The incidence of Freudian self‐analysis in the construction of the psychoanalytic theory of anxiety

The value and function of self‐analysis has been a contentious issue in several studies dedicated to the Freudian legacy. For some writers, Freud's experience of self‐analysis is rightly considered to be the master key to an understanding of the origins of the fundamentals of psychoanalysis. For others, the exaggerated importance attributed to the process merely led to the construction of a foundational myth. Nevertheless, if it is recognized to be a process in which Freud, in collaboration with Fliess, analysed personal aspects, working hypotheses and psychopathological debates, a reconsideration of self‐analysis may contribute new elements to our understanding of the paths that were taken in the elaboration of the theory and practice of pyschoanalysis. Starting from this premise, the present work will consider the systematic examination that Freud conducted of his own phobia in the course of his self‐analysis to be a process of great relevance to the elaboration of the early psychoanlytic conceptualizations of anxiety, in that in the course of this process the possible role of sexuality, fantasy, memory and unconscious determinism in the etiology of anxiety became part of the discussion.     

The effect of psychological stress and expectation on auditory perception: A signal detection analysis

Both psychological stress and predictive signals relating to expected sensory input are believed to influence perception, an influence which, when disrupted, may contribute to the generation of auditory hallucinations. The effect of stress and semantic expectation on auditory perception was therefore examined in healthy participants using an auditory signal detection task requiring the detection of speech from within white noise. Trait anxiety was found to predict the extent to which stress influenced response bias, resulting in more anxious participants adopting a more liberal criterion, and therefore experiencing more false positives, when under stress. While semantic expectation was found to increase sensitivity, its presence also generated a shift in response bias towards reporting a signal, suggesting that the erroneous perception of speech became more likely. These findings provide a potential cognitive mechanism that may explain the impact of stress on hallucination‐proneness, by suggesting that stress has the tendency to alter response bias in highly anxious individuals. These results also provide support for the idea that top‐down processes such as those relating to semantic expectation may contribute to the generation of auditory hallucinations.     

A Probabilistic and Individualized Approach for Predicting Treatment Gains: An Extension and Application to Anxiety Disordered Youth

The objective of this study was to extend the probability of treatment benefit method by adding treatment condition as a stratifying variable, and illustrate this extension of the methodology using the Child and Adolescent Anxiety Multimodal Study data. The probability of treatment benefit method produces a simple and practical way to predict individualized treatment benefit based on pretreatment patient characteristics. Two pretreatment patient characteristics were selected in the production of the probability of treatment benefit charts: baseline anxiety severity, measured by the Pediatric Anxiety Rating Scale, and treatment condition (cognitive-behavioral therapy, sertraline, their combination, and placebo). We produced two charts as exemplars which provide individualized and probabilistic information for treatment response and outcome to treatments for child anxiety. We discuss the implications of the use of the probability of treatment benefit method, particularly with regard to patient-centered outcomes and individualized decision-making in psychology and psychiatry.     

An atypical anxious‐impulsive pattern of social anxiety disorder in an adult clinical population

An atypical subgroup of Social Anxiety Disorder (SAD) with impulsive rather than inhibited traits has recently been reported. The current study examined whether such an atypical subgroup could be identified in a clinical population of 84 adults with SAD. The temperament dimensions harm avoidance and novelty seeking of the Temperament and Character Inventory, and the Liebowitz Social Anxiety Scale were used in cluster analyses. The identified clusters were compared on depressive symptoms, the character dimension self‐directedness, and treatment outcome. Among the six identified clusters, 24% of the sample had atypical characteristics, demonstrating mainly generalized SAD in combination with coexisting traits of inhibition and impulsivity. As additional signs of severity, this group showed low self‐directedness and high levels of depressive symptoms. We also identified a typically inhibited subgroup comprising generalized SAD with high levels of harm avoidance and low levels of novelty seeking, with a similar clinical severity as the atypical subgroup. Thus, higher levels of harm avoidance and social anxiety in combination with higher or lower levels of novelty seeking and low self‐directedness seem to contribute to a more severe clinical picture. Post hoc examination of the treatment outcome in these subgroups showed that only 20 to 30% achieved clinically significant change.     

Social anxiety and depressive symptoms mediate instrumentality and maladaptive interpersonal styles

This study sought to examine the relationships between stereotypically masculine (instrumentality) and feminine (expressiveness) personality traits, social anxiety and depressive symptoms, and three interpersonal styles of relating: destructive overdependence (DO), dysfunctional detachment (DD), and healthy dependence (HD). Based on theories of social anxiety and recent research on social anxiety and close relationships, it is argued that individuals with higher levels of social anxiety would display greater detachment and overdependence in their interpersonal relationships. Students at an Australian university (n = 524) completed a battery of online self-report measures. The findings suggest that low levels of instrumentality are related to social anxiety and depressive symptoms, which both mediate the relationship between instrumentality and the two maladaptive interpersonal styles of relating: DO and DD.     

Positive beliefs about worry: A psychometric evaluation of the Why Worry-II

Positive beliefs about worry are theorized to maintain excessive and uncontrollable worry, the hallmark of generalized anxiety disorder (GAD; American Psychiatric Association, 2013). The Why Worry-II (WW-II) is a 25-item revised questionnaire designed to measure five positive beliefs about worry. These five beliefs are that worry: (1) facilitates problem solving; (2) enhances motivation; (3) protects against negative emotions; (4) prevents negative outcomes; and (5) reflects a positive personality trait. The main goal of this study was to assess the WW-II’s psychometric properties, including its factor structure. Undergraduate participants (N = 309) completed the WW-II, and measures of worry, depression, anxiety, and positive and negative beliefs about worry. Overall, the results suggest that the five-factor model is a good fit to the data. The WW-II demonstrated excellent internal consistency, good test–retest reliability at six weeks, and evidence of convergent and divergent validity. The WW-II also uniquely predicted worry severity. Overall, our findings suggest that the WW-II has a five-factor structure congruent with theoretical predictions, sound psychometric properties, and a unique relationship to excessive worry. The theoretical and clinical implications of these findings are discussed.     

ERNEST BECKER'S PSYCHOLOGY OF RELIGION FORTY YEARS ON: A VIEW FROM SOCIAL COGNITIVE PSYCHOLOGY

This article distinguishes between three projects in Ernest Becker's (1924–1974) later work: his psychology of “religion,” his psychology of religion, and his psychology of Religion (with a capital R). The first is an analysis of culture and civilization as immortality projects, means by which to deny death. The second, which overlaps with the first, is a characterization of religion‐as‐practiced (e.g., by adherents of the world religions) as a particularly effective immortality project vis‐à‐vis death anxiety. The third is less social scientific and more theological; Becker argues for a view of God that is in the tradition of Søren Kierkegaard and Paul Tillich (and, arguably, Pseudo‐Dionysius, Augustine, and Thomas Aquinas). Focusing on the second of these projects—as much has already been written on the first, and little can be said about the third—this article evaluates Becker's claims about religion‐as‐practiced in light of recent developments in social cognitive psychology.     

A SYSTEMS MODEL OF SPIRITUALITY

Within the scientific study of spirituality there are substantial ambiguities and uncertainties about relevant concepts, terms, evidences, methods, and relationships. Different disciplinary approaches reveal or emphasize different aspects of spirituality, such as outcomes, behaviors, skills, ambitions, and beliefs. I argue that these aspects interdepend in a way that constitutes a “systems model of spirituality.” This model enables a more holistic understanding of the nature of spirituality, and suggests a new definition that disambiguates spirituality from related concepts such as religion, cultural sophistication, and prosocial behavior in animals. It also exposes important open questions about the nature of spirituality. To support the emerging scientific approach to the study of spirituality, I propose the development of a “philosophy of spirituality” that can clarify the conceptual terrain, identify important research directions, and facilitate a comprehensive and interdisciplinary investigation into the nature, validity, and implications of spirituality's conceptual and practical entailments.     

焦虑障碍的系统式家庭治疗

焦虑障碍是最常见的心理障碍之一.其具有症状重、病程慢、复发率高、社会功能明显缺损等特点,给个人、家庭和社会造成了巨大的负担.家庭环境因素在焦虑障碍的发病、转归和预后方面都起到重要作用.本文介绍了国内外关于焦虑障碍患者家庭特点和家庭互动模式的研究结果.系统式家庭治疗作为一种家庭治疗模式,具有其独特的治疗理念和方法,国内外研究结果表明系统式家庭治疗用于焦虑障碍具有良好疗效.今后,还应该运用更加多元化的研究方法探讨中国焦虑症家庭动力学特点和家庭功能,并采用更加严格的随机对照设计,进一步证实系统式家庭治疗对焦虑障碍的治疗效果.