Attachment style and long‐term singlehood

This study examined how long‐term single people satisfy their attachment and sexual needs. A community sample of single and coupled adults (N = 142) located in the United States completed measures of attachment style, attachment figures, loneliness, depression, anxiety, quality of relationships with parents, and sexual behavior. In a structured interview, they answered questions about their childhoods and managing attachment, support, and sexual needs. Quality of childhood relationships with parents as well as use of attachment‐related words was coded. Single participants were as likely as coupled ones to exhibit attachment security and rely on attachment figures, although compared to coupled participants, they reported higher levels of loneliness, depression, anxiety, sexual dissatisfaction, and troubled childhood relationships with parents.     

Association of prenatal attachment and early childhood emotional,behavioral, and developmental characteristics: A longitudinal study

This study examines the associations between prenatal attachment and child development, socioemotional behavioral problems, and competence at early childhood. It also inquires whether maternal depression and anxiety at the prenatal period and at early childhood are associated with child outcomes. The study consisted of 83 mothers and their children. Data regarding the prenatal attachment, depression, and anxiety were collected during Weeks 28 to 40 of gestation. When the children were 21 to 31 months old, the Brief Infant and Toddler Social Emotional Assessment (BITSEA) and the Ankara Developmental Screening Inventory (ADSI) were applied to children along with Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI) administered to mothers. Results showed that prenatal attachment scores significantly correlated with BITSEA-Competency subscale scores and ADSI total scores at early childhood, r(83) = 0.246, P = .025, and r(82) = 0.316, P = .004, respectively. Prenatal attachment levels were found to be the predictors of both behavioral and emotional competence and development at early childhood, b = 0.081, t(83) = 2.273, P = .014, and b = 0.281, t(83) = 3.225, P = .002, respectively. In addition, prenatal attachment was shown to be even a stronger predictor of development than was worsening maternal depression at early childhood, b = −0.319, t(83) = 2.140, P = .035. Our results indicate that fostering prenatal attachment may be beneficial for better infant outcomes at early childhood.     

Does interview anxiety predict job performance and does it influence the predictive validity of interviews?

Interview anxiety is negatively related to interview performance; however, its relation to job performance is unknown. It could correlate negatively with job performance, and it could moderate the interview performance–job performance relation. In a sample of applicants for Residence Assistant positions, interview anxiety had near‐zero correlations with job performance, rated by supervisors and supervisees. It moderated the relation between interview performance and supervisor‐rated facilitating peer and team performance, such that interview performance did not predict this job performance component for anxious applicants. The moderation was not found for supervisor‐rated task proficiency, or for supervisee ratings of either job performance component, suggesting that the impact of interview anxiety depends on rater source and which job performance component is rated.     

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.     

Psychologists’ Evaluation of Bariatric Surgery Candidates Influenced by Patients’ Attachment Representations and Symptoms of Depression and Anxiety

This study examines whether patients self-reported attachment representations and levels of depression and anxiety influenced psychologists’ evaluations of morbidly obese patients applying for bariatric surgery. A sample of 250 patients (mean age 44, 84 % female) who were referred for bariatric surgery completed questionnaires to measure adult attachment and levels of depression and anxiety. Psychologists rated patients’ suitability for bariatric surgery using the Cleveland Clinic Behavioural Rating System (CCBRS), unaware of the results of the completed questionnaires. Attachment anxiety (OR = 2.50, p = .01) and attachment avoidance (OR = 3.13, p = .001) were found to be associated with less positive evaluations on the CCBRS by the psychologists, and symptoms of depression and anxiety mediated this association. This study strongly supports the notion that patients’ attachment representations influence a psychologist’s evaluation in an indirect way by influencing the symptoms of depression and anxiety patients report during an assessment interview. The clinical implications of these findings are discussed.     

Attachment styles and clinical correlates in people at ultra high risk for psychosis

Evidence suggests that attachment styles may influence subclinical psychosis phenotypes (schizotypy) and affective disorders and may play a part in the association between psychosis and childhood adversity. However, the role of attachment in the initial stages of psychosis remains poorly understood. Our main aim was to describe and compare attachment styles in 60 individuals at ultra high risk for psychosis (UHR) and a matched sample of 60 healthy volunteers (HV). The HV had lower anxious and avoidant attachment scores than the UHR individuals (p < .001). Sixty-nine percentage of the UHR group had more than one DSM-IV diagnosis, mainly affective and anxiety disorders. The UHR group experienced more trauma (p < .001) and more mood and anxiety symptoms (p < .001). Interestingly, in our UHR group, only schizotypy paranoia was correlated with insecure attachment. In the HV group, depression, anxiety, schizotypy paranoia, and social anxiety were correlated with insecure attachment. This difference and some discrepancies with previous studies involving UHR suggest that individuals at UHR may compose a heterogeneous group; some experience significant mood and/or anxiety symptoms that may not be explained by specific attachment styles. Nonetheless, measuring attachment in UHR individuals could help maximize therapeutic relationships to enhance recovery.     

Impact of End-of-Life Circumstances on the Adjustment of Bereaved Siblings of Children Who Died from Cancer

The aim of this study was to examine the impact of end-of-life (EoL) circumstances on grief and internalizing symptoms among bereaved siblings. Bereaved families (N?=?88) were recruited from three sites 3–12 months (M?=?11.57, SD?=?3.48) after their child’s death from cancer. One sibling per family aged 8–17 years (M?=?12.41, SD?=?2.64) was randomly selected to participate. Families completed measures of siblings’ grief and internalizing symptoms, as well as a structured interview about circumstances surrounding the death. Mother and sibling reports of EoL circumstances were generally concordant, except there was a discrepancy between mothers and children about whether or not children expected their sibling’s death (t(75)?=?1.52, p?=?.018). Mother reports of sibling internalizing symptoms were above the normative mean (t(83)?=?4.44, p?≤?.001 (M?=?56.01?±?12.48), with 39% (n?=?33) in the borderline/clinical range. Sibling opportunity to say goodbye was associated with greater grief-related growth (t(79)?=?? 1.95, p?=?.05). Presence at the death and wishing they had done something differently were both associated with greater grief (t(80)?=?? 2.08, p?=?.04 and t(80)?=?? 2.24, p?=?.028, respectively) and grief-related growth (t(80)?=?? 2.01, p?=?.048 and t(80)?=?? 2.31, p?=?.024, respectively). However, findings were primarily unique to sibling report, with few mother-reported effects. The adjustment of bereaved siblings may be affected by certain modifiable circumstances surrounding the death of their brother or sister. A proportion of bereaved siblings had elevated internalizing symptoms irrespective of circumstances at EoL. Further work is needed to understand predictors of adjustment among bereaved siblings to provide better support and optimize their outcomes.

     

Internet-delivered transdiagnostic and tailored cognitive behavioral therapy for anxiety and depression: a systematic review and meta-analysis of randomized controlled trials

Anxiety and depressive disorders are often comorbid. Transdiagnostic and tailored treatments seem to be promising approaches in dealing with comorbidity. Although several primary studies have examined the effects of Internet-delivered cognitive behavior therapy (iCBT) for anxiety and depression, no meta-analysis including different types of iCBT that address comorbidity has been conducted so far. We conducted systematic searches in databases up to 1 July 2016. Only randomized trials comparing transdiagnostic/tailored iCBT for adult anxiety and/or depression with control groups were included. Nineteen randomized trials with a total of 2952 participants that met inclusion criteria were analyzed. The quality of the studies was high, however the blinding criteria were not fulfilled. The uncontrolled effect size (Hedges’ g) of transdiagnostic/tailored iCBT on anxiety and depression outcomes was large and medium for quality of life. The controlled effect size for iCBT on anxiety and depression outcomes was medium to large (anxiety: g = .82, 95% CI: .58–1.05, depression: g = .79, 95% CI: .59–1.00) and medium on quality of life (g = .56, 95% CI: .37–.73). Heterogeneity was small (quality of life) to moderate (anxiety, depression). There was a large effect on generic outcome measures and a moderate effect on comorbidities. When compared to disorder-specific treatments there were no differences on anxiety and quality of life outcomes, however there were differences in depression outcomes. Transdiagnostic and tailored iCBT are effective interventions for anxiety disorders and depression. Future studies should investigate mechanisms of change and develop outcome measures for these interventions.     

Longitudinal Model Predicting Self‐Concept in Pediatric Chronic Illness

Although self‐concept has been identified as salient to the psychosocial adjustment of adolescents dealing with a chronic illness (CI), little research has focused on its predictors it. Given that depression and parent–child attachment have been linked to self‐concept in the population at large, the goal of this study was to evaluate these relationships longitudinally in a sample of adolescents with CI. Using participant data from the Mastering Each New Direction (MEND) program, a 3‐month psychosocial, family based intensive outpatient program for adolescents with CI, we employed multilevel modeling to test longitudinal changes in self‐concept, as predicted by depressive symptoms and parent–child attachment, in a sample of 50 youths (M_age = 14.56, SD_age = 1.82) participating in MEND. Both “time spent in the program” and decreases in depressive symptoms were associated with increases in self‐concept over time. Higher baseline levels of avoidant attachment to both mother and father were also associated with greater initial levels of self‐concept. Targeting depressive symptoms and supporting adaptive changes in attachment may be key to promoting a healthy self‐concept in pediatric CI populations. The association between avoidant attachment and higher baseline self‐concept scores may reflect differences in participants’ autonomy, self‐confidence, or depression. Limitations of the study include variability in the amount of time spent in the program, attrition in final time point measures, and the inability to fully examine and model all potential covariates due to a small sample size (e.g. power).     

Relationships among pain intensity,pain-related distress,and psychological distress in pre-surgical total knee arthroplasty patients: a secondary analysis

The current study aimed to examine the relationships between movement and resting pain intensity, pain-related distress, and psychological distress in participants scheduled for total knee arthroplasty (TKA). This study examined the impact of anxiety, depression, and pain catastrophizing on the relationship between pain intensity and pain-related distress. Data analyzed for the current study (N = 346) were collected at baseline as part of a larger Randomized Controlled Trial investigating the efficacy of TENS for TKA (TANK Study). Participants provided demographic information, pain intensity and pain-related distress, and completed validated measures of depression, anxiety, and pain catastrophizing. Only 58% of the sample reported resting pain >0 while 92% of the sample reported movement pain >0. Both movement and resting pain intensity correlated significantly with distress (r_s = .86, p < .01 and .79, p < .01, respectively). About three quarters to two thirds of the sample (78% for resting pain and 65% for movement pain) reported different pain intensity and pain-related distress. Both pain intensity and pain-related distress demonstrated significant relationships with anxiety, depression, and catastrophizing. Of participants reporting pain, those reporting higher anxiety reported higher levels of distress compared to pain intensity. These findings suggest that anxious patients may be particularly distressed by movement pain preceding TKA. Future research is needed to investigate the utility of brief psychological interventions for pre-surgical TKA patients.     

Parents’ Attachment Styles and Adolescents’ Regulatory Emotional Self-efficacy: The Mediating Role of Adolescents’ Attachment to Parents in China

Guided by attachment theory, this longitudinal study examined the mediating role of parent-adolescent attachment on the relation between parents’ attachment styles and adolescents’ regulatory emotional self-efficacy (RESE, including managing negative affect and expressing positive affect). Five hundred seventy-three Chinese junior high school students (46% male; aged 11–14 years, M = 12.76 years, SD = 0.74) completed measures of RESE at T1, parent-adolescent attachment at T2 (six months later), and RESE at T3 (another six months later), while 573 students’ parents (one student only has a parent, 241 fathers and 332 mothers) completed measures of adult attachment styles (anxiety and avoidance) at T1. Results from structural equation modeling indicated that father-adolescent attachment mediated the association between fathers’ attachment anxiety and adolescents’ self-efficacy beliefs in managing negative affect, while mother-adolescent attachment marginally mediated the relation between mothers’ attachment anxiety and adolescents’ self-efficacy beliefs in managing negative affect and expressing positive affect. These findings suggest that parents’ attachment anxiety could predict their children’s attachment to parents, in turn, impacting their children’s regulatory emotional self-efficacy.

     

Chest pain without coronary artery disease: An exploratory comparison with panic disorder

Recent reports have indicated similarities between patients with persistent chest pain of nonorganic origin and patients with panic disorder. In order to explore this association further, we administered a structured interview and three self-report measures (State-Trait Inventory, Beck Depression Inventory, and SCL90-R) to three subject groups: (1) a sample with persistent chest pain (CP; n=14) who had been screened and found to have normal coronary arteries, (2) a sample of patients with panic disorder (PD; n=14), and (3) a sample of matched normals (n=14). CP patients were considered to be free of coronary artery disease (CAD) following normal cardiac catheterization and/or normal thallium stress tests and were not diagnosed initially with panic disorder. PD patients were diagnosed with a standardized psychiatric interview and were free of organic causes of panic. Using an exploratory data analytic approach, the results indicated that both CP and PD samples reported increased levels of state and trait anxiety (p <.0001), depression (p <.01), and somatization (p <.0001) compared with normals. CP patients differed from PD patients in their less frequent use of anxiolytic medication (p <.01) and lower levels of reported panic anxiety and phobic avoidance (p <.0001). These data suggest that persistent chest pain in the absence of CAD shares some features with panic disorder, yet differs from panic in key ways as well. The results are discussed in light of the role of anxiety in contributing to symptom labeling.This research was supported by Grant 86G-491 from the American Heart Association, Texas Affiliate, to J.G.B. H.T. is the recipient of USPHS Research Career Development Award K04-HL-0122246.     

Distress and Family Functioning in Oncogenetic Counselling for Hereditary and Familial Breast and/or Ovarian Cancers

We conducted a psychological assessment during oncogenetic counseling for hereditary breast/ovarian cancer. Anxiety and depression were assessed with the HAD scale, and family functioning and satisfaction with FACES III. HAD was administered at baseline (t ₁)_, at risk communication (t ₂), at genetic test result communication, or at first surveillance in not tested subjects (t ₃); FACES III was administered at baseline only. We analysed a total of 185 questionnaires administered to the 37 subjects studied. Although not pathological, distress was significantly higher at t ₂ and t ₃ (p = 0.027 and p = 0.039, respectively). Health and marital status were significantly associated with distress. In a disease-free condition, anxiety was higher (p = 0.027) at t _2, and for single status, depression increased from t ₁ to t ₂ (p = 0.026). Families were perceived to be well functioning, and subjects were satisfied with their families. The data collected in this analysis could help to improve the quality of oncogenetic counselling in clinical practice.     

Anxiety and Depression in Brazilian Orthopaedics Inpatients: A Cross Sectional Study with a Clinical Sample Comparison

There are few studies on the development of anxiety and depression in orthopaedics and trauma (O&T) inpatients. We designed a cross-sectional study aimed at comparing the prevalence of depression and anxiety in 100 O&T inpatients and 100 clinical inpatients in the same hospital. O&T patients were divided into subgroups: trauma and non-trauma (arthroplasty, tumour, and infection sub grouping). We measured anxiety and depression by the Hospital Anxiety and Depression Scale and co-morbidities by the Charlson age-adjusted comorbidity index (CCI). For the trauma subgroup, AO/OTA fracture classification and Gustillo and Anderson grade of open fractures classification was applied. The prevalence of anxiety and depression was 35% and 28%, respectively for the clinical sample, and 44% and 33% for the O&T sample. Compared with the clinical sample, anxiety scores were higher in the O&T sample (p = .047), and in arthroplasty (p = .020) and trauma subgroups (p = .031). In the O&T sample, high CCI scores were associated with high anxiety scores (p = .033).     

The Influence of Perceived Interviewer and Job and Organizational Characteristics on Applicant Attraction and Job Choice Intentions: The role of applicant anxiety

This study examined whether interviewer characteristics have (a) a direct influence on applicant attraction and job choice intentions, (b) an indirect influence via job and organizational characteristics, and (c) direct influence on applicant anxiety. A sample of graduate applicants (N=450) was surveyed before a selection interview (Time 1) and after the employment interview (Time 2). Structural equation modeling was used to examine the hypothesized model. The results showed that interviewer characteristics (warmth, unfriendliness, job knowledge, general competence and humor) had both a direct and indirect effect on applicant attraction and job choice intentions. In addition, interviewer characteristics had a significant positive impact on applicant anxiety. Theoretical and practical implications of the findings are discussed.     

Psychological health in long-term cancer survivorship: an Italian survey on depression and anxiety

Since long-term survivorship is now a reality for an increasingly number of people with a history of cancer, understanding their psychological health can inform health care policy as well as help supporting individual patients. This study was aimed to describe depression and anxiety (i.e. two of the most common psychological symptoms reported in oncology) in a sample of Italian long-term cancer survivors (LTCSs) defined as people who have been free from cancer and cancer treatments for at least five years. Four hundred and four Italian adult LTCSs completed a battery of questionnaires including the Zung Self-rating Depression Scale and the State Anxiety sub-scale of the State-Trait Anxiety Inventory respectively for depression and anxiety assessment. 16.5% of the sample displayed mild depression, 11.1% moderate depression, and 7.1% severe depression. depression was negatively associated with education (p = .017), perceived social support as provided by the family (p = .028), and perceived social support provided by friends (p = .008), and it was positively associated with occupational status (p = .023), presence of health issues (p = .010), and anxiety (p < .001). 8.7 and 15.8% of the sample were respectively possible and probable cases of anxiety. Anxiety was negatively associated with occupational status (p = .038) and it was positively associated with depression (p < .001). These data support ongoing assessment and monitoring of depression and anxiety in LTCSs, and stimulate the development and testing of psychological interventions for such individuals. In addition, they encourage further study on the psychological health of this specific population.     

Patterns of attachment and parents' adjustment to the death of their child

The impact of adult attachment on psychological adjustment among bereaved parents and the mediating effect of relationship satisfaction were examined among a sample of 219 couples of parents. Data collection took place 6, 13, and 20 months after loss. Use of the actor partner interdependence model in multilevel regression analysis enabled exploration of both individual as well as partner attachment as predictors of grief and depression. Results indicated that the more insecurely attached parents were (on both avoidance and anxiety attachment), the higher the symptoms of grief and depression. Neither the attachment pattern of the partner nor similarity of attachment within the couple had any influence on psychological adjustment of the parent. Marital satisfaction partially mediated the association of anxious attachment with symptomatology. Contrary to previous research findings, avoidant attachment was associated with high grief intensity. These findings challenge the notion that the avoidantly attached are resilient.     

Field Trial of a Complicated Grief Psychosocial Program for Adolescents in Occupied Palestine

The current study evaluated the new “Children and Grief” program for Palestinian adolescents (n = 158), aged 10–18, referred to counselors for complicated grief. A mixed methods quasi-experimental design involved non-randomized intervention group (n = 79), waitlist (n = 79), and measures of program fidelity and cost. Traumatic loss was identified from case files. Standardized measures assessed complicated grief, posttraumatic stress, and depression at pre and post-test. Interviews of 9 adolescents and 9 presenters explored subjective experience of program delivery. Analysis involved multivariate analysis of variance (MANOVA) and quasi-qualitative analysis of interviews. A large effect size was found for reduced complicated grief. Randomized control trials, longitudinal research, and studies that explore the impact of martyrdom on coping with grief are needed.     

Does worry affect adjustment to bereavement? A longitudinal investigation

Background and objectives: Repetitive thought is a trans-diagnostic risk-factor for development of psychopathology. Research on repetitive thought in bereaved individuals has focused primarily on clarifying the role of rumination, repetitive thinking about past negative events and/or negative emotions. While detrimental effects of rumination have been demonstrated following bereavement, surprisingly few studies have aimed to clarify the role of worry, repetitive thinking about potential future negative events, in adjustment to loss. This study sought to fill this gap in knowledge. Methods/Design: One hundred eighty-three bereaved individuals (85.3% women) filled out questionnaires on sociodemographic and loss-related characteristics, worry, and symptom measures of depression, anxiety, and prolonged grief. After six months, 155 participants completed worry and symptom measures again. Using multiple regression analyses, concurrent and longitudinal associations between loss-related variables, worry, and symptoms of psychopathology were examined. Results: Main results were that worry was strongly positively associated with symptoms of anxiety, depression and prolonged grief concurrently and also predicted higher levels of anxiety, depression and prolonged grief longitudinally. Conclusions: Findings suggest that worry influences adjustment to bereavement negatively and may be a potential target in grief therapy, especially when aiming to reduce anxiety.     

A Serbian Version of Modified and Revised Experiences in Close Relationships Scale (SM–ECR–R)

We present details about the validation of the Serbian version of the Experiences in Close Relationships–Revised questionnaire modified to measure attachment in close relationships in general (SM–ECR–R). Its psychometric features were examined with 2 samples of students (N = 719 and N = 91) and 1 group of employed adults (N = 259). The results obtained in the student sample were equivalent to those obtained in validation studies worldwide, whereas in the more heterogeneous sample of employed adults, internal consistency of both avoidance and anxiety was lower and their intercorrelation was higher. Test–retest reliability was satisfactory, and relations with measures of attachment, empathy, and personality structure were meaningful. The results support the SM–ECR–R as a reliable and valid research instrument, but its internal structure and consistency might vary in different samples, depending on age, education, gender, and culture.