Anxious attachment and psychological distress in cardiac rehabilitation patients

This study investigated the relevance of anxious attachment to the differentiation of psychologically distressed and non-psychologically distressed cardiac patients. Attachment is a biologically based behavioral system in which proximity to a special other is sought or maintained to achieve a sense of safety and security. Anxious attachment, as the name denotes, fails to achieve the function of attachment in the sense of individuals having little or no confidence in the availability of their attachment figures. Empirically, three scales (feared loss of the attachment figure, proximity seeking and separation protest) capture the features of anxious attachment as elaborated by Bowlby. These scales were administered to 178 cardiac rehabilitation patients drawn from the cardiac rehabilitation program of the Calgary General Hospital. The results indicate that feared loss and proximity seeking differentiated psychologically distressed from non-psychologically distressed patients. The implications of this finding for the understanding of psychologically distressed cardiac patients are discussed.     

Excessive Object Attachment in Hoarding Disorder: Examining the Role of Interpersonal Functioning

Excessive attachment towards possessions can be maladaptive because it can lead individuals to excessively acquire and save objects. Little is known about how attachment to objects develops and changes over time; however, interpersonal factors have been theorized to play a role. The current study examined whether interpersonal factors, specifically interpersonal attachment style and empathy, moderate changes in object attachment over time. A total of 145 participants with excessive acquiring and discarding difficulties rated their level of attachment to a novel object just after receiving it, and 1 week later. Participants also completed measures of interpersonal anxious attachment and interpersonal functioning. We found that changes in object attachment over time were moderated by interpersonal anxious attachment. Also, our findings suggested that individuals with hoarding problems are likely not impaired in their ability to empathize with others, but rather have difficulty displaying empathy in tense social situations and also have more empathy for fictional characters. Further, greater discomfort in tense social situations and greater empathy for fictional characters interacted to predict greater object attachment. Taken together, these findings indicate that individuals with an interpersonal anxious attachment style may be those at risk of forming greater attachments to objects over time. A learning history that includes inconsistent support from caregivers may result in individuals experiencing more empathy for fictional characters and discomfort in tense social situations, which may produce a vulnerability for becoming excessively attached to objects. Our results are in line with theories of hoarding which propose that individuals use objects to compensate for unmet interpersonal needs and suggest that treatment may need to target interpersonal functioning to reduce hoarding symptoms.     

Psychometric Properties of Two Implicit Associations Tests measuring Adult Attachment

Adult attachment style has consequences for mental health, interpersonal functioning and emotion regulation. This occurs partly deliberately, also referred to as explicit, and partly on an automatic level outside of conscious awareness, also referred to as implicit. Whereas explicit adult attachment can be assessed with self-report instruments, measurement of implicit adult attachment requires indirect methods. This paper describes the psychometric properties of two Implicit Association Tests measuring general adult attachment in a population sample. The study evaluated the reliability and the validity of the Avoidant Attachment IAT (ANX-IAT) and the Anxious Attachment IAT (AVOID-IAT). Validity was evaluated against self-report measures of adult attachment style (RQ), psychopathology (SQ-48), and well-being (MHC-SF). The split-half reliabilities of both IATs were good; the test-retest reliability of the ANX-IAT was adequate; however the AVOID-IAT had low test-retest reliability. Both IATs did not explain variance in psychopathology additional to explicit measures. The AVOID-IAT showed added value over explicit measurement of avoidant attachment in explaining variance in well-being, particularly regarding emotional and psychological well-being. The ANX-IAT did not explain variance in any measure of well-being additional to the explicit measure of anxious attachment. Our findings provide a basis from which more valid IATs measuring general adult attachment can be developed. Furthermore, they suggest that implicit avoidant attachment might be related to well-being, particularly emotional and psychological well-being. However, further research is needed to investigate the role of implicit general adult attachment in mental health and to optimize the two IATs in terms of validity before clinical use is recommended.     

An atypical anxious‐impulsive pattern of social anxiety disorder in an adult clinical population

An atypical subgroup of Social Anxiety Disorder (SAD) with impulsive rather than inhibited traits has recently been reported. The current study examined whether such an atypical subgroup could be identified in a clinical population of 84 adults with SAD. The temperament dimensions harm avoidance and novelty seeking of the Temperament and Character Inventory, and the Liebowitz Social Anxiety Scale were used in cluster analyses. The identified clusters were compared on depressive symptoms, the character dimension self‐directedness, and treatment outcome. Among the six identified clusters, 24% of the sample had atypical characteristics, demonstrating mainly generalized SAD in combination with coexisting traits of inhibition and impulsivity. As additional signs of severity, this group showed low self‐directedness and high levels of depressive symptoms. We also identified a typically inhibited subgroup comprising generalized SAD with high levels of harm avoidance and low levels of novelty seeking, with a similar clinical severity as the atypical subgroup. Thus, higher levels of harm avoidance and social anxiety in combination with higher or lower levels of novelty seeking and low self‐directedness seem to contribute to a more severe clinical picture. Post hoc examination of the treatment outcome in these subgroups showed that only 20 to 30% achieved clinically significant change.     

不安全依恋者注意偏向的形成机制及神经基础

不安全依恋者的注意偏向是指依恋焦虑和回避个体对依恋信息产生或趋近或回避的注意偏好, 这一注意偏好使得个体形成了处理与依恋对象关系的特殊认知机制：依恋回避个体偏好采用防御性机制, 倾向于回避对依恋信息的注意; 依恋焦虑个体偏好采用夸大性机制, 倾向于夸大威胁性信息, 因而会积极寻求与依恋对象的亲近。不安全依恋者注意偏向的差异主要体现在情绪信息、痛觉感受和工作记忆三个方面; 加工阶段特征主要涉及P1、N1波等代表的注意自动加工和LPP波代表的注意控制加工; 脑网络上主要包括两个子网络, 即负责情绪评估的边缘系统和负责情绪调节的以前额叶为代表的神经网络。未来研究中更应该关注刺激物的生态效度, 检验依恋系统是否激活, 不安全依恋者注意偏向的自动加工和控制加工阶段的关系, 不安全依恋者注意偏向产生的分子遗传机制以及注意偏向的跨文化研究。     

焦虑情绪状态下老年个体返回抑制成分的特征*

考察焦虑情绪状态对老年个体基于位置和基于颜色返回抑制的影响。被试为22名焦虑老年者和21名正常老年者,实验为E-prime软件编程、返回抑制为范式的行为实验。实验任务要求被试辨别靶刺激的颜色,记录被试反应时和错误率。结果：（1）焦虑组老年者和正常组老年者均出现了基于位置的返回抑制,且两组效应量差异不显著。（2）正常老年组出现了基于颜色的返回抑制,焦虑老年组并未出现该效应,且两组的效应量差异显著。因此,焦虑作为一种负性的情绪状态,影响了老年组被试基于颜色特征返回抑制的出现,导致被试对于相同颜色的抑制失败,而基于位置特征返回抑制的出现却没有影响。     

Adults who are more anxious and were anxiously attached as children report later first memories

Here, we examined retrospective reports of adults’ earliest autobiographical memory, the age of this report and whether the reported age was associated with exposure to early life adversity, current anxiety and childhood attachment. Across four studies, we found that reporting a later ‘earliest’ memory was associated with higher self-reported anxiety in both American (Studies 1, 2 and 4) and Australian (Study 3) samples. Furthermore, in Studies 2–4, we found that reporting a later earliest memory uniquely predicted anxiety when controlling for number of adverse childhood events (a risk factor for the development of anxiety). In Study 4, we established that this relation is partially mediated by childhood anxious attachment. Although we consistently demonstrated that later earliest memories were associated with current anxiety, we found little evidence for a relation between reported age at the time of earliest memory and childhood adversity. We also found no evidence of gender differences in the associations of interest. These results suggest that poorer memory of early childhood is associated with greater childhood anxious attachment and anxiety in adulthood. The implications of this work are discussed in terms of the adaptive nature of autobiographical memory and the development of a coherent life narrative.     

Mobility,Cognitions, and panic

Responses to the Mobility Inventory for Agoraphobia and the Cognitions Questionnaire were compared from samples of agoraphobics, social phobics, senior citizens, students, and students' relatives. The data illustrate the occurrence of avoidant behavior and panic in groups other than agoraphobics. The Mobility Inventory was shown to have good discriminative power, but the Cognitions Questionnaire failed to discriminate between agoraphobics and social phobics. The relationship of panic to mobility and cognitions is considered.     

Anxiety sensitivity as a specific and unique marker of anxious symptoms in youth psychiatric inpatients

We addressed several questions regarding the relation of anxiety sensitivity to anxious symptoms among 47 youth psychiatric inpatients (18 boys, 29 girls), ages 9–17 (M = 14.23, SD = 1.89). Participants completed measures of anxiety sensitivity, anxious and depressive symptoms, trait anxiety, and positive and negative affect; chart diagnoses were available. Consistent with hypotheses, we found that (a) anxiety sensitivity was associated with anxious symptoms, even controlling for trait anxiety and depressive symptoms; and (b) anxiety sensitivity displayed symptom specificity to anxious versus depressive symptoms (i.e., was associated with anxiety controlling for depression but not with depression controlling for anxiety). Furthermore, regarding factors of anxiety sensitivity, we obtained mixed support for our prediction that phrenophobia would be associated with both depression and anxiety, whereas fear of physical arousal would be associated with anxiety but not depression. Implications for the construct validity of anxiety sensitivity were discussed.     

Interpersonal predictors of stress generation: Is there a super factor?

Hammen's (1991, Journal of Abnormal Psychology, 100, 555–561) seminal paper on stress generation highlighted the reciprocal relationship between stress and depression. Not only does stress predict depression, but women with a diagnosis of depression also experienced subsequent increased levels of stress. In the ensuing years, depression researchers have moved beyond clinical predictors and examined whether depression vulnerability factors also contribute to stress generation. This interest has led to a growing focus on interpersonal vulnerability factors that contribute to stress generation. To date, the research examining interpersonal predictors of stress generation has tended to examine vulnerability factors singly and thus potential overlap and unique predictions among vulnerability factors have not been determined. This study examines interpersonal vulnerability factors from various schools of thought (dependency, attachment, and unmitigated communion) as predictors of interpersonal stress generation. Three hundred and sixty-four young adults completed baseline measures of interpersonal vulnerabilities and provided weekly reports of depressive symptoms and stressful life events. Multilevel models were estimated to examine their unique predictions of interpersonal stress generation. Despite converging theories, there does not appear to be a single super factor. Of the interpersonal vulnerability factors tested, anxious attachment emerged as a consistent predictor of interpersonal stress generation both when examined singly and when in combination with related variables.