Dispositional Anxiety and Frontal‐Midline Theta: On the Modulatory Influence of Sex and Situational Threat

In their adaptive control hypothesis, Cavanagh and Shackman (2015) recently claimed that dispositional anxiety is correlated with frontal‐midline theta (FMθ) as a generic “need for control” signal of the anterior midcingulate cortex. Here, we tested this assumption, also considering potential modulatory influences of anticipatory threat and individuals’ sex. In a nonclinical sample of 168 participants (84 women), electroencephalogram was recorded while individuals performed a simple two‐choice task. Half of the participants were assigned to a threat anticipation condition (anticipation of public speaking), whereas the other half was assigned to a control condition. State anxiety was monitored across the experiment. Dispositional anxiety was assessed by self‐report scales, which were completed before individuals came to the laboratory. Target stimuli in the two‐choice task induced a transient increase in FMθ power that was subject to an interaction of dispositional anxiety, sex, and experimental group. Only in women who anticipated public speaking did we observe a substantial positive relation between dispositional anxiety and general FMθ power. Our results indicate that the link between dispositional anxiety and FMθ is not universal but rather depends on complex interactions of individuals’ sex and situational threat.     

Does the Implicit Association Test for assessing anxiety measure trait and state variance?

The stability of the Implicit Association Test for assessing anxiety (IAT‐Anxiety) is lower than its internal consistency, indicating that the IAT‐Anxiety measures both stable and occasion‐specific variance. This suggests that the IAT‐Anxiety may be not only a valid measure of trait anxiety but also one of state anxiety. To test this assumption, two studies were conducted in which state anxiety was experimentally induced by a public speaking task. However, both studies showed that the IAT‐Anxiety score did not change when a state of anxiety was induced. Thus, it seems that occasion‐specific factors other than variations in state anxiety lead to occasion‐specific variance in the IAT‐Anxiety score. Implications for the indirect assessment of personality dispositions with the IAT are discussed. Copyright © 2004 John Wiley & Sons, Ltd.     

Social anxiety,self‐regulation,and fear of negative evaluation

Social anxiety was investigated in a self‐regulation framework in a sample of 174 undergraduates (124 females; 50 males). As expected, individuals higher in social anxiety were lower on the expectancy to achieve goals, lower on self‐esteem and lower on the frequency on self‐reinforcement. Multiple regression analyses revealed that expectancy to achieve goals, fear of negative evaluation, and public self‐consciousness accounted for 33 per cent of the variance in social anxiety. Fear of negative evaluation was found to mediate between (i) self‐esteem and social anxiety (as hypothesized) and (ii) self‐reinforcement and social anxiety (investigated in an exploratory nature). Copyright © 2000 John Wiley & Sons, Ltd.     

Targeted Prevention of Childhood Anxiety: Engaging Parents in an Underserved Community

Selective prevention programs hold the promise of alleviating child anxiety symptoms, decreasing the risk for emotional problems across the lifespan. Such programs have particular public health import for young children of poor, underserved communities. Identifying factors related to parent engagement, and methods to improve engagement, are paramount in the effort to develop anxiety‐focused, community prevention programs. This feasibility study investigated the effect of an enhanced recruitment strategy to maximize parent engagement, as well as factors related to attendance in a single session focused on anxiety prevention. Participants were poor, ethnic minority parents of children aged 11–71 months (n = 256) who completed a survey that assessed anxiety risk according to trauma exposure, child anxiety, or parent anxiety, as well as preferences for preventive services (phase 1). Those meeting risk criteria (n = 101) were invited to a preventive group session (phase 2). Half of parents received enhanced recruitment (ER), which included personalized outreach, matching parent preferences, and community endorsement. Other parents were invited by mail. Chi square analyses indicated that ER was associated with planning to attend (49 vs. 6 % of control). Parents receiving ER were 3.5 times more likely to attend. Higher sociodemographic risk was correlated with higher child anxiety symptoms but not attendance. Results highlight the need for improved strategies for engaging parents in preventive, community‐based interventions.     

A cognitive‐behavioral model of anxiety disorders in children and adolescents

This study investigated a cognitive‐behavioral model of anxiety disorders in Japanese children and adolescents. Participants comprised 532 children from elementary schools and 751 adolescents from junior high schools as a community group, and 41 children and adolescents who fulfilled the criteria for childhood anxiety disorders as a clinical group. All participants completed three questionnaires about anxiety symptoms, self‐statements, and cognitive errors. While the clinical group showed more anxiety symptoms, negative self‐statements, and cognitive errors than the community group, there was no significant difference in positive self‐statements. Multigroup structural equation modeling found the presence of cognitive links for the community and clinical groups. Specifically, cognitive errors generated negative self‐statements, exacerbating a higher‐order factor (childhood anxiety) affecting six anxiety symptoms corresponding to the diagnostic criteria of psychological disorders. Mediated relationships were supported in only the community sample. Clinical implications for prevention and treatment of anxiety disorders in children and adolescents are discussed.     

The ABCs of CBT (Cognitive Behavior Therapy): Evidence‐Based Approaches to Child Anxiety in Public School Settings

This study evaluated a locally developed cognitive behavior therapy (CBT) intervention program in a public elementary school. In the prevention approach, 118 children were randomly assigned either to an 8‐week intervention or to a waitlist control. Results of statistical analysis indicated that the manualized CBT intervention did not reduce symptoms of anxiety on either self‐reports or parent reports of anxiety symptoms in the general school population. Challenges to translational efforts to public school settings are discussed.     

Performance on creativity measures with examination‐taking instructions intended to induce high or low levels of test anxiety

The major purpose of this investigation was to ascertain whether differential levels of performance on three tests of creativity portraying divergent production of verbal (semantic), figural (visual), and mathematical (symbolic) responses would be associated with two sets of test‐taking instructions: (a) one intended to induce a relatively high level of anxiety or stress and (b) the other designed to minimize the degree of anxiety or stress in the testing experience. Participants were 132 private secondary school students (82 females and 50 males) in a college preparatory program who were divided into experimental and control groups. On the basis of three univariate four‐way factorial designs at each of two levels per variable (treatment x sex x test anxiety x mathematics anxiety) with the pretest serving as a covariate, it was observed that only in the instance of a mathematics fluency test did the experimental group exposed to anxiety‐inducing test‐taking instructions achieve a significantly lower mean score on the posttest than did the control group that had been administered instructions intended to minimize anxiety (p < .001). A marginally significant interaction occurred between gender and mathematics anxiety on the mathematics fluency test with highly‐anxious males showing a greater decrement in performance than highly‐anxious females when exposed to anxiety‐inducing instructions. The results were interpreted primarily within a conceptual framework developed by Tobias (1985), who proposed an integration of cognitive capacity and interference as explanatory constructs for decrements in the performance of tasks involving anxiety.     

Health anxiety,anxiety sensitivity,and attentional biases for pictorial and linguistic health‐threat cues

The study investigated attentional biases for pictorial and linguistic health‐threat stimuli in high and low health anxious individuals, who were selected from the upper and lower quartile ranges of a normal sample using a screening measure of health anxiety. Attentional bias was assessed using a visual probe task which presented health‐threat and neutral pictures and words at two exposure durations, 500 ms and 1250 ms. The prediction that the high health anxious group would show a greater attentional bias for health‐threat cues than the low health anxious group was not supported despite the groups being well‐differentiated on a general measure of health anxiety, the Illness Attitudes Scale (IAS). Instead, the results indicated that individuals with high levels of anxiety sensitivity showed a significantly greater initial attentional bias for threat pictures compared with those with low anxiety sensitivity, as assessed by the Anxiety Sensitivity Index (ASI).     

Fear of Pain is Elevated in Adults with Co‐Occurring Trauma‐Related Stress and Social Anxiety Symptoms

The aim of this study was to determine whether fear of pain and related fear constructs are elevated in people with co‐occurring trauma‐related stress and social anxiety symptoms relative to people with 1 or neither of these conditions. Eighty students were selected from a larger sample and divided into 4 equal groups comprising those with both high trauma‐related stress and social anxiety symptom scores (TRS/SAS), only high trauma‐related stress symptom scores (TRS), only high social anxiety symptom scores (SAS), or neither (N). Results indicated that the TRS/SAS group had significantly higher scores on all fear of pain measures, anxiety sensitivity, and illness/injury sensitivity than any other group, even when level of current pain was included as a covariate. These findings suggest that people with co‐occurring trauma‐related and social anxiety symptoms are most likely to be fearful of pain and to thereby be at increased risk of developing chronic and disabling pain. Implications for future research and treatment are discussed.     

Temporal Discounting Mechanisms of Future‐oriented Coping: Evidence from Delay Discounting and Task Prioritization Paradigms

Four studies were conducted to examine the relationship between future‐oriented coping and temporal discounting under different situational conditions. In Study 1, 138 participants were primed with either stressful or neutral stimuli, followed by a delay‐discounting task. In Study 2, 118 participants were primed with either stressful or neutral stimuli, followed by a task‐prioritization activity. The results of both studies indicated that future‐oriented coping had a significant negative association with temporal discounting or the number of rational choices in the neutral‐priming condition, but the relationship was not significant in the stress‐priming condition. In Study 3, qualitative data revealed that the major reason for shifting choices from larger but later payoffs to smaller but sooner rewards in a stressful condition was to reduce the stressful mood, create a positive mood, and promote a sense of accomplishment. This explanation was corroborated by Study 4, in which one group was allowed to choose an immediate payoff and the other group was blocked from choosing that immediate payoff. We confirmed that post‐test anxiety was significantly lower in the immediate payoff group compared with the delayed‐payoff group in proactive and preventive coping, using pre‐test anxiety as a covariate. Preventive coping helped to reduce anxiety levels in a stressful condition only when there was a choice to obtain an immediate payoff. These findings underscore the relationship between future‐oriented coping and temporal discounting, as well as the flexibility of discounting in the face of stress. Copyright © 2015 John Wiley & Sons, Ltd.     

Heterogeneity of treatment changes after psychodynamic therapy within a one year follow‐up: A replication study

Naturalistic psychotherapy effect studies commonly report effect sizes for the total sample. However, a previous study of SCL‐90 Global Severity Index (GSI) improvement in a large outpatient sample used a cluster analytic strategy and reported clinical relevant outcome trajectories that could be grouped into early within‐treatment improvement, late improvement in the follow‐up period, and deteriorating patients with slight improvement that was lost at follow‐up. We explore GSI outcome trajectories and clinical significant change in a sample of 320 patients at a public psychiatric outpatient psychodynamic group therapy unit, the majority with anxiety, personality, and mood disorders. The study revealed large discharge and follow‐up effect sizes but more than one third of the patients were without measurable improvement. The major clusters described above were confirmed, and revealed unique clinical and socio‐demographic characteristics. Late improvers, as compared with early improvers, were characterized by anxiety symptoms and lack of network support after controlling for GSI at admission. Similarly, deteriorating patients had longer duration of illness and less favourable social characteristics compared with the other two groups. Early improving patients were less likely to have participated in short‐term groups, and only one third participated in additional treatment compared with more than 69% of the other patients. Severe and socially affected psychiatric patients, and patients with anxiety and agoraphobic symptoms may be less optimally treated in short‐term time limited psychodynamic groups. There is an obvious need for diversity of treatment offers, better integration of psycho‐social treatment components, and long‐term open ended treatment.     

Future-Oriented Positive Mental Imagery Reduces Anxiety for Exposure to Public Speaking

Exposure therapy is the recommended treatment for anxiety disorders, but many anxious individuals are unwilling to expose themselves to feared situations. Episodic simulation of future situations contributes to adaptive emotion regulation and motivates behavior. This study investigated whether future-oriented positive mental imagery reduces anticipatory anxiety and distress during exposure, and increases exposure willingness and duration. Forty-three individuals with moderate public speaking anxiety were randomized to a standardized positive mental imagery exercise about future public speaking or no-task. All participants were then asked to present in a virtual reality environment. Anticipatory anxiety reduced in the positive mental imagery group, but not in the control group. Additionally, the positive mental imagery group reported lower distress during exposure than the control group, but groups did not differ in exposure willingness. Due to limited variance, effects on exposure duration could not be tested. Future-oriented positive mental imagery is promising to prepare individuals for exposure to previously avoided situations.     

Self‐esteem and emotional health in adolescents – gender and age as potential moderators

Moksnes, U. K. & Espnes, G. A. (2012). Self‐esteem and emotional health in adolescents – gender and age as a potential moderators. Scandinavian Journal of Psychology 53, 483–489. The present paper investigates possible gender and age differences on emotional states (depression and anxiety) and self‐esteem as well as the association between self‐esteem and emotional states. The cross‐sectional sectional sample consists of 1,209 adolescents 13–18 years from public elementary and secondary schools in mid‐Norway. The results showed that girls reported higher scores on state anxiety and state depression, whereas boys consistently scored higher on self‐esteem in all age groups. Self‐esteem was strongly and inversely associated with both state depression and state anxiety. An interaction effect of gender by self‐esteem was found on state depression, where the association was stronger for girls than for boys. The associations found give support for the positive role of self‐esteem in relation to adolescents’ emotional health and well‐being.     

Increasing access to low‐intensity interventions for childhood anxiety: A pilot study of a guided self‐help program for Scandinavian parents

Cognitive Behavior Therapy (CBT) is an effective treatment for child anxiety. However, access to treatment is limited. It has been suggested that low‐intensity formats of parent‐delivered CBT may improve access to treatment. Our aim was to develop and pilot‐test the acceptability and effect of a low‐intensity therapist‐guided parent‐delivered group program for anxious children (age 7–12 years) adjusted to the Scandinavian culture. The program required 1.5 hours of therapist‐time per family. Mothers, fathers and children reported on revised child anxiety and depression scale (RCADS) at referral, pre‐ and post‐treatment. Mothers and fathers also gave a qualitative account of their experiences. Thirty‐one families were enrolled and only one family dropped out. Mean age of the children was 9 years. Intent‐to‐treat analyses revealed significant reductions in anxiety and depressive symptoms from pre‐ to post‐treatment for all informants. Large effect sizes were found for child anxiety symptoms as reported by mothers and fathers, and for child depressive symptoms as reported by mothers. Medium to large effect sizes was found for the self‐reported anxiety symptoms by the children, and for depressive symptoms reported by both children and fathers. More than 93% of the parents would recommend the program. Results suggest that our program may provide a new approach to improve access to treatment for anxious children in Scandinavia; however, further research must be conducted before firm conclusions can be drawn.     

A Self-Modeling Intervention for High School Students with Public Speaking Anxiety

ABSTRACT

The study investigated the effectiveness of self-modeling as an intervention for public speaking anxiety. The participants were six high school students with elevated levels of self-reported public speaking anxiety. Students presented public speeches to randomly selected peer audiences. Direct observations measured the behavioral manifestations of public speaking anxiety. In the intervention phase, students viewed self-modeling videotapes that were edited to remove speech dysfluencies and behavioral symptoms of speech anxiety. The self-modeling tapes depicted only adaptive, exemplary behavior with an edited-in audience feature making it appear that the students were producing a fluent speech to an audience of their peers. All of the participants evidenced substantial decreases in behavioral symptoms of speech anxiety and these changes were maintained throughout follow-up. The range of the participants' effect sizes was 2.7 to 4.9. Self-report measures of state anxiety and confidence as a speaker were used to assess additional effects of treatment. For all participants, there were also substantial decreases in self-reported public speaking anxiety and state anxiety from baseline to follow-up. A post-treatment interview revealed high social validity and self-reported generalization of treatment.     

Cognitive assessment of social anxiety: a comparison of self-report and thought listing methods

The goal of the present study was to compare 2 cognitive assessment methods for social anxiety: a thought listing and a self-report method. The focus of this study was on the convergent and divergent validity of these methods using a multi-trait multi-method approach. Furthermore, treatment sensitivity was explored. Fifty-eight patients with social phobia completed thought listings followed by 2 different social stress tasks before and after an exposure group treatment (n = 33), or following a waiting period (n = 25). One task consisted of speaking in front of 2 confederates while the other task involved initiating a conversation with an opposite-sex confederate. Two questionnaires measuring positive and negative self-statements regarding public speaking and social interactions were also completed. To compare the balance of positive and negative thoughts, the State of Mind ratio [positive thoughts/(positive+negative thoughts)] was calculated for both cognitive assessment methods. Results demonstrate that methods related to social interaction anxiety showed better convergent validity than methods related to public speaking anxiety; however, public speaking methods captured treatment effects better than methods related to social interaction anxiety. This study questions the common assumption that different cognitive assessment methods measure the same construct.     

Test anxiety in UK schoolchildren: Prevalence and demographic patterns

Background. Despite a large body of international literature concerning the antecedents, correlates of and treatments for test anxiety, there has been little research until recently using samples of students drawn from the UK. There is a need to establish some basic normative data for test anxiety scores in this population of students, in order to establish whether international research findings may generalize to UK schoolchildren. Aim. To collect some exploratory data regarding test anxiety scores in a sample of UK schoolchildren, along with socio‐demographic variables identified in the existing literature as theoretically significant sources of individual and group differences in test anxiety scores. Sample. Key Stage 4 students (1348): 690 students in the Year 10 cohort and 658 students in the Year 11 cohort, drawn from seven secondary schools in the North of the UK. Method. Data on test anxiety were collected using a self‐report questionnaire, the Test Anxiety Inventory ( Spielberger, 1980 ) and additional demographic variables through the Student Profile Questionnaire. The factor structure of the Test Anxiety Inventory was explored using principal components analysis and multiple regression analysis used to predict variance in self‐reported test anxiety scores from individual and group variables. Results. The principal components analysis extracted two factors, worry and emotionality, in line with theoretical predictions. Gender, ethnic and socio‐economic background were identified as significant predictors of variance in test anxiety scores in this dataset. Whether English was an additional, or native, language of students did not predict variance in test anxiety scores and year group was identified as a predictor of emotionality scores only. Conclusion. Variance in the test anxiety scores of Key Stage 4 students can be predicted from a number of socio‐demographic variables. Further research is now required to assess the implications for assessment performance, examination arrangements and appropriateness of using a North American measure of test anxiety in a UK context.     

Adaptive working memory training can reduce anxiety and depression vulnerability in adolescents

Adolescents can be at heightened risk for anxiety and depression, with accumulating research reporting on associations between anxiety and depression and cognitive impairments, implicating working memory and attentional control deficits. Several studies now point to the promise of adaptive working memory training to increase attentional control in depressed and anxious participants and reduce anxiety and depression symptoms, but this has not been explored in a non‐clinical adolescent population. The current study explored the effects of adaptive dual n‐back working memory training on sub‐clinical anxiety and depression symptomology in adolescents. Participants trained on either an online adaptive working memory task or non‐adaptive control task for up to 20 days. Primary outcome measures were self‐reported anxiety and depression symptomology, before and after intervention, and at 1‐month follow‐up. Self‐reported depression (p = 0.003) and anxiety (p = 0.04) decreased after training in the adaptive n‐back group relative to the non‐adaptive control group in the intention‐to‐treat sample (n = 120). These effects were sustained at follow‐up. Our findings constitute proof of principle evidence that working memory training may help reduce anxiety and depression vulnerability in a non‐clinical adolescent population. We discuss the findings’ implications for reducing risk of internalizing disorders in youth and the need for replication.     

Perfectionism and self-consciousness in social phobia and panic disorder with agoraphobia.

Social phobics were compared to patients with panic disorder with agoraphobia and normal controls on perfectionism and self-consciousness. On concern over mistakes and doubts about action, social phobics scored higher than patients with panic disorder. Social phobics also demonstrated a higher level of public self-consciousness than patients with panic disorder and when this difference was controlled for the significant differences on perfectionism disappeared. Within each patient group, however, perfectionism was more robustly related to social anxiety than was public self-consciousness, which replicates the findings of Saboonchi and Lundh [Saboonchi, F. & Lundh, L. G. (1997). Perfectionism, self-consciousness and anxiety. Personality and Individual Differences, 22, 921-928.] from a non-clinical sample. The results are discussed in terms of public self-consciousness being a differentiating characteristic of the more severe kind of social anxiety which is typical of social phobia.     

Study of a cognitive effects model in Dohsa‐hou for the elderly

This study investigates the primary factors responsible for cognitive performance improvements as a result of dohsa‐hou (Japanese body‐oriented psychotherapy) for the elderly. The study divided participants into two homogeneous groups: an experimental group that attempted to improve upright balance by performing dohsa‐hou, and a control group to establish the drop‐off period for the effect of performing the given activities. The task processing time of Stroop Test and body sway and the situational anxiety during task processing of Stroop Tests were measured before and after the dohsa‐hou and drop‐off period. The results confirm that only the experimental group improved in body sway, had a shorter Stroop Color Test processing time and lower situational anxiety. From this study, it has been identified that: (a) information‐processing capacities spared for posture control are affected by distribution of processing resources towards solving other cognitive tasks; and (b) the effect of the release of attention from threat‐related information due to a decrease in attentional bias, which accompanied the decrease in situational anxiety, are primary factors in improving cognitive task performance.