Predicting state anxiety: A comparison of multidimensional and unidimensional trait approaches

Endler has proposed that trait anxiety is multidimensional, with individual differences varying across several dimensions of stressing situations. Despite empirical support for the independence of some dimensions, some researchers have employed a single score on a multidimensional measure of trait anxiety, summed from the dimension scale scores, as a singular measure of generalized trait anxiety. This violates the theoretical underpinnings of the approach. This study examined whether a total score on a multidimensional measure of trait anxiety could supplement the ability of individual dimension scale scores in predicting state anxiety responses to dimension-congruent stress. Thirty-two female college students who scored at differing levels of dimensional and general anxiety were required to perform two laboratory stress tasks under conditions of stress representing different dimensions of trait anxiety. The results provide support for a multidimensional approach to general trait anxiety but indicate some value of a total score in supplementing predictions based on individual scale scores. The data provide a cautionary note that a total score on a multidimensional measure is of little value unless full consideration is given to the profile of dimension scale scores.     

Evaluation of a parent's manual for training enuretic children

An operant method of training enuretic children had previously been evaluated by direct training of the child and parent. A manual describing the method was used by 13 parents in the present study with no professional assistance. Bedwetting was reduced from its pre-treatment level of 68% of the nights to 27% during the first week. 10% during the third month and 7% the sixth month. These results closely approximated those obtained previously with direct training.     

Acceptability bias: The effects of treatment acceptability on visual analysis of graphed data

Vignettes depicting a mildly or severely self-abusive child with profound mental retardation who received either a differential reinforcement of other behavior or a contingent electric shock treatment were presented to 161 undergraduates. After subjects rated the acceptability of the given treatment on the Treatment Evaluation Inventory (TEI), they evaluated the efficacy of the given treatment based upon six AB data graphs. Visual analytic judgments were not significantly effected by type of treatment, severity of self-injurious behavior (SIB), or the treatment × SIB interaction. TEI scores differed significantly according to type of treatment. Simple and multiple correlations computed between TEI scores and graph evaluations provided evidence ofacceptability bias, such that more favorable appraisals of treatment acceptability were related to perceptions of greater treatment effectiveness.     

Effective—and Tolerable: Acceptance and Side Effects of Intensified Exposure for Anxiety Disorders

Despite striking empirical support, exposure-based treatments for anxiety disorders are underutilized. This is partially due to clinicians’ concerns that patients may reject exposure or experience severe side effects, particularly in intensive forms of exposure. We examined acceptance and side effects of two randomly assigned variants of prediction error-based exposure treatment differing in temporal density (1 vs. 3 sessions/week) in 681 patients with panic disorder, agoraphobia, social anxiety disorder, and multiple specific phobias. Treatment acceptance included treatment satisfaction and credibility, engagement (i.e., homework completion), and tolerability (i.e., side effects, dropout, and perceived treatment burden). Side effects were measured with the Inventory for the Balanced Assessment of Negative Effects of Psychotherapy (INEP). We found treatment satisfaction, credibility, and engagement to be equally high in both variants of exposure-based treatment, despite higher treatment burden (β = 0.25) and stronger side effects (β = 0.15) in intensified treatment. 94.1% of patients reported positive effects in the INEP. 42.2% reported side effects, with treatment stigma (16.6%), low mood (14.8%) and the experience to depend on the therapist (10.9%) being the most frequently reported. The mean intensity of side effects was low. We conclude that prediction error-based exposure treatment is well accepted by patients with different anxiety disorders and that patients also tolerate temporally intensified treatment, despite higher perceived treatment burden and stronger side effects. Clinicians should be aware of the most frequent side effects to take appropriate countermeasures. In sum, temporal intensification appears to be an acceptable strategy to achieve faster symptom reduction, given patients’ well-informed consent.     

Predictors of changes in child behaviour following parent management training: Child,context, and therapy factors

This non‐randomised study examined a set of predictive factors of changes in child behaviour following parent management training (PMTO). Families of 331 Norwegian girls (26%) and boys with clinic‐level conduct problems participated. The children ranged in age from 3 to 12 years (M_age = 8.69). Retention rate was 72.2% at post‐assessment. Child‐, parent‐ and therapy‐level variables were entered as predictors of multi‐informant reported change in externalising behaviour and social skills. Behavioural improvements following PMTO amounted to 1 standard deviation on parent rated and ½ standard deviation on teacher rated externalising behaviour, while social skills improvements were more modest. Results suggested that children with higher symptom scores and lower social skills score at pre‐treatment were more likely to show improvements in these areas. According to both parent‐ and teacher‐ratings, girls tended to show greater improvements in externalising behaviour and social skills following treatment and, according to parents, ADHD symptomology appeared to inhibit improvements in social skills. Finally, observed increases in parental skill encouragement, therapists' satisfaction with treatment and the number of hours spent in therapy by children were also positive and significant predictors of child outcomes.     

Resistance to Violence Prevention Interventions in Schools: Barriers and Solutions

Studies of the prevalence and impact of aggression among school-age children and adolescents document the pervasiveness of bully-victim problems and indicate clear linkages between bully-victim problems, psychological distress, and, in rare instances, lethal attacks on perceived tormentors or towards the self. Evidence is slowly accumulating to show how well-conceived school-based strategies can be effective in addressing bully-victim problems—if implemented and sustained. However, anecdotal evidence suggests many comprehensive school-based initiatives suffer from incomplete implementation, resulting in limited effectiveness. We propose that multiple factors nested within different levels of social ecological complexity (e.g., individual, school, community, and culture) limit the widespread use of schoolwide approaches to reducing bully–victim–bystander problems. Challenges arise at each of these levels and can potentially thwart efforts to produce meaningful changes in the problems of peer victimization in and around school. Drawing from efforts to implement and evaluate bully–victim–bystander programs, we describe a core set of potential barriers at each ecological level and offer possible strategies for action.     

Comorbid anxiety and mood disorders among persons with social anxiety disorder.

Axis I comorbidity is associated with greater severity of social anxiety disorder. However, the differential effects of comorbid mood and anxiety disorders on symptom severity or treatment outcome have not been investigated. We evaluated 69 persons with uncomplicated social anxiety disorder, 39 persons with an additional anxiety disorder, and 33 persons with an additional mood disorder (with or without additional anxiety disorders). Those with comorbid mood disorders reported greater duration of social anxiety than those with uncomplicated social anxiety disorder. They were also judged, before and after 12 weeks of cognitive-behavioral group treatment and at follow-up, to be more severely impaired than those with no comorbid diagnosis. In contrast, persons with comorbid anxiety disorders were rated as more impaired than those with no comorbid diagnosis on only a single measure. Type of comorbid diagnosis did not result in differential rates of improvement of social anxiety disorder.     

Validation and predictive utility of the Sociocultural Attitudes Toward Appearance Questionnaire for Eating Disorders (SATAQ-ED): internalization of sociocultural ideals predicts weight gain

A widely used measure of societal influences on body image and eating disturbances—the Sociocultural Attitudes Toward Appearance Questionnaire (SATAQ) was validated in women with eating disorders. The original SATAQ and measures of convergence and divergence were administered to 165 eating disordered inpatients. Factor analyses were conducted to determine the underlying structure of the SATAQ. Convergent validity, diagnostic category norms and the predictive utility of the revised SATAQ were examined. Factor analyses indicated three factors: Internalization, Awareness, and Success. Internalization significantly predicted treatment success after controlling for admission BMI and drive for thinness. The revised SATAQ-ED measures multiple aspects of societal influence, predicts short-term outcome, and can be a useful tool for evaluating potential outcome and treatment efficacy.