%0 Journal Article
%T Social Anxiety, Tremor Severity, and Tremor Disability: A Search for Clinically Relevant Measures
%A Duane A. Lundervold
%A Patrick A. Ament
%A Peter Holt
%J Psychiatry Journal
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/257459
%X Background. While social anxiety has been reported among essential tremor (ET) patients, very little is known about the relation between self-report measures of social anxiety, tremor severity and disability, and cognition. Methods. Sixty-three individuals diagnosed with ET took part in a comprehensive study examining neurocognition and behavioral functioning. A psychiatric diagnostic interview, three social anxiety questionnaires, and an idiographic-based behavioral assessment to pinpoint anxiety provoking situations and related distress were completed. Results. Thirty percent of the participants met diagnostic criteria for social anxiety disorder (SAD). Social anxiety questionnaires were negligibly related to tremor severity and disability. Idiographic behavioral assessment of subjective distress was moderately related to resting tremor severity and disability and strongly related to social anxiety questionnaires scores. Only one cognitive variable was related to tremor severity. Conclusions. These findings suggest that (a) self-report measures of social anxiety with ET patients may underestimate distress; (b) emphasis on tremor severity may be misleading; (c) tremor disability may be a more sensitive and functional measure related to cognition and effect; (d) SAD is wide spread and does not appear to be related to dysregulated executive function; and (e) development of an ET-specific measure of social anxiety is called for. 1. Introduction Over the last 25 years, there has been a gradual acknowledgment that essential tremor (ET) is comprised of much more than a benign rhythmic oscillation of a limb [1¨C4]. A significant amount of data has been accumulated indicating ET is a multifaceted syndrome with multiple neurologic causal pathways, and, possibly, is a family of diseases [5]. Concurrent with closer examination of neurologic connections has been an increasing awareness of the breadth and magnitude of nonmotor symptoms, including cognition, disability and well-being [3, 4]. Evidence is emerging that ET is related to subtle, but significant cognitive impairment; however, the relationship between changes in cognition and nonmotor features of ET have rarely been examined [2, 3]. Data supporting impaired cognition is primarily based on clinic samples or individuals being considered for deep brain stimulation implant surgery. Such samples are not representative the population of individuals with ET and those patients who present for consideration of implant surgery are the most severe cases. Little is known about independent living, community dwelling,
%U http://www.hindawi.com/journals/psychiatry/2013/257459/