A multicomponent investigation of the interaction of generalized anxiety and phobia

Forty female undergraduates forming four groups, high or low trait anxiety with or without a specific fear (rats), participated in a psychophysiological assessment of their response to the phobic object, a neutral object (rabbit), and to a general anxiety-induction procedure (threat of shock). Subjects also completed a number of tasks requiring sustained attention. Blood samples were drawn to determine thyroid hormone (T3 and T4) levels. Trait anxiety was found to interact with specific fear in response to the feared object. The high-trait anxious/high-fear group was most physiologically responsive to the rat. Trait- anxious subjects were more responsive to the threat of shock and showed performance deficits on reaction time, vigilance, and backward digit span tasks. These subjects also had significantly higher T3 and T4 levels. The findings are discussed with regard to the role of general anxiety in the etiology and/or maintenance of specific fears and the role of thyroid hormones in accentuating physiological response to feared stimuli.     

The Development and Validation of the Multicomponent AIDS Phobia Scale

The development, reliability, and validity of a new instrument, the Multicomponent AIDS Phobia Scale (MAPS), is described. Based on a sample of 181 university students, the results indicate that the MAPS has strong internal consistency and moderate test-retest reliability. In addition, an assessment of concurrent and discriminant validity indicates statistically significant correlations with other self-report measures of anxiety, hypochondriasis, obsessive-compulsive disorder, and fear of AIDS. The results of a factor analysis indicate that the scale consists of two factors: Fear of Infection and Fear of Others/Avoidance. Although further research with the MAPS in a clinical population is warranted to investigate the generalizability of this study's results, the instrument appears to be a reliable and valid measure of AIDS Phobia and may prove useful for improving clinical assessment and documenting treatment outcome.     

Self-reported change in health behaviour after a mass media-based health education campaign

A comprehensive short-term fund-raising campaign, was launched in 1987 by a health charity organization in cooperation with the only Norwegian TV-channel covering the whole country. The campaign which was extensively announced on TV and other media and which involved large proportions of the population, finished up with a six hour TV-show on the fund-raising day. Because a considerable amount of information on prevention of heart disease was presented in connection with the campaign, it is presently evaluated as a nationwide health education campaign. Twenty-two per cent of the population reported changes in one or more habits in connection with the campaign (one third of them took more exercise, while one quarter reduced/quit their smoking). Health behaviour change among family/friends, reported new knowledge of health and worry created by the campaign, were the factors most clearly associated with self-reported behaviour change. The paper discusses the magnitude of the effects of the campaign in relation to the study design, and the importance of social environment and fear arousal on health behaviour.     

Validity of Two Questionnaires to Assess Social Fears: The Dutch Social Phobia and Anxiety Inventory and the Blushing, Trembling and Sweating Questionnaire

This report evaluates some psychometric properties of the Dutch Social Phobia and Anxiety Inventory (SPAI-N) as well as a newly developed instrument to assess fear of showing somatic symptoms among social phobic, the Blushing, Trembling and Sweating Questionnaire (BTS-Q). Results support the reliability and discriminative validity of the Dutch SPAI and the BTS-Q. Both questionnaires are able to discriminate social phobics from a community sample. Social phobics with fear of blushing, trembling, and sweating as the main complaint could be discriminated from social phobics without fear of blushing, trembling, and sweating as the main complaint using the BTS-Q. In contrast with expectations derived from cognitive models of social phobia, social phobics with fear of blushing, trembling, and sweating did not have stronger dysfunctional beliefs about (the social consequences of) blushing, trembling, and sweating than social phobics without such fears.     

Assessment of the aftermath of rape: Changing patterns of fear

In order to test a social learning theory model which states that fear and anxiety responses are classically conditioned by a terror-inducing rape experience, 46 recent rape victims and 35 nonvictims matched for age, race, and neighborhood of residence were assessed with the 120-item Modified Fear Survey at four postrape intervals: (1) 6–10 days, (2) 1 month, (3) 3 months, and (4) 6 months. Victims were significantly more fearful than nonvictims, and victim fears declined somewhat over time but remained at high levels at the 6-month postrape period. Content analysis of highly feared situations revealed that most fears were rape related in that they were rape cues, rape-precipitated concerns, and/or cues signaling vulnerability to subsequent attack. Patterns of fear appeared to change such that attack vulnerability cues were most feared.This research was supported by NIMH Grant No. 1 RO1 MH29602 from the National Center for Prevention and Control of Rape.An earlier version of this article was presented at the Twelth Annual Convention of the Association for Advancement of Behavior Therapy, Chicago, November 18, 1978.     

Traits,states, situations,and uncertainty

The shift of paradigm from psychodynamic therapy to behavior modification has changed the views of assessment and challenged traditional broad trait concepts. Behavioral assessment has used narrow, situation-specific trait tests, state self-report tests given in situations, and behavioral observations and performance ratings. Comparison of these types of measures are reported from a study of fear reactions in three situations. Narrow trait measures are generally more predictive of behavior than broad trait measures. State measures are even more predictive when given just before the performance. But only a sampling of such state measures can be used to define a trait because of the lower reliability of states. It is argued that behavior in situations is only predictable when an adequate number of behavioral samples is used.     

Early trauma and narcissism—autism bipolarity1

The analyst makes a series of considerations taken a posteriori from the analysis of a small number of patients. These patients have saved themselves from an early narcissistic catastrophe by developing precocious mental processes, while affective relationships rudimentarily repeat the impact with the original trauma. Primitive defences, essentially denial and vertical splitting, dissociate the tear in the psyche and structure a narcissism–autism bipolarity, revealed in aspects of the character which oblige the patient to automatically repeat a single matrix of experience. In therapy, it is necessary to construct a rst time of the trauma, by pending and linking threads of the primary relationship and strengthening them in the analytic relationship. This reconstruction of the background, a screen to project what had originally been rejected, is the prerequisite for coming out, in deferred action, from the hold of the pathological identifications. The author dedicates particular attention to the undifferentiated background, the nature‐environment torn by the trauma, and to the need to reconstruct this fabric of experience in the analytical relationship, as a fundamental element to the recomposition of the dissociated nuclei. In the clinical case, the analyst describes in particular how the analyst's words encounter an unbridgeable gap, a failure in the capacity for representation when opening the autistic nucleus. Through a regression lasting for about a year, a patient was able to live the experience of primitive agonies and that of an unbearable helplessness and, at the same time, was able to feel how the analyst supported her sense of existence. Subsequently, the patient was able to give shape, through visual images, to deep states of being and start the process of metabolising and symbolising the trauma.     

A predictive model for psychological reactions to crime in Italy: an analysis of fear of crime and concern about crime as a social problem

In this study a model for predicting fear of crime (FC) and concern about crime as a social problem (CC) in Italy has been built, using three sets of independent variables concerning: (a) the sociodemographic and criminal victimization domain; (b) the psychosocial domain; and (c) the mass media. A secondary analysis on data gathered by the Observatory of the North‐West (N = 3262, a mail panel that is representative of the Italian population over 18) has been performed. Results showed that FC and CC are related yet distinct constructs: FC is less widespread than CC, and has different predictors. FC predictors are sociodemographic, psychosocial and, above all, victimization variables; whereas mass media and psychosocial variables predict CC. Results were compared with the literature on the topic. Implications, limitations, and future directions are discussed. Copyright © 2004 John Wiley & Sons, Ltd.     

Is pain-related fear a predictor of somatosensory hypervigilance in chronic low back pain patients?

Pain-related fear has been found to be associated with increased disability and increased pain perception in patients with chronic low back pain. A possible mechanism by which pain-related fear could lead to increased pain perception is heightened attention to somatosensory sensations. In the present study, chronic pain patients reporting either a high or low level of pain related fear and control participants performed an auditory reaction time task, while occasionally non-painful electrical stimuli--accompanied by threatening instructions--were given to the arm or back. In the primary task condition, participants had to perform the auditory task while ignoring the electrical stimuli. Next, the task was presented under dual task conditions in which participants had to respond both to tones as well as to detection of electrical stimuli. It was hypothesized that for the primary task, high fearful patients would show greater disruption of performance on the auditory task than low fearful patients and controls when stimuli were presented to the back. For the dual task, slower reaction times for the auditory task, in combination with faster detection of electrical stimuli was expected. The hypotheses were not confirmed but patients scoring high on pain-related fear did show an overall increase in reaction time for all conditions of the primary task, with or without simultaneous stimulation. Regression analyses demonstrated that high pain-related fear was associated with increased reaction time to tones both in patients and healthy controls, and that within patients pain-related fear was a better predictor of reaction time to tones than present pain intensity. The findings may be interpreted as showing that patients with elevated levels of pain-related fear habitually attend to somatic sensations, giving less priority to other attention-demanding tasks.