A new study published in eClinical Medicine looked at hyperarousal and how different dimensions characterize mood, anxiety, insomnia, posttraumatic stress and attention deficit hyperactivity disorders.
“In our study, we aimed to better understand hyperarousal and how it is measured in different mental disorders,” study author Tom Bresser told us. “Despite its role in multiple mental disorders, it remained unclear whether different questionnaires were measuring the same hyperarousal construct. We were hoping to find out if hyperarousal is a single shared construct or whether different hyperarousal dimensions exist.”
Based on literature the researchers knew that hyperarousal is a core symptom in several mental disorders with different questionnaires to assess hyperarousal. These questionnaires often target specific manifestations so they expected to find transdiagnostic properties, but were curious to better understand if hyperarousal has multiple dimensions.
“Hyperarousal is a core symptom in insomnia disorder which we study in the lab,” Bresser told us. “To better understand the interaction between insomnia and other mental disorders it would be valuable to study hyperarousal because it is a shared core symptom. We realized that different research fields had slightly different definitions and assessments, and that it would be very valuable to facilitate a transdiagnostic understanding and assessment of hyperarousal.”
To conduct their study, the research team first asked a panel of experts for their recommendations regarding existing questionnaires related to hyperarousal. Then they collected data by inviting a large group of people to answer all hyperarousal questionnaires and additional questions regarding demographics and symptom severity of several mental disorders.
“After we obtained our first results and developed a new questionnaire to asses transdiagnostic hyperarousal, we invited a second group of people to fill out the new questionnaire in order to validate it,” Bresser told us. “We identified the dimensions using factor analysis and performed follow-up analyses to better understand how different dimensions are correlated with symptom severity of insomnia, depression, anxiety, panic disorder, post-traumatic stress, and ADHD.”
The results of the study identified seven transdiagnostic dimensions of hyperarousal. While almost every type of hyperarousal contributed to the symptom severity of multiple disorders, the relative severity of each type of hyperarousal differed among people with insomnia, depression, anxiety, panic disorder, post-traumatic stress, and ADHD. This suggests that different combinations of dimensions contribute to the symptom severity of different mental disorders.
“I was surprised that we found seven dimensions and that we were able to measure them using only 27 items,” Bresser told us. “As a result we were able to develop the 27-item transdiagnostic hyperarousal dimensions questionnaire (THDQ) that measures all dimensions.”
Bresser hopes that the results help to better understand transdiagnostic hyperarousal and facilitate future research. The ability to measure different types of hyperarousal can help to better understand the mechanisms underlying multiple mental disorders and lead to better assessment and hopefully improved treatments.
“The new, concise THDQ allows researchers and clinicians to map hyperarousal much more easily,” Bresser told us. “We hope that the questionnaire is helpful in future clinical practice by providing insight in the different forms of hyperarousal.”
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Patricia Tomasi is a mom, maternal mental health advocate, journalist, and speaker. She writes regularly for the Huffington Post Canada, focusing primarily on maternal mental health after suffering from severe postpartum anxiety twice. You can find her Huffington Post biography here. Patricia is also a Patient Expert Advisor for the North American-based, Maternal Mental Health Research Collective and is the founder of the online peer support group – Facebook Postpartum Depression & Anxiety Support Group – with over 1500 members worldwide. Blog: www.patriciatomasiblog.wordpress.com
Email: tomasi.patricia@gmail.com