Pain anxiety among chronic pain patients: specific phobia or manifestation of anxiety sensitivity?

Rather than viewing anxiety among chronic pain patients as simply a component of negative affectivity, investigators have developed a model of "pain anxiety" in which patients develop fear and avoidance of activity linked to pain. We examined whether pain anxiety can be conceptualized as a specific phobia, or whether evidence supported the notion that pain anxiety is better understood as a manifestation of anxiety sensitivity in the context of chronic pain. Chronic musculoskeletal pain patients (N=70) underwent cold pressor and mental arithmetic tasks while cardiovascular, self-report, and behavior indexes were recorded. They completed measures of pain anxiety, anxiety sensitivity, fear of negative evaluation, depression and trait anxiety. Correlation analyses showed pain anxiety was related to pain-relevant responses during cold pressor, but it was also related to evaluation-relevant responses during cold pressor, and to pain- and evaluation-relevant responses (including subtraction accuracy) during mental arithmetic. Regression analyses showed that almost all effects of pain anxiety on task responses were accounted for by anxiety sensitivity. Fear of negative evaluation, in contrast, correlated only with evaluation-relevant responses, and mostly during mental arithmetic. These effects remained significant when depression, trait anxiety, or anxiety sensitivity were statistically controlled. Pain anxiety may be an expression of anxiety sensitivity rather than a circumscribed phobia; a distinction that could profitably guide treatment strategies.     

Model comparison of nonlinear structural equation models with fixed covariates

Recently, it has been recognized that the commonly used linear structural equation model is inadequate to deal with some complicated substantive theory. A new nonlinear structural equation model with fixed covariates is proposed in this article. A procedure, which utilizes the powerful path sampling for computing the Bayes factor, is developed for model comparison. In the implementation, the required random observations are simulated via a hybrid algorithm that combines the Gibbs sampler and the Metropolis-Hastings algorithm. It is shown that the proposed procedure is efficient and flexible; and it produces Bayesian estimates of the parameters, latent variables, and their highest posterior density intervals as by-products. Empirical performances of the proposed procedure such as sensitivity to prior inputs are illustrated by a simulation study and a real example.This research is fully supported by a grant from the Research Grant Council of the Hong Kong Special Administrative Region, China (Project No. CUHK 4346/01H). The authors are thankful to the Editor, the Associate Editor, and anonymous reviewers for valuable comments which improve the paper significantly, and grateful to ICPSR and the relevant funding agency for allowing use of the data in the example. The assistance of Michael K.H. Leung and Esther L.S. Tam is gratefully acknowledged.     

The Relation Between Coordinated Interpersonal Timing and Maternal Sensitivity in Four-Month-Old Infants

The relation between mother–infant coordinated interpersonal timing, an automated microanalytic measure of dyadic vocal coordination, and maternal sensitivity was explored. Thirty-five mothers and their developmentally normal 4-month-old infants were audio-recorded during a 20-min laboratory vocal interaction session, that was later analyzed for degree of vocal coordination. Maternal Sensitivity ratings (Ainsworth & Bell, 1969) were based on a video-taped 45-min unstructured laboratory interaction period. A significant curvilinear relation between the degree to which mother coordinated her noninterruptive co-occurring speech to that of her infant was found and revealed that mothers highest in sensitivity were characterized by moderate levels of coordination. Examining mother-infant interaction at the specific behavioral level, while incorporating tests of nonlinear trends, may provide important information about the nature of sensitive parenting.     

Age constraints on first versus second language acquisition: evidence for linguistic plasticity and epigenesis

Does age constrain the outcome of all language acquisition equally regardless of whether the language is a first or second one? To test this hypothesis, the English grammatical abilities of deaf and hearing adults who either did or did not have linguistic experience (spoken or signed) during early childhood were investigated with two tasks, timed grammatical judgement and untimed sentence to picture matching. Findings showed that adults who acquired a language in early life performed at near-native levels on a second language regardless of whether they were hearing or deaf or whether the early language was spoken or signed. By contrast, deaf adults who experienced little or no accessible language in early life performed poorly. These results indicate that the onset of language acquisition in early human development dramatically alters the capacity to learn language throughout life, independent of the sensory-motor form of the early experience.     

Predictors of Self-Reported Anxiety and Panic Symptoms: An Evaluation of Anxiety Sensitivity, Suffocation Fear, Heart-Focused Anxiety, and Breath-Holding Duration

The purpose of this study was to examine the extent to which anxiety-related individual difference variables predict anxious responding when individuals experience aversive bodily sensations. Thus, we explore several psychological and behavioral predictors of response to a single 25-sec inhalation of 20% carbon dioxide-enriched air in 70 nonclinical participants. Predictor variables included anxiety sensitivity, suffocation fear, heart-focused anxiety, and breath-holding duration. Multiple regression analyses indicated that only anxiety sensitivity significantly predicted postchallenge panic symptoms, whereas both anxiety sensitivity and suffocation fear predicted postchallenge anxiety. These data are in accord with current models of panic disorder that emphasize the role of fear of fear in producing heightened anxiety and panic symptoms and help clarify specific predictors of anxiety-related responding to biological challenge.     

Assessment of Disgust Sensitivity in Children With an Age-Downward Version of the Disgust Emotion Scale

The present study examined the psychometric properties of the Disgust Emotion Scale for Children (DES-C). Principal components analysis of the DES-C data revealed five factors reflecting disgust toward (a) rotting foods, (b) injection and blood, (c) odors, (d) mutilation and death, and (e) animals, which were largely in keeping with the intended subscales. The DES-C showed good reliability, excellent convergent validity (as established by correlations with an alternative self-report index of disgust), fairly good predictive validity (as assessed by correlations with measures of fear/anxiety and a behavioral index of disgust), and acceptable parent–child agreement (in particular with the mothers). Importantly, the DES-C proved to perform better on some psychometric indicators than an age-downward version of the Disgust Scale. These findings indicate that the DES-C should be regarded as the preferred scale for measuring disgust sensitivity and its role in the etiology and maintenance of anxiety problems in children.     

Maternal sensitivity during distressing tasks: a unique predictor of attachment security

The extent to which maternal sensitivity during a non-arousing free play task and during distressing tasks at 6 months predicted infant-mother attachment security was examined. When considered simultaneously, only maternal sensitivity during distressing tasks predicted subsequent attachment security. Infant temperament was unrelated to attachment security.     

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.     

Gender variance in interreligious sensitivity among Finnish pupils

This paper examines gender variance in the interreligious sensitivity among Finnish children and youth using a non-probability sample of 1000 Finnish lower secondary school pupils representing the age group 12–16. The data were gathered in three geographical locations: the capital city of Helsinki area, and two smaller municipalities in other parts of the country. The pupils’ self-reported attitudes towards interreligious sensitivity were measured using the Interreligious Sensitivity Scale. The results showed significant variation between the genders in the pupils’ interreligious sensitivity. Also geographical variance (city of residence) and pupils’ religious affiliation influenced their interreligious sensitivity.