Effects of anxiety sensitivity on anxiety and pain during a cold pressor challenge in patients with panic disorder

Fear of anxiety symptoms, or anxiety sensitivity (AS), has been extensively studied in anxiety disorders and more recently has been linked to other psychopathological conditions including pain. Asmundson and colleagues have suggested that AS may act as a risk factor for chronic pain and several studies have demonstrated an association between AS, avoidance behaviors and pain. The present study assessed whether AS levels would be predictive of pain and anxiety during a brief pain induction task. Clinical participants meeting DSM-IV criteria for panic disorder (n = 22) were age and sex matched with nonclinical controls (n = 22) and exposed to a 2-min cold pressor challenge. Diagnostic status and AS were significantly predictive of pain and anxiety during the cold pressor task. Moreover, AS appears to mediate the relationship between diagnostic status and pain. However, AS appears to be only indirectly associated with pain through its contribution to anxiety.     

Prospective evaluation of anxiety sensitivity in the pathogenesis of panic: replication and extension.

Increasing evidence suggests that anxiety sensitivity (AS) may be a premorbid risk factor for the development of anxiety pathology. The principal aim of this study was to replicate and extend a previous longitudinal study evaluating whether AS acts as a vulnerability factor in the pathogenesis of panic (N. Schmidt, D. Lerew, & R. Jackson, 1997). A large nonclinical sample of young adults (N = 1,296) was prospectively followed over a 5-week, highly stressful period of time (i.e., military basic training). Consistent with the authors' initial study, AS predicted the development of spontaneous panic attacks after controlling for a history of panic attacks and trait anxiety, and AS was found to possess symptom specificity with respect to anxiety versus depression symptoms. AS 1st-order factors differentially predicted panic attacks, with the Mental Concerns factor being the best predictor of panic in this sample.     

Panic Disorder: Cognitive Behavioral and Pharmacological Treatment Strategies

The past decade has seen significant advances in both psychosocial, notably cognitive behavioral (CBT), and pharmacological treatments for panic disorder. Given the widely acknowledged efficacy of both forms of treatment, it is reasonable to consider that the combination of approaches should yield an extremely potent strategy to treating panic disorder. The present report summarizes scientific evidence for the singular and combined treatment approaches to panic disorder. Data across studies indicate that combined treatments yield immediate and short-term benefits above those provided by either pharmacologic treatment or CBT alone. In the long-term, however, these benefits disappear. In fact, the combination of benzodiazepines and CBT appears to produce poorer end-state functioning than CBT alone. Other data indicate that the sequencing of pharmacotherapy and CBT may be useful for benzodiazepine fading. Although these data are preliminary, combined treatments do not appear to be the treatment of choice for patients with panic disorder. Treatment algorithms are suggested based on existing data.     

Development of a tool to assess suicide risk factors in urban adolescents

Dramatic increases in the adolescent suicide rate over the past three decades have underscored the need for risk-assessment tools. The tools that do exist are oriented to older populations and their application to adolescents is questionable. A project was initiated at the University of Utah's Health Education Department to develop a pilot instrument to examine the differences between adolescents who have attempted suicide and other teenagers. Eighty-two subjects between the ages of 14 and 19 participated in the test of this instrument. Twenty-five subjects were identified by a physician or psychologist as having failed in a sincere suicide attempt within the previous 18 months. Fifty-seven nonsuicide attempters with similar demographic profiles served as a comparison group. An 86-item questionnaire was administered to both groups. Questions were generated from a review of the literature of the past three decades for problems associated with suicide in this population. Questions were sorted into three domains (family environment, social environment, and self-perceptions), with each domain having several subdomains. Statistical analysis revealed significant differences for each of the three domains and on 55 of 86 questions. The results were used to create a streamlined instrument for assessing suicide risk that can be administered in 20 minutes.     

Psychosocial management of glioma patients treated with combined therapy

Based on an empirical study it is pointed out that psychosocial care of patients with glioma differs in some points from that of other cancer patients. The first essential difference is that the emotional involvement of the care staff is not as intensive as those of other cancer patients. Other differences concern some illness- and therapy related effects such as family problems or monotony problems resulting from the longterm therapy. These specific problems are described in detail.     

Terminal accuracy of unexpectedly loaded rapid movements: evidence for a mass-spring mechanism in programming

Experiments using rapid-positioning movements in humans, where the subject is suddenly and unexpectedly provided with a change in the load characteristics of the limb, are described. Taken together, the pattern of results supports a mass-spring model of unidirectional limb action, where the limb moves to a position defined by the relative tensions in the agonist and antagonist. As well, various results provide evidence contrary to predictions from an impulse-timing viewpoint, where the motor program times the onset of impulses to the musculature, and against a feedback-processing viewpoint, where limb position is defined by minimizing positioning error indicated by feedback. The evidence suggests that the role of phasing in motor programs may be different for unidirectional actions on the one band and multi-directional and/or multi-component actions on the other.     

Comparison of deaf and hearing children on body-object localization.

20 profoundly deaf and 20 normal hearing children from ages 10 to 13 were compared as to their ability to locate visually the position of apparent vertical and the apparent location of the longitudinal axis of the body under erect and 30 degrees left and right body-tilt. Both deaf and normal hearing children were able accurately to locate a rod to the apparent visual vertical, but deaf children were significantly more accurate in aligning a rod to their apparent body-position than hearing children. This finding is discussed from both a learning view and from a hypothesis of developmental lag.     

Semantic expectancy effects on word access

Summary Access to word-representations in memory was studied in an experiment that used a lexical decision task: Ss had to decide whether a string of letters was a word or a nonword. Independent variables were context-similarity and semantic expectancy. The former is defined in terms of the categorical relationship that holds between a set of context words and the subsequently presented test word. The second refers to the cue-value given to subjects as to the likelihood with which related or unrelated test words would be presented. Cue-values did not provide information on the likelihood with which word or nonword decisions were required, but only on the most probable semantic relationship holding among context and test words. In theory, Meyer and Ellis' (1970) race model for word access was extended for the present purpose. It is shown that the two search processes assumed to mediate lexical access interfere on the basis of limited processing capacity, at least under the special conditions prevailing during the experiment. Furthermore, it is shown that Ss effectively manage to control the point in time at which they decide to issue a nonword response. Cuing for related test words tends to produce faster nonword decisions than cuing for unrelated words.This paper reports work that was conceived and begun at Stanford University, Calif., USA, where the author spent a year as a post-doctoral fellow. This fellowship was made possible by the Deutsche Forschungsgemeinschaft, Bad Godesberg, Federal Republic of Germany, Grant Schm 350/1. I am grateful to R.C. Atkinson, S. Monsell, P. Matthews, and D. Vorberg for supporting this research in a number of ways.