Conceptual,methodological, and clinical issues in the assessment of anxiety disorders

Many conceptual, methodological, and clinical issues remain unresolved in the assessment of anxiety disorders. Despite the prevalence, incidence, chronicity, and severity of anxiety disorders, research efforts and funding have fallen behind with regard both to other disorders and to addressing critical issues in the field. The primary objective of this paper is to provide a scientific critique regarding a number of often ignored yet salient considerations in anxiety-disorders assessment. Critical analyses of and recommendations regarding the multidimensional nature of anxiety, comorbidity, uniformity myths, synchrony, normative comparisons, psychometric properties of measures, and treatment integrity are offered. Finally, promising areas of clinical research are presented to enhance further the current understanding of the complexities inherent in assessing anxiety disorders.Preparation of this paper was supported in part by NIMH Grant MH36299.     

Process and content in an outpatient schizophrenic group

Process and content issues were evaluated during the first six months of an outpatient schizophrenic group. Compared with groups composed of neurotic and characterological patients, the schizophrenic group scored higher in the Avoiding dimension of the Group Climate Questionnaire (GCQ-S). There was more cohesion and less interpersonal conflict as time went on. Although topics related to engagement and differentiation were discussed, there was no obvious GCQ-S evidence of these first two stages of group development. However, the data supported the presence of stage 3 (individuation) during sessions 20–26. Interpersonal topics dominated the group discussions, followed by issues involving reality-testing, expression of emotions, and advice-giving.The authors wish to thank Dr. K. Roy MacKenzie for his helpful comments on a draft of this paper.     

Memory lapses during a pandemic: Differential associations between COVID-stress and daily memory lapses?

The policies related to COVID-19 pandemic such as stay at home orders and social distancing increased daily stress and associated impairments in mental health. This study examines the association between COVID-related stress and cognitive functioning by examining two different types of daily memory lapses, those related to prospective memory (i.e., memory for future plans) and retrospective memory (i.e., memory for past information) as well as the perceived emotional and functional consequences of daily memory problems. As part of a larger study, 58 adults (18 men; 22 ± 3 years) completed a web-based version of the daily inventory of stressful events including stress related to COVID-19 and positive/negative affect for eight consecutive days between 8 September 2020 and 11 November 2020. Findings showed that prospective lapses were positively correlated with COVID-19 stressors (r = 0.41, p = 0.002). At the within-person level, daily COVID-19 stressors were significantly associated with the number of prospective lapses (b = 0.088, SE = 0.040). COVID-19-related stressors were not significantly related to retrospective lapses (all ps > 0.05). Our findings suggested that more daily COVID-19 stressors were related to greater numbers of prospective lapses in daily life even among healthy younger adults. Thus, future research should address long term relations of COVID-19 stress and cognitive functioning in addition to the specific cognitive impairments related to COVID-19 infection.     

Peer-group association and adolescent tobacco use

Mosbach & Leventhal (1988) examined the relation of cigarette smoking to peer-group identification in rural Wisconsin adolescents. They found that among dirts (problem-prone youth), regulars (average youth), hot-shots (good social or academic performers), and jocks (athletes), youth most likely to smoke were dirts and hot-shots. We performed a replication with a Southern California cohort and also for use of smokeless tobacco. We hypothesized that jocks would be the main users of smokeless tobacco. We identified the same groups and an additional one, skaters (skateboarders or surfers). As Mosbach & Leventhal found, cigarettes were used most by dirts. Contrary to their results, but consistent with other research, we found that hot-shots were least likely to smoke. Contrary to our prediction, we found that skaters and dirts were more likely to use smokeless tobacco than were jocks. Our data show that both tobacco forms are used by problem-prone youth.     

Informal Caregiving to Persons with AIDS in the United States: Caregiver Burden Among Central Cities Residents Eighteen to Forty-Nine Years Old

Characteristics and caregiving experiences of friends and family members caring for people with AIDS (PWAs) were examined. Based on a probability sample of informal AIDS caregivers ages 18–49 living in central cities of the United States (n = 260), analyses were conducted to (a) identify the sociodemographic characteristics of young central city caregivers; and (b) examine the effects of caregiver characteristics (relationship to PWA, gender, race/ethnicity, income, sexual orientation, HIV status, perceived susceptibility), and level of objective caregiving demands, on subjective caregiver burden. Results indicate that the largest group of caregivers in this age category are male friends of the PWA—a group not typically found among caregivers to persons with other types of illnesses. In general, gay or bisexual caregivers, caregivers who have traditional family ties to the PWA, men relative to women, and lower income caregivers, report the greatest burden. While level of caregiving demands represents the most influential predictor of caregiver burden, white and male caregivers experience greater burden, independent of level of involvement and other caregiver characteristics. Receiving instrumental support with caregiving buffers the impact of high objective demands on subjective burden.     

The renormalisation group and effective field theories

Much apprehension has been expressed by philosophers about the method of renormalisation in quantum field theory, as it apparently requires illegitimate procedure of infinite cancellation. This has lead to various speculations, in particular in Teller (1989). We examine Teller's discussion of perturbative renormalisation of quantum fields, and show why it is inadequate. To really approach the matter one needs to understand the ideas and results of the renormalisation group, so we give a simple but comprehensive account of this topic. With this in hand, we explain how renormalisation can and should be understood. One thing that is revealed is that apparently very successful theories such as quantum electro-dynamics cannot be universally true; resolving the tension between success and falsity leads to a picture in which any theory may be viewed as irreducibly phenomenological. We explain how, and argue that the support for this view is tenuous at best.We are very grateful to Stephen Shenker in his patient efforts to help us understand this material, and to the helpful comments of Paul Teller and two anonymous referees. Some of the ideas presented here are based on material in the Ph.D. thesis of one of us (Huggett) submitted to Rutgers University.     

Individual differences and cheating behavior: Guilt and cheating in competitive situations

To examine whether guilt would inhibit immoral behavior, subjects were differentiated on their feelings of anticipatory (AG) and posttransgressional (PTG) guilt and subsequently placed in an anagram task shown to induce a high level of cheating. Results indicated that neither pre- nor post-test AG was related to cheating behavior, and test-retest administration indicated that the AG scale was unreliable. The PTG scale, however, was found to be a temporally reliable measure of guilt. In order to assess the relative contributions of pre-test posttransgressional guilt, the ability to persist, and gender to cheating behavior, a saturated multiple regression model of centered predictor effects and interaction terms was constructed. Results revealed a significant gender × persistence interaction. The cheating behavior of males was not significantly influenced by the ability to persist. On the other hand, females who exhibited a strong ability to persist rarely cheated, while those who were unable to persist cheated a great deal. Finally, subjects who felt the most posttransgressional guilt cheated more frequently. These findings provide additional evidence that guilt may be positively related to cheating behavior.