Interpretation bias and social anxiety: does interpretation bias mediate the relationship between trait social anxiety and state anxiety responses?

Two studies aimed to examine whether high socially anxious individuals are more likely to negatively interpret ambiguous social scenarios and facial expressions compared to low socially anxious individuals. We also examined whether interpretation bias serves as a mediator of the relationship between trait social anxiety and state anxiety responses, in particular current state anxiety, bodily sensations, and perceived probability and cost of negative evaluation pertaining to a speech task. Study 1 used ambiguous social scenarios and Study 2 used ambiguous facial expressions as stimuli to objectively assess interpretation bias. Undergraduate students with high and low social anxiety completed measures of state anxiety responses at three time points: baseline, after the interpretation bias task, and after the preparation for an impromptu speech. Results showed that high socially anxious individuals were more likely to endorse threat interpretations for ambiguous social scenarios and to interpret ambiguous faces as negative than low socially anxious individuals. Furthermore, negative interpretations mediated the relationship between trait social anxiety and perceived probability of negative evaluation pertaining to the speech task in Study 1 but not Study 2. The present studies provide new insight into the role of interpretation bias in social anxiety.     

Does anxiety sensitivity predict symptoms of panic, depression, and social anxiety?

This study examined whether the lower-order factors of the Anxiety Sensitivity Index (ASI) exhibited specificity in predicting symptoms of panic, depression, and social anxiety prospectively. This question was addressed using a sample of undergraduates stratified to represent low, medium, and high levels of anxiety sensitivity (AS). It was hypothesized that the physical concerns, mental concerns, and social concerns subscales of the ASI would predict increases in panic, depression, and social anxiety symptoms, respectively, one year later. Results found that the physical concerns subscale predicted increases in both panic and depressive symptoms. Neither the mental concerns nor the social concerns subscales predicted significant variance in any of the Time 2 symptoms. Theoretical implications of these data for AS are discussed.     

The state-trait anxiety inventory, trait version: does it really measure anxiety?

To clarify what is actually measured by the trait version of the State-Trait Anxiety Inventory (STAI; Spielberger, Gorsuch, & Lushene, 1970), we conducted a confirmatory factor analysis of various models and evaluated convergent and discriminant validity. The best fit was obtained with both a bifactor model, comprising 2 specific factors plus a general factor, and a 1-construct, 2-method model. The total score and the 2 method subscales of the STAI trait version were more strongly correlated with depression than with anxiety. In the bifactor model with 2 specific factors, the depression subscale showed stronger correlations with measures of depression than with measures of anxiety. The correlation of the hypothetical anxiety subscale with measures of depression was equivalent to or higher than its correlation with measures of anxiety. These results suggest that the questionnaire does not strictly evaluate anxiety but, rather, negative affect.     

Pain anxiety among chronic pain patients: specific phobia or manifestation of anxiety sensitivity?

Rather than viewing anxiety among chronic pain patients as simply a component of negative affectivity, investigators have developed a model of "pain anxiety" in which patients develop fear and avoidance of activity linked to pain. We examined whether pain anxiety can be conceptualized as a specific phobia, or whether evidence supported the notion that pain anxiety is better understood as a manifestation of anxiety sensitivity in the context of chronic pain. Chronic musculoskeletal pain patients (N=70) underwent cold pressor and mental arithmetic tasks while cardiovascular, self-report, and behavior indexes were recorded. They completed measures of pain anxiety, anxiety sensitivity, fear of negative evaluation, depression and trait anxiety. Correlation analyses showed pain anxiety was related to pain-relevant responses during cold pressor, but it was also related to evaluation-relevant responses during cold pressor, and to pain- and evaluation-relevant responses (including subtraction accuracy) during mental arithmetic. Regression analyses showed that almost all effects of pain anxiety on task responses were accounted for by anxiety sensitivity. Fear of negative evaluation, in contrast, correlated only with evaluation-relevant responses, and mostly during mental arithmetic. These effects remained significant when depression, trait anxiety, or anxiety sensitivity were statistically controlled. Pain anxiety may be an expression of anxiety sensitivity rather than a circumscribed phobia; a distinction that could profitably guide treatment strategies.     

The age of anxiety? Birth cohort change in anxiety and neuroticism, 1952-1993

Two meta-analyses find that Americans have shifted toward substantially higher levels of anxiety and neuroticism during recent decades. Both college student (adult) and child samples increased almost a full standard deviation in anxiety between 1952 and 1993 (explaining about 20% of the variance in the trait). The average American child in the 1980s reported more anxiety than child psychiatric patients in the 1950s. Correlations with social indices (e.g., divorce rates, crime rates) suggest that decreases in social connectedness and increases in environmental dangers may be responsible for the rise in anxiety. Economic factors, however, seem to play little role. Birth cohort, as a proxy for broad social trends, may be an important influence on personality development, especially during childhood.     

Is the state-trait anxiety inventory multidimensional?

The factor structure of the State-Trait Anxiety Inventory (STAI) was investigated to determine whether the STAI State and Trait Anxiety scales were multidimensional. The STAI (Form Y) was administered to a heterogeneous sample of Air Force recruits (N = 1728); the scores for all 40 STAI items were factor-analyzed together, using the principal axis method and varimax rotation. Two- and four-factor solutions were found to be equally good in simple structure and psychological meaningfulness. Clearly defined state and trait anxiety factors were found in the more parsimonious two-factor solution. In the four-factor solution, the factors were: State Anxiety-Present, State Anxiety-Absent, Trait Anxiety-Present and Trait Anxiety-Absent. Using Cattell's (1966) confactor method, these factors were found to be congruent with similar factors previously identified for high school students by Spielberger et al. (1980). The anxiety-present and anxiety-absent factors were interpreted as reflecting either ‘item method’ variance or ‘item-intensity specificity’. There was no evidence in the present study that the STAI scales were multidimensional in terms of item content.     

Health anxiety,anxiety sensitivity,and attentional biases for pictorial and linguistic health‐threat cues

The study investigated attentional biases for pictorial and linguistic health‐threat stimuli in high and low health anxious individuals, who were selected from the upper and lower quartile ranges of a normal sample using a screening measure of health anxiety. Attentional bias was assessed using a visual probe task which presented health‐threat and neutral pictures and words at two exposure durations, 500 ms and 1250 ms. The prediction that the high health anxious group would show a greater attentional bias for health‐threat cues than the low health anxious group was not supported despite the groups being well‐differentiated on a general measure of health anxiety, the Illness Attitudes Scale (IAS). Instead, the results indicated that individuals with high levels of anxiety sensitivity showed a significantly greater initial attentional bias for threat pictures compared with those with low anxiety sensitivity, as assessed by the Anxiety Sensitivity Index (ASI).     

Test anxiety,anxiety disorders,and school-related wellbeing: Manifestations of the same or different constructs?

Previous studies have shown that highly test anxious persons are more likely to meet criteria for an anxiety disorder and report more frequent symptoms of anxiety disorders than their low test anxious counterparts. However, it is unclear whether test anxiety should be treated as distinct to, or a manifestation of, anxiety disorders. Furthermore, the Dual Factor Model of Mental Health proposes that high subjective wellbeing cannot be solely inferred from the absence of psychopathology. To date, no studies have examined the Dual Factor Model in relation to test anxiety. In the present study, we examined how test anxiety, two common anxiety disorders (i.e., generalized anxiety disorder [GAD] and panic disorder [PD]), and subjective wellbeing in the school domain (i.e., school-related wellbeing) were related in a sample of 918 adolescents (M age = 15.77 years) using network analysis and latent profile analysis. Results from the network analysis indicated that test anxiety, GAD, PD, and school-related wellbeing were represented as distinct constructs. Bridge nodes were identified that linked test anxiety with GAD, PD, and school-related wellbeing. The latent profile analysis identified three of the four profiles predicted by the Dual Factor Model, including (a) troubled (i.e., low school-related wellbeing, high test anxiety, GAD, and PD), (b) complete mental health (i.e., high school-related wellbeing, low test anxiety, GAD, and PD), and (c) symptomatic but content (i.e., average school-related wellbeing, test anxiety, GAD, and PD). We concluded that test anxiety was distinct from, rather than a manifestation of, GAD and PD. We found support for the Dual Factor Model, albeit not unequivocal, using test anxiety as an additional indicator of psychopathology to that of GAD and PD.     

Is anxiety sensitivity distinguishable from trait anxiety? Reply to Lilienfeld, Jacob, and Turner (1989)

Lilienfeld, Jacob, and Turner (1989) questioned the conceptual and empirical distinction between anxiety sensitivity and trait anxiety, and suggested that results attributed to anxiety sensitivity are more parsimoniously explained by trait anxiety. In the present article, I clarify the theoretical distinction between these constructs, and provide further data that support this distinction.     

Why worry? The cognitive function of anxiety

The phenomenon of worry is considered to arise from cognitive processes involved in anxiety, that serve to maintain high levels of vigilance for personal danger. Rather than rely on self-report alone, the research described here draws on information processing methodology, to investigate this hypothesized cognitive function. Evidence is summarized to show that anxious subjects selectively attend to threatening information, and interpret ambiguous events in a relatively threatening way. However, the evidence on memory suggests that although such information may be easily activated, it is not necessarily more accessible. The allocation of attentional priority to threatening information is seen as a characteristic of anxious (rather than depressed) mood, while the ease with which this processing mode is adopted may underlie trait anxiety and vulnerability to anxiety disorders.     

Does high state anxiety exacerbate distractor interference?

Attentional Control Theory states that anxiety can cause attention to be allocated to irrelevant sources of information by hindering the ability to control attention and focus on the information that matters. In a separate line of inquiry, action-centred views of attention state that non-target distractors involuntarily activate response codes that may cause interference with target-directed movements (distractor interference effect). Due to the proposed negative effects of anxiety on attentional control, we examined whether anxiety could also modulate distractor interference. Participants executed target-directed aiming movements to one of three targets with the potential of a distractor being presented at near or far locations. Distractors were presented at different times with respect to the target presentation in order to explore the excitatory (0, −100 ms) and inhibitory (−850 ms) processing of the distractor. As a broad indication of the effect of anxiety, the analysis of no distractor trials indicated a lower proportion of time and displacement to reach peak velocity under high compared to low anxiety conditions. Meanwhile, the typical excitatory influence of the distractors located near, compared to far, at a short distractor-onset asynchrony was found in movement time and overall response time. However, this distractor excitation was even greater under high compared to low anxiety in the reaction time component of the response. These findings broadly implicate the attentional control perspective, but they further indicate an influence of anxiety on the excitation rather than inhibition of responses.     

Does anxiety lead to selective processing of threat-related information?

Four experiments investigating the detailed nature of the attentional bias in anxiety are reported. Previous research using the Stroop task has shown that, when compared with non-patient controls, anxious patients are relatively slower at colour naming threat-related words than non-threat words. Experiments One and Two investigated whether this apparent attentional bias is a function of anxiety per se and/or is related to patient/non-patient status. Experiment One compared colour-naming times for threat and non-threat words in low, medium and high trait anxiety normal subjects. High anxiety was not associated with slower colour-naming times for threat words. Experiment Two compared generalized anxiety disorder patients with equally anxious non-patients and found that the patients were significantly slower at colour-naming threat words. Read aloud and dwell tasks were also included in these experiments in order to identify the mechanism of Stroop interference. Experiments Three and Four investigated whether anxious patients' attentional bias is specific to threat-related material or also extends to certain positive, emotional material. In Experiment Three words used in previous Stroop studies were rated for emotionality. Threat words were more emotional, as well as more threatening, than control words, indicating that previous studies have confounded threat and emotionality. Experiment Four compared colour-naming times for threat words, equally emotional positive words, and neutral words. Consistent with the emotionality hypothesis, generalized anxiety disorder patients were slower than non-anxious controls at colour naming both threat words and positive words. The theoretical, methodological and clinical implications of these results are discussed.     

Does sex moderate the relationship between anxiety and pain?

Objectives : Sex differences exist in the relationship between anxiety and pain, although findings are mixed. One reason could be because a number of anxiety measures have been used. Therefore, this study aimed to identify the core components within commonly used pain anxiety measures, and see whether these components are differentially related to sensation and pain thresholds in men and women.

Design, main outcome measures : One hundred and eighty-nine healthy adults (119 female) completed the Fear of Pain Questionnaire, Pain Catastrophising Scale, Pain Anxiety Symptoms Scale, Anxiety Sensitivity Index-3 and the Depression Anxiety Stress Scale. Thermal sensation and pain thresholds, mechanical sensation and pressure pain thresholds were also collected.

Results : A Principal Components Analysis of anxiety measures revealed three constructs: general distress, cognitive intrusion and fear of pain from injury/insult. Sex did not moderate the relationship between these anxiety constructs and sensation/pain thresholds. However, a significant main effect of sex was found to predict thermal pain thresholds.

Conclusion : Preliminary indications suggest that pain anxiety dimensions can be reduced to three core constructs, and used to examine pain sensation. However, sex did not moderate this relationship. Further research is required to establish the extent and strength of sex differences in the relationship between anxiety and pain.     

Negative self‐imagery in social anxiety contaminates social interactions

Patients with social phobia report experiencing negative images of themselves performing poorly when in feared social situations. The present study investigates whether such negative self‐imagery (based on memory of past social situations) contaminates social interactions. High socially anxious volunteers participated in two conversations with another volunteer (conversational partner). During one conversation, the socially anxious volunteers held in mind a negative self‐image, and during the other they held in mind a less negative (control) self‐image. As predicted, when holding the negative image the socially anxious volunteers felt more anxious, reported using more safety behaviours, believed that they performed more poorly, and showed greater overestimation of how poorly they came across (relative to ratings by the conversational partner). Conversational partners rated the socially anxious volunteers' performance as poorer in the negative image condition. Furthermore, the conversation was contaminated since both groups of participants rated its quality as poorer in the negative image condition.     

Social anxiety and attentional biases: A top-down contribution?

Selective attention toward threatening facial expressions has been found to precipitate and maintain symptoms of social anxiety. However, the automaticity of this bias is under debate. In the present study, we aimed to test whether top-down (controlled) engagement and disengagement of attention toward threatening faces is associated with social anxiety. This was examined by testing the impact of a secondary working memory (WM) load on attentional biases. In a variation of the dot-probe task, participants’ attention was initially cued to the left or right of fixation before an upright face paired with an inverted face was presented (displaying a disgust or neutral expression), and participants responded to a subsequently presented probe. The task was performed under no-load, low-load (one-digit memory task), and high-load (six-digit memory task) conditions. Social anxiety was not found to be associated with delayed disengagement from threat. However, surprisingly, high social anxiety was associated with an engagement bias away from threat, whereas low social anxiety was associated with a bias toward threat. These results were unaffected by the WM load manipulation. This indicates that engagement with threatening facial expressions has minimal contributions from top-down mechanisms, since it is likely that orienting to facial expressions occurs relatively automatically.     

Does the social concerns component of the anxiety sensitivity index belong to the domain of anxiety sensitivity or the domain of negative evaluation sensitivity?

The present study utilized an exploratory factor-analytic approach (i.e. principal-components analysis; PCA) to investigate whether the Social Concerns component of the Anxiety Sensitivity Index (ASI [Peterson, R. A., & Reiss, S. (1992). Anxiety Sensitivity Index manual (2nd ed.). Worthington, OH: International Diagnostic Systems.]) is best conceptualized as belonging to the domain of anxiety sensitivity (AS) and/or the domain of negative evaluation sensitivity (NES). A sample of university students (N = 216) was administered measures of both NES (i.e. Brief Fear of Negative Evaluation scale; Leary, 1983) and AS (i.e. ASI). Participants' responses to the items comprising these measures were subjected to a PCA with oblique rotation. Factors representing the NES construct and the three lower-order AS constructs (i.e. AS Physical, Psychological and Social Concerns) were obtained. Subscales derived from these four factors were positively and significantly correlated with one another and loaded on a single higher-order factor labeled Threat Sensitivity. Thus, the present findings suggest that the AS Social Concerns factor is distinct from NES and the other lower-order components of AS. However, correlational analyses and higher-order PCA indicated that the AS Social Concerns factor taps a blend of AS and NES as well as something unique and distinct from both global AS and NES.