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Journal of Anxiety Disorders Mar 2020Although visual avoidance of faces is a hallmark feature of social anxiety disorder (SAD) on clinical and theoretical grounds, empirical support is equivocal. This...
Although visual avoidance of faces is a hallmark feature of social anxiety disorder (SAD) on clinical and theoretical grounds, empirical support is equivocal. This review aims to clarify under which conditions socially anxious individuals display visual avoidance of faces. Through a systematic search in Web of Science and PubMed up to March 2019 we identified 61 publications that met the inclusion criteria. We discuss the influence of three factors on the extent to which socially anxious individuals avoid looking at faces: (a) severity of social anxiety symptoms (diagnosed SAD versus High Social Anxiety levels in community samples [HSA] or related characteristics [Shyness, Fear of Negative Evaluation]), (b) three types of social situation (computer facial-viewing tasks, speaking tasks, social interactions), and (c) development (age-group). Adults with SAD exhibit visual avoidance across all three types of social situations, whereas adults with HSA exhibit visual avoidance in speaking and interaction tasks but not in facial-viewing tasks. The relatively few studies with children and adolescents suggest that visual avoidance emerges during adolescence. The findings are discussed in the context of cognitive-behavioral and skills-deficit models. Suggestions for future research include the need for developmental studies and more fine-grained analyses of specific areas of the face.
Topics: Anxiety; Avoidance Learning; Face; Fear; Humans; Phobia, Social; Vision, Ocular
PubMed: 32058889
DOI: 10.1016/j.janxdis.2020.102193 -
Neuroscience and Biobehavioral Reviews Apr 2020Responding to stimuli in ambiguous environments is partially governed by approach-avoidance tendencies. Imbalances in these approach-avoidance behaviors are implicated...
How interindividual differences shape approach-avoidance behavior: Relating self-report and diagnostic measures of interindividual differences to behavioral measurements of approach and avoidance.
Responding to stimuli in ambiguous environments is partially governed by approach-avoidance tendencies. Imbalances in these approach-avoidance behaviors are implicated in many mental disorders including anxiety disorders, phobias and substance use disorders. While factors biasing human behavior in approach-avoidance conflicts have been researched in numerous experiments, a much-needed comprehensive overview integrating those findings is missing. Here, we systematically searched the existing literature on individual differences in task-based approach-avoidance behavior and aggregated the current evidence for the effect of self-reported approach/avoidance traits, anxiety and anxiety disorders, specific phobias, depression, aggression, anger and psychopathy, substance use and related disorders, eating disorders and habits, trauma, acute stress and, finally, hormone levels (mainly testosterone, oxytocin). We highlight consistent findings, underrepresented research areas and unexpected results, and detail the amount of controversy between studies. We discuss potential reasons for ambiguous results in some research areas, offer practical advice for future studies and highlight potential variables such as task-related researcher decisions that may influence how interindividual differences and disorders drive automatic approach-avoidance biases in behavioral experiments.
Topics: Avoidance Learning; Behavioral Symptoms; Humans; Individuality; Mental Disorders; Oxytocin; Personality; Self Report; Testosterone
PubMed: 31954150
DOI: 10.1016/j.neubiorev.2020.01.008 -
The Journal of Sexual Medicine Aug 2021Posttraumatic stress disorder (PTSD) is associated with sexual difficulties but the nuances of this relationship remain elusive. Research has increased in recent years,... (Review)
Review
BACKGROUND
Posttraumatic stress disorder (PTSD) is associated with sexual difficulties but the nuances of this relationship remain elusive. Research has increased in recent years, most notably following publication of several reviews in 2015.
AIM
This systematic review examines the relationship between PTSD and sexual difficulties in veterans/military personnel.
METHODS
A systematic review was conducted using PRISMA guidelines in PsycINFO and PubMed databases for studies examining a diagnosis of PTSD or PTSD severity in relation to a range of sexual difficulties. Forty-three studies were identified that met inclusion and exclusion criteria for this review.
RESULTS
PTSD was associated with increased risk of experiencing at least one sexual difficulty. PTSD was most clearly associated with overall sexual function, sexual desire, sexual satisfaction, and sexual distress. Results were mixed for sexual arousal, orgasm function, erectile dysfunction, premature ejaculation, sexual pain, and frequency of sexual activity. PTSD symptom clusters of avoidance and negative alterations in cognition/mood were most commonly associated sexual difficulties. Few studies compared results by gender and trauma type.
CLINICAL IMPLICATIONS
Clinicians should inquire about sexual health in relation to PTSD symptoms and target avoidance and negative mood symptoms by incorporating sexual exposure assignments and sexual activation exercises when appropriate.
STRENGTHS & LIMITATIONS
This systematic review synthesizes an extensive literature that has grown substantially in the past 5 years and includes studies with low to moderate risk of bias. Limitations of the existing literature include challenges differentiating between PTSD and depression, inconsistent measurement of PTSD and trauma histories, inconsistent operationalization and measurement of sexual outcomes, and largely cross-sectional study designs.
CONCLUSION
PTSD is linked to a range of sexual outcomes. The current literature suggests that PTSD is associated with sexual difficulties related to both the sexual response cycle (ie, sexual desire) and one's emotional relationship to sexual activity (eg, sexual distress). More research is needed to increase confidence in findings. Bird ER, Piccirillo M, Garcia N, et al. Relationship Between Posttraumatic Stress Disorder and Sexual Difficulties: A Systematic Review of Veterans and Military Personnel. J Sex Med 2021;18:1398-1426.
Topics: Cross-Sectional Studies; Humans; Male; Military Personnel; Sexual Behavior; Stress Disorders, Post-Traumatic; Veterans
PubMed: 34257051
DOI: 10.1016/j.jsxm.2021.05.011 -
Heliyon Apr 2021In the face of ongoing attempts to achieve gender equality, there is increasing focus on the need to address outdated and detrimental gendered stereotypes and norms, to... (Review)
Review
In the face of ongoing attempts to achieve gender equality, there is increasing focus on the need to address outdated and detrimental gendered stereotypes and norms, to support societal and cultural change through individual attitudinal and behaviour change. This article systematically reviews interventions aiming to address gendered stereotypes and norms across several outcomes of gender inequality such as violence against women and sexual and reproductive health, to draw out common theory and practice and identify success factors. Three databases were searched; ProQuest Central, PsycINFO and Web of Science. Articles were included if they used established public health interventions types (direct participation programs, community mobilisation or strengthening, organisational or workforce development, communications, social marketing and social media, advocacy, legislative or policy reform) to shift attitudes and/or behaviour in relation to rigid gender stereotypes and norms. A total of 71 studies were included addressing norms and/or stereotypes across a range of intervention types and gender inequality outcomes, 55 of which reported statistically significant or mixed outcomes. The implicit theory of change in most studies was to change participants' attitudes by increasing their knowledge/awareness of gendered stereotypes or norms. Five additional strategies were identified that appear to strengthen intervention impact; peer engagement, addressing multiple levels of the ecological framework, developing agents of change, modelling/role models and co-design of interventions with participants or target populations. Consideration of cohort sex, length of intervention (multi-session vs single-session) and need for follow up data collection were all identified as factors influencing success. When it comes to engaging men and boys in particular, interventions with greater success include interactive learning, co-design and peer leadership. Several recommendations are made for program design, including that practitioners need to be cognisant of breaking down stereotypes amongst men (not just between genders) and the avoidance of reinforcing outdated stereotypes and norms inadvertently.
PubMed: 33912699
DOI: 10.1016/j.heliyon.2021.e06660 -
Steroids Oct 2021In recent years the expanding misuse of Nandrolone among non-athletes, particularly adolescent males is a prevalent global concern due to its adverse effects. This...
BACKGROUND AND AIM
In recent years the expanding misuse of Nandrolone among non-athletes, particularly adolescent males is a prevalent global concern due to its adverse effects. This article provides a summary of the experimental studies to clarify the relationship between Nandrolone exposure and behavioral and cognitive performances.
MATERIALS AND METHODS
The present systematic review was conducted using PubMed, Embase and ScienceDirect databases, from 2000 to 2020, using the following key terms: Nandrolone AND Cognition, Nandrolone AND Learning, Nandrolone AND Memory, Nandrolone AND (Synaptic plasticity or Hippocampal synaptic plasticity), Nandrolone AND (Aggression or Aggressive-like behavior), Nandrolone AND (Anxiety or Anxiety-like behavior), Nandrolone AND (Depression or Depressive-like behavior).
RESULTS
33 qualified papers were selected from the 2498 sources found. Of the 33 cases, 32 (96.97%) were males while only 1 (3.03%) was female and male. From 33 selected articles 8 reported studies were related to spatial memory, 2 reported studies were related to avoidance memory, 11 studies reported information on synaptic plasticity, 11 reported studies were related to aggressive behavior, 8 reported studies were related to aggressive behavior and 6 reported studies were related to depression.
CONCLUSION
Nandrolone can change spatial ability, avoidance memory and hippocampal synaptic plasticity. Also, Nandrolone exposure produces variable effects on behavioral function such as aggression, depression and anxiety. This despite the fact that the results are contradictory. These discrepancies might be due to the differences in sex, age, dosage and treatment duration, and administration route. However, the negative results are more common than the published positive ones.
Topics: Nandrolone
PubMed: 34407462
DOI: 10.1016/j.steroids.2021.108901 -
Frontiers in Psychiatry 2022The outbreak of the COVID-19 pandemic at the end of 2019 and the Russian-Ukrainian war in February 2022 created restrictions and uncertainties that affected the general... (Review)
Review
BACKGROUND
The outbreak of the COVID-19 pandemic at the end of 2019 and the Russian-Ukrainian war in February 2022 created restrictions and uncertainties that affected the general population's mental health. One of the affected groups was students. This systematic review summarizes the current literature on the prevalence, outcomes, and interventions for stress and anxiety among university, college, graduate, or postsecondary populations.
METHODS
A systematic literature search was performed on PubMed, Web of Science, Scopus, Embase, Cochrane Library, CINAHL, PsychInfo, and ProQuest, following PRISMA guidelines. Specific inclusion and exclusion criteria were applied, and screening was performed to identify the definitive studies.
RESULTS
The prevalence of anxiety was relatively high, ranging from 88.9 to 13.63%, and the prevalence of stress ranged from 56 to 28.14%. The predictors of stress and anxiety included young age, gender being female, STEM course, loneliness, low academic level in school, urban lockdown, confinement, having a preexisting disease, having relatives or friends infected with COVID-19, and proximity to a COVID-19 zone. The predictors of stress included gender being female, living with family, living in a household with many people, being confined rather than having the freedom to relocate, proximity to confirmed cases of COVID-19, lack of access to materials on COVID-19, preexisting mental disorders, and lack of knowledge on the preventable nature of COVID-19. The sources of anxiety among the university students identified in the study included academics, postponement of graduation, cancelation or disruption of planned events, inability to achieve goals, and finances. In addition, the students used trauma-focused, forward-focused, task-oriented, emotion-oriented, and avoidance-oriented coping strategies.
CONCLUSION
The included studies showed that stress and anxiety increased during the pandemic and the war, with gender and uncertainty playing a critical role. The studies provide insights into the widespread use of problem-focused and task-focused coping strategies despite their impact on increasing stress and anxiety.
PubMed: 36506419
DOI: 10.3389/fpsyt.2022.1081013 -
Archives of Pediatrics & Adolescent... Apr 2009To summarize current evidence on the association between infant pacifier use and breastfeeding. (Review)
Review
OBJECTIVE
To summarize current evidence on the association between infant pacifier use and breastfeeding.
DATA SOURCES
MEDLINE, CINAHL, the Cochrane Library, EMBASE, POPLINE, and bibliographies of identified articles.
STUDY SELECTION
A search for English-language records (from January 1950 through August 2006) containing the Medical Subject Heading terms pacifiers and breastfeeding was conducted, resulting in 1098 reports. Duplicate and irrelevant studies were excluded, yielding 29 studies that fit inclusion criteria for the review (4 randomized controlled trials, 20 cohort studies, and 5 cross-sectional studies). Two independent reviewers abstracted data and scored these studies for quality; disagreements were settled through consensus with a third investigator.
MAIN EXPOSURE
Pacifier use.
MAIN OUTCOME MEASURES
Breastfeeding duration or exclusivity.
RESULTS
Results from 4 randomized controlled trials revealed no difference in breastfeeding outcomes with different pacifier interventions (pacifier use during tube feeds, pacifier use at any time after delivery, an educational program for mothers emphasizing avoidance of pacifiers, and a UNICEF [United Nations Children's Fund]/World Health Organization Baby Friendly Hospital environment). Most observational studies reported an association between pacifier use and shortened duration of breastfeeding.
CONCLUSIONS
The highest level of evidence does not support an adverse relationship between pacifier use and breastfeeding duration or exclusivity. The association between shortened duration of breastfeeding and pacifier use in observational studies likely reflects a number of other complex factors, such as breastfeeding difficulties or intent to wean. Ongoing quantitative and qualitative research is needed to better understand the relationship between pacifier use and breastfeeding.
Topics: Breast Feeding; Feeding Behavior; Female; Follow-Up Studies; Humans; Infant; Infant Behavior; Infant, Newborn; Male; Pacifiers; Pediatrics; Practice Guidelines as Topic; Randomized Controlled Trials as Topic; Risk Assessment; Sucking Behavior; Time Factors; United States; Weaning
PubMed: 19349568
DOI: 10.1001/archpediatrics.2008.578 -
Quantifying Fear Avoidance Behaviors in People With Concussion: A COSMIN-Informed Systematic Review.The Journal of Orthopaedic and Sports... Sep 2023The validity of existing fear avoidance behavior patient-reported outcome measures (PROMs) for concussion is unknown. This study aims to (1) identify PROMs that assess...
The validity of existing fear avoidance behavior patient-reported outcome measures (PROMs) for concussion is unknown. This study aims to (1) identify PROMs that assess fear avoidance behavior in individuals with concussion and (2) assess the measurement properties of these PROMs. A systematic review of outcome measurement instruments using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. We performed a systematic search of 7 databases. Studies were included if they assessed fear avoidance behavior (eg, kinesiophobia or cogniphobia) in participants with concussion, occurring in all settings (eg, sport, falls, assaults). Methodological quality of the PROMs was assessed using the COSMIN checklist, and the certainty of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. We identified 40 studies assessing fear avoidance. Four studies (n = 875 participants, representing 3 PROMs) were eligible for COSMIN assessment. Content validity for all PROMs was insufficient due to extreme risk of bias. The Fear Avoidance Short Form Scale demonstrated the greatest validity: moderate-certainty evidence for sufficient structural validity and internal consistency, and low-certainty evidence for measurement invariance. Current PROMs for measuring fear avoidance behaviors in people with concussion have insufficient content validity and should be used with caution in research and clinical practice. .
Topics: Humans; Avoidance Learning; Psychometrics; Brain Concussion; Checklist; Sports; Patient Reported Outcome Measures; Quality of Life; Reproducibility of Results
PubMed: 37561611
DOI: 10.2519/jospt.2023.11685 -
Clinical Child and Family Psychology... Jun 2017The measurement of avoidance behavior in youth with anxiety and related disorders is essential. Historically, the behavioral avoidance task (BAT) has been used as a... (Review)
Review
The measurement of avoidance behavior in youth with anxiety and related disorders is essential. Historically, the behavioral avoidance task (BAT) has been used as a measure of avoidance that can be tailored to a youth's particular fear. Although in use for over 90 years, there has yet to be a systematic review of its use, properties, etc. Here we examine the use of the BAT with youth as a measure of avoidance over the past 30 years. Studies have used the BAT as a measure of treatment outcome, to explore theories related to avoidance, and provide evidence for the psychometric properties of phobia questionnaires. Specifically, we compare the results of these studies, the purposes of the BAT, and the types of data collected. Results indicated that the BAT might be particularly sensitive to treatment effects. Furthermore, youth with specific phobias can be expected to complete an average of 30% of the BAT at pre-treatment and 60% at post-treatment. These affects have generally been maintained at 6-month follow-ups. Measures of subjective units of distress (SUDS) proved more consistent than steps completed, but more resistant to treatment effects; researchers can expect a SUDS rating of approximately 55% at pre-treatment and 40% at post-treatment. We review the properties and procedures that are used within these studies and provide a critical review. Overall, the BAT is in need of a standardized procedure to allow for psychometric studies to provide evidence of the task's reliability and validity.
Topics: Adolescent; Adolescent Behavior; Anxiety; Anxiety Disorders; Avoidance Learning; Child; Child Behavior; Humans
PubMed: 27995381
DOI: 10.1007/s10567-016-0220-3 -
Frontiers in Nutrition 2022Both the World Health Organization and the Lancet Series on Adolescent nutrition recommend that governments adopt fiscal policies to combat diet-related non-communicable...
INTRODUCTION
Both the World Health Organization and the Lancet Series on Adolescent nutrition recommend that governments adopt fiscal policies to combat diet-related non-communicable diseases (NCDs). However, rigorous, systematic evidence regarding the effects of these interventions is lacking.
METHODS
We synthesize the available evidence regarding the impacts of taxes and subsidies that directly affect consumer prices on availability and accessibility of foods and beverages, purchasing behavior, diet quality, health and well-being outcomes as well as considerations for implementation, sustainability and equity.
RESULTS
Our initial search returned 2,113 de-duplicated studies, and ultimately 24 impact evaluations and two systematic reviews met final eligibility criteria and represented unique evaluations. Our meta-analysis of these studies suggests that taxes may decrease purchases of taxed beverages (SMD = -0.14 [95% CI: -0.29 to -0.07], = 15). Results should be interpreted cautiously due to considerable heterogeneity ((14) = 335.19, = 0.01, , = 95.82%).
DISCUSSION
The evidence base is too limited to draw conclusions about the effects of taxes on beverages and calorie-dense foods on purchases, or on the effects of subsidies on purchasing or diet quality. Overall, the evidence base is inconclusive on whether fiscal policies can meaningfully influence the availability and accessibility of foods and beverages, diet quality, and health outcomes. Policymakers implementing fiscal policies should consider information campaigns on health benefits and health risks associated with certain food and beverage consumption. For taxes, exposure to health information may amplify signaling effects of taxes and reduce avoidance behaviors, such as cross-border shopping. Future evaluations should diversify data sources to better understand impacts on diet and health outcomes.
PubMed: 36532551
DOI: 10.3389/fnut.2022.967494