Comparison of cognitive-behavioural therapy and psychodynamic therapy in the treatment of anxiety among university students: an effectiveness study

The aim of the present study was to compare the effectiveness of cognitive-behavioural (CBT) and psychodynamic (PDT) therapies in the treatment of anxiety among university students. To this aim, the Symptom Questionnaire (SQ) was completed by 30 students assigned to CBT and by 24 students assigned to PDT, both at the beginning and at the end of treatment. The main problem presented by all patients was anxiety. Except for one sub-scale, we observed significant differences in the scores of all sub-scales and scales of SQ, with lower scores at the end of the therapy, indicating lower distress, regardless of the type of treatment. The present findings suggest that both therapies are effective in the treatment of anxiety among university students.     

Anxiety reactivity and anxiety perseveration represent dissociable dimensions of anxiety vulnerability: A replication and extension

Trait anxiety is a unitary construct reflecting individual differences in the tendency to experience anxious symptomatology, typically measured with questionnaires such as the Spielberger Trait Anxiety Inventory (STAI‐T). Recent research by Rudaizky, Page, and MacLeod has found evidence that two different dimensions of trait anxiety account for independent variance in trait anxiety scores. These dimensions are anxiety reactivity (AR), reflecting the probability of experiencing an anxious reaction, and anxiety perseveration (AP), reflecting the persistence of anxious symptoms once elicited. There are two key issues addressed in this study: first, the replicability of Rudaizky et al.'s findings and second, the ability of the measures of AR and AP developed by Rudaizky et al. to predict independent variance in STAI‐T scores after statistically controlling for variance shared with a measure of depression. Regression analysis determined that AR and AP do account for independent variance in STAI‐T trait anxiety scores even after statistically controlling for depression. The implications of these findings for the understanding of anxiety vulnerability are discussed.     

Recent developments in family behavioral marital therapy

This paper reviews recent developments in the area of behavioral marital therapy (BMT). New information is summarized regarding the long-term efficacy of BMT and the identification of predictors of positive response to treatment and to relapse. Finally, new applications of BMT techniques are reviewed (e.g., spouse-involved therapies as the sole treatment for presenting problems in which marital distress is not the primary focus such as anxiety and affective disorders).     

The relationship between the adult attachment and the tendency to judge others as liars

The relationship between 2 dimensions (anxiety and avoidance) of adult attachment and tendency to judge others as liars was examined in this study. We measured 308 participants' adult attachment and tendency to judge others as liars in self‐, other‐, or relationship‐oriented situations. Results supported our hypotheses by showing that (a) anxiety positively predicted the tendency to judge others as liars in self‐oriented situations and (b) avoidance moderated the relationship between anxiety and the tendency to judge others as liars in other‐ and relationship‐oriented situations. Attachment anxiety could positively predict the tendency to judge others as liars only when participants' avoidance was high. Theoretical implications and suggestions for future studies were discussed.     

The Nature of the Association between Anxiety Sensitivity and Pain-Related Anxiety: Evidence from Correlational and Intervention Studies

High anxiety sensitivity (AS) has been associated with elevated pain-related anxiety in anxiety and pain samples. The present study investigated (a) the associations among the lower order dimensions of AS and pain-related anxiety, using a robust measure of AS, and (b) the pain-related anxiety outcomes of a telephone-delivered cognitive behavioural treatment (CBT) designed to reduce high AS. Participants were 80 anxiety treatment-seeking participants with high AS (M age = 36 years; 79% women). After providing baseline data on AS and pain-related anxiety, participants were randomly assigned to an eight-week telephone CBT or a waiting list control. At baseline, bivariate correlations showed AS physical and cognitive, but not social, concerns were significantly associated with pain-related fear and arousal but not escape/avoidance behaviours. Multiple regression revealed that after accounting for emotional distress symptoms, AS physical, but not cognitive or social, concerns uniquely predicted pain-related anxiety. Multilevel modelling showed that the AS-targeted CBT reduced pain-related anxiety and treatment-related changes in global AS and AS physical concerns mediated changes in pain-related anxiety. Results suggest that an AS-targeted intervention may have implications for reducing pain-related anxiety. Further research is needed in a chronic pain sample.     

ERNEST BECKER'S PSYCHOLOGY OF RELIGION FORTY YEARS ON: A VIEW FROM SOCIAL COGNITIVE PSYCHOLOGY

This article distinguishes between three projects in Ernest Becker's (1924–1974) later work: his psychology of “religion,” his psychology of religion, and his psychology of Religion (with a capital R). The first is an analysis of culture and civilization as immortality projects, means by which to deny death. The second, which overlaps with the first, is a characterization of religion‐as‐practiced (e.g., by adherents of the world religions) as a particularly effective immortality project vis‐à‐vis death anxiety. The third is less social scientific and more theological; Becker argues for a view of God that is in the tradition of Søren Kierkegaard and Paul Tillich (and, arguably, Pseudo‐Dionysius, Augustine, and Thomas Aquinas). Focusing on the second of these projects—as much has already been written on the first, and little can be said about the third—this article evaluates Becker's claims about religion‐as‐practiced in light of recent developments in social cognitive psychology.     

Anxiety Disorders in Late Life: Considerations for Assessment and Cognitive-Behavioral Treatment

Anxiety disorders are among the most frequently diagnosed mental disorders in late life. As older adults comprise a growing segment of the population, evidence-based treatments for anxiety disorders in late life have come into sharper focus. Cognitive-behavioral therapy (CBT) for anxiety disorders in late life has received less empirical attention and widespread dissemination relative to other age groups. Increasing older adults’ access to timely assessment and effective treatment can help reduce the personal and societal costs of anxiety disorders. The purpose of this review paper is to discuss important considerations for the assessment of anxiety disorders in older adults and offer adaptations to CBT treatment for this population. As part of assessment considerations, we discuss how physical health conditions, cognitive impairment, and functional limitations can impact anxiety disorder diagnoses with older adults. We also outline validated self-report measures of anxiety disorder symptoms for older adults and highlight the importance of assessing older adults’ suitability for CBT. Several recommendations for adapting CBT protocols for older adults with anxiety disorders are described, such as extending psychoeducation, altered treatment pacing, use of content aids, and medical contraindications for interoceptive exposure. A case study is included that illustrates helpful assessment and treatment adaptions for an older woman with panic disorder. We highlight the pressing need to increase research and dissemination of CBT for anxiety disorders for older adults to meet the needs of an increasing segment of the population worldwide.     

Seeing Is Believing: Using Video Feedback in Cognitive Therapy for Social Anxiety Disorder

Distorted negative self-images and impressions appear to play a key role in maintaining Social Anxiety Disorder (SAD). In previous research, McManus et al. (2009) found that video feedback can help people undergoing cognitive therapy for SAD (CT-SAD) to develop a more realistic impression of how they appear to others, and this was associated with significant improvement in their social anxiety. In this paper we first present new data from 47 patients that confirms the value of video feedback. Ninety-eighty percent of the patients indicated that they came across more favorably than they had predicted after viewing a video of their social interactions. Significant reductions in social anxiety were observed during the following week and these reductions were larger than those observed after control periods. Comparison with our earlier data (McManus et al., 2009) suggests we may have improved the effectiveness of video feedback by refining and developing our procedures over time. The second part of the paper outlines our current strategies for maximizing the impact of video feedback. The strategies have evolved in order to help patients with SAD overcome a range of processing biases that could otherwise make it difficult for them to spot discrepancies between their negative self-imagery and the way they appear on video.     

Computer‐Aided Psychotherapy for Anxiety Disorders: A Meta‐Analytic Review

Computer‐aided psychotherapy (CP) is said to (1) be as effective as face‐to‐face psychotherapy, while requiring less therapist time, for anxiety disorder sufferers, (2) speed access to care, and (3) save traveling time. CP may be delivered on stand‐alone or Internet‐linked computers, palmtop computers, phone‐interactive voice response, DVDs, and cell phones. The authors performed a meta‐analysis of 23 randomised controlled studies (RCTs) that compared CP with non‐CP in anxiety disorders: phobias, n = 10; panic disorder/agoraphobia, n = 9; PTSD, n = 3; obsessive–compulsive disorder, n = 1. Overall mean effect size of CP compared with non‐CP was 1.08 (95% confidence interval: 0.84–1.32). CP and face‐to‐face psychotherapy did not differ significantly from each other (13 comparisons, d = ?0.06). Much caution is needed when interpreting the findings indicating that outcome was unrelated to type of disorder, type of comparison group, mode of CP delivery (Internet, stand‐alone PC, palmtop), and recency of the CP system and that effect size decreased when more therapist time was replaced by the computer. Because CP as a whole was as effective as face‐to‐face psychotherapy, certain forms of CP deserve to be integrated into routine practice.     

Rationale and principles for early intervention with young children at risk for anxiety disorders

Anxiety disorders are one of the most prevalent categories of disorder among adults and children. Children of parents with anxiety disorders are known to be at higher risk for anxiety disorders themselves, with manifestations of this risk often appearing in toddlerhood or early childhood. Yet because affected parents are often unskilled in anxiety management, they often have difficulty in helping their young children learn to manage anxiety. Literature on the course of anxiety disorders through childhood and on effective cognitive-behavioral interventions suggests that preventive interventions even with very young children could potentially be of benefit in mitigating the course of these often debilitating disorders. This paper outlines the rationale for offering early or preventive interventions to preschool-age children at risk and their parents and discusses means of identifying children to target for intervention and the importance of parental involvement. Drawing upon the literature on parental factors in childhood anxiety disorders as well as on effective intervention strategies with preschool-age children, it delineates principles for intervention with parents and effective components of intervention with youngsters in this age range.     

生物反馈疗法对大学生考试焦虑的治疗作用

探讨生物反馈疗法对大学生考试焦虑的治疗作用。在某大学随机抽取学生1500名,采用考试焦虑量表进行筛查,选取焦虑组和对照组各30名。利用生物反馈疗法进行干预,采用脑电α波相对功率、肌电和皮电导联进行检测,每周2次,持续4周。结果表明：1.经过4周的干预,焦虑组干预前后各生理指标存在差异;2.生物反馈疗法干预考试焦虑在疗效上存在性别差异。结论：生物反馈疗法能有效降低大学生考试焦虑水平,对其治疗取得良好的效果。     

Need for closure and reactions to innovation

In two studies using Italian (N = 852) and American (N = 94) samples, we hypothesized that high NFC individuals would have lower intentions to use new technological developments, and that this relationship would be mediated by anxiety about the new technology. We found support for this hypothesis in Study 1, but not Study 2. In the second study, we found that the closed‐mindedness subscale of the full NFC scale was related to greater anxiety about new technology, which in turn led to lower intentions to use the new technology. This suggests that the closed‐mindedness facet of NFC may have been responsible for our results. A meta‐analytic synthesis of both studies provided some support for our original mediation hypothesis.     

Sleep problems,anxiety and cognitive style in school‐aged children

The associations between sleep problems, anxiety, anxiety sensitivity and attributional style were examined in self‐report data from 79 children aged 8–11 years. Total anxiety score was associated with different types of sleep problems (bedtime resistance, sleep anxiety and nightmares). Conversely, total sleep problem score was associated with different sub‐scales of anxiety (from r(78) = 0.15, p = NS to r(79) = 0.47, p < 0.01). Symptoms of anxiety correlated significantly with anxiety sensitivity, but not with attributional style. After controlling for other symptoms of anxiety, school phobias (Beta = 0.26, p < 0.05), the mental incapacitation concerns scale of anxiety sensitivity (Beta = 0.26, p < 0.05), and attributional style (Beta = −0.31, p < 0.01, R² = 0.45) predicted sleep problems. These results suggest that anxiety is associated with a range of sleep problems, and that sleep problems are associated with different types of anxiety. Furthermore, certain cognitive styles are associated with both anxiety and sleep problems and may be good candidates for further research into the association between sleep problems and anxiety in children. Copyright © 2005 John Wiley & Sons, Ltd.     

Mindfulness as a way to cope with COVID‐19‐related stress and anxiety

COVID‐19 brought significant challenges to college students in Spring 2020. Mindfulness‐based interventions might help students cope with COVID‐19‐related stressors in at least three ways: by cultivating attention that is self‐directed rather than reactive to a rapidly changing situation; by teaching the acceptance and regulation of negative thoughts and feelings; and by encouraging individuals to view adverse events non‐judgementally and as opportunities for growth. The purpose of our study was to determine whether Koru Mindfulness (KM), a four‐week, mindfulness‐based group therapy designed for emerging adults, could help students cope with COVID‐19‐related stress and anxiety. Students were assigned to either KM or waitlist at the beginning of the 2020 Spring semester. Assessment of students’ functioning occurred at baseline before the onset of COVID‐19, mid‐semester at the height of the COVID‐19 crisis on campus, and the end of the semester after students had returned home and transitioned to remote learning. After treatment, KM participants reported greater mindfulness and self‐compassion and less stress, anxiety and sleep problems than controls. KM participants also showed superior functioning on performance‐based measures of attention. Most gains were maintained over time. Increased mindfulness mediated the relationship between KM and reductions in stress and anxiety. KM can help students cope with academic and COVID‐19‐related stressors by improving mindfulness.     

Maternal pre‐ and postnatal anxiety and infant temperament. The generation R study

The aim of this study was to investigate whether maternal anxiety that is temporary or chronic during the pre‐ and postnatal period predicts infant temperament. Mothers of 2997 infants in a population‐based birth cohort reported levels of pregnancy‐specific anxiety (Pregnancy Outcome Questionnaire) and general anxiety symptoms (Brief Symptom Inventory) prenatal and at 6 months postnatal. Temperament characteristics were assessed by maternal report using the Infant Behavior Questionnaire—Revised when the infants were 6 months of age. Maternal pregnancy‐specific and general anxiety during the pre‐ and postnatal period were all independently associated with perceived infant temperamental difficulties. Chronically high maternal anxiety predicted the highest perceived infant activity level and negative affectivity. These findings show that different forms of maternal anxiety during both the pre‐ and postnatal period are independently related to perceived temperamental problems in infancy. They also emphasize the significance of chronic maternal anxiety for infant mental health. Copyright © 2009 John Wiley & Sons, Ltd.     

Episode Type,Attachment Orientation,and Frame Salience: Evidence for a Theory of Relational Framing

Relational framing theory asserts that dominance‐submission and affiliation‐disaffiliation tend to displace each other as frames for processing social interaction; involvement is argued to be a content‐free intensifier variable that contributes to judgments of dominance or affiliation as a function of the salient relational frame. The present study seeks to replicate and extend previous tests of these claims by evaluating three hypotheses: (a) The differential salience of dominance‐submission and affiliation‐disaffiliation frames as a function of the type of social episode is robust across same‐sex and cross‐sex friendship dyads; (b) the magnitude of the association between involvement and dominance and affiliation varies as a function of frame salience instantiated by the type of episode; and (c) attachment anxiety is positively correlated with the perceived relevance of both dominance‐submission and affiliation‐disaffiliation to social episodes. Results are consistent with all three of the hypotheses, but relational framing is unrelated to subscales operationalizing the comfort with closeness dimension of attachment orientation.     

Relationship between self‐worrying and self‐critical messages in clients with generalised anxiety engaging in emotion‐focused worry dialogues

Emotion‐focused therapy (EFT) has recently been adapted as a treatment for generalised anxiety disorder (GAD). One intervention used in this adaptation is a worry dialogue, in which the client enacts worry in one chair (“worrier”) and is facilitated to experience the impact of this worry in another chair (“experiencer”). Although not formally studied, anecdotal observations from therapists in the EFT for GAD treatment development study suggested that within worry dialogues there might be a link between client's self‐worrying and self‐critical messages. This study used data from 47 worry dialogues from fourteen study clients who received EFT for GAD. An observation based qualitative analysis of clients' self‐directed messages as present in in‐session worry dialogues was conducted using video/audio recordings of relevant sessions. Results indicate a relationship between self‐worrying and self‐critical messages. A total of 90 paired self‐worry and self‐critic messages across the 47 worry dialogues were logged. Six recurring clusters of themes/relationships were observed: (a) I need to be prepared for future negative events because… I'm weak and a failure; (b) I need to stop worrying… I'm flawed for being a worrier; (c) People will negatively judge me if I engage with them… because I'm not good enough; (d) If I don't worry, there will be negative consequences… and I will be responsible and will be unable to bear it; (e) I worry/ruminate that I cause(d) some damage… because I'm incompetent; and, (f) I must always be prepared against others taking advantage of me… because I'm weak. Given the observed close link between self‐critical and worry processes, it is important that therapists differentiate between these processes and remember to address both in therapy for GAD.     

Dropping Safety Aids and Maximizing Retrieval Cues: Two Keys to Optimizing Inhibitory Learning During Exposure Therapy

The inhibitory learning model of exposure therapy posits that clinical anxiety is most effectively treated when clinicians employ strategies that maximize the (a) violation of negative expectancies and (b) generalization of nonthreat associations. Translation of basic learning research to exposure therapy via this explanatory model underscores two keys to optimizing inhibitory learning during exposure: dropping safety aids and maximizing retrieval cues. Although topographically similar, safety aids and retrieval cues are functionally distinct as well as therapeutically incompatible. In the present article, we delineate safety aids and retrieval cues in the context of exposure therapy from an inhibitory learning perspective, providing illustrative case examples of how clinicians may address the two when treating patients with clinical anxiety.     

Automatic thoughts and meta‐cognition as predictors of depressive or anxious symptoms: A prospective study of two trajectories

The purpose of this prospective study was to explore the Automatic Thought Questionnaire Negative (ATQ‐30‐N) and the Meta‐cognitions Questionnaire (MCQ‐30) as predictors in the development of depressive or anxious symptoms. A sample (N = 201) completed the ATQ‐30‐N, MCQ‐30, and the Hopkins Symptom Checklist‐25 (HSCL‐25) twice with a three month interval. The HSCL‐25 measures both depressive and anxiety symptoms. Separate multiple hierarchical regression analyses indicated that the ATQ‐30‐N was a positive predictor for levels of depressive symptoms, while the MCQ‐30 was a predictor of both levels of anxiety and depressive symptoms, at follow‐up, when controlling for gender, age and pre‐test levels of symptoms. However, the MCQ‐30 did not predict future levels of depressive symptoms, when levels of automatic negative thoughts measured by the ATQ‐30‐N were statistically controlled for. The findings suggested that the ATQ‐30‐N predicts future levels of depressive symptoms, while the MCQ‐30 primarily predicts future levels of anxiety.