Efficacy of a cognitive-behavioural therapy administered by videoconference for generalized anxiety disorder

IntroductionDelivering psychotherapy by videoconference could considerably extend the accessibility of empirically validated treatments.ObjectiveThe aim of this study was to evaluate the efficacy of a cognitive-behavioural therapy (CBT) for generalized anxiety disorder (GAD), administered via videoconference.MethodFive participants with a primary diagnosis of GAD took part in an experimental multiple baseline case study protocol. The efficacy of the treatment was evaluated using a semi-structured interview, self-report questionnaires, and daily self-monitoring diaries.ResultsThe results demonstrate that overall, participants’ conditions were improved following treatment and they no longer met the diagnostic criteria for GAD in the short-term. Participants’ conditions improved clinically and statistically at each follow-up point, achieving a greater global level of functioning at post-test, as well as at 3-month and 12-month follow-up.ConclusionClinical implications of this new treatment modality and directions for future research are discussed.     

Money talks in attention bias modification: Reward in a dot-probe task affects attentional biases

Attention bias modification (ABM) aimed at correcting dysfunctional biases in anxiety patients has met with only mild success. Inspired by recent studies showing large effects of financial reward upon attention shifts, we contrasted effects of traditional dot-probe ABM and reward upon attention biases in a between-subject 2 × 2 design. Twenty-seven participants in group cognitive behavioural therapy (GCBT) for social anxiety disorder (SAD) were randomly assigned to undergo six sessions of a dot-probe task consisting of ABM or placebo ABM along with random or high reward following neutral stimuli. There was no influence of ABM on participants' attention bias over and above the influence of GCBT. Reward, however, had a strong influence on attention bias. Neither ABM nor reward reduced SAD symptoms over and above the effects of GCBT. The results add to the growing evidence that benefits of ABM through dot-probe training are unreliable but suggest on the other hand that rewarding attention may strongly influence dysfunctional attention biases.     

Paranoia predicts out-group prejudice: preliminary experimental data

This article examines the relationships between exposure to terrorism news and state social paranoia, death anxiety and Islamophobia. In two experiments we show that, contrary to previous research in this area, the terrorism news condition did not significantly increase state social paranoia, death anxiety and prejudice towards Muslims, but that paranoid thinking was the sole predictor of Islamophobia. Trait paranoia is associated with both poor well-being and with negative perceptions of Muslim competitive players – a form of inter-relational prejudice. Results indicated that the frequency of paranoid thoughts mediates the relationship between death anxiety and anti-Muslim prejudice and trait paranoia is the main predictor of the negative perceptions of a Muslim competing player. This study elucidates new pathways to understanding terror management theory, by including paranoia as a type of thinking that predisposes individuals to be suspicious of salient out-groups.     

State test‐anxiety,selective attention and concentration in university students

The principal aim of this study was to assess the level of selective attention and mental concentration before exams in a sample of university students and to determine a possible relationship between anxiety and reduction of levels of attention in this circumstance. A total of 403 university students, 176 men and 227 women, aged from 18 to 46 years, participated in the study. Of them, 169 were first‐year undergraduates, 118 were second to fourth‐year undergraduates and 116 were postgraduate Master's degree students. All of them completed the Spanish version of the Spielberger State‐Anxiety Inventory and the D2 Attention Test just before taking an exam. Our results showed that participants with lower levels of anxiety had higher levels of selective attention and mental concentration before the exam. These results specifically indicate that when anxiety levels are very high, this could over‐activate the orientating and alerting functions and to reduce the capacity of attentional control. These processes could have a negative impact on specific attentional processes and become a negative influence on performance in exams.     

Validity of the German Test Anxiety Inventory (TAI‐G) in an Australian sample

Test anxiety (TA) is a prevalent issue among students that can result in deleterious consequences, such as underachievement. However, a contemporary measure that has been validated for use with Australian students seems to be lacking. This study, therefore, investigated the suitability of the German Test Anxiety Inventory (TAI‐G) for use with Australian university students. While the original TAI‐G contains 30 items and was designed to measure four factors (worry, emotionality, interference, and lack of confidence), differing factorial models have been supported in the literature using either the original or a shortened 17‐item version of the measure. These differing TAI‐G models were tested and compared in the current study via confirmatory factor analysis using 224 Australian university students. As expected, results supported the superior fit of the 17‐item four‐factor model. Additionally, the convergent validity of the measure was supported since measures of self‐esteem, self‐efficacy, and general anxiety were all found to correlate significantly with the TAI‐G in the hypothesised directions. Finally, the finding that all of the TAI‐G subscales had acceptably high reliabilities led to the conclusion that the 17‐item TAI‐G is a valid and reliable measure of TA in an Australian university population.     

DSM-defined anxiety disorders symptoms in South African youths: Their assessment and relationship with perceived parental rearing behaviors

This study investigated DSM-defined anxiety symptoms in South African youths. Children and adolescents (N = 701) from various cultural groups completed the SCARED and a questionnaire measuring perceived parental rearing behaviors. Results indicated that the psychometric properties of the SCARED were satisfactory in the total sample of South African youths, and acceptable in colored and black children and adolescents. Further, colored and black youths displayed higher SCARED scores than white youths, and there were also differences in the perceived parental rearing behaviors of the cultural groups. White youths generally rated their parents' rearing behaviors as less anxious, overprotective, and rejective, but more emotionally warm than colored and black youths. Finally, positive correlations were found between anxious rearing, overprotection, and rejection and anxiety symptoms. The clinical and research implications of these findings are briefly discussed.     

Gender Role Orientation and Anxiety Symptoms Among African American Adolescents

The present study evaluated gender role theory as an explanation for the observed gender differences in anxiety symptoms among adolescents. Specifically, the relation between gender, gender role orientation (i.e., masculinity and femininity), self-esteem, and anxiety symptoms was examined in a community sample of 114 African Americans aged 14 to 19 (mean age 15.77; 57 girls). Results revealed that masculinity was negatively associated with anxiety symptoms whereas femininity was positively associated with anxiety symptoms. Gender role orientation accounted for unique variance in anxiety scores above biological gender and self-esteem, and self-esteem moderated the relation between femininity (but not masculinity) and overall anxiety symptoms. Consistent with research on children and Caucasians, findings supported gender role theory as a partial explanation for the observed gender disparity in anxiety symptoms among African American adolescents.     

The effects of modifying interpretation bias on worry in generalized anxiety disorder

This study investigated whether facilitating a benign interpretive bias decreases negative thought intrusions in generalized anxiety disorder (GAD). Clients were randomly allocated to an interpretation modification condition in which they repeatedly accessed benign meanings of emotionally ambiguous homographs and scenarios, or to a control condition in which they accessed threat and benign meanings with equal frequency. Worry frequency was assessed using a breathing focus task that involved categorising the valence of thought intrusions before and after an instructed worry period. Interpretation bias was assessed during the modification tasks, and on a different measure of interpretation bias (sentence completion) following a period of worry. The experimental procedure modified interpretations made during training, and in the later sentence completion task. Furthermore, compared to the control group, the benign group showed fewer negative thought intrusions during breathing focus (as rated by both participants and an assessor). These findings show that it is possible to induce a more benign interpretive bias in GAD clients and that this reduces negative thought intrusions.     

Targeting the probability versus cost of feared outcomes in public speaking anxiety

Cognitive-behavioral theory suggests that social phobia is maintained, in part, by overestimates of the probability and cost of negative social events. Indeed, empirically supported cognitive-behavioral treatments directly target these cognitive biases through the use of in vivo exposure or behavioral experiments. While cognitive-behavioral theories and treatment protocols emphasize the importance of targeting probability and cost biases in the reduction of social anxiety, few studies have examined specific techniques for reducing probability and cost bias, and thus the relative efficacy of exposure to the probability versus cost of negative social events is unknown. In the present study, 37 undergraduates with high public speaking anxiety were randomly assigned to a single-session intervention designed to reduce either the perceived probability or the perceived cost of negative outcomes associated with public speaking. Compared to participants in the probability treatment condition, those in the cost treatment condition demonstrated significantly greater improvement on measures of public speaking anxiety and cost estimates for negative social events. The superior efficacy of the cost treatment condition was mediated by greater treatment-related changes in social cost estimates. The clinical implications of these findings are discussed.