcare. To improve care, it is therefore of great importance to understand the care-experience from the patient's perspective. Aim: Where to describe patients' experiences of factors that influence care for depressive and/or anxiety disorders. Method: A literature review of eleven articles with a qualitative approach was carried out. Results: Six main categories were identified: coping strategies as contributing factors, factors that the patient perceives as promoting care, factors that the patient perceives as making care more difficult, the consequences of stigma for care, attitudes to drug treatment of depressive and anxiety disorder, and how the patient's self-image affects care. The results report overall on patients' experiences of care where inhibiting factors occur to a greater extent than promoting factors. Experiences that emerged were deficient treatment in healthcare, shortcomings in the organization, unenlightenment about the clinical characteristics of the disease and how the stigma affects the patient and their self-image. Experiences of enablers were family and relatives as motivators as well as their or the individual's own previous positive experiences of care. Conclusion: Person-centred care can both facilitate care and increase adherence for this patient group. To achieve good nursing care a trustful and unprejudiced relationship between the nurse and patient needs to be established. With person-centred nursing care, patient safety is strengthened, and the nurse creates a trusting relationship with the patient more easily.

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.