“It's wrong to relax,you have to be on the go,go, go,all the time”: Emotional transformation in a case of emotion-focused therapy for generalised anxiety disorder

Generalised anxiety disorder (GAD) is a highly prevalent, chronic and impairing disorder. The aim of this study was to qualitatively describe the transformation in emotional processing across 16 sessions of a successful emotion-focused therapy (EFT) treatment for GAD. A theoretical framework derived from the EFT model of in-session emotional transformation proposed by Pascual-Leone and Greenberg was used as the basis for qualitative analysis. Additionally, the Classification of Affective Meaning States, the Client-Expressed Arousal Scale-III and the Client Emotional Productivity Scale-Revised were utilised by observer–raters to classify moment-by-moment shifts in client affective-meaning states, emotional arousal and emotional productivity. Results supported the emotion transformation model. The client presented in a state of poorly differentiated but highly aroused distress provoked by identifiable interpersonal and intrapersonal triggers. Emotional and behavioural avoidance provoked by fear of pain was evident. Accessing core pain and responding to attendant needs with compassion and protective anger was shown to facilitate the higher order emotional processing states of grief, relief and agency. Implications are proposed, including that addressing core emotional vulnerability may be a critical intervention in the successful treatment of GAD.     

Examining Safety Behavior Subtypes Across Distinct Social Contexts in Social Anxiety Disorder and Major Depression

People with social anxiety disorder (SAD) use different types of safety behaviors that have been classified as avoidance vs. impression management. The current study investigated differences in safety behavior subtype use in 132 individuals with principal diagnoses of social anxiety disorder (SAD, n = 69), major depressive disorder (MDD, n = 30), and nonpatient controls (n = 33) across two social contexts: an interpersonal relationship-building task (social affiliation) and a speech task (social performance). We examined whether diagnostic groups differed in safety behavior subtype use and whether group differences varied by social context. We also explored relationships between avoidance and impression management safety behaviors, respectively, and positive and negative valence affective and behavioral outcomes within the social affiliation and social performance contexts. Safety behavior use varied by diagnosis (SAD > MDD > nonpatient controls). The effect of diagnosis on impression management safety behavior use depended on social context: use was comparable for the principal SAD and MDD groups in the social performance context, whereas the SAD group used more impression management safety behaviors than the MDD group in the social affiliation context. Greater use of avoidance safety behaviors related to higher negative affect and anxious behaviors, and lower positive affect and approach behaviors across contexts. Impression management safety behaviors were most strongly associated with higher positive affect and approach behaviors within the social performance context. These findings underscore the potential value of assessing safety behavior subtypes across different contexts and within major depression, in addition to SAD.     

Reducing intergroup anxiety: Applying an imagined contact intervention with counselors-in-training

This study assessed the impacts of an (elaborated) imagined contact intervention (eICI) with graduate-level counseling students (N = 38) in a multicultural counseling course. Participant levels of intergroup anxiety were assessed, comparing those who completed an eICI versus those who did not. Intergroup anxiety decreased for both groups over time, albeit with a greater immediate reduction for those who received the ICI. Qualitative commentary suggests specific student learning from the activity.     

Rice-farming areas report more anxiety across two years of the COVID-19 pandemic in China

Cultures responded to the COVID-19 pandemic differently. We investigated cultural differences in mental health during the pandemic. We found regional differences in people's reports of anxiety in China over two years from 2020 to 2021 (N = 1186). People in areas with a history of rice farming reported more anxiety than people in wheat-farming areas. Next, we explored more proximal mechanisms that could help link the distal, historical factor of rice farming to people's modern experience of anxiety. Rice areas scored higher on collectivism and tight social norms than wheat areas, and collectivism, rather than norm tightness, mediated the rice-anxiety relationship. These findings advance our understanding of the distal sources of cultural differences, the proximal mechanisms, and mental health problems during the pandemics.     

Sense of purpose and food insecurity during the COVID-19 pandemic

The COVID-19 pandemic brought new attention to the issues of food insecurity faced by individuals throughout the United States, a stressor exacerbated by disruptions to work status and supply chains. The burden of food insecurity likely carries consequences for whether individuals feel capable of pursuing their broad goals and life engagements; put differently, food insecurity may pose a threat to people perceiving a sense of purpose in life. The current study tested this claim across three samples taken during 2020 (n = 2009), 2021 (n = 1666), and 2022 (n = 1975). Participants completed inventories for perceived food insecurity, sense of purpose, depressive symptoms, and anxiety, among other measures. Results found consistent negative associations between food insecurity and sense of purpose across all three samples. In addition, food insecurity moderated associations between sense of purpose and depressive or anxiety symptoms. Sense of purpose was more strongly negatively associated with depressive and anxiety symptoms for those participants who reported no food insecurity. That said, sense of purpose remained negatively associated with psychological distress even among those reporting food insecurity.     

Safety behaviors were associated with greater anxious symptoms during the first year of the COVID-19 pandemic

Research shows that people who use safety behaviors are at greater risk factor for anxiety than people who do not use safety behaviors. However, the perception of some safety behaviors changed during the COVID-19 pandemic; behaviors that were once considered unnecessary or excessive were now commonplace (e.g., monitoring bodily symptoms, avoiding crowds). The purpose of this study was to determine the degree to which the pandemic changed the status of health-related safety behaviors as a risk factor for symptoms of anxiety. To this end, we tested the effect of safety behavior use on anxious symptoms during the first year of the pandemic using a longitudinal design with 8 time points and participants (n = 233) from over 20 countries. Despite possible changes in their perception, those engaging in high levels of safety behaviors reported the greatest levels of anxious symptoms throughout the pandemic year. However, the outcomes for safety behavior users were not all negative. Safety behavior use at baseline was the only predictor of participants' willingness to receive the COVID-19 vaccine (measured one year later).     

Depression and unemployment: Panel findings from the Epidemiologic Catchment Area study

Studies that have found an association between unemployment and psychological depression often fail to establish the direction of causal influence. Analyses of Epidemiologic Catchment Area panel data revealed that of employed respondents not diagnosed with major depression at first interview, those who became unemployed had over twice the risk of increased depressive symptoms and of becoming clinically depressed as those who continued employed. Although the increase in symptoms was statistically significant, the effect on clinical depression was not, possibly because of the low power of the test. The reverse causal path from clinical depression at Time 1 to becoming unemployed by Time 2 was not supported. The unemployment rate in the respondent's community at time of interview was not related directly to psychological depression but appeared associated indirectly with depression via its impact on the risk of becoming unemployed. Implications for policy and further research were discussed. The research described in this paper was supported by Grant #5 RO1 AA08379-02 from the National Institute of Alcohol Abuse and Alcoholism. The authors appreciate the suggestions provided by members of the Consortium for Research Involving Stress Processes sponsored by the W. T. Grant Foundation and by two anonymous journal reviewers.