Presentation of Mexican Americans to a Memory Disorder Clinic

Despite the rapidly growing nature of the Mexican American population in the United States, relatively little is known regarding cognitive aging among this minority group compared to non-Hispanic, white individuals. The current study was conducted to describe the nature of cognitive and affective characteristics of Mexican American patients with dementia or other cognitive disorders on initial presentation to a Memory Disorder Clinic. Archival data were reviewed from this specialty clinic for 219 patients who were evaluated for the first time over a 2-year period. Twenty-two Mexican American patients were identified, and a sample of 22 matched non-Hispanic white patients was derived for comparison. When compared to non-Hispanic white patients, Mexican Americans were found in fewer numbers, reported higher levels of anxiety and depression, and produced lower scores on neurocognitive assessments. Results support the notion that Mexican American patients present for cognitive assessment and treatment at a greater stage of impairment severity as compared to non-Hispanic whites.     

The relationship between anxiety sensitivity and latent symptoms of emotional problems: A structural equation modeling approach

A large body of research suggests that common and specific psychopathology dimensions underlie the symptoms that occur within mood and anxiety disorders. As of yet, it is unclear precisely how the facets of Anxiety Sensitivity (AS), or fear of the symptoms of fear and anxiety, relate to these latent factors. Using data from 606 adolescents participating in the baseline phase of a longitudinal study on risk factors for emotional disorders, we modeled the facets of AS as measured by the Anxiety Sensitivity Index-Expanded Form (ASI-X) and related these facets to a hierarchical model of latent symptoms of psychological distress. Results suggest that one facet of AS is associated with a broad General Distress factor underlying symptoms of most emotional disorders while others relate to intermediate-level and conceptually-meaningful narrow factors representing aspects of psychological distress specific to particular emotional disorders.     

Emotion regulation in unipolar depression: the effects of acceptance and suppression of subjective emotional experience on the intensity and duration of sadness and negative affect

This study examined the effects of emotional suppression and acceptance in a depressed sample. Sixty participants with diagnoses of unipolar depression completed a questionnaire packet and participated in an experiment. The experiment utilized two conditions to explore correlates of the spontaneous use of emotion regulation strategies and the effects of an experimental manipulation of acceptance and suppression. Results demonstrated that suppression produced short-term reductions in sadness. Notably, anxiety about the experience of depressed mood influenced the efficacy of emotional suppression with findings showing that suppression was no longer effective at moderate and higher levels of anxiety about the experience of depressed mood. Implications of study findings for understanding emotion dysregulation in depressive disorders and the treatment of depression are discussed.     

Personality traits and anxiety symptoms: the multilevel trait predictor model

Investigation of relations between personality traits and mental disorders can inform key issues in psychopathology research. However, it has been hindered by extensive correlations among the traits. Building on studies of affect-psychopathology relations (e.g., the tripartite model), an organizational framework is proposed to solve this problem with respect to anxiety pathology. To test the resulting model, associations between four traits (negative emotionality, positive emotionality, anxiety sensitivity, and negative evaluation sensitivity) and four anxiety symptoms (chronic worry, obsessive-compulsive symptoms, panic, and social anxiety) were examined in an undergraduate sample (N=907). Confirmatory factor analyses supported operationalizations of the constructs in this study. Examination of the trait-symptom links using hierarchical multiple regression analyses supported most of the predicted relations. Specifically, negative emotionality emerged as a general predictor that was significantly related to all four symptom dimensions. In contrast, anxiety sensitivity was specific to panic and worry, whereas negative evaluation sensitivity was specific to social anxiety and worry. Finally, positive emotionality was uniquely related to social anxiety. The model accounted for a substantial amount of variance in the symptoms and almost all of the covariation among them.     

Rumination and worrying as possible mediators in the relation between neuroticism and symptoms of depression and anxiety in clinically depressed individuals

Rumination and worrying are considered possible mediating variables that may explain the relation between neuroticism and symptoms of depression and anxiety. The current study sought to examine the mediational effects of rumination and worry in the relationships between neuroticism and symptoms of depression and anxiety in a sample of clinically depressed individuals (N = 198). All patients completed a battery of questionnaires including measures of neuroticism, rumination, worrying, depression, and anxiety. Results showed that in subsequent analyses, rumination and worrying both mediated the relation between neuroticism and depression and anxiety. When rumination and worrying were simultaneously entered in the mediation analysis, only rumination was found to mediate the relation between neuroticism and symptoms of anxiety and depression. Two components of rumination (i.e., brooding and reflection) were also analyzed in the mediational analysis. Both reflection and brooding were significant mediators with respect to depressive symptoms, whereas brooding was the only significant mediator in relation to anxiety symptoms. The results are discussed in the light of current theories, previous research, and recent treatment developments. Clinical implications and suggestions for future research are provided.     

Maternal prenatal psychological distress and temperament in 1–4 month old infants – A study in a non-western population

In this longitudinal study, conducted in women attending antenatal visits at the obstetrics and gynecology clinic of a general hospital in Bangalore, India, we aimed to assess the relationship between prenatal distress in mothers, and maternal report of infant temperament at four months. 100 mothers with normal full term deliveries completed the General Health Questionnaire-28 item version (GHQ) in the third trimester and postnatally. Salivary cortisol and temperament (using the Early Infancy Temperament Questionnaire – EITQ) were assessed in their infants aged 1–4 months. In this study, maternal prenatal psychological distress was not significantly associated with maternal report of difficult temperament in infants. Infants of mothers who were a negative screen for psychological distress (GHQ < 7), n = 85 had higher scores on the adaptability and approach dimensions of temperament. Infant salivary cortisol was significantly higher in infants with higher intensity scores. These results introduce the possibility of cultural differences in the relationship between prenatal distress in the mother and infant temperament. These could be factors linked to child rearing practices or to the measures employed to study infant temperament. These findings derive from a small sample with few mothers with psychological distress, and need replication in a larger sample.     

Smoking motives in the prediction of affective vulnerability among young adult daily smokers

The primary aim of this study was to examine whether smoking to reduce negative affect was uniquely related to a range of affective vulnerability factors (e.g., anxiety sensitivity, anxious arousal, and negative affectivity) among daily smokers. Participants were 276 young adult daily smokers (124 females; M(age)=25.12, SD=10.37). Partially consistent with prediction, the motivation to smoke to reduce negative affect was significantly related to anxiety sensitivity and negative affectivity, but not anxious arousal; the observed significant effects were above and beyond other theoretically relevant factors (e.g., smoking rate, years smoked, age, gender). In contrast to prediction, habitual smoking motives demonstrated significant incremental associations with anxiety sensitivity and anxious arousal symptoms. These results suggest that there are important associations between certain smoking motives and negative affective states and that such relations are not attributable to other smoking factors (e.g., smoking rate).     

On the Discriminant Validity of Burnout,Depression and Anxiety: A Re-examination of the Burnout Measure

We investigated the discriminant validity of the frequently used Burnout Measure (BM) (Pines et al ., 1981), in relation to depressive symptomatology and anxiety. Following Russell's (1980) work on the multidimensional space of affective states, BM's items were hypothesized to reside in three separate regions of that space, labeled anxiety, depression, and wornout, with wornout representing a combination of physical and emotional exhaustion. Respondents were 704 senior army officers, who completed a questionnaire that included BM items, standard measures of depression and anxiety, and measures of military-related stresses. Their responses to the BM items and to the depression and anxiety scales were subjected to multidimensional scaling analysis. Excepting an unexpected finding related to a fourth construct, loss of vigor, the results were supportive of the hypothesis and led to the construction of three unidimensional measures, respectively gauging anxiety, depression, and wornout. The correlations of the three measures with the stress measures supported their discriminant validity. We suggest that future research using the BM should focus on the set of items that were found to load on the dimension of wornout, to the exclusion of items tapping depression and anxiety.     

Mindfulness and Emotion Regulation: The Development and Initial Validation of the Cognitive and Affective Mindfulness Scale-Revised (CAMS-R)

As interest grows in mindfulness training as a psychosocial intervention, it is increasingly important to quantify this construct to facilitate empirical investigation. The goal of the present studies was to develop a brief self-report measure of mindfulness with items that cover the breadth of the construct and that are written in everyday language. The resulting 12-item measure demonstrated acceptable internal consistency and evidence of convergent and discriminant validity with concurrent measures of mindfulness, distress, well-being, emotion-regulation, and problem-solving approaches in three samples of university students. To address potential construct contamination in two items, data are also presented on an alternate 10-item version of the measure.

Stress Sensitization and Adolescent Depressive Severity as a Function of Childhood Adversity: A Link to Anxiety Disorders

The goal of the present study was to determine whether exposure to adversity in childhood contributes to a differential threshold at which stressful life events provoke depressive reactions in adolescence. In addition, to address empirical and conceptual questions about stress effects, the moderating effect of anxiety disorder history was also explored. This examination was conducted in a sample of 816 children of depressed and nondepressed mothers, who were followed from birth to age 15. Information on adversities experienced in childhood was collected both from mothers during the first five years of their youth's life and from the youths themselves at age 15, and included information on the mother's relationship with her partner, maternal psychopathology, as well as youth-reported abuse. Results indicated that youths with both greater exposure to adversity in childhood and a history of an anxiety disorder displayed increased depressive severity following low levels of episodic stress compared to youths with only one or neither of these risk factors. The results are speculated to reflect the possibility that early anxiety disorders associated with exposure to adversity in childhood may be a marker of dysregulated stress responses, and may help to account for the comorbidity of depression and anxiety in some individuals.     

Individually-tailored, Internet-based treatment for anxiety disorders: A randomized controlled trial

Previous studies on Internet-based treatment with minimal to moderate therapist guidance have shown promising results for a number of specific diagnoses. The aim of this study was to test a new approach to Internet treatment that involves tailoring the treatment according to the patient’s unique characteristics and comorbidities.A total of 54 participants, regardless of specific anxiety diagnosis, were included after an in-person, semi-structured diagnostic interview and randomized to a 10 week treatment program or to a control group. Treatment consisted of a number of individually-prescribed modules in conjunction with online therapist guidance. Significant results were found for all dependent measures both immediately following treatment and at 1 and 2 year intervals. Mean between-group effect size including measures of anxiety, depression and quality of life was Cohen’s d = 0.69 at post-treatment, while the mean within-group effect size was d = 1.15 at post-treatment and d = 1.13 and d = 1.04 at 1 and 2 year follow-up respectively.The tentative conclusion drawn from these results is that tailoring the Internet-based therapy can be a feasible approach in the treatment of anxiety in a homogeneous population.     

A cross-sectional evaluation of the factorial invariance of anxiety sensitivity in adolescents and young adults

This study examined the cross-sectional factorial invariance of anxiety sensitivity in an ethnically diverse sample of adolescents (n = 173; mean age 15.5 years) and young adults (n = 291; mean age 20.1 years). Research in adult and youth samples suggests that anxiety sensitivity is best understood as a hierarchical construct with several lower-order factors. Factor models based on previous research using both adult and youth samples were compared and a hierarchical model with three lower-order factors provided the best fit to the data. Results supported the hypothesis that the factor structure of the Anxiety Sensitivity Index was invariant across age and gender. The factor scores also demonstrated differential correlations with symptoms of anxiety and depression. Results are discussed with regard to construct validation and understanding the structure of anxiety sensitivity in youth.     

Worry and rumination: differential associations with anxious and depressive symptoms and coping behavior

Worry and rumination are closely allied cognitive processes that impact on the experience of anxious and depressive symptoms. Using a prospective design, this study examined overlapping and distinct features of worry and rumination in relation to symptoms and coping behavior in a nonclinical sample of Singaporean college students. Worry and rumination were highly correlated, but they retained distinct components that predicted anxious and depressive symptoms differentially within and across time. Specifically, worry was uniquely associated with anxious and depressive symptoms whereas rumination was uniquely related to depression. In comparison to rumination, worry emerged as the dominant cognitive vulnerability factor that predicted increments in symptoms over time. With regards to coping behavior, low perceived coping effectiveness partially mediated the relation between worry and increases in anxiety and depression. Conversely, rumination uniquely predicted higher disengagement from problems, which resulted in further exacerbation of depressive mood. These results demonstrated not only the distinct features of worry and rumination on coping behavior, but also the different coping pathways by which they differentially impact on subsequent symptoms.     

Psychometric properties of the Revised Child Anxiety and Depression Scale in a clinical sample

This study examined the psychometric properties of the Revised Child Anxiety and Depression Scale (RCADS) in a clinical sample of 513 youth referred for mental health assessment at a university clinic. Internal consistency and factor analysis provided support for the factorial validity of the RCADS. Convergent and discriminant validity tests against both clinical interview and self-report criteria also suggested favorable properties of the RCADS. In comparative tests with traditional measures of anxiety and depression, the RCADS generally showed greater correspondence to specific diagnostic syndromes. Clinical cutoffs are reported for the purposes of future clinical and research applications.     

Perfectionistic strivings and perfectionistic concerns interact to predict negative emotionality: Support for the tripartite model of perfectionism in Canadian and Chinese university students

For most individuals, perfectionistic strivings and perfectionistic concerns coexist to varying degrees. While there is agreement that within-person combinations of perfectionistic strivings and perfectionistic concerns produce meaningful “subtypes”, the number and characterization of these within-person combinations is still debated. The two most prominent person-centered perfectionism models (the tripartite model and the 2 × 2 model) offer differing characterizations of how perfectionistic strivings effects perfectionistic concerns’ relationship with psychological outcomes. According to the 2 × 2 model, perfectionistic strivings buffers against the negative effects of perfectionistic concerns. The 2 × 2 model thus claims the most deleterious within-person combination of perfectionistic strivings and perfectionistic concerns is low strivings and high concerns. In contrast, according to the tripartite model, perfectionistic strivings exacerbates the maladaptive effects of perfectionistic concerns. The tripartite model thus claims the most maladaptive within-person combination of perfectionistic strivings and perfectionistic concerns is high strivings and high concerns. The present study tested these competing claims in a group of English speaking Canadians and a group of Mandarin speaking Chinese. Results support the tripartite model of perfectionism.     

Rumination as a transdiagnostic factor in depression and anxiety

The high rate of comorbidity among mental disorders has driven a search for factors associated with the development of multiple types of psychopathology, referred to as transdiagnostic factors. Rumination is involved in the etiology and maintenance of major depression, and recent evidence implicates rumination in the development of anxiety. The extent to which rumination is a transdiagnostic factor that accounts for the co-occurrence of symptoms of depression and anxiety, however, has not previously been examined. We investigated whether rumination explained the concurrent and prospective associations between symptoms of depression and anxiety in two longitudinal studies: one of adolescents (N = 1065) and one of adults (N = 1317). Rumination was a full mediator of the concurrent association between symptoms of depression and anxiety in adolescents (z = 6.7, p < .001) and was a partial mediator of this association in adults (z = 5.6, p < .001). In prospective analyses in the adolescent sample, baseline depressive symptoms predicted increases in anxiety, and rumination fully mediated this association (z = 5.26, p < .001). In adults, baseline depression predicted increases in anxiety and baseline anxiety predicted increases in depression; rumination fully mediated both of these associations (z = 2.35, p = .019 and z = 5.10, p < .001, respectively). These findings highlight the importance of targeting rumination in transdiagnostic treatment approaches for emotional disorders.     

A reduction in positive self-judgment bias is uniquely related to the anhedonic symptoms of depression

Identifying patterns of biased cognitive processing specific to depression has proved difficult. The tripartite model of mood disorders [Clark, L. A., & Watson, D. (1991). Tripartite model of anxiety and depression: psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 100, 316-336] suggests that a clearer processing ‘blueprint’ may emerge if depression is viewed dimensionally rather than categorically and by focusing on variations in the degree of positive, rather than negative, processing bias. To investigate this possibility, the present study examined the extent to which a reduced positive self-judgment bias previously found in depressed individuals relates to depression-specific anhedonic symptoms. Sixty participants with varying levels of anxiety and depression symptoms evaluated their own performance on a working memory task in the absence of external feedback. Overall, participants showed a positive self-judgment bias, overestimating the number of trials they had performed correctly relative to objective criteria. Consistent with the tripartite framework, the extent of this positive self-judgment bias was significantly and uniquely related to depression-specific symptoms, with the positive bias reducing as anhedonia severity increased across three different symptom measures.