Implicit associations between anxiety-related symptoms and catastrophic consequences in high anxiety sensitive individuals

Anxiety sensitivity refers to the fear of anxiety-related physical sensations arising from beliefs that these sensations have harmful consequences (Reiss & McNally, 1985). The present study examined whether individuals with high (vs. low) anxiety sensitivity show stronger implicit associations in memory between anxiety-related symptoms, as opposed to neutral body parts, and harmful, as compared to harmless, consequences. A total of 22 undergraduate students (14 F, 8 M) completed the Extrinsic Affective Simon Task (EAST; De Houwer, 2003). Results indicated that high anxiety sensitive individuals (n = 10) tended to implicitly associate harmful consequences with anxiety-related symptoms. Their performance was significantly faster on trials where target words related to anxiety symptoms were mapped on to the same response key as harmful consequences. No significant difference in performance was found for low anxiety sensitive individuals (n = 12) or when target words were body parts unlikely related to diseases. Between-group differences persisted after controlling for trait anxiety and history of panic attacks, but not when illness-related beliefs were introduced as a covariate. Identifying this implicit association bias provides additional empirical support for the concept of anxiety sensitivity.     

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.

     

Emotional regulation,attachment to possessions and hoarding symptoms

This study aimed to test which particular facets of emotion regulation (ER) are most linked to symptoms of hoarding disorder, and whether beliefs about emotional attachment to possessions (EA) mediate this relationship. A non‐clinical sample of 150 participants (108 females) completed questionnaires of emotional tolerance (distress tolerance, anxiety sensitivity, negative urgency – impulsivity when experiencing negative emotions), depressed mood, hoarding, and beliefs about emotional attachment to possessions. While all emotional tolerance measures related to hoarding, when considered together and controlling for depression and age, anxiety sensitivity and urgency were the significant predictors. Anxiety sensitivity was fully mediated, and urgency partially mediated, via beliefs regarding emotional attachment to possessions. These findings provide further support for (1) the importance of anxiety sensitivity and negative urgency for hoarding symptoms, and (2) the view that individuals with HD symptoms may rely on items for emotion regulation, leading to stronger beliefs that items are integral to emotional wellbeing.     

How Do Elements of a Reduced Capacity to Withstand Uncertainty Relate to the Severity of Health Anxiety?

Intolerance of uncertainty (IU)—a multidimensional cognitive vulnerability factor—is associated with a variety of anxiety disorders and health anxiety (HA). To date, few studies have assessed whether IU dimensions (prospective and inhibitory IU) are differentially associated with HA and whether their contributions are independent of anxiety sensitivity (AS). This study addressed these issues using independent community (n = 155; 81% women) and undergraduate (n = 560; 86% women) samples. Results indicated that prospective IU, but not inhibitory IU, had significant positive associations with HA in community dwellers and undergraduate students. AS somatic and cognitive concerns were also significant predictors among both samples. In addition, severity of IU dimensions among individuals reporting elevated HA were compared against individuals diagnosed with generalized anxiety disorder, social anxiety disorder, panic disorder, and obsessive–compulsive disorder. Results indicated minimal differences between those with elevated HA and each of the anxiety disorder diagnoses. Findings lend support to the unique transdiagnostic nature of IU and support commonalities between HA and anxiety disorders.     

The Effect of Attachment Insecurity in the Development of Eating Disturbances across Gender: The Role of Body Dissatisfaction

The present study examined the effects of insecure attachment on the development of negative body image as a contributing factor to the development of disturbed-eating patterns in male and female university students. Participants were nonclinical male (n = 100) and female (n = 381) university students. Administering self-report questionnaires, the authors assessed demographic information (gender, age), anthropometric data (Body Mass Index [BMI], age), romantic attachment (ECRS-R; R. C. Fraley, N. G. Waller, & K. A. Brennan, 2000), body dissatisfaction (BSQ), and disturbed eating (EAT-26). The authors found body dissatisfaction to fully mediate the relationship between attachment anxiety and disordered eating in women. Body dissatisfaction mediated anxious attachment and dieting in men. In addition, attachment avoidance had a direct impact on eating behaviors for both genders, without the mediation of any variables measured in this study. The findings of the present study suggest that the anxiety and avoidance dimensions of attachment insecurity affect eating behaviors differently, and the effects are different across genders. The authors discuss results in the context of therapeutic interventions design.     

Anxiety sensitivity and risk-taking behavior

High trait anxiety has been linked with risk-avoidant decision-making, though little is known regarding the specific facets of anxiety contributing to this negative association. Anxiety sensitivity (AS), a transdiagnostic vulnerability factor for anxiety-related pathology, may be particularly relevant to risk decision-making given that risk-taking behaviors generate heightened somatic arousal and produce many of the sensations feared by individuals with high AS. Two studies were conducted to investigate the relation between AS and risk decision-making. In the first study, 268 undergraduate students completed a series of questionnaires that included measures of AS and gambling behaviors. Significant negative correlations were observed between AS and several gambling-related risk-taking activities, and hierarchical multiple regression analyses indicated that AS scores added significant incremental validity in predicting risk-taking over and above demographic variables, negative affect, and trait anxiety. In the second study, 43 participants who had screened for high (n = 20) or low (n = 23) AS completed the Iowa gambling task, a behavioral measure of risk-taking. Results indicated that, when placed under conditions of risk, individuals with high AS engaged in significantly less risk-taking than their low AS counterparts. The implications of these findings and potential directions for future research are discussed.     

Sleep problems,anxiety and cognitive style in school‐aged children

The associations between sleep problems, anxiety, anxiety sensitivity and attributional style were examined in self‐report data from 79 children aged 8–11 years. Total anxiety score was associated with different types of sleep problems (bedtime resistance, sleep anxiety and nightmares). Conversely, total sleep problem score was associated with different sub‐scales of anxiety (from r(78) = 0.15, p = NS to r(79) = 0.47, p < 0.01). Symptoms of anxiety correlated significantly with anxiety sensitivity, but not with attributional style. After controlling for other symptoms of anxiety, school phobias (Beta = 0.26, p < 0.05), the mental incapacitation concerns scale of anxiety sensitivity (Beta = 0.26, p < 0.05), and attributional style (Beta = −0.31, p < 0.01, R² = 0.45) predicted sleep problems. These results suggest that anxiety is associated with a range of sleep problems, and that sleep problems are associated with different types of anxiety. Furthermore, certain cognitive styles are associated with both anxiety and sleep problems and may be good candidates for further research into the association between sleep problems and anxiety in children. Copyright © 2005 John Wiley & Sons, Ltd.     

Health anxiety and hypochondriasis in the light of DSM-5

Background: In the DSM-5, the diagnosis of hypochondriasis was replaced by two new diagnositic entities: somatic symptom disorder (SSD) and illness anxiety disorder (IAD). Both diagnoses share high health anxiety as a common criterion, but additonal somatic symptoms are only required for SSD but not IAD. Design: Our aim was to provide empirical evidence for the validity of these new diagnoses using data from a case–control study of highly health-anxious (n = 96), depressed (n = 52), and healthy (n = 52) individuals. Results: The individuals originally diagnosed as DSM-IV hypochondriasis predominantly met criteria for SSD (74%) and rarely for IAD (26%). Individuals with SSD were more impaired, had more often comorbid panic and generalized anxiety disorders, and had more medical consultations as those with IAD. Yet, no significant differences were found between SSD and IAD with regard to levels of health anxiety, other hypochondriacial characteristics, illness behavior, somatic symptom attributions, and physical concerns, whereas both groups differed significantly from clinical and healthy controls in all of these variables. Conclusion: These results do not support the proposed splitting of health anxiety/hypochondriasis into two diagnoses. Further validation studies with larger samples and additional control groups are warranted to prove the validity of the new diagnoses.     

Differentiation of self and trait anxiety: A cross‐cultural perspective

Cultural differences are likely to affect the ability to deal with anxiety. We investigated this issue among four cultural groups—Germans and Italians (Europeans living in South Tyrol, Italy), Jews and Arabs (Israelis)—in terms of their levels of differentiation of self, trait anxiety and somatic symptoms. We also examined the relationship of differentiation of self to trait anxiety and somatic symptoms. The sample consisted of 824 students: 387 Israelis (mean age 23.6) and 437 Europeans (mean age 22.3). Israeli participants reported lower levels of trait anxiety than European students. Jewish students reported lower trait anxiety than Arab students (mean difference = ?.14, p < .009), while there was no difference between German and Italian students (mean difference = .03, p > .99). Jews reported a significantly lower level of emotional cutoff than Arabs (mean difference = ?.45, p < .001), and Germans reported a significantly lower level of emotional reactivity than Italians (mean difference = .29, p < .001). Emotional reactivity and I‐position predicted all participants' trait anxiety. On the whole, results point to the importance of examining differentiation of self when trying to reduce trait anxiety, as well as some important cultural differences.     

Changes in Anxiety Control Beliefs Following a Brief CBT Treatment and Their Association With Anxiety Symptom Reduction

Anxiety control beliefs (i.e., beliefs regarding one’s ability to cope with external, fear-inducing threats and internal reactions to those perceived threats) have been found to negatively predict anxiety symptoms in children and adults and to be modifiable by cognitive-behavioral therapy for anxiety disorders. The current study examines whether changes in anxiety control beliefs were seen following a brief, intensive treatment for specific phobias, and whether those changes were associated with improvements in the targeted phobia and comorbid anxiety disorder symptoms. Participants were 135 children and adolescents (M age = 9.01 years, 49% male) who received one-session treatment (OST) with or without parental involvement for their primary specific phobia. Results indicated that self-reported anxiety control beliefs significantly increased following treatment and that these increases significantly predicted reductions in specific phobia severity and symptoms of comorbid anxiety disorders 6 months and 1 year following treatment. Findings illustrate that involvement in a single 3-hour OST was associated with changes in anxiety control beliefs and demonstrate the potential importance of targeting control beliefs in pediatric anxiety treatment.     

Marijuana Use Among Daily Tobacco Smokers: Relationship to Anxiety-Related Factors

The present investigation evaluated the incremental validity of regular marijuana use and frequency of such use in relation to anxiety and depressive symptoms and perceived health among young adult tobacco smokers (n = 202). Approximately 72% of the sample were current marijuana smokers, using this drug on an average of 7.6 (SD = 9.2) times per week. As expected, after controlling for theoretically-relevant smoking (cigarettes per day), alcohol use, and affect factors (i.e., negative affectivity and anxiety sensitivity), marijuana use predicted anxiety symptoms and perceived general health, whereas frequency of marijuana use predicted only anxiety symptoms. These results are discussed in relation to better understanding the role of regular marijuana use in terms of anxiety-relevant emotional vulnerability and beliefs about physical health among regular smokers.     

Establishing a trait anxiety threshold that signals likelihood of anxiety disorders

Abstract

Evidence suggests that the State Trait Inventory for Cognitive and Somatic Anxiety (STICSA) may be a more pure measure of anxiety than other commonly used scales. Further, the STICSA has excellent psychometric properties in both clinical and nonclinical samples. The present study aimed to extend the utility of the STICSA – Trait version by identifying a cut-off score that could differentiate a group of clinically diagnosed anxiety disorder patients (n=398) from a group of student controls (n =439). Two receiver operating characteristic curve analyses indicated cut-off scores of 43 (sensitivity=.73, specificity=.74, classification accuracy=.74) and 40 (sensitivity=.80, specificity=.67, classification accuracy=.73), respectively. In a large community sample (n =6685), a score of 43 identified 11.5% of individuals as probable cases of clinical anxiety, while a score of 40 identified 17.0% of individuals as probable cases of clinical anxiety. As a result of differences in sensitivity and specificity, the present findings suggest a cut-off score of 43 is optimal to identify probable cases of clinical anxiety, while a cut-off score of 40 is optimal to screen for the possible presence of anxiety disorders.     

Heightened sensitivity to emotional expressions in generalised anxiety disorder,compared to social anxiety disorder,and controls

Few studies have examined potential differences between social anxiety disorder (SAD) and generalised anxiety disorder (GAD) in the sensitivity to detect emotional expressions. The present study aims to compare the detection of emotional expressions in SAD and GAD. Participants with a primary diagnosis of GAD (n?=?46), SAD (n?=?70), and controls (n?=?118) completed a morph movies task. The task presented faces expressing increasing degrees of emotional intensity, slowly changing from a neutral to a full-intensity happy, sad, or angry expressions. Participants used a slide bar to view the movie frames from left to right, and to stop at the first frame where they perceived an emotion. The frame selected thus indicated the intensity of emotion required to identify the facial expression. Participants with GAD detected the onset of facial emotions at lower intensity of emotion than participants with SAD (p?=?0.002) and controls (p?=?0.039). In a multiple regression analysis controlling for age, race, and depressive symptom severity, lower frame at which the emotion was detected was independently associated and GAD diagnosis (B?=?–5.73, SE?=?1.74, p?相似文献   

Hearing Impairment, Coping Strategies, and Anxiety Sensitivity

The aim was to study coping strategies among hearing-impaired individuals by using a validated coping instrument—The Ways of Coping Questionnaire (WOCQ; S. Folkman & R. Lazarus, 1988)—and to relate the use of coping with anxiety sensitivity and experience of hearing impairment. A questionnaire booklet was sent out to the members of the local branch of the Swedish Hard of Hearing Association. Ninety-four members responded to the questionnaire, yielding a 53% response rate. Primary outcome measures were the WOCQ, the Anxiety Sensitivity Index, and visual analogue scale rating of discomfort from hearing impairment. Repeated measures analysis of WOCQ subscales showed that the participants used planful problem solving and self-controlling coping strategies whereas escape/avoidance responses were less frequently used than the other coping strategies. Anxiety sensitivity was associated with escape/avoidance coping (r = .63, p < .0001). In conclusion, hearing-impaired individuals do not use escape/avoidance coping more than other coping strategies. However, escape/avoidance coping is associated with anxiety sensitivity, suggesting that sensitivity to anxiety sensations is an important associated factor. Coping strategies were not associated with discomfort from hearing impairment in any meaningful way.     

Focus-of-attention behavioral experiment: an examination of a therapeutic procedure to reduce social anxiety

A clinical protocol based on contemporary cognitive behavioral treatment for social anxiety was developed and examined. Previously published instructions for conducting a focus-of-attention behavioral experiment targeting self-focused attention and safety behaviors during exposure were used to create a structured protocol. Individuals (n = 45) with high levels of social anxiety and public-speaking anxiety were randomly assigned to either a focus-of-attention behavioral experiment (FABE) or an Exposure-Only Control (EOC) condition. During four exposure trials, those in the FABE condition (n = 24) were alternately instructed to engage in self-focused attention vs. externally focused attention and to eliminate safety behaviors. Those in the EOC condition (n = 21) were not so instructed. At post-intervention, individuals in the FABE condition showed significantly less self-focused attention and anxiety, and better observed performance as rated by audience members. Focus-of-attention statistically mediated the effect of condition on anxiety. For those in the FABE condition, the degree of association between focus-of-attention and anxiety during the intervention predicted less self-focused attention post-intervention. The FABE appears to be a useful procedure for implementing part of the contemporary cognitive behavioral treatment model.     

Do socially anxious individuals fear embarrassment by close others? Development of the Fear of Embarrassment by Others Scale

Social anxiety disorder is characterized by an intense fear of social or performance situations, and a fear of acting in a way that will be humiliating or embarrassing. However, the extent to which socially anxious individuals fear embarrassment due to the behavior of close others remains unknown. The Fear of Embarrassment by Others Scale (FEOS) was developed to assess the extent to which individuals with social anxiety fear being embarrassed by others. To assess the psychometric properties of this measure, 162 undergraduate students low or high in social anxiety completed the FEOS, along with additional questionnaires. An exploratory factor analysis suggested a single factor. The measure demonstrates high internal consistency, and is correlated with measures of social anxiety, fear of negative evaluation, and anxiety sensitivity. Fear of embarrassment by others was not found to be a significant predictor of social anxiety, as compared to anxiety sensitivity and fear of negative evaluation. The FEOS discriminated among participants high and low in social anxiety, as those high in social anxiety scored significantly higher on the measure than did participants low in social anxiety. The utility of this scale for research and clinical practice is discussed.     

Test anxiety: contributions of gender,age, parent's occupation and self-esteem among secondary school students in Nigeria

Most of the previous studies on test anxiety have focused on students in higher institutions with little research on test anxiety in secondary school students. The present study examined the contributions of gender, age, parent's occupation and self-esteem on test anxiety among secondary school students. Participants were 281 students (males?=?156, females?=?125; mean age?=?17.05, SD?=?1.87) who were candidates for centralised, high-stakes examinations in two randomly selected secondary schools in Onitsha, Anambra state, Nigeria. Data were collected using questionnaires comprising the State Self-esteem Scale, the Test Anxiety Inventory and spaces for the provision of relevant socio-demographic information. Results of a hierarchical multiple regression analysis indicated that age and gender did not significantly contribute to test anxiety. Parent's occupation explained 2% of the variance in test anxiety and self-esteem contributed 10% in explaining test anxiety. Based on the findings, personal predispositions explain test anxiety among school students more than do their demographics.     

Emotion Beliefs and Cognitive Behavioural Therapy for Social Anxiety Disorder

Despite strong support for the efficacy of cognitive behavioural therapy (CBT) for social anxiety disorder (SAD), little is known about mechanisms of change in treatment. Within the context of a randomized controlled trial of CBT, this study examined patients' beliefs about the fixed versus malleable nature of anxiety—their ‘implicit theories’—as a key variable in CBT for SAD. Compared to waitlist (n = 29; 58% female), CBT (n = 24; 52% female) led to significantly lower levels of fixed beliefs about anxiety (M_baseline = 11.70 vs. M_Post = 7.08, d = 1.27). These implicit beliefs indirectly explained CBT-related changes in social anxiety symptoms (κ² = .28, [95% CI = 0.12, 0.46]). Implicit beliefs also uniquely predicted treatment outcomes when controlling for baseline social anxiety and other kinds of maladaptive beliefs (perceived social costs, perceived social self-efficacy, and maladaptive interpersonal beliefs). Finally, implicit beliefs continued to predict social anxiety symptoms at 12 months post-treatment. These findings suggest that changes in patients' beliefs about their emotions may play an important role in CBT for SAD.