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.     

Fear and pain: investigating the interaction between aversive states

Pain and fear often co-occur and appear to interact, although the nature and direction of their relation is not clearly delineated. The present study investigates how exposure to the experience of one of these states subsequently affects responding to the other. Pressure stimulation and carbon dioxide-enriched air (CO2) were used to induce pain and fear, respectively, in 48 healthy individuals. The order in which the stimuli were introduced was manipulated, as was the CO2 level. Measures of overt behavior, physiological responding, and self-report were obtained; analyses of stimuli effects generally supported their ability to produce pain or fear. Results indicate that the stimulus rated as the most aversive, the higher level of CO2, led to the highest levels of distressed responding across dependent measures. This pattern was replicated for the stimuli found to be less aversive (i.e., pressure stimulation and low-level CO2, respectively). The authors conclude that fear and pain, in and of themselves, do not dictate the nature of their interaction; the most important factor is how aversive they are perceived to be in relation to one another.     

Exaggerated grain growth and improved properties of Y1 Ba2 Cu3 O7-x by Pt addition

Abstract

Superconducting and mechanical properties of Y₁ Ba₂Cu₃ O₇ can be improved by the use of sintering aids. 0·2 wt% of finely divided laser-ablated platinum powder has been mixed with the parent material and produced a dense product with exaggerated grain growth and improved critical current density and Vickers hardness. At higher concentrations of platinum, while the mechanical properties are further improved, the increased density appeared to inhibit access of oxygen for the tetragonal to orthorhombic phase transition and the current density was reduced.     

GENERALITY AND SIDE EFFECTS OF OVERCORRECTION1

The effects and side effects of overcorrection for self-stimulatory behaviors of two children in a specialized day-care program were evaluated. For one child, a “hand” overcorrection procedure involving arm and hand exercises was introduced contingent upon inappropriate hand movements and later contingent upon inappropriate foot movements. After “hand” overcorrection was withdrawn for inappropriate foot movements, a “foot” overcorrection procedure involving foot and leg exercises was introduced contingent upon inappropriate foot movements. For a second child, the “hand” overcorrection procedure was introduced contingent upon inappropriate hand movements during a free-play period, and later contingent upon inappropriate vocalizations at naptime. “Hand” overcorrection was withdrawn and then re-introduced sequentially for both behaviors. Several concurrent behaviors were measured to assess multiple effects of treatment. Results for both children indicated the “hand” overcorrection procedure suppressed inappropriate hand movements and inappropriate behaviors that were topographically dissimilar. In addition, inverse relationships were observed between the second child's inappropriate hand movements and appropriate toy usage during free play and between his inappropriate vocalizations and inappropriate foot movements during naptime. Results suggest that overcorrection procedures that are effective for one behavior can be used to reduce the frequency of topographically different behaviors. This finding is discussed in terms of its practical implications for therapists.     

An on-line computer-based system for determining social costs and benefits

An on-line computerized program for determining social costs and social benefits for individuals in psychiatric treatment is described. The use of such a program yields a dollar value indicating how much a patient contributes to society. Mental health administrators and program evaluators can therefore be provided with information regarding the economic impact that their mental health programs have upon society. The program displays a series of multiple-choice questions on a CRT which reflect possible costs and benefits. Through the use of branching logic, unnecessary questioning is omitted. Each item is “costed” such that, upon completion of testing, a cost-benefit index is provided.     

Pain anxiety, acceptance, and outcomes among individuals with HIV and chronic pain: a preliminary investigation

The current study investigated the role of during treatment changes in pain anxiety in the relation between during treatment changes in pain acceptance and chronic pain outcomes. Participants included 45 (15 women) adults (M_age = 50.42, SD = 7.69) who were HIV positive and experienced chronic pain. They were offered 12 weekly, 90-min group CBT sessions to increase understanding about chronic pain and to improve coping skills. Four hierarchical regression analyses were conducted to examine the mediating role of treatment changes in pain anxiety in the relation between treatment changes in pain acceptance and chronic pain outcomes. Results suggest that increases in pain acceptance during treatment were associated with decreased levels of pain anxiety during treatment, as well as decreases in pain-related impairment at treatment completion. Furthermore, decreases in pain anxiety during treatment were associated with decreases in pain-related impairment at treatment completion. Finally, treatment changes in pain anxiety were found to partially mediate the association between treatment changes in pain acceptance and pain-related impairment at treatment completion. Results are discussed within the context of better understanding the processes of change within a CBT model for chronic pain patients.     

Targeting Acceptance,Mindfulness, and Values-Based Action in Chronic Pain: Findings of Two Preliminary Trials of an Outpatient Group-Based Intervention

Cognitive behavior therapy (CBT) for chronic pain is effective, although a number of issues in need of clarification remain, including the processes by which CBT works, the role of cognitive changes in the achievement of outcomes, and the formulation of a coherent theoretical model. Recent developments in psychology have attempted to address these issues by focusing specifically on processes of acceptance, present-focused awareness (e.g., mindfulness), and values-based action. The present study evaluated the effectiveness of Acceptance and Commitment Therapy (ACT), perhaps the most widely researched of these developing approaches. Initial evidence suggests that ACT-consistent treatments for chronic pain are effective, although there is a need to study treatment in more traditional pain-management settings, where treatment is generally time-limited, unidisciplinary, and outpatient. Data from two pilot studies are presented. Results support the feasibility of treatment and suggest that effectiveness rates compare favorably with more established forms of treatment, in this case, CBT. Although these data are preliminary, they set a foundation upon which more intensive evaluations can take place.     

Acceptance and Commitment Therapy for generalized anxiety disorder in older adults: a preliminary report

Some evidence suggests that acceptance-based approaches such as Acceptance and Commitment Therapy (ACT) may be well-suited to geriatric generalized anxiety disorder (GAD). The primary goal of this project was to determine whether ACT was feasible for this population. Seven older primary-care patients with GAD received 12 individual sessions of ACT; another 9 were treated with cognitive-behavioral therapy. No patients dropped out of ACT, and worry and depression improved. Findings suggest that ACT may warrant a large-scale investigation with anxious older adults.