Specific fears as predictors of generalized anxiety

Three hundred thirty-seven female undergraduates completed the Trait Form of the State-Trait Anxiety Inventory (STAI) and the Fear Survey Schedule-II (FSS) to determine if any specific fear factor was significantly related to STAI score. All fear factor scores and the total FSS-II score were significantly correlated with the STAI score and with each other. A stepwise regression procedure indicated that Factor 1, Fear of Social Interaction, accounted for 25.2% of the variance in STAI scores (p <.001), while Factor 4, of Negative Social Evaluation, accounted for an additional 1.8% of the variance (p <.01). The implications for theory, assessment, and intervention are discussed.     

Do childhood anxiety measures measure anxiety?

The Fear Survey Schedule for Children-Revised (FSSC-R), Revised-Children's Manifest Anxiety Scale (RCMAS), and the Modified State-Trait Anxiety Inventory for Children (STAIC-M) are three widely used self-report measures of childhood anxiety. While previous studies have established the reliability of these measures, their validity in discriminating anxious from non-anxious youngsters remains to be established. The present study examines the discriminant validity of the three measures by comparing clinic referred samples of boys with an anxiety disorder (n=105) or ADHD (n=59) with a community sample of never-psychiatrically-ill boys (n=49). Results indicated that the two patient groups differed significantly from the never-psychiatrically-ill group on the RCMAS and STAIC-M, but the anxious and ADHD groups did not differ from each other. None of the three groups differed on the FSSC-R. The implications of these findings for the assessment of childhood anxiety disorders are discussed.     

Three traditional and three new childhood anxiety questionnaires: their reliability and validity in a normal adolescent sample

The current study examined the psychometrics of three traditional [i.e., the trait anxiety version of the State-Trait Anxiety Inventory for Children (STAIC), the Revised Children's Manifest Anxiety Scale (RCMAS), and the Fear Survey Schedule for Children - Revised (FSSC-R)] and three new childhood anxiety scales [the Multidimensional Anxiety Scale for Children (MASC), the Screen for Child Anxiety Related Emotional Disorders (SCARED), and the Spence Children's Anxiety Scale (SCAS)] in a large sample of normal adolescents (N=521). Childhood anxiety scales were generally found to be reliable in terms of internal consistency. Furthermore, evidence was obtained for the convergent and divergent validity of the various anxiety questionnaires. That is, anxiety questionnaire scores were found to be substantially intercorrelated. Particularly strong associations were found between total scores of the STAIC and the RCMAS, total scores of the SCARED and the SCAS, and between subscales that intend to measure specific categories of anxiety symptoms. Childhood anxiety questionnaires were substantially connected to an index of depression, although correlations among anxiety questionnaires were generally higher than those between anxiety scales and a measure of depression.     

Empirically Supported Treatments for Insomnia

The purpose of this study was to examine the level of fears in Swedish children and to examine the relation of those fears to state and trait anxiety. The purpose was also to do a normative study of FSSC-R (Fear Survey Schedule for Children - Revised). In total, 550 children between 8 and 16 years of age answered the questionnaires. The results indicate that there are no gender differences in total fear score, factor scores and number of fears. In contrast to earlier results, there was no correlation between fear and trait anxiety; however, a modest correlation was found between fear and state anxiety     

Anxiety Symptoms and Fears in Hispanic and European American Children: Cross-Cultural Measurement Equivalence

The cross cultural equivalence of child (n = 217) and parent (n = 283) versions of the revised children’s manifest anxiety scale (RCMAS), multidimensional anxiety scale for children (MASC), and the fear survey schedule for children—revised (FSSC-R) was examined in Mexican youth in Mexico, and Hispanic and white European American youth in the USA. The RCMAS, MASC, and FSSC-R showed cross ethnic measurement equivalence. The Mexican and Hispanic youth reported more worries, and the Mexican youth reported more somatic symptoms than the European American youth. Per mother report, Mexican and Hispanic youth express more somatic symptoms than European American youth who also show the least number of fears of the unknown and fears of danger and death. The results support the validity of commonly used child anxiety measures with these populations and accrue evidence for greater anxiety and fear expression by Hispanic and Mexican youth in certain domains.

Cross-cultural aspects of fears in African children and adolescents

The purpose of this study was to compare level and type of fears in Nigerian and Kenyan children using the Fear Survey Schedule for Children, Revised (FSSC-R; [Ollendick, T.H. (1983). Reliability and validity of the Revised Fear Survey Schedule for Children (FSSC-R). Behaviour Research and Therapy, 21, 685-692]). A total of 852 males and females between the ages of 8 and 17 were surveyed. Results indicated that Nigerian children reported significantly higher total fear than Kenyan children and that scores from both countries were higher than those found in the United States, Australia and China. This suggests that the cultures of Kenya and Nigeria may share a common variable that makes reporting of fears greater than that reported by children of other world cultures. In addition, Christian children in both countries reported higher levels of fear on several factors than Muslim children, indicating that Islamic beliefs may encourage children to report less fear or to deal with their fears better than Christian beliefs. Finally, children between the ages of 8 and 12 reported greater fear of the unknown than children between 13 and 17 years of age. Overall, these findings suggest that important cultural, religious and age differences exist for levels of childhood fears reported in Nigeria and Kenya.     

Sensitivity for Treatment Effects of the Screen for Child Anxiety Related Emotional Disorders

The Screen for Child Anxiety Related Emotional Disorders (SCARED) is a relatively new self-report questionnaire that measures DSM-defined anxiety disorders symptoms in children. The present study examined the treatment sensitivity of the SCARED. Eleven anxiety-disordered children aged 10 to 13 years received cognitive-behavioral treatment, an intervention that is generally known to be effective. Children completed the SCARED on three occasions: (1) 3 months before treatment (i.e., baseline), (2) at pretreatment, and (3) at posttreatment. Before and after treatment, scores on traditional childhood anxiety measures (i.e., State-Trait Anxiety Inventory for Children, Revised Children's Manifest Anxiety Scale, and Fear Survey Schedule for Children) were also obtained. Results showed that children's SCARED scores remained relatively stable from baseline to pretreatment. However, from pre- to post-treatment, significant decreases were evident for the SCARED and for all traditional measures. These results suggest that the SCARED reliably taps treatment effects and, thus, provide further support for its utility as a self-report index of childhood anxiety in clinical and research settings.     

Relationships between psychoevolutionary fear of evaluation,cognitive distortions,and social anxiety symptoms: A preliminary structural equation model

Social anxiety disorder is a mental health condition that affects 4.7% of Australians each year. The complex interplay between psychoevolutionary and cognitive models has become the focus of research in recent years, particularly with the development of the bivalent fear of evaluation model (i.e., negative and positive evaluation fears). The present study aimed to test a model of social anxiety symptoms using structural equation modelling, integrating previously fragmented evidence. A sample of 255 participants (75.3% female; M_age = 31.9, SD = 10.3) undertook an online survey, including Social Phobia Scale, Brief Fear of Negative Evaluation—Straightforward, Fear of Positive Evaluation, Concerns of Social Reprisal, and Disqualifications of Positive Social Outcomes measures. The hypothesised model for social anxiety symptoms described the data reasonably well (χ²(1) = 4.917, p = .027, CFI = .995, GFI = .992, SRMR = .017), explaining 57.1% of social anxiety variance. Study hypotheses were supported with bivalent fear of evaluation accounting for unique variance in cognitive distortions, which in turn accounted for unique variation in social anxiety symptoms. Effect sizes indicate bivalent fears of evaluation and disqualification of positive social outcomes as important predictors of social anxiety symptoms. Although replication in a clinical cohort and experimental confirmation are needed, the findings suggest a focus on disqualification of positive social outcomes to alleviate social anxiety symptoms.     

Fear of fear,trait anxiety and aerobic fitness in relation to state anxiety during adrenalin provocation

Abstract

Psychological explanations of both spontaneous and experimentally induced panic anxiety stress the role of fear of fear, especially fear of bodily symptoms of arousal. Fear of fear is conceptually different from trait anxiety but may be associated with repeated experience of arousal symptoms in fearful situations, while frequent physical exercise may lead to habituation to these symptoms. To test this hypothesis, 44 healthy male volunteers, classified as having high or low trait anxiety and high or low aerobic fitness, underwent a single-dose adrenalin infusion (80 nanogram/kilogram bodyweight/minute). In both groups, during the experiment a significant rise in state anxiety was found; compared to the group with low trait anxiety, subjects with high trait anxiety reported higher levels of state anxiety, which could be attributed to differences in aerobic fitness. In the high-anxious group, subjects showed a greater decrease in state anxiety during the recovery phase. State anxiety during adrenalin was strongly associated with fear of bodily symptoms only in the high-anxious group. Correlations between trait anxiety and somatic anxiety were not significant; state anxiety scores tended to correlate negatively with physical fitness. It is concluded that these results lend support to a fear of fear-model of panic anxiety.     

State–trait anxiety and existential fear: an empirical analysis

The Fear Checklist consists of 18 items (e.g. intimacy, loss of control, failure) a respondent checks to signify areas that have been or currently are personal sources of concern and/or apprehension. Total scores on the Fear Checklist, along with scores on each of its three subscales (Social, Control, Identity), were correlated with the state (A-State) and trait (A-Trait) anxiety scales of the State–Trait Anxiety Inventory (STAI). Both the A-State and A-Trait scales demonstrated significant association with the total Fear Checklist score (r_stat =0.48, r_trait=0.50) and each of its three subscales in a group of 135 male federal prisoners. Despite substantial overlap between the A-State and A-Trait scales (r=0.76), each achieved significant partial correlations with the total Fear Checklist score when the other scale was controlled (i.e. the A-Trait score was controlled in the state anxiety–fear relationship and the A-State score was controlled in the trait anxiety–fear relationship). These results lend preliminary support to the notion that existential fear, as measured by the Fear Checklist, is sensitive to both dispositionally (A-Trait) and situationally (A-State) based anxiety, although the majority of variance shared by the STAI and Fear Checklist was common to both STAI scales.     

Children and adolescents who stutter: Further investigation of anxiety

PurposeDespite the greatly increased risk of social anxiety disorder in adults who stutter, there is no clear indication of the time of onset of this disorder in childhood and adolescence. The purpose of this study was to explore this issue further using the Revised Children's Manifest Anxiety Scale (RCMAS), so that appropriate interventions can be developed prior to adulthood. This is the first time the RCMAS has been completed by children younger than 11 years. Using the same test for both school-age children and adolescents can potentially identify when anxiety starts to develop from age 6 years through to adulthood.MethodsThe RCMAS was administered to 18 school-age boys, five school-age girls, 41 adolescent boys and nine adolescent girls who were seeking treatment for their stuttering. Participants also rated the severity of their own stuttering.ResultsAll mean scaled scores on the four RCMAS subscales and Total Anxiety scores were within normal limits. However, for both groups of boys, scores on the Lie Scale were significantly higher than scores on the other three subscales.ConclusionsExperts suggest high scores on the RCMAS Lie Scale are indicative of participants attempting to present themselves in a positive light and so cast doubt on the veracity of their other responses on the test. One interpretation, then, is that the boys were concealing true levels of anxiety about their stuttering. The results suggest why findings of anxiety studies in children and adolescents to date are equivocal. Clinical implications are discussed.Educational objectives: The reader will be able to: (a) discuss why understanding when anxiety starts in people who stutter is important, (b) describe the function of the RCMAS Lie sub scale and (c) summarize the possible implications of the RCMAS findings in this study.     

What is the Revised Fear Survey Schedule for Children measuring?

The Fear Survey Schedule for Children-Revised (FSSC-R) is a widely used self-report questionnaire that purports to measure the number of fears and the overall level of fearfulness in children. A number of studies have shown that the ten most common childhood fears can be found on the Danger and Death subscale of the FSSC-R, with upwards of 50% of children endorsing such fears. However, some researchers (e.g., H. McCathie & S.H. Spence, 1991; Behaviour Research and Therapy, 29, 495-502) have questioned the validity of these findings, suggesting that these items do not reflect actual childhood fears that children have or experience on a daily or regular basis. Rather, they suggest that children are responding to these fear items as if they were actually occurring to them in the here and now. The current study examined the occurrence of five Danger and Death fears from the FSSC-R (i.e., "Not being able to breathe", "Being hit by a car or truck", "Falling from high places", "Bombing attacks or being invaded", and "Fire or getting burned") in a sample of normal school children aged eight to 12 years (N=102). More specifically, we used three different methods to asses these fears: (1). prevalence as determined by the standard FSSC-R procedure, (2). prevalence as determined by a fear list procedure, and (3). actual occurrence or prevalence of these fears in the past week, as determined by a diary method. Results indicated that while these fears ranked high when using the standard FSSC-R procedure, they were considerably less common when using the fear list procedure, and had a low probability of actual occurrence on a daily basis, as well as possessing a short duration and low intensity. Implications for the assessment of fears and the use of self-report measures like the FSSC-R are briefly discussed.     

Treatment of Poststroke Anxiety in an Older Adult Male: A Single-Case Analysis

A single-case analysis was carried out to study the nonpharmacological treatment of post-stroke anxiety in an older adult male. The intervention consisted of a biofeedback-assisted program of autogenic training; efficacy was demonstrated using multiple discontinuations and reinstatements of treatment. Physiological indices and self-report measures of anxiety and depression documented treatment success, although a moderate increase in fear was evident on the Fear Survey Schedule II at the final follow-up assessment.     

Testing the Bivalent Fear of Evaluation Model of Social Anxiety: The Relationship between Fear of Positive Evaluation,Social Anxiety,and Perfectionism

The Bivalent Fear of Evaluation (BFOE) model of social anxiety proposes that fear of negative evaluation (FNE) and fear of positive evaluation (FPE) play distinct roles in social anxiety. Research is however lacking in terms of how FPE is related to perfectionism and how these constructs interact to predict social anxiety. Participants were 382 individuals from the general community and included an oversampling of individuals with social anxiety. Measures of FPE, FNE, perfectionism, and social anxiety were administered. Results were mostly consistent with the predictions made by the BFOE model and showed that accounting for confounding variables, FPE correlated negatively with high standards but positively with maladaptive perfectionism. FNE was also positively correlated with maladaptive perfectionism, but there was no significant relationship between FNE and high standards. Also consistent with BFOE model, both FNE and FPE significantly moderated the relationship between maladaptive perfectionism and social anxiety with the relationship strengthened at high levels of FPE and FNE. These findings provide additional support for the BFOE model and implications are discussed.     

Do socially anxious individuals fear embarrassment by close others? Development of the Fear of Embarrassment by Others Scale

Social anxiety disorder is characterized by an intense fear of social or performance situations, and a fear of acting in a way that will be humiliating or embarrassing. However, the extent to which socially anxious individuals fear embarrassment due to the behavior of close others remains unknown. The Fear of Embarrassment by Others Scale (FEOS) was developed to assess the extent to which individuals with social anxiety fear being embarrassed by others. To assess the psychometric properties of this measure, 162 undergraduate students low or high in social anxiety completed the FEOS, along with additional questionnaires. An exploratory factor analysis suggested a single factor. The measure demonstrates high internal consistency, and is correlated with measures of social anxiety, fear of negative evaluation, and anxiety sensitivity. Fear of embarrassment by others was not found to be a significant predictor of social anxiety, as compared to anxiety sensitivity and fear of negative evaluation. The FEOS discriminated among participants high and low in social anxiety, as those high in social anxiety scored significantly higher on the measure than did participants low in social anxiety. The utility of this scale for research and clinical practice is discussed.     

Anxiety reactivity and anxiety perseveration represent independent dimensions of anxiety vulnerability: an in vivo study

Trait anxiety is a relatively stable disposition reflecting an individual's tendency to experience anxious symptomatology, typically measured using questionnaires such as the Spielberger Trait Anxiety Inventory (STAI-T). While trait anxiety commonly is considered a unitary construct, recent questionnaire research suggests that two different dimensions of anxiety vulnerability account for independent variance in trait anxiety scores. These dimensions are anxiety reactivity (AR), reflecting the intensity of anxiety reactions to stressors, and anxiety perseveration (AP), reflecting the persistence of anxiety symptoms. This study investigated whether in vivo measures of these two facets independently contribute to anxiety vulnerability. Seventy-two participants were exposed to a novel stress task designed to yield measures of AR and AP. Regression analysis determined that these in vivo measures were unrelated to each other, and each accounted for independent variance in trait anxiety scores. The implications of these findings for the assessment and understanding of anxiety vulnerability are discussed.     

恐惧学习的发展认知神经机制研究回顾与展望

恐惧可以帮助个体快速地评估危险情景,并调动生理和行为反应来应对危险刺激。恐惧发展始于婴儿时期,神经回路表现为杏仁核未参与恐惧反应,但杏仁核功能连接可以预测早期恐惧反应;发展到童年期的恐惧学习特点为安全学习不足和过度泛化,其根源是负责辨别刺激的海马还处于发育中;进入青春期恐惧加工主要特征是由于前额叶发育较晚导致的消退能力弱。恐惧虽有益于人类生存,但恐惧异常会引发焦虑障碍,本文从恐惧的习得、消退和泛化三个阶段,对比了焦虑与健康青少年的恐惧学习差异。最后,文章从增加婴儿时期研究、创新青少年恐惧研究范式和开发安全有效的干预手段三个方面对未来研究提出展望,以期进一步推动恐惧研究的发展。     

Anxiety disorders in African-American and white children

There are little available data on African-American children with anxiety disorders. Treatment-seeking African-American (n=30) and white children (n=139), with a current DSM-III-R anxiety disorder, were compared on sociodemographic background variables, clinical characteristics, and lifetime rates of specific DSM-III-R anxiety disorders. Overall, results suggested that the anxiety-disordered African-American and white children who sought treatment from an outpatient mental health facility were more similar than different. The two groups did, however, differ somewhat on several variables (trend only), including rates of school refusal, severity of primary anxiety disorder, lifetime prevalence of posttraumatic stress disorder, and total scores on the Fear Survey Schedule for Children-Revised. More specifically, white children were more likely to present with school refusal and higher severity ratings, while African American children were more likely to have a history of posttraumatic stress disorder and score higher on the FSSC-R. The impact of these findings and the need for additional research are discussed.This study was supported in part by MH grant 40021 from the National Institute of Mental Health.     

What is the revised Fear Survey Schedule for Children measuring?

This study was designed to investigate parameters of children's fear in terms of frequency of fearful thoughts and avoidance behaviour. It is suggested that current measures such as the Fear Survey Schedule for Children--Revised (FSSC-R) do not assess fearful behaviour in the sense of the occurrence of fearful responding in daily life, but rather reflect a negative affective response to the thought of occurrence of specific events. A modified version of the FSSC-R examined the frequency of fearful thoughts/feelings and avoidance activities amongst 376 children aged 7-12 yr. Contrary to predictions, it was found that children reported high levels of fearful thoughts and avoidance behaviour to those items identified as the greatest fears on the FSSC-R, namely fears of injury, illness, death and danger. These events were typically of low probability (e.g. earthquakes) and the question was raised as to what children are responding to when they are asked to rate their fearful responses. The same pattern of results was reflected in older compared to younger children. It is suggested that even when children are asked to rate frequency of fearful thoughts or avoidance behaviour, they tend to respond to fear questionnaire items according to their affective response to the image or thought of the stimulus situation rather than their actual fear responses. Both the FSSC-R and the modified version were found to discriminate between teacher nominated high and low fearful children and to correlate significantly with a self report measure of anxiety.     

Treatment hurts: Lay theories of graded exposure in the treatment of four anxiety disorders

Objective: This paper concerned the perceived suffering/side effects caused by various well-known treatments for personal problems. It looked at whether people understood whether potentially painful treatments that confront negative aversive affect were effective or not.

Method: In total, 106 participants completed a long questionnaire assessing the ‘psychological pain’ ratings of 30 psychotherapy treatments, varying in fear exposure, for four relatively common anxiety disorders: social phobia, agoraphobia, post-traumatic stress disorder, and obsessive compulsive disorder.

Results: Factor analytic results revealed four clear factors underlying lay efficacy beliefs of psychotherapy interventions, varying in fear exposure: talking therapies, fear confrontation, fear avoidance, and alternative therapies. Talking therapies were rated the most effective across all disorders, but also the most painful. Fear avoidance therapies were rated the least effective and, along with alternative medicine, the least painful. Treatments involving fear exposure were rated the most painful. Regression analysis revealed talking therapies to be rated more efficacious by younger subjects than older subjects.

Conclusion: Most people seem able to differentiate between the efficacies of interventions for different anxiety disorders and hold consensually held optimistic conceptions about the usefulness of psychotherapy treatments and counseling that involve fear exposure, despite knowledge of the psychophysical side effects that these therapies often entail. They favored talking cures over others, but that may have been due to misleading items in the questionnaire.