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.     

Predictors of Self-Reported Anxiety and Panic Symptoms: An Evaluation of Anxiety Sensitivity, Suffocation Fear, Heart-Focused Anxiety, and Breath-Holding Duration

The purpose of this study was to examine the extent to which anxiety-related individual difference variables predict anxious responding when individuals experience aversive bodily sensations. Thus, we explore several psychological and behavioral predictors of response to a single 25-sec inhalation of 20% carbon dioxide-enriched air in 70 nonclinical participants. Predictor variables included anxiety sensitivity, suffocation fear, heart-focused anxiety, and breath-holding duration. Multiple regression analyses indicated that only anxiety sensitivity significantly predicted postchallenge panic symptoms, whereas both anxiety sensitivity and suffocation fear predicted postchallenge anxiety. These data are in accord with current models of panic disorder that emphasize the role of fear of fear in producing heightened anxiety and panic symptoms and help clarify specific predictors of anxiety-related responding to biological challenge.     

Twenty-five Years of Research on Childhood Anxiety Disorders: Publication Trends Between 1982 and 2006 and a Selective Review of the Literature

We examined trends in publications on childhood anxiety disorders over the past 25 years. A PsycINFO search was carried out to find relevant research articles published between 1982 and 2006. Results indicated a gradual and significant rise in the frequency of publications on childhood anxiety disorders during the past 25 years, and this increase was particularly strong for post-traumatic stress disorder, obsessive–compulsive disorder, social phobia, and multiple anxiety disorders. Most studies concerned the phenomenology of childhood anxiety disorders (i.e., >50%). Considerable less research has been conducted on the etiology, intervention, and assessment of these disorders in youths. Nevertheless, the conclusion seems warranted that the research on childhood anxiety disorders has made significant advancements during the past decades. This notion is supported by a selective review of the literature, which highlights important developments in this field of study.     

Dimensions of Perfectionism and Anxiety Sensitivity

The current study investigated the extent to which dimensions of perfectionism are associated with components of the anxiety sensitivity construct. A sample of 177 undergraduate students completed the Multidimensional Perfectionism Scale, the Perfectionism Cognitions Inventory, the Perfectionistic Self-Presentation Scale, and the Expanded Anxiety Sensitivity Index developed by Taylor and Cox (1998). The results confirmed that automatic thoughts involving perfectionism and the interpersonal aspects of the perfectionism construct are associated with anxiety sensitivity. Examination of the Anxiety Sensitivity Index factors showed that perfectionism cognitions were associated primarily with anxiety sensitivity involving fears of cognitive dyscontrol, while socially prescribed perfectionism and perfectionistic self-presentation were associated primarily with fears of publicly observable anxiety reactions in a manner suggesting that the interpersonal perfectionism dimensions are linked closely with an anxious sensitivity to negative social evaluation and subsequent panic attacks. The theoretical and treatment implications of the link between perfectionism and anxiety sensitivity are discussed.     

Assessment of Disgust Sensitivity in Children With an Age-Downward Version of the Disgust Emotion Scale

The present study examined the psychometric properties of the Disgust Emotion Scale for Children (DES-C). Principal components analysis of the DES-C data revealed five factors reflecting disgust toward (a) rotting foods, (b) injection and blood, (c) odors, (d) mutilation and death, and (e) animals, which were largely in keeping with the intended subscales. The DES-C showed good reliability, excellent convergent validity (as established by correlations with an alternative self-report index of disgust), fairly good predictive validity (as assessed by correlations with measures of fear/anxiety and a behavioral index of disgust), and acceptable parent–child agreement (in particular with the mothers). Importantly, the DES-C proved to perform better on some psychometric indicators than an age-downward version of the Disgust Scale. These findings indicate that the DES-C should be regarded as the preferred scale for measuring disgust sensitivity and its role in the etiology and maintenance of anxiety problems in children.     

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.     

Replication and Extension of a Hierarchical Model of Social Anxiety and Depression: Fear of Positive Evaluation as a Key Unique Factor in Social Anxiety

Wang, Hsu, Chiu, and Liang (2012, Journal of Anxiety Disorders, 26, 215–224) recently proposed a hierarchical model of social interaction anxiety and depression to account for both the commonalities and distinctions between these conditions. In the present paper, this model was extended to more broadly encompass the symptoms of social anxiety disorder, and replicated in a large unselected, undergraduate sample (n = 585). Structural equation modeling (SEM) and hierarchical regression analyses were employed. Negative affect and positive affect were conceptualized as general factors shared by social anxiety and depression; fear of negative evaluation (FNE) and disqualification of positive social outcomes were operationalized as specific factors, and fear of positive evaluation (FPE) was operationalized as a factor unique to social anxiety. This extended hierarchical model explicates structural relationships among these factors, in which the higher-level, general factors (i.e., high negative affect and low positive affect) represent vulnerability markers of both social anxiety and depression, and the lower-level factors (i.e., FNE, disqualification of positive social outcomes, and FPE) are the dimensions of specific cognitive features. Results from SEM and hierarchical regression analyses converged in support of the extended model. FPE is further supported as a key symptom that differentiates social anxiety from depression.     

Depression and Anxiety: Integrating the Tripartite and Cognitive Content-Specificity Assessment Models

The cognitive content-specificity hypothesis proposes that depression and anxiety can be discriminated on the basis of unique cognitive profiles. Alternatively, the Tripartite model suggests that, although depression and anxiety share a general distress factor, anhedonia is a characteristic of depression with anxious arousal a characteristic of anxiety. Past research devoted to integrating these two models has been limited in a number of ways. To remedy these limitations, this study attempted to assess the complete Tripartite model and used a multidimensional cognitive assessment tool to handle the heterogeneity of anxious cognitive content. Results on data collected from 411 clients seeking services at a university counseling center suggested that a one-to-one mapping between Tripartite dimensions and cognitive content was possible. Further, variables from each model simultaneously explained unique variance in depression and anxiety ratings.     

状态焦虑对条件恐惧习得和消退的影响

采用44名正常女性大学生作为被试, 通过心理社会压力暴露的方法诱发焦虑组被试的状态焦虑, 采用主观预期值作为指标, 考察焦虑对条件恐惧习得和消退的直接影响, 并探讨这种影响是否也表现在评价性条件作用上。结果表明：心理社会压力暴露显著提高了焦虑组被试的状态焦虑。在习得阶段, 状态焦虑降低了被试对条件刺激的辨别条件恐惧反应, 具体而言, 状态焦虑降低了被试对CS+的主观预期值, 但是却提高了对CS?的主观预期值; 在消退阶段, 状态焦虑抑制了被试对条件刺激的消退。状态焦虑的影响也表现在评价性条件作用上, 和控制组相比, 焦虑组在习惯化和消退阶段对条件刺激表现出了更为负性的效价评定。     

The Beck Anxiety Inventory in Older Adults With Generalized Anxiety Disorder

The authors investigated the psychometric properties of the Beck Anxiety Inventory (BAI) in a sample of 75 older generalized anxiety disorder (GAD) patients and a comparison group of 32 older adults without significant psychopathology. Internal consistency was above .80, and the BAI showed evidence of convergent validity in both groups. Evidence for discriminant validity with respect to measures of depression was weaker. Two items, fearing the worst and nervousness, correctly distinguished 86.5% of patients with GAD and 93.8% of the normal controls. Medical comorbidity was associated with somatic but not cognitive anxiety symptoms in the normal older sample. Overall, results indicate the limitations of the BAI in assessing anxiety symptoms in older adults and suggest the need for use of an instrument focusing on cognitive aspects of anxiety.     

The Anxiety of Strangers and the Fear of Enemies

In this paper I use a distinction between the "anxiety of strangers" and the "fear of enemies" to show how uncertainty and tension experienced in the face of what is other and different need not lead to a nationalist insularity, but can be the occasion for an existential philosophical education - an education in which the resolute acceptance of strangeness allows us to reflect on our taken-for-granted about the everyday.     

线上社交焦虑:社交媒体中的人际负性体验

线上社交焦虑指个体在社交媒体交往情境中感知到的紧张和恐惧等人际负性体验,包含隐私担忧、交往焦虑和负面评价恐惧三个方面。线上社交焦虑可以通过质性分析法、实验诱发法和问卷测量法进行研究。线上社交焦虑既会受到社交媒体自身特点、个体特征因素、网络欺凌和文化因素的影响,还会对个体的心理与行为产生后效。未来研究者需要开发有效的本土化测量工具、探索其形成和作用机制、关注线上社交焦虑悖论以及推动对其干预。     

Enduring without avoiding: Pauses and verbal dysfluencies in public speaking fear

Direct measures of overt behavior have been underutilized in speech and other social fear, anxiety, and phobia research. This study demonstrates the usefulness of such variables in the evaluation of public speaking fear. A molecular behavioral assessment methodology was used to examine pauses and verbal dysfluencies of individuals with circumscribed speech fear (n=8) or general social anxiety (n=8), as well as nonanxious control participants (n=16), during an impromptu speech behavior test. Speech fear and generally social anxious individuals paused more often and for a longer duration than the nonanxious group. Results also indicated greater increases in state anxiety during the speech in the circumscribed speech fear sample, relative to the generalized social anxiety and control groups. Taken together with other research, these findings provide evidence that circumscribed speech fear is a meaningful subtype and can be independent of generalized social anxiety. The utility of measuring pausing and verbal dysfluencies in the behavioral assessment of speech fear and other social anxiety and phobia is discussed.     

负面评价恐惧对社交焦虑的影响:基于社交焦虑的认知行为模型

在社交焦虑认知行为模型的理论视角下，本研究拟探讨负面评价恐惧、不确定性容忍度和依赖型自我构念对社交焦虑的影响及其作用机制。以424名大学生为被试，使用问卷调查法的研究结果表明：（1）负面评价恐惧对社交焦虑有显著预测作用，且不确定性容忍度在这一关系中的中介作用显著；（2）不确定性容忍度的间接效应受到依赖型自我构念的调节。具体而言，该中介效应在高依赖型自我构念群体中更为显著。本研究结果不仅有助于揭示负面评价恐惧对社交焦虑的影响及其作用机制，而且对社交焦虑的预防和干预也有一定的理论和实践指导价值。     

大学生评价恐惧在自尊与社交焦虑间的中介效应分析

为探讨评价恐惧在自尊与社交焦虑间的作用,本研究采用正向评价恐惧量表、负向评价恐惧量表、自尊量表、社交互动焦虑量表,以大学生作为研究对象进行问卷调查,得到655份有效问卷。研究结果表明:(1)正向评价恐惧量表在本研究大学生样本中具有良好的信、效度。(2)正向评价恐惧、负向评价恐惧在自尊与社交焦虑间起着部分中介作用,中介效应值为47.17%,即自尊一方面直接影响社交焦虑,另一方面通过负向评价恐惧、正向评价恐惧影响社交焦虑。     

Predictive Relationship Between Parental Beliefs and Accommodation of Pediatric Anxiety

Behavior performed by parents to assist a youth in avoiding or alleviating anxiety, known as accommodation, is ubiquitous among pediatric anxiety disorders and strongly related to poor treatment outcome. According to cognitive-behavioral theory, the beliefs parents hold regarding accommodation should predict parental accommodating behavior. Unfortunately, little is known about the beliefs parents hold regarding accommodation, as there exists no validated measure of this construct. First, the psychometric properties were examined for the Parental Accommodation Scale (PAS), a novel measure of parental accommodating behavior frequency (PAS-Behavior scale) and parental beliefs about accommodation (PAS-Belief scale). Second, the relationship between parental beliefs about accommodation and accommodation frequency was examined. Results provide preliminary evidence of the internal consistency and convergent validity of the PAS. Stronger positive beliefs about accommodation significantly predicted accommodation frequency, even after controlling for youth anxiety severity. Specifically, beliefs that accommodation prevents youth from losing behavioral and emotional control significantly predicted accommodation frequency. Therefore, efforts to decrease accommodation in clinical settings should involve correcting maladaptive parental beliefs about accommodation, with a particular emphasis on beliefs regarding the necessity of accommodation in preventing a youth from losing behavioral and emotional control.     

Smart-Glass Guided Exposure for Anxiety Disorders: A Proof-of-Concept Study

Exposure is a highly effective treatment for pathological fear and anxiety, but rarely used in routine care. Issues of practicability and lack of therapists in rural areas are main barriers for the dissemination of exposure. Smartglass devices may enable therapists to guide exposure from their own office via real-time feedback and may thereby increase practicability. The present study explored the technological usability and clinical feasibility of Smartglass-guided exposure in a behavioral approach test in spider-fearful individuals (N = 40).Fearful individuals were asked to start the Smartglass themselves and established a connection to a therapist, who guided the exposure test from afar. Clinical severity of spider fear was assessed via questionnaire. Technological usability was assessed with established measures of usability, user experience, and user acceptance. Exploratory, individual characteristics of exposure were collected (e.g., within-session fear reduction, duration, safety behavior).Overall, fearful individuals (94.9%) and therapists (100%) were able to establish a connection. Usability of Smartglass-guided exposure was evaluated as positive. Within-session fear reduction was large (d = 1.91). Adverse events were minimal. There were, however, some associations between exposure characteristics and usability evaluation (e.g., lower user-friendliness and exposure duration). Two case examples further highlight chances and risks of Smartglass-guided exposure.These findings provide first evidence that Smartglass-guided exposure could be useful in exposure therapy. Smartglass-guided exposure may ultimately help to increase practicability of exposure and increase dissemination, also in rural areas. These findings are promising for future research on the long-term outcome of evidence-based exposure in treatment seeking patients.     

The Assessment of Normal Fear in Children and Adolescents

Published research into normal fear now spans more than one century. During this time, a large number of papers have been published in the area. The resulting literature has led to a detailed understanding of normal fear experiences and, in particular, the ways in which they change with maturation. Of central importance, when evaluating the documented outcomes of this work, is the soundness of the methods and tools used in assessment. It is not surprising given the large number of researchers that have been involved in this area, that the assessment methods used have varied substantially. These have ranged from the methodologically problematic technique of obtaining retrospective adult reports to the administration of psychometrically validated fear survey schedules. An extensive review of this literature reveals that, for the last two decades, the fear survey schedule has been the most widely used technique for the fear assessment. The preference that has and is being demonstrated for the fear survey schedule as an assessment tool is most likely due to its many advantages including ease of use, objectivity in scoring, and provision of a substantial amount of information in a short period. However, despite its advantages, researchers and clinicians need to be cognizant of its potential limitations and, depending on the questions being asked, may need to consider using it in combination with alternative assessment strategies.     

Questionnaire Assessment Potentially Overestimates Anxiety in Parkinson's Disease

Assessment of anxiety in Parkinson's disease (PD) is complicated by symptoms, such as trembling and shaking, that the two disorders have in common. This symptom overlap produces a potential for overestimation of the rate and severity of anxiety when assessed by self-report questionnaire. The purpose of this study is to estimate the extent to which anxiety scores in PD patients might be overestimated by two commonly-used mood state questionnaires. Fifty-nine patients with PD were administered the Beck Anxiety Inventory and the Profile of Mood States. Results indicate that the rate of clinically significant anxiety on these measures is indeed higher than the rate of clinical anxiety as determined by interview alone, suggesting the potential for overestimation of anxiety in PD when using self-report questionnaires.     

Relations Among Children's Coping Strategies and Anxiety: The Mediating Role of Coping Efficacy

The current study tests a model that depicts the relationships among coping strategies (active, distraction, avoidance, and support seeking) and anxiety symptoms. SEM is used to test if the relationship between these variables is mediated by coping efficacy. A large sample of Canadian children (N = 506) aged 8 to 11 years (boys = 249, girls = 245, unknown gender = 12) participated in the study. Results showed that coping efficacy is a partial mediator of the relations between active coping strategies and anxiety symptoms, however support was not found for it to be an effective mediator for other coping strategies. This study contributes to the understanding of childhood anxiety by highlighting the importance of the relationship between anxiety and the methods children use to cope with stress and how perceptions of their coping abilities influence this relationship.