Psychopathology in anxiety disorders

Complaints of anxiety, often meetingDiagnostic and Statistical Manual of Mental Disorders, 3rd ed. (DSM-III), criteria for anxiety disorder, are among the most common problems presenting to health practitioners. In spite of the frequency of anxiety and anxiety disorders, little is known about the basic psychopathology of these conditions that would lead to the development of more efficient and effective treatments and possible preventive efforts. Recently, there has been an increase in research on the psychopathology of anxiety disorders from biological, psychological, and social perspectives. The National Institute of Mental Health's Clinical Research Branch sponsored a 2-day workshop of investigators representing diverse research approaches to discuss emerging issues and research practices within the anxiety disorders. Discussions centered on a review of the general areas of classification, phenomenology, and etiology. A selective summary of this workshop is presented along with recommendations for specific research directions.     

Conceptual,methodological, and clinical issues in the assessment of anxiety disorders

Many conceptual, methodological, and clinical issues remain unresolved in the assessment of anxiety disorders. Despite the prevalence, incidence, chronicity, and severity of anxiety disorders, research efforts and funding have fallen behind with regard both to other disorders and to addressing critical issues in the field. The primary objective of this paper is to provide a scientific critique regarding a number of often ignored yet salient considerations in anxiety-disorders assessment. Critical analyses of and recommendations regarding the multidimensional nature of anxiety, comorbidity, uniformity myths, synchrony, normative comparisons, psychometric properties of measures, and treatment integrity are offered. Finally, promising areas of clinical research are presented to enhance further the current understanding of the complexities inherent in assessing anxiety disorders.Preparation of this paper was supported in part by NIMH Grant MH36299.     

The importance of assessing treatment integrity: An example in the anxiety disorders

One purpose of this investigation was to examine the importance of assessing treatment integrity in a study evaluating a treatment for specific anxiety disorders. Three subjects, two social phobics and one simple phobic, received self-instruction training (Phase I) followed by exposure and self-instruction training (Phase II) in a multiple baseline across subjects design. All subjects were assessed during a pretreatment baseline and throughout treatment using measures of treatment integrity and measures of change in phobic severity. Improvement took place at different times for different subjects. Measures of treatment integrity, which consisted of monitoring of self-statements as well as practice outside the session, indicated that treatment was not always received as intended and that improvement was correlated with practice. The usefulness of measures of treatment integrity in both clinical and research settings is highlighted.     

Food anticipation and lever-directed activities in rats

Three experiments are described which elaborate some of the conditions under which rats will contact and manipulate a periodically presented retractable lever. Experiment 1 demonstrated that (i) initial manipulative oral and manual contact with the lever was facilitated if the rat had previous experience of food delivery in the experimental chamber; (ii) persistence in contacting the lever on successive presentations was a function of whether food continued to be presented in the experimental environment; and (iii) food satiation significantly reduced the tendency of the rat to contact the lever even though an expectancy of food had previously been established under conditions of food deprivation. Experiment 2 suggested that the tendency to approach and contact the lever was in part a function of the local moment-to-moment conditional probability of food delivery. Experiment 3 found that the probability of contacting the lever was higher during presentation of an auditory CS signaling a high rate of food delivery than during stimuli signaling no food at all. These results are interpreted as suggesting that the food-signaling aspects of an appetitive CS and that CS's ability to generate signal-directed behaviors are experimentall separable properties.     

Message from the Ecumenical Youth Gathering

This is the message of the Ecumenical Youth Gathering held in advance of the 11th Assembly of the World Council of Churches, which met in Karlsruhe, Germany, in August–September 2022. In their message, the youth voiced a series of laments, and recognized and prayed for justice, forgiveness, and reconciliation of the wounds the church has inflicted and continues to inflict in the world, and they called on the WCC to provide a meaningful space for an equal representation of young people in all its processes.     

What analytic metaphysics can do for scientific metaphysics

The apparent chasm between two camps in metaphysics, analytic metaphysics and scientific metaphysics, is well recognized. I argue that the relationship between them is not necessarily a rivalry; a division of labour that resembles the relationship between pure mathematics and science is possible. As a case study, I look into the metaphysical underdetermination argument for ontic structural realism, a well-known position in scientific metaphysics, together with an argument for the position in analytic metaphysics known as ontological nihilism. I argue that we can ascribe the same schema to both arguments, which indicates that analytic metaphysics can offer an abstract model that scientific metaphysics may find useful.     

Centering culture in the treatment of opioid use disorder with American Indian and Alaska Native Communities: Contributions from a National Collaborative Board

American Indian/Alaska Native (AI/AN) communities are disproportionally impacted by the opioid overdose epidemic. There remains a dearth of research evaluating methods for effectively implementing treatments for opioid use disorder (OUD) within these communities. We describe proceedings from a 2-day Collaborative Board (CB) meeting tasked with developing an implementation intervention for AI/AN clinical programs to improve the delivery of medications to treat OUD (MOUD). The CB was comprised of Elders, cultural leaders, providers, individuals with lived experience with OUD, and researchers from over 25 communities, organizations, and academic institutions. Conversations were audio-recorded, transcribed, and coded by two academic researchers with interpretation oversight provided by the CB. These proceedings provided a foundation for ongoing CB work and a frame for developing the program-level implementation intervention using a strength-based and holistic model of OUD recovery and wellbeing. Topics of discussion posed to the CB included engagement and recovery strategies, integration of extended family traditions, and addressing stigma and building trust with providers and clients. Integration of traditional healing practices, ceremonies, and other cultural practices was recommended. The importance of centering AI/AN culture and involving family were highlighted as priorities for the intervention.     

Examining awareness of privilege among midwestern college students: An analysis of race/ethnicity,gender, and religion

Dominant group members often are not aware of the privileges they benefit from due to their dominant group membership. Yet individuals are members of multiple groups and may simultaneously occupy multiple categories of dominance and marginality, raising the question of how different group memberships work in concert to facilitate or inhibit awareness of multiple forms of privilege. Examining awareness of privilege is important as awareness may be linked to action to dismantle systems of privilege that maintain oppression and inequality. Grounded in intersectional scholarship, in this study we examined how occupying intersecting categories of race/ethnicity, gender, and religion corresponded to an awareness of White, male, and Christian privilege. In a sample of 2321 Midwestern college students, we demonstrated that students from marginalized groups broadly reported greater awareness of all forms of privilege than students from dominant groups, and the difference between marginalized and dominant groups was most pronounced when the specific group category (e.g., gender) aligned with the type of privilege (e.g., male privilege). We also tested interactions among race/ethnicity, gender, and religion, only finding an interaction between race/ethnicity and religion for awareness of White and male privilege. These findings helped to clarify that multiple group memberships tended to contribute to awareness as multiple main effects rather than as multiplicative. Finally, we examined mean differences among the eight intersected groups to explore similarities and differences among groups in awareness of all types of privilege. Taken together, these findings quantitatively demonstrate the ways in which group memberships work together to contribute to awareness of multiple forms of privilege. We discuss study limitations and implications for community psychology research and practice.     

The Intergenerational Transmission of Party Preferences in Multiparty Contexts: Examining Parental Socialization Processes in the Netherlands

Research shows that parents have a strong influence on the party preferences of their children. Yet little is known about how such preferences are transmitted in multiparty systems with weak party identification and high electoral volatility. We propose a model of intergenerational transmission that includes both direct effects of parents' party preferences on those of their children, as well as indirect effects through left–right and issue positions. We test this model with original survey data of Dutch adolescents (14–20 years old) and their parents (N = 751 adolescent-parent pairs). We find two paths through which parents exert influence on the party preferences of their adolescent children. On the first path, parental party preferences function as a direct predictor of adolescent party preferences. On the second path, adolescent left–right and issue positions function as a mediator between parental left–right and issue positions and adolescent party preferences, with the effect of left–right positions being stronger than that of issue positions. The frequency with which adolescents discuss political topics with their parents moderates these effects.