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ABSTRACT: Military mental health research has rarely investigated social anxiety disorder, despite its known serious consequences in the general population, and what work has been conducted has used specialized samples (e.g., veterans) not representative of all military personnel.
Data were from the 2002 Canadian Community Health Survey-Canadian Forces Supplement, a representative survey of 8441 active regular and reserve military personnel.
Social anxiety disorder has a high lifetime (8.2%) and past-year (3.2%) prevalence in the military. It is associated with increased odds of depression, panic attacks/disorder, generalized anxiety disorder, and post-traumatic stress disorder (AOR range 4.16-16.29). Being female, ages 35-44, or separated/divorced/widowed increases the odds of having social anxiety disorder, while being an officer or a reservist decreases the odds. Treatment-seeking, as in the general population, is relatively rare. Overall, military personnel with social anxiety disorder experience significant rates of role impairment in all domains (53.1-88.3% report some impairment), with the rate of role impairment increasing with the number of social fears. Notably, many (70.6%) report at least some impairment at work (i.e., in their job with the military).
Social anxiety disorder is an important disorder to take into account when considering military mental health. Observing low rates of treatment-seeking for social anxiety disorder among military personnel highlights the importance of initiatives to allow its identification and treatment.
Journal of psychiatric research 04/2010; 44(14):887-93. · 3.72 Impact Factor
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ABSTRACT: Growing evidence points to a relationship between obesity and both mood and anxiety disorders, but the question of what accounts for this association remains unanswered. The present study examined the use of psychotropic medications as a mediator of the mood/anxiety disorder-obesity relationship. Data came from the public use dataset of the Canadian Community Health Survey Cycle 1.2 (age 15 years and older, N = 36,984). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition psychiatric diagnoses of 12-month mood disorders (e.g., major depressive disorder, mania) and anxiety disorders (e.g., panic attacks, panic disorder, social phobia, agoraphobia) were examined as was use of psychotropic medications (e.g., antidepressants, antipsychotics, anxiolytics, hypnotics, mood stabilizers) and obesity (defined as body mass index ≥30). A series of multiple logistic regression analyses were completed to test study hypotheses. Covariates in these analyses included sociodemographic factors, physical activity, and physical illness burden. The use of two medication classes, namely antidepressants and antipsychotics, emerged as significant predictors of obesity as well as mediators of the psychiatric diagnosis-obesity relationship after evaluating all psychotropic medication classes simultaneously, while also controlling for other theoretically relevant variables. The use of these two medications accounted for 86% of the relationship between mood disorders and obesity and 32% of the relationship between anxiety disorders and obesity. The study findings guide advances in the theoretical conceptualization of the mechanisms involved in mood/anxiety disorder-obesity relations. Clinical implications are discussed.
Journal of psychiatric research 04/2010; 44(15):1010-6. · 3.72 Impact Factor
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ABSTRACT: To determine whether obesity is associated with a variety of psychiatric outcomes after taking into account physical health conditions.
Data came from the public use dataset of the Canadian Community Health Survey Cycle 1.2 (age 15 years and older, N=36,984). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition psychiatric diagnoses of major depressive disorder, mania, panic attacks, panic disorder, social phobia, agoraphobia, alcohol dependence, and drug dependence were examined, as was suicidal behavior (ideation or attempts). Multiple logistic regression was utilized to examine the association between obesity (defined as body mass index >or=30) and mental health outcomes. Covariates in the regressions included sociodemographic factors and a measure of physical illness burden (the Charlson Comorbidity Index).
In adjusted models, obesity was positively related to several lifetime psychiatric disorders (depression, mania, panic attacks, social phobia, agoraphobia without panic disorder), any lifetime mood or anxiety disorder, suicidal ideation, and suicide attempts [adjusted odds ratio (AOR) range: 1.22-1.58]. Obesity was similarly positively associated with past-year depression, mania, panic attacks, social phobia, any anxiety disorder, and suicidal ideation (AOR range: 1.24-1.52), and negatively associated with past-year drug dependence (AOR=0.53, 95% CI 0.31-0.89). Most of these associations were found to be specific to women, while some were also present in men.
Independent of physical health conditions, obesity was associated with psychiatric disorders and suicidal behavior in the Canadian population. Possible mechanisms and clinical implications of these findings are considered.
Journal of psychosomatic research 04/2009; 66(4):277-85. · 2.91 Impact Factor
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ABSTRACT: To determine whether, in the general population, individuals in numerous abnormal body weight categories had higher odds of having personality disorders (PDs) than normal-weight individuals. Although personality functioning is hypothesized to be associated with body weight, there is a dearth of empirical evaluation of this topic.
The association of body weight (five categories: underweight [body mass index [BMI] <18.5]; normal [18.5 <or= BMI <25]; overweight [25 <or= BMI <30]; obese [30 <or= BMI <40]; and extremely obese [BMI >or=40]) with personality disorders was investigated using data from the nationally representative National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) (n = 43,093). Lifetime paranoid, schizoid, antisocial, histrionic, avoidant, dependent, and obsessive-compulsive PDs were examined, as assessed by the Alcohol Use Disorders and Associated Disabilities Interview Schedule-DSM-IV version (AUDADIS-IV).
After adjusting for sociodemographics, Axis I disorders, schizophrenia, physical health conditions, and comorbid PDs, extreme obesity was associated with antisocial or avoidant PDs (adjusted odds ratio (AOR) range = 1.66-1.73), whereas underweight was associated with increased odds of schizoid PD (AOR = 1.89). The pattern of associations differed when stratified by gender. Overweight men had lower odds of paranoid PD (AOR = 0.73). Women with higher-than-normal body weights had higher odds of paranoid, antisocial, and avoidant PDs (AOR range = 1.33-2.50), whereas underweight women more often met the criteria for schizoid PD (AOR = 1.95).
Higher-than-normal body weight is associated with paranoid, antisocial, and avoidant PDs for women, whereas overweight men have lower rates of paranoid PD and underweight women have higher odds of schizoid PD. Possible clinical implications of this research are discussed.
Psychosomatic Medicine 10/2008; 70(9):1012-9. · 3.97 Impact Factor
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ABSTRACT: Rats (rattus norvegicus) anticipated the arrival of a food pellet unconditioned stimulus (US) even when the conditioned stimulus (CS) signaled no overall change or a substantial decrease in the overall rate of US occurrence. Pellet USs were scheduled probabilistically in the intertrial interval at either an equivalent rate (Experiment 1) or a four times higher rate (Experiments 2 and 3) than in the CS, which included one fixed-time target US. Conditioning has been said to involve learning "whether" (contingency) the CS signals a change in the US, and if so, "when" (contiguity) the US is scheduled to arrive. Our results suggest that "when" trumps "whether," challenging the received view that a positive CS-US contingency is necessary for successful conditioning.
Journal of Experimental Psychology Animal Behavior Processes 02/2008; 34(1):94-105. · 2.05 Impact Factor
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ABSTRACT: Appetitive contextual excitation supported by intertrial unconditioned stimuli was more easily overcome by timed conditioned responding in rats using quiet (Experiment 1) rather than noisy (Experiment 2) food pellet deliveries. Head-entry responding in acquisition peaked above the contextual baseline when pellet delivery occurred 10, 30, 60, or 90 s after the onset of the 120-s white-noise conditioned stimulus (CS). Special tests in extinction revealed CS onset and offset were conditioned by pellet delivery at 0 and 120 s, respectively. Responding was not undermined in Experiment 3 when noisy pellet deliveries replaced quiet pellet deliveries. Our results suggest that micro-stimuli occasioned at different times during the CS are vulnerable to overshadowing, but do not lose strength if they are already predictive.
Learning and Motivation. 40(4):394-407.
