惊反射在创伤后应激障碍研究中的应用:高唤醒与恐惧抑制

创伤后应激障碍(PTSD)是唯一在诊断标准中包含惊反射改变的精神疾病.相比自我报告法,对惊反射的实验室测量与总体症状关联更紧密,并已积累了较多神经机制研究成果,可作为连接前临床与临床研究的桥梁.在惊反射应用于PTSD研究的初期,它主要作为PTSD患者高唤醒症状的客观指标,但是尚未发现惊反射强度的变化与总体症状的明确关系.近年来,惊反射与情境性焦虑、恐惧抑制等新范式结合,发现特定情境下惊反射改变是PTSD患者特有的表现.惊反射在创伤应激障碍研究中所取得的新进展对PTSD病理机制的探索和临床诊断都有所启发和推进.     

The three latent classes of adolescent delinquency and the risk factors for membership in each class

This study used latent class analysis to examine subpopulation membership based on self-reports of delinquent behaviors obtained from Australian youth. Three discrete identifiable classes were derived based on 51 indicators of physical violence, property damage, minor infractions, drug use, and social delinquency. One class of youth engaged in primarily rule breaking and norm violations including underage alcohol use, typical of this age period. A second class was more actively delinquent emphasizing drug use, trespassing, and various forms of disobedience. A third class of highly delinquent youth differed from their counterparts by endorsing drug use, thievery that involved stealing money, goods, and cars, property damage, gambling, precocious sexual experiences, involvement with pornographic materials, and fighting. Multinomial logistic regression predicting class membership indicated highly delinquent youth were more likely to be older males, use venting coping strategies, and be fun or novelty seeking compared with rule breakers. Findings are discussed in terms of refining current taxonomic arguments regarding the structure of delinquency and implications for prevention of early-stage antisocial behavior.     

Gender Role Traits Among Individuals with Social Anxiety Disorder

The present study investigated differences between individuals with and without social anxiety disorder (SAD) in instrumentality and expressiveness, personality traits traditionally linked to the male and female gender roles, respectively. Based on evolutionary and self-discrepancy theories, it was hypothesized that individuals with SAD would score lower on instrumentality and report a discrepancy between their perceived and ideal level of instrumentality compared to control participants. Sixty-four patients with SAD and 31 non-anxious control participants completed a battery of questionnaires, including ratings of their perceived and ideal gender role attributes and current psychosocial distress. Results supported the hypotheses, and provided initial evidence that a discrepancy between perceived and ideal instrumentality may be linked to social anxiety severity, depression and lower quality of life. No differences were detected between groups in expressiveness. The present findings suggest that individuals with SAD perceive themselves to be deficient in instrumentality. They also suggest that increasing instrumentality among individuals with SAD may be beneficial for treatment.     

Initial validation of a measure of self-efficacy in romantic relationships

This study examines the psychometric properties of a self-report measure of self-efficacy in romantic relationships (SERR). Analyses (with 775 undergraduates) indicated a coherent factor structure representing broad beliefs about task demands in romantic relationships and abilities to meet such demands. SERR scores predict relationship anxiety and expectations of relationship success when demographic characteristics, current romantic relationship status, general self-efficacy, and social self-efficacy are considered. The SERR assesses broad feelings of relationship self-efficacy, independent of specific relationships or partners, important for understanding individual-level relationship expectations, behaviors, and interventions.     

Specific and differential prediction of health anxiety by disgust sensitivity and propensity

Current models of health anxiety suggest that fear resulting from false alarms to perceived threats to one's health results in the development of hypochondriasis and related disorders. Disgust has been proposed as an affective response that may function as an etiological and maintenance mechanism in health anxiety. Moreover, the way in which an individual perceives the disgust response (disgust sensitivity) may affect health anxiety, separately from their likelihood of experiencing disgust (disgust propensity). The present study utilized multiple hierarchical regression analysis to investigate the degree to which self-reported disgust sensitivity and disgust propensity differentially predict elevated health anxiety in a sample of 620 non-treatment-seeking undergraduates. Further, this effect is tested in comparison to that of anxiety sensitivity, a construct demonstrated to be strongly related to health anxiety. Analyses indicate that disgust sensitivity, rather than disgust propensity, is primarily responsible for this relation. An additional analysis tested the specificity of disgust sensitivity relative to anxiety sensitivity. Disgust sensitivity was no longer significant after including anxiety sensitivity in the model. Suggestions for further evaluation of this relation are provided. These results suggest that although disgust sensitivity may appear related to health anxiety, this relation may be confounded by anxiety sensitivity.     

Negative cognitive style and looming cognitive style synergistically predict stress generation

There is a growing body of evidence that suggests that cognitive vulnerabilities to depression or anxiety may lead individuals to generate negative interpersonal life events. However, there has been no study to date that examines the effects of co-occurring vulnerabilities to depression and anxiety. In a sample of 304 participants, we examined the potential interaction of co-occurring negative cognitive style, a vulnerability to depression and looming cognitive style, vulnerability to anxiety. Results indicate that co-occurring cognitive vulnerabilities synergistically predict higher levels of negative interpersonal life events six weeks later, even when controlling for initial levels of stressful life events and symptoms of depression and anxiety. Thus, co-occurring vulnerabilities may have stronger stress generating effects than would be expected from the additive effects of each vulnerability considered separately. This finding highlights the importance of examining cognitive vulnerabilities as interactive effects rather than as individual vulnerabilities.     

A model-based cluster analysis of social experiences in clinically anxious youth: links to emotional functioning

Social difficulties are commonly associated with anxiety disorders in youth, yet are not well specified in the literature. The aim of this study was to identify patterns of social experiences in clinically anxious children and examine the associations with indices of emotional functioning. A model-based cluster analysis was conducted on parent-, teacher-, and child-reports of social experiences with 64 children, ages 7–12 years (M = 8.86 years, SD = 1.59 years; 60.3% boys; 85.7% Caucasian) with a primary diagnosis of separation anxiety disorder, social phobia, and/or generalized anxiety disorder. Follow-up analyses examined cluster differences on indices of emotional functioning. Findings yielded three clusters of social experiences that were unrelated to diagnosis: (1) Unaware Children (elevated scores on parent- and teacher-reports of social difficulties but relatively low scores on child-reports, n = 12), (2) Average Functioning (relatively average scores across all informants, n = 44), and (3) Victimized and Lonely (elevated child-reports of overt and relational victimization and loneliness and relatively low scores on parent- and teacher-reports of social difficulties, n = 8). Youth in the Unaware Children cluster were rated as more emotionally dysregulated by teachers and had a greater number of diagnoses than youth in the Average Functioning group. In contrast, the Victimized and Lonely group self-reported greater frequency of negative affect and reluctance to share emotional experiences than the Average Functioning cluster. Overall, this study demonstrates that social maladjustment in clinically anxious children can manifest in a variety of ways and assessment should include multiple informants and methods.     

College students' search for sexual health information from their best friends: An application of the theory of motivated information management

Guided by the theory of motivated information management, this study investigated the extent to which Singaporean college students' sexual health information‐seeking behaviour could be accounted for by their anxiety of uncertainty discrepancy, their perceived outcomes of information seeking and their perceived confidence in seeking and coping with sexual health information acquired from their best friends. Taking into account that issue relevance may play a role in individuals' health decision‐making, this study also examined the effect of perceived vulnerability on respondents' sexual health information‐seeking behaviour. An online survey was conducted with 202 undergraduate students at a university in Singapore. Respondents were asked to report the frequency with which they sought four types of sexual health information from their best friends: unwanted pregnancy, abortion, HIV/AIDS and other sexually transmitted infections. Survey data showed that respondents' uncertainty discrepancy was positively associated with their anxiety. Anxiety had negative effects on efficacy and outcome expectancy. Outcome expectancy was positively associated with efficacy. Both efficacy and perceived vulnerability accounted for a significant amount of variance in respondents' sexual health information‐seeking behaviour. Findings from this study contribute to a better understanding of young adults' sexual health information behaviour in a Singapore context.     

Digital Mental Health Interventions for Child and Adolescent Anxiety

Anxiety disorders are the most common mental health conditions in children, with approximately 13% of kids struggling with excessive anxiety. The vast majority do not have access to effective treatments and there continues to be a disjunction between treatments that are empirically supported and those that are available in the community. Digital mental health interventions (DMHI) can increase efficiency, reach, and standardization as well as reduce costs of providing of mental health care. Here we review the extant research on DMHI, including web- or cloud-based programs, mobile applications (apps), virtual reality (VR), and digital assessment methods such as ecological momentary assessment (EMA) for the delivery and/or support of evidence-based care in child anxiety. Preliminary research is promising for these tools to improve access and efficiency of evidence-based practice. However, ethics and practice guidelines are needed and questions remain regarding what level and quality of therapeutic involvement is needed to maximize treatment completion and outcomes in youth and whether DMHIs are contraindicated for certain populations or whether they are similarly effective with those with comorbid conditions is unclear.     

Culturally Attuned Behavior Therapy for Anxiety and Depression in Asian Americans: Addressing Racial Microaggressions and Deconstructing the Model Minority Myth

Extant research has shown that racial discrimination and microaggressions can have negative effects on anxiety and depression among Asian Americans. However, not much has been published regarding how to process and integrate experiences of racism into culturally attuned behavior therapy specifically for Asian Americans. In this article, I describe the process of culturally attuned behavior therapy for two Asian American clients, with an emphasis on integrating racial microaggressions into exposures for social anxiety, and deconstructing the model minority stereotype through value-driven behavioral activation for depression. Cultural attunements common to both case examples are then summarized, alongside practical recommendations for clinicians. Limits to generalizability are also discussed. Finally, the article closes by addressing the importance of cultural humility in effective culturally attuned behavior therapy with Asian Americans.