Explaining the effects of a decision intervention on mammography intentions: The roles of worry,fear and perceived susceptibility to breast cancer

Objective: This study examines the effects of a mammography decision intervention on perceived susceptibility to breast cancer (PSBC) and emotion and investigates how these outcomes predict mammography intentions.

Design: Randomised between-subjects online experiment. Participants were stratified into two levels of risk. Within each stratum, conditions included a basic information condition and six decision intervention conditions that included personalised risk estimates and varied according to a 2 (amount of information: brief vs. extended) × 3 (format: expository vs. untailored exemplar vs. tailored exemplar) design. Participants included 2465 US women ages 35–49.

Main Outcome Measures: PSBC as a percentage, PSBC as a frequency, worry, fear and mammography intentions.

Results: The intervention resulted in significant reductions in PSBC as a percentage for women in both strata and significant increases in worry and fear for women in the upper risk stratum. Of the possible mediators examined, only PSBC as a percentage was a consistent mediator of the effect of the intervention on mammography intentions.

Conclusion: The results provide insight into the mechanism of action of the intervention by showing that PSBC mediated the effects of the intervention on mammography intentions.     

A Predictive Study of Stress Among Australian Dual-Career Couples

Abstract

Frank Lorimer and Frederick Osborne. Dynamics of Population: Social and biological significance of changing birth rates in the United States. New York: Macmillan, 1934. Pp. xiii+461. Reviewed by Gardner Murphy     

Are You Sure There Isn't a Monster in the Closet? Regulation of Children's Worrying in Uncertain Contexts

Intolerance of uncertainty and maladaptive information seeking are linked in many models of worry and clinical anxiety. This study aimed to examine children's use of information to regulate negative arousal associated with uncertainty in an exciting or threatening pretend play context. Children were presented with a positively or negatively valenced imaginary creature in a closed box. They were then given visual, verbal, or no reminder as to the pretend status of the entity. Children in the verbal and no information conditions were significantly more likely to spontaneously check as to the presence or absence of the creature during the game. These results confirm that some children react with more intense worry in situations of uncertainty, and that the type of information provided to children is important in assisting them to regulate that emotional response. The study provides analogue experimental support for the value in clinical contexts of direct experience in order to reduce uncertainty regarding imagined possibilities, and, in turn, worrying.     

Performing well in an evaluative situation: The roles of perceived competence and task-irrelevant interfering thoughts

Abstract

This research expands on previous research by arguing and demonstrating that high perceived competence buffers the detrimental effects of an evaluative situation. In Study 1 (n=75, 38.7% male), the situation (evaluative vs. non-evaluative) and perceived competence (high vs. low) were manipulated, whereas in Study 2 (n=42, 33.3% male), perceived competence relied on naturally occurring differences in perceived competence. The results of Study 1 indicate that people may underachieve in an evaluative situation. More importantly, in Study 2 it was demonstrated that such an evaluative situation had only a negative effect on test performance among individuals low in perceived competence. The occurrence of task-irrelevant interfering thoughts during task completion accounted for this inimical effect of an evaluative situation on test performance among these individuals.     

Dimensions of belief about miraculous healing

Although social scientists have convincingly demonstrated relationships between religious beliefs/practices and mental health, almost none of the empirical findings or related theory apply specifically to Jews. To address this limitation, we investigated the role of Jewish religiousness in anxiety, depression, and happiness, in a large Jewish community sample (n = 565). Several facets of global Jewish religiousness were examined, as well as a theoretically based Jewish religious variable, trust in God. A self-report measure of trust in God was created, and factor analyses yielded two reliable and valid subscales: trust in God and mistrust in God. Contrary to our hypotheses, global Jewish religiousness was on the whole unrelated to mental-health functioning. As expected, higher levels of trust in God were associated with less anxiety and depression, and greater personal happiness, whereas inverse associations emerged for the unanticipated but robust mistrust subscale.     

Effects of dispositional self-focus,appraisal and attention instructions on responses to a threatening stimulus

Abstract

Two studies are reported which explored the relationship between self-focused attention and anxiety. The first study tested the hypotheses that self-focused attention is associated with anxiety in threatening situations and that the relationship is mediated by negative appraisal processes. Study 1 showed no significant interaction between self-focus and negative appraisal on state-anxiety. However, self-focus was associated with increments in state-anxiety, high levels of worry and somatic symptom reports in a threatening situation. The relationship between self-focus and state-anxiety was mediated by somatic symptoms. Study 2 used cognitive and somatic self-attention instructions and external focus instructions to verify the hypothesis that self-focus on somatic arousal is associated with anxiety. It is concluded that specific self-focusing tendencies are associated with the elicitation and exacerbation of anxiety.     

Distress and Avoidance in Generalized Anxiety Disorder: Exploring the Relationships with Intolerance of Uncertainty and Worry

Theory and research suggest that treatments targeting experiential avoidance may enhance outcomes for patients with generalized anxiety disorder (GAD). The present study examined the role of experiential avoidance and distress about emotions in a treatment-seeking sample with a principal diagnosis of GAD compared with demographically matched nonanxious controls and sought to explore their shared relationship with two putative psychopathological processes in GAD: intolerance of uncertainty and worry. Patients with GAD reported significantly higher levels of experiential avoidance and distress about emotions compared with nonclinical controls while controlling for depressive symptoms, and measures of these constructs significantly predicted GAD status. Additionally, experiential avoidance and distress about anxious, positive, and angry emotions shared unique variance with intolerance of uncertainty when negative affect was partialed out, whereas only experiential avoidance and distress about anxious emotions shared unique variance with worry. Discussion focuses on implications for treatment as well as future directions for research.     

People's Perceptions of Women's and Men's Worry about Life Issues: Worrying about Love, Accomplishment, or Money?

The study was designed to examine people's perceptions of women's and men's worry about life issues and self-perceptions of worry. Some undergraduates (n = 498) rated typical women's or men's worry, and others (n = 396) rated significant others' worry based on the Worry Domain Questionnaire (Tallis, Eysenck, & Mathews, 1992). As expected, participants perceived women as worrying more than men do about relationships, when they rated typical or significant others. As well, they rated typical men as worrying more than typical women about achievement and finances. Participants who rated significant others' worry also rated their own worry and parallel findings were expected. However, women tended to report more worry about achievement than men did. Overall, the findings indicate that the better people know their targets, the less likely they are to perceive their worry in gender stereotypical terms. This article is partially based on Wendy-Jo Wood's Master's thesis.     

Individuals Intolerant of Uncertainty: The Maintenance of Worry and Distress Despite Reduced Uncertainty

The intolerance of uncertainty model of worry posits that individuals worry as a means to cope with the discomfort they feel when outcomes are uncertain, but few experimental studies have investigated the causal relationships between intolerance of uncertainty, situational uncertainty, and state worry. Furthermore, existing studies have failed to control for the likelihood of future negative events occurring, introducing an important rival hypothesis to explain past findings. In the present study, we examined how individuals with high and low trait intolerance of uncertainty differ in their behavioral, cognitive, and emotional reactions to situational uncertainty about an upcoming negative event (watching emotionally upsetting film clips), holding constant the likelihood of that negative event taking place. We found that although individuals high in trait prospective intolerance of uncertainty reported a higher degree of belief that being provided with detailed information about the upcoming stressor would make them feel more at ease, they did not experience an actual decrease in distress or state worry upon being provided with more information, during anticipation of the film clips, or during the film clips themselves. Our results suggest that heightened distress regarding negative events may be more central than intolerance of uncertainty to the maintenance of worry.     

Effects of Rumination and Worry on Sleep

Recent research suggests that the stress-sleep relationship is mediated by pre-sleep arousal (PSA) and that cognitive arousal has a stronger mediating effect than somatic arousal; however, this has not been directly tested. Using multilevel moderated mediation, we compared the effects of cognitive arousal and somatic arousal within the stress-sleep relationship. We also assessed whether two forms of repetitive negative thought—rumination and worry—are similarly involved in the stress-sleep relationship. Data was collected from 178 participants across the United States via an online platform. Participants completed baseline self-report surveys examining rumination tendencies and worry tendencies. Over the course of 2 weeks, participants completed daily questionnaires assessing daily stress, PSA, and sleep quality. Results indicated that indirect effects from stress to sleep quality via PSA were statistically significant at low and high levels of rumination and worry, and people at high levels of rumination and worry had stronger relationships between stress and PSA. Across all models, cognitive arousal consistently accounted for more of the variance in the stress-sleep relationship as compared to somatic arousal. Implications for the cognitive behavioral treatment of insomnia are discussed.