Anxiety Disorders: Bar-Haim Y

Pine DS, Helfinstein SM, Bar-Haim Y, Nelson E, Fox NA. · Mood and Anxiety Disorders Program, Intramural Research Program, The National Institute of Mental Health, Bethesda, MD 20892-2670, USA. · Neuropsychopharmacology. · Pubmed #18754004 No free full text.

Abstract: Alterations in brain development may contribute to chronic mental disorders. Novel treatments targeted toward the early-childhood manifestations of such chronic disorders may provide unique therapeutic opportunities. However, attempts to develop and deliver novel treatments face many challenges. Work on pediatric anxiety disorders illustrates both the inherent challenges as well as the unusual opportunities for therapeutic advances. The present review summarizes three aspects of translational research on pediatric anxiety disorders as the work informs efforts to develop novel interventions. First, the review summarizes data on developmental conceptualizations of anxiety from both basic neuroscience and clinical perspectives. This summary is integrated with a discussion of the two best-established treatments, cognitive behavioral therapy and selective serotonin reuptake inhibitors. Second, the review summarizes work on attention bias to threat, considering implications for both novel treatments and translational research on neural circuitry functional development. This illustrates the manner in which clinical findings inform basic systems neuroscience research. Finally, the review summarizes work in basic science on fear learning, as studied in fear conditioning, consolidation, and extinction paradigms. This summary ends by describing potential novel treatments, illustrating the manner in which basic neuroscience informs therapeutics.

Kogan E, Lidor R, Bart O, Bar-Haim Y, Mintz M. · Psychobiology Research Unit, Department of Psychology, Tel Aviv University, Israel. · J Psychol. · Pubmed #19049239 No free full text.

Abstract: Comorbidity between balance and anxiety disorders has been documented in clinical psychiatric and neurological samples. The authors aimed to determine whether the comorbidity of balance and anxiety disorders has an analogous representation in the normal population. Participants were 20 undergraduate students ages 22-29 years. The authors assigned them to high or low trait anxiety groups and performed a balance task in 3 experimental stages: baseline, training, and test. The baseline and test stages consisted of 4 wobbly and 4 stable trials each. The authors measured state anxiety in the form of auditory startle responses (ASRs) during the stable trials. In the baseline stage, the ASR amplitudes were higher in the high trait anxiety participants. In the test stage, the low trait anxiety participants performed the balance task better than the high trait anxiety participants did. These data suggest that the clinical entity designated as a comorbidity of balance and anxiety disorders has an analogous representation in the normal population.

Bart O, Bar-Haim Y, Weizman E, Levin M, Sadeh A, Mintz M. · Department of Occupational Therapy, Tel-Aviv University, Tel Aviv 69978, Israel. · Res Dev Disabil. · Pubmed #18775641 No free full text.

Abstract: Comorbidity between balance and anxiety disorders in adult population is a well-studied clinical entity. Children might be particularly prone to develop balance-anxiety comorbidity, but surprisingly they are practically neglected in this field of research. The consequence is that children are treated for what seems to be the primary disorder without noticing possible effects on the other disorder. In Study 1, children with balance dysfunction were compared to normally balanced controls on anxiety and self-esteem. In study 2, children with balance dysfunction were assigned to either balance training or a waiting-list control. Training consisted of 12 weekly sessions of balance treatment. Anxiety and self-esteem were tested before and after treatment/waiting. Study 1 confirmed significantly higher anxiety and lower self-esteem in the balance dysfunction group compared to the control group. Study 2 showed that treatment improved balance performance, reduced anxiety, and increased self-esteem relative to the control waiting list group. Taken together, the present findings are in accord with the observations of comorbidity between balance and anxiety disorders in adults and confirm their validity in children younger than 7 years of age. This profile of comorbidity between balance dysfunction and anxiety also include lower self-esteem.

Helfinstein SM, White LK, Bar-Haim Y, Fox NA. · Child Development Laboratory, Department of Human Development, University of Maryland, College Park, MD 20742, USA. · Behav Res Ther. · Pubmed #18472088 links to  free full text

Abstract: Anxious individuals show an attention bias towards threatening information. However, under conditions of sustained environmental threat this otherwise-present attention bias disappears. It remains unclear whether this suppression of attention bias can be caused by a transient activation of the fear system. In the present experiment, high socially anxious and low socially anxious individuals (HSA group, n=12; LSA group, n=12) performed a modified dot-probe task in which they were shown either a neutral or socially threatening prime word prior to each trial. EEG was collected and ERP components to the prime and faces displays were computed. HSA individuals showed an attention bias to threat after a neutral prime, but no attention bias after a threatening prime, demonstrating that suppression of attention bias can occur after a transient activation of the fear system. LSA individuals showed an opposite pattern: no evidence of a bias to threat with neutral primes but induction of an attention bias to threat following threatening primes. ERP results suggested differential processing of the prime and faces displays by HSA and LSA individuals. However, no group by prime interaction was found for any of ERP components.

Bar-Haim Y, Dan O, Eshel Y, Sagi-Schwartz A. · The Adler Center for Research in Child Development and Psychopathology, Department of Psychology, Tel-Aviv University, Ramat Aviv, Tel-Aviv 69978, Israel. · J Anxiety Disord. · Pubmed #17276031 No free full text.

Abstract: This study assessed whether infants with anxious-ambivalent attachment develop higher levels of anxiety later in childhood than do infants with secure attachment. Infants (N=136) participated in Ainsworth's Strange Situation Procedure at 12 months of age. The Screen for Child Anxiety Related Emotional Disorders (SCARED) was completed by children and their mothers at 11 years of age. Results show that compared with children who were securely attached in infancy, children who were ambivalently attached had higher levels of school phobia, and, that compared with boys who were securely attached boys who were ambivalently attached had higher levels of social phobia at 11 years. However, in this normative sample, anxious-ambivalent attachment was not related to anxiety levels that approach pathological significance. These findings are discussed within the context of previous research on associations between attachment and anxiety disorders.

Bar-Haim Y, Lamy D, Pergamin L, Bakermans-Kranenburg MJ, van IJzendoorn MH. · Adler Center for Reasearch in Child Development and Psychopathology, Department of Psychology, Tel Aviv University, Tel Aviv, Israel. · Psychol Bull. · Pubmed #17201568 No free full text.

Abstract: This meta-analysis of 172 studies (N = 2,263 anxious,N = 1,768 nonanxious) examined the boundary conditions of threat-related attentional biases in anxiety. Overall, the results show that the bias is reliably demonstrated with different experimental paradigms and under a variety of experimental conditions, but that it is only an effect size of d = 0.45. Although processes requiring conscious perception of threat contribute to the bias, a significant bias is also observed with stimuli outside awareness. The bias is of comparable magnitude across different types of anxious populations (individuals with different clinical disorders, high-anxious nonclinical individuals, anxious children and adults) and is not observed in nonanxious individuals. Empirical and clinical implications as well as future directions for research are discussed.