Discomfort intolerance: evaluation of a potential risk factor for anxiety psychopathology

Discomfort intolerance, defined as an individual difference in the capacity to tolerate unpleasant bodily sensations, is a construct recently posited as a risk factor for panic and anxiety psychopathology. The present report used a biological challenge procedure to evaluate whether discomfort intolerance predicts fearful responding beyond the effects of trait anxiety and a well-established psychological vulnerability factor (i.e., anxiety sensitivity). Nonclinical community participants (N=44) with no history of panic attacks or any Axis I condition completed a 35% CO(2) challenge. Results are consistent with our hypothesis suggesting that discomfort intolerance incrementally predicts increased subjective reactivity to the challenge. Moreover, there was some suggestion that discomfort intolerance interacted synergistically with anxiety sensitivity to increase anxiety-related symptoms. These findings add to a small but growing literature suggesting that discomfort intolerance may play a role in the development of anxiety problems.     

Diazepam-stress interactions in the rat: effects on autoanalgesia and a plus-maze model of anxiety

On six occasions spaced at least a week apart, two groups of rats were subjected to a variety of stressful conditions consisting of a restraint/bright light complex, either alone or in combination with a tail pinch, whole-body inversion, or partial immersion in cold water. One of these groups was injected with diazepam (2.0 mg/kg) 30 min prior to the stressors, while the other group experienced the drug in their home cages the following day. A third group also received the diazepam but was not exposed to the stressors. In three test sessions all animals were injected with either diazepam or saline and were then exposed to a novel stressor: a plus-maze used as a screening device for anxiolytic drugs. This was immediately followed by a tail-flick measure of analgesia. The longest tail-flick latencies, indicating stress-induced analgesia ("autoanalgesia"), were observed in the group that had not been exposed to stress prior to testing. The other two groups exhibited substantially shorter latencies but did not differ from one another, thus showing a "stress inoculation" effect that was uninfluenced by diazepam. In the plus-maze, diazepam tends to increase the amount of time rats will spend in the two exposed arms of the maze relative to the two enclosed arms. This effect was significantly attenuated in the group that had previously experienced the variety of stressors after a diazepam injection, suggesting a learned association between drug and stress that resulted in a diminution of the drug's anxiolytic property.     

Toward an integrative model of suicide attempt: a cognitive psychological approach.

Applying a cognitive approach, the purpose of the present study was to expand previous research on stress-vulnerability models of depression and problem-solving deficits, as it relates to suicide attempt. Structural equation modelling, involving latent variables, was used to evaluate (a) whether low self-esteem, a low sense of self-efficacy, loneliness, and divorce constituted vulnerability factors for the development of depression; (b) whether hopelessness and suicidal ideation mediated the relationship between depression and suicide attempt; and (c) whether problem-solving deficits mediated the relationship between the vulnerability factors and suicide attempt, separate from depression/hopelessness. A total of 123 individuals, aged 18-75 years, participated in the study (72 suicide attempters and 51 psychiatric outpatients with no history of suicidal behavior). The results indicated a two path model of suicide attempt. The first path began with low self-esteem, loneliness, and separation or divorce, which advanced to depression, and was further mediated by hopelessness and suicidal ideation which led to suicide attempt. The second path developed from low self-esteem and a low sense of self-efficacy and advanced to suicide attempt, mediated by a negative appraisal of one's own problem-solving capacity, and poor interpersonal problem-solving skills. The importance of addressing both depression/hopelessness, and problem-solving deficits when working with suicide attempters is noted.     

The multilevel latent covariate model: a new, more reliable approach to group-level effects in contextual studies

In multilevel modeling (MLM), group-level (L2) characteristics are often measured by aggregating individual-level (L1) characteristics within each group so as to assess contextual effects (e.g., group-average effects of socioeconomic status, achievement, climate). Most previous applications have used a multilevel manifest covariate (MMC) approach, in which the observed (manifest) group mean is assumed to be perfectly reliable. This article demonstrates mathematically and with simulation results that this MMC approach can result in substantially biased estimates of contextual effects and can substantially underestimate the associated standard errors, depending on the number of L1 individuals per group, the number of groups, the intraclass correlation, the sampling ratio (the percentage of cases within each group sampled), and the nature of the data. To address this pervasive problem, the authors introduce a new multilevel latent covariate (MLC) approach that corrects for unreliability at L2 and results in unbiased estimates of L2 constructs under appropriate conditions. However, under some circumstances when the sampling ratio approaches 100%, the MMC approach provides more accurate estimates. Based on 3 simulations and 2 real-data applications, the authors evaluate the MMC and MLC approaches and suggest when researchers should most appropriately use one, the other, or a combination of both approaches.     

Peer functioning, family dysfunction, and psychological symptoms in a risk factor model for adolescent inpatients' suicidal ideation severity

Examined models of suicidal ideation severity that include two psychosocial risk factors (i.e., peer and family functioning) and four domains of psychological symptoms (i.e., generalized anxiety, depression, conduct problems, and substance abuse/dependence). Participants were 96 psychiatric inpatients (32 boys, 64 girls), ages 12 to 17, who were hospitalized because of concerns of suicidality. Adolescents completed a structured diagnostic interview, measures of suicidal ideation, and several dimensions of family and peer functioning. Results supported a model in which greater levels of perceived peer rejection and lower levels of close friendship support were associated directly with more severe suicidal ideation. In addition, indirect pathways included deviant peer affiliation and global family dysfunction related to suicidal ideation via substance use and depression symptoms. The results are among the first to demonstrate relations between suicidal ideation and several areas of adolescent peer functioning, as well as divergent processes for peer and family predictors of suicidal ideation.     

Physiological and psychological reactivity in women with asthma: the effects of anxiety and menstrual cycle phase.

The relation between menstrual cycle timing, panic attacks, and diagnosis of asthma was explored in this study. Women with or without asthma and with or without a history of panic attacks engaged in a psychophysiological task during either the intermenstrual or premenstrual cycle phase and completed self-report measures of menstrual symptoms and attitudes, general psychological symptoms, and attitudes toward illness. No significant differences were identified for psychological or psychophysiological measures with menstrual cycle phase as a factor. However, women with both asthma and a history of panic attacks reported more general psychological distress than women in the other groups, and more state anxiety than controls. Women in the asthma, asthma and panic, and panic groups reported higher anxiety sensitivity than the control group. After listening to asthma-related scenes, women with asthma exhibited a decrease in peak expiratory air flow, and women with asthma and panic exhibited increased skin conductance response magnitude. Implications for the role of anxiety in lung function are discussed, as well as directions for future research with asthma and anxiety populations.     

基于心理痛苦理论与决策树的中学生心理危机分类模型

中学生心理危机分类模型属于复杂数据模型,本文采用分类树算法探究家庭、校园、同伴和个体因素在中学生心理危机分类中的相对重要性差异,尤其是心理痛苦三因素对致死性危机的独特作用。结果显示：（1）中学生自杀危机和非致死性危机分类树的分类效果良好,自伤危机分类树的分类效果欠佳;（2）中学生自杀危机中,痛苦逃避最为重要,痛苦唤醒次之,之后为痛苦体验和学校满意度;（3）中学生自伤危机中,同伴问题行为最为重要,之后为父母陪伴和家庭监督;（4）中学生非致死性危机中,歧视知觉最为重要,之后为痛苦唤醒和同伴支持。提示中学生不同心理危机的促发机制存在差异,心理痛苦三因素模型在自杀分类模型中作用显著,但并非自伤危机和非致死性危机的关键变量。     

Low perceived control as a risk factor for episodic memory: the mediational role of anxiety and task interference

Low perceived control is considered a risk factor for poor cognitive functioning, but the mechanisms are unclear. The goal of the present study was to analyze anxiety and task interference as sequential mediators of the association between control beliefs and episodic memory. Cognitive-specific control beliefs were assessed prior to the lab session. State anxiety was assessed in the lab, followed by a word list recall task. The frequency of intrusive thoughts during the memory task was reported by the participants as a measure of task interference after the completion of the cognitive testing. The results for 152 participants from the ages of 22 to 84 years supported the predicted three-path mediation model. Lower levels of control beliefs were associated with higher state anxiety, which in turn affected episodic memory performance by increasing the likelihood of task interference, with age, sex, and verbal abilities as covariates. The implications of the results for developing interventions to improve memory performance are considered.     

Evaluating a split processing model of visual word recognition: effects of orthographic neighborhood size

The split fovea theory proposes that visual word recognition of centrally presented words is mediated by the splitting of the foveal image, with letters to the left of fixation being projected to the right hemisphere (RH) and letters to the right of fixation being projected to the left hemisphere (LH). Two lexical decision experiments aimed to elucidate word recognition processes under the split fovea theory are described. The first experiment showed that when words were presented centrally, such that the initial letters were in the left visual field (LVF/RH), there were effects of orthographic neighborhood, i.e., there were faster responses to words with high rather than low orthographic neighborhoods for the initial letters ('lead neighbors'). This effect was limited to lead-neighbors but not end-neighbors (orthographic neighbors sharing the same final letters). When the same words were fully presented in the LVF/RH or right visual field (RVF/LH, Experiment 2), there was no effect of orthographic neighborhood size. We argue that the lack of an effect in Experiment 2 was due to exposure to all of the letters of the words, the words being matched for overall orthographic neighborhood count and the sub-parts no longer having a unique effect. We concluded that the orthographic activation found in Experiment 1 occurred because the initial letters of centrally presented words were projected to the RH. The results support the split fovea theory, where the RH has primacy in representing lead neighbors of a written word.     

Test anxiety and the hierarchical model of approach and avoidance achievement motivation

This research was designed to incorporate the test anxiety (TA) construct into the hierarchical model of approach and avoidance achievement motivation. Hypotheses regarding state and trait TA were tested in 2 studies, and the results provided strong support for the predictions. State TA (specifically, worry) was documented as a mediator of the negative relationship between performance-avoidance goals and exam performance. The positive relationship between performance-approach goals and exam performance was shown to be independent of TA processes. A series of analyses documented the conceptual and functional convergence of trait TA and fear of failure (FOF), and further validation of the proposed integration was obtained by testing trait TA/FOF and state TA together in the same model. Mastery goals were positively and performance-avoidance goals negatively related to long-term retention.     

Prediction of psychological reactions to bone density screening for osteoporosis using a cognitive-behavioral model of health anxiety

Pre-screening measures derived from a cognitive-behavioral theory of health anxiety were significant predictors of individual differences in post-screening reactions to a health screening procedure, bone densitometry. Predictors included specific illness beliefs (vulnerability, severity/consequences, coping and treatment) and general health anxiety measures. Three months after a low bone mineral density (BMD) result, women with high levels of pre-existing general health anxiety gave higher ratings of anxiety about osteoporosis and perceived likelihood of developing osteoporosis than women with low levels of preexisting health anxiety, even though the two groups' initial ratings had not differed significantly. Women with a low BMD result generally showed "minimization" of the seriousness of low BMD but women with very high levels of pre-existing health anxiety did not. After a high BMD result, highly health anxious women were only temporarily reassured. The results were consistent with the cognitive-behavioral analysis of health anxiety.     

Disclosure and anxiety: a test of the fever model.

According to the fever model of Disclosure, the relationship of Disclosure (utterances that reveal subjective information) to psychological distress is analogous to the relationship of fever to physical infection: Both are indicators of some underlying disturbance and part of a restorative process. High and moderate trait anxious university students (but not the low trait anxious students) used higher percentages of Disclosure when speaking about an anxiety-arousing topic than when speaking about a happy topic. With topic order counterbalanced, students tended to use more Disclosure during their 1st presentation than during their 2nd. These results support the fever model's suggestion that people tend to Disclose when they are distressed.     

Evaluating a dual‐process model of risk: affect and cognition as determinants of risky choice

In three studies we addressed the impact of perceived risk and negative affect on risky choice. In Study 1, we tested a model that included both perceived risk and negative affect as predictors of risky choice. Study 2 and Study 3 replicated these findings and examined the impact of affective versus cognitive processing modes. In all the three studies, both perceived risk and negative affect were shown to be significant predictors of risky choice. Furthermore, Study 2 and Study 3 showed that an affective processing mode strengthened the relation between negative affect and risky choice and that a cognitive processing mode strengthened the relation between perceived risk and risky choice. Together, these findings show support for the idea of a dual‐process model of risky choice. Copyright © 2008 John Wiley & Sons, Ltd.     

Positive psychological states and anxiety: the mediating effect of proactive coping

The current study examined the mediating role of proactive coping in the relationship between positive psychological states like optimism and self-esteem and trait anxiety. 204 undergraduate students completed measures of optimism, self-esteem, and trait anxiety, together with the proactive coping subscale of the Proactive Coping Inventory (PCI). Mediated effects were explored using a series of regression analyses and were confirmed through bootstrapping procedures. Results revealed that proactive coping was a partial mediator in the relationship between both optimism and self-esteem and trait anxiety. Findings indicated that proactive coping enhances a perspective on life that involves a positive attitude toward future events in the form of optimistic expectancies and enhanced feelings of self-worth. Implications of the findings for clinical practice and mental health promotion are discussed.     

Word frequency effects in high-dimensional co-occurrence models: A new approach

The HAL (hyperspace analog to language) model of lexical semantics uses global word co-occurrence from a large corpus of text to calculate the distance between words in co-occurrence space. We have implemented a system called HiDEx (High Dimensional Explorer) that extends HAL in two ways: It removes unwanted influence of orthographic frequency from the measures of distance, and it finds the number of words within a certain distance of the word of interest (NCount, the number of neighbors). These two changes to the HAL model produce     

The structure of death anxiety: a factor analytic study.

University students in Canada (n = 255) and Northern Ireland (n = 315), graduate nursing students (n = 124), funeral service students (n = 79), and members of the Unitarian Fellowship (n = 83) completed Templer's Death Anxiety Scale (DAS). The responses of each group were subjected to principal components factor analysis using varimax rotational procedures and the factor scores derived from this analysis were then contrasted using multiple discriminant function analysis. Results indicated that there was more commonality than uniqueness in the factor patterns for these groups. Four common death anxiety patterns were classified as follows: (a) cognitive-affective concerns; (b) concern about physical alterations; (c) concern about the passage of time; and (d) concern about stressors and pain. These factors are consistent with and extend the views expressed in previous research (i.e., Pandy, 1974-75; Pandy & Templer, 1972.     

Elevated responding to safe conditions as a specific risk factor for anxiety versus depressive disorders: evidence from a longitudinal investigation

The current study evaluated the degree to which startle reflexes (SRs) in safe conditions versus danger conditions were predictive of the onset of anxiety disorders. Specificity of these effects to anxiety disorders was evaluated in comparison to unipolar depressive disorders and with consideration of level of neuroticism. A startle paradigm was administered at baseline to 132 nondisordered adolescents as part of a longitudinal study examining risk factors for emotional disorders. Participants underwent a repetition of eight safe-danger sequences and were told that delivery of an aversive stimulus leading to a muscle contraction of the arm would occur only in the late part of danger conditions. One aversive stimulus occurred midway in the safe-danger sequences. Participants were assessed for the onset of anxiety and unipolar depressive disorders annually over the next 3 to 4 years. Larger SR magnitude during safe conditions following delivery of the aversive stimulus predicted the subsequent first onset of anxiety disorders. Moreover, prediction of the onset of anxiety disorders remained significant above and beyond the effects of comorbid unipolar depression, neuroticism, and subjective ratings of intensity of the aversive stimulus. In sum, elevated responding to safe conditions following an aversive stimulus appears to be a specific, prospective risk factor for the first onset of anxiety disorders.     

Self-reported psychological stress and the risk of breast cancer: a case-control study

The aim of this study was to examine the relationship between severe life events and breast cancer risk. This study was based on a case-control examination of 858 Polish invasive breast cancer cases and 1085 controls matched for age and place of residence. Data on life events, sociodemographic characteristic, reproductive factors, family history of breast cancer, current weight and height, and lifestyle habits were collected between January 2003 and May 2007 using a self-administered questionnaire. Odds ratios with 95% confidence intervals were estimated as the measure of the relationship between life event stress and breast cancer risk using unconditional logistic regression analyses. After adjustment for potential breast cancer risk factors, women with four to six individual major life events had 5.33 times higher risk for breast cancer, compared with those in the lowest quartile. Similarly, women with a lifetime life change score greater than 210 had about 5 times higher risk compared to women with corresponding scores in the range 0-70. Several life events (death of a close family member, personal injury or illness, imprisonment/trouble with the law, retirement) were significantly associated with breast cancer risk. These findings suggest that major life events can play an important role in the etiology of breast cancer.