Distinguishing manifestations of anxiety: how do personality traits of compulsive checkers differ from other anxious individuals?

To better understand relations between personality and anxiety in general, and personality differences between compulsive checkers and nonchecking anxious individuals in particular, the current study was conducted. Participants included a nonclinical undergraduate sample of 36 compulsive checkers, 33 nonchecking anxious controls and 33 nonchecking nonanxious controls who were compared on five basic personality dimensions: emotional stability, extraversion, agreeableness, conscientiousness and intellect (Goldberg, 1992). Results indicated that a combined group of all anxious individuals was less extraverted and less emotionally stable than nonchecking/nonanxious controls. Results further indicated that compulsive checkers were less emotionally stable and more conscientious than nonchecking anxious controls. The implications of these findings, as well as the impact of the order of personality item presentation, are considered and discussed.     

Attentional control in OCD and GAD: specificity and associations with core cognitive symptoms

Obsessive–compulsive disorder (OCD) and generalized anxiety disorder (GAD) are both defined by excessive negatively-valenced cognitions. Although obsessional thoughts are considered essential to OCD and perseverative worry is considered essential to GAD, these excessive cognitions have been found to co-occur in both disorders. Accordingly, a common diathesis may influence the emergence of excessive thoughts in both disorders. The present study examined deficits in attentional control as a cognitive vulnerability that may contribute to both obsessional thought and perseverative worry. Patients with OCD (n = 30), GAD (n = 29), and non-clinical controls (NCC; n = 29) completed measures of obsessional thoughts, perseverative worry, and attentional control. Deficits in self-reported attentional control were found in both OCD and GAD relative to the NCC. However, attentional control was only related to excessive cognition in the GAD patient group, where deficits were associated with increased perseverative worry. Mediational modeling suggested that trait anxiety mediated the relationship between attentional control and perseverative worry in GAD. Implications of these findings for conceptualizing the role of attentional control in the genesis of excessive cognitions in OCD and GAD are discussed.     

Nonsuicidal Self‐Injury in College Students: The Role of Perfectionism and Rumination

A paucity of research exists examining personality and cognitive characteristics that may contribute to nonsuicidal self‐injury (NSSI). The purpose of the current study was to clarify the contribution of perfectionism and rumination, along with depression and anxiety, to NSSI within a sample of 170 college students. Group comparisons revealed that participants with a history of NSSI endorsed significantly more rumination and depressive and anxious symptoms then non‐NSSI controls. Results regarding perfectionism were mixed, with NSSI participants differing from controls on select aspects of perfectionism. Results suggest higher levels of depression and anxiety and a ruminative cognitive style may increase vulnerability for NSSI; however, further research is needed to clarify the contribution of perfectionism.     

Searching for Specificity Between Cognitive Vulnerabilities and Mood and Anxiety Symptoms

Using two large nonclinical samples (N = 725), relations between five targeted cognitive variables [intolerance of uncertainty, negative problem orientation, perfectionism/certainty, responsibility/threat estimation, and importance/control of thoughts] and mood [depression] and anxiety [social anxiety, generalized anxiety, and obsessive–compulsive] symptoms were examined. Analyses provided multiple levels of specificity, including zero-order correlations, partial correlations controlling for the effects of positive and negative affect, regression analyses, and hierarchical structural modeling. Results were that (a) intolerance of uncertainty showed relative specificity to anxiety versus depression symptoms and (b) negative problem orientation was common to mood and anxiety symptoms. Although certain analyses suggested that (c) perfectionism/certainty specifically predicted generalized anxiety and (d) both responsibility/threat estimation and importance/control of thoughts were unique predictors of obsessive–compulsive symptoms, these three cognitive variables inconsistently predicted symptom scores across the two studies. Conceptual and therapeutic implications are discussed.     

Links between neuroticism,emotional distress,and disengaging attention: Evidence from a single-target RSVP task

Anxiety and depression are often associated with attention control deficits, but few studies have explored whether neuroticism can account for these links. In the present study, undergraduate students (n=146) completed self-report measures of neuroticism, worry, anxious arousal, and anhedonic depression and also completed a visual attention task in which they were asked to identify a red target letter embedded within a rapid sequence of items. Neuroticism was associated with detection of the target when it was preceded by a distracter with which it shared a feature in common (a green letter). Specifically, these distracters produced longer attentional blinks in individuals with elevated levels of neuroticism. In contrast, target detection was not significantly associated with worry, anxious arousal, or anhedonic depression. We discuss the implications of this link between neuroticism and attention for cognitive models of emotional distress and disorders.     

Cognitive deficits in compulsive checkers: An exploratory study

Compulsive-checking behavior can be conceptualized as resulting, in part, from a memory failure. In order to determine if memory difficulties are associated with compulsive checking, the performance of college-student checkers were compared with the performance of non-checkers on a number of cognitive tasks hypothesized to be relevant to understanding checking behavior. Using the Checking and Cleaning subscales of the Maudsley Obsessional-Compulsive Inventory, four groups of subjects were identified: (1) Cleaning Checkers (N = 13); (2) Noncleaning Checkers (N = 13); (3) Cleaning Noncheckers (N = 13); and (4) Noncleaning Noncheckers (N = 15). It was hypothesized that the cognitive deficits studied would characterize individuals with cheeking compulsions, but not persons with non-checking compulsions (i.e. Cleaning Noncheckers) or normal controls (i.e. Noncleaning Noncheckers). Compulsive checkers were found to have a poorer memory for prior actions than non-checkers and were also found to underestimate their ability at distinguishing memories of real and imagined events, a process referred to as reality monitoring. Both of these deficits were specific to compulsive checkers and can be viewed as contributing to the likelihood that an individual will engage in checking behavior. If an individual has difficulty in recalling whether an intended action has been executed, they may be inclined to engage in checking behavior to insure the intended action is carried out. Similarly, a tendency to underestimate reality-monitoring ability could result in increased checking behavior as the individual attempts to reduce his/her uncertainty over whether a previous behavior actually occurred or merely was thought to occur. It is concluded that the study of cognitive deficits in compulsive checking is a potentially fruitful avenue for further inquiry.     

Emotional,behavioral, and cognitive factors that differentiate obsessive-compulsive disorder and other anxiety disorders in youth

Abstract

The current study examined specific emotional, behavioral, and cognitive variables that may distinguish obsessive-compulsive disorder (OCD) from generalized anxiety disorder (GAD), social phobia (SoP), and separation anxiety disorder (SAD) in youth. Youth with OCD (n=26) and other anxiety disorders (ADs; n=31), aged 7–12 years (56.1% males), and their parents participated. The study compared the two anxious groups on levels of emotional, behavioral, and cognitive functioning, as well as impairment associated with the disorder. Results indicated that in comparison to youth with GAD, SoP, or SAD, youth with OCD were found to have poorer emotion regulation skills, as well as greater oppositionality, cognitive problems/inattention, and parent impairment associated with the disorder. The findings suggest that there are unique characteristics of OCD that may differentiate this disorder from other ADs in youth. Potential clinical implications and directions for future research are discussed.     

Vagal influence during worry and cognitive challenge

Abstract

The primary foci of the study were exploration of the linkage between cognitive and autonomic inflexibility of worry and generalized anxiety disorder (GAD) and examination of the effects of an analog cognitive restructuring task on this relationship. Cardiac responses of GAD and non-GAD participants were measured to examine the sympathetic and parasympathetic effects of worry and cognitive challenge. Diagnostic groups of undergraduate students were determined via administration of a structured interview, yielding a GAD group (n=16) and a control group (n=19) of individuals without GAD, depression, or panic disorder diagnoses. Cardiac autonomic responses were acquired via electrocardiogram during rest, worry, and cognitive challenge conditions by an experimenter blind to diagnosis. Metrics were compared between the two groups and across the three conditions. Individuals diagnosed with GAD did not differ significantly from controls on autonomic indices. Worry was associated with significantly decreased parasympathetic influence and increased sympathetic activity. Cognitive challenge did not result in significant increased cardiac responsivity. The results indicate that worry behavior is associated with decreased vagal activity, suggest a linkage between autonomic and cognitive inflexibility, and provide further suggestions for improving protocols to assess the autonomic effects of cognitive therapy techniques.     

Emotional, cognitive and physiological correlates of abuse-related stress in borderline and antisocial personality disorder

Childhood abuse is an important precursor of borderline personality disorder (BPD) and antisocial personality disorder (ASPD). The current study compared the emotional reactivity to abuse-related stress of these patients on a direct and an indirect level. Changes in self-reported affect and schema modes, psychophysiology and reaction time based cognitive associations were assessed following confrontation with an abuse-related film fragment in patients with BPD (n = 45), ASPD (n = 21), Cluster C personality disorder (n = 46) and non-patient controls (n = 36). Results indicated a hyperresponsivity of BPD-patients on self-reported negative affect and schema modes, on some psychophysiological indices and on implicit cognitive associations. The ASPD-group was comparable to the BPD group on implicit cognitions but did not show self-reported and physiological hyper-reactivity. These findings suggest that BPD and ASPD-patients are alike in their implicit cognitive abuse-related stress reactivity, but can be differentiated in their self-reported and physiological response patterns.     

Personality predicts prospective memory task performance: an adult lifespan study

Do interindividual differences in prospective memory task performance reflect individual differences in personality and lifestyle? Do the cognitive abilities known to change with age retain their power to predict episodic prospective memory task performance after controlling for personality and lifestyle variables, and do personality and lifestyle variables offer predictive power apart from that provided by cognitive ability measures? To answer these questions, we conducted a study with community‐living healthy individuals (n= 141) between 18 and 81 years of age. They completed three different episodic prospective memory tasks – two laboratory tasks and one field task – as well as various measures of personality, lifestyle, and cognitive ability. The results indicated that personality and lifestyle reliably predicted who will succeed and who will fail on all three episodic prospective memory tasks. Conscientiousness predicted performance on two of the prospective memory tasks; socially prescribed perfectionism and neuroticism each predicted performance on one of the prospective memory tasks. Cognitive ability predicted performance on one of the laboratory prospective memory tasks but not on the other two prospective memory tasks. After we controlled for individual differences in personality and lifestyle variables, cognitive ability was no longer able to predict performance on the laboratory prospective memory task. By contrast, controlling for cognitive ability had no influence on the predictive power of the personality and lifestyle variables.     

Multidimensional Perfectionism and the Big Five Personality Traits: A Meta‐analysis

Multidimensional perfectionism includes the dimensions perfectionistic concerns and perfectionistic strivings. Many studies have investigated the nomological network of multidimensional perfectionism by relating perfectionistic concerns and perfectionistic strivings to the Big Five personality traits. Results from these studies were largely inconsistent. In the present study, we meta‐analytically integrated 672 effect sizes from 72 samples (N = 21 573) describing relations between multidimensional perfectionism and the Big Five personality traits. Perfectionistic concerns correlated positively with Neuroticism (r = 0.383) and negatively with Extraversion (r = ?0.198), Agreeableness (r = ?0.198), Conscientiousness (r = ?0.111), and Openness (r = ?0.087). Perfectionistic strivings correlated positively with Conscientiousness (r = 0.368), Openness (r = 0.121), Neuroticism (r = 0.090), and Extraversion (r = 0.067) and were unrelated to Agreeableness (r = 0.002). The measures of perfectionistic concerns and perfectionistic strivings moderated most of these relations. Meta‐analytic structural equation modelling allowed controlling each perfectionism dimension for the respective other. This partialling increased all correlations with the exception of the previously positive correlation between perfectionistic strivings and Neuroticism, which ceased to be significant. The findings support the distinction between perfectionistic strivings and perfectionistic concerns and demonstrate how multidimensional perfectionism is situated in the context of broader personality traits. © 2019 European Association of Personality Psychology     

Neurocognitive Performance in Children with ADHD and OCD

Attention-deficit/hyperactivity Disorder (ADHD) and obsessive–compulsive disorder (OCD) have both been linked to dysfunction in the cortico-striato-thalamo-cortical circuitry (CSTCC). However, the exact nature of neurocognitive deficits remains to be investigated in both disorders. We applied two neuropsychological tasks that tap into different functions associated with the CSTCC, namely a serial reaction time (SRT) task, developed to assess implicit sequence learning, and a delay aversion (DA) task in order to assess abnormal motivational processes. The performance data of boys with ADHD (n = 20), OCD (n = 20) and healthy controls (n = 25), all aged 10–18 years, were compared. Subjects with ADHD less frequently chose the larger, more delayed reward compared to those with OCD and controls, while subjects with OCD showed impaired implicit learning. In contrast, the ADHD group was unimpaired in their implicit learning behavior and the OCD group was not characterized by a DA style. Within the OCD-group, severity of obsessions was associated with implicit learning deficits and impulsive symptoms with DA in the ADHD-group. This double dissociation highlights the distinct cognitive dysfunctions associated with ADHD and OCD and might possibly point to different neural abnormalities in both disorders.     

Overcoming Negative Aspects of Perfectionism through Group Treatment

The tendency to hold and pursue excessively high standards for oneself and for others can interfere with academic achievement. Counsellors who work in university settings are often presented with students whose capabilities do not reflect their levels of achievement. This study reports on the evaluation of an eight-week group intervention designed to help university students shift from negative and often debilitating perfectionism to positive and enhancing perfectionism. The group treatment focused on changing attitudes, beliefs, feelings, and interpersonal interactions affected by perfectionism using combined cognitive-behavioral and interpersonal approaches. Standardized measures, including the Beck Depression Inventory (Beck et al., BDI-II manual. San Antonio: The Psychological Corporation, 1996), the Beck Anxiety Inventory (Beck and Steer, Beck Anxiety Inventory: Manual. San Antonio: The Psychological Corporation, 1993), and the Multidimensional Perfectionism Scale (Hewitt and Flett, Journal of Personality & Social Psychology, 60, 456–470, 1991a), provided data for pre- and post analysis of a treatment group (n = 30), and comparison groups of students attending group programs on career planning (n = 30) and attending psychology classes (n = 30). Results show that students participating in the treatment group significantly reduced their levels of depression, anxiety, and perfectionism in comparison to students who did not attend the treatment program. Implications of the findings suggest the importance of considering perfectionism on a continuum of negative and positive influences while helping students to address the intrapersonal and interpersonal dimensions of perfectionism.     

The style of planning action (STOP) questionnaire in OCD spectrum disorders

This article describes the exploratory and confirmatory validation of an everyday style of planning (STOP) questionnaire in a tic disorder (n = 88), Tourette syndrome (n = 76), body-focused repetitive behaviour group (n = 121), obsessive compulsive disorder (n = 251) and a non-clinical control group (n = 127).Exploratory factor analysis was performed on half of the sample and confirmatory analysis on the other half. A three factor solution accounted for 38% of the variance. The factors were labelled respectively: overcomplication, overpreparation, and overactivity. The internal consistency for the overcomplication score and total score was high and for the other two scales, satisfactory. Test–retest was satisfactory and the subscales discriminated amongst clinical groups, and clinical groups from controls. All subscales became significantly less pathological following cognitive behavioural treatment. Convergent validity showed strong correlations with depression, anxiety and perfectionism but not impulsivity. The study confirms style of action as an important characteristic of obsessive compulsive spectrum disorders. Further analysis of the structure of each factor is warranted.     

Perfectionism Dimensions and the Five‐factor Model of Personality

This study of university students (n = 357) and community adults (n = 223) examined personal standards (PS) and evaluative concerns (EC) higher‐order dimensions of perfectionism that underlie several measures from three different theoretical frameworks. In both students and community adults, confirmatory factor analyses supported PS perfectionism and EC perfectionism higher‐order latent factors. In relation to the revised NEO Personality Inventory, PS perfectionism was primarily related to conscientiousness and achievement striving. In contrast, EC perfectionism was primarily related to neuroticism, and lower positive emotions, trust and competence. EC perfectionism accounted for unique variance in current depressive and anxious symptoms over and above the five‐factor domain scores. Copyright © 2011 John Wiley & Sons, Ltd.     

Obsessive compulsive personality disorder as a predictor of exposure and ritual prevention outcome for obsessive compulsive disorder

Despite elevated rates of obsessive compulsive personality disorder (OCPD) in patients with obsessive compulsive disorder (OCD), no study has specifically examined comorbid OCPD as a predictor of exposure and ritual prevention (EX/RP) outcome. Participants were adult outpatients (n = 49) with primary OCD and a Yale-Brown Obsessive Compulsive Scale (YBOCS) total score ≥ 16 despite a therapeutic serotonin reuptake inhibitor dose for at least 12 weeks prior to entry. Participants received 17 sessions of EX/RP over 8 weeks. OCD severity was assessed with the YBOCS pre- and post-treatment by independent evaluators. At baseline, 34.7% of the OCD sample met criteria for comorbid DSM-IV OCPD, assessed by structured interview. OCPD was tested as a predictor of outcome both as a diagnostic category and as a dimensional score (severity) based on the total number of OCPD symptoms coded as present and clinically significant at baseline. Both OCPD diagnosis and greater OCPD severity predicted worse EX/RP outcome, controlling for baseline OCD severity, Axis I and II comorbidity, prior treatment, quality of life, and gender. When the individual OCPD criteria were tested separately, only perfectionism predicted worse treatment outcome, over and above the previously mentioned covariates. These findings highlight the importance of assessing OCPD and suggest a need to directly address OCPD-related traits, especially perfectionism, in the context of EX/RP to minimize their interference in outcome.     

Relationships between two dimensions of employee perfectionism,postwork cognitive processing,and work day functioning

This daily diary study examined relations between two distinct perfectionism dimensions and work-related cognitions experienced by employees during evening leisure time. Drawing from perseverative cognitive processing theory, we hypothesized that perfectionistic concerns would be related to work-related worry and rumination during post-work evenings. In contrast, we hypothesized that a theoretically more adaptive perfectionist dimension (perfectionistic strivings) would be associated with positively valenced self-reflections about work across consecutive evenings. A sample of 148 full-time workers completed an initial survey, which included a trait perfectionism measure, reported their work-related cognitions across four consecutive evenings of a working week, rated their sleep quality immediately upon awakening on each subsequent morning, and their daily levels of emotional exhaustion and work engagement at the end of each work day. Results showed that perfectionistic concerns were indirectly negatively associated with sleep quality and work day functioning via the tendency to worry and ruminate about work. In contrast, perfectionistic strivings were indirectly positively associated with work day engagement via the propensity to experience positive thoughts about work during evening leisure time. The theoretical and practical implications of these findings are discussed.     

Perfectionism as a Predictor of Post-event Rumination in a Socially Anxious Sample

Socially anxious individuals tend to have elevated levels of perfectionism and engage in excessive rumination following social situations. The present research aimed to examine perfectionism, in both state and trait forms, as a predictor of post-event rumination. Socially anxious students (N = 104) completed measures of trait perfectionism prior to, and state perfectionism following, an anxiety inducing speech task. Post-event rumination was assessed 2 days later. State and trait perfectionism were significant predictors of post-event rumination (2 days later), while controlling for baseline social anxiety, depression and state anxiety. These results support the need to target perfectionism in treatments for social anxiety disorder.     

Differentiating Cognitive Content between Depressed and Anxious Outpatients

Quantitative research suggests that depressed and anxious patients can be differentiated based on their cognitive content. This study used qualitative research methods to separate the specific components of open‐ended depressive and anxious thought content in 79 psychiatric outpatients. Patients with major depressive disorder (MDD; n = 36), generalized anxiety disorder (GAD; n = 10), and other psychiatric disorders (PC; n = 33) were instructed to (a) describe their most bothersome problem; (b) imagine the worst possible negative outcome followed by the best possible positive outcome; and (c) describe associated thoughts and emotions for each scenario. The content of patients' responses were coded to examine (a) the types and severity of problems; (b) the presence or absence of hopelessness, catastrophizing, hopefulness, and unrealistic positive expectations; and (c) the presence or absence of particular emotions associated with imagined worst and best outcomes. More GAD patients than MDD and PC patients indicated anticipated anxious emotions associated with imagined worst outcomes, and fewer MDD patients than GAD and PC patients indicated anticipated happiness associated with imagined best outcomes. No group differences emerged for the other variables considered. These findings suggest that depressed and anxious patients differ in their cognitive expectancies about future life events in terms of their own anticipated emotional reactions.     

Applicability of a cognitive model of worry to children and adolescents

BackgroundIntolerance of uncertainly (IU), cognitive avoidance (CA) and positive beliefs about worry (PB) independently predict worry frequency in older adolescents and adults, and when targeted together in treatment produce significant reductions in both worry and anxiety in this age range. The present study addresses a gap in the literature by testing whether a cognitive model of excessive worry and anxiety incorporating these process variables is applicable to children and adolescents.MethodPrimary and secondary school students (n = 515; aged 7–19 years) completed modified self-report measures of worry frequency, anxiety, IU, CA and PB and a path analysis undertaken to test whether IU was a higher order variable for CA and PB and whether the relationship between IU/CA/PB and anxiety was mediated by worry frequency.ResultsSignificant (bivariate) correlations were observed between the measures of IU, PB, CA, worry and anxiety across the age range. However separate path models had to be fitted for children (aged 7–12 years) and adolescents (aged 13–19) with PB being dropped from the child model. CA was related to anxiety only through worry in children while IU showed direct paths to worry and anxiety in both children and adolescents.ConclusionsCognitive models of persistent worry in adults and older adolescents may, with some modification, have applicability to children. Further testing and refinement of these cognitive models of worry may lead to improvements in existing treatments for anxious youth.