Dimensions of Perfectionism and Anxiety Sensitivity

The current study investigated the extent to which dimensions of perfectionism are associated with components of the anxiety sensitivity construct. A sample of 177 undergraduate students completed the Multidimensional Perfectionism Scale, the Perfectionism Cognitions Inventory, the Perfectionistic Self-Presentation Scale, and the Expanded Anxiety Sensitivity Index developed by Taylor and Cox (1998). The results confirmed that automatic thoughts involving perfectionism and the interpersonal aspects of the perfectionism construct are associated with anxiety sensitivity. Examination of the Anxiety Sensitivity Index factors showed that perfectionism cognitions were associated primarily with anxiety sensitivity involving fears of cognitive dyscontrol, while socially prescribed perfectionism and perfectionistic self-presentation were associated primarily with fears of publicly observable anxiety reactions in a manner suggesting that the interpersonal perfectionism dimensions are linked closely with an anxious sensitivity to negative social evaluation and subsequent panic attacks. The theoretical and treatment implications of the link between perfectionism and anxiety sensitivity are discussed.     

Fear and Anxiety in COVID-19: Preexisting Anxiety Disorders

The general population has experienced a significant elevation in fear and anxiety during COVID-19 both as a direct result of the virus but also due to measures taken to prevent it spreading, such as the need to stay inside and increase hand-washing. Lockdown has been used in many/most countries to prevent widespread infection. The advice and imposed actions are necessary to prevent the virus from spreading, but they might exacerbate the problems experienced by people with a preexisting anxiety-related disorder. The treatment of anxiety-related disorders can be provided while in quarantine. Staying at home in self-isolation does not preclude obtaining psychological treatment for anxiety-related disorders. Dealing with cognitive biases, over-estimations of threat, intolerance of uncertainty, inflated responsibility and excessive safety behavior, are useful clinical directions.     

Emotional Distress Intolerance,Experiential Avoidance,and Anxiety Sensitivity: The Buffering Effect of Attentional Control on Associations with Posttraumatic Stress Symptoms

A number of individual difference factors, including emotional distress intolerance (EDI), experiential avoidance (EA), and anxiety sensitivity (ASI), have been implicated in the development and maintenance of posttraumatic stress (PTS) symptomatology. Attentional control (AC) has been shown to serve as a protective factor against the development of maladaptive psychological outcomes across a number of studies, even among those with outcome-specific vulnerabilities. The purpose of the present study was to examine AC as a moderator of the relations between three constructs pertaining to the way that people relate to their internal experiences (i.e., EDI, EA, AS) and PTS symptoms among a trauma exposed community sample (N?=?903). As predicted, AC moderated the relations between each individual difference factor and PTS symptoms, such that as attentional control decreased, the strength of the association between each individual difference factor and PTS symptoms increased. Study results suggest that AC abilities may be one factor that differentiates those who recover from trauma from those who do not, even among those who may be vulnerable for developing PTS symptomatology. Clinical implications and results of a PTS cluster level analysis will be discussed.     

Sensitivity for Treatment Effects of the Screen for Child Anxiety Related Emotional Disorders

The Screen for Child Anxiety Related Emotional Disorders (SCARED) is a relatively new self-report questionnaire that measures DSM-defined anxiety disorders symptoms in children. The present study examined the treatment sensitivity of the SCARED. Eleven anxiety-disordered children aged 10 to 13 years received cognitive-behavioral treatment, an intervention that is generally known to be effective. Children completed the SCARED on three occasions: (1) 3 months before treatment (i.e., baseline), (2) at pretreatment, and (3) at posttreatment. Before and after treatment, scores on traditional childhood anxiety measures (i.e., State-Trait Anxiety Inventory for Children, Revised Children's Manifest Anxiety Scale, and Fear Survey Schedule for Children) were also obtained. Results showed that children's SCARED scores remained relatively stable from baseline to pretreatment. However, from pre- to post-treatment, significant decreases were evident for the SCARED and for all traditional measures. These results suggest that the SCARED reliably taps treatment effects and, thus, provide further support for its utility as a self-report index of childhood anxiety in clinical and research settings.     

Relations Between Anxiety Sensitivity and Attachment Style Dimensions

This study replicated and extended the work of C. F. Weems, S. L. Berman, W. K. Silverman, and E. T. Rodriquez (2002) by investigating relations between anxiety sensitivity (AS) and attachment dimensions in a sample of young adults. Two hundred and twenty-six undergraduate students completed self-report measures including the Anxiety Sensitivity Index and the measure of adult romantic attachment used by C. F. Weems et al. (2002). In order to investigate the association between AS and a different domain of attachment, a measure of adult attachment referring to close relationships was included. As defined by both measures, insecurely attached individuals, specifically those classified as preoccupied and fearful (i.e., those with negative Models of Self), reported significantly higher levels of AS than those with secure and dismissing attachment styles (i.e., those with positive Models of Self). Results indicated that across both measures the Model of Self attachment dimension accounted for unique variance in AS levels beyond that contributed by trait anxiety. The Model of Others attachment dimension had a more limited association with AS.     

The Differential Role of Anxiety Sensitivity and its Components in the Relation between Emotional Nonacceptance and Anxiety and Depressive Symptoms and Disorders among Latinos in Primary Care

The present investigation examined anxiety sensitivity (AS) in the relation between emotional nonacceptance (unwillingness to experience unwanted emotions) and mood and anxiety symptoms among Latinos seeking health services at a primary healthcare facility. Participants included 267 adult Latinos (85.4% female; Mage = 38.8 years, SD = 10.7, and 95.9% used Spanish as their first language). Results indicated that emotional nonacceptance was indirectly related to number of mood and anxiety disorders, anxious arousal, social anxiety, and depressive symptoms through AS. The observed effects were evident above and beyond the variance accounted for by gender, age, marital status, educational status, employment status, years living in the United States, and negative affectivity. Using a multiple mediation model revealed that the AS cognitive, physical, and social concerns demonstrated unique incremental explanatory effects (above and beyond the other two AS sub-scales) for depressive, anxious arousal, and social anxiety symptoms, respectively. Thus, specific sub-scales of AS were uniquely related with the expression of particular affective symptom domains. Overall, the present findings suggest that there is merit in focusing further scientific attention on the interplay between nonacceptance and AS in regard to better understanding and intervening to reduce anxiety/depressive vulnerability among Latinos in primary care.     

Emotional Intelligence in Social Phobia and Other Anxiety Disorders

This study examined the associations between clinical anxiety, domains of emotional intelligence (EI), and three clinician-rated indices of maladjustment. Of key interest was whether social phobia (SP) is unique among anxiety disorders in being characterized by lower levels of Interpersonal and, particularly, Intrapersonal EI, and whether these differentially predict maladjustment. Individuals with SP (n = 169) obsessive-compulsive disorder (n = 65) and panic disorder (n = 64), and nonclinical controls (n = 169) completed the short form self-report Emotional Quotient Inventory (EQ-i: S). All anxiety disorder groups showed lower total EI than controls, and differed among themselves with the SP group displaying the lowest levels of total EI and lower scores on two EQ-i:S subscales (Interpersonal and, more robustly, Intrapersonal). The Intrapersonal dimension alone predicted all indices of greater maladjustment in the SP group. These findings indicate a negative relationship between anxiety disorders and EI, and reaffirm the foremost link between Intrapersonal EI and SP and its functional outcomes.     

Emotional Schemas and Resistance to Change in Anxiety Disorders

Cognitive-behavioral treatment for all anxiety disorders involves exposure to feared situations and feared emotions. Dropout from therapy is a continued problem for final treatment effectiveness. A meta-emotional model of fear of negative emotions (and anxious sensations and thoughts) is advanced that can be used as a transdiagnostic treatment model for anxiety disorders. According to this model, anxious individuals hold theories of anxiety that interfere with effective treatment. Specific treatment recommendations are developed from this model to counter roadblocks in cognitive-behavioral therapy of the various anxiety disorders.     

Emotion Regulation and the Specific Associations with Health Anxiety

This study investigated two primary research aims surrounding health anxiety: (a) to examine what differences exist in emotion regulation strategies of health anxious and non-health anxious populations and (b) to investigate what emotion regulation strategies predict health anxiety, before and after controlling for trait cognitive and somatic anxiety. A total of 95 participants of the general population completed a series of online questionnaires. A single factor between groups MANOVA revealed that a health anxious group scored significantly higher in several emotion regulation strategies: distraction, external attribution, emotion expression and acting out; anxiety-related variables: trait cognitive and somatic anxiety; and beliefs about the negative consequences of becoming ill. Hierarchical regressions showed that several emotion regulation strategies were significantly associated with higher levels of health anxiety, before: distraction, external attribution, capitalising, positive reappraisal and emotional expression; and after: external attribution and capitalising, the control of trait anxiety. Overall, the results demonstrated that (a) emotional intelligence and behavioural attempts to understand emotional experiences may be associated with specific health anxiety symptomology, while a lack of effective cognitive strategies and worry may be responsible for the associated trait anxiety dimensions.     

Dimensions of Pediatric Procedural Distress: Children's Anxiety and Pain During Immunizations

The purpose of this study was to isolate and compare children's procedural anxiety and pain. The study was conducted in a school-based pediatric health clinic with 39 fourth graders receiving 3 injection vaccinations over a 6-month period. Child and nurse ratings and an observational scale assessed anxiety and pain. Results suggest that anxiety and pain are highly correlated, however self-report and an observational measure discriminate between these constructs. Self-report and observational measurement indicated more pediatric pain than anxiety, whereas nurse reports did not indicate differences between children's pain and anxiety.     

Dimensions of Anxiety Sensitivity and Their Relationship to Nonclinical Panic

The goal of the present study was to examine the factor structure of the Anxiety Sensitivity Index (ASI; S. Reiss, R. A. Peterson, D M. Gursky, & R. J. McNally, 1986) and the replicability, reliability, and validity of its dimensions in a nonclinical sample. One-thousand-and-seventy-one undergraduate volunteers completed the ASI and a modified version of the Panic Attack Questionnaire (PAQ; G. R. Norton, J. Dorward, & B. J. Cox, 1986). A principal components analysis, using oblique rotation and parallel analysis, yielded three ASI dimensions that were highly consistent with those reported in previously published studies. Individuals classified as nonclinical panickers scored higher than nonpanickers on the Physical Concerns and Cognitive Concerns subscales of the ASI. Although spontaneous panic attacks were not significantly related to scores on any ASI scale, the occurrence of panic attacks in the past month was related to higher scores on the Cognitive Concerns subscale. The results are discussed in terms of cognitive theories of panic, and limitations of the present study and directions for future research are addressed.     

Social Anxiety in Children with Anxiety Disorders: Relation with Social and Emotional Functioning

Investigated the psychometric properties of the Social Anxiety Scale for children-Revised (SASC-R) as well as relations between social anxiety and children's social and emotional functioning. Participants were a clinic sample of children, ages 6–11 with anxiety disorders (N = 154) who completed the SASC-R. For a subset of these children, parent ratings of social skills, and self-ratings of perceived competence and peer interactions were also obtained. Factor analysis of the SASC-R supported the original three-factor solution and internal consistencies were in the acceptable range. Among children with simple phobia, scores on the SASC-R differentiated those with and without a comorbid social-based anxiety disorder. Social anxiety was also associated with impairments in social and emotional functioning. Specifically, highly socially anxious children reported low levels of social acceptance and global self-esteem and more negative peer interactions. Girls with high levels of social anxiety were also rated by parents as having poor social skills, particularly in the areas of assertive and responsible social behavior.     

Patterns of Emotional Reactivity and Regulation in Children with Anxiety Disorders

Emotion dysregulation is believed to be a key factor in anxiety disorders. However, the empirical basis for this view is limited, particularly in children and adolescents. This study aimed to examine whether anxious children display negative emotional hyper-reactivity and deficits in emotion regulation, using a new task that presents ambiguous situations with potentially threatening meanings. Forty-nine children diagnosed with either generalized anxiety disorder, social anxiety, or separation anxiety disorder, were compared with 42 non-anxious controls. Relative to controls, anxious children demonstrated (a) greater intensity and frequency of negative emotional responses, (b) deficits in using reappraisal in negative emotional situations and corresponding deficits in reappraisal self-efficacy, and (c) greater reliance on emotion regulation strategies that increase the risk of functional impairment, intense negative emotion, and low emotion regulation self-efficacy. Implications for the assessment and treatment of childhood anxiety are discussed.     

Relations of Tripartite Dimensions of Emotion to Childhood Anxiety and Mood Disorders

This study examined preliminary higher-order models relating tripartite dimensions of emotion to severity of anxiety and depressive disorders in 100 clinically referred children and adolescents. In light of the accumulating support for multifactor models of vulnerability and negative emotion in children, the present investigation was designed to establish preliminary estimates of the structure and magnitude of the relations of three emotion factors with dimensions of social anxiety, depression, panic, generalized anxiety, obsessions/compulsions, and separation anxiety. Results were consistent with structures that minimally specified two higher-order emotion factors, yet only some parameter estimates were consistent with theory regarding the tripartite model. Problems with the measurement of tripartite factors and possibilities for further research are outlined.     

Common and Specific Dimensions of Self-Reported Anxiety and Depression in Adolescent Outpatients

To investigate the common and specific dimensions of anxiety and depression in adolescents, the Beck Anxiety Inventory (BAI; Beck, A. T., & Steer, R. A. Manual for the Beck Anxiety Inventory. San Antonio, TX: Psychological Corporation 1993a) and Beck Depression Inventory-II (BDI-II; Beck, A. T., Steer, R. A., & Brown, G. K. Manual for Beck Depression Inventory (2nd Ed.). San Antonio, TX: Psychological Corporation 1996) were administered to 840 adolescent (13–17 years old) outpatients who were diagnosed with various types of psychiatric disorders. A Schmid-Leiman transformation was used with the iterated-principal-factor pattern matrix of the BAI and the BDI-II loadings. The amounts of orthogonalized common variance that were explained by the one second-order (56%), one first-order depression (22%), and two first-order anxiety (22%) dimensions were comparable to those previously reported for adult psychiatric outpatients. The results were discussed as supporting the construct of negative affectivity that is proposed in L. A. Clark and Watson’s (1991) tripartite model of anxiety and depression.

Associations Among Anxiety Disorders and Non-anxiety Disorders,Functional Impairment and Medication in Children and Adolescents

This is a study of comorbid anxiety disorders and how they affect the clinical picture of comorbid cases. The sample consisted of 576 Spanish children aged 8 to 17 years receiving psychiatric outpatient consultation that were evaluated using a semi-structured diagnostic interview for both parents and children. A specific association of homotypic comorbidity among anxiety disorders that was independent of the presence of other disorders was found. There was heterotypic comorbidity between anxiety and depressive disorders, ADHD, anorexia and tic disorders. Relationships between non-anxiety disorders were, in general, independent of anxiety, but anxiety moderated the relationship between ADHD-Conduct disorder and Conduct disorder-enuresis. Comorbid anxiety increased difficulties in social interaction, was related with higher global impairment and had an impact on consultation and medication. Anxiety disorder comorbidity should be well recognized in order not to disregard the treatment of all present disorders.     

Anxiety Sensitivity and Negative Interpretation Biases: Their Shared and Unique Associations with Anxiety Symptoms

Anxiety sensitivity (AS) is a psychological risk factor for anxiety disorders. Negative interpretation biases are a maladaptive form of information-processing also associated with anxiety disorders. The present study explored whether AS and negative interpretation biases make independent contributions to variance in panic and generalized anxiety symptoms and whether particular interpretation bias domains (e.g., of ambiguous arousal sensations) have specific associations with panic and/or generalized anxiety symptoms. Eighty-nine female undergraduates (44 low AS; 45 high AS) completed measures of AS, interpretation biases, and panic and generalized anxiety symptoms. Findings showed that AS and negative interpretation biases both significantly added to the prediction of anxiety symptoms. Negative interpretations of ambiguous arousal sensations were uniquely associated with panic symptoms, while negative interpretations of ambiguous general and social events were uniquely associated with generalized anxiety symptoms. Findings support the conceptual validity of AS and negative interpretation biases and their unique and shared contributions to anxiety symptoms.     

Predictors of Self-Reported Anxiety and Panic Symptoms: An Evaluation of Anxiety Sensitivity, Suffocation Fear, Heart-Focused Anxiety, and Breath-Holding Duration

The purpose of this study was to examine the extent to which anxiety-related individual difference variables predict anxious responding when individuals experience aversive bodily sensations. Thus, we explore several psychological and behavioral predictors of response to a single 25-sec inhalation of 20% carbon dioxide-enriched air in 70 nonclinical participants. Predictor variables included anxiety sensitivity, suffocation fear, heart-focused anxiety, and breath-holding duration. Multiple regression analyses indicated that only anxiety sensitivity significantly predicted postchallenge panic symptoms, whereas both anxiety sensitivity and suffocation fear predicted postchallenge anxiety. These data are in accord with current models of panic disorder that emphasize the role of fear of fear in producing heightened anxiety and panic symptoms and help clarify specific predictors of anxiety-related responding to biological challenge.