Association between anxiety and depression in children and adolescents with anxiety disorders

The relationship between anxiety and depression was examined in a sample of 106 children and adolescents referred to an outpatient anxiety disorder clinic for children. Twenty-eight percent of patients with DSM-III diagnoses of anxiety disorders displayed a concurrent major depression. Children with anxiety disorders plus major depression were found (1) to be older, (2) to demonstrate more severe anxiety symptomatology, and (3) to be diagnosed with different rates of certain anxiety-disorder subtypes, when compared to anxious patients without major depression. Nondepressed anxious children and adolescents did not differ from a psychopathological control group in severity of either anxiety or depression symptoms.     

Overanxious disorder: An examination of developmental differences

Differences between a clinical sample of younger (ages 5 to 11) and older (ages 12 to 19) children meeting DSM-III criteria for overanxious disorder (OAD) were examined. Younger and older children were compared in terms of (1) the rates of OAD diagnoses occurring in the two age groups, (2) sociodemographic characteristics, (3) symptom expression, (4) association with other forms of maladjustment, and (5) self-reported anxiety and depression. The prevalence of OAD diagnoses and sociodemographic characteristics did not differ. Although younger and older OAD children showed similar rates of most specific DSM-III OAD symptoms, older children presented with a higher total number of overanxious symptoms than younger children. Older children more frequently exhibited a concurrent major depression or simple phobia, whereas younger OAD children more commonly had coexisting separation anxiety or attention deficit disorders. Older OAD children reported significantly higher levels of anxiety and depression on self-report measures. Findings indicated that the expression of OAD varies by developmental level.     

From appraisal to emotion: Differences among unpleasant feelings

Recent research has indicated strong relations between people's appraisals of their circumstances and their emotional states. The present study examined these relations across a range of unpleasant situations in which subjects experienced complex emotional blends. Subjects recalled unpleasant experiences from their pasts that were associated with particular appraisals and described their appraisals and emotions during these experiences. Situations defined by particular appraisals along the human agency or situational control dimensions were reliably associated with different levels of anger, sadness, and guilt, as predicted. However, predicted differences in emotion were not observed for situations selected for appraisals along the certainty or attention dimensions. Most subjects reported experiencing blends of two or more emotions, and correlation/regression analyses indicated that even in the context of these blends, patterns of appraisal similar to those observed previously (Smith & Ellsworth, 1985, 1987) characterized the experience of the individual emotions. The regressions further indicated that appraisals along some dimensions were more important to the experience of particular emotions than were appraisals along other dimensions. Thesecentral appraisals are compared with the adaptive functions their associated emotions are believed to serve, and the implications of these findings are discussed.This research was supported in part by a Stanford University graduate fellowship and in part by a National Institute of Mental Health training grant to Craig Smith. Part of the writing was done while Phoebe Ellsworth was a fellow at the Center for Advanced Study in the Behavioral Sciences, supported by the John D. and Catherine T. MacArthur Foundation and by the James McKeen Cattell Fund.     

Selective impairment of phonation: A case study

A 47-year-old right-handed man underwent craniotomy for clipping of an aneurism at the trifurcation of the left middle cerebral artery. Subsequently, he suffered a left hemisphere CVA after which his speech and language resembled that of Broca's aphasia with accompanying apraxia of speech. Medical, behavioral, and acoustical data amassed over a period of several months indicated numerous contraindications to traditional diagnoses of Broca's aphasia, apraxia of speech, and dysarthria. Ultimately, it was determined that the patient had a selective impairement of phonation or laryngeal apraxia. This was illustrated dramatically when he was taught to use an electrolarynx which allowed him to bypass his disrupted phonatory system. Speaking with the electrolarynx, the patient communicated normally. Any semblance of Broca's aphasia disappeared. Supralaryngeal articulation was normal; apraxia of speech behaviors were absent. This case report indicates that dissociation of oral and laryngeal gestures due to brain injury is possible. Mechanisms underlying such a dissociation for this case are reviewed. The possibility of discrete center lesions in the frontal motor association area causing different types of apraxia of speech is discussed.     

A developmental study of the auditory Stroop effect

A pediatric auditory version of the Stroop procedure was developed and administered to 48 normal children from 3 to 6 years of age. Our purpose was to define the developmental course characterizing interaction between auditory and semantic speech dimensions in young children. The procedure was a reaction time (RT) task that required children to respond as quickly and as accurately as possible to words spoken by a male or a female voice. Children were instructed to ignore what was said and to push the "Mommy" button if Mommy was talking or the "Daddy" button if Daddy was talking. Performance was obtained for words with neutral, congruent, and conflicting semantic content. Preschool children manifested processing dependencies that were similar to those observed in adults on the visual Stroop procedure. Conflict between semantic and auditory dimensions significantly increased RT and congruence between the two dimensions significantly decreased RT relative to the neutral condition. The pattern of results indicated that the meaning of words was processed automatically in the normal children. The magnitude of the Stroop effect reflected developmental change with increasing age.     

Assessment of methods for measuring social support

A rapidly expanding literature documents the effects of social support on physical and psychological well-being. Although definitions vary, most include both tangible components (e.g., financial assistance and physical aid) and intangible components (e.g., encouragement and guidance). Social support has been implicated in the mediation of stressful life events, recovery from illness, and increased program adherence. There are many inconsistent findings in the literature, however, and it is difficult to resolve discrepancies because measures of social support vary widely from study to study. To guide in the selection of measurement methods for research and applied work, 23 techniques for assessing social support are reviewed and evaluated. Criteria for favorable evaluation included reliability coefficients greater than .8 and documentation of validity. Correlations between various social support and criterion measures are simulated in order to demonstrate the consequences of choosing a measure with low reliability. Scale developers reported reliability data for 19 of the reviewed measures. Internal consistency coefficients ranged from .31 to .98. Test-retest coefficients ranged from .22 to .96. At least some validity documentation was available for 13 of the scales. Discriminant validity evidence, however, is almost universally absent. Despite psychometric weaknesses and variability among the scales, researchers have several instruments available to them.     

Knowledge and beliefs regarding the consequences of cigarette smoking and their relationships to smoking status in a biracial sample

The purpose of this investigation was to evaluate carefully smoking-related knowledge and beliefs and their relationships to smoking status in a large, heterogeneous sample of smokers and nonsmokers in two settings: (a) a large, biracial southern city and (b) a small midwestern community. Participants were 611 (198 male, 413 female) adult respondents to a random-dialing telephone survey in Fargo, North Dakota (n = 200), and Memphis, Tennessee (n = 411). Each participant was given the Smoking Attitudes Survey, which assesses generalized health beliefs as well as health-related problems associated with smoking. Participants' knowledge of smoking-associated diseases (e.g., lung cancer) and of diseases not associated with smoking (e.g., kidney stones) was assessed. Stepwise regression analysis of composite knowledge scores revealed four independent predictors of the health consequences of smoking: education, race, smoking status, and income. Smokers, compared to nonsmokers, reported less knowledge related to the health consequences of smoking, were more likely to be male, were less concerned with the health consequences of smoking, and were more concerned about the health consequences of cholesterol. The best predictor of smokers who had never attempted cessation was their greater concern over weight control when compared to smokers with a history of smoking cessation attempts. The results are discussed in terms of smoking prevention and intervention efforts.     

The relationship among genital herpes simplex virus, stress, and social support

Despite widespread popular belief in the activation of recurrent lesions in genital herpes simplex virus (HSV) by psychosocial stress, little empirical evidence supports that contention. This study retrospectively examined the role of stress in activation of HSV lesions as mediated by social support. Participants were 59 volunteers who had self-reported culture-positive genital HSV for at least 10 months. Measures of stress proneness (State-Trait Anxiety Inventory; STAI-Trait), recent stressful events (Schedule of Recent Events; SRE), and subjective appraisal of stress (global self-rating) were administered along with measures of general social support and herpes-specific social support. When retrospective reports of HSV symptoms were examined using a multiple-regression approach, duration of disease and amount of herpes-specific social support were found to be significant moderators of the relation between stress and number of HSV recurrences in the preceding 12 months. When duration of disease was short (less than 4 years), stress (SRE) and number of recurrences were positively associated; when disease duration was longer, there was no relationship. Similarly, at low levels of herpes-specific social support, a positive relation between stress (SRE) and number of recurrences was found. However, at higher levels of herpes-specific social support, no association was found. No relation was found between stress proneness (STAI-Trait) and HSV symptoms. However, subjective appraisal (global rating) of stress in the preceding 12 months was positively and significantly correlated with reported number of recurrences. Results are discussed in terms of their clinical implications.     

Smoking, caffeine, and stress: effects on blood pressure and heart rate in male and female college students

This study examined the independent and joint effects of cigarette smoking and caffeine consumption on blood pressure (BP) and heart rate (HR) reactions to stress in male and female college students. Following an initial physiological baseline, participants received one of four experimental treatments (paced smoking, caffeine, smoking plus caffeine, or neither) and had BP and HR measured before, during, and after two stressful tasks. The results revealed that, compared with the control condition, caffeine ingestion enhanced the magnitude of stress-induced systolic BP and HR reactions. Smoking combined additively with stress, and the joint effect of smoking and caffeine was no greater than either taken alone. Males and females were generally similar in their BP and HR responses to smoking, caffeine, and stress. Inconsistencies with previous research and possible physiological mechanisms underlying the observed effects are discussed.