Reliability and validity of some specific fear questionnaires

Normative psychometric data on a Swedish translation of fear questionnaires concerning snakes, spiders, public speaking, and mutilation given to 223 college students are presented. High internal consistencies were found for all four questionnaires, and low intercorrelations among the four inventories emerged. In a separate study the inventories were administered to a clinical sample of spider and snake phobics. Phobics scored higher on their respective phobic scale than the college group but did not differ from controls on mutilation or public speaking scales. A significant negative correlation emerged between snake and spider scores among the phobics. One year test-retest reliabilities in the phobic sample were high. Finally, snake and spider phobics viewed and rated phobic and nonphobic slides. Snake phobics rated snake slides as more aversive than spider slides, whereas the reverse was true for spider phobics. The correlation between fear ratings and questionnaire scores was significant. Use of these scales in evaluating therapeutic changes is encouraged.     

Validity of Two Questionnaires to Assess Social Fears: The Dutch Social Phobia and Anxiety Inventory and the Blushing, Trembling and Sweating Questionnaire

This report evaluates some psychometric properties of the Dutch Social Phobia and Anxiety Inventory (SPAI-N) as well as a newly developed instrument to assess fear of showing somatic symptoms among social phobic, the Blushing, Trembling and Sweating Questionnaire (BTS-Q). Results support the reliability and discriminative validity of the Dutch SPAI and the BTS-Q. Both questionnaires are able to discriminate social phobics from a community sample. Social phobics with fear of blushing, trembling, and sweating as the main complaint could be discriminated from social phobics without fear of blushing, trembling, and sweating as the main complaint using the BTS-Q. In contrast with expectations derived from cognitive models of social phobia, social phobics with fear of blushing, trembling, and sweating did not have stronger dysfunctional beliefs about (the social consequences of) blushing, trembling, and sweating than social phobics without such fears.     

条件性恐惧提取消退的性别差异

基于记忆再巩固理论的提取消退范式能够有效地削弱非适应性恐惧记忆。性别差异是个体差异性研究的关键变量, 但在提取消退范式的研究中仍然比较少见关于性别差异的探索。因此本研究以立体几何图形作为条件刺激, 腕部电击作为非条件刺激, 皮肤电反应为恐惧反应指标, 探究提取消退范式在恐惧消退效果上是否存在性别差异。结果表明, 在恐惧自发恢复测试中, 提取消退范式的所有被试都成功抑制了恐惧复发, 但恐惧重建测试中只有女性被试抑制了恐惧复发。这说明, 提取消退范式在抑制恐惧自发恢复方面效果显著, 在恐惧重建上女性的消退效果显著优于男性。     

Assessment of fear of fear among Agoraphobic patients: The Agoraphobic Cognitions Scale

A self-report scale for the measurement of fear of fear, the Agoraphobic Cognitions Scale (ACS), was psychometrically evaluated. Two samples of inpatients satisfying DSM-III-R criteria for unipolar depressive and/or anxiety disorder were studied. Intercorrelational and factor analyses indicated that the ACS measured three dimensions of fear of fear: fear of bodily incapacitation, fear of losing control, and fear of acting embarrassingly. Three subscales were constructed to measure these dimensions. The subscales proved to have satisfactory internal consistency and criterion-related validity. However, fear of losing control was related not only to other anxiety symptoms, but also to depressive symptomatology. Agoraphobic patients reported more fear of bodily incapacitation and fear of losing control than social phobic, generally anxious, and nonanxious depressed patients. Fear of embarrassing action was higher among agoraphobic and social phobic patients than among generally anxious and nonanxious depressed patients. These results were obtained after controlling for general anxiety and depression level and, thus, support the validity of the fear of fear construct.     

Facial reactions to facial expressions in subjects high and low in public speaking fear

This study investigated whether subjects high and low in public speaking fear react with different facial electromyographic (EMG) activities when exposed to negative and positive social stimuli. A High-fear and Low-fear group were selected by help of a questionnaire and were exposed to slides of angry and happy faces while facial-EMG from the corrugator and zygomatic muscle regions were measured. The subjects also rated the stimuli on different emotional dimensions. Consistent with earlier research it was found that Low fear subjects reacted with increased corrugator activity to angry faces and increased zygomatic activity to happy faces. The High fear group, on the other hand, did not distinguish between angry and happy faces. Rating data indicated that the High fear group perceived angry faces as being emotionally more negative. The present results are consistent with earlier studies, indicating that the facial-EMG technique is sensitive to detect differential responding among clinical interesting groups, such as people suffering from social fears.     

An experimental test of stimulus estimation theory: danger and safety with snake phobic stimuli

The stimulus estimation model (Taylor & Rachman, 1994) asserts that fear overprediction stems from: (a) overprediction of the danger elements of a phobic stimulus, and (b) underprediction of existing safety resources. Using a 2x2 factorial design, with danger (high vs low) and safety (high vs low) as between-subjects variables, an experimental test of the model was conducted with 25 snake-fearful participants per condition. The four experimental conditions were matched on initial levels of snake fearfulness, as assessed by the Snake Questionnaire (SNAQ). For the 51 participants who demonstrated overprediction of fear, high danger led to reliably more fear overprediction than low danger; and low safety led to reliably more fear overprediction than high safety. The interaction between danger and safety was not statistically significant. The results offer the first convincing experimental support for the stimulus estimation model of fear overprediction.     

Greater Expectations: Using Hierarchical Linear Modeling to Examine Expectancy for Treatment Outcome as a Predictor of Treatment Response

A client's expectation that therapy will be beneficial has long been considered an important factor contributing to therapeutic outcomes, but recent empirical work examining this hypothesis has primarily yielded null findings. The present study examined the contribution of expectancies for treatment outcome to actual treatment outcome from the start of therapy through 12-month follow-up in a clinical sample of individuals (n = 72) treated for fear of flying with either in vivo exposure or virtual reality exposure therapy. Using a piecewise hierarchical linear model, outcome expectancy predicted treatment gains made during therapy but not during follow-up. Compared to lower levels, higher expectations for treatment outcome yielded stronger rates of symptom reduction from the beginning to the end of treatment on 2 standardized self-report questionnaires on fear of flying. The analytic approach of the current study is one potential reason that findings contrast with prior literature. The advantages of using hierarchical linear modeling to assess interindividual differences in longitudinal data are discussed.     

I am going to gag: Disgust cognitions in spider and blood-injury-injection fears

There is mounting evidence that disgust plays an important role in certain anxiety disorders, yet little is known about disgust's cognitive component. The current study introduces a measure of cognitions associated with disgust and contamination to assess the role of disgust-specific primary and secondary appraisals in phobic responding. A multi-modal assessment of blood-injury-injection (BII) and spider phobia was conducted using BII (N=29) and spider (N=30) fearful groups, and a non-fearful control group (N=30). The Disgust Cognitions scale showed good reliability and validity, and distinguished among the groups. For example, relative to the other groups, the spider fear group reported higher disgust cognitions following presentation of a live spider, whereas the BII Fear group reported higher disgust cognitions following a surgery video. Moreover, the scale was associated with multiple phobic indicators (behavioral avoidance, subjective distress, symptom endorsement), suggesting cognitions may be critical to understanding how disgust contributes to anxiety disorders.     

A multicomponent investigation of the interaction of generalized anxiety and phobia

Forty female undergraduates forming four groups, high or low trait anxiety with or without a specific fear (rats), participated in a psychophysiological assessment of their response to the phobic object, a neutral object (rabbit), and to a general anxiety-induction procedure (threat of shock). Subjects also completed a number of tasks requiring sustained attention. Blood samples were drawn to determine thyroid hormone (T3 and T4) levels. Trait anxiety was found to interact with specific fear in response to the feared object. The high-trait anxious/high-fear group was most physiologically responsive to the rat. Trait- anxious subjects were more responsive to the threat of shock and showed performance deficits on reaction time, vigilance, and backward digit span tasks. These subjects also had significantly higher T3 and T4 levels. The findings are discussed with regard to the role of general anxiety in the etiology and/or maintenance of specific fears and the role of thyroid hormones in accentuating physiological response to feared stimuli.     

Development and Initial Validation of an Abbreviated Spider Phobia Questionnaire Using Item Response Theory

An abbreviated Spider Phobia Questionnaire (SPQ) was developed using methods based in item response theory. Fifteen of the 31 SPQ items that demonstrated good to excellent discrimination along the spider fear continuum were retained in Study 1 that consisted of 1,555 nonclinical and clinical participants. The SPQ-15 demonstrated good internal consistency and correlated highly with the full SPQ. Structural equation modeling revealed that the SPQ-15 demonstrated excellent convergent validity, with strong associations with small animal disgust and other phobic symptoms. Supportive evidence was also found for divergent validity in relation to panic-related symptoms. The SPQ-15 was uniquely predictive of avoidance behavior and fear and disgust responding towards spiders in nonclinical, analogue, and treatment-seeking samples in Studies 2, 3, and 4. Lastly, in Study 5, the SPQ-15 was sensitive to the effects of exposure-based treatment. These findings suggest that the SPQ-15 has considerable strengths, including decreased assessment and scoring time while retaining high reliability, validity, and sensitivity.     

Subjectively rated physiological and cognitive symptoms in six different clinical phobias

The purpose of the present study was an attempt to describe clinical symptoms in terms of physiological reactions and negative cognitions experienced by phobic patients. A total of 267 clinical phobic patients divided among blood phobia, small animals phobia, dental phobia, claustrophobia, social phobia and agoraphobia, participated in the study. The patients within each phobic category were separated into a Conditioned and an Indirect Acquisition group, based on their answers to a set of specific questions concerning the etiology of the phobia. All patients rated (0–4) how intensively they experienced 11 specified physiological reactions and 10 negative cognitions when confronted with their phobic situation in vivo. A mean score was calculated for each item within each group, and an item rank-order hierarchy was set up for each group. Differences between items within each hierarchy were statistically evaluated by one-way ANOVAs and Turkey's HSD-tests. Results showed particular idiosyncratic patterns of responding for the blood phobic, agoraphobic and social phobic groups as well as several commonalities among all the groups concerning activation of specific physiological reactions and negative cognitions. A more fine-grained analysis of the data is best made by direct visual inspection of the figures in this paper.     

Facial reactions to fear-relevant stimuli for subjects high and low in specific fear

This study was performed to investigate whether subjects high and low in fear of snakes react with different facial electromyographic (EMG) responses when exposed to snakes. Two groups of subjects were exposed to slides of snakes or flowers. After the experiment they rated their fear of snakes on a questionnaire and based on these ratings they were divided into high and low fear groups. Facial EMG was measured from the corrugator and zygomatic muscle regions. As predicted the high fear group reacted with a facial response interpretable as a negative emotional reaction whereas the low fear group did not. This difference was specific to snakes because high and low groups did not differ in responses to slides of flowers. The results are consistent with the proposition that facial EMG technique is a sensitive tool to distinguish reactions between subjects high and low in specific fears.     

Animal fears in the Antipodes: normative data from an Australian sample

The present study investigated reported fear of snakes, spiders and mutilation in an Australian sample ( N =235). Standardized questionnaires were used, and scores from the Australian sample were compared with those obtained by other authors from North American and Swedish samples. The psychometric characteristics of test scores from the Australian sample were similar to those from the North American and Swedish samples. Although there were no differences in reported fear of snakes between the three samples, both the Australian and North American samples reported greater fear of spiders than did the Swedish sample. Females scored higher on all scales than did males, and Australian and North American females reported greater fear of mutilation than did Swedish females. Test-retest reliability in a non-clinical Australian subsample ( n =48) was low for all scales. The results are discussed in terms of the adaptation/habituation hypothesis and the preparedness account of the acquisition of fear.     

Virtual Reality Exposure Therapy in the Treatment of Fear of Flying

A new and innovative approach to treating fear of flying has been developed using Virtual Reality Exposure Therapy. This article discusses the development of Virtual Reality Exposure Therapy and reviews a case study of a fear of flying patient seen in our practice. Early results are very promising and may indicate that Virtual Reality Exposure Therapy may also lead to creative interventions with other anxiety disorders.     

‘Preparedness’ and ‘arousability’ as determinants of electrodermal conditioning

‘Arousability’, as defined through spontaneous electrodermal responses, has been empirically linked to anxiety, phobic symptoms and outcome of systematic desensitization. Previous data from our laboratory indicate that ‘preparedness’, as defined through potentially phobic vs. fear-irrelevant or ‘neutral’ conditioned stimuh, is an important determinant of electrodermal conditioning. The present experiment compared groups selected to be high or low in spontaneous responding during differential conditioning to potentially phobic or neutral stimuh. It was found that the effects of these two factors were essentially additive, i.e. conditioning and resistance to extinction were better for phobic stimuli and for high-arousal groups. The high-aroused group with phobic stimuh showed diffuse responding during acquisition, not differentiating between reinforced and unreinforced cues. However, it was the only group that failed to extinguish during 20 trials, which indicates that high arousal gives superior resistance to extinction particularly for phobic stimuli.     

An exploratory investigation of the origin and maintenance of phobias

Phobies were asked to relate past events which they believed caused or contributed to their fear, and to describe cognitive events experienced while imagining phobic interactions. Approximately half the subjects were able to recall relevant learning experiences, with direct experiences far more common than vicarious experiences or learning based on verbal instruction. Almost all of the subjects reported self-verbalizations while imagining the phobic situation, in every case phobic relevant. However, in a minority of instances were the verbalizations ‘catastrophic’ in nature. In only about half the cases did the phobies report that, in vivo, thoughts preceeded fear in the phobic situation (in contrast to a comparison group of less fearful subjects for which thoughts did preceed fear to a significant degree). Results are discussed in terms of possible limitations of a cognitive interpretation of phobic behavior.     

The effect of worry on cardiovascular response to phobic imagery

Cardiovascular response to phobic exposures has been shown to reflect the degree of emotional processing of phobic material and relates in important ways to outcome in exposure therapy. The present study investigated the effect of worry on such processing. Speech anxious subjects visualized a phobic scene for 10 trials. Three groups differed according to whether they engaged in relaxed, neutral, or worrisome thinking just prior to each scene presentation. Although the three types of thinking had no effect on cardiovascular activity during the thinking periods, subjects in the worry group displayed significantly less heart rate response to the phobic image than those in the neutral condition who had significantly less response than the relaxed condition. However, the worry group showed significantly greater subjective fear to the images than the neutral condition, with the relaxed group near to the level of the worry group and not significantly different from either of the other two conditions. The results suggest that worry may inhibit emotional processing and thus preserve cognitive/affective fear structure, and are discussed in terms of Gray's (Behavioral and Brain Sciences, 5, 469-534, 1982) theory of the behavioral inhibition system and semantic satiation effects in cognitive psychology.     

I am going to gag: Disgust cognitions in spider and blood–injury–injection fears

There is mounting evidence that disgust plays an important role in certain anxiety disorders, yet little is known about disgust's cognitive component. The current study introduces a measure of cognitions associated with disgust and contamination to assess the role of disgust-specific primary and secondary appraisals in phobic responding. A multi-modal assessment of blood–injury–injection (BII) and spider phobia was conducted using BII (N=29) and spider (N=30) fearful groups, and a non-fearful control group (N=30). The Disgust Cognitions scale showed good reliability and validity, and distinguished among the groups. For example, relative to the other groups, the spider fear group reported higher disgust cognitions following presentation of a live spider, whereas the BII Fear group reported higher disgust cognitions following a surgery video. Moreover, the scale was associated with multiple phobic indicators (behavioural avoidance, subjective distress, symptom endorsement), suggesting cognitions may be critical to understanding how disgust contributes to anxiety disorders.     

The structure of negative emotions in adolescents

This study examined the structure of negative emotions in a sample of nonclinical adolescents, using an approach that exclusively relied on child self-report. A large sample of adolescents (N = 968) completed self-report questionnaires measuring symptoms of fear, anxiety, and depression. Confirmatory factor analysis provided support for the notion that fear, anxiety, and depression are distinct yet correlated components of negative emotions. This result is in agreement with recent empirical findings and current theoretical notions on the structure of negative emotions in children and should be taken as an encouragement for researchers to develop more specific measures for assessing fear, anxiety, and depression in children.     

The Koala Fear Questionnaire: Its Relationship with Fear of Storms and Hurricanes in 4- to 14-Year-Old Antillean Children

The present study further investigated the reliability and validity of the recently developed Koala Fear Questionnaire (KFQ) in a large sample of 4- to 14-year-old school children (N = 378) who lived on Sint-Maarten, The Netherlands Antilles. The results confirmed that the KFQ is a reliable scale with good internal consistency. Furthermore, evidence was obtained for the concurrent validity of the scale. That is, KFQ scores were substantially correlated with a highly relevant fear of the children on Sint-Maarten, namely fear of storms and hurricanes. Finally, psychometric properties in the younger children of our sample were highly similar to those obtained in older children. Altogether, these findings provide further support for the notion that the KFQ is a reliable and valid scale for assessing fears and fearfulness in children aged 4 years and above.