Childhood maltreatment and adult personality disorder symptoms in a non‐clinical sample

It can be argued that the well‐substantiated relationship between childhood maltreatment and adult personality disorder (PD) symptoms may be confounded by comorbid symptoms of depression, anxiety or dysfunctional childhood family environments. Therefore, the current study was designed to test the hypothesis that retrospective reports of childhood maltreatment would still be significantly related to reports of more PD symptoms when statistically controlling for these factors. One hundred and seventy‐eight non‐clinical participants were divided into groups reporting childhood maltreatment (n = 54) or not (n = 124) according to scores on the Childhood Trauma Questionnaire. Participants also completed questionnaires measuring current depression, anxiety, and PD symptoms as well as retrospective reports of their childhood environment. Results showed that individuals reporting childhood maltreatment reported more symptoms of PD than those not reporting childhood maltreatment, even when statistically controlling for depression, anxiety and retrospective reports of dysfunctional family environment. These findings underscore the relevance and independent contribution of childhood maltreatment to the development of PDs, with important implications for further research and clinical practice.     

Self-report and stability of physical symptoms by adolescents

Verbal reports of physical complaints and their relationship to school-related stress was investigated in two adolescent samples. It was hypothesized that symptom reporting is a function of age and sex, and is connected to psychological factors such as test (state) and trait anxiety. In addition, the consistency of symptoms reported during the course of one year was evaluated. It was found that, overall, the two adolescent groups complained of more physical symptoms than did Br?hler's (1978) adult sample. Differences between males and females in reporting symptoms were apparent only in the older adolescent group (ages 14 to 15); females reported more physical complaints. The positive correlation between body symptoms and test-trait anxiety was highly significant. During the year, few adolescents exhibited well-defined patterns of body complaints. On the contrary, many complaints seemed to be transient phenomena, although the number was high. In this respect, adolescence plays an important role in the self-reporting evaluation and development of physical complaints.     

Anxiety and post-traumatic stress symptoms following wisdom tooth removal

The purpose of the present study was to determine the psychological impact of wisdom teeth removal and to identify the psychological risk factors for the development of dental anxiety and post-traumatic stress symptoms. Participants were 34 consecutive elective patients referred for surgical removal of a wisdom tooth under local anesthesia. Frequency of previous distressing dental events and general traumatic life events were assessed at baseline (t1), and emotional distress (pain, state anxiety and disturbance) immediately after treatment (t2). Post-traumatic stress responses were determined three days after treatment (t3), and at four weeks follow-up (t4), while severity of dental trait anxiety was assessed at t1 and at t4. Two patients (8%) met screening criteria for Post-Traumatic Stress Disorder (PTSD) at t4. Multivariate analysis revealed that previous exposure to distressing dental events and pre-operative anxiety level predicted anxiety level at t4, accounting for 71% of the variance. Severity of pain during treatment was a significant predictor variable of PTSD symptom severity at t4 (25% explained variance). The findings underline the importance of pain-free treatments and awareness of patients' individual predisposition to anxiety or trauma-related symptoms to reduce the risk of iatrogenic psychological harm.     

Menstrual Reactivity: The Role of Gender-Specificity,Anxiety Sensitivity,and Somatic Concerns in Self-Reported Menstrual Distress

To determine the impact of gender roles, anxiety sensitivity, and somatic concerns on self-reported menstrual distress, two studies were conducted. In the first study using 278 primarily Caucasian college females, anxiety-sensitivity level, not current menstrual cycle phase, influenced reports of menstrual symptom severity and depression. Regardless of cycle phase at the time of self-report, women high in anxiety sensitivity reported significantly more depressed mood, trait anxiety, and retrospective menstrual symptoms. In the second study of 158 primarily Caucasian college females varying in anxiety sensitivity levels, adherence to sex role stereotypes, feminist beliefs, and illness attitudes were examined. Participants also completed measures of general premenstrual, most-recent premenstrual, and current menstrual symptoms. Women high in anxiety sensitivity reported the highest levels of sex-specificity, feminist embeddedness, and illness attitudes, with sex-specificity accounting for significant variance in current menstrual symptoms. Results are discussed within the context of the menstrual reactivity hypothesis, which proposes that beliefs surrounding the menstrual cycle and body sensations expectancies contribute to self-reports of greater menstrual distress. Women high in anxiety sensitivity appear to represent one subgroup vulnerable to menstrual reactivity.     

Eating disorders: relations with inconsistent discipline,anxiety, and drinking among college women

Since as many as 20% of all college women report symptoms of eating disorders, the present study examined the relationship between self-reported eating disorder symptoms. anxiety, drinking, and retrospective reports of inconsistent parenting during childhood. 101 college women, 85% Euro-Americans of mean age 19 yr., completed an anonymous survey including questions from the Eating Disorder Index-1, the Retrospective Family Unpredictability Scale, the Trait Anxiety Scale, and measures of drinking in the previous month. Eating disorder symptoms correlated with self-reported drinking quantity, anxiety, and retrospective ratings of inconsistent discipline. This appears to be the first time eating disorder symptoms have been associated with inconsistent discipline. Implications for etiology and treatment of eating disorders are discussed.     

Discrepancies among mother,child, and teacher reports: Examining the contributions of maternal depression and anxiety

The relationship between maternal affective symptomatology and discrepancies in maternal reports of child symptoms, relative to teacher and child reports, was evaluated in a community sample of 188 children ages 9–12 years. Mothers, teachers, and children were administered a structured interview about child psychopathology. In general, mothers reported more child behavior problems than children and teachers, regardless of maternal symptomatology. However, maternal affective symptoms were associated with discrepancies between mothers' and daughters' reports and between mothers' and teachers' reports of girls' externalizing symptoms. Furthermore, mothers who reported high levels of both anxiety and depressive symptomatology tended to report a large number of symptoms that were not confirmed by either their daughters or teachers. Findings are discussed as possible evidence of the role of maternal affective symptomatology in both actual increases in child symptomatology and maternal reporting distortions. Although maternal depressive and anxiety symptoms shared variance in reporting discrepancies, only anxiety explained unique variance. Consistent with previous studies, cross-informant agreement was modest to moderate (r= .16 to .50) and all informants reported more behavior problems in boys than in girls. This work was undertaken with the support of National Institute of Mental Health Grants MH43909 and MH46717.     

Disgust sensitivity, trait anxiety and anxiety disorders symptoms in normal children.

There is evidence to suggest that disgust sensitivity plays a role in the development of small animal fears and phobias. Recently, Phillips, Senior, Fahy, and David (1998) [Phillips, M. L., Senior, C., Fahy, T., & David, A. S. (1998). Disgust: the forgotten emotion of psychiatry. British Journal of Psychiatry, 172, 373-375.] suggested that disgust sensitivity is also involved in various other anxiety-based symptoms (e.g. obsessive-compulsive complaints, social phobia). The present study sought to test this suggestion in a large sample of normal school children (N = 189). Children completed a measure of disgust sensitivity, the trait anxiety version of the Spielberger State-Trait Anxiety Inventory for Children and the Screen for Child Anxiety Related Emotional Disorders, an instrument that measures DSM-defined anxiety disorders symptoms. Disgust sensitivity was indeed found to be correlated with a broad range of anxiety disorders symptoms. However, results also indicated that these correlations were predominantly carried by trait anxiety. That is, when controlling for levels of trait anxiety, only specific phobia symptoms (including animal phobia, blood-injection-injury phobia and situational-environmental phobia) and separation anxiety disorder symptoms were significantly related to disgust sensitivity, although correlations were rather modest. Taken together, these findings cast doubts on the claim that disgust sensitivity is an unique and independent factor that contributes to a broad range of anxiety disorders.     

A longitudinal analysis of anxiety and depressive symptoms

The authors modeled depressive and anxiety symptom data from 1,391 participants in a longitudinal study of middle-aged and older Swedish twins (M age = 60.9 years, SD = 13.3). Although anxiety and depression were highly correlated, a model with distinct Anxiety and Depression factors fit the data better than models with Positive and Negative Affect factors or a single Mental Health factor. Lack of well-being was associated with anxiety rather than depression. Over two 3-year intervals, anxiety symptoms led to depressive symptoms, but the relationship was not reciprocal. Anxiety symptoms were more stable than depression. These findings provide additional support for the idea that anxiety symptoms may reflect a personality trait such as neuroticism more than do depressive symptoms and suggest that low positive affect may not be as specific to depression among older adults as in younger people.     

Structural differentiation of disgust from trait anxiety in the prediction of specific anxiety disorder symptoms

Research has begun to implicate the role of disgust in the etiology of specific phobias and obsessive–compulsive disorder (OCD). However, it remains unclear if the association between disgust and specific anxiety disorder symptoms is an artifact of trait anxiety or a potential mechanism through which trait anxiety effects specific anxiety disorder symptoms. The present study employed structural equation modeling to differentiate disgust from trait anxiety in the prediction of four types of specific anxiety disorder symptoms in a non-clinical sample (N=352). Results indicate that disgust and trait anxiety latent factors were independently related to spider fears, blood-injection-injury (BII) fears, general OCD symptoms, and OCD washing concerns. However, when both variables were simultaneously modeled as predictors, latent disgust remained significantly associated with the anxiety disorder symptoms, whereas the association between latent trait anxiety and the anxiety disorder symptoms became non-significant or was substantially reduced. Statistical tests of intervening variable effects converged in support of disgust as a significant intervening variable between trait anxiety and spider fears, BII fears, and OCD symptoms (particularly washing concerns). The relevance of these findings for future research investigating the role of disgust in specific anxiety disorders is discussed.     

Anxiety symptom interpretation in high-anxious, defensive high-anxious, low-anxious and repressor sport performers

For the first time in a sport setting this study examined the intensity and direction of the competitive state anxiety response in collegiate athletes as a function of four different coping styles: high-anxious, defensive high-anxious, low-anxious and repressors. Specifically, the study predicted that repressors would interpret competitive state anxiety symptoms as more facilitative compared to high-anxious, defensive high-anxious, and low-anxious performers. Separate Multivariate Analyses of Variance (MANOVA) were performed on the intensity and direction subscales of the modified Competitive State Anxiety Inventory-2 (CSAI-2). A significant main effect was identified for trait worry revealing that low trait anxious athletes reported lower intensities of cognitive and somatic anxiety and higher self-confidence and interpreted these as more facilitative than high trait anxious athletes. The prediction that performers with a repressive coping style would interpret state anxiety symptoms as more facilitative than performers with non-repressive coping styles was not supported.     

Does Problem Focused Coping Buffer the Effects of Trait Anxiety on Depressive Symptoms of Chronic Urticaria Patients?

The present study examined the moderating role of problem-focused coping in trait anxiety—depressive symptoms' relationship in patients with chronic urticaria (CU). Eighty-eight CU patients, who applied to an outpatient clinic of Clinical Immunology and Allergic Diseases, filled out a questionnaire set including State-Trait Anxiety Inventory, Ways of Coping Inventory, and Beck Depression Inventory. The results suggested that CU patients high on trait anxiety reported more depressive symptoms, and the ones using more problem-focused coping (PFC) strategies reported less depressive symptoms. Also, PFC strategies moderated trait anxiety-depressive symptoms relation. Accordingly, PFC strategies did not lead to any significant difference in CU patients who were low on trait anxiety in terms of the level of depressive symptoms. However, CU patients with high trait anxiety experienced significantly less depressive symptoms if they used more PFC strategies. The findings were discussed in the light of the relevant literature.     

The symptom perception hypothesis revised: depression and anxiety play different roles in concurrent and retrospective physical symptom reporting

According to the classic symptom perception hypothesis (Costa & McCrae, 1987; Watson & Pennebaker, 1989), the global predisposition to frequently experience a variety of negative emotions-that is, neuroticism (N) or trait negative affectivity (NA)-is associated with inflated physical symptom reporting. We tested a revision of this hypothesis, which posits distinctive roles for depression and anxiety in the physical symptom experience. Three studies tested predictions from the revised symptom perception hypothesis: (a) that depressive affect should be related to inflated retrospective physical symptom reports and (b) that anxious affect should be related to inflated concurrent, or momentary, physical symptom reports. Study 1 assessed the relations among N/NA, depressive affect, and recall of physical symptoms experienced in the previous 3 weeks. Depressive affect was uniquely and positively associated with recalling more symptoms. When entered with depressive affect in multiple regression analyses, neuroticism was not associated with level of symptoms recalled. In Study 2, participants were randomly assigned to anxious, depressed, angry, happy, or neutral mood inductions and then reported about concurrent symptom experience. Participants in the anxious mood condition reported significantly more concurrent physical symptoms than did those in the other 4 conditions. In Study 3, anxious, depressed, or neutral mood was induced, followed by assessment of both concurrent and retrospective physical symptoms. Those assigned to the anxious mood induction reported more concurrent symptoms, while those in the depressed mood condition reported having experienced more symptoms in the past. These findings are consistent with the idea that encoding and retrieval processes, which are differentially associated with anxious versus depressed affect, influence different aspects of physical symptom reporting. The results have implications for self-diagnosis, medical treatment-seeking, and care, and potential insights about other complex social and interpersonal behaviors are discussed.     

Presence,Content, and Characteristics of Memories of Individuals with Dental Phobia

Knowledge about memories of distressing events underlying fears and specific phobias is limited. This study assessed (1) the presence, content, and characteristics of memories of events that initiated or exacerbated dental anxiety levels; and (2) the relationship between dental trait anxiety and some key features of these memories. This study used a semi‐structured interview and included dental phobics (n = 42), subthreshold dental phobics (n = 41), and normal controls (n = 70). Dental phobics were more likely to report a memory underlying their anxiety than the normal controls. Moreover, dental phobics' memories were reported as more vivid, disturbing, and more intensely relived than the memories of the normal controls. Greater severity of dental trait anxiety was significantly associated with greater disturbance of patients' memories. The results suggest that memories of distressing events play a significant role in the development of dental phobia and that their characteristics are associated with severity of dental trait anxiety. Copyright © 2015 John Wiley & Sons, Ltd.     

Failure to capitalize on sharing good news with romantic partners: Exploring positivity deficits of socially anxious people with self-reports,partner-reports,and behavioral observations

Extending prior work on social anxiety and positivity deficits, we examined whether individual differences in social anxiety alter the ability to share and respond to the good news of romantic partners (i.e., capitalization support) and how this influences romantic relationship satisfaction and commitment. In this study of 174 heterosexual couples (average age of 21.5 with 58.3% identifying as Caucasian), greater social anxiety was associated with the provision and receipt of less supportive responses to shared positive events as measured by trait questionnaires, partner reports, and behavioral observations in the laboratory. In longitudinal analyses, individuals in romantic relationships with socially anxious partners who experienced inadequate capitalization support were more likely to terminate their relationship and report a decline in relationship quality six months later. As evidence of construct specificity, social anxiety effects were independent of depressive symptoms. Taken together, social anxiety influenced a person's ability to receive and provide support for shared positive events; these deficits had adverse romantic consequences. Researchers and clinicians may better understand social anxiety by exploring a wider range of interpersonal contexts and positive constructs. The addition of capitalization support to the social anxiety literature offers new insights into interpersonal approaches and treatments.     

Anxiety sensitivity in adolescents: factor structure and relationships to trait anxiety and symptoms of anxiety disorders and depression

The current study examined the anxiety sensitivity construct in a large sample of normal Dutch adolescents aged 13-16 years (n=819). Children completed the Childhood Anxiety Sensitivity Index (CASI; Silverman, W. K., Fleisig, W., Rabian, B. & Peterson, R. A. (1991). Journal of Clinical Child Psychology, 20, 162-168) and measures of trait anxiety, anxiety disorder symptoms and depression. Results showed that (1) anxiety sensitivity as indexed by the CASI seems to be a hierarchically organized construct with one higher-order factor (i.e., anxiety sensitivity) and three or four lower-order factors, (2) anxiety sensitivity and trait anxiety were strongly correlated, (3) anxiety sensitivity was substantially connected to symptoms of anxiety disorders (in particular of panic disorder and agoraphobia) and depression, and (4) anxiety sensitivity and trait anxiety both accounted for unique proportions of the variance in anxiety disorder symptoms. Altogether these findings are in agreement with those of previous research in adult and child populations, and further support the notion that anxiety sensitivity should be viewed as an unique factor of anxiety vulnerability.     

Thought-action fusion and anxiety disorders symptoms in normal adolescents.

The present study examined thought-action fusion (TAF) in a large sample of normal adolescents (n=427). Participants completed the Thought-Action Fusion Questionnaire for Adolescents (TAFQ-A) and scales measuring trait anxiety, symptoms of obsessive-compulsive disorder, other anxiety disorders, and depression. Results showed that the TAFQ-A is a reliable instrument assessing two dimensions of TAF, viz. Morality (i.e., the belief that unacceptable thoughts are morally equivalent to overt actions) and Likelihood (i.e., the belief that thinking of an unacceptable or disturbing situation will increase the probability that that situation actually occurs). Furthermore, TAF was not only associated with symptoms of OCD, but also with symptoms of other anxiety disorders and depression. However, when controlling for levels of trait anxiety, most connections between TAF and anxiety disorders symptoms disappeared. Symptoms of OCD and generalised anxiety remained significantly related to TAF. Altogether, the data are supportive of the notion that TAF is involved in a broad range of anxiety disorders and in particular OCD.     

Anxiety symptom interpretation in high-anxious,defensive high-anxious,low-anxious and repressor sport performers

Abstract

For the first time in a sport setting this study examined the intensity and direction of the competitive state anxiety response in collegiate athletes as a function of four different coping styles: high-anxious, defensive high-anxious, low-anxious and repressors. Specifically, the study predicted that repressors would interpret competitive state anxiety symptoms as more facilitative compared to high-anxious, defensive high-anxious, and low-anxious performers. Separate Multivariate Analyses of Variance (MANOVA) were performed on the intensity and direction subscales of the modified Competitive State Anxiety Inventory-2 (CSAI-2). A significant main effect was identified for trait worry revealing that low trait anxious athletes reported lower intensities of cognitive and somatic anxiety and higher self-confidence and interpreted these as more facilitative than high trait anxious athletes. The prediction that performers with a repressive coping style would interpret state anxiety symptoms as more facilitative than performers with non-repressive coping styles was not supported.     

Psychological reactions to radiation therapy: reconsideration of the adaptive aspects of anxiety

A common form of cancer treatment is radiation therapy. In this investigation individual differences in the psychological reactions of 45 patients undergoing external treatment were examined in the context of the Janis (1958) and linear decline models (e.g., Spielberger, Auerbach, Wadworth, Dunn, & Taulbee, 1973) of medical stressor anxiety. Evaluation included pre- and postradiation assessments of the subjects' state and trait anxiety, somatic complaints, and treatment side effects. Technologists administering the daily treatments assessed behavioral indicants of affective distress. Data analyses revealed that increases in complaints and side effects were reported by all patients at treatment conclusion. More interesting, significant changes in state anxiety were obtained from pre- to posttreatment: (a) Patients with an initial high level of anxiety reported a significant reduction, although they remained the most anxious subgroup; (b) patients with a moderate level of pretreatment anxiety reported no change; and (c) patients with low levels of anxiety reported significant increases in state anxiety. No change in trait anxiety was found for any group, suggesting that the foregoing changes in state anxiety were not simply attributable to regression. Data trends suggested that patients who were either low or high in state anxiety were also characterized by more anger or hostility than patients moderate in anxiety. The findings are consistent with the Janis model, which posits that in threatening situations the level of fear can potentially determine the adequacy of adaptation.     

Prediction of symptoms of emotional distress by mood regulation expectancies and affective traits

Three studies examined negative mood regulation expectancies (NMRE) and affective traits as independent predictors of self‐reported symptoms of emotional distress. NMRE represent individuals' beliefs that they can alleviate unpleasant emotional states. Stronger NMRE are associated with more adaptive coping, more positive cognition during negative moods, more effective responses under stress and less emotional distress. Affective traits represent long‐term tendencies toward particular affective experiences; they confer risk for specific symptoms of emotional distress. In Study 1, NMRE, trait negative affect (TNA) and trait positive affect (TPA) were all independently associated with depression among students and staff of a German university. In Study 2, in prospective analyses among U.S. college students traits exhibited hypothesised relationships with anxiety and depressive symptoms, and NMRE uniquely predicted anhedonic depression. Study 3 revealed independent prediction of change in symptoms over time by NMRE among U.S. college students, whereas traits were not associated with change in distress, anxiety and depression symptoms. Results suggest independent roles for NMRE and traits in the development of depression and anxiety symptoms and highlight the importance of NMRE as a potential target of therapeutic intervention in the process of symptom change.     

Self-mutilation and symptoms of depression, anxiety, and borderline personality disorder

The goal of this study was to examine the relationship between self-mutilation and symptoms of depression and anxiety in a nonclinical population. Self-mutilators reported significantly more symptoms of depression and anxiety than did the control group. When the group of self-mutilators was divided into individuals who cut themselves and individuals who harm themselves in other ways, we found that the between-group differences were primarily due to individuals with a history of cutting. Yet when symptoms of borderline personality disorder (BPD) were statistically controlled, all significant between-group differences in depressive and anxious symptoms were reduced to nonsignificant. These findings highlight the importance of assessing symptoms of BPD in self-mutilators, regardless of diagnosis.