Comparison of social anxiety between Japanese adults who stutter and non-stuttering controls

PurposeAdults who stutter (AWS) often develop social anxiety disorder. This study was to provide comparative data on the Liebowitz Social Anxiety Scale-Japanese version (LSAS-J) from AWS and non-stuttering adult controls.MethodsLSAS-J, a 24-item self-reported survey of social phobia and avoidance across various daily situations, was administered to 130 AWS (Mean Age = 41.5 years, SD = 15.8, 111 males) and 114 non-stuttering adults (Mean Age = 39.5, SD = 14.9, 53 males). The test-retest reliability and internal consistency of the LSAS-J were assessed. A between-subject multivariate analysis of variance (MANOVA) was also conducted to determine whether attitude toward social anxiety differed between AWS and AWNS, or by age (<40 and ≥ 40 years old), or sex (female and male).ResultsAWS reported higher scores on both fear subscales of the LSAS-J. Age had no significant influence on the social anxiety levels reported by either participant group. Sex differences were found in the fear subscales, with females scoring higher on both fear subscales, although these were only marginally significant (p = .06). LSAS-J showed good test-retest reliability and high Cronbach’s alpha coefficient, indicating that it is an internally consistent measure of attitudes about social anxiety.ConclusionGiven the similarly high incidence of social anxiety in adults in Japan who stutter compared with those in other countries, social anxiety should be identified and assessed during clinical decision making and before decisions are made about stuttering treatment. LSAS-J is an easy tool to administer, and showed reliable results of social phobia and avoidance for AWS.     

Social anxiety and emotion regulation flexibility: considering emotion intensity and type as contextual factors

Background and objectives: Individuals with social anxiety disorder have often been considered inflexible in their emotion regulation. The aim of this study was to investigate emotion regulation flexibility in socially anxious individuals in response to two contextual factors, namely different levels of emotion intensity and emotion type.

Methods: A daily diary approach was employed, investigating emotion regulation (i.e., experiential avoidance, expressive suppression and cognitive reappraisal) in college students scoring high (N?=?62; HSA) and low (N?=?52; LSA) on social anxiety.

Results: Results revealed that HSAs were found to use more experiential avoidance than LSAs, especially at higher levels of negative intensity. The use of this emotion regulation strategy appeared to be driven by guilt, nervousness, and sadness. There were no between-group differences concerning the other strategies in response to varying levels of emotional intensity.

Conclusions: Together, the results provide evidence for inflexible emotion regulation in HSAs, reflected in an unwillingness to experience negative emotions.     

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.     

Life,Death, and Life After Death: Meanings of the Relationship Between Death Anxiety and Religion

ABSTRACT

A sample of 389 individuals completed a death anxiety scale and a series of items that measured self-reported religious practices and beliefs. Those lowest in religious practices and beliefs were significantly higher in death anxiety. Contrary to some prior research, depth of belief had a stronger negative association with death anxiety than did religious activities. Strongest relationships had to do with concepts of life after death. The oldest respondents reported the least death anxiety.     

Spanish version of Super Skills for Life: short- and long-term impact of a transdiagnostic prevention protocol targeting childhood anxiety and depression

ABSTRACT

Background and Objectives: Super Skills for Life (SSL) is a transdiagnostic protocol based on cognitive–behavioral therapy designed for children with internalizing problems. The present study examined for the first time the impact of the Spanish-adapted version of SSL in reducing anxiety and depressive symptoms in Spanish-speaking children.

Design: A quasi-experimental design with one group, pre- and posttest, and 1-year follow-up was conducted. Analyses were performed on an intent-to-treat basis.

Methods: Participants were 119 children (42.9% female; 8–12 years) recruited from nine schools. Children completed assessments of anxiety, depression, emotional and behavioral difficulties, and the extent to which anxiety interfered with life before and after receiving the 8-session SSL, and 12-months post-intervention.

Results: Anxiety and depressive symptoms were significantly reduced at post-test and 12-month follow-up assessments. SSL also had positive impact on other symptoms assessed (e.g., interference of anxiety with children’s life, peer problems, conduct problems). Overall, the long-term benefits of SSL appeared to be greater than the short-term benefits.

Conclusions: The results of this study suggest that SSL may be useful in reducing symptoms of anxiety and depression, and a broad range of other issues, in Spanish children.     

Effects of emotion regulation strategies on anxiety during job interviews in Chinese college students

Background and objectives: Few studies related to the impact of different emotion regulation strategies on anxiety have used externally and ecologically valid emotion-eliciting stimuli or Eastern populations. The present study compares the effects of reappraisal, suppression, and acceptance on anxiety induced by a simulated job interview in a Chinese sample. Methods: Eighty-two subjects were randomly assigned to one of four instructions: reappraisal, suppression, acceptance, or no-regulation strategies during a simulated job interview. Anxiety was assessed with an observer-based behavior rating scale during the interview and the State Anxiety Inventory before, during, and after the interview. Results: A repeated-measures MANOVA indicated a significantly greater reduction in anxiety in the reappraisal and acceptance groups compared to the control group during the interview (reappraisal: d = 1.42; acceptance: d = 1.30; each p < .001), but not during the recovery stage. The suppression and control group did not differ in any stage. Suppression led to a higher (p_max < .04) anxiety than reappraisal/acceptance in the anticipation (d = 0.65/0.68), interview (d = 0.87/0.79), and recovery stages (d = 0.94/1.03). No significant differences were found between reappraisal and acceptance. Conclusions: In Chinese students reappraisal and acceptance seem to be more effective anxiety regulation strategies than suppression.     

The utility of screen for child anxiety related emotional disorders (scared) as a tool for identifying children at high risk for prevalent anxiety disorders

Abstract

The current study examined the utility of the Screen for Child Anxiety Related Emotional Disorders (SCARED) as a screening tool for the identification of children at high risk for prevalent childhood anxiety disorders. The child version of the Structured Clinical Interview for DSM (KSCID) was used as the diagnostic standard. It was investigated whether SCARED scores are indicative for the presence of generalized anxiety disorder, separation anxiety disorder, and social phobia. Five-hundred-and-thirty-seven children aged 7–14 years completed the SCARED. From this sample, 82 children were selected on the basis of their SCARED scores. A subgroup of these children scored relatively high on the generalized anxiety disorder, separation anxiety disorder, and/or social phobia scale(s) of the SCARED. A comparison group of children scored relatively low on these SCARED scales. Both groups of children then received the semi-structured interview to assess to what extent they fulfilled the DSM-IV criteria for the relevant anxiety disorders. Results provided some support for the predictive validity of the SCARED generalized anxiety disorder and separation anxiety disorder subscales. The implications of these findings for the detection of anxiety disorders in normal children are briefly discussed.     

Decision-related action orientation predicts police officers' shooting performance under pressure

Background and Objectives: We aimed to test whether police officers’ trait self-control strength decreases negative effects of high pressure (HP) on state anxiety, shooting behavior, and shooting performance. Design and Methods: Forty-two officers performed a shooting test under both high and low-pressure (LP) conditions. Self-control strength was assessed with the decision-related action orientation (AOD) scale of the Action Control Scale (ACS-90). Effects of AOD on perceived anxiety, heart rate, shooting time, and shot accuracy were estimated and controlled for those of other individual difference measures (i.e. age, police working experience, trait anxiety, and threat-related action orientation). Results: After controlling for baseline values in the LP condition as well as the other individual difference measures, AOD significantly predicted shot accuracy in the HP condition. Conclusions: Results suggest that trait self-control strength in the form of AOD helps officers cope with anxiety and maintain perceptual-motor performance under HP.     

The meaning profiles of anxiety and depression: similarities and differences in two age groups

ABSTRACT

The distinctiveness of anxiety and depression is discussed concerning their nature, definitions, uses, manifestations and determinants. The objective was to examine the difference and similarity of anxiety and depression by applying the psychosemantic approach, which is a theory and methodology based on analysing the cognitive processes applied in communicating meanings. In Study 1, there were 760 participants of both genders, 23–31 years old. They were administered the Meanings Test, which yields the respondent’s meaning profile, and one of seven anxiety scales or one of three depression scales. Significant correlations between the meaning profiles and the anxiety or depression scales were summarised and compared. In Study 2, there were 78 individuals over 65 years old who were administered the Meanings Test plus an anxiety or depression scale. The findings for anxiety and depression were compared within and across age groups. The results yielded two distinct meaning profiles for anxiety and depression in the two age groups. The anxiety profile indicated more focusing on one’s internal world. whereas the depression profile indicated focusing both on the personal and the interpersonally shared reality. The conclusion was that anxiety and depression are different constructs that need to be considered as separate theoretically and practically.     

Enhancing recovery rates: Lessons from year one of IAPT

BackgroundThe English Improving Access to Psychological Therapies (IAPT) initiative aims to make evidence-based psychological therapies for depression and anxiety disorder more widely available in the National Health Service (NHS). 32 IAPT services based on a stepped care model were established in the first year of the programme. We report on the reliable recovery rates achieved by patients treated in the services and identify predictors of recovery at patient level, service level, and as a function of compliance with National Institute of Health and Care Excellence (NICE) Treatment Guidelines.MethodData from 19,395 patients who were clinical cases at intake, attended at least two sessions, had at least two outcomes scores and had completed their treatment during the period were analysed. Outcome was assessed with the patient health questionnaire depression scale (PHQ-9) and the anxiety scale (GAD-7).ResultsData completeness was high for a routine cohort study. Over 91% of treated patients had paired (pre-post) outcome scores. Overall, 40.3% of patients were reliably recovered at post-treatment, 63.7% showed reliable improvement and 6.6% showed reliable deterioration. Most patients received treatments that were recommended by NICE. When a treatment not recommended by NICE was provided, recovery rates were reduced. Service characteristics that predicted higher reliable recovery rates were: high average number of therapy sessions; higher step-up rates among individuals who started with low intensity treatment; larger services; and a larger proportion of experienced staff.ConclusionsCompliance with the IAPT clinical model is associated with enhanced rates of reliable recovery.     

Psychotraumatic Stress and Anxiety

Abstract

A systematic review of all available treatment studies for music performance anxiety was undertaken. Interventions were categorised into psychological treatments and pharmacological treatments. Psychological treatments included behavioral, cognitive, cognitive-behavioral, combined treatments and other therapies. Issues such as the number of studies in each treatment modality, their sample sizes and the methodological quality of most of the studies reviewed precluded firm conclusions about the effectiveness of any of the treatments assessed for music performance anxiety. The field is in urgent need of larger scale, methodologically rigorous studies to assist the large minority of musicians who suffer from performance impairing music performance anxiety.     

‘It’s the unknown’ – understanding anxiety: from the perspective of people with multiple sclerosis

Objective: A qualitative study of PwMS who had clinically significant levels of anxiety was conducted to gain a richer perspective on their experience. The objective was to explore PwMS’ experiences of anxiety and their perspectives on causes and outcomes. Design: Twenty in-depth, semi-structured interviews were conducted with PwMS consecutively recruited from the Neurology Department of a NHS University Hospital. Sixteen had a relapsing-remitting course, three had a secondary progressive course and one person had primary progressive multiple sclerosis (MS). Interviews were recorded, transcribed and analysed using inductive thematic analysis. Results: Although participants thought different factors had initially triggered their anxiety, being given the diagnosis of MS appeared to be the most significant factor for many participants. Difficulties in the workplace and in relationships, particularly related to perceived dependence on others were also important themes. A wide range of emotional responses and negative thinking patterns were associated with anxiety; this suggested the presence of comorbid depression. Participants were able to acknowledge the positive and negative coping strategies that impacted on their anxiety. Conclusion: This review confirms that anxiety can have many negative implications for PwMS and suggests that early detection and intervention are necessary in order to improve patient’s well-being.     

Validity and reliability of the Connor-Davidson Resilience Scale (CD-RISC) in competitive sport

ObjectiveThis study replicates and extends the work of Gucciardi, Jackson, Coulter, and Mallett (2011) in relation to the validity of the Connor-Davidson Resilience Scale (CD-RISC; Connor & Davidson, 2003) in sport. Three primary aims were explored: 1) Examine the factor structure and fit of three versions of the CD-RISC: the original 25-item CD-RISC, both as a 25-item five factor scale and as a 25-item unidimensional scale, and the 10-item CD-RISC-10; 2) examine gender invariance of the best fitting version of the CD-RISC; and 3) examine the validity of the best fitting CD-RISC by relating it to affect and performance anxiety in a sample of competitive American distance runners (N = 409).DesignCross-sectional.MethodsMultiple self-report questionnaires were delivered through an online medium.ResultsUsing confirmatory factor and item level analyses, the CD-RISC-10-item scale was psychometrically superior to the unidimensional 25-item and the five factor 25-item CD-RISC versions. The CD-RISC-10-item exhibited measurement invariance for gender, with significant configural, strong, and weak analyses. Using structure equation modeling, the CD-RISC-10-item scale moderately and positively correlated with positive affect and was inversely related to negative affect and performance anxiety, establishing convergent and divergent validity.ConclusionThe findings offer some initial psychometric evidence for the use of the CD-RISC-10 in sport performers.     

Information giving and involvement in treatment decisions: Is more really better? Psychological effects and relation with adherence

Objectives : The aim of this study is to improve our understanding of the ways in which a medical consultation style relates to satisfaction and adherence.

Design : Participants completed questionnaires about preferred and perceived consultation styles; psychological variables such as satisfaction, anxiety and depression; and questions about taking medication. Questionnaires were completed prior to the consultation, immediately after, three months later and one year later. Doctors also completed a scale on completion of the consultation. The decisions in question related to women seeking advice about Hormone Replacement Therapy (HRT) and decisions about pain management.

Results : Patients expressed preferences for information about the treatment options and for active involvement in the decision process. The extent to which patients perceived themselves as having received information about the treatment options was a particularly consistent predictor of satisfaction. The extent to which patients perceived themselves as having been prepared for the side effects of HRT was a consistent predictor of anxiety.

Conclusions : Perceptions of the amount of information received about medical options, including information preparing individuals for potential side effects of medication, appears to be more important to satisfaction and anxiety, than actual involvement in the decision.     

Children and adolescents who stutter: Further investigation of anxiety

PurposeDespite the greatly increased risk of social anxiety disorder in adults who stutter, there is no clear indication of the time of onset of this disorder in childhood and adolescence. The purpose of this study was to explore this issue further using the Revised Children's Manifest Anxiety Scale (RCMAS), so that appropriate interventions can be developed prior to adulthood. This is the first time the RCMAS has been completed by children younger than 11 years. Using the same test for both school-age children and adolescents can potentially identify when anxiety starts to develop from age 6 years through to adulthood.MethodsThe RCMAS was administered to 18 school-age boys, five school-age girls, 41 adolescent boys and nine adolescent girls who were seeking treatment for their stuttering. Participants also rated the severity of their own stuttering.ResultsAll mean scaled scores on the four RCMAS subscales and Total Anxiety scores were within normal limits. However, for both groups of boys, scores on the Lie Scale were significantly higher than scores on the other three subscales.ConclusionsExperts suggest high scores on the RCMAS Lie Scale are indicative of participants attempting to present themselves in a positive light and so cast doubt on the veracity of their other responses on the test. One interpretation, then, is that the boys were concealing true levels of anxiety about their stuttering. The results suggest why findings of anxiety studies in children and adolescents to date are equivocal. Clinical implications are discussed.Educational objectives: The reader will be able to: (a) discuss why understanding when anxiety starts in people who stutter is important, (b) describe the function of the RCMAS Lie sub scale and (c) summarize the possible implications of the RCMAS findings in this study.     

The psychometric properties of the Greek version of the State-Trait Anxiety Inventory in cancer patients receiving palliative care

Objectives: To validate the Greek version of the State-Trait Anxiety Inventory (STAI) in a sample of cancer patients. Design: The scale was administered twice, with a 3-day interval, to 99 eligible patients with cancer. Together with the Greek version of STAI scale, the patients also completed the anxiety subscale from the Hospital Anxiety and Depression scale (HAD). Observations: Factor analysis yielded a three-factor solution, explaining 47.143% of the variance. Cronbach α for three scales was between 0.729 and 0.852. Inter-scale correlations were moderate-to-high and ranged from 0.282 to 0.563 (p < 0.0005, p < 0.005). The assessment of the relationships among the Greek STAI scales and HAD-Anxiety showed statistically significant correlations between them (r ranged between 0.428 and 0.596, p < 0.0005). The test/retest reliability of scale (Pearson's ‘r’), showed that the coefficient agreement ranged between 0.85 and 0.90 (p < 0.0005). Univariate analysis revealed significant correlations between female gender, metastasis, performance status, chemotherapy, mild opioids and low education level with increased anxiety. Conclusions: These results support that the Greek version of STAI is an instrument with satisfactory psychometric properties, and is a valid research tool for Greek cancer patients.     

Perfectionistic concerns predict increases in adolescents’ anxiety symptoms: a three-wave longitudinal study

Background and Objectives: Although perfectionism has been proposed to be a risk factor for the development of anxiety, research on perfectionism and anxiety symptoms in adolescents is scarce and inconclusive. The aim of the present study was to investigate whether the two higher-order dimensions of perfectionism – perfectionistic strivings and perfectionistic concerns – predict the development and maintenance of anxiety symptoms. An additional aim of the present study was to examine potential reciprocal effects of anxiety symptoms predicting increases in perfectionism.

Design: The study used a longitudinal design with three waves spaced 4–5 months apart.

Methods: A non-clinical sample of 489 adolescents aged 12–19 years completed a paper-and-pencil questionnaire.

Results: As expected, results showed a positive effect from perfectionistic concerns to anxiety symptoms, but the effect was restricted to middle-to-late adolescents (16–19 years old): Perfectionistic concerns predicted longitudinal increases in adolescents’ anxiety symptoms, whereas perfectionistic strivings did not. Furthermore, anxiety symptoms did not predict increases in perfectionism.

Conclusions: Implications for the understanding of the relationship between perfectionism and anxiety symptoms are discussed.     

Comorbidity of anxiety-depression among Australian university students: implications for student counsellors

ABSTRACT

The incidence, factor structure and scale item differences in anxiety-depression comorbidity were investigated in a sample of Australian university students defined according to the presence of anxiety and/or depression. The incidence of anxiety-depression comorbidity was over 32%, about four times that for anxiety or depression alone. Participants with comorbidity had significantly higher Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) total and factor scores than those with anxiety or depression alone. The major differences between the comorbid and unitary disordered subgroups were for self-disintegration and autonomic arousal. Comorbidity of anxiety and depression is a more serious disorder than either anxiety or depression alone, and appears to exist in large proportions among university students. Assessment and treatment plans might benefit from inclusion of this comorbidity.     

Biases in attention and interpretation in adolescents with varying levels of anxiety and depression

ABSTRACT

This is the first study to investigate multiple cognitive biases in adolescence simultaneously, to examine whether anxiety and depression are associated with biases in attention and interpretation, and whether these biases are able to predict unique variance in self-reported levels of anxiety and depression. A total of 681 adolescents performed a Dot Probe Task (DPT), an Emotional Visual Search Task (EVST), and an Interpretation Recognition Task. Attention and interpretation biases were significantly correlated with anxiety. Mixed results were reported with regard to depression: evidence was found for an interpretation bias, and for an attention bias as measured with the EVST but not with the DPT. Furthermore, interpretation and attention biases predicted unique variance in anxiety and depression scores. These results indicate that attention and interpretation biases are unique processes in anxiety and depression. They also suggest that anxiety and depression are partly based on similar underlying cognitive mechanisms.     

The multidimensionality of test anxiety: A test of different models

Abstract

Confirmatory factor analysis was employed to test the multidimensional structure of test anxiety. Starting with the traditional two-factor model, it was of interest whether additional dimensions could still be represented by a single higher-order factor of test anxiety or whether the additional dimensions represented correlates of test anxiety. The Revised Test Anxiety (RTA) scale and the German Test Anxiety Inventory (TAI-G) were combined collecting data from a binational sample of 218 American and 218 German university students. Considering the statistical and theoretical aspects of model fit, they indicated that a model consisting of three primary factors (worry, emotionality, and lack of confidence) fit the data best. While distraction and self-efficacy may be regarded as correlates of test anxiety, lack of confidence was substantiated as a component of test anxiety. Implications for the conceptualization of the content domain and hence area of test anxiety were discussed.