A meta-analysis of the relationship between anxiety and telomere length

Background and objectives: Telomeres are protective caps at the ends of chromosomes, and shorter telomeres are associated with poor physical health. The present study set out to consolidate the varying effect sizes found so far in studies of anxiety and telomere length.

Design and methods: A meta-analytic investigation of the relationship between anxiety and telomere length used information from 17 different samples comprising a total of 19,424 participants.

Results: The results showed a small but significant association, r?=??.06, between higher anxiety and shorter telomeres. Studies comparing individuals diagnosed with an anxiety disorder with other individuals had a significant effect size, and studies that did not use this comparison threshold did not have a significant effect size.

Conclusions: Anxiety is associated with an important biomarker related to health. Future experimental studies that examine the impact of interventions intended to reduce anxiety in conjunction with measurement of telomere length can further clarify the impact of anxiety on telomere length.     

Perfectionistic concerns predict increases in adolescents’ anxiety symptoms: a three-wave longitudinal study

Background and Objectives: Although perfectionism has been proposed to be a risk factor for the development of anxiety, research on perfectionism and anxiety symptoms in adolescents is scarce and inconclusive. The aim of the present study was to investigate whether the two higher-order dimensions of perfectionism – perfectionistic strivings and perfectionistic concerns – predict the development and maintenance of anxiety symptoms. An additional aim of the present study was to examine potential reciprocal effects of anxiety symptoms predicting increases in perfectionism.

Design: The study used a longitudinal design with three waves spaced 4–5 months apart.

Methods: A non-clinical sample of 489 adolescents aged 12–19 years completed a paper-and-pencil questionnaire.

Results: As expected, results showed a positive effect from perfectionistic concerns to anxiety symptoms, but the effect was restricted to middle-to-late adolescents (16–19 years old): Perfectionistic concerns predicted longitudinal increases in adolescents’ anxiety symptoms, whereas perfectionistic strivings did not. Furthermore, anxiety symptoms did not predict increases in perfectionism.

Conclusions: Implications for the understanding of the relationship between perfectionism and anxiety symptoms are discussed.     

Social anxiety and post-event processing among African-American individuals

Background: Social anxiety is among the most prevalent psychiatric conditions, yet little attention has been paid to whether putative cognitive vulnerability factors related to social anxiety in predominantly White samples are related to social anxiety among historically underrepresented groups.

Design: We tested whether one such vulnerability factor, post-event processing (PEP; detailed review of social event that can increase state social anxiety) was related to social anxiety among African-American (AA; n?=?127) persons, who comprise one of the largest underrepresented racial groups in the U.S. Secondarily, we tested whether AA participants differed from non-Hispanic White participants (n?=?127) on PEP and social anxiety and whether race moderated the relation between PEP and social anxiety.

Method: Data were collected online among undergraduates.

Results: PEP was positively correlated with social anxiety among AA participants, even after controlling for depression and income, pr?=?.30, p?=?.001. AA and White participants did not differ on social anxiety or PEP, β?=??1.57, 95% CI: ?5.11, 1.96. The relation of PEP to social anxiety did not vary as a function of race, β?=?0.00, 95% CI: ?0.02, 0.02.

Conclusions: PEP may be an important cognitive vulnerability factor related to social anxiety among AA persons suffering from social anxiety.     

A New CBT Model of Panic Attack Treatment in Comorbid Heart Diseases (PATCHD): How to Calm an Anxious Heart and Mind

Treating anxiety comorbid with heart disease is challenging due to (a) diagnostic overlap between anxiety and heart disease, (b) the high risk associated with ignoring chest pain symptoms and delaying seeking medical attention, (c) that cognitive-behavioral therapy based on catastrophic misinterpretation of bodily symptoms requires adaption to incorporate the element of risk, and (d) that certain interoceptive symptom induction experiments may be harmful and are therefore fraught with liability. We describe Panic Attack Treatment in Comorbid Heart Diseases (PATCHD) that is based on enhancing coping skills, performing safe interoceptive exposures and supervised exercise, and countering avoidance to reduce panic attack frequency. Pre- and posttreatment data from 18 patients shows a significant reduction in cardiovascular hospital admissions and length of stay, panic attacks, general anxiety, and depression (all p < .05). Because of the complex nature of panic disorder comorbid with heart disease, health professionals should familiarize themselves with several necessary CBT adaptions.     

Multimedia Field Test Thinking About Exposures? There’s an App for That!

Anxiety Coach is a smartphone application (“app”) for iOS devices that is billed as a self-help program for anxiety in youth and adults. The app is currently available in the iTunes store for a one-time fee of $4.99. Anxiety Coach is organized around three related content areas: (a) self-monitoring of anxiety symptoms, (b) learning about anxiety and its treatment, and (c) guiding users through the development of a fear hierarchy and completion of exposure tasks. Although the app includes psychoeducation about anxiety as well as information regarding specific skills individuals can use to cope with anxiety (e.g., cognitive restructuring), the primary focus of the app is on exposure tasks. As such, the app includes a large library of potential exposure tasks that are relevant to treating common fears and worries, making Anxiety Coach useful to clients and clinicians alike. Additionally, Anxiety Coach prompts users to provide fear ratings while they are carrying out an exposure task and displays a message instructing users to stop the exposure once fear ratings drop by half. These features work together to create an app that has the potential to greatly increase the reach of exposure-based cognitive behavioral therapy for anxiety.     

Demonstration of an Integrated Treatment for Smoking Cessation and Anxiety Symptoms in People With HIV: A Clinical Case Study

Despite high rates of co-occurring tobacco use and anxiety symptoms and disorders among persons with HIV, evidence-based interventions for these individuals are not yet available. The present study sought to evaluate an integrated treatment model addressing smoking cessation and anxiety sypmtoms among HIV-positive smokers. Treatment was an 8-week intervention integrating a standard smoking cessation protocol (i.e., cognitive-behavioral therapy [CBT], nicotine replacement therapy) with CBT for anxiety. Inclusion criteria were 18–65 years of age, ≥ 10 cigarettes/day, State–Trait Anxiety Inventory [STAI-T] score of > 39, and moderate motivation (i.e., ≥ 5 out of 10 on a 10-point Likert scale) to quit smoking. Primary outcomes included scores on the Anxiety Sensitivity Index (ASI) and cigarettes smoked per day. Self-reported abstinence was biochemically verified by carbon monoxide breath analysis. Three male participants (mean age 49.3, SD = 9.1) completed through 2-month follow-up. At baseline all participants reported smoking an average of 20 cigarettes per day. Two participants quit smoking and maintained abstinence by the 2-month follow-up, and demonstrated a reduction in ASI scores. Participant 3 continued to smoke but at a reduced rate. Participants’ response to cognitive and behavioral strategies (e.g., creating balanced thoughts, interoceptive exposures) will be discussed. Clinical lessons learned include use of a flexible approach to cognitive restructuring, use of imaginal and in vivo exposures in session to better prepare patients for homework practice, and flexibility in delivering the treatment in an individual or group format. This clinical presentation provides preliminary support for the feasibility and initial effectiveness of an integrated treatment to reduce anxiety symptoms and aid in smoking cessation in anxious, HIV-positive smokers.     

大学生外语写作自我效能感在写作焦虑对写作成绩影响中的中介效应

在外语写作课堂教学的情境下,使用写作自我效能感量表、外语写作焦虑量表和一篇英语命题作文分别调查356名大学一年级学生的外语写作自我效能感、写作焦虑与外语写作成绩,探讨写作自我效能感在写作焦虑与写作成绩之间的中介效应。结果表明:(1)外语写作焦虑显著负向预测外语写作自我效能感;(2)外语写作自我效能感显著正向预测外语写作成绩;(3)外语写作自我效能感在外语写作焦虑对外语写作成绩的影响中起到了完全中介的作用。     

焦虑情绪对图像信息意识提取和无意识提取影响的实验研究

采用加工分离程序,以不同性价图片为实验材料,考察了特质焦虑、启动焦虑和非焦虑三种焦虑类型对图片信息意识提取和无意识提取的影响,结果表明：（1）不同焦虑类型对图像信息的意识提取和无意识提取均有影响,其中特质焦虑对图像的无意识提取更敏感,非焦虑状态对意识提取更敏感;（2）特质焦虑明显促进了负性图片的意识和无意识提取且干扰了正性图片的提取,启动焦虑促进了对负性图片的意识提取。     

Retrieval properties of negative vs. positive mental images and autobiographical memories in social anxiety: outcomes with a new measure

High (n = 41) and low (n = 39) socially anxious (SA) participants completed the Waterloo Images and Memories Interview (WIMI), a new assessment tool that measures the accessibility and properties of mental images and associated autobiographical memories that individuals may experience across both anxiety-provoking (negative) and non-anxiety-provoking (positive) social situations. Results indicated that both high and low SA individuals experience negative images and associated autobiographical memories in anxiety-provoking social situations, but the rates of endorsement of such images and memories among high SA participants were substantially lower than those reported in recent studies. Moreover, whereas low SA individuals were capable of accessing a relatively balanced array of both negative and positive self-representations that were rich in episodic detail, high SA individuals retrieved a higher, more unbalanced ratio of negative-to-positive images and memories, as well as impoverished positive images that were significantly degraded in episodic detail. Finally, negative images influenced the two groups differently, with high SA individuals experiencing more negative emotional and cognitive consequences associated with bringing such images to mind. These results are discussed in relation to theoretical models of learning and memory within the context of contemporary cognitive behavioral models of social anxiety.     

Social anxiety and the effects of negative self-imagery on emotion, cognition, and post-event processing

Numerous studies have shown that social phobia patients experience negative self-impressions or images during social situations. Clark and Wells (1995) posited that such negative self-images are involved in the maintenance of social phobia. Thus, the present study investigated the effects of negative self-imagery on cognition and emotion during and following a brief social situation. Specifically, high and low socially anxious participants (N = 77) were instructed to hold either a negative or control self-image as they engaged in a brief speech. Participants then rated their anxiety, performance, cognitions, and focus of attention. Twenty-four hours later, they returned to the laboratory and completed questionnaires assessing the amount of post-event processing (PEP) they engaged in. The results showed that, irrespective of the level of social anxiety or depressive symptoms, participants that held the negative self-image experienced higher levels of anxiety, were more self-focused, experienced more negative thoughts, rated their anxiety as more visible, appraised their performance more negatively, and engaged in more negative and less positive PEP than participants that held the control self-image. Collectively the results indicate that negative imagery is causally involved in the maintenance of social phobia, as well as in the generation of social anxiety among non-anxious individuals.