No attentional bias for pictoral stimuli in spider-fearful subjects

A number of experiments have shown that (spider) fearful subjects direct their attention to fear-relevant words, even when these words are irrelevant to the completion of a target task (e.g., color naming). The present study examined whether subjects with an intense fear of spiders also display such attentional bias for a fear-relevant pictoral stimulus. Female spider-fearful (n=13) and control subjects (n=13) saw neutral patterns (i.e., horizontal and vertical bars). One pattern served as target for a reaction time, while the other pattern served as nontarget. Targets and nontargets were accompanied by either fear-relevant or neutral pictoral material (i.e., a picture of a spider or a picture of a flower, respectively). The fear-relevant picture did not selectively delibate reaction time performance of spider-fearful subjects. Thus, no evidence was found for an attentional bias for fear-relevant pictoral material in subjects with an intense fear of spiders. Instead, fearful subjects exhibited a general inhibition of performance which became stronger over trials. This suggests that the fear-relevant picture induced a state of anxious arousal or defensive withdrawal that interfered with reaction time performance on both fear-relevant and neutral trials.     

Changes in Anxiety Control Beliefs Following a Brief CBT Treatment and Their Association With Anxiety Symptom Reduction

Anxiety control beliefs (i.e., beliefs regarding one’s ability to cope with external, fear-inducing threats and internal reactions to those perceived threats) have been found to negatively predict anxiety symptoms in children and adults and to be modifiable by cognitive-behavioral therapy for anxiety disorders. The current study examines whether changes in anxiety control beliefs were seen following a brief, intensive treatment for specific phobias, and whether those changes were associated with improvements in the targeted phobia and comorbid anxiety disorder symptoms. Participants were 135 children and adolescents (M age = 9.01 years, 49% male) who received one-session treatment (OST) with or without parental involvement for their primary specific phobia. Results indicated that self-reported anxiety control beliefs significantly increased following treatment and that these increases significantly predicted reductions in specific phobia severity and symptoms of comorbid anxiety disorders 6 months and 1 year following treatment. Findings illustrate that involvement in a single 3-hour OST was associated with changes in anxiety control beliefs and demonstrate the potential importance of targeting control beliefs in pediatric anxiety treatment.     

Psychiatric correlates of childhood shyness in a nationally representative sample

Relations between adult anxiety and mood disorders and retrospective reports of excessive childhood shyness were investigated in the US National Comorbidity, Survey (n=5877). Results indicated that 26% of women and 19% of men described themselves as 'very shy' when they were growing up. Of these shy individuals, 53% of women and 40% of men met criteria for a lifetime diagnosis of one or more anxiety or mood disorders. Relations between excessive shyness and each of the anxiety and mood disorders were examined after adjusting for elevated neuroticism, self-criticism, and low maternal care. The largest odds ratios were found for social phobia in both men and women, particularly for the complex subtype of this disorder. Significant associations also emerged for posttraumatic stress disorder in women and for major depressive disorder in men. Childhood shyness remained significantly associated with a lifetime history of social phobia when individuals with current (past year) social phobia were excluded from the analysis. The results of this study suggest that childhood shyness is strongly related to the complex subtype of social phobia in the general population. Excessive shyness does not appear to be strongly associated with other anxiety and mood disorders when related psychosocial and developmental dimensions are statistically controlled. Finally, many individuals who report excessive childhood shyness do not meet criteria for any anxiety or mood disorder. In a similar fashion, approximately 50% of individuals with a lifetime history of complex social phobia did not view themselves as very shy when growing up.     

Framing social information and generalized social phobia

Patients with generalized social phobia (GSP, N=33) and matched community controls (N=31) engaged in a social interaction that was constructed to go well, and then received feedback that framed social cues reflecting either the absence of negative outcomes or the presence of positive outcomes. Following feedback that framed positive social cues, the GSP group predicted they would experience more anxiety in a subsequent interaction than did non-phobic controls. In contrast, following feedback framing the absence of negative outcomes, the GSP group did not differ from controls in their anxiety predictions. The results demonstrated that framing paradigms and methods can be usefully applied to the study of cognitive processes in social phobia and indicated that research to examine how GSP patients process specific types of social information is needed.     

Internal versus external attention in social anxiety: an investigation using a novel paradigm

Several cognitive models propose that social anxiety is associated with increased self-focused attention. Indirect evidence for this hypothesis has been provided by questionnaire studies, and by cognitive psychology paradigms that have demonstrated reduced processing of external information during feared social-evaluative situations. However, no studies have simultaneously measured on-line attention to internal and external events. A probe detection task that aimed to measure the balance of attention between internal and external stimuli was developed. High and low socially anxious individuals were instructed to detect two probes. The external probe was superimposed on pictures of faces (happy, neutral, angry) or household objects that were presented on a VDU. The 'internal' probe was a pulse to the finger which participants were led to believe represented significant changes in their physiology. Compared to low speech anxious individuals, high speech anxious individuals showed an internal attentional bias, that was specific to conditions of social-evaluative threat.     

Active-imaginal exposure: examination of a new behavioral treatment for cynophobia (dog phobia)

The aims of this study were to investigate exposure-based treatments for cynophobia (dog phobia) and to test a newly developed hybrid imaginal exposure treatment that we have named active imaginal exposure. The treatment introduces an in vivo coping component to imaginal exposure whereby the patient physically performs coping responses to an imagined feared stimulus. Eighty-two participants meeting DSM-IV criteria for specific phobia (animal subtype) were randomly assigned to one of three 30-min. treatments: (a) active-imaginal exposure (AI), (b) imaginal exposure alone (IE), or (c) graduated in vivo exposure (IV). Participants completed a behavioral approach test at pre, post, and four-week follow-up. Significant pre- to posttreatment improvement was observed in all three treatment conditions. Response rates at posttreatment were 51.9, 62.1, and 73.1% for the IE, AI, and IV groups respectively. Likewise, effect sizes at posttreatment were 0.76, 1.41, and 1.55 for the IE, AI, and IV groups respectively. Although in the predicted direction, the between group differences were not significant. A similar pattern of results was observed at follow-up. Further, safety behavior utilization during treatment was associated with less improvement--particularly in the two imaginal treatment conditions. Exposure treatments of dog phobia appear feasible and effective in reducing phobic fear and avoidance associated with dog phobia. Furthermore, preliminary evidence suggests that our active-imaginal exposure treatment may be a viable alternative to in vivo exposure.     

Social Anxiety Disorder in Childhood and Adolescence: Current Status and Future Directions

This paper reviews the current status of research on the phenomenology, etiology, maintenance, assessment, and treatment of childhood and adolescent social anxiety disorder (SAD). Despite being one of the most prevalent disorders of childhood and adolescence, SAD paradoxically stands as one of the least recognized, researched, and treated pediatric disorders. The small treatment outcome literature provides preliminary support to the effectiveness of various forms of cognitive behavior therapy. The majority of studies to date, however, are limited by inadequate control conditions. Other findings include some support for the utility of parental involvement in treatment, significant advancements in outcome measures (e.g., normative comparisons, indices of naturalistic social functioning), and impressive durability of gains for the majority of treatments. Future directions are suggested, including experimental and naturalistic studies of developmental pathways and maintenance factors, the incorporation of positive psychology constructs (e.g., positive emotions, hope, self-control) in treatment and prevention, and the continued delineation of differences between child, adolescent, and adult manifestations of SAD.     

A case study of behavioral assessment and treatment of insect phobia

We assessed the academic performance of a 14-year-old boy with insect phobia in the context of feared stimuli. The dependent measure was math calculation rate across three conditions that varied therapist statements about the presence of crickets and the actual presence of live crickets. Subsequent treatment consisted of graduated exposure and contingent rewards for math problem completion. Assessment results indicated that the boy's performance was consistently low in the presence of live crickets but not when he was spuriously informed that crickets were present (the primary referral concern). Treatment results indicated no effect from exposure alone and a dramatic effect when exposure was combined with contingent rewards.     

The incidence of Freudian self‐analysis in the construction of the psychoanalytic theory of anxiety

The value and function of self‐analysis has been a contentious issue in several studies dedicated to the Freudian legacy. For some writers, Freud's experience of self‐analysis is rightly considered to be the master key to an understanding of the origins of the fundamentals of psychoanalysis. For others, the exaggerated importance attributed to the process merely led to the construction of a foundational myth. Nevertheless, if it is recognized to be a process in which Freud, in collaboration with Fliess, analysed personal aspects, working hypotheses and psychopathological debates, a reconsideration of self‐analysis may contribute new elements to our understanding of the paths that were taken in the elaboration of the theory and practice of pyschoanalysis. Starting from this premise, the present work will consider the systematic examination that Freud conducted of his own phobia in the course of his self‐analysis to be a process of great relevance to the elaboration of the early psychoanlytic conceptualizations of anxiety, in that in the course of this process the possible role of sexuality, fantasy, memory and unconscious determinism in the etiology of anxiety became part of the discussion.