Surveillance outcomes of respiratory pathogen infections during the 2021-2022 season among U.S. Military Health System beneficiaries, October 3, 2021-October 1, 2022.

The Department of Defense Global Respiratory Pathogen Surveillance Program conducts continuous surveillance for influenza, severe acute respiratory syndrome 2 (SARS-CoV-2), and other respiratory pathogens at 104 sentinel sites across the globe. These sites submitted 65,475 respiratory specimens for clinical diagnostic testing during the 2021-2022 surveillance season. The predominant influenza strain was influenza A(H3N2) (n=777), of which 99.9% of strains were in clade 3C.2a1b.2a2. A total of 21,466 SARSCoV-2-positive specimens were identified, and 12,225 of the associated viruses were successfully sequenced. The Delta variant predominated at the start of the season, until December 2021, when Omicron became dominant. Most circulating SARS-CoV-2 viruses were subsequently held by Omicron sublineages BA.1, BA.2, and BA.5 during the season. Clinical manifestation, obtained through a self-reported questionnaire, found that cough, sinus congestion, and runny nose complaints were the most common symptoms presenting among all pathogens. Sentinel surveillance can provide useful epidemiological data to supplement other disease monitoring activities, and has become increasingly useful with increasing numbers of individuals utilizing COVID-19 rapid self-test kits and reductions in outpatient visits for routine respiratory testing.

Pandemic response across Ohio's public universities: Novel approaches, emergent challenges and future opportunities.

Objective: We describe and analyze case investigation and contact tracing (CICT) efforts across Ohio's public universities in response to COVID-19 to distill challenges and lessons learned and suggest future opportunities for universities to mobilize in the face of emergent public health crises. Participants: Faculty, staff, and graduate students from Ohio's fourteen public universities. Methods: In-depth, semi-structured interviews were conducted with representatives from nine of the 14 universities; representatives from the remaining five universities completed a brief questionnaire. Interviews were transcribed in their entirety and thematically analyzed. Results: Emergent themes include the significance of local relationships for implementing locally tailored solutions; the presence of discrete challenges in doing CICT work with university and local communities, and the importance of university students in pandemic response. Conclusions: There are unique challenges associated with disease control across university populations and surrounding communities, but students from diverse academic background are a potential source of assistance.

The role of intolerance of uncertainty in social anxiety subtypes.

OBJECTIVES: Intolerance of uncertainty (IU) is thought to underlie several internalizing disorders; however, it has only begun to be explored within social anxiety (SA). This study extends previous findings by examining IU's relation to performance and interaction SA subtypes and by accounting for obsessive-compulsive symptoms. METHODS: A total of 472 undergraduates completed measures of IU, SA, perfectionism, worry, obsessions/compulsions, and fear of negative evaluation (FNE). RESULTS: IU and obsessions/compulsions predicted performance SA beyond FNE. IU predicted interaction SA beyond FNE. Inhibitory anxiety IU contributed to both SA types but contributed more to performance SA. Prospective anxiety IU was negatively related to performance SA and unrelated to interaction SA, though a trend emerged. Contrasts between those high in one SA type, both, or neither revealed IU was highest when both types were present. CONCLUSIONS: Inhibitory IU plays a significant role in both SA subtypes and may play a slightly greater role in performance SA.

Somatic symptoms in those with performance and interaction anxiety.

This study (n = 304) examined the relationship between somatic symptoms and social anxiety. Significant differences in the experience of somatic symptoms were found among four groups (i.e. performance anxious, interaction anxious, generalized socially anxious, and controls). Post hoc analyses revealed that those who exceeded the clinical cutoff for generalized social anxiety exhibited more somatic symptoms than those who exceeded the clinical cutoff in the other two social anxiety domains or controls. Individuals in each group exhibited more somatic symptoms than controls, but subtypes did not differ in the amount of somatic symptoms experienced. Additionally, regression analyses revealed that type of somatic symptoms experienced varied depending on subtype.

Differentiating among singular and comorbid obsessive-compulsive disorder and social phobia symptomology.

Social phobia is a frequent co-occurring diagnosis with obsessive-compulsive disorder (OCD); however, co-occurring OCD in those with social phobia is less common. Genetic, environmental, and cognitive traits are common risk factors for anxiety disorders broadly. It is plausible that shared variables related to OCD and/or social phobia could provide insight into the co-occurrence of these two disorders. The current study explored differences in fear of negative evaluation (FNE) and perfectionism among four groups: those with (1) elevated social phobia symptoms, (2) elevated OCD symptoms, (3) elevated symptoms of OCD and social phobia, and those who were (4) asymptomatic as a control group. A non-clinical sample of 196 participants completed several online questionnaires about social phobia and OCD symptomology. Results identified three cognitive variables (i.e., FNE, total perfectionism, and concern over mistakes) as differential variables in comorbid symptom presentation of OCD and social phobia. A fourth variable (i.e., doubts about actions) was identified as a potential dual risk factor, and four subsequent variables (i.e., parental criticism, personal standards, parental expectations, and organization) were not implicated in differential symptom presentation. Given the different rates of OCD and social phobia co-occurrence, identification of differentiating variables could aid in better understanding of potential risk factors, which may enhance preventative and therapeutic techniques. Study implications, limitations, and future recommendations are discussed.

The behavioral avoidance task using imaginal exposure (BATIE): a paper-and-pencil version of traditional in vivo behavioral avoidance tasks.

Behavioral avoidance tasks (BATs) have been used for decades in the assessment of specific phobias, but they also involve a number of prohibitive difficulties. This study investigated a new imaginal/self-report instrument, the Behavioral Avoidance Task Using Imaginal Exposure (BATIE), and evaluated whether it was an efficient paper-and-pencil alternative. Forty-nine adults diagnosed with specific phobias were matched to 49 participants without those particular phobias who served as control participants. The participants were 89.8% female and 79.6% Caucasian and had a mean age of 20.81 years (SD = 3.62). Diagnosis was determined using the Anxiety Disorders Interview Schedule (Brown, DiNardo, & Barlow, 1994). Participants completed a BAT following a BATIE. Results indicated BATIE ratings significantly correlated with BAT performance and ratings. Significant differences were also found between the phobic and control groups on all BATIE ratings (all differences indicated poorer performance or more fear in those with specific phobias). Also, the BATIE scores demonstrated good evidence of convergent and discriminant validity compared to other self-reports, significantly predicted BAT performance even when controlling for those measures of fear and anxiety, and significantly predicted diagnostic severity ratings. Overall, results indicated that the BATIE may be a reasonable alternative to in vivo BATs in certain situations (e.g., clinical practice, unavailability of BAT stimuli).

Intolerance of uncertainty as a mediator of the relationship between perfectionism and obsessive-compulsive symptom severity.

BACKGROUND: Intolerance of uncertainty (IU) and perfectionism have both been shown to predict severity of obsessive-compulsive disorder (OCD) symptoms in populations diagnosed with OCD, as well as analogue samples. According to cognitive models of OCD, symptoms are maintained by dysfunctional beliefs including IU and perfectionism. The purpose of the current study is to extend research on the cognitive theory of OCD by describing how dysfunctional thoughts interact with each other. METHODS: In an analogue sample for OCD (N = 475), undergraduate students completed measures online pertaining to IU (IU scale), perfectionism (Frost Multidimensional Perfectionism Scale), and OCD symptoms and severity (Florida Obsessive-Compulsive Inventory). RESULTS: The proposed model of IU fully mediating the relationship between perfectionism and OCD severity was supported using structural equation modeling (SEM) analysis. Bootstrapping testing within AMOS 20 and Sobel tests further corroborated full mediation. CONCLUSIONS: Results from the current study suggest that IU fully mediates the relationship between perfectionism and severity of OCD symptoms. This finding has an impact for understanding the nature and treatment of OCD with perfectionism as a primary symptom. Findings suggest that in order to address perfectionism, it is necessary to first treat cognitions and obsessions associated with IU and that this practice would lessen distress and interference associated with perfectionistic obsessions.

The effect of communication deficits on anxiety symptoms in infants and toddlers with autism spectrum disorders.

Autism spectrum disorders (ASDs) are life-long developmental disorders characterized by impairments in the development of reciprocal social and communication skills, abnormal language development, and a restricted repertoire of behaviors and interests. While it has been known for some time that children with ASD can evince elevated rates of anxiety symptoms, little research has been conducted on whether deficits in communication skills affect the range of anxiety symptoms in infants and toddlers with ASD. This study represents a first attempt to determine whether deficits in communication skills have an effect on the expression of anxiety in infants and toddlers with autistic disorder and pervasive developmental disorder-not otherwise specified. Seven hundred thirty-five infants were evaluated with respect to the nature and extent of anxiety symptoms and developmental functioning. Both receptive and expressive communication skills appeared to play a significant role in the manifestation of anxiety symptoms.