Anticipatory anxiety and avoidance in panic disorder with agoraphobia

The present study utilized the responses of 34 patients with panic disorder with agoraphobia to investigate the occurrence and anticipation of panic attacks in relation to the avoidance of specific situations from the Fear Questionnaire [Marks & Mathews (1979) Behaviour Research and Therapy, 17, 263-267]. Results indicated that self-reports of avoidance of specific situations were often significantly correlated with the anticipation of panic but rarely with the occurrence of panic. The occurrence and anticipation of panic were also frequently associated with social phobic situations in addition to agoraphobic situations.     

Loss, Healing, and the Power of Place

Human beings have a tendency to transform geographical spaces into dwelling places which assume significance in terms of their social, cultural and personal identities. The authors describe the ways in which this occurs, how it is disrupted by a natural disaster - an Australian bushfire - and how the reciprocal relationship between place and person can contribute to personal and communal healing. The discussion draws on a doctoral thesis conducted by the principal author, and is illuminated by excerpts from narratives provided by those who experienced the bushfire. The discussion is informed by insights from phenomenological geography and ecological philosophy.     

Causal modeling of relations among learning history, anxiety sensitivity, and panic attacks

We used structural equation modeling (SEM) to test the hypothesis that childhood instrumental and vicarious learning experiences influence frequency of panic attacks in young adulthood both directly, and indirectly through their effects on anxiety sensitivity (AS). A total of 478 university students participated in a retrospective assessment of their childhood learning experiences for arousal-reactive sensations (e.g., nausea, racing heart, shortness of breath, dizziness) and arousal-non-reactive sensations (i.e., colds, aches and pains, and rashes). SEM revealed that learning history for arousal-reactive somatic symptoms directly influenced both AS levels and panic frequency; AS directly influenced panic frequency; and learning history for arousal-non-reactive symptoms directly influenced AS but did not directly influence panic frequency. These results are consistent with the findings of previous retrospective studies on the learning history origins of AS and panic attacks, and provide the first empirical evidence of a partial mediation effect of AS in explaining the relation between childhood learning experiences and panic attacks in young adulthood. Implications for understanding the etiology of panic disorder are discussed.     

Self-Report Differentiation of Anxiety and Depression in a Mood Disorders Sample

Several lines of research suggest there is considerable overlap between anxiety and depression and that it is difficult to distinguish between these two constructs. However, a few studies utilizing factor analytic procedures have provided evidence that anxiety and depression can be differentiated when measures of these constructs are considered at the item level. In addition, there is some evidence that differentiation can be accomplished in samples experiencing high levels of anxiety (i.e., a clinically anxious sample; B. J. Cox, R. P. Swinson, L. Kuch, & J. Reichman, 1993). In the present study, this research strategy was extended to a sample of patients with high levels of depressed mood (i.e., a mood disorders sample; N = 378). Their responses to widely used measures of depression (i.e., Beck Depression Inventory; A. T. Beck, C. H. Ward, M. Mendelson, J. Mock, & J. Erbaugh, 1961) and anxiety (i.e., Spielberger State-Trait Anxiety Inventory—State subscale; C. D. Spielberger, R. L. Gorsuch, & R. E. Lushene, 1970) were entered into a principal-components analysis with oblique rotation. A 4-factor solution was retained. This solution was comprised of factors representing anxiety, anxiety absent (a reverse scored factor), cognitive symptoms of depression, and somatic/vegetative symptoms of depression. These findings indicated that anxiety and depression, as emotional states, can be differentiated within a mood disorders sample, using existing popular self-report measures. The clinical and research implications of these findings are briefly discussed.     

Confirmatory Factor Analysis of the Depression–Anxiety–Stress Scales in Depressed and Anxious Patients

The Depression–Anxiety–Stress Scales (DASS; P. F. Lovibond & S. H. Lovibond, 1995) have shown considerable promise in their ability to differentially assess depression and anxiety symptoms. Most of the work to date has relied on normal or predominantly anxious clinical samples. To extend this research to a predominantly depressed sample, a psychiatric sample from a mood disorders program (N = 439) was used to investigate the factor structure of the DASS. Confirmatory factor analyses indicated that a 3-factor model for the 21-item DASS was supported. A 3-factor model with crossloading items for the 42-item version showed no practical improvement. Further confirmatory analyses evaluated the ability of item subsets from the DASS to represent the constructs specified in the tripartite model (L. A. Clark & D. Watson, 1991). Strong support was obtained for the DASS to represent the construct of anhedonia and physiological hyperarousal, and their relative importance is consistent with predictions of the tripartite model in understanding the relationship between anxiety and depression.     

Mother's milk: an existential perspective on negative reactions to breast-feeding

Drawing from an existential perspective rooted in terror management theory, four studies examined the hypothesis that breast-feeding women serve as reminders of the physical, animal nature of humanity and that such recognition is threatening in the face of one's unalterable mortality. Study 1 demonstrated that mortality salience (MS) led to more negative reactions toward a scenario depicting a woman breast-feeding her infant in public, and in Study 2, MS decreased liking and increased physical avoidance of a potential task partner described as breast-feeding in another room. Further supporting the hypothesis that such reactions are rooted in threats associated with human creatureliness, MS in conjunction with a breast-feeding prime led to an increase in the accessibility of creaturely related cognitions (Study 3) and priming human/animal similarities (i.e., creatureliness) led to increased negativity toward a magazine cover depicting a woman breast-feeding her child (Study 4). Implications of this research are discussed.     

Fear of hypoglycemia: relationship to physical and psychological symptoms in patients with insulin-dependent diabetes mellitus.

Among diabetic patients, experience with hypoglycemia ranges from the unpleasant to the life threatening. The aversiveness of these episodes often results in fear. To examine the impact of hypoglycemia on fear, 69 patients with insulin-dependent diabetes mellitus completed the Behavior and Worry subscales of the Hypoglycemia Fear Survey along with measures of psychological symptoms, perceived stress, risk of future hypoglycemic episodes, and glycosylated hemoglobin. Behavior and Worry scores were positively related to psychological symptoms, perceived stress, and previous experiences with hypoglycemia. Fear was unrelated to glycosylated hemoglobin but was significantly higher for patients who had greater variability and lower mean daily blood glucose.     

Points to Consider in the Clinical Use of NGS Panels for Mitochondrial Disease: An Analysis of Gene Inclusion and Consent Forms

Mitochondrial next generation sequencing (NGS) panels offer single-step analysis of the numerous nuclear genes involved in the structure, function, and maintenance of mitochondria. However, the complexities of mitochondrial biology and genetics raise points for consideration in clinical use of these tests. To understand the current status of mitochondrial genetic testing, we assessed the gene offerings and consent forms of mitochondrial NGS panels available from seven US-based clinical laboratories. The NGS panels varied markedly in number of genes (101–1204 genes), and the proportion of genes causing “classic” mitochondrial diseases and their phenocopies ranged widely between labs (18 %–94 % of panel contents). All panels included genes not associated with classic mitochondrial diseases (6 %–28 % of panel contents), including genes causing adult-onset neurodegenerative disorders, cancer predisposition, and other genetic syndromes or inborn errors of metabolism. Five of the panels included genes that are not listed in OMIM to be associated with a disease phenotype (5 %–49 % of panel contents). None of the consent documents reviewed had options for patient preference regarding receipt of incidental findings. These findings raise points of discussion applicable to mitochondrial diagnostics, but also to the larger arenas of exome and genome sequencing, including the need to consider the boundaries between clinical and research testing, the necessity of appropriate informed consent, and the responsibilities of clinical laboratories and clinicians. Based on these findings, we recommend careful evaluation by laboratories of the genes offered on NGS panels, clear communication of the predicted phenotypes, and revised consent forms to allow patients to make choices about receiving incidental findings. We hope that our analysis and recommendations will help to maximize the considerable clinical utility of NGS panels for the diagnosis of mitochondrial disease.     

When past meets present: the relationship between website‐induced nostalgia and well‐being

The present research examined whether social media websites increase feelings of nostalgia, and whether this nostalgic reverie promotes psychological and social health. Specifically, in comparison to control conditions, participants exposed to the websites Dear Old Love and Dear Photograph reported greater feelings of nostalgia (Studies 1–3), positive affect (Studies 1 and 3), life satisfaction (Study 1), and relationship need satisfaction (Study 2). Further, mediational analyses revealed that increased thoughts of nostalgia heightened subjective well‐being and social connectedness. Study 3 showed that the relationship between nostalgia and positive affect was specific to the Dear Photograph website and did not generalize to any website focused on close relationships. The implications of this research for nostalgia, internet use, and well‐being are further discussed.