Anxiety sensitivity as a specific and unique marker of anxious symptoms in youth psychiatric inpatients

We addressed several questions regarding the relation of anxiety sensitivity to anxious symptoms among 47 youth psychiatric inpatients (18 boys, 29 girls), ages 9–17 (M = 14.23, SD = 1.89). Participants completed measures of anxiety sensitivity, anxious and depressive symptoms, trait anxiety, and positive and negative affect; chart diagnoses were available. Consistent with hypotheses, we found that (a) anxiety sensitivity was associated with anxious symptoms, even controlling for trait anxiety and depressive symptoms; and (b) anxiety sensitivity displayed symptom specificity to anxious versus depressive symptoms (i.e., was associated with anxiety controlling for depression but not with depression controlling for anxiety). Furthermore, regarding factors of anxiety sensitivity, we obtained mixed support for our prediction that phrenophobia would be associated with both depression and anxiety, whereas fear of physical arousal would be associated with anxiety but not depression. Implications for the construct validity of anxiety sensitivity were discussed.     

Loneliness and Negative Affective Conditions in Adults: Is There Any Room for Hope in Predicting Anxiety and Depressive Symptoms?

This study examined the role of hope in understanding the link between loneliness and negative affective conditions (viz., anxiety and depressive symptoms) in a sample of 318 adults. As expected, loneliness was found to be a significant predictor of both anxiety and depressive symptoms. Noteworthy, hope was found to significantly augment the prediction of depressive symptoms, even after accounting for loneliness. Furthermore, we found evidence for a significant Loneliness × Hope interaction effect in predicting anxiety. A plot of the interaction confirmed that the association between loneliness and anxiety was weaker among high, compared to low, hope adults. Some implications of the present findings are discussed.     

Trajectories of adolescent stressful life events and young adults’ socioeconomic and relational outcomes: Weight and depressive symptoms as mediators

Little is known about how biological and psychological consequences of adolescent stressful life events (SLEs) are jointly associated with socioeconomic and relational outcomes in adulthood. To address this gap, the present study involved testing a model based on the life course perspective that posits adolescent SLE trajectories produce parallel trajectories of depressive symptoms and weight status, which are jointly associated with socioeconomic status and intimate relationship quality in adulthood. Prospective data over 13 years from a nationally representative sample of 11,677 US adolescents was utilized. The results demonstrated that trajectories of BMI and depressive symptoms, which showed contemporaneous and longitudinal comorbidities over the early life course, were influenced by adolescent SLEs. Both BMI and depressive symptoms trajectories are additively and jointly associated with socioeconomic status and intimate relationship quality in adulthood. Additionally, adolescent SLE trajectories are directly associated with these adult outcomes. These observed associations persisted even after controlling for early family socioeconomic adversity and race/ethnicity. The theoretical and practical implications of these findings are discussed.     

The role of goal adjustment in symptoms of depression,anxiety and fatigue in cancer patients receiving psychosocial care: A longitudinal study

Objective: This study examined whether cancer patients reported increases in their goal adjustment capacities while receiving psychosocial care and whether these increases were related to changes in symptoms of depression, anxiety and fatigue. Goal adjustment was conceptualised as two independent capacities: goal disengagement (i.e. disengage from unattainable goals) and goal reengagement (i.e. reengage into new goals).

Design: This naturalistic, longitudinal study focused on 241 cancer patients receiving psychosocial care at one of the seven psycho-oncology institutions in the Netherlands. Data was collected before the start of psychosocial care (T1) and nine months thereafter (T2). Hierarchical regression analysis was used to examine the research questions.

Main Outcome Measures: Goal adjustment, symptoms of depression, anxiety and fatigue.

Results: At group level, patients reported small increases in goal disengagement (d = .22) but no significant change in goal reengagement (d = .09). At an individual level, 34% of cancer patients reported an increase in goal disengagement and 30% reported an increase in goal reengagement. Increases in goal reengagement were significantly associated with decreases in both depressive and anxiety symptoms, but not to changes in fatigue.

Conclusion: Findings indicate that particularly improvements in goal reengagement are beneficial for cancer patients’ psychological functioning.     

The Role of Hope in the Psychological Adjustment of Gastropareutic Patients Receiving the Gastric Pacemaker: A Longitudinal Study

Hope, depressive symptoms, anxiety, and physical quality of life (QOL) were assessed in three subgroups of patients receiving the gastric pacemaker. Patients (n = 22) completed questionnaires prior to pacemaker implantation and at 3 and 6 months post-surgery. The idiopathic subgroup reported a significantly greater degree of hope and less anxiety at 6-month follow-up, compared to the diabetes patients. The idiopathic patients also reported significantly less anxiety at 6 months than the postsurgical patients. Across all subgroups, there was an increase in hope and physical QOL, and decrease in depressive symptoms and anxiety, from baseline levels. There was a significant negative relationship between hope and both depressive symptoms and anxiety at baseline and 3- and 6-month follow-up. Presurgical hope level did not significantly predict depressive symptoms or anxiety after implantation. This study provides evidence that the pacemaker improves the physical and psychological health of gastropareutic patients; hope appears to play a role in the psychological adjustment of these patients.     

Eating Behavior Among Thais and Americans

A cross-cultural analysis of eating patterns was conducted to examine the possible relationship between eating style and obesity. Thai and American students were surveyed about such bad eating habits as eating between meals, eating too quickly, eating when not hungry, and eating in response to external food cues. Contrary to the learning model of obesity, which postulates a causal relationship between eating style and body size, American subjects reported significantly better eating habits than did their much thinner Thai counterparts. A within-culture comparison of the American subjects showed a less significant but similar trend, with obese subjects claiming to have better eating patterns than both thin and underweight subjects.     

Delineating generalized anxiety: A preliminary investigation

The present study examined the nature of generalized anxiety, which was defined as the constellation of symptoms listed as diagnostic criteria for generalized anxiety disorder in DSM-III-R. Generalized anxiety was assessed by means of a questionnaire that was especially constructed for this study. Although multidimensional scaling of symptoms reported by a clinically anxious sample produced orthogonal anxiety and panic dimensions, many symptoms were common to both dimensions. Whereas worry was found to be the cardinal feature of generalized anxiety, respiratory symptoms were found to associate closely with panic. These dimensions were replicated in a student sample. It is argued that while generalized anxiety symptoms constitute a unique dimension in the field of anxiety disorders, both panic and generalized anxiety may be linked with a basic anxiety response system. The findings also indicated that worry associated more closely with generalized anxiety than did apprehensive expectations. The heuristic value of the findings are discussed in light of the issue relating to an anxiety-panic continuum.     

Testing Cognitive and Emotion-Focused Models of Worry in Black and White Samples

Several models have been proposed to conceptualize worry. Broadly, the models can be classified as cognitive (including the Avoidance Model, the Intolerance of Uncertainty Model, and the Metacognitive Model) and emotion-focused (including Emotion Dysregulation and Acceptance-Based models). Although these models have received strong empirical investigation in primarily non-Hispanic White samples, no known study has examined the applicability to racial and ethnic minority groups. The current study compared the proportion of variance explained by cognitive and emotion-focused models of worry in White and Black samples. Results indicated that cognitive and emotion-focused models significantly predicted worry in both Black and White samples. However, the overall amount of variance in worry explained by the models was less for Black samples. Specifically, controlling for gender, the cognitive models explained 53% of the variance in worry in the White sample compared with 19% in the Black sample. Similarly, the emotion-focused models explained 34% of the variance in worry in the White sample but only 13% in the Black sample. These findings suggest that well-established conceptual frameworks for worry failed to explain the bulk of the variance in worry in Black samples, leaving much unknown. Additional research is needed to identify key variables that may further explain worry in ethnic minority samples.     

Countering Perfectionism in Research on Clinical Practice. III: Implications for Randomized Designs of the Presence of Uncontrolled Interactions and Spontaneous Changes

In a crossover study, we took pre-test, post-first-treatment, and post-second-treatment measures of self-expressiveness (assertiveness) and of acute emotional distress while we successively trained different groups of students in assertiveness and group therapy exercises. Our (unfulfilled) expectations were straightforward: We thought that assertiveness training would produce specific improvement in self-expression measures with little impact on overall distress and that group therapy would produce specific improvement in general distress with little impact on assertiveness. Both treatments improved assertiveness and decreased distress. The fact that our treatments had impure effects enhanced the likelihood of Type II statistical errors and compromised the effectiveness of our design. In addition, quite surprisingly, assertiveness training selectively improved the mental health of women students, and group therapy selectively improved the assertiveness of men students more than the alternative treatment did. This interaction between gender and randomly administered experimental treatment procedures raises serious, generally important questions about the logic of statistically controlled experimentation that relies on randomization to eliminate the effects of uncontrolled, but relevant, variables.     

Test anxiety,self-evaluative worry,and sleep disturbance in college students

Abstract

The present research examined the extent to which sleep disturbance is involved in the experience of test anxiety. In Study 1, a sample of 80 subjects completed a trait measure of test anxiety and completed a sleep inventory with reference to the past 30 days. In Study 2, a sample of 188 subjects provided measures of trait and state test anxiety and completed a sleep inventory for the night preceding an actual test. The results of Study 1 and Study 2 confirmed that test anxiety is associated with self-reported sleep disturbance. In addition, the results of Study 2 showed that sleep disturbance is also associated with increased state test anxiety. Finally, it was found in Study 2 that sleep disturbance was not related to actual test performance. However, poorer test performance was associated with increased state and trait test anxiety. It is concluded that certain characteristics associated with test anxiety are stable and may be detected in evaluative and non-evaluative situations. The results are discussed with particular reference to their implications for the test anxiety construct itself as well as treatment strategies for the test-anxious student.