Cognitive Behavioral Treatment of Comorbid Anxiety Disorders and Social Difficulties in Children with High-Functioning Autism: A Case Report

A substantial proportion of children with high-functioning autism (HFA) or Asperger syndrome (AS) have one or more comorbid anxiety disorders. Because anxiety disorders exacerbate the social difficulties and other functional impairments caused by an autism spectrum disorder (ASD), there is a need for efficacious treatments to address the clinical needs of youth with this comorbid presentation. This article describes an evidence-based cognitive behavioral therapy (CBT) treatment manual enhanced to address the unique characteristics and clinical needs of children with ASD. A case study is presented in which CBT was utilized in the successful treatment of an 11-year-old girl with HFA. The intervention was effective in reducing anxiety and improving social and adaptive functioning. These findings suggest that an enhanced CBT approach may be a viable intervention for children with comorbid HFA and anxiety disorders that should be further evaluated.     

青少年焦虑、抑郁与偏差行为的行为遗传学研究

焦虑、抑郁和偏差行为等问题的行为遗传学研究有助于了解人类情绪与行为受遗传和环境交互影响的内在机制。近年来,行为遗传学研究方法的迅速发展使科学家们能够更深入地探讨了基因与环境的作用和影响。文章了分析了焦虑、抑郁和偏差行为的行为遗传学研究进展,介绍了国内外双生子研究的发展情况,提出在我国建立双生子数据库,开展有关青少年焦虑、抑郁和偏差行为的行为遗传学研究     

Interrelationships between spider fear associations,attentional disengagement and self-reported fear: A preliminary test of a dual-systems model

Recent conceptualisations of anxiety posit that equivocal findings related to the time-course of disengaging from threat-relevant stimuli may be attributable to individual differences in associative and rule-based processing. The current study was designed to test the hypothesis that strength of spider-fear associations would indirectly predict reported spider fear via impaired disengagement. One hundred and thirty-one undergraduate volunteer participants completed the Go/No-go Association Task, a visual search task, and self-report spider fear questionnaires. Stronger spider-fear associations were associated with reduced disengagement accuracy, whereas higher levels of reported spider fear were related to faster engagement with and disengagement from spiders. Bootstrapping multiple mediation analyses demonstrated that stronger-spider fear associations evidenced an indirect relationship with reported spider fear via reduced disengagement accuracy, highlighting the importance of fine-grained analyses of different aspects of cognitive bias. Results are discussed in terms of cognitive models of anxiety.     

Gray's three-arousal model: an empirical investigation

We evaluated the validity of Gray's and Fowles' three-arousal model in two studies of criminal offenders using a continuous motor task involving rewards and punishments. Consistent with predictions for the behavioral approach/activation system (BAS), offenders displayed significant (p<0.00001) increases in response time and heart rate (HR) from a no-incentive practice phase to a reward-only (experiment 1) and active-avoidance (experiment 2) phase. Trait impulsivity was correlated with the response time index of BAS activation in experiment 1 but not experiment 2. Consistent with predictions for the behavioral inhibition system (BIS), offenders showed a significant increase in number of skin conductance responses (SCRs) (p<0.05) from a reward-only to a mixed-incentive phase in experiment 1 and a significant increase in SC amplitude to punishment cues in both experiments. Consistent with predictions for the dynamics of the model, participants showed significant slowing of response time (p<0.0001) from reward-only (experiment 1) or active avoidance (experiment 2) to mixed-incentive phases despite showing an initial tendency toward response facilitation to the onset of the punishment cue signifying the beginning of the mixed-incentive phases. Participants also showed significant (p<0.002) decreases in HR between these phases in both studies, but this effect was only evident on trial 1. The BIS-influenced response time and HR indices were significantly (p<0.05) correlated with anxiety in experiment 1, but unexpectedly, anxiety was not correlated with SC indices of the BIS in either study. Although much of the data support the validity of the Gray/Fowles model, particular findings suggest that further refinement of this theory is indicated.     

Response expectancy theory and application: A decennial review

Response expectancy is the anticipation of automatic, subjective, and behavioral responses to particular situational cues. More than a decade of research in diverse laboratories indicates that response expectancies are important considerations in designing and administering treatments and prevention programs for such problems as anxiety disorders, depression, substance abuse, and sexual dysfunction. Response expectancy also plays a central role in the effects of antidepressive medication, psychotherapy, and hypnosis. In addition, studies of the effects of placebos reveal that response expectancies can produce lasting changes in pain, anxiety, depression, alertness, tension, sexual arousal, alcohol craving and consumption, aggression, asthma, warts, and contact dermatitis. The veracity of many self-reported placebo effects have been corroborated by changes in physiological function.     

Excessive Worrying as a Central Feature of Anxiety during the First COVID-19 Lockdown-Phase in Belgium: Insights from a Network Approach

Since the WHO declared the COVID-19 pandemic on March 11, 2020, the novel coronavirus, SARS-CoV-2, has profoundly impacted public health and the economy worldwide. But there are not the only ones to be hit. The COVID-19 pandemic has also substantially altered mental health, with anxiety symptoms being one of the most frequently reported problems. Especially, the number of people reporting anxiety symptoms increased significantly during the first lockdown-phase compared to similar data collected before the pandemic. Yet, most of these studies relied on a unitary approach to anxiety, wherein its different constitutive features (i.e., symptoms) were tallied into one sum-score, thus ignoring any possibility of interactions between them. Therefore, in this study, we seek to map the associations between the core features of anxiety during the first weeks of the first Belgian COVID-19 lockdown-phase (n = 2,829). To do so, we implemented, in a preregistered fashion, two distinct computational network approaches: a Gaussian graphical model and a Bayesian network modelling approach to estimate a directed acyclic graph. Despite their varying assumptions, constraints, and computational methods to determine nodes (i.e., the variables) and edges (i.e., the relations between them), both approaches pointed to excessive worrying as a node playing an especially influential role in the network system of the anxiety features. Altogether, our findings offer novel data-driven clues for the ongoing field’s larger quest to examine, and eventually alleviate, the mental health consequences of the COVID-19 pandemic.     

Application of the Minority Stress Theory: Understanding the Mental Health of Undocumented Latinx Immigrants

This paper applies the Minority Stress framework to data collected from an ongoing community-based participatory research project with health and social service agencies in Southeast Michigan. We examine the stressors and coping strategies employed by undocumented Latinx immigrants and their families to manage immigration-related stress. We conducted in-depth interviews with 23 immigrant clients at Federally Qualified Health Care Centers (FQHC) in Southeast Michigan and 28 in-depth interviews with staff at two FQHC's and a non-profit agency serving immigrants. Findings suggest that immigrants face heightened anxiety and adverse mental health outcomes because of unique minority identity-related stressors created by a growing anti-immigrant social environment. Chronic stress experienced stems from restrictive immigration policies, anti-immigrant rhetoric in the media and by political leaders, fear of deportation, discriminatory events, concealment, and internalized anti-immigrant sentiment. Though identity can be an important effect modifier in the stress process, social isolation in the immigrant community has heightened the impact of stress and impeded coping strategies. These stressors have resulted in distrust in community resources, uncertainty about future health benefits, delayed medical care, and adverse mental health outcomes. Findings provide a framework for understanding the unique stressors experienced by immigrants and strategies for interventions by social service agencies.     

Burnout‐depression overlap: Nomological network examination and factor‐analytic approach

Burnout has been defined as a condition in which individuals are left exhausted by a long‐term confrontation with unmanageable job stressors. The question of whether burnout reflects anything other than depressive responses to unresolvable stress remains an object of debate. In this 911‐participant study (83% female; mean age: 42.36), we further addressed the issue of burnout‐depression overlap. Burnout was assessed with the exhaustion subscale of the Maslach Burnout Inventory‐General Survey (MBI ‐GS ) and depression with the PHQ ‐8. The relationships of burnout and depression with three job‐related variables – illegitimate work tasks, work‐nonwork interference, and job satisfaction – and three “context‐free” variables – social support, general health status, and trait anxiety – were examined. Burnout and depression were found to be strongly correlated, to cluster together, and to exhibit overlapping nomological networks. Remarkably, the average correlations of burnout and depression with job‐related variables were almost identical. A principal component analysis and a principal axis factor analysis both showed that the items of the MBI ‐GS and of the PHQ ‐8 loaded on a single dimension. All in all, our findings are consistent with the view that burnout is a depressive condition. The distinction between burnout and depression may be an instance of the jangle fallacy.     

Anxiety and dimensions of perfectionism in first year college students: The mediating role of mindfulness

IntroductionAnxiety and perfectionism affect academic success of college students. Mindfulness is associated with decrease anxiety and perfectionism among college students.ObjectiveThis study evaluates the mediating role of dispositional mindfulness on the relationship between adaptive and maladaptive dimensions of perfectionism and anxiety in first year college students.MethodThe subjects, 283 first year college students (59.5% girls), completed self-reported measures of anxiety, perfectionism and dispositional mindfulness.ResultsOur results show that maladaptive perfectionism is associated with greater anxiety, and a higher dispositional mindfulness score is associated with less anxiety symptoms. Also, mindfulness mediates the relationship between maladaptive perfectionism and anxiety symptoms, especially in girls. When the shared variance of maladaptive and adaptive perfectionism is statistically controlled, adaptive perfectionism is associated with anxiety symptoms in boys and mindfulness in girls.ConclusionThis study confirms the mediating role of mindfulness on the relation between maladaptive perfectionism and anxiety. Gender differences, limits of the mindfulness measure and future research are discussed.