Eating Disorder Symptom and Fear Change Trajectories During Imaginal Exposure Therapy: A Slope Network Analysis

Eating disorders (EDs) are characterized by fears related to food, body image, and social evaluation. Exposure-based interventions hold promise for targeting a range of ED fears and reducing ED psychopathology. We investigated change mechanisms and optimal fear targets in imaginal exposure therapy for EDs using a novel approach to network analysis. Individuals with an ED (N = 143) completed up to four online imaginal exposure sessions. Participants reported ED symptoms and fears at pretreatment, posttreatment, and 6-month follow-up. We constructed networks of symptoms (Model 1), fears (Model 2), and combined symptoms and fears (Model 3). Change trajectory networks from the slopes of symptoms/fears across timepoints were estimated to identify how change in specific ED symptoms/fears related to change in other ED symptoms/fears. The most central changing symptoms and fears were feeling fat, fear of weight gain, guilt about one’s weight/shape, and feared concerns about consequences of eating. In Model 3, change in ED fears bridged to change in desire to lose weight, desiring a flat stomach, following food rules, concern about eating with others, and guilt. As slope networks present averages of symptom/fear change slopes over the course of imaginal exposure therapy, further studies are needed to examine causal relationships between symptom changes and heterogeneity of change trajectories. Fears of weight gain and consequences of eating may be optimal targets for ED exposure therapy, as changes in these fears were associated with maximal change in ED pathology. Slope networks may elucidate change mechanisms for EDs and other psychiatric illnesses.     

The Role of Social and Cognitive Processes in the Relationship Between Fear Network and Psychological Distress Among Parents of Children Undergoing Hematopoietic Stem Cell Transplantation

The current study examined whether cognitive and social processing variables mediated the relationship between fear network and depression among parents of children undergoing hematopoietic stem cell transplant (HSCT). Parents whose children were initiating HSCT (N = 179) completed survey measures including fear network, Beck Depression Inventory, cognitive processing variables (positive reappraisal and self-blame) and social processing variables (emotional support and holding back from sharing concerns). Fear network was positively correlated with depression (p < .001). Self-blame and holding back emerged as individual partial mediators in the relationship between fear network and depression. Together they accounted for 34.3 % of the variance in the relationship between fear network and depression. Positive reappraisal and emotional support did not have significant mediating effects. Social and cognitive processes, specifically self-blame and holding back from sharing concerns, play a negative role in parents’ psychological adaptation to fears surrounding a child’s HSCT.     

Distribution of the midgap density of states and their capture cross-sections in hydrogenated amorphous silicon deduced from space-charge-limited conduction in the dark and under illumination

Space-charge-limited current measurements in the dark and under illumination offer the means of obtaining the density of states N(E) and their capture cross-sections s(E) in a range of energy E above the equilibrium Fermi level in hydrogenated amorphous silicon (a-Si:H) n⁺–i–n⁺ structures. N(E) and s(E) have been measured in the energy region from 0.65 to 0.5?eV below the conduction-band edge E _c. The decrease on s(E) observed as the energy E increases agrees with recent observations and is attributed to the coexistence of two types of defect having different capture cross-sections. This is confirmed by light soaking of a-Si:H which makes the defects with high s(E) predominant.     

Living with painful diabetic neuropathy: insights from focus groups into fears and coping strategies

Objective: Painful diabetic neuropathy (PDN) is known to negatively affect quality of life. Being physically active is a crucial part of successful diabetes self-management, but regimen adherence is often low. Coping strategies and fears have shown to be related to less physical activity (PA). The aim of the present study was to obtain more in-depth information on psychological risk factors leading to less PA in persons with PDN.

Design: Three semi-structured focus group interviews were conducted with a representative sample of persons with PDN (N?=?12). Data were transcribed verbatim and analysed using a hybrid method of thematic analyses and a grounded theory approach.

Main Outcome Measures: Fears and coping strategies related to PA in persons with PDN.

Results: Several specific fears were identified; fear of hypoglycaemia, fear of pain increase, fear of total exhaustion, fear of physical injury, fear of falling, fear of loss of identity, and fear of negative evaluation by others. To cope with these fears, avoidance, remaining active, cognitive distraction, and acceptance strategies were described.

Conclusion: In persons with PDN, diabetes-related fears and pain-related fears play a role in less engagement in PA, indicating the need for new methods for improving self-management in persons with PDN.     

The Association Between Religious Beliefs and Practices and End-of-Life Fears Among Members of the Presbyterian Church (U.S.A)

This study examines the association between various religious beliefs and practices and fears pertaining to death and dying in a national sample of liberal Protestant U.S. adults. Data were analyzed from a 2002 survey of members and elders of the Presbyterian Church (U.S.A) (N = 935). Four measures of religion were tested together in models predicting four end-of-life fears. Church attendance (p < .01), other church involvement (p < .05), and belief in life after death (p < .001) had negative associations with the fear of what happens after death. Private devotion was inversely related to the fear of dying in pain (p < .05). Involvement in church activities (p < .05), aside from religious services, was inversely related to the fear of leaving loved ones behind. Females tended to be more fearful than males of dying alone and dying in pain and older adults tended to be less fearful than younger adults of the unknown and of leaving loved ones behind.     

Relationships between psychoevolutionary fear of evaluation,cognitive distortions,and social anxiety symptoms: A preliminary structural equation model

Social anxiety disorder is a mental health condition that affects 4.7% of Australians each year. The complex interplay between psychoevolutionary and cognitive models has become the focus of research in recent years, particularly with the development of the bivalent fear of evaluation model (i.e., negative and positive evaluation fears). The present study aimed to test a model of social anxiety symptoms using structural equation modelling, integrating previously fragmented evidence. A sample of 255 participants (75.3% female; M_age = 31.9, SD = 10.3) undertook an online survey, including Social Phobia Scale, Brief Fear of Negative Evaluation—Straightforward, Fear of Positive Evaluation, Concerns of Social Reprisal, and Disqualifications of Positive Social Outcomes measures. The hypothesised model for social anxiety symptoms described the data reasonably well (χ²(1) = 4.917, p = .027, CFI = .995, GFI = .992, SRMR = .017), explaining 57.1% of social anxiety variance. Study hypotheses were supported with bivalent fear of evaluation accounting for unique variance in cognitive distortions, which in turn accounted for unique variation in social anxiety symptoms. Effect sizes indicate bivalent fears of evaluation and disqualification of positive social outcomes as important predictors of social anxiety symptoms. Although replication in a clinical cohort and experimental confirmation are needed, the findings suggest a focus on disqualification of positive social outcomes to alleviate social anxiety symptoms.     

Prediction of end-of-life fears in COPD – hoping for the best but preparing for the worst

Objective: The diagnosis of a life-threatening illness can trigger end-of-life fears. Early studies show that end-of-life fears play an important role in chronic obstructive pulmonary disease (COPD). However, predictors of these fears have not yet been identified. This study investigated the relevance of socio-demographic variables, illness severity, psychological distress and disease-specific anxieties as predictors of end-of-life fears in COPD.

Design: A total of 131 COPD patients participated at two time points. Regression and mediation analyses, as well as cross-lagged panel analyses were conducted.

Main outcome measures: The participants completed questionnaires assessing end-of-life fears (Multidimensional Orientation toward Dying and Death Inventory), psychological distress (Hospital Anxiety and Depression Scale), and disease-specific anxieties (COPD Anxiety Questionnaire). Pulmonary function and a 6-min walk test served as measures of illness severity.

Results: Illness severity was not predictive of end-of-life fears. However, gender and psychological distress explained incremental variance. When disease-specific anxieties were included as additional predictors, psychological distress was no longer significant. Cross-lagged panel analyses mostly supported these results. Moreover, disease-specific anxieties mediated the association between psychological distress and end-of-life fears.

Conclusion: Administration and intensity of end-of-life care (especially concerning end-of-life fears) in COPD patients should be based not only on illness severity, but rather on psychological distress and disease-specific anxieties.     

The Big-Five, sense of control, mental health and fear of crime as contributory factors to attitudes towards punishment

Low sense of control (SoC), mental health problems and fear of crime (FoC) have separately and previously been linked to the Big-Five personality dimensions, but no study to date has sought to integrate these constructs simultaneously in relation to overall punitiveness. These constructs were assessed in 232 participants using an online survey to examine hypothesised relations between FoC and SoC, poorer mental health, Neuroticism (N), Extraversion (E) and Conscientiousness (C), and any resultant punitiveness. Measures were highly correlated, and an exploratory factor analysis summarised these as ‘instability’ and ‘crime attitude’ dimensions. A structural equation model found that high levels of N and poor mental health, as well as low levels of C, E and SoC were related to a latent variable of ‘distress’, which fed into heightened FoC. High levels of C further influenced FoC, which subsequently had an effect on individuals’ greater punitiveness. The current study supports the previous literature regarding variables that influence FoC and attitudes to punishment, and establishes novel associations involving personality.     

“I’m Not Really Afraid of Osama Bin Laden!” Fear of Terrorism in Dutch Children

We examined to what extent children in The Netherlands are affected by the threat of terrorism. For this purpose, a sample of school children living in Rotterdam or adjacent satellites (N = 216) completed a fear survey that included a number of terrorism-related items, and were confronted with ambiguous vignettes to measure threat-related interpretation bias. The results demonstrated that although a number of terrorism-related items (i.e., bombing attacks, explosions in a bus or subway) listed high in a ranking of most intense childhood fears, very few children made terrorist-related interpretations of ambiguous situations.     

Examining Race/Ethnicity and Fears of Children and Adolescents in the United States: Differences Between White,African American,and Hispanic Populations

The American Fear Survey Schedule for Children (FSSC‐AM; J. J. Burnham, 1995, 2005) has been used to measure fears of children and adolescents. The FSSC‐AM is based on the 2nd revision of a psychometrically sound and well‐known fear scale (i.e., FSSC‐II; E. Gullone & N. J. King, 1992). In this study, age and gender differences, fear intensity scores, and fear prevalence scores were analyzed across race/ethnicity (i.e., White, African American, and Hispanic populations). Multivariate analyses of variance yielded significant effects for race/ethnicity.     

Conditional Reactions in the Rat

To assess the effects of the presence of the experimenter (E) and/or modelrewarder (MR), elementary school children observed a model emit specific sequences on a button pressing task in two separate experiments (N = 50 and N = 80). The first design was a 2 × 2 factorial involving the presence-absence of the E/MR and model reward vs. model no-consequences; the second design was a 4 × 2 factorial with all possible combinations of presence-absence of the E and/or MR, and model reward vs. model no-consequences. It was found that model reward increased imitation only in the condition in which the E was present and the MR was absent.     

The dimensional structure of people's fears,threats, and concerns and their relationship with right‐wing authoritarianism and social dominance orientation

Most theories addressing the topic have proposed that threat and fear underlie right‐wing authoritarianism (RWA), and many empirical findings have been consistent with this proposition. Important questions, however, remain unanswered, such as whether RWA is associated with fear and threat in general or only specific kinds of fear and threat. Theories of RWA generate markedly different predictions on this issue, particularly with respect to social or personal fears, and whether the association would also hold for the closely related construct of social dominance orientation (SDO). We investigated the issue by asking 463 undergraduate students to rate their feelings of fear, concern, and anxiety to a comprehensive 93‐item list of potential fears and threats, which were formulated as either personal or social. Exploratory factors analysis identified five distinct fear–threat factors: Harm to Self, Child, or Country; Personal and Relationship Failures; Environmental and Economic Fears; Political and Personal Uncertainties; and Threats to Ingroup. All the fear–threat factors were correlated with RWA, with the strongest correlations being for Threats to Ingroup, and with stronger effects for social than for personal fears. None of the fear factors correlated with SDO. These relationships were not affected by controlling for Social Desirability or Emotional Stability (EMS). When the intercorrelations between fear factors and EMS were controlled using ridge regression, only Threats to Ingroup predicted RWA. Structural equation modeling indicated good fit for a model in which low levels of EMS had a significant path to Threats to Ingroup, which in turn had a significant path to RWA, and EMS having a significant though weak indirect (fully mediated) inverse effect on RWA. Implications of these findings for theories of authoritarianism and future research are discussed.     

Behavioral avoidance tests and disgust in contamination fears: distinctions from trait anxiety

Much of the existing literature examining the role of disgust is limited to specific phobia. Recent research has begun to examine the role of disgust in contamination fear, a subtype of obsessive-compulsive symptoms. Through the use of behavioral avoidance tasks (BATs), the current study was designed to examine the role of disgust in people with contamination fears, with attention to distinguishing high and low trait anxiety. From a large screening of undergraduate students, three groups were formed based on their level of contamination fear and level of trait anxiety: contamination fearful ( n = 12 ), high-trait anxiety ( n = 11 ), and low trait anxiety ( n = 15 ). Subjects were asked to engage in six different BATs corresponding to six domains of disgust (food, animals, body products, body envelope violations, death, and sympathetic magic). One-way analysis of variance (ANOVA) showed significant differences between the contamination fearful group and the high trait anxiety group on the animal and sympathetic magic BATs. Significant differences on the food, animal, body envelope violations, and death BATs were also found between the contamination fearful group and the low-trait anxious group. The findings modestly support the importance of disgust in contamination fears. Implications for the study of disgust in contamination fear are provided.     

Social evaluation fear in childhood and adolescence: Normative developmental course and continuity of individual differences

Using cross‐sectional (N =910) and longitudinal (N =261) data from Gullone and King's (1993, 1997 ) studies of normal fear in children and adolescents aged 7 to 18 years, the normative developmental pattern of social evaluation fear and the continuity of individual differences were investigated. Participants' responses were analysed according to two subscales (Social Evaluation and Punishment) within the Failure and Criticism scale of the Fear Survey Schedule. The findings indicated that: (a) social evaluation fear increased between childhood and adolescence, while punishment fear decreased, (b) individual differences in social evaluation fear displayed only modest continuity over the 3‐year follow‐up period, (c) continuity of social evaluation fear increased with increased age and (d) discontinuity was particularly salient for relatively high fear levels.     

Fear response to dissociation challenge

Abstract

Participants (N = 101) scoring high or low on a new scale for assessing fear of dissociative sensations (Dissociation Sensitivity Index) underwent an audio/visual sensory challenge using a device called the D.A.V.I.D. Participants' report of subjective fear and level of dissociation were measured before and after completing the audio/visual sensory challenge. Consistent with prediction, participants scoring high on the DSI responded to the challenge with significantly greater increases in subjective fear and dissociative symptoms relative to those scoring low on the DSI. Contrary to prediction, the DSI performed poorer than the Anxiety Sensitivity Index in predicting participants' response to the audio/visual sensory challenge. Theoretical and clinical implications of the findings are discussed.     

The Eysenck personality scales: stability and change after therapy.

Eysenck has linked personality theory with the aetiology and treatment of abnormal behaviour (Eysenck, 1970). At least four levels of explanation link hypothetical neurophysiological mechanisms to self-report measures of personality, laboratory task performance and observed social habits and attitudes (Eysenck, 1960). The phenomena of neurotic breakdown and recovery provide one natural test of predictions from personality theory with respect to neuroticism (N) and extraversion (E). Taking phobias as an example, it is predicted that persons with a high score on N (a low threshold for emotional activation) develop phobic reactions more readily, and the more introverted the person, the more quickly and strongly are the phobic reactions acquired and lastingly maintained (Eysenck and Rachman, 1965, p. 36).In a prospective study of university students. Kelvin et al. (1965) were unable to find a relationship between initial N score and psychological distress up to 2.5 years later. Rather, the N scale appeared to reflect current mental status, increasing when distress was reported. E scores also dropped in a group of students who happened to be referred to a psychiatrist. Similarly, in a 3-year follow-up of patients who had attended a psychiatrist. Ingham (1966) found that change in clinical status was reflected in a change of N, with the score of the improved group returning to the population mean. Initial personality did not predict change in clinical status. It was also found in a number of analyses that improvement was related to an increase in extraversion.The present study was designed to replicate Ingham's experiment on a more homogeneous group of neurotic patients—all phobic—who had received fantasy or in vivo exposure treatment (Marks, 1974). This treatment can be compared to an extinction procedure, i.e. the non-reinforced presentation of the CS, and should therefore provide a good testing ground of personality theory. Eysenck's theory predicts that the speed and success of treatment will be related to initial E and N scores. In particular, the speed of extinction of the neurotic fear should be related to extraversion; the more extraverted the patient the more rapidly should the fear extinguish.     

The role of posttraumatic fear and social support in the relationship between trauma severity and posttraumatic growth among adolescent survivors of the Yaan earthquake

Middle school students in Lushan county (N = 315) were assessed 6 months after the Yaan earthquake using a trauma severity questionnaire, a posttraumatic fear questionnaire, a social support questionnaire and a posttraumatic growth inventory to examine the effects of posttraumatic fear and social support in the relationship between trauma severity and posttraumatic growth (PTG). The results showed that posttraumatic fear mediated the relationship between trauma severity and PTG, and social support moderated the relationship between posttraumatic fear and PTG. These findings suggested that trauma severity could be positively associated with PTG in a direct way or in an indirect way through posttraumatic fear. Moreover, posttraumatic fear had a positive relation to PTG under the condition of high social support level, whereas the relation was non‐significant when the level of social support was low. These results were discussed in terms of their implications for adolescents after trauma.     

Exploring Different Forms of Job (Dis)Satisfaction and Their Relationship with Well‐Being,Motivation and Performance

Job satisfaction is often treated as a one‐dimensional construct. In contrast, Bruggemann ( 1974 ) postulated six distinct forms of (dis)satisfaction: four types of satisfaction (progressive, stabilised, resigned, pseudo) and two types of dissatisfaction (constructive, fixated). Despite her theory's practical relevance, few researchers have explored its assumptions or applications. The current study aimed to characterise a German‐speaking employee sample (n = 892) according to Bruggemann's theory using mixture modelling. We investigated stability of the (dis)satisfaction forms over a five‐month period, as well as their relationship with well‐being, motivation and (self‐reported) performance. We found latent clusters corresponding to most Bruggemann types, though no distinction between progressive and stabilised satisfaction was possible. While cluster membership varied over time, some clusters (e.g. resigned satisfaction) were more stable than others (e.g. constructive dissatisfaction). Overall satisfaction level explained 25–51 per cent variance in well‐being and motivation, and 13–16 per cent variance in performance. Including forms of satisfaction improved cross‐sectional prediction by 2–6 per cent explained variance. Results suggest that unfavourable consequences of job dissatisfaction may be limited to fixated—not constructive—dissatisfaction, though no consistent longitudinal effects emerged. We argue that exploring qualitative differences in job satisfaction promotes a more nuanced and potentially useful understanding of the relationship between satisfaction and work outcomes.     

The Koala Fear Questionnaire: Its Relationship with Fear of Storms and Hurricanes in 4- to 14-Year-Old Antillean Children

The present study further investigated the reliability and validity of the recently developed Koala Fear Questionnaire (KFQ) in a large sample of 4- to 14-year-old school children (N = 378) who lived on Sint-Maarten, The Netherlands Antilles. The results confirmed that the KFQ is a reliable scale with good internal consistency. Furthermore, evidence was obtained for the concurrent validity of the scale. That is, KFQ scores were substantially correlated with a highly relevant fear of the children on Sint-Maarten, namely fear of storms and hurricanes. Finally, psychometric properties in the younger children of our sample were highly similar to those obtained in older children. Altogether, these findings provide further support for the notion that the KFQ is a reliable and valid scale for assessing fears and fearfulness in children aged 4 years and above.