The Need for Absolute Truth and Self-Rumination as Basic Suppressors in the Relationship Between Private Self-Consciousness and Mental Health

Self-reflection has not so far been shown to have any specific benefits for mental health except for self-knowledge. Recent research showed that the controversy concerning the relationship between self-reflection and mental health could completely be eliminated if self-rumination and the need for absolute truth, especially the need for absolute truth, were considered as suppressor variables. This research replicated these findings in a different sample and expanded these findings by showing that the same is true for private self-consciousness. The need for absolute truth as a new variable was shown to be highly important in understanding the effects of self-consciousness on mental health.     

Does worry affect adjustment to bereavement? A longitudinal investigation

Background and objectives: Repetitive thought is a trans-diagnostic risk-factor for development of psychopathology. Research on repetitive thought in bereaved individuals has focused primarily on clarifying the role of rumination, repetitive thinking about past negative events and/or negative emotions. While detrimental effects of rumination have been demonstrated following bereavement, surprisingly few studies have aimed to clarify the role of worry, repetitive thinking about potential future negative events, in adjustment to loss. This study sought to fill this gap in knowledge. Methods/Design: One hundred eighty-three bereaved individuals (85.3% women) filled out questionnaires on sociodemographic and loss-related characteristics, worry, and symptom measures of depression, anxiety, and prolonged grief. After six months, 155 participants completed worry and symptom measures again. Using multiple regression analyses, concurrent and longitudinal associations between loss-related variables, worry, and symptoms of psychopathology were examined. Results: Main results were that worry was strongly positively associated with symptoms of anxiety, depression and prolonged grief concurrently and also predicted higher levels of anxiety, depression and prolonged grief longitudinally. Conclusions: Findings suggest that worry influences adjustment to bereavement negatively and may be a potential target in grief therapy, especially when aiming to reduce anxiety.     

The gap that makes us desperate: Paths from language to mental health

Although past research provided some clues about the relation of language use with mental health, the mediatory functions of personality variables in this relationship have been ignored. This research examined the mediatory role of self‐concept clarity in the relationship between language use perceived by individuals and mental health indicators including anxiety, depression, and alexithymia. Based on the theoretical framework suggested by ?im?ek (2010), two studies sought to test two alternative structural equation models in data from university students in the first study (n = 250) and data from other groups in the second study (n = 331). The first model assumed that the relationship of language use with anxiety, depression, and alexithymia was mediated by self‐concept clarity. The second model tested the mediatory role of both anxiety and self‐concept clarity in this relationship. The results of the first study showed that the second model fitted better to the data than the first. Consistent with the first study, the results of the second study confirmed that the second model produced better goodness of fit statistics than the first model.     

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.     

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.     

Self‐absorption paradox is not a paradox: Illuminating the dark side of self‐reflection

Although considered an important component of a healthy personality, self‐reflection has not so far been shown to have any specific benefits for mental health. This research addresses this issue by taking into consideration two important suppressor variables, self‐rumination and the need for absolute truth. The latter is an innovative variable, defined and presented in this research. The first two studies aimed to validate a new measure that acts as an operational definition of the need for absolute truth. The first study was conducted with two group of participants; the first group consisted of 129 females and 67 males, mean age = 20 years, and the second 182 females and 104 males, mean age = 27. In the second study, participants were 22 females and 18 males, mean age = 20.5. In the final study, conducted with 296 female, 163 male participants (mean age = 37), suppressor effects were tested using structural equation modeling. The results showed that by taking account of these two suppressor variables, particularly the need for absolute truth, the expected relationship between self‐reflection and mental health was revealed. The need for absolute truth was shown to be crucial for understanding the effects of self‐reflection on mental health, therefore it should be considered in all processes of psychotherapy.     

The influences of cultural values, ethnic identity, and language use on the mental health of Korean American college students

Little research has examined ethnic identity, cultural values, and native language maintenance as predictors of mental health in Korean Americans. The authors explored the influences of ethnic identity, maintenance of Asian cultural values, and maintenance of Korean language usage on self-esteem, anxiety, and depression in Korean American college students (N = 133). Findings indicated that Korean American men reported relatively high levels of state and trait anxiety and that the overall sample reported a relatively high level of depression. Whereas language and ethnic identity had a minimal influence on the mental health of students, greater cultural value maintenance was associated with decreased self-esteem and increases in state anxiety, trait anxiety, and depression. The positive relationship between cultural values and mental health problems may be indicative of being caught in an ethnic bind, in which the clash of traditional and modern values contributes to psychological distress. The authors discuss clinical implications of the findings.     

恋爱中大学生依恋焦虑与心理健康的关系：恋爱关系质量的中介和调节作用

依恋焦虑与个体心理健康存在密切关联,恋爱关系质量可能在二者关系中发挥着重要作用。本文以595名处于恋爱关系中的大学生为被试,探讨了恋爱关系质量在大学生依恋焦虑与心理健康关系中的作用。结果表明,恋爱关系质量在大学生依恋焦虑与心理健康的关系中既发挥着中介作用,也发挥着调节作用。一方面,依恋焦虑能够通过影响恋爱关系质量对心理健康造成影响,另一方面,高质量的恋爱关系能够缓解依恋焦虑对心理健康的消极影响。     

Differentiating anxiety and depression: the State-Trait Anxiety-Depression Inventory

ABSTRACT

The differentiation of trait anxiety and depression in nonclinical and clinical populations is addressed. Following the tripartite model, it is assumed that anxiety and depression share a large portion of negative affectivity (NA), but differ with respect to bodily hyperarousal (specific to anxiety) and anhedonia (lack of positive affect; specific to depression). In contrast to the tripartite model, NA is subdivided into worry (characteristic for anxiety) and dysthymia (characteristic for depression), which leads to a four-variable model of anxiety and depression encompassing emotionality, worry, dysthymia, and anhedonia. Item-level confirmatory factor analyses and latent class cluster analysis based on a large nation-wide representative German sample (N?=?3150) substantiate the construct validity of the model. Further evidence concerning convergent and discriminant validity with respect to related constructs is obtained in two smaller nonclinical and clinical samples. Factors influencing the association between components of anxiety and depression are discussed.     

Regulation strategies during COVID-19 quarantine: The mediating effect of worry on the links between coping strategies and anxiety

IntroductionThe COVID-19 outbreak forced Italian citizens into a generalized quarantine from March to May 2020. The quarantine is a successful measure to reduce the virus's spread through physical and social distancing, but it can also have negative psychological consequences on the population. People experience high levels of worry and anxiety and have to cope with the consequences of the health emergency. The aim of this study was to preliminarily assess the causal relations among coping, worry and state anxiety at the time of COVID-19 first wave, and the mediation role of worry between coping and state anxiety.MethodsDuring March 2020, 1273 Italian citizens completed an ad hoc online survey composed of sociodemographic and preoccupation-related questions, and standardized self-report questionnaire (Brief COPE, Penn State Worry Questionnaire and State-Trait Anxiety Inventory-State form). Three separate mediation models were performed.ResultsThe relationship between coping strategies (i.e.: problem-focused coping, emotion-focused coping and dysfunctional coping) and state anxiety resulted to be mediated by worry. Dysfunctional and problem-focused coping had a negative effect on anxiety scores and this effect was amplified by high levels of worry. Emotion-focused coping reduced state anxiety scores through its effect on reducing the levels of worry, which in turn was related to a reduction in anxiety.ConclusionThe present study offers first evidence for the mediation role of worry in the relation between coping and anxiety during quarantine caused by COVID-19 pandemic. It supports the clinical importance of investigating people's coping strategies along with the levels of (cognitive) worry and their long-term effects on the psychological well-being during the outbreak, in order to deliver adequate personalized interventions. Psychological support should enhance emotion-focused coping strategies that have a protective effect on both worry and anxiety.     

Counseling Older Adults with Dementia: A Survey of Therapists in Massachusetts

Although much has been written about therapeutic interventions with caregivers, little is known about the counseling services that are available for victims of dementia. The present study was designed to explore community mental health center (CMHC) services and therapists' experiences in providing psychotherapy to this population in Massachusetts. Only 27 of the 36 CMHCs in the state reported providing mental health services to older adults with a dementing illness. A survey of therapists who specialized in working with older adults found that the percentage of older adult clients estimated to have dementia averaged about half of their caseload. Older persons in the early phase of a dementing illness were most frequently referred for depression and anxiety, whereas those with moderate decline were most frequently referred for management of disruptive behavior. The most common services provided to clients with dementia consisted of assessment and individual counseling. The latter finding indicates a discrepancy between what is practiced and the professional literature. Most of the psychotherapy described in the literature concerns group interventions, which were rarely provided by the mental health centers in Massachusetts. The centers tended to offer individual counseling; however, little information on how to provide this form of treatment can be found.     

A randomized controlled pilot study evaluating Worry Less,Live More: The Mindful Way Through Anxiety Workbook

ABSTRACT

Effective interventions for generalized anxiety exist, but barriers to treatment prevent their broad dissemination. Commercially available self-help materials may help bridge this gap, but few have been empirically evaluated. This study compared self-reported change in generalized anxiety symptomology and associated problems between community members with excessive worry who were randomly assigned to receive the Worry Less, Live More: The Mindful Way through Anxiety Workbook (n = 35) and those in a delayed condition (n = 29). Participants in the workbook condition reported significantly greater reductions between baseline and 11-week follow-up in self-reported worry (η ² =.15), general anxiety/tension (η ² =.13), and anxiety (η ² =.24) than those in the delayed condition, although no statistically significant differences across condition on changes in depression, functional impairment or acceptance were detected. This pilot study provides support for continued research examining the efficacy of acceptance-based behavioral therapy delivered in a self-help format.     

The Roles of Social Support and Self-Efficacy in Physical Health’s Impact on Depressive and Anxiety Symptoms in Older Adults

Physical illness may precipitate psychological distress among older adults. This study examines whether social support and self-efficacy moderate the associations between physical health and depression and anxiety. Predictions were tested in 222 individuals age 60 or older presenting for help with worry. Physical health was assessed through self-report (subjective) and physical diagnoses (objective). Objective physical health did not have a significant association with depression or anxiety. Worse subjective physical health was associated with increased somatic anxiety, but not with depression or worry. The relationship between subjective physical health and depressive symptoms was moderated by self-efficacy and social support. As predicted, when self-efficacy was low, physical health had its strongest negative association with depressive symptoms such that as physical health improved, depressive symptoms also improved. However, the moderation effect was not as expected for social support; at high levels of social support, worse physical health was associated with increased depressive affect.     

To be sure, to be sure: intolerance of uncertainty mediates symptoms of various anxiety disorders and depression

The Intolerance of Uncertainty Model was initially developed as an explanation for worry within the context of generalized anxiety disorder. However, recent research has identified intolerance of uncertainty (IU) as a possible transdiagnostic maintaining factor across the anxiety disorders and depression. The aim of this study was to determine whether IU mediated the relationship between neuroticism and symptoms related to various anxiety disorders and depression in a treatment-seeking sample (N=328). Consistent with previous research, IU was significantly associated with neuroticism as well as with symptoms of social phobia, panic disorder and agoraphobia, obsessive-compulsive disorder, generalized anxiety disorder, and depression. Moreover, IU explained unique variance in these symptom measures when controlling for neuroticism. Mediational analyses showed that IU was a significant partial mediator between neuroticism and all symptom measures, even when controlling for symptoms of other disorders. More specifically, anxiety in anticipation of future uncertainty (prospective anxiety) partially mediated the relationship between neuroticism and symptoms of generalized anxiety disorder (i.e. worry) and obsessive-compulsive disorder, whereas inaction in the face of uncertainty (inhibitory anxiety) partially mediated the relationship between neuroticism and symptoms of social anxiety, panic disorder and agoraphobia, and depression. Sobel's test demonstrated that all hypothesized meditational pathways were associated with significant indirect effects, although the mediation effect was stronger for worry than other symptoms. Potential implications of these findings for the treatment of anxiety disorders and depression are discussed.     

Relationship (in)congruency may differently impact mental health

BackgroundBeing involved in romantic relationships has historically been related to better mental health compared to being single. However, research exploring heterogeneity within these status groups is still understudied. Our study examined the role of (in)congruency between relationship desire, dismissal, satisfaction with relationship status, and current relationship status on the mental health measured in terms of anxiety, depression, insomnia, and romantic loneliness.MethodThe online questionnaire survey included 790 participants aged 18 – 40 (M = 26.51, SD = 5.60) at baseline and 421 at a 1-month follow-up. Participants represented five relationship statuses (single, casual dating, LAT relationships, cohabitation, and engagement/marriage).ResultsOur results suggest that greater relationship desire and dismissal at baseline were associated with higher anxiety and depression in casual daters one month later, while greater relationship desire was linked to lower anxiety for individuals in living apart together relationships (LATs). Higher relationship dismissal in casual daters and engaged/married individuals was associated with lower insomnia. Higher satisfaction with relationship status was associated with lower depression in single individuals and lower romantic loneliness in cohabitors and engaged/married individuals.ConclusionsThis study highlights that relationship (in)congruency may operate differently across various relationship status subgroups on mental health outcomes.     

A Taxometric Investigation of the Latent Structure of Worry: Dimensionality and Associations With Depression, Anxiety, and Stress

Worry has been described as a core feature of several disorders, particularly generalized anxiety disorder (GAD). The present study examined the latent structure of worry by applying 3 taxometric procedures (MAXEIG, MAMBAC, and L-Mode) to data collected from 2 large samples. Worry in the first sample (Study 1) of community participants (n = 1,355) was operationalized by worry engagement, absence of worry, and the worry feature of trait anxiety. Worry in the second sample (Study 2) of undergraduate participants (n = 1,171) was operationalized by the tendency to experience worry, intolerance of uncertainty, beliefs about worry, and symptoms of GAD. Results across both samples provided converging evidence that worry is best conceptualized as a dimensional construct, present to a greater or lesser extent in all individuals. Findings from Study 2 also indicated that the latent dimension of worry generally has an equal association with symptoms of depression, anxiety, and stress across the entire continuum. These findings are discussed in relation to the conceptualization and assessment of worry in GAD and related disorders.     

Age and gender differences in adolescent worry

The purpose of the present study was to explore gender and age differences in adolescent worry. High school students filled out measures of worry, negative problem orientation, intolerance of uncertainty, and general mental health. Girls and boys of different ages were then compared and the relationships between gender, beliefs about worry, intolerance of uncertainty, negative problem orientation and mental health were also examined. Boys reported greater negative problem orientation and intolerance of uncertainty while girls reported more positive beliefs about worry. Findings also revealed certain age trends, indicating that the variables under study may be under the influence of developmental tasks. Regression analysis was performed and positive beliefs about worry emerged as a significant predictor of worry in both sexes. Positive beliefs about worry and negative problem orientation appear to be the key processes in adolescent anxiety and depression.     

The Meta-Cognitive Beliefs Questionnaire: development of a measure of obsessional beliefs

A 67 item self-report questionnaire called the Meta-Cognitive Beliefs Questionnaire (MCBQ) was developed to assess endorsement of beliefs about the importance of control and negative consequences associated with unwanted, ego-dystonic intrusive thoughts, images and impulses. The MCBQ and a battery of questionnaires that assessed symptoms and cognitions of worry, obsessive-compulsive disorder, anxiety, and depression were administered to large samples of undergraduate students. Beliefs about control of intrusive thoughts and perceived negative consequences due to uncontrolled mental intrusions had a unique significant relationship with obsessions, and to a lesser extent, worry. These findings are consistent with current cognitive behavioral theories that suggest an important role for meta-cognitive beliefs in the pathogenesis of obsessions.     

Worry and Pathological Worry in Patients with Psoriasis: Cross Sectional and Longitudinal Analyses of the Penn State Worry Questionnaire (PSWQ) in Four Samples of Patients

The purpose of the present study was to examine the psychometric properties of the Penn state Worry Questionnaire (PSWQ) in patients with psoriasis. A series of cross-sectional and longitudinal studies were undertaken to assess the reliability, stability and validity of the measure. Patients with psoriasis from four samples (consecutive attendees, anxious patients, depressed patients, and 6-month follow-up of consecutive attendees) completed the PSWQ and measures assessing related constructs of anxiety and depression (HADS) and coping (COPE). The clinical severity of patients psoriasis was also assessed by dermatologists using the Psoriasis Area and Severity Index (PASI). Exploratory factor analysis was undertaken and receiver operator characteristic (ROC) analyses were used to examine the clinical utility of the PSWQ cut-off score for normal and pathological worry. Exploratory factor analysis suggested that the PSWQ is essentially unidimensional in patients with psoriasis. Intraclass correlation demonstrated that, over a 6-month period, the reproducibility of the PSWQ total scale was good in patients with anxiety and moderate in patients with depression. ROC analysis suggested that the optimum cutoff differentiating pathological worry was > 60, which is commensurate with findings in adult mental health more generally. The PSWQ cutoff for pathological worry showed a lower specificity for depression than anxiety. The PSWQ is an appropriate measure of pathological worry in patients with psoriasis. The cutoff on the scale for pathological worry demonstrates appropriate conceptual overlap with subordinate distress categories of anxiety and depression.