Toward the content validity of premenstrual dysphoric disorder: do anger and irritability more than depressed mood represent treatment-seekers' experiences?

The content validity of Premenstrual Dysphoric Disorder in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) has been questioned in the literature. We tested whether mood-related symptoms reported by 26 women seeking treatment for premenstrual disorders were among the proposed criteria. These women were asked to list their premenstrual symptoms and rate the severities of listed symptoms daily for two menstrual cycles before treatment. They completed semistructured interviews to differentiate symptoms of Premenstrual Dysphoric Disorder from those of other psychiatric disorders in women who had other disorders. All participants reported functional interference due to the symptoms. 19 symptoms of or similar to those of Premenstrual Dysphoric Disorder were among the 22 most frequent premenstrual symptoms experienced. Premenstrual depressed mood was less frequent than premenstrual irritability or anger when other psychiatric disorders such as major depression were taken into account. Results suggest that the DSM-IV-TR criteria have generally good content validity but may need revision to represent treatment-seekers experiences more accurately.     

Self-esteem moderates affective reactions to briefly presented emotional faces

According to the sociometer hypothesis individuals with low self-esteem experience increased negative affect in response to negative social stimuli, even when these stimuli are not perceived consciously. Using an affective priming paradigm, the present study examined whether trait self-esteem would moderate mood following briefly presented facial expressions. Results from 43 undergraduates revealed that, after controlling for baseline mood, anxiety and depression, the degree of negative affect experienced by the participants following exposure to expressions of anger and disgust varied as a function of their self-esteem. Implications for individuals with low-self esteem and our understanding of the link between self-esteem and negative affect are discussed.     

The Influence of Dysphoria on Reactivity to Naturalistic Fluctuations in Anger

Abstract We used an experience sampling methodology to explore the relationship between current symptoms of dysphoria and momentary mood fluctuations following everyday experiences of anger. Using PDA devices, participants rated their mood, ruminative cognitions, feelings of dependency, and stressful events 4 times per day for 1 week. We hypothesized and found that those higher in dysphoria would demonstrate a stronger link between anger and depressed mood than those who were lower in dysphoria. Those participants who reported higher initial dysphoria indicated more anger over the course of the week, a stronger within-person association between anger and depressed mood, and a slower recovery from anger experiences. Multilevel moderated mediation analyses indicated that the link between anger and depressed mood for those high in dysphoria is largely explained by a stronger carryover of anger from one assessment to the next and partially explained by greater increases in ruminative cognitions and feelings of dependency. The change in depressed mood appears to occur with increases in anger, specifically, and not other negative mood states. Our results extend previous research on the anger–depression relationship by investigating the short-term relationships between anger and depressed mood among those with varying levels of dysphoria.     

Biases in affective forecasting and recall in individuals with depression and anxiety symptoms

The authors used experience sampling to investigate biases in affective forecasting and recall in individuals with varying levels of depression and anxiety symptoms. Participants who were higher in depression symptoms demonstrated stronger (more pessimistic) negative mood prediction biases, marginally stronger negative mood recall biases, and weaker (less optimistic) positive mood prediction and recall biases. Participants who were higher in anxiety symptoms demonstrated stronger negative mood prediction biases, but positive mood prediction biases that were on par with those who were lower in anxiety. Anxiety symptoms were not associated with mood recall biases. Neither depression symptoms nor anxiety symptoms were associated with bias in event prediction. Their findings fit well with the tripartite model of depression and anxiety. Results are also consistent with the conceptualization of anxiety as a "forward-looking" disorder, and with theories that emphasize the importance of pessimism and general negative information processing in depressive functioning.     

Interactions between emotion regulation strategies and affective style: Implications for trait anxiety versus depressed mood

Affective style reflecting approach and inhibition is thought to be associated in distinct ways with anxious versus depressed mood; relatively few studies, however, consider how the interaction between affective style and the strategies individuals use to regulate mood and emotion might influence these associations. Sixty-seven non-disordered adults self-reported on their use of two emotion regulation strategies (cognitive reappraisal and expressive suppression), behavioral approach (BAS) and behavioral inhibition sensitivity (BIS) dimensions of affective style, and anxious and depressed mood (trait anxiety and symptoms of depression). Trait anxiety versus depressed mood was associated with unique interactive patterns of emotion regulation and affective style: enhanced use of reappraisal was linked to less depressed mood in those reporting low BAS, whereas high suppression was linked to greater trait anxiety in those reporting low BIS. The implications of findings for typical emotional processes and for clinical disorders and interventions are discussed.     

The role of anger in generalized anxiety disorder

Little is known about the role of anger in the context of anxiety disorders, particularly with generalized anxiety disorder (GAD). The aim of study was to examine the relationship between specific dimensions of anger and GAD. Participants (N?=?381) completed a series of questionnaires, including the Generalized Anxiety Disorder Questionnaire (GAD-Q-IV; Newman et al., 2002, Behavior Therapy, 33, 215-233), the State-Trait Anger Expression Inventory (STAXI-2; Spielberger 1999, State-Trait Anger Expression Inventory-2: STAXI-2 professional manual, Odessa, FL: Psychological Assessment Resources) and the Aggression Questionnaire (AQ; Buss & Perry 1992, Journal of Personality and Social Psychology, 63, 452-459). The GAD-Q-IV identifies individuals who meet diagnostic criteria for GAD (i.e. GAD analogues) and those who do not (non-GAD). The STAXI-2 includes subscales for trait anger, externalized anger expression, internalized anger expression, externalized anger control and internalized anger control. The AQ includes subscales for physical aggression, verbal aggression, anger and hostility. The GAD-Q-IV significantly correlated with all STAXI-2 and AQ subscales (r's ranging from .10 to .46). Multivariate analyses of variance revealed that GAD analogues significantly differed from non-GAD participants on the combined STAXI-2 subscales (η(2)?=?.098); high levels of trait anger and internalized anger expression contributed the most to GAD group membership. GAD analogue participants also significantly differed from non-GAD participants on the combined AQ subscales (η(2)?=?.156); high levels of anger (affective component of aggression) and hostility contributed the most to GAD group membership. Within the GAD analogue group, the STAXI-2 and AQ subscales significantly predicted GAD symptom severity (R (2)?=?.124 and .198, respectively). Elevated levels of multiple dimensions of anger characterize individuals who meet diagnostic criteria for GAD.     

Affective individual differences and startle reflex modulation

Potentiation of startle has been demonstrated in experimentally produced aversive emotional states, and clinical reports suggest that potentiated startle may be associated with fear or anxiety. To test the generalizability of startle potentiation across a variety of emotional states as well as its sensitivity to individual differences in fearfulness, the acoustic startle response of 17 high- and 15 low-fear adult subjects was assessed during fear, anger, joy, sadness, pleasant relaxation, and neutral imagery. Startle responses were larger in all aversive affective states than during pleasant imagery. This effect was enhanced among high fear subjects, although followup testing indicated that other affective individual differences (depression and anger) may also be related to increased potentiation of startle in negative affect. Startle latency was reduced during high- rather than low-arousal imagery but was unaffected by emotional valence.     

Motor vehicle accident trauma exposure: Personality profiles associated with posttraumatic diagnoses

Abstract

Personality profiles associated with diagnostically distinct posttraumatic responses were examined. Profiles were compared between three groups defined on the basis of posttraumatic diagnosis following motor vehicle accident (MVA) trauma exposure. The diagnostic groups were: Posttraumatic Stress Disorder (PTSD), Acute Stress Disorder (ASD) without progression to PTSD, and subclinical responses. Participants were male and female community volunteers aged 18 to 77 (N = 83) who had all been exposed to an MVA meeting the DSM-IV diagnostic criteria for a traumatic event. The Personality Assessment Inventory (Morey, 1991) was used to assess psychological variables in the framework of posttraumatic diagnostic groups. The PTSD group scored significantly higher than the ASD and subclinical groups on scales assessing somatic complaints, anxiety, anxiety related disorders, depression, non-psychotic symptoms of schizophrenia, and negative relationships. The profile of the ASD group was characterized by self report of greater interpersonal warmth and a trend for greater egocentricity than the PTSD group. There were no significant differences in the personality profiles of the ASD and subclinical groups. The role of personality factors in posttraumatic adjustment is discussed in the context of previous literature.     

Temporal lobe signs and personality characteristics

Mature university students (14 men and 16 women) were asked to complete the 16 PF and a scale that samples temporal lobe signs in the normal population. People who reported frequent temporal lobe experiences were more emotionally unstable, impulsive, emotionally sensitive (imaginative inner self, actions based upon intuition and self-anxiety), and tense (free-floating anxiety). The results were compatible with personality characteristics of people who report "temporal lobe experiences" and have been assessed by the Minnesota Multiphasic Personality Inventory and the California Personality Inventory.     

Predicting anger in social anxiety: The mediating role of rumination

Anger and the way that anger is expressed have been linked to attrition and poorer treatment outcomes in patients with Social Anxiety Disorder (e.g., Erwin, B. A., Heimberg, R. G., Schneier, F. R. & Liebowitz, M. R. (2003). Anger experience and expression in social anxiety disorder: Pretreatment profile and predictors of attrition and response to cognitive-behavioral treatment. Behavior Therapy, 34, 331–350). Understanding the connection between social anxiety and anger may be one way to improve outcomes in this population. A cross-sectional regression design was used in a sample of 363 undergraduates to examine the suggestion that ruminative thought is a critical factor linking social anxiety to anger. In support of this hypothesis, brooding fully mediated the relationship between social anxiety and trait anger and partially mediated the relationship between social anxiety and outward anger expression. The relationship between brooding and anger suppression became non-significant after depression was controlled. In contrast, reflective pondering partially mediated the relationship between social anxiety and anger suppression. These results suggest that addressing rumination may be useful in the treatment of socially anxious patients who struggle with anger. They also support the utility of considering multiple forms of rumination and multiple anger outcomes in a single study.     

Measuring the negative mood component of stress experiences: description and psychometric properties of a short adjective check-list of stress responses

Negative Mood (NM) is a 19-items adjective check-list developed to assess negative mood and stress responses. The items of the scale reflect dimensions such as depressed mood, anxiety, anger and time urgency. The data were collected from four different samples, two random population samples and two smaller selective samples. The psychometric properties of the NM showed high internal consistency (Cronbach's Alpha). When analysed with principal components analysis, three factors emerged, anxiety/depression, time pressure, and anger. The factors emerged in all four samples, within samples and between gender. The NM factors were tested for convergent and discriminative validity by correlating them with other more established measures of different aspects of negative mood. The results showed high convergent and discriminative validity for two of the NM factors, i.e., anxiety/depression, and anger, whereas the results for the third factor, time pressure, were more ambiguous. This scale has proven to be useful in capturing some vital dimensions of negative affect across different kinds of populations.     

The Relationship of a Measure of Frustration Intolerance with Emotional Dysfunction in a Student Sample

This study extended earlier research (Harrington in Cong Ther Res 30:699–709, 2006) on the relationship of the multidimensional Frustration Discomfort Scale (FDS) with measures of depressed mood, anxiety and anger, independent of self-esteem. The study employed a non-clinical student sample (N = 323) and measures of both state and trait anger and anxiety. In addition, the Unconditional Self-Acceptance Questionnaire (USAQ) was also used to specifically assess REBT self-acceptance beliefs regarding self-worth, as well as a measure of self-esteem. A Serbian version of the FDS was developed for use in the study. Consistent with the earlier research, significant predictive relationships were found, whilst controlling for self-worth, between entitlement and anger, emotional intolerance and anxiety, and discomfort intolerance with depressed mood. Emotional intolerance also proved to be a significant positive predictor of depression, whilst achievement frustration had a negative relationship with depression. Overall, the FDS dimensions had a weaker relationship with emotional states than traits. The results are discussed in regard to the relationship between FDS dimensions and dysfunctional emotions in a non-clinical sample.     

Affective correlates of trichotillomania

Affective correlates of hair pulling were investigated in a sample of 44 participants diagnosed with trichotillomania (TM). Participants completed the Hair Pulling Survey on which they rated the intensity of ten different affective states across three different phases of hair pulling (before, during and after). Repeated measures analysis of variance was used to examine the change of emotional experience across the hair pulling cycle. Results indicated significant decreases in boredom, anxiety and tension, and significant increases in guilt relief, sadness and anger across time (p<0.005). The role of co-existent anxiety and mood disorders also was examined using repeated measures analysis of variance. Results of these analyses indicated that patients with and without co-existent disorders differed only on patterns of anger across time, and therefore do not support affective subtypes of TM patients based on co-existent diagnosis. Implications of these findings for conceptualization and treatment of TM are discussed.     

前额叶皮质损伤患者的情绪异常

人类前额叶皮质与情绪之间有着密切的关系,文章在相关的临床和神经成像研究结果基础上,分析了前额叶皮质损伤对情绪行为造成的影响,分别概述了精神分裂症、重性抑郁和焦虑患者的情绪变化、前额叶切除对情绪的影响以及左右前额叶皮质与情绪的关系,重点阐述了前额叶功能异常的神经生理学特点,认为情绪的改变会随着前额叶皮质不同部位的结构缺损或功能变化而有所不同,此有利于对前额叶皮质损伤患者情绪异常的评价与防治。     

Anxiety,anger and depression: Relationships at the trait level

Abstract

The relationship between anxiety and depression has been extensively researched at the state and clinical syndrome levels. However, relatively few studies have directed their attention to the interrelations between the constructs at the trait level. The present two studies investigated the interrelationships between anxiety, anger and depression at the trait level in nonclinical, subclinical and clinical samples. The results showed anxiety and depression to be highly correlated in students, adults, medical and psychiatric in-patients. As to the relationship of anger with both anxiety and depression, results, especially between anxiety and anger, were likewise significant although much weaker than commonly reported at the affective state level. Moreover, partial correlations suggested the results on the anger-depression relationship to be mainly due to the mediating (causal) influence of anxiety. The results are discussed with reference to the discrepancy of distinctions commonly made between the constructs at the theoretical level and lack of such distinction found at the empirical level. The possible mediating role of both trait-anxiety and trait-anger-in in the development of a depressive disposition is offered as an alternative explanation for the interrelatedness of the three constructs at the trait level.     

I Did OK,but Did I Like It? Using Ecological Momentary Assessment to Examine Perceptions of Social Interactions Associated With Severity of Social Anxiety and Depression

Socially anxious and depressed individuals tend to evaluate their social interactions negatively, but little is known about the specific real-time contributors to these negative perceptions. The current study examined how affect ratings during social interactions predict later perceptions of those interactions, and whether this differs by social anxiety and depression severity. Undergraduate participants (N = 60) responded to a smartphone application that prompted participants to answer short questions about their current affect and social context up to 6 times a day for 2 weeks. At the end of each day, participants answered questions about their perceptions of their social interactions from that day. Results indicated that the link between negative affective experiences reported during social interactions and the end-of-day report of enjoyment (but not effectiveness) of those experiences was more negative when social anxiety was more severe. The link between negative affective experiences rated during social interactions and the end-of-day report of effectiveness (but not enjoyment) during those social encounters was more negative when depression was more severe. These findings demonstrate the importance of examining self-perceptions of social interactions based both on the extent to which individuals think that they met the objective demands of an interaction (i.e., effectiveness, mastery) and the extent to which they liked or disliked that interaction (i.e., enjoyment, pleasure). These findings also highlight how real-time assessments of daily social interactions may reveal the key experiences that contribute to negative self-evaluations across disorders, potentially identifying critical targets for therapy.     

Generalized expectancies for negative mood regulation predict change in anxiety and depression among college students

Negative mood regulation (NMR) expectancies, or the beliefs held by individuals that, when faced with various manifestations of stress and negative affect, they can successfully cope with such mood states, have proven to be a most useful construct in the context of better understanding self-regulatory processes. In the present prospective study, we examined the predictive utility of NMR expectancies with respect to its ability to predict residual change in both depressive and anxiety symptoms over an 8-week timeframe in a sample of 322 college students. Initial correlational analyses revealed that, as anticipated, NMR expectancies were negatively correlated with depressive and anxiety symptomatology, as well as with maladaptive coping style. Conversely, NMR expectancies were positively associated with self-reported adaptive coping. A series of hierarchical regression analyses revealed that, even when controlling for age, sex, baseline levels of affective distress (depression or anxiety), and coping styles, NMR expectancies predicted change in both depressive and anxiety symptomatology. Implications of the findings pertinent to theory building and testing are discussed.     

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.     

A Psychometric Analysis of the Revised Child Anxiety and Depression Scale—Parent Version in a Clinical Sample

The Revised Child Anxiety and Depression Scale—Parent Version (RCADS-P) is a 47-item parent-report questionnaire of youth anxiety and depression, with scales corresponding to the DSM-IV categories of Separation Anxiety Disorder, Social Phobia, Generalized Anxiety Disorder (GAD), Panic Disorder, Obsessive-Compulsive Disorder, and Major Depressive Disorder (MDD). The RCADS-P is currently the only parent-report questionnaire that concurrently assesses youth symptomatology of individual anxiety disorders as well as depression in accordance with DSM-IV nosology. The present study examined the psychometric properties of the RCADS-P in a large (N = 490), clinic-referred sample of youths. The RCADS-P demonstrated favorable psychometric properties, including high internal consistency, convergent/divergent validity, as well as strong discriminant validity—evidencing an ability to discriminate between anxiety and depressive disorders, as well as between the targeted anxiety disorders. Support for the DSM-related six-factor RCADS-P structure was also evidenced. This structure demonstrated superior fit to a recently suggested alternative to the DSM-IV classification of anxiety and affective disorders—namely, the MDD/GAD “distress” factor.     

Self-talk and affective problems in college students: valence of thinking and cognitive content specificity

The aim of this study was to develop a Self-Talk Inventory for young adults. This inventory consisted of two scales. The Negative Self-Talk Scale included three categories of self-talk (depressive, anxious, and angry thoughts) and the Positive Self-Talk Scale, three categories (minimization, positive orientation, and coping self-instructions). Participants were 982 undergraduate students (Mean age = 20.35 years, SD = 2.16). They completed the self-talk scales together with the following scales to measure symptoms of affective disorders: the Center for Epidemiological Studies Depression Scale (CES-D), the State-Trait Anxiety Inventory (STAI), and the State-Trait Anger Expression Inventory (STAXI-T). Factor analyses confirmed the hypothesized structure for the Self-Talk Inventory. The relations between self-talk and symptoms of affective disorders (depression, anxiety, and anger) were also evaluated. In general, states-of-mind -SOM- ratios and negative cognitions showed a greater association with psychological symptoms than did positive cognitions. Results concerning the cognitive characteristics of depression, anxiety, and anger were mixed and partially supported the cognitive content specificity theory.