A cascade of rejection and appearance preoccupation: Adolescents’ body dysmorphic symptoms and appearance rejection sensitivity over 4 years

Adolescence is a high-risk period for body image disturbance and appearance concerns. In a cascade model, we examined interrelations of body dysmorphic symptoms (BDS) with appearance rejection sensitivity (ARS) and tested gender moderation. Participants were 397 Australian adolescents (T1 Mage = 11.7, SD = 0.91; 56% girls) who completed six surveys over 4 years. In a random-intercept cross-lag model, two (of five possible) paths showed ARS predicted higher subsequent BDS, and three (of five possible) paths showed BDS predicted higher subsequent ARS. Girls reported more BDS and ARS than boys, and random intercepts of BDS and ARS were correlated with the correlation stronger in girls than boys. Cross-lag BDD-ARS associations over the six waves were not significantly moderated by gender. Overall, girls are at higher risk of appearance concerns than boys, but BDD-ARS cascade effects do not differ between girls and boys.     

Daily stress and anxiety and their relation to daily fluctuations of symptoms in asthma and chronic obstructive pulmonary disease (COPD) patients

Although stress and anxiety have long been assumed to play an exacerbatory role in asthma, no study has systematically documented that daily exacerbations of asthma symptoms are related to stress and/or anxiety. In this study, 24 airways obstruction patients (12 asthmatics and 12 chronic obstructive pulmonary disease patients) were instructed to monitor the severity of daily respiratory symptoms. In addition, subjects recorded their daily anxiety level and the number and perceived impact of daily stressors. The results showed that although there were differences between high- and low-stress days for both groups, there were no differences between groups on symptom severity or between high- and low-anxiety days, as measured by the State-Trait Anxiety Inventory (STAI). Thus, although the number and impact of daily stressors were found to be directly associated with the severity of asthma symptoms, anxiety does not appear to have a direct role in the exacerbation of asthma. The findings failed to support the anxiety theory of asthma but provided an explanation for the poor results obtained in previous treatment studies which employed anxiety management with asthmatics.     

The rhetorical foundation of philosophical argumentation

The rejection of rhetoric has been a constant theme in Western thought since Plato. The presupposition of such a debasement lies at the foundation of a certain view of Reason that I have called propositionalism, and which is analyzed in this article. The basic tenets of propositionalism are that truth is exclusive, i.e. it does not allow for any alternative, and that there is always only one proposition which must be true, the opposite one being false. Necessity and uniqueness are the ideals of propositionalism. But the question of the necessity of such a necessity is bound to arise. Foundationalism and propositionalism are intrinsically related. Since necessity excludes alternatives, rhetoric, which is based on the possibility of opposite standpoints, is unavoidably devalued as the crippled child of Reason, identical to sophistry or eristic. But propositionalism cannot justify itself and provide a justification for its own foundation without circle or contraditction. Since it responds to the problem of eradicating problems and alternatives through propositional entities, propositionalism is ultimately based on questioning to which it replies in the mode of denial. The unavowed foundation of Reason is therefore the question of questioning, even though this very question is suppressed as propositionalism. The trace of such a question is not only historical, but can also be seen, for instance, in the role played by the principle of contradiction in the constitution of propositional Reason (Artitotle): opposite propositions are not the expression of a problematic situation, they are either possible or successively unique propositions.We want to replace propositionalism by problematology which allows for the conceptualization of alternatives, thereby rendering a true rhetoric possible. Argumentation cannot then be equated with eristic any more, as propositionalism maintained.Rationality must be seen as having questioning as its true starting-point. Reason must be rhetorical if it is to survive the death of propositionalism which took place after the radical criticisms of Marx, Nietzsche and Freud. Even if it is still hard ffor philosophers and rhetoricians to think within another framework and even though they prefer endlessly to deconstauct the old one instead of changing it, problematology is bound to impose itself as the new voice for rationality, because Reason has always endeavored to solve problems. Propositionalism has been only one way of conceiving problems, based on the view that solutions could be but the suppression of questioning.     

Hypnotizability, imaginative involvement, and anxiety

Forty-five undergraduate students were investigated to determine the relationship between hypnotizability, imaginative involvement (absorption), and anxiety responses. Hypnotizability was measured independently with the Creative Imagination Scale (CIS), and imaginative involvement was measured with the Absorption Scale (ABS). The results indicated moderate significant correlations between CIS, ABS, and several of the anxiety measures. In particular self-reported physiological aspects of anxiety/activation were associated with the CIS and the ABS. Three of the subjects reported having panic attacks. These subjects also exhibited high hypnotic responsiveness, and their scores on the ABS and several of the anxiety scales were considerably elevated as compared with the group mean level.     

Chest pain without coronary artery disease: An exploratory comparison with panic disorder

Recent reports have indicated similarities between patients with persistent chest pain of nonorganic origin and patients with panic disorder. In order to explore this association further, we administered a structured interview and three self-report measures (State-Trait Inventory, Beck Depression Inventory, and SCL90-R) to three subject groups: (1) a sample with persistent chest pain (CP; n=14) who had been screened and found to have normal coronary arteries, (2) a sample of patients with panic disorder (PD; n=14), and (3) a sample of matched normals (n=14). CP patients were considered to be free of coronary artery disease (CAD) following normal cardiac catheterization and/or normal thallium stress tests and were not diagnosed initially with panic disorder. PD patients were diagnosed with a standardized psychiatric interview and were free of organic causes of panic. Using an exploratory data analytic approach, the results indicated that both CP and PD samples reported increased levels of state and trait anxiety (p <.0001), depression (p <.01), and somatization (p <.0001) compared with normals. CP patients differed from PD patients in their less frequent use of anxiolytic medication (p <.01) and lower levels of reported panic anxiety and phobic avoidance (p <.0001). These data suggest that persistent chest pain in the absence of CAD shares some features with panic disorder, yet differs from panic in key ways as well. The results are discussed in light of the role of anxiety in contributing to symptom labeling.This research was supported by Grant 86G-491 from the American Heart Association, Texas Affiliate, to J.G.B. H.T. is the recipient of USPHS Research Career Development Award K04-HL-0122246.     

Issues in diagnosing anxiety disorders

Research progress in the anxiety disorders is predicated on a useful classification system. In this paper, we review the reliability and validity data for theDiagnostic and Statistical Manual of Mental Disorders, 3rd ed. (DSM-III) anxiety disorders and discuss the salient issues associated with both the conceptualization of anxiety disorders and the diagnostic criteria offered in the DSM-III. It is concluded that the diagnostic reliability for these disorders is, overall, satisfactory. A dearth of validity data, however, hinders progress in both the diagnosis and the treatment of the anxiety disorders. Nevertheless, the DSM-III work group has proposed several changes in the diagnostic criteria for the anxiety disorders. We find some of these proposed changes helpful in that they clarify current diagnostic criteria; changes in diagnostic criteria that alter the basic classification schema, however, seem to be premature.Preparation of this paper was supported in part by MIMH Research Grant 1368.On sabbatical leave from Indiana State University.     

Psychopathology in anxiety disorders

Complaints of anxiety, often meetingDiagnostic and Statistical Manual of Mental Disorders, 3rd ed. (DSM-III), criteria for anxiety disorder, are among the most common problems presenting to health practitioners. In spite of the frequency of anxiety and anxiety disorders, little is known about the basic psychopathology of these conditions that would lead to the development of more efficient and effective treatments and possible preventive efforts. Recently, there has been an increase in research on the psychopathology of anxiety disorders from biological, psychological, and social perspectives. The National Institute of Mental Health's Clinical Research Branch sponsored a 2-day workshop of investigators representing diverse research approaches to discuss emerging issues and research practices within the anxiety disorders. Discussions centered on a review of the general areas of classification, phenomenology, and etiology. A selective summary of this workshop is presented along with recommendations for specific research directions.     

Conceptual,methodological, and clinical issues in the assessment of anxiety disorders

Many conceptual, methodological, and clinical issues remain unresolved in the assessment of anxiety disorders. Despite the prevalence, incidence, chronicity, and severity of anxiety disorders, research efforts and funding have fallen behind with regard both to other disorders and to addressing critical issues in the field. The primary objective of this paper is to provide a scientific critique regarding a number of often ignored yet salient considerations in anxiety-disorders assessment. Critical analyses of and recommendations regarding the multidimensional nature of anxiety, comorbidity, uniformity myths, synchrony, normative comparisons, psychometric properties of measures, and treatment integrity are offered. Finally, promising areas of clinical research are presented to enhance further the current understanding of the complexities inherent in assessing anxiety disorders.Preparation of this paper was supported in part by NIMH Grant MH36299.     

The importance of assessing treatment integrity: An example in the anxiety disorders

One purpose of this investigation was to examine the importance of assessing treatment integrity in a study evaluating a treatment for specific anxiety disorders. Three subjects, two social phobics and one simple phobic, received self-instruction training (Phase I) followed by exposure and self-instruction training (Phase II) in a multiple baseline across subjects design. All subjects were assessed during a pretreatment baseline and throughout treatment using measures of treatment integrity and measures of change in phobic severity. Improvement took place at different times for different subjects. Measures of treatment integrity, which consisted of monitoring of self-statements as well as practice outside the session, indicated that treatment was not always received as intended and that improvement was correlated with practice. The usefulness of measures of treatment integrity in both clinical and research settings is highlighted.     

Existence and the existential quantifier

This paper draws a distinction between the existential quantifier and the symbol ‘∃’ used to express it, on the one hand, and existence and ‘exists’, on the other. It argues that some popular arguments in metaphysics, including arguments against vague existence and arguments against deflationary metaontology (which views ontological disputes as lacking substance), are guilty of fudging this distinction. The paper draws some lessons for metaphysical debate about existence and highlights some heretofore ignored and attractive positions in logical space.