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.     

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.     

Morale and Job Satisfaction Among Nurses: What Can Hospitals Do?

In an attempt to account for morale and job satisfaction among 314 nurses, this study investigated the influence of work-related and interpersonal variables. Morale on the unit was directly related to supervisor support, co-worker relationships, and work recognition. Personal morale was accounted for by recognition, physical environment, the job itself, and pay. Job satisfaction was predicted by personal morale, work commitment, job clarity, work pressure, and innovation. Suggestions for improving nurse morale and job satisfaction are made.     

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.     

The nature of aspiration in psychotherapy

This paper underscores the importance of aspiration as an active, progressive striving toward goals. Aspiration is often borne out of new experiences with new objects that differ from the patient's archaic objects. Patients who take inventory of their aspirations start to understand how they consciously and unconsciously work toward or ward off the attainment of goals. Self-discrepancy approaches (e.g., Jacobson, 1964; Schafer, 1967; Blos, 1974; Higgins, 1987) emphasizing the gap between the patient's present self-experience and the ideal self are especially useful in understanding how aspiration is facilitated or stymied. Aspirations may signal shifts in self-esteem. The patient who risks wanting more or wanting to be more has begun to alter the static view of the self. Aspiration facilitates the patient's imaginative, visualizing capacities as he or she focuses on foreseeing future possibilities.     

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.