Beliefs in personality disorders: a test with the personality disorder belief questionnaire

The hypothesis that each personality disorder (PD) is characterized by a specific set of beliefs was tested in a sample of 643 subjects, including non-patient controls, axis-I and axis-II patients, diagnosed with SCID-I and -II interviews. Beliefs of six PDs (avoidant, dependent, obsessive-compulsive, paranoid, histrionic, borderline) were assessed with the Personality Disorder Belief Questionnaire (PDBQ). Factor analyses supported the existence of six hypothesized sets of beliefs. Structural equation modeling (SEM) supported the hypothesis that each PD is characterized by a specific set of beliefs. Path coefficients were however in the medium range, suggesting that PDs are not solely determined by beliefs. Nevertheless, empirically derived cutoff scores of the six belief subscales were reasonably successful in classifying subjects, percentages ranging form 51% to 83%. It appeared that there was a monotonical increase in scores on each belief subscale from non-patient controls, to patients without any PD, to patients with PDs (other than the pertinent PD), to patients with the pertinent PD. This suggests that PD-related beliefs are at least partly associated with (personality) psychopathology in general. Another explanation is that many patients' position on the underlying dimensions is not high enough to lead to a DSM PD diagnosis, but high enough to lead to an elevated belief score.     

Psychological reactions in Icelandic earthquake survivors

The aim of this study was to explore the psychological consequences of two earthquakes in Iceland in two probability samples of subjects--residents in the exposed area and a control group from an unexposed area. The sample was composed of 52 adults exposed to the earthquakes and 29 adults in a control group. Three months after the earthquakes, both groups were approached with questions from a survey consisting of the Harvard Trauma Questionnaire (HTQ), the Trauma Symptom Checklist (TSC), the Coping Styles Questionnaire (CSQ), the World Assumption Scale (WAS), and the Crisis Support Scale (CSS). The results revealed that 24% in the exposed group had Posttraumatic Stress Disorder (PTSD), and none in the control group had PTSD. Earthquake-related anxiety, inability to express one's thoughts and feelings, and emotional coping predicted 81% of the HTQ variance for both groups. Previous life events, low self-worth, and luck attributions, together with numbing and the feeling of being let down, predicted 56% of the symptom variance for both groups. When degree of traumatization and emotional coping were added to the model, another 30% of the variance could be explained.     

Measuring "negative body image": validation of the Body Image Disturbance Questionnaire in a nonclinical population

Despite numerous measures of facets of the body image construct, no single assessment broadly measures a continuum of body image disturbance. Accordingly, this study developed the Body Image Disturbance Questionnaire (BIDQ), derived from the Body Dysmorphic Disorder Questionnaire. Participants were 220 college women and 75 college men who completed an online survey containing this new assessment and established measures of body image and psychosocial functioning. Results confirmed that the Body Image Disturbance Questionnaire was internally consistent and free of impression-management response bias. For both sexes, the measure converged appropriately with other body image indices (evaluation, affect, investment, and impact), was positively correlated with depression, social anxiety, and eating disturbance. Scores on this assessment also predicted psychosocial functioning above and beyond body dissatisfaction as a predictor. Greater body image disturbance was observed among women than men, among heavier than lighter women, and among White than African American women. Limitations and future research implications are discussed.     

The relationship between disgust sensitivity, anxiety and obsessions

Three hundred participants, including volunteers from an obsessional support group, filled in questionnaires relating to disgust sensitivity, health anxiety, anxiety, fear of death, fear of contamination and obsessionality as part of an investigation into the involvement of disgust sensitivity in types of obsessions. Overall, the data supported the hypothesis that a relationship does exist between disgust sensitivity and the targeted variables. A significant predictive relationship was found between disgust sensitivity and total scores on the obsessive compulsive inventory (OCI; Psychological Assessment 10 (1998) 206) for both frequency and distress of symptomatology. Disgust sensitivity scores were significantly related to health anxiety scores and general anxiety scores and to all the obsessional subscales, with the exception of hoarding. Additionally, multiple regression analyses revealed that disgust sensitivity may be more specifically related to washing compulsions: frequency of washing behaviour was best predicted by disgust sensitivity scores. Washing distress scores were best predicted by health anxiety scores, though disgust sensitivity entered in the second model. It is suggested that further research on the relationship between disgust sensitivity and obsessionality could be helpful in refining the theoretical understanding of obsessions.     

Confirmatory factor analysis of the Penn State Worry Questionnaire: Multiple factors or method effects?

The latent structure of the Penn State Worry Questionnaire (PSWQ) was evaluated with confirmatory factor analyses (CFAs) in 1200 outpatients with DSM-IV anxiety and mood disorders. Of particular interest was the comparative fit and interpretability of a two-factor solution (cf. Behaviour Research and Therapy 40 (2002) 313) vs. a one-factor model that specified method effects arising from five reverse-worded items. Consistent with prediction, the superiority of the one-factor model was demonstrated in split-sample CFA replications (ns=600). Multiple-group CFAs indicated that the measurement properties of the PSWQ were invariant in male and female patients. In addition to their direct relevance to the psychometrics of the PSWQ, the results are discussed in regard to methodological considerations for using factor analytic methods in the evaluation of psychological tests.     

Cognitive behaviour therapy of acute stress disorder: a four-year follow-up

The aim of this study was to index the long-term benefits of early provision of cognitive behavior therapy to trauma survivors with acute stress disorder. Civilian trauma survivors (n = 80) with acute stress disorder were randomly allocated to either cognitive behavior therapy (CBT) or supportive counseling (SC) - 69 completed treatment, and 41 were assessed four years post-treatment for post-traumatic stress disorder (PTSD) with the Clinician Administered PTSD Scale. Two CBT patients (8%) and four SC patients (25%) met PTSD criteria at four-year follow-up. Patients who received CBT reported less intense PTSD symptoms, and particularly less frequent and less avoidance symptoms, than patients who received SC. These findings suggest that early provision of CBT in the initial month after trauma has long-term benefits for people who are at risk of developing PTSD.     

Anxiety and selective attention in obsessive-compulsive disorder

Recently, there has been increasing evidence for information-processing deficits in individuals with obsessive-compulsive disorder (OCD). While impairments in selective attention have been identified to be central to the symptomatology of OCD, the role that situational anxiety plays in attentional processes has not been fully explored. Previous research findings were limited to tasks containing anxiety-relevant materials, only permitting for the evaluation of the impact of anxiety on simultaneous cognitive processing. Furthermore, it has not yet been determined whether the impact of anxiety is limited to selective attention or is indicative of a more general cognitive impairment. This study was designed to examine the role that situational anxiety plays in selective attention impairments. OCD participants and controls were presented with an anxiety producing statement and a neutral statement, followed by the Stroop Task. Results indicated that situational anxiety plays a significant role in the performance of tasks that require selective attention in OCD. A significant deterioration was detected in performance on selective attention tasks for the OCD participants after confronting anxiety-provoking scenarios, as compared to neutral scenarios. Anxiety did not impair performance on simple reading tasks. Possible explanations are discussed.     

Treatment of pharmacotherapy-refractory posttraumatic stress disorder among Cambodian refugees: a pilot study of combination treatment with cognitive-behavior therapy vs sertraline alone

Cambodian refugees with posttraumatic stress disorder (PTSD) represent a cohort in severe need of treatment, but little information is available to guide treatment choices. We selected a sample of pharmacotherapy-refractory individuals to test the efficacy of combination treatment with sertraline and cognitive-behavior therapy (CBT) for treating PTSD. Participants in this pilot study were ten Khmer-speaking women who had been at a mean age of 22-26 years during the Pol Pot period (1975-1979). These patients were randomly assigned to either sertraline alone or combined treatment. We found that combined treatment offered additional benefit in the range of medium to large effect sizes for PTSD and associated symptoms. Our findings indicate that substantial gains can be achieved by adding CBT to pharmacotherapy for PTSD, and that a program of CBT emphasizing information, exposure, and cognitive-restructuring can be successfully modified for Khmer-speaking refugees.     

The Meta-Cognitive Beliefs Questionnaire: development of a measure of obsessional beliefs

A 67 item self-report questionnaire called the Meta-Cognitive Beliefs Questionnaire (MCBQ) was developed to assess endorsement of beliefs about the importance of control and negative consequences associated with unwanted, ego-dystonic intrusive thoughts, images and impulses. The MCBQ and a battery of questionnaires that assessed symptoms and cognitions of worry, obsessive-compulsive disorder, anxiety, and depression were administered to large samples of undergraduate students. Beliefs about control of intrusive thoughts and perceived negative consequences due to uncontrolled mental intrusions had a unique significant relationship with obsessions, and to a lesser extent, worry. These findings are consistent with current cognitive behavioral theories that suggest an important role for meta-cognitive beliefs in the pathogenesis of obsessions.     

Anger-associated panic attacks in Cambodian refugees with PTSD; a multiple baseline examination of clinical data

Despite the increasing recognition of the importance of anger as a key aspect of post-traumatic stress disorder (PTSD), the presence of anger-induced panic attacks has been understudied in traumatized groups. The present investigation determines the prevalence of anger-associated panic attacks among Cambodian refugees suffering from PTSD. Specific characteristics of these episodes that were examined included frequency, symptoms, and cognitions (in particular, fear of death from bodily dysfunction). In a survey of 100 Khmer patients suffering PTSD, 58% reported anger-associated panic attacks in the last month. These attacks occurred at a mean rate of 6.2 attacks a month and were characterized by extreme arousal and in 81% of these cases, fears of death due to bodily dysfunction during the anger-induced panic. Mechanisms for this high rate of fear of death during anger arousal are discussed with a focus on culture-specific catastrophic cognitions.