Symptom-positive and symptom-negative items in the state-trait anxiety inventory: A comparison and replication

Substantially higher mean scores on symptom-negatively versus symptom-positively worded items have consistently been reported in the literature for the balanced Stait-Trait Anxiety Inventory. In this study we aimed at replicating and comparing these findings for the Dutch adaptation of the inventory. Results indicated significantly higher mean subscale scores for symptom-negative as opposed to symptompositive items of both the Trait and State version, across sexes and age groups as well as across different levels of distress in students, policemen and psychiatric out-patients. Positive-negative mean difference scores were consistently larger for the State than for the Trait version. State and Trait mean difference scores were found to be mainly confined to symptom-positive subscales. Scale intercorrelations were lowest between symptom-positive and symptom-negative subscales both within and across measures. Factor analyzing the combined versions identified separate symptom-negative and symptom-positive factors, tentatively labeled “absence of positive affect” and “presence of negative affect”. Several explanations of the findings among which item-intensity specificity, the response style of social desirability and the model of positive and negative affectivity are discussed.     

The recognized benefits of negative thinking/affect in depression and anxiety: Developing a scale

Negative thinking/affect (NTA) in depression and anxiety is an important target of clinical intervention. However, individuals recognize the benefit of NTA. There is a need to develop a scale for empirical studies of NTA. Two‐hundred and fifty‐nine Japanese university students were assigned to answer: (a) the state in the past week (positive affect (PA) and Center for Epidemiologic Studies Depression Scale), (b) the current state (PA and State‐Trait Anxiety Inventory‐State (STAI‐S)), and (c) the usual state (PA and STAI‐Trait), after completing the Recognized Benefit of NTA Scale (RBNTA). Another 291 students completed the Rosenberg Self‐Esteem Scale and the Revised Life Orientation Test, after completing the RBNTA. Two weeks later, 76 participants completed the RBNTA. The RBNTA with nine subscales was developed after comparing the indices of fitness from 14 different factor solutions. The internal and test‐retest reliability and content validity were confirmed. Correlation analyses revealed that the recognition of trying to obtain benefits/avoid costs tends to associate with positive/negative affect and that most of such recognitions did not associate with self‐esteem and optimism.     

The tripartite model and dimensions of anxiety and depression: an examination of structure in a large school sample

This study was designed to build on recent findings that (a) factors of the tripartite model in adults are not uniformly related to all anxiety disorder dimensions as recent research has suggested (T. A. Brown, B. F. Chorpita, & D. H. Barlow, 1998; S. Mineka, D. W. Watson, & L. A. Clark, 1998), and (b) the tripartite model of emotion appears to have increasing support and utility in child samples (e.g., C. J. Lonigan, E. S. Hooe, C. F. David, & J. A. Kistner, 1999). The structural relations were evaluated among tripartite factors and dimensions representing selected anxiety disorders and depression in a large multiethnic school sample of children and adolescents. General aspects of the tripartite model were supported. For example, Negative Affect was positively related with all anxiety and depression scales, and Positive Affect was negatively correlated with the depression scale. Consistent with previous observations in adult samples, Physiological Hyperarousal was positively related with Panic only, and was not significantly positively correlated with other anxiety syndromes. The structure of the best fitting model appeared robust across different grade levels and gender. In follow-up analyses, several interactions of grade level with structural parameters emerged, such that the relation of some of the tripartite factors with anxiety and depression were noted to increase or decrease across grade level.     

Effect of affect on social cost bias in social anxiety disorder

Abstract

The cognitive model of social anxiety disorder (SAD) assumes that cognitive biases are important maintaining factors of the disorder. Research and theory have highlighted the impact of cognitive self-regulatory processes on affect, but have not sufficiently focused on the influence of affect on self-regulatory cognitions. The present study examined the influence of affect on cognitive self-regulatory mechanisms in SAD by focusing on one critical cognitive bias, estimated social cost. Individuals with SAD (N=48) and non-anxious controls (N=48) were randomly assigned to one of three experimental, affect induction conditions (negative, positive, or neutral) before giving a 10-minute impromptu, videotaped speech. As expected, the affect manipulation resulted in changes in estimated social cost. However, this effect was not specific to individuals with SAD. Participants in the positive affect condition in both groups had the highest social cost estimates post-speech challenge. These results suggest that social cost bias is dependent on the affective state in both individuals with SAD and controls.     

The contribution of anxiety and depression to fatigue among a sample of Australian university students: suggestions for university counsellors

Responses to the Zung Self-Rating Anxiety Scale (SAS: Zung, W. (1971). A rating instrument for anxiety disorders. Psychosomatics, 12, 371–379), the Self-Rating Depression Scale (SDS: Zung, W. (1973). From art to science: The diagnosis and treatment of depression. Archives of General Psychiatry, 29, 328–337) and the Fatigue Severity Scale (FSS) developed by Krupp and colleagues (Krupp, L.B., LaRocca, N.G., Muir-Nash, J., & Steinberg, A.D. (1989). The fatigue severity scale: Application to patients with multiple sclerosis and systemic lupus erythematosus. Archives of Neurology, 46, 1121–1123) were collected from 200 Australian university students to explore the links between these three disorders. Reliability data were satisfactory for all three scales and there were no significant gender or age-related differences between total scale scores. Factor analyses revealed a 5-factor solution for the SAS, a 6-factor solution for the SDS and a single factor for the FSS. There were 8 major and meaningful correlations found and these were entered into a regression of the SAS and SDS factor scores upon the single factor of the FSS. Fatigue factor scores were most powerfully predicted by psychomotor agitation, pain and resultant fatigue and cognitive and emotional arousal factor scores from the SAS and SDS. These data argue for an arousal/anxiety-fatigue-depression progression in disease that may be developmental or accumulative, with extreme levels of psychomotor arousal, resultant muscle fatigue and pain, plus concurrent elevated emotional state and cognitive arousal contributing to an eventual depletion of physical resources, leaving the individual in extreme fatigue. Implications for diagnosis and treatment by counsellors are discussed.     

Cognitive reappraisal and secondary control coping: associations with working memory,positive and negative affect,and symptoms of anxiety/depression

Abstract

The current study examined the relations of measures of cognitive reappraisal and secondary control coping with working memory abilities, positive and negative affect, and symptoms of anxiety and depression in young adults (N=124). Results indicate significant relations between working memory abilities and reports of secondary control coping and between reports of secondary control coping and cognitive reappraisal. Associations were also found between measures of secondary control coping and cognitive reappraisal and positive and negative affect and symptoms of depression and anxiety. Further, the findings suggest that reports of cognitive reappraisal may be more strongly predictive of positive affect whereas secondary control coping may be more strongly predictive of negative affect and symptoms of depression and anxiety. Overall, the results suggest that current measures of secondary control coping and cognitive reappraisal capture related but distinct constructs and suggest that the assessment of working memory may be more strongly related to secondary control coping in predicting individual differences in distress.     

Parenting behaviour as a mediator between young children's negative emotionality and their anxiety/depression

The goal of this longitudinal study was to examine observed paternal and maternal control (psychological control and autonomy granting) and support (rejection and emotional warmth) as mediators of the relation between children's negative emotionality at 3.5 years of age and depression and anxiety problems at 4.5 years. For 35 children, 60‐min unstructured parent–child interactions were rated at 4.5 years. Results indicated that maternal rejection mediated the relation between children's negative emotionality and their later anxiety/depression. Higher levels of child negative emotionality predicted more psychological control in mothers, but did not predict any parenting behaviours in fathers. Higher levels of paternal autonomy granting were associated with more child anxiety/depression. Unexpectedly, however, more maternal emotional warmth was related to higher levels of child anxiety/depression. The findings offer new insights to guide future research on the (mediating) role of parenting behaviours in the relation between children's negative emotionality and their internalizing problems. Copyright © 2010 John Wiley & Sons, Ltd.     

The relationship between rumination, avoidance and depression in a non-clinical sample

Recent commentaries have proposed conceptualizations of rumination in terms of both cognitive and behavioral avoidance. This study examined the relationship between rumination, avoidance and depression using a newly developed self-report measure of avoidance in depression, the Cognitive-Behavioral Avoidance Scale (CBAS) [Ottenbreit, N.D., & Dobson, K.S. (2004). Avoidance and depression: The construction of the cognitive-behavioral avoidance scale. Behaviour Research and Therapy, 42, 293-313]. A non-clinical sample (N=104) of undergraduate students completed self-report measures of depression, anxiety, rumination and avoidance. Rumination, avoidance and depression were all significantly correlated. Rumination and behavioral avoidance remained intercorrelated when anxiety was controlled, confirming an association that is independent of anxiety. By contrast, the relationship between cognitive avoidance and rumination disappeared when anxiety was partialled out. Notably, avoidance predicted unique variance in depression scores, over and above anxiety and rumination. Consistent with the proposal of Ottenbreit and Dobson [Avoidance and depression: The construction of the cognitive-behavioral avoidance scale. Behaviour Research and Therapy, 42, 293-313], our findings support the value of clinicians and psychopathologists giving consideration to avoidance in their conceptualization of depression.     

Rehearsal partially mediates the negative relations of the fading affect bias with depression,anxiety, and stress

The fading affect bias (FAB) is defined by unpleasant affect fading faster than pleasant affect. The FAB persists across several cultures and event types, and it is positively related to healthy outcomes and negatively related to unhealthy outcomes. Although the notion of the FAB as a healthy process fits well with contemporary theoretical perspectives, such as self‐enhancement theory, few studies have (a) examined and established reliable relations between the FAB and psychological distress variables and (b) established overall rehearsal as a mediator of these relations. We examined and found reliable, negative relations between psychological distress and the FAB for combined data from several studies examining different event types. We also examined and showed that overall rehearsal partially mediated these relations. These findings help legitimize the relation of psychological distress and FAB as a reliable scientific phenomenon, show that the FAB results from cognitive mechanisms, and support therapeutic emotional memory reinterpretation.     

The potential mediating role of anxiety sensitivity in the impact of mindfulness training on anxiety and depression severity and impairment: A randomized controlled trial

The benefits of mindfulness-based interventions to alleviate anxiety and depression have been supported by many studies. Given the effectiveness of mindfulness-based interventions on anxiety and depression, the underlying mechanisms need to be explored. Using a randomized waitlist-controlled design, this study investigated whether anxiety sensitivity was a potential mechanism for the impact of mindfulness training on anxiety and depression. Participants with high psychological distress were randomly assigned to an eight-week mindfulness intervention (N = 35) or a wait-list control group (N = 34). Before and after the intervention or corresponding waitlist period, participants completed measures of anxiety and depression severity and impairment and anxiety sensitivity. Separate mixed ANOVA demonstrated significant group (intervention vs. control group) × time (pre- vs. post-test) interactions for anxiety sensitivity and overall anxiety severity and impairment and marginally significant interaction for overall depression severity and impairment. Moreover, simple mediation models showed that reductions of anxiety sensitivity from pre- to post-test mediated the impact of mindfulness training on changes in anxiety and depression severity and impairment. The findings suggest that anxiety sensitivity is a potential mechanism underlying the effect of mindfulness training on anxiety and depression, which provides a new perspective for the study of processes of change of mindfulness-based interventions.     

Worry and anxiety account for unique variance in the relationship between intolerance of uncertainty and depression

The evidence supporting the relationship between intolerance of uncertainty (IU), a cognitive construct well established in the anxiety literature, and depression is mixed. Some research has demonstrated a direct association between IU and depression, whereas other studies suggest that IU is either unrelated or indirectly related to depression through other pathways, including anxiety. The present study aimed to further elucidate the relationship between IU and depression in an undergraduate sample (N = 221). We posited a model in which worry and anxiety account for unique variance in the association between IU and depression. Results supported this hypothesis. Worry and trait anxiety significantly accounted for unique variance in the relationship between IU and depression. Furthermore, the model that best fit the data included two additional direct paths, from IU to anxiety and from worry to depression, and excluded the direct path from IU to depression. Our findings support the notion that IU and depression are indirectly related through worry and anxiety. Limitations and future directions are discussed.     

Trait anxiety, trait depression, worry, and memory

A study is reported which investigated the proposal that high trait anxiety is associated with a memory bias for worry themes. Forty-five participants were categorised as being high or low trait anxious on the basis of scores on the (Spielberger et al., 1983) (Manual for the State-Trait Anxiety Inventory (Form Y) (1983)). The participants were requested to rate a number of worry and non-worry statements for how much they generally thought about the issues represented by them. Analysis of the ratings given by the participants showed that low trait anxiety individuals thought about the non-worry items significantly more than worry items. The high trait anxiety participants, however, showed little or no difference in the amount of time spent thinking about worry and non-worry themes. In a subsequent free recall task of the statements it was observed that the low trait anxiety group recalled significantly more non-worry than worry items, whereas there was no such difference for the high trait group. It was also found that the degree of memory bias was related to both positive affectivity and trait anxiety. The implications of such findings are discussed.     

Perceived self‐society moral discrepancies predict depression but not anxiety

Discrepancies between one's own beliefs, standards and practices and the standards expected by others are associated with increased vulnerability to depression and anxiety. Perhaps the most important personal standard is morality, one's standard of acceptable behaviour. We therefore reason that perceived discrepancies between one's own moral standards and those of society predict anxious and depressed moods. We tested this hypothesis, for the first time, in a sample of 99 female Turkish students. Moral discrepancies were assessed using an adapted moral foundations scale: participants were asked how much payment they would require to perform a series of potentially immoral acts, and how much payment they thought the average person in society would require. Participants also completed standard questionnaire measures of depression and trait anxiety. Results show that perceived self‐society moral discrepancies were significantly related to depression scores, but not to anxiety scores. Furthermore, only discrepancies related to the moral dimensions of respect for ingroups and avoiding harm were related to depression. We argue that perceiving a discrepancy between one's own standards of behaviour and those of society can increase vulnerability to depression, much as other kinds of self‐other discrepancies can; however, the specific moral standards which predict depression may vary with culture and the characteristics of the sample.     

Anxiety and Depression in Children: A Preliminary Examination of the Utility of the PANAS-C

Recent research has questioned the validity of identifying depression and anxiety as separate constructs in children. The current investigation examined the usefulness of the Positive and Negative Affect Schedule for Children (PANAS-C) in differentiating between anxiety and depression in children while also providing needed reliability and validity data on the PANAS-C. In addition, the relationship between positive and negative affect and coping was examined. Subjects included 110 third through fifth graders from a semirural public school setting. Children completed the PANAS-C, as well as self-report measures of depression, anxiety, and coping strategies. Moderate item–total correlations and high internal consistency indicated that the PANAS-C has good reliability. Validity results were mixed: a two-factor solution resembled previous studies, and negative affect was associated with avoidance coping strategies whereas positive affect was associated with approach coping strategies, as expected. However, correlations of positive and negative affect, anxiety, and depression scales suggest that positive and negative affectivity are negatively related in children as opposed to separate and independent constructs. Results of the present investigation question the validity of the use of the PANAS-C for differentiating anxiety and depression with this age group and lend support to the possibility that high overlap between anxiety and depression in this age group may be specific for childhood depression.     

Efficacy of brief guided self-help cognitive behavioral treatment for perfectionism in reducing perinatal depression and anxiety: a randomized controlled trial

Perfectionism has been proposed as a transdiagnostic process that maintains depression and anxiety through shared cognitive and behavioral processes. The purpose of this study was to investigate the efficacy of a brief, guided cognitive behavioral treatment (CBT) for perfectionism delivered via a self-help booklet in reducing perfectionism and symptoms of depression and anxiety during the antenatal period. Pregnant women in their third trimester were randomly allocated to self-help (n = 30) or waitlist control (n = 30). There were significant reductions in perfectionism and symptoms for participants who received CBT for perfectionism from pre- to post-treatment, which were maintained at 3-month follow-up, while the waitlist control group demonstrated no significant changes. Path analysis demonstrated a significant indirect effect of treatment condition on post-treatment depression and anxiety scores via perfectionism, controlling for pre-treatment scores, suggesting changes in perfectionism were associated with decreases in symptoms. The findings suggest that it would be useful for future research with larger samples to further investigate the efficacy of CBT for perfectionism for perinatal depression and anxiety.     

Understanding associations between negatively biased attention and depression and social anxiety: positively biased attention is key

ABSTRACT

Background and objectives: Although research supports the premise that depressed and socially anxious individuals direct attention preferentially toward negative emotional cues, little is known about how attention to positive emotional cues might modulate this negative attention bias risk process. The purpose of this study was to determine if associations between attention biases to sad and angry faces and depression and social anxiety symptoms, respectively, would be strongest in individuals who also show biased attention away from happy faces.

Methods: Young adults (N?=?151; 79% female; M?=?19.63 years) completed self-report measures of depression and social anxiety symptoms and a dot probe task to assess attention biases to happy, sad, and angry facial expressions.

Results: Attention bias to happy faces moderated associations between attention to negatively valenced faces and psychopathology symptoms. However, attention bias toward sad faces was positively and significantly related to depression symptoms only for individuals who also selectively attended toward happy faces. Similarly, attention bias toward angry faces was positively and significantly associated with social anxiety symptoms only for individuals who also selectively attended toward happy faces.

Conclusions: These findings suggest that individuals with high levels of depression or social anxiety symptoms attend preferentially to emotional stimuli across valences.     

Evaluating anxiety and depression symptoms in children and adolescents with prior mild traumatic brain injury: Agreement between methods and respondents

Psychological functioning can be adversely impacted after a mild traumatic brain injury (mTBI) and may be a potential target for intervention. Despite the use of symptom ratings or structured diagnostic interview to assess long-term anxiety and depression symptoms in children and adolescents post-injury, no known studies have considered the agreement between different assessment methods and between respondents. The objectives of this study were to investigate the agreement between symptom ratings and structured diagnostic interview and between children and parents’ symptom reporting. Participants (N = 33; 9–18 years old) were recruited from the Emergency Department and assessed on average 22.8 months (SD = 5.6) after their mTBI. Anxiety and depression symptoms were evaluated via subscales of a questionnaire (Behavior Assessment System for Children) and parts of a computerized structured diagnostic interview (generalized anxiety disorder and major depressive episode; Diagnostic Interview Schedule for Children – C-DISC-IV) administered individually to children and their parents. Results showed that the inter-method agreement to identify high levels of anxiety and depression was moderate to perfect in children while it was lower in parents. Although a similar percentage of participants with elevated anxiety or depression were identified by both children and parents, the agreement between youth and parents was variable, ranging from poor to good for anxiety and poor to moderate for depression. These results highlight the importance of collecting youth and parents’ reports of anxiety and depression symptoms and considering potential discrepancies between informants’ answers.     

Attentional processing of emotional material in types of anxiety and depression

ABSTRACT

The present study was designed to address the hypothesis that differences and similarities in patterns of attentional processing in recently proposed types of anxiety and depression are connected with the dominant (reactive, regulative) function they play in stimulation processing and their structural components. Participants (N?=?1247) filled out the Anxiety and Depression Questionnaire, which assesses types of anxiety and depression, and completed the Emotional Faces Attentional Test one week later. The obtained results confirmed our prediction and suggested that the proposed typology of anxiety and depression is valid in the adaptive meanings of both phenomena.     

Spatial affect learning restricted in major depression relative to anxiety disorders and healthy controls

Detecting and learning the location of unpleasant or pleasant scenarios, or spatial affect learning, is an essential skill that safeguards well-being (Crawford & Cacioppo, 2002). Potentially altered by psychiatric illness, this skill has yet to be measured in adults with and without major depressive disorder (MDD) and anxiety disorders (AD). This study enrolled 199 adults diagnosed with MDD and AD (n=53), MDD (n=47), AD (n=54), and no disorders (n=45). Measures included clinical interviews, self-reports, and a validated spatial affect task using affective pictures (IAPS; Lang, Bradley, & Cuthbert, 2005). Participants with MDD showed impaired spatial affect learning of negative stimuli and irrelevant learning of pleasant pictures compared with non-depressed adults. Adults with MDD may use a “GOOD is UP” heuristic reflected by their impaired learning of the opposite correlation (i.e., “BAD is UP”) and performance in the pleasant version of the task.     

The relation between low self-esteem and depressive mood in a non-clinical sample: The role of gender and negative life events

The suggestion that self-esteem is both a protective and a risk factor for depression is well documented. However, this association is not consistently observed by empirical research. The current study investigated the main and interactive effects of low self-esteem and stressful life events on depressive mood in a sample of university students (N = 862; female = 72%; black = 67%; mean age = 21.70, SD = 13.51). The students completed the Hopkins Symptom Checklist, the Rosenberg Self-Esteem Scale, and the Perceived Stress Scale. Data were analysed using structural equation modelling (SEM); with stressful life events scores as a mediator, and gender as a moderator, of the relation between low self-esteem and depression. Results indicate that low self-esteem significantly predicted depression, and that stressful life events partially mediated that relationship. Support emerged for the vulnerability effects of low self-esteem on depression and they held across gender groups. Low self-esteem may be a significant indicator of individuals who are at risk for developing depressive mood.