Identity Processing Styles and Psychosocial Balance during Early and Middle Adulthood: The Role of Identity in Intimacy and Generativity

Identity styles and Eriksonian psychosocial balance were examined in young adults (N = 163; 64.4% women) and middle-aged adults (N = 132; 51.5% women). Participants completed self-report measures of identity styles (informational, normative, and diffuse-avoidant), identity commitment, and psychosocial balance (identity, intimacy, and generativity). Different patterns of psychosocial balance were found for each identity style, with largely consistent findings across age groups. The diffuse-avoidant style was negatively associated with all forms of psychosocial balance, the normative style was positively associated with identity and intimacy balance, and the informational style was positively associated with intimacy and generativity. Structural equation modeling revealed that identity balance predicted both intimacy and generativity for the diffuse-avoidant style (negative prediction) and normative style (positive prediction), whereas the informational style provided direct positive prediction of intimacy and generativity. The importance of an informational identity style for psychosocial balance during both early and middle adulthood is discussed.     

A simultaneous test of the relationship between identified psychosocial risk factors and recurrent events in coronary artery disease patients

Psychosocial factors are increasingly recognized as risk indicators for coronary artery disease (CAD) prognosis and they are likely interrelated. The objective of this study is to simultaneously test the relationship between key psychosocial constructs as independent factor scores and recurrent events in CAD patients. There were 1268 CAD outpatients of 97 cardiologists surveyed at two points. Recurrent events or hospitalization in the intervening nine months were reported. Factor analysis of items from the Hospital Anxiety and Depression Scale, Perceived Stress Scale, the ENRICHD Social Support Inventory, and Hostile Attitudes Scale was performed to generate orthogonal factor scores. With adjustment for prognostic variables, logistic regression analysis was performed to examine the relationship between these factor scores and recurrent events. Factor analysis resulted in a six-factor solution: hostility, stress, anxiety, depressive symptoms, support, and resilience. Logistic regression revealed that functional status and anxiety, with a trend for depressive symptoms, were related to experiencing a recurrent event. In this simultaneous test of psychosocial constructs hypothesized to relate to cardiac prognosis, anxiety may be a particularly hazardous psychosocial factor. While replication is warranted, efforts to investigate the potential benefits of screening and to investigate treatments are needed.     

Why do they exercise less? Barriers to exercise in high-anxiety-sensitive women

Anxiety sensitivity (AS; fear of arousal sensations) is a risk factor for mental and physical health problems, including physical inactivity. Because of the many mental and physical health benefits of exercise, it is important to better understand why high-AS individuals may be less likely to exercise. The present study's aim was to understand the role of barriers to exercise in explaining lower levels of physical exercise in high-AS individuals. Participants were undergraduate women who were selected as high (n = 82) or low (n = 72) AS. High-AS women participated in less physical exercise and perceived themselves as less fit than low-AS women. Mediation analyses revealed that barriers to exercise accounted for the inverse relationships between AS group and physical exercise/fitness levels. Findings suggest that efforts to increase physical exercise in at-risk populations, such as high-AS individuals, should not focus exclusively on benefits to exercise but should also target reasons why these individuals are exercising less.     

A brief cognitive-behavioral approach to reducing anxiety sensitivity decreases pain-related anxiety

Anxiety sensitivity (AS; fear of anxiety-related sensations) is a known risk factor for anxiety disorders and recently has been linked to pain disorders. The present study was guided by the hypothesis that a program designed to reduce AS levels might also result in a decrease in anxiety related to pain sensations. Female undergraduates, selected as either high or low in AS according to screening scores on the Anxiety Sensitivity Index (ASI), were randomly assigned to participate in 3 1-hour, small group sessions of either cognitive behavioral therapy (CBT; psycho-education, cognitive restructuring, and interoceptive exposure) or a non-specific treatment (NST). Immediately prior to and following the intervention, participants completed the 20-item Pain Anxiety Symptoms Scale (PASS-20). Consistent with hypothesis, results revealed a 3-way interaction between AS group, intervention condition, and time on PASS-20 total scores. Only participants with high pre-morbid levels of AS assigned to the CBT condition showed a significant reduction in scores on the PASS-20 from pre- to post-treatment. Implications for improving CBT approaches for pain disorders are discussed.     

Differences in high and low anxiety sensitive women's responses to a laboratory-based cold pressor task

Anxiety sensitivity (AS) has been linked to a variety of disabling chronic health conditions, including pain-related conditions. A recent study has found that healthy women with high AS reported significantly higher levels of sensory and affective pain on an experimental cold pressor task compared to women with low AS. However, this study found no differences between AS groups for pain tolerance or pain threshold. In the present study, which was designed to replicate and extend these findings, 90 undergraduate university women were selected for inclusion in 1 of 2 AS groups (high or low) based on their screening scores on a 16-item measure of AS. Participants were tested individually on a lab-based cold pressor task using a variety of self-report and observer-measured variables. Data analyses revealed that, as expected, the high AS participants reported significantly more fear in response to the cold pressor on a relevant item of the McGill Pain Questionnaire-Short Form (SF-MPQ) than did the low AS participants. Also as expected, the high AS participants reported more pain in response to the cold pressor on the Present Pain Index (PPI) of the SF-MPQ than did the low AS participants. High AS participants did not differ from low AS participants on other aspects of the cold pressor response (e.g. pain threshold, pain tolerance, pain recovery). These results support the role of pain-related fear as a mediating variable between AS and increased perceived pain intensity.     

Anxiety sensitivity and its impact on pain experiences and conditions: a state of the art

This paper serves as an introduction to the special issue of Cognitive Behaviour Therapy devoted to the topic of anxiety sensitivity (AS) and its impact on pain experiences and conditions. We provide a historical overview of relevant cognitive behavioural models of chronic pain, summarize recent models incorporating the AS construct, and introduce the papers in the special issue. These papers are organized into two sets--basic laboratory-based investigations and relatively more applied studies. We attempt to highlight some of the most important findings from each of these investigations and studies, in turn. Then, we consider several important conclusions derived from the set of special issue papers and the implications of these for the practice of cognitive-behavioural interventions with pain populations. Finally, we make several suggestions for directions for future investigations in this burgeoning area of cognitive behavioural research and practice.     

Social risk and protective factors for suicide attempts in low income African American men and women

A case-control study was conducted to examine a broad array of potential social risk and protective factors for suicide attempt among 200 African American men and women receiving care at a large, public, urban hospital. Specifically, we examined the effect of the following potential risk factors for suicide attempt: life hassles, partner abuse, partner dissatisfaction, and racist events; as well as the following potential protective factors: effectiveness of obtaining resources, social embeddedness, and social support. Using logistic regression, suicide attempter status was predicted by two independently significant social variables: one risk factor (life hassles) and one protective factor (social support). Male versus female suicide attempters were not distinguished by the social variables. These findings, which support the utility of an ecological conceptualization of risk and protective factors for suicide attempt, help to clarify the independently significant social environment risk and protective factors for suicide attempts among economically disadvantaged African Americans in particular. Research on both risk factors and protective factors provide a basis for culturally competent interventions aimed at reducing both the risk of future suicide attempts and completions.     

Human participants challenges in youth tobacco cessation research: researchers' perspectives

Recruiting adolescents into smoking cessation studies is challenging, particularly given institutional review board (IRB) requirements for research conducted with adolescents. This article provides a brief review of the federal regulations that apply to research conducted with adolescents, and describes researchers' experiences of seeking IRB approval for youth cessation research. Twenty-one researchers provided information. The most frequently reported difficulty involved obtaining parental consent. Solutions to commonly reported problems with obtaining IRB approval are also identified. Waivers of parental consent can facilitate recruitment of youths into studies; however, researchers must ensure that their protocols comply with federal regulations when requesting a waiver.     

Note on the Scope of Truth-functional Logic

A plausible and popular rule governing the scope of truth-functional logic is shown to be indequate. The argument appeals to the existence of truth-functional paraphrases which are logically independent of their natural language counterparts. A more adequate rule is proposed.