The Interactive Contributions of Perceived Control and Anxiety Sensitivity in Panic Disorder: A Triple Vulnerabilities Perspective

Within the triple vulnerabilities model of anxiety disorders, a genetic contribution to the development of anxiety and negative affect (i.e., generalized biological vulnerability), a diminished sense of perceived control over aversive events and emotional experiences (i.e., generalized psychological vulnerability), and elevated levels of anxiety sensitivity (i.e., specific psychological vulnerability) are posited to increase the risk of developing and maintaining panic disorder (Barlow American Psychologist 55(11):1247–1263, 2000). The purpose of the present study was to investigate the direct and interactive effects of perceived control and anxiety sensitivity on panic disorder symptom severity. Structural equation models (SEM) were conducted in data derived from a sample of 379 adults with panic disorder participating in a multi-site randomized controlled trial. Findings indicated that both perceived control and anxiety sensitivity uniquely predicted panic disorder symptoms. A moderation model examining the interactive effects of perceived control and anxiety sensitivity on panic symptoms indicated that the effect of anxiety sensitivity on panic symptoms increased with greater deficits in perceived control. The present findings suggest that deficits in perceived control and elevated levels of anxiety sensitivity exert unique and shared effects on panic disorder symptoms, thereby illustrating the relationship between putative vulnerability factors and panic disorder symptoms as predicted by the triple vulnerabilities model.     

Health care utilisation in patients with non-cardiac chest pain: A longitudinal analysis of chest pain,anxiety and interoceptive fear

Chest pain can be a frightening experience that leads many to seek medical evaluation. The symptom results in costly health care utilisation. Over half of patients referred for cardiac evaluations of chest pain do not obtain definitive medical explanations for their symptoms; these cases are described as non-cardiac chest pain (NCCP). Some patients with NCCP are not reassured after being informed their chest pain is non-cardiac in origin and seek repeated medical evaluation. Co-morbid anxiety and mood disorders often coexist with NCCP and are associated with health care utilisation. The current study examined chest pain, general anxiety, interoceptive fear and health care utilisation in a sample of 196 chest pain patients near the time of cardiac evaluation (Time 1), and 70 of these patients one year later (Time 2). Results indicate that anxiety and interoceptive fear were significantly associated with health care utilisation at Time 1, and only interoceptive fear (at Time 1) predicted health care utilisation at Time 2. This study develops research in this area by examining the relation of anxiety and health care utilisation longitudinally in patients with NCCP.     

The Job Demand-Control-Social Support Model and Wellness/Health Outcomes: A European Study

The EUROTEACH study which is reported here, comprised 2796 secondary school teachers from 13 European countries. The study firstly aimed at testing an extended Job Demand-Control-Social support (JDCS) model and checking its gender specificity. While this study failed to provide evidence for the buffer hypothesis derived from the JDCS-model, the strain hypothesis was mostly supported. Additional job conditions tested in this study proved to be important predictors of the outcome variables (emotional exhaustion, depersonalisation, personal accomplishment, somatic complaints and job satisfaction) and standard of living indicators also added explained variance in these outcomes. The study proved that the JDCS model cannot be called a male model. Secondly the study looked at the comparability of 3 European regions (South, West, East). Apart from important regional differences in job conditions, standard of living indicators and outcomes, the most important finding is that the JDCS model explains most variance in outcome variables in Western Europe, and the least in Eastern Europe, and thus seems to suffer from a Western bias.     

Age Related Effects in Children Taking the Computerized Assessment of Response Bias and Word Memory Test

The assessment of effort is a fundamental component of test performance analysis, since effort determines whether a psychological evaluation is valid. The assessment of effort in children has proven problematic. This may be related to the variable and inconsistent nature of children’s developing self-regulatory systems, and the fact that measures commonly used to assess effort were standardized on adults. If one uses effort measures designed for adults to assess children, then one must presume that the maintenance of effort in children is comparable to the same behavior in adults. However, because children’s executive functioning, including their abilities to self-regulate, attend, concentrate, and to engage in various cognitive activities improve with time (Barkley, 1997, pp. 209-234), our hypothesis is that young children’s effort regulation is dissimilar to that of adults, and the presumption of similarity is implausible. The purpose of this study was to determine whether age is a significant influence upon young children’s performances on the Computerized Assessment of Response Bias (CARB) and Word Memory Test (WMT). Statistical analysis suggests that younger children (those under 10 years of age) tended to produce poorer performance on these instruments. Younger children’s scores differed significantly from children ages 10 and older. Children 11 years and older produced CARB and WMT results similar to adult participants, suggesting a viability for adult normative comparisons with children in this age range. The current investigation concluded that children’s maintenance of effort appears to be significantly related to age and reading ability level. Consequently, the use of current adult-based norms with the CARB and WMT, without regard for a child’s developmental status and other contextual factors such as the child’s ability to read, appears ill-advised especially with children under 11 years of age.     

Perturbations in Action Goal Influence Bimanual Grasp Posture Planning

The authors examined the effects of perturbations in action goal on bimanual grasp posture planning. Sixteen participants simultaneously reached for 2 cylinders and placed either the left or the right end of the cylinders into targets. As soon as the participants began their reaching movements, a secondary stimulus was triggered, which indicated whether the intended action goal for the left or right hand had changed. Overall, the tendency for a single hand to select end-state comfort compliant grasp postures was higher for the nonperturbed condition compared to both the perturbed left and perturbed right conditions. Furthermore, participants were more likely to plan their movements to ensure end-state comfort for both hands during nonperturbed trials, than perturbed trials, especially object end-orientation conditions that required the adoption of at least one underhand grasp posture to satisfy bimanual end-state comfort. Results indicated that when the action goal of a single object was perturbed, participants attempted to reduce the cognitive costs associated with grasp posture replanning by maintaining the original grasp posture plan, and tolerating grasp postures that result in less controllable final postures.     

A Multitrait Multimethod Measurement Approach to the Traits (or States) of Anxiety,Depression and Hostility

This study tested the convergent and discriminant validities of various psychological techniques used for the measurement of the affects of anxiety, depression and hostility. The subjects were 29 psychiatric patients and 25 normal controls, all males. Subjects were interviewed and rated for the three affects and given an extensive battery of tests. Anxiety and depression measures from ratings, checklists, and questionnaires demonstrated good convergent validity but poor discriminant validity. The projective methods did not demonstrate much convergent validity. Hostility was separable from anxiety and depression but the tests showed poor convergent validity for hostility. In the normals, fantasy hostility (TAT) and admitted hostility (Multiple Affect Adjective Check List) showed some convergence, but in the patients there was no congruence between these two levels.     

Individual differences in neural regions functionally related to real and imagined stuttering

Recent brain imaging investigations of developmental stuttering show considerable disagreement regarding which regions are related to stuttering. These divergent findings have been mainly derived from group studies. To investigate functional neurophysiology with improved precision, an individual-participant approach (N = 4) using event-related functional magnetic resonance imaging and test–retest reliability measures was performed while participants produced fluent and stuttered single words during two separate occasions. A parallel investigation required participants to imagine stuttering or not stuttering on single words. The overt and covert production tasks produced considerable within-subject agreement of activated voxels across occasions, but little within-subject agreement between overt and covert task activations. However, across-subject agreement for regions activated by the overt and covert tasks was minimal. These results suggest that reliable effects of stuttering are participant-specific, an implication that might correspond to individual differences in stuttering severity and functional compensation due to related structural abnormalities.     

Childhood anxiety associated with low BMI in women with Anorexia Nervosa

Objective

Extremely low body mass index (BMI) values are associated with increased risk for death and poor long-term prognosis in individuals with anorexia nervosa (AN). The present study explores childhood personality characteristics that could be associated with the ability to attain an extremely low BMI.

Methods

Participants were 326 women from the Genetics of Anorexia Nervosa (GAN) Study who completed the Structured Interview for Anorexia Nervosa and Bulimic Syndromes and whose mother completed the Child Behavioral Checklist and/or Revised Dimensions of Temperament Survey.

Results

Children who were described as having greater fear or anxiety by their mothers attained lower BMIs during AN (p < 0.02). Path analysis in the GAN and a validation sample, Price Foundation Anorexia Nervosa Trios Study, confirmed the relation between early childhood anxiety, caloric restriction, qualitative food item restriction, excessive exercise, and low BMI. Path analysis also confirmed a relation between childhood anxiety and caloric restriction, which mediated the relation between childhood anxiety and low BMI in the GAN sample only.

Conclusion

Fearful or anxious behavior as a child was associated with the attainment of low BMI in AN and childhood anxiety was associated with caloric restriction. Measures of anxiety and factors associated with anxiety-proneness in childhood may index children at risk for restrictive behaviors and extremely low BMIs in AN.     

The development of perceptual grouping biases in infancy: A Japanese-English cross-linguistic study

Perceptual grouping has traditionally been thought to be governed by innate, universal principles. However, recent work has found differences in Japanese and English speakers’ non-linguistic perceptual grouping, implicating language in non-linguistic perceptual processes (Iversen, Patel, & Ohgushi, 2008). Two experiments test Japanese- and English-learning infants of 5–6 and 7–8 months of age to explore the development of grouping preferences. At 5–6 months, neither the Japanese nor the English infants revealed any systematic perceptual biases. However, by 7–8 months, the same age as when linguistic phrasal grouping develops, infants developed non-linguistic grouping preferences consistent with their language’s structure (and the grouping biases found in adulthood). These results reveal an early difference in non-linguistic perception between infants growing up in different language environments. The possibility that infants’ linguistic phrasal grouping is bootstrapped by abstract perceptual principles is discussed.