The purpose of this study was to investigate the influences of interpersonal rejection sensitivity on depressive symptoms and social anxiety symptoms in social anxiety disorder (SAD) patients. Eighty-one SAD patients completed the questionnaire assessing their rejection sensitivity, depressive symptoms, and social anxiety symptoms. The results indicated that rejection sensitivity led an increase in SAD symptoms through depressive symptoms. In rejection sensitivity, “discrepancy between social self-image and true self-image” and “obsequence to others” in particular are strongly related with depressive symptoms. These results suggest that rejection sensitivity as a possible cause of depressive symptoms in the course of SAD, and were discussed in terms of possibility of approach that focus on rejection sensitivity.

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As most of mental disorders are accompanied with sleep disturbances, sleep may be robustly associated with mental disorders including panic disorder (PD). Clinical experiences suggest that in the study of the association, habits of sleep, not only its disturbance may be essential to investigate. We, therefore, examined the relationship between sleep habits and mental health status (GHQ-12 score) in PD patients, using a self-reported questionnaire. We also examined a small number of social anxiety disorder (SAD) patients. PD patients had trends of late bedtime and short sleep length. Sleep length of < 6 hours was significantly associated with poor mental health. In PD patients without major depression, TV/PC use after lights-out was also associated with poor mental health. The TV/PC use was observed in close to 40% of PD patients, while it was observed in approximately 20% in SAD patients. The undesired sleep habits may have adverse effects on mental health in PD patients.

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Age at the onset of panic disorder is considered useful for understanding the pathology of this disorder. We examined the association between age at onset and personality characteristics in 288 individuals with panic disorder (PD). The subjects were 77 men and 211 women with a DSM-IV diagnosis of PD and 112 healthy controls (43 men, 69 women). The subjects were further clinically characterized using the Revised NEO Personality Inventory (NEO-PI-R) and the State-Trait Anxiety Inventory (STAI). We compared the NEO PI-R and the STAI scores of the 146 subjects with early-onset (<30 years) PD, the 142 subjects with late-onset (> or =30 years) PD, and the healthy controls. We found that the STAI and Neuroticism scores of the early-onset PD group were significantly higher than those of the late-onset PD and healthy control groups. These findings suggest an association between neuroticism and anxiety sensitivity and age at onset in individuals with PD.

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The cognitive behavioral treatments for panic disorder and agoraphobia are the most representative evidence-based psychotherapies for psychiatric disorders, and many treatment studies and meta-analyses have been conducted. Exposure and behavioral experiments, relaxation and breathing re-training, psycho-education and cognitive intervention, and homework assignment are included in most of the empirically-supported treatment programs for panic disorders, and a recent meta-analysis indicated that exposure and relaxation are the most effective treatment components. It was assumed to be necessary for the evoked fear and anxiety to be reduced thoroughly through long enough exposure in order to extinguish fear conditioning, but many recent studies showed that the newly associative inhibitory learning is indispensable for the extinction. The reduction of fear in an exposure trial is not mandatory for the inhibition learning to be promoted, but fully experiencing feared symptoms and sensations without safety behaviors and recognizing that negative consequences do not pursue are vital. The role of acceptance during exposure has attracted much attention for those purposes.

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