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Welcome to Anxiety & Depression Insights
On behalf of the Anxiety and Depression Association of America (ADAA), I am pleased to welcome you to the inaugural issue of Anxiety & Depression Insights. This is a free, biweekly update of research, practice, and legislative news about anxiety disorders, depression, PTSD, and OCD.

Insights will announce available resources and events to give you a one-stop source for news and information about anxiety and depression. We also encourage you to visit the ADAA website (www.adaa.org), which has a host of provider- and patient-related materials, as well as information about the organization.

Plan on joining us at the ADAA Annual Conference March 27-30, in Chicago. It is a terrific meeting with outstanding continuing education sessions, top-quality research, and many opportunities to network. Visit the ADAA website (www.adaa.org/conference) for program and registration details.

Mark Pollack, MD, ADAA President
Chair, Department of Psychiatry, Rush University Medical Center
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TAKING ACTION


CME webinar, Jan. 13
Treatment of Refractory Anxiety

ADAA-Wiley Health Learning
Despite the availability of a number of evidence-based pharmacotherapies and psychosocial treatments for anxiety disorders, most patients remain at least somewhat symptomatic after initial interventions and some fail to respond at all to any significant degree. The impact of persistent symptomatology in terms of patient distress and disability as well as risk for complete relapse and recurrence is substantial. In this presentation we will review patient characteristics and treatment factors that may conduce to treatment resistance and discuss therapeutic strategies that may improve outcomes for affected individuals.
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RESOURCES


Depression and Anxiety
Official Journal of ADAA
January issue focus on prognosis and risk factors.
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ADAA featured expert podcast
Lizabeth Roemer
Mindfulness- and Acceptance-Based Behavioral Therapy for Generalized Anxiety and Comorbid Disorders.
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RESEARCH AND PRACTICE NEWS


Where and how are fear-related behaviors and anxiety disorders controlled?
The Almagest
Using an approach combining in vivo recordings and optogenetic manipulations in mice, the researchers succeeded in showing that the inhibition of parvalbumin-expressing prefrontal interneurons triggers a chain reaction resulting in fear behavior. Conversely, activation of these parvalbumin interneurons significantly reduces fear responses in rodents. Some traumatic events may lead to the development of severe medical conditions such as anxiety disorders or posttraumatic stress disorder.
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Prospective study of anxiety and incident stroke
American Heart Association
Higher levels of anxiety are associated with increased risk for coronary heart disease. However, few studies have investigated whether anxiety is associated with stroke risk. The purpose of this study was to examine the association between anxiety symptoms and incident stroke in a nationally representative longitudinal study of the U.S. population.
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Fearful memories haunt mouse descendants
Nature
Certain fears can be inherited through the generations, a provocative study of mice reports. The authors suggest that a similar phenomenon could influence anxiety and addiction in humans. But some researchers are skeptical of the findings because a biological mechanism that explains the phenomenon has not been identified.
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The importance of theory in cognitive behavior therapy: A perspective of contextual behavioral science
Science Direct
For the past 30 years, generations of scholars of cognitive behavior therapy (CBT) have expressed concern that clinical practice has abandoned the close links with theory that characterized the earliest days of the field. There is also a widespread assumption that a greater working knowledge of theory will lead to better clinical outcomes, although there is currently very little hard evidence to support this claim. We suggest that the rise of so-called “third generation” models of CBT over the past decade, along with the dissemination of statistical innovations among psychotherapy researchers, have given new life to this old issue. We argue that theory likely does matter to clinical outcomes, and we outline the future research that would be needed to address this conjecture.
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Postpartum depression and post-traumatic stress disorder
Psych Central
Pregnancy and childbirth bring feelings of joy, excitement and anticipation. They also can complicate existing mental health issues and can create new mental health problems during the pregnancy, at the time of the birth and afterward. Mother and baby both can be affected long-term. The correlation between PTSD and depression has been documented. One study conducted by Shalev et al. (1998) found that 44.4 percent of traumatized participants suffered from comorbid depression one month after the trauma occurred, and 43.2 percent continued experiencing symptoms four months following the trauma.
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Antidepressant-induced liver injury underestimated
Medscape (free subscription)
All antidepressant drugs may potentially cause liver injury, even at recommended doses, and some groups are more vulnerable than others, French researchers report. "Antidepressant liver toxicity has been underestimated in the scientific literature," say Gabriel Perlemuter, M.D., PhD, from AP-HP Hôpital Bicêtre, Kremlin-Bicêtre, France, and colleagues. In some cases, antidepressant-induced liver injury can be irreversible. Given that there currently is no strategy available to prevent antidepressant-induced liver injury, "early detection and prompt drug discontinuation remain critical,".
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After heart surgery, physical inactivity linked with depression risk
The Huffington Post
If you've just undergone heart surgery, the best thing you can do for your mental health may be to get moving. A new study in the Canadian Journal of Cardiology shows an association between physical inactivity after cardiac surgery and increased likelihood of developing depression — a known risk factor for heart complications. However, the researchers from the University of Manitoba and St. Boniface General Hospital were quick to note that the study only showed an association between depression and physical inactivity after cardiac surgery — it did not say whether inactivity led to depression, or if depression then spurred inactivity.
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Reflections on the theory-practice gap in cognitive behavior therapy
Science Direct
The papers in this special series, edited by Pilecki and McKay, are devoted to examining the theory-practice gap in cognitive-behavior therapy (CBT). A gap between theory and practice can occur at more than one level. First, there exists a substantial and concerning gap between the theories and interventions supported by research and those being offered to patients in the community. There is also a growing concern in the field that the techniques and procedures that characterize cognitive-behavioral therapies are becoming increasingly divorced from underlying theories.
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Anxiety may lead to suicide
Decoded Science
Which mental health conditions are most likely to lead to suicidal thoughts and behavior? According to several recent studies, anxiety, more than depression, is a strong risk factor for suicide. Suicide is one of the three leading causes of death for Americans ages 15 to 44.
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Neuroscientists determine how treatment for anxiety disorders silences fear neurons
The Almagest
Excessive fear can develop after a traumatic experience, leading to anxiety disorders such as post-traumatic stress disorder and phobias. During exposure therapy, an effective and common treatment for anxiety disorders, the patient confronts a fear or memory of a traumatic event in a safe environment, which leads to a gradual loss of fear. A new study in mice, published online in Neuron, reports that exposure therapy remodels an inhibitory junction in the amygdala, a brain region important for fear in mice and humans. The findings improve our understanding of how exposure therapy suppresses fear responses and may aid in developing more effective treatments.
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The complex associations among sleep quality, anxiety-depression, and quality of life in patients with extreme obesity
Sleep Research Society
Sleep duration and quality have been associated with obesity. Sleep disturbance has been reported to be associated with stress and depression among non-obese populations, but these relationships have not been previously examined in the obese population. The objective of the current study was to examine the complex associations among sleep disturbance, quality of life, anxiety, and depression in a patient sample with severe obesity.
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The practice of exposure therapy: Relevance of cognitive-behavioral theory and extinction theory
Science Direct
Exposure therapy is the most effective psychological intervention for people with anxiety disorders. While many therapists learn how to implement exposure techniques through clinical training programs or instructional workshops, not all of these educational efforts include a focus on the theory underlying this treatment. The availability of treatment manuals providing step-by-step instructions for how to implement exposure makes it easier for clinicians to use these techniques with less training than they might otherwise receive. This raises questions regarding whether it is necessary to understand the theory behind the use of exposure.
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About Anxiety & Depression Insights
ADAA
This news brief is a timely update about anxiety disorders and depression sent to members of the Anxiety and Depression Association of America and other professionals interested in this area. Links to articles are provided for the convenience of the reader. External resources are not a part of the ADAA website, and ADAA is not responsible for the content of external sites. Linking to a website does not constitute an endorsement by ADAA of the sponsors of the site or the information presented on the site. For more information about ADAA, visit www.ADAA.org.
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Anxiety & Depression Insights
Colby Horton, Vice President of Publishing, 469.420.2601
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Lauren Swan, Content Editor, 202.684.7496  
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