Beyond Negative Affectivity: A Hierarchical Model of Global and Transdiagnostic Vulnerabilities for Emotional Disorders

Background: Negative affectivity (NA) has been linked to anxiety and depression (DEP). Identifying the common factors between anxiety and DEP is important when explaining their overlap and comorbidity. However, general factors such as NA tend to have differential relationships with different disorders, suggesting the need to identify mediators in order to explicate these relationships. Methods: The current study tests a theoretically and empirically derived hierarchical model of emotional disorders including both a general factor (NA) and transdiagnostic risk factors [anxiety sensitivity (AS) and intolerance of uncertainty (IoU)] using structural equation modeling. AS was tested as a mid-level factor between NA and panic disorder/agoraphobia, while IoU was tested as a mid-level factor between NA and social phobia, generalized anxiety disorder, obsessive-compulsive disorder, and DEP. Data from 642 clinical outpatients with a heterogeneous presentation of emotional disorders were available for analysis. Results: The hierarchical model fits the data adequately. Moreover, while a simplified model removing AS and IoU fits the data well, it resulted in a significant loss of information for all latent disorder constructs. Limitations: Data were unavailable to estimate post-traumatic stress disorder or specific phobias. Future work will need to extend to other emotional disorders. Conclusions: This study demonstrates the importance of both general factors that link disorders together and semi-specific transdiagnostic factors partially explaining their heterogeneity. Including these mid-level factors in hierarchical models of psychopathology can help account for additional variance and help to clarify the relationship between disorder constructs and NA.     

The Effects of Social Anxiety and State Anxiety on Visual Attention: Testing the Vigilance–Avoidance Hypothesis

A growing theoretical and research literature suggests that trait and state social anxiety can predict attentional patterns in the presence of emotional stimuli. The current study adds to this literature by examining the effects of state anxiety on visual attention and testing the vigilance–avoidance hypothesis, using a method of continuous visual attentional assessment. Participants were 91 undergraduate college students with high or low trait fear of negative evaluation (FNE), a core aspect of social anxiety, who were randomly assigned to either a high or low state anxiety condition. Participants engaged in a free view task in which pairs of emotional facial stimuli were presented and eye movements were continuously monitored. Overall, participants with high FNE avoided angry stimuli and participants with high state anxiety attended to positive stimuli. Participants with high state anxiety and high FNE were avoidant of angry faces, whereas participants with low state and low FNE exhibited a bias toward angry faces. The study provided partial support for the vigilance–avoidance hypothesis. The findings add to the mixed results in the literature that suggest that both positive and negative emotional stimuli may be important in understanding the complex attention patterns associated with social anxiety. Clinical implications and suggestions for future research are discussed.     

Attention Modification in Persons with Fibromyalgia: A Double Blind,Randomized Clinical Trial

Contemporary models of chronic musculoskeletal pain emphasize the critical roles of fear, anxiety, and avoidance as well as biases in attention in the development and maintenance of chronic pain disability. Evidence supports the influence of individual difference variables such as anxiety sensitivity, pain-related anxiety, and catastrophizing on the pain experience and on pain-related attentional biases. Changes in attentional biases have been associated with treatment gains in patients with clinically significant anxiety. The Attentional Modification Paradigm (AMP) is a modification of the dot-probe paradigm used to facilitate such changes in attentional biases. Given the relationship between chronic musculoskeletal pain and anxiety, AMP may be effective in reducing pain as well. Participants included persons (n = 17) with fibromyalgia and were randomly assigned to either an AMP condition or a control condition. The participants completed two 15-minute AMP sessions per week for 4 weeks. Those in the AMP condition reported statistically significant and substantial reductions on several individual difference variables relative to those in the control condition, and a greater proportion experienced clinically significant reductions in pain. These preliminary results offer a promising new avenue for treating chronic musculoskeletal pain that warrants additional research. Comprehensive results, limitations, and future directions are discussed.     

Nature and Role of Change in Anxiety Sensitivity During NRT-Aided Cognitive-Behavioral Smoking Cessation Treatment

This study evaluated the associations between change in anxiety sensitivity (AS; fear of the negative consequences of anxiety and related sensations) and lapse and relapse during a 4-week group NRT-aided cognitive-behavioral Tobacco Intervention Program. Participants were 67 (44 women; M _age = 46.2 years, SD = 10.4) adult daily smokers. Results indicated that participants who maintained high levels of AS from pretreatment to 1 month posttreatment, compared to those who demonstrated a significant reduction in AS levels during this time period, showed a significantly increased risk for lapse and relapse. Further inspection indicated that higher continuous levels of AS physical and psychological concerns, specifically among those participants who maintained elevated levels of AS from pre- to posttreatment, predicted significantly greater risk for relapse. Findings are discussed with respect to better understanding change in AS, grounded in an emergent taxonic-dimensional factor mixture model of the construct, with respect to lapse and relapse during smoking cessation.     

Intolerance of Uncertainty as a Contributor to Fear and Avoidance Symptoms of Panic Attacks

Panic disorder symptoms are persistent for 50–80% of cases even after treatment, resulting in experiences of disability and dissatisfaction in life. Previous research has focused on anxiety sensitivity (AS) and its dimensions as contributing to symptoms of panic disorder; however, recent research has suggested that intolerance of uncertainty (IU)—the tendency for a person to consider the possibility of a negative event occurring as threatening, irrespective of the actual probability of its occurrence—may also play a critical role. The current study was designed to assess the specific relationships between dimensions of IU (i.e. prospective IU and inhibitory IU) and the fear and avoidance symptoms associated with panic disorder. Participants included 122 community members (81% women) with a history of at least one panic attack who participated in a larger study on fear. Participants completed measures of AS, IU, and panic disorder symptoms. Correlation and regression analyses supported a significant and substantial relationship between AS, inhibitory IU, and panic disorder symptoms. Inhibitory IU accounted for relatively more variance in avoidance symptoms related to panic disorder than did the fears of physical sensations dimension of AS. As such, further investigation of the role of IU in panic disorder symptoms appears warranted. Comprehensive results, implications, and directions for future research are discussed.     

创伤个体注意控制、焦虑及情绪对闯入记忆的影响

以往研究认为认知控制在闯入记忆的发展中起一定作用。研究以83名大学生本科生为被试,采用创伤电影范式和问卷调查结合的方式,旨在考察创伤个体注意控制、焦虑及情绪对闯入记忆的影响。结果显示,注意控制、焦虑和情绪与闯入记忆相关;注意控制和观看创伤电影前的消极情绪对闯入记忆有一定的预测作用;注意控制与焦虑、情绪相关;高低注意控制组分别在焦虑、情绪上差异显著。注意控制、焦虑、创伤前负性情绪与闯入记忆相关;注意控制、创伤前负性情绪显著影响闯入记忆。 关键词：闯入记忆;注意控制;焦虑;情绪;创伤     

Is the practice of yoga associated with positive outcomes? The role of passion

Using the dualistic model of passion [Vallerand, R.J., Blanchard, C.M., Mageau, G.A., Koestner, R., Ratelle, C.F., Léonard, M.,?…?Marsolais, J. (2003). Les passions de l’âme: On obsessive and harmonious passion. Journal of Personality and Social Psychology, 85, 756–767], this research represents an initial attempt to examine whether an activity that is generally recognized to have widespread benefits, namely yoga, can still relate differently to outcomes as a function of the type of activity involvement (i.e., passion). Vallerand et al. (2003) distinguish two types of passion: harmonious passion, characterized by a volitional engagement in a beloved activity, and obsessive passion, which entails an uncontrollable urge to partake in the activity. Study 1 (n?=?75) revealed that harmonious passion for yoga was more positively associated with positive psychological outcomes than obsessive passion. In Study 2 (n?=?89), these findings were replicated and extended using a 3-month prospective design. Although preliminary, the results of this research suggest that the type of passion one has for a ‘positive’ activity makes a difference for one's psychological and physical well-being.     

注意偏向训练对社交焦虑的干预：方法、效果与机制

社交焦虑障碍是最普遍且难于治疗的精神障碍之一。大量研究发现, 注意偏向训练可以有效缓解社交焦虑。研究者从自我报告、结构化评估、生理记录等方面考察发现, 接受了注意偏向训练的社交焦虑个体其注意偏向、生理唤醒和脑神经活动发生变化并且社交焦虑症状有所缓解。注意偏向训练对社交焦虑的干预机制可能是因为训练提升了个体对威胁性刺激的注意解除能力。今后的研究可以进一步明确注意偏向训练干预社交焦虑的效果与机制, 拓宽评估注意偏向训练效果的手段, 并探索其对社交焦虑干预的长期效果和对其它心理疾病的作用。     

网络社交存在较低的社交焦虑水平吗

网络时代引发了现代人社交方式的改变, 特别是年轻人更加偏爱网络社交方式。已有研究发现较之面对面的现实社交, 非面对面的网络社交有较小的社交压力, 存在较低的社交焦虑水平。研究者分别从自我表露、评价恐惧、成就动机和行为抑制系统四个方面对这个现象进行了解释。但总体来看, 这些解释还缺乏更加统合的理论架构和客观的实验研究结果的支持。     

The acceptability and feasibility of an anxiety reduction intervention for emergency department patients with non-cardiac chest pain

Despite good physical prognosis, patients who receive a diagnosis of non-cardiac chest pain (NCCP) may experience persistent pain and distress. While cognitive-behavioural interventions have been found to be effective for this group, they are difficult to deliver in busy emergency department (ED) settings. Addressing the acceptability and relevance of self-help interventions is an important initial step in addressing this need. This study sought to examine the acceptability and relevance of an evidence-based self-help intervention for ED patients with persistent NCCP and anxiety. Patient (interviews: N = 11) and specialist chest pain nurse (focus group: N = 4) views on acceptability and feasibility were examined. Data were analysed using thematic analysis. Patients and nurses reported that there was a need for the intervention, as stress and anxiety are common among patients with NCCP, and provision of psychosocial support is currently lacking. Both patients and nurses reported that the intervention was relevant, acceptable, and potentially useful. Some changes to the intervention were suggested. Nurses reported that the intervention could be used within the existing staff resources available in an ED setting. This study represents an important first step towards developing a brief self-help intervention for ED patients with NCCP and anxiety. Further research should seek to determine the efficacy of the intervention in a pilot trial.