Explore This Research Lab

The psychiatrists and psychologists on staff in the Center for Anxiety and Traumatic Stress Disorders (CATSD) and Complicated Grief Program at Massachusetts General Hospital explore the causes and treatments for a variety of anxiety-related disorders and seek to also learn more about the underlying causes and course of these disorders.

The research studies conducted by the CATSD provide the opportunity for staff and patients to work together on identifying and developing new treatment methods for these anxiety-related disorders.

Our Specialties

We work on a variety of anxiety disorders through our treatment and research program, including:

  • Complicated grief
  • Generalized anxiety disorder (GAD)
  • Panic disorder
  • Post-traumatic stress disorder (PTSD) 
  • Social anxiety 

Complicated Grief

Complicated grief (CG) has also been called "traumatic grief" or "pathological grief" at times. CG grief usually occurs after the death of a loved one. Individuals with CG may find that they are unable to accept the death and that their feelings remain strong and persistent. In addition, there may be certain types of disturbing ideas that seem to inhibit the natural process of gradual diminishing grief intensity. Another way of saying this is that grief isn't working, and the bereaved person is "stuck" in the grieving process. When this happens, grief intensity remains high and adjustment does not occur.

Complicated grief is characterized by a number of symptoms that continue for six months or more after a loss:

  • Marked depression
  • Anxiety
  • Preoccupation with the deceased
  • Disbelief or longing
  • Anger
  • Guilt
  • Withdrawal or avoidance

These symptoms can cause substantial distress and have been associated with impaired quality of life, poor medical outcomes and increased rates of suicide.

Standard treatments include medications aimed at specific symptoms such as antidepressants, anti-anxiety medications, and sleep-aids. Recent studies suggest that antidepressants such as bupropion (Wellbutrin) and paroxetine (Paxil) may help relieve symptoms of CG.

Use this brief questionnaire (PDF) to evaluate the presence of complicated grief symptoms.

Generalized Anxiety

People with generalized anxiety disorder (GAD) find it difficult to control their worry. This inability to stop worrying or to relax, even in the absence of major life stresses, is one of the cardinal features of the disorder.

Individuals with GAD also often experience a number of associated symptoms:

  • Restlessness or feeling keyed up or on edge
  • Being easily fatigued
  • Difficulty concentrating
  • Irritability
  • Muscle tension
  • Sleep disturbance

The anxiety and worry is considered a disorder if it is severe enough to cause an individual significant distress or interferes with social or occupational functioning. Adults with GAD often worry excessively about every day, routine life circumstances such as possible job responsibilities, finances, or the health of family members. A number of effective treatments are available for GAD, such as anti-anxiety medication or cognitive-behavioral therapy (which reduces worry through changes in thinking and behavior patterns).

Panic Disorder

Panic disorder is characterized by recurrent unexpected panic attacks followed by at least a month of persistent concern about having more attacks, worry about the implications of having an attack (e.g., is there something wrong with my heart?) or a change in behavior related to the attacks (such as avoidance).

Panic attacks are periods of marked fear or anxiety that tend to come on quickly, peak within 10 minutes and are accompanied by distressing symptoms of arousal including:

  • Palpitations or heart racing
  • Shortness of breath
  • Sweating or flushing
  • Lightheadedness
  • Abdominal distress
  • Spaciness or feeling as if you may be going crazy, dying or losing control

Many patients with panic disorder develop agoraphobia, which is a concern about being in places or situations in which help or easy escape may not be available in the event of having an attack, or in which previous attacks have occurred. Some individuals with agoraphobia avoid the situations they are afraid of or require a companion to accompany them, others endure them with a great deal of distress.

Panic disorder can cause significant difficulties, including marked distress, social and job-related dysfunction, increased utilization of medical services (e.g., visits to doctors and emergency rooms) and increased rates of depression and alcohol abuse. A number of effective treatments are available, including medications such as antidepressants or benzodiazepines ("Valium-like" medications) and psychotherapies such as cognitive-behavioral therapy.

Post-traumatic Stress Disorder (PTSD)

Many kinds of traumatic events can lead to the development of PTSD, such as:

  • Car accidents
  • Natural disasters such as hurricanes or earthquakes
  • Physical or sexual assault
  • Emotional, physical or sexual abuse
  • Combat exposure
  • Learning about the unexpected death or injury of a loved one

Although not all individuals exposed to a trauma develop PTSD, some individuals experience a number of distressing psychological and physical symptoms including re-experiencing, avoidance or numbing and hyperarousal.

Re-experiencing symptoms include:

  • Recurrent and intrusive thoughts about the event
  • Upsetting dreams or nightmares
  • Flashbacks to the trauma
  • Becoming extremely upset or anxious when reminded of the trauma

Avoidance and numbing symptoms include:

  • Avoiding thinking or talking about the trauma
  • Avoiding places, situations or people reminiscent of the trauma
  • Being unable to recall certain parts of what happened
  • Losing interest in previously valued activities
  • Feeling distant or detached from others
  • Having difficulty experiencing strong emotions
  • Feeling a lack of interest or hope in the future (e.g., feeling one will never have a career, get married, live to old age)

Hyperarousal symptoms include:

  • Difficulty falling or staying asleep
  • Feeling irritable or having outbursts of anger
  • Difficulty concentrating
  • Feeling hypervigilant even if there is no reason to be
  • Being easily startled

In order to receive a PTSD diagnosis, symptoms must persist for at least one month and cause significant distress, interference, or impairment in work, school, or social functioning. Symptoms may last for several months, or become even more chronic. For some, PTSD symptoms emerge six months or more after the traumatic event.

Treatment of PTSD

There are a number of effective medications available to treat the symptoms of PTSD, including antidepressants and some newer anti-anxiety or mood-stabilizing medications. Many individuals with PTSD do well with treatment that includes both psychotherapy and medication.

Cognitive behavioral therapy (CBT), including prolonged exposure, cognitive processing therapy and skills training in affect and interpersonal regulation, is effective for many patients with PTSD. CBT usually involves working closely with a therapist to systematically process the traumatic event, identify and modify negative thoughts that interfere with recovery from the trauma and learn to face situations or feelings associated with the trauma. In addition, CBT helps individuals learn skills for managing difficult emotions and overcoming difficulties in interpersonal relationships.

Social Anxiety Disorder (Social Phobia)

When an individual with social phobia enters or thinks about entering a feared situation, anxiety increases and for some may result in symptoms of a panic attack. Examples of feared situations include persistent fear of public speaking, meeting new people, attending parties, going to school or having social contact through a job.

Although most people have some anxiety about social and/or performance situations, these fears are more severe, persist and may limit participation in or enjoyment of every-day activities for an individual with social phobia. Social anxiety symptoms may interfere with success or completion of school, making new friends, creating relationships and employment.

Nonetheless, many individuals suffer with social phobia for many years without a diagnosis or treatment. However, there are a number of effective treatments available. Options include medications such as antidepressants or benzodiazepines ("Valium-like" medications) and psychotherapy (counseling or "talk therapy"), especially cognitive behavioral therapy.

Research Projects

The Center for Anxiety and Traumatic Stress Disorders and Complicated Grief Program conducts research on post-traumatic stress disorder, complicated grief disorder, panic disorder, generalized anxiety disorder and social anxiety disorder.

To learn more about enrolling in our research, please contact us by phone (617-726-6944) or email (anxietystudy@mgh.harvard.edu).

Anxiety Disorders

Comparative Effectiveness of Mindfulness-Based Stress Reduction and Pharmacotherapy for Anxiety

Description: The purpose of this study is to compare the effects of mindfulness-based stress reduction (MBSR) with Lexapro (escitalopram) to see how they compare for treating anxiety disorders. MBSR is a class that instructs participants in the theory and practice of several forms of mindfulness meditation. Escitalopram (Lexapro) is an antidepressant medication that is FDA-approved for the treatment of generalized anxiety disorder and depression. It is commonly used in practice for other anxiety disorders.

This research is being done because there is a need for more information about the comparison of treatments to be able to make informed decisions about health care for disorders. Although mindfulness meditation is gaining popularity, there is no information how this treatment strategy compares with standard treatment, such as medication, for anxiety disorders.

If you are interested in participating in or learning more about this research study, please email us at anxietystudy@partners.org or call 1-866-44-WORRY.

Compensation: May be available for eligible participants

Post-traumatic Stress Disorder

Enhancing fear extinction via angiotensin type 1 receptor inhibition: A randomized controlled trial in post-traumatic stress disorder

Study Sponsor: Department of Defense

Description: The purpose of this research study is to see whether Losartan, an FDA-approved medication that is commonly prescribed for the treatment of high blood pressure, may be effective for treating Post-traumatic Stress Disorder (PTSD). After medical and psychiatric evaluations are completed, eligible participants are randomly assigned (that is, by chance) to one of two study medications lasting approximately 12 weeks: Losartan or Placebo (a sugar pill without active medication).

Eligibility Criteria:

  • Adults ages 18-70 who have PTSD or post-traumatic stress symptoms
  • PTSD symptoms experienced for at least three months

Compensation: Participants will be paid $25 upon completion of the intake visit, as well as $25 for each of 7 study assessment visits, for a maximum total of $200.

Complicated Grief Disorder

Network Psychiatry: Using Network Science to Advance Our Understanding of Post-Bereavement Psychopathology

Description: We are is seeking adult participants who experienced the death of a loved one more than six months ago for a study of bereavement. The aim of this study is to learn more about how people adjust to the death of a loved one. Specifically, we hope to investigate the psychological and biological mechanisms that lead grief to persist for some bereaved adults but not others. The study will last approximately 2.5 weeks and will require two in-person visits to our clinic. Additionally, you will be asked to complete daily surveys on your phone. All collected information will remain strictly confidential.

You may be eligible if:

  • You are 18 or older
  • You own a smartphone (iPhone or Android) and have daily access to a laptop or computer
  • You have lost a loved one more than six months ago

Please call our phone screen line at 1-866-44-WORRY (866-449-6779) or email us at anxietystudy@partners.org for a full phone screen to determine if you would be eligible to come into the clinic to meet with one of the study doctors.

Compensation: Eligible participants would receive up to $250 in compensation.

Panic Disorder

Optimizing cognitive behavioral therapy for panic disorder: Examining mechanisms of treatment change using an intra-individual network of panic attacks

Description: The purpose of this research study is to examine how symptoms of panic disorder change during cognitive behavioral therapy (CBT) for panic disorder. The aim of this type of research is to focus on the symptoms and experiences of each person through the course of treatment, in order to develop a framework for a personalized medicine approach to treating panic disorder. All participants will receive seven sessions of CBT.

Eligibility Criteria:

  • Individuals 18 years of age and older with a primary diagnosis of panic disorder (as determined by the psychiatrists who conduct our initial screening process)
  • Participants need to own a smart phone to complete the pre- and post- treatment assessments.
  • Participants cannot have agoraphobia that limits their ability to travel to weekly sessions. Participants cannot be at current risk of suicide.
  • Psychotropic medication is permitted if the participant is on a stable dose.
  • Within the last 3 months, participants cannot have received psychotherapy directed at the treatment of panic disorder. Prior non-response to adequately delivered exposure therapy also disqualifies.

Please call our phone screen line at 866-44-WORRY (866-449-6779) or email us at anxietystudy@partners.org for a full phone screen to determine if you would be eligible to come into the clinic to meet with one of the study doctors.

Generalized Anxiety Disorder

We are not currently conducting any studies for generalized anxiety disorder. Please check back soon for updates.

Social Anxiety Disorder

We are not currently conducting any studies for social anxiety disorder. Please check back soon for updates.

What to Expect in a Research Study

First Step: Phone Interview

The first step to participating in a research study is a brief phone interview, which will help us determine whether any of our studies might be appropriate for you. If eligible, we will invite you in for an initial screening visit.

Please call 1-866-44-WORRY (866-449-6779) for this phone interview.

Initial Visit

The initial visit for all of our studies takes two to three hours and involves:

  • A medical and psychiatric history
  • Lab work to ensure that you are healthy and eligible for the study

At this visit, our research staff will review the specific risks and benefits of participating in a study with you.

The number of visits and their specific type(s) after the initial appointment varies depending on which study you enroll in. Our studies currently range from eight weeks to six months in length. You will typically be asked to come in about once a week to meet your doctor for assessment or treatment. The length of these visits depends on the study. You may also be asked to fill out some questionnaires and have your vital signs taken to ensure that you are healthy.

Frequently Asked Questions About Research Participation

Q: How will my privacy be protected if I enroll in a research study at your clinic?
A: We are committed to protecting your privacy. All study data will be labeled with a unique study ID code, rather than any information that could be used to identify you such as your name or date of birth. Signed consent forms and any correspondence containing your name or other identifying information is stored in a locked cabinet. At your first appointment with us, you will receive the Mass General Brigham Notice for Use and Sharing of Protected Health Information, which gives more details about how your privacy is protected. The consent form for the study you participate in will also contain this information.

Q: Will my participation in a research study go on my medical record?
A: No. However, if you choose to enroll in a study, information from your medical records within Mass General Brigham that is reasonably related to the conduct and oversight of the study may be accessed during the course of the study. If health information is needed from your doctors or hospitals outside Mass General Brigham, you will be asked to give permission for your medical records to be sent to us.

Q: Will my insurance company be notified of my participation in a research study?
A: No.

Q: Is there any cost to me for participating in a research study?
A: No, there is no cost to you or your health insurance company for you taking part in a study. Parking is available at no cost.

Q: Is there compensation for participating in a research study?
A: Evaluation and study treatments are provided at no cost. Some studies (but not all) also provide a small compensation for your time.

Q: I am pregnant or planning to become pregnant in the near future. Can I participate in a study?
A: We ask that women who enroll in our studies do not become pregnant or breastfeed throughout the course of the study.

Q: Can I be seen through your clinic as a private patient?
A: Our clinic primarily provides treatment through research studies. If you are interested in being seen outside of research, please call the Psychiatric Triage line: 617-724-7792.

Please note: Generally you must have a primary care physician at Mass General to be seen in the outpatient (non-research) clinics in the Psychiatry Department. If you do not have a primary care physician at Mass General, please see our list of referrals.

Q: Can children or adolescents be seen at the Center for Anxiety and Traumatic Stress Disorders?
A: We only treat patients who are 18 or older. If you are under 18 or looking for treatment for your child, please call Pediatric Psychopharmacology at 617-934-4644.